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Where theater and psychology intersect. Interviews & insight from Broadway's psychologist. #theaterandtherapy

You Oughta Know – 7 Truths About Addiction in Jagged Little Pill

You Oughta Know – 7 Truths About Addiction in Jagged Little Pill

Sean Allan Krill as Steve Healy and Elizabeth Stanley as Mary Jane Healy In Jagged Little Pill at the American Repertory Theater (Photo: Evgenia Eliseeva)

Jagged Little Pill, which premiered last year at the American Repertory Theater and opens on Broadway December 5, 2019, is a musical about life’s messy truths. For Mary Jane, the housewife head of the Healy family, that truth includes the fact that she is addicted to her pain medication. Mary Jane is like millions of Americans living with and dying (approximately 130 individuals each day) from an opioid addiction. These numbers have reached epidemic proportions in recent years, due partly to the pendulum swing during the 1990’s in the medical establishment to more aggressively treat chronic pain, increasing numbers of opioids (such as Vicodin and Percocet) prescribed to patients. This is a particular problem in the U.S. which consumes about 80% of the global opioid supply although we contain less than 5% of the world population.

The show, based on the music of Alanis Morissette, deftly tackles prescient topics in the context of an intimate family drama. The creative team (including a book by Diablo Cody and direction by Diane Paulus) have clearly done their research, presenting an honest and accurate portrayal of one family’s experience with this disease.

Here are 7 ways that Jagged Little Pill provides an absolutely accurate depiction of addiction:

  1. Addicts Do Look Like Your Next Door Neighbor – Jagged Little Pill is set in suburban Connecticut, complete with yoga pants, liberalism and competitive social media. Mary Jane Healy (deftly played by Elizabeth Stanley) is the stay-at-home mother and wife to her lawyer husband, Steve. Between writing cloying annual Christmas newsletters and sweating it out in spin class, she has become addicted to her opioid pain medication. Mary Jane jokes that she expected people in recovery to look like “junkies”. Addicts are your neighbor, your brother, your grandmother, your doctor. They look like you and they look like Mary Jane.

    Sean Allan Krill and Elizabeth Stanley (Photo: Evgenia Eliseeva)
  2. Opioid Addiction Often Begins With A Legal Prescription – Mary Jane was originally prescribed opioid pain medication to manage back pain sustained from a car accident. She claims to be doing just fine, gripping her omnipresent prescription bottle, even though she is anything but. Once her doctors and pharmacist become wise to her problem, they start cutting her off from her source. She is already addicted, from a legally prescribed medication.

  3. Fentanyl Is Extremely Dangerous – As many opioid addicts often do, Mary Jane eventually starts getting her supply from the street. tries Fentanyl, which is a synthetic opioid (as opposed to heroin, which is manufactured directly from the opium plant) is up to 100 times more potent than morphine. Because it is inexpensive to manufacture, it is often laced into bags of the more expensive opioids, leading unsuspecting addicts to take a significantly higher dose than expected, which can cause respiratory depression and death. Fentanyl recently became the most common drug to cause a deadly overdose.

    (Photo: Evgenia Eliseeva)
  4. Trauma History Is A Significant Risk Factor For Addiction – Without giving away any spoilers, there is reference to a past trauma in Mary Jane’s life, which she initially discloses flippantly as a way to try to minimize its impact. Like many addicts, a traumatic experience or chronic exposure to trauma is a significant risk factor for addiction, as are family history of addiction and emotional or behavioral dysregulation (e.g. Bipolar Mood Disorder).

  5. Addicts Need Help To Stop – Mary Jane tries to wean herself off of her pills. She makes a plan, she tries to commit to that plan, she even goes to church to ask God for help in stopping. It doesn’t work, it rarely does. Like most people, Mary Jane only obtains early recovery when she receives medical and psychological intervention.

    (Photo: Evgenia Eliseeva)
  6. Recovery Is Lifelong – When recovery from addiction is discussed in the show, the dialogue acknowledges that it is an active process that lasts a lifetime. Recovery does not stop after detox, it is just beginning. It is also common for an addict in recovery to experience a relapse, with a rate between 40%-60%. This number is similar to relapse rate for other chronic illnesses, such as asthma and Type I diabetes.

  7. Addiction IS Uninvited – In a stunning piece of choreography by Sidi Larbi Cherkaoui to the song “Uninvited”, Mary Jane seems to be grappling directly with her addiction as embodied in the number by dancer Heather Lang. The words, previously heard in the context of Alanis to a potential lover, take on a new meaning as she sings: “But you, you’re not allowed/You’re uninvited/An unfortunate slight”. It is easy to be angry at addicts. They should know better, they should be smarter than this, they should just stop, etc. The anger is warranted, for addiction comes with an unrelenting path of destruction. But no one, NO ONE, who becomes an addict every wishes for it. As little children, it is not what they dreamed to become. It is always uninvited.

    (Photo: Evgenia Eliseeva)

If you or a loved one are one of the millions of Americans who are struggling with an addiction, please check out the following resources:

To find treatment for a substance abuse disorder, visit the Substance Abuse and Mental Health Services Administration at https://www.samhsa.gov/find-help/national-helpline

For information about 12-step recovery and to find local meetings, visit the Alcoholics Anonymous website at https://www.aa.org/

For the latest on research and policies, visit the National Institute on Drug Abuse at https://www.drugabuse.gov/

Best,

Dr. Drama