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Substance Abuse in Fear and Loathing in Las Vegas Essay

Fear and Loathing in Las Vegas is a movie adaptation of an eponymous novel written by Hunter S. Thompson. The movie tells a story of a journalist, Raoul Duke, and his attorney, Dr. Gonzo, who under the influence of psychoactive substances explore a dark underbelly of Las Vegas (Gilliam, 1998). The initially assigned purpose of their journey was to report on a motorcycle race; however, after consuming substantial doses of stimulants, sedative-hypnotics, hallucinogens, and other types of drugs, the protagonists decide to cover a district attorneys’ convention while wandering mindlessly around bars and hotels of the city.

The aim of this paper is to analyze the movie from an addiction counselor’s perspective. The paper will discuss substance use, its effects, and treatment options.


The movie opens with Duke and Dr. Gonzo riding a car across the Nevada desert after taking orally a large dose of a hallucinogen—mescaline (Gilliam, 1998). Both protagonists appear distant and have hypersensitivity to light; therefore, they are wearing dark glasses. The journalist experiences both auditory and visual hallucinations that take the form of giant bats that swarm over the car in a random manner. Even though mescaline is less potent than tryptamines such as LSD, it is an extremely powerful drug effect of which may last for 12 to 15 hours (Hermle, Simon, Ruchsow, & Geppert, 2012). Later in the movie, under the influence of the drug, the protagonists experience other visual hallucinations that are manifest as altering shapes. Many hallucinations have upsetting qualities during the highest point of the hallucinatory phase: Duke sees moving walls and colorful interplays of carpet patterns that make him anxious. The protagonists constantly increase the dose of the hallucinogen, which leads to “a quantitative increase in the effects of the experience” (Preedy, 2016, p. 117).

At the certain point, the characters’ response to mescaline becomes qualitatively different: they appear to lose connection to the real world and hardly differentiate their surroundings (Preedy, 2016). At the peak of hallucinatory experience, Duke feels extremely anxious and feels that he is in the middle of a “reptile zoo” (Gilliam, 1998). Upsetting qualities of his visual and auditory hallucinations completely change with the change of setting: negative reactions slowly subside. With lowering of the intensity of distress caused by abnormal perceptions, the protagonists feel the urge to administer other drugs, which they have in abundance. At the beginning of the movie, Duke states that they have “two bags of grass, 75 pellets of mescaline, five sheets of high-powered blotter acid, a saltshaker half-full of cocaine, a whole galaxy of multi-colored uppers, downers, screamers, laughers… Also, a quart of tequila, a quart of rum, a case of beer, a pint of raw ether, and two dozen amyls” (Gilliam, 1998). It has to be mentioned that mescaline is associated with a side effect—vomiting. Duke and Dr. Gonzo experience this response several times throughout the movie. However, it is not a single negative response that the characters experience from the intake of the drug. In the pursuit of new ‘highs’ Duke and Dr. Gonzo combine mescaline with other drugs that include but are not limited to cocaine, amphetamines, marijuana, and alcohol. In addition to producing adverse physiological effects such as a hypertensive crisis, the combination of hallucinogens and amphetamines results in “an exacerbation of the hallucinogenic response” (Preedy, 2016, p. 118).

Consequences of Drug Use

The use of psychoactive drugs may result in adverse psychological effects that cannot be overcome by a user who is under the influence of a substance (Preedy, 2016). Intoxication with mescaline or amphetamines often leads to irrational behavior. Even though the use of hallucinogens is not associated with neural damage, if it is protracted it may result in addiction. Users that develop tolerance to mescaline may even overdose and die. Furthermore, one of the most common adverse attributes of the drug is posthallucinogen perceptual disorder. Also, frequent users of mescaline can experience flashbacks caused by the release of fat-soluble psychoactive components of the drug from adipose tissues (Preedy, 2016). Users of amphetamines, which are neurotoxic drugs, may suffer from “a persistent reduction of serotonergic nerve terminals” (Preedy, 2016, p. 118). Alterations in serotonin systems may be long-lasting, and they depend on the quantities of consumed drugs. Persistent use of amphetamines is associated with antisocial tendencies and personality disorders.


The pattern of drug use displayed in Fear and Loathing in Las Vegas suggests that Duke and Dr. Gonzo suffer from chronic substance abuse. The characters often engage in reckless disregard for their safety, show lack of remorse, and fail to fulfill their occupational obligations and conform to social norms (Brooks & McHenry, 2015). The unique focus of treatment should be on the patients rather than on the drugs that they abuse. A counselor’s goal in the treatment is to help the clients to reassess their relationships with substances. It is especially important, due to the fact that neither Duke nor Dr. Gonzo has tried or even considered abstinence; therefore, the counselor has to motivate the men to engage in drug treatment. Given the severity of substance abuse, “medical intervention and inpatient detoxication” (Brooks & McHenry, 2015, p. 138) are needed to support them in the process of withdrawal. It seems that the clients lack coping skills, which means that they have to be encouraged to discuss their fears associated with the treatment. The counselor has to realize that the clients that show symptoms of mescaline, amphetamine, and cocaine dependency can resist the idea of being referred to a drug treatment facility.

Motivational interviewing can become a potent instrument for dealing with the clients’ ambivalence about the addiction treatment. Given that the counselor lacks therapeutic leverage such as a potential incarceration for noncompliance with treatment recommendations, they would have to create the groundwork for the future treatment (Brooks & McHenry, 2015). Preparation of clients will reduce the chances of Duke and Dr. Gonzo missing their referral appointments. Taking into consideration the fact that the clients have not shown the willingness to discontinue their use of substances, they will not be encouraged to engage in complete abstinence during the initial treatment. Instead, the counselor will help them to develop personal recover plans. They will also assist the clients in learning about negative consequences of their addiction, thereby preparing them for future growth. When Duke and Dr. Gonzo are ready for treatment, the counselor will help them to locate the best addiction treatment program and schedule an initial screening appointment. There are several levels of care and dimensions of severity, on the continuum of treatment; therefore, the counselor has to consider multiple factors in order to determine the optimal level and dimension for the point of progression of clients’ addiction (Brooks & McHenry, 2015).


The paper provided an analysis of Fear and Loathing in Las Vegas from an addiction counselor’s perspective. It discussed substance use, its effects, and treatment options for the movie protagonists—Duke and Dr. Gonzo.


Brooks, F., & McHenry, B. (2015). A contemporary approach to substance use disorders and addiction counselling (2nd ed.). New York, NY: American Counselling Association.

Gilliam, T. (Director). (1998). [Video file]. Web.

Hermle, L., Simon, M., Ruchsow, M., & Geppert, M. (2012). Hallucinogen-persisting perception disorder. Therapeutic Advances in Psychopharmacology, 2(5), 199-205.

Preedy, V. (2016). Neuropathology of drug addictions and substance misuse: Stimulants, Club and dissociative drugs, hallucinogens, steroids, inhalants and international aspects (Vol. 2). New York, NY: Academic Press.

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