BY TARA LAW
UPDATED: FEBRUARY 28, 2022 3:58 PM EST | ORIGINALLY PUBLISHED: FEBRUARY 28, 2022 2:26 PM EST
Euphoria—the most tweeted-about TV show of the decade in the U.S.— thrust teenage drug use into the cultural spotlight. The HBO show follows 17-year-old Rue Bennett, a sweet but troubled teen played by Zendaya, as she navigates a deepening drug use disorder.
於美國十年來，最多在推特上發佈的《欣快症》電視節目，已經將青少年吸毒推向了文化聚光燈下。美國有線電視系統的優質電影頻道HBO節目，對17歲的Rue Bennett發生興趣。她是一名由美國女演員Zendaya所飾演，甜美卻陷入困境的青少年(13到19歲)。因為，她處於日益嚴重的吸毒障礙中。
It’s not pretty. Rue takes the powerful opioid fentanyl, injects morphine, and drags around a suitcase filled with thousands of dollars worth of drugs (a stash she can’t resist dipping into). Meanwhile, she rips apart her life: tearing through her house, ransacking strangers’ homes, and screaming at the people she loves the most.
這不是好事。Rue服用強效的鴉片類藥物芬太尼、注射嗎啡及到處拖著一個，裝滿價值數千美元藥物的手提箱(一個她無法抗拒伸手進入的的存放物)。在此同時，她摧毀了自己的生活：毀掉她的房子，洗劫陌生人的家，並對她最愛的人大吼大叫。
Yet the show’s season two finale, which aired on Feb. 27, ends on a hopeful note for Rue’s recovery. Here’s what addiction experts who watch the show say that Euphoria gets right about teen drug use and treatment—and where it misses the mark.
然而，該節目的第二季結局，於2022年2月27日播出，以對Rue之康復充滿希望的暗示結束。這裡是觀看該節目之成癮專家們所表示的，《欣快症》節目，在青少年吸毒及治療方面是正確的。不過，它未把握住探討的問題核心。
The show has sparked controversy over how it portrays teen drug use. In January, D.A.R.E.—the Drug Abuse Resistance Education program—criticized the show for “glorify[ing]” high school drug use and making it seem “common and widespread in today’s world.”
該節目引發了，有關它如何描繪青少年吸毒的爭議。在2022年1月，美國抗藥物濫用教育計劃(D.A.R.E.)批評，該節目“美化了”高中吸毒，並使其看起來“在當今世界中是普遍且廣泛的”。
But drug use is not uncommon among high school students today. In the U.S., about 1.6 million kids ages 12 to 17—6.3% of the adolescent population—had substance use disorder in 2020, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
不過，在高中生中，當今吸毒並不罕見。根據美國物質濫用暨心理健康服務管理局(SAMHSA)的數據，在美國，2020年約有160萬12至17 歲的兒童(占青少年人口6.3%)具有物質使用障礙。
“That’s a huge problem,” says Dr. Lynn Fiellin, professor of medicine at the Yale School of Medicine and Child Study Center, who is trained in addiction medicine and behavioral health (and who is a fan of the show). The problem seems to be growing, too; in 2020, millions more kids tried drugs for the first time. “Euphoria depicts exactly what is going on,” she says.
美國耶魯大學醫學院及兒童研究中心的內科學教授，接受過成癮醫學及行為健康方面培訓(且是該節目粉絲)的Lynn Fiellin博士宣稱：「那是個極大問題。此問題似乎也正擴大中。於2020年，數百多萬兒童首次嘗試毒品。她宣稱：「《欣快症》節目確切描述了，正在發生的事。」
Rue takes many different types of drugs throughout the show—from marijuana to Xanax—but she most commonly uses opioids. This is a major concern, because opioid use is often deadly in young people: in 2020, nearly 6,000 youth ages 15 to 24 died of an overdose involving opioids in the U.S, amounting to 84% of all drug overdose deaths in that age group, according to National Center for Health Statistics data.
在整個該節目中，Rue服用了多種不同類型藥物(從大麻到贊安諾)。不過，她最常服用類鴉片藥物。根據美國國家衛生統計數據中心的數據，這是一個重大問題。因為，在年輕人中，服用類鴉片藥物，往往是致命的：於2020年，在美國近6千名15至24歲的年輕人，死於類鴉片類藥物過量。在那年齡群中，相當於所有藥物過量死亡的84%。
The show excels at portraying the “chaos” that can happen when a young person’s substance abuse gets out of control, as Rue’s does, says Fiellin. In the first episode, Rue’s little sister discovers her overdosing in a puddle of her own vomit; the two seasons follow Rue as her drug use continues to wreck her closest relationships.
Fiellin表示，該節目擅長描繪，年輕人物質濫用失控時，如同Rue會發生的“混亂狀態”。於第一集中，Rue的小妹妹，在一灘嘔吐物中，發現其用藥過量。這兩季密切關注Rue，因為她的吸毒持續破壞其最親密的關係。
Something the program does less well is showing the range of options people have to help them recover from substance use disorder. While psychiatrists and experts agree that Rue—or someone like her—faces a difficult recovery, she hasn’t explored all of her options, or even the best ones.
該節目做得不太好的事，是表露出，人們必須協助他們從物質使用障礙中，恢復的選擇範圍。儘管，精神病學家及專家們一致認為，Rue或像她一樣的人，面臨著艱難的康復。不過，她一直沒有探索其所有的選擇。也就是，甚至是最好的選擇。
On Euphoria, Rue has participated in two main treatments: inpatient rehab in season one and Narcotics Anonymous (NA)—which, like Alcoholics Anonymous, is a 12-step-model emphasizing spirituality and abstinence from substances.
在《欣快症》節目上，Rue已經參與兩種主要的治療方法：在第一季中的住院病患康復，及是一種強調精神性及對物質禁慾之12個步驟的模式，類似匿名戒酒的匿名戒毒(NA)。
While these programs can help some people, they’re not for everyone, and come with certain drawbacks, psychiatrists say. Rehab programs can vary in quality and be very expensive, while NA can sometimes alienate people who are less religious—like Rue, who declares she doesn’t believe in God.
精神病學家們表示，儘管此些計劃能有助於某些人。不過，並不適合所有人，且隨同某些缺點而來。在品質上，諸多康復計劃會呈現差異，且非常高代價。另一方面，匿名戒毒有時會疏離，像聲明不相信上帝之Rue，較不篤信宗教的人。
However, NA does enable Rue to develop a powerful connection with her sponsor, Ali Muhammad, who pushes her to change the way she looks at the world. Fiellin says that relationships like this with “folks who are supporting you and listening,” can be essential for recovery. That proved to be true for Rue.
不過，匿名戒毒確實使Rue與其，促使她改變看待世界之方式的贊助人，Ali Muhammad發展出一種強有力的溝通。Fiellin表示，就康復而言，像這種與“支持並傾聽你之人們”的關係，會是不可或缺的。對Rue來說，那證明是真實的。
Dr. Sulman Aziz Mirza, a psychiatrist who specializes in adult, child and adolescent, and addiction psychiatry (and who watches the show), says he wishes Rue’s storyline would show her trying different options that could help her recover.
(也觀看此節目)專攻成人、兒童及青少年與成癮精神病學的精神病學家，Sulman Aziz Mirza博士表示，他希望Rue的故事情節能顯示出，她嘗試可能有助於其康復的不同選擇。
“There’s just an inevitable [sense] that we’re going to see Rue die” in future seasons, he says. “I’m hoping that at least there’s some acknowledgement that, ‘Hey, there are options there.’”
他宣稱：「只是，有一種不可避免的 [感覺] ，我們將看到Rue死亡。」在未來幾季中，「我期盼，至少有些認知，『嘿，在那事情上有諸多選擇。」
So far, the show has not depicted one of the most successful treatments for opioid-use disorder: medications like buprenorphine.
迄今為止，該節目不曾描述，服用類鴉片藥物之障礙，最成功的治療法之一：諸如，丁丙諾啡等藥物。
According to Robert Miranda, professor of psychiatry and human behavior at Brown University (who knows about the show’s emphasis on drug use but does not watch it), buprenorphine reduces cravings and withdrawal symptoms by activating the same parts of the brain as opioids, but doesn’t trigger the same “high” or side effects.
根據(知道該節目對吸毒的重視，不過沒有觀看之)美國布朗大學精神病學及人類行為學教授，Robert Miranda的說法，丁丙諾啡透過激活，與類鴉片藥物相同大腦部位，卻不會引發相同“恍惚狀態”(也就是副作用)，來減少渴望及戒毒過程中產生的症狀。
“I think that’s a missed opportunity to highlight a treatment like buprenorphine,” says Fiellin. Buprenorphine and other similar medications, including naltrexone and methadone, have been found to reduce opioid use, decrease the risk of overdose, and increase the odds that a patient will stay in treatment, according to the National Institute on Drug Abuse.
Fiellin宣稱：「我認為，那是一種錯失了，強調像丁丙諾啡之治療法的機會。」根據美國國家藥物濫用研究所的說法，丁丙諾啡及其他類似藥物，包括納曲酮及美沙酮，已經被發現能減少類鴉片藥物的使用、降低藥物過量的風險及增加患者會持續治療的機率。
Taking medication for opioid use disorder “can offer an advantage, an often-needed edge,” says Miranda. “It can offer reprieve from the intense cravings and adverse drug withdrawal symptoms that people face—including many teens—while struggling to reduce their drug use.”
為服用類鴉片藥物之障礙，進行藥物治療。Miranda宣稱：「能提供一種，經常需要之優越條件的優勢。這能提供，當人們(包括許多青少年)因努力減少吸毒時，面臨強烈渴望及有害藥物戒毒過程中，產生之症狀的暫時緩解。」
Therapy is another option that can be especially effective when paired with medication, Fiellin says. Cognitive behavioral therapy, family therapy, and an approach called motivational interviewing have all been shown to help people with opioid use disorder.
Fiellin表示，當治療與藥物配合時，會是特別有效的另一種選擇。認知行為療法、家庭療法及一種，被稱為激勵性訪談的方法，已經被證實，皆有助於具有服用類鴉片藥物障礙的人。
Motivational interviewing, a counseling approach in which a counselor talks with a patient about the reasons why they need to change and their reasons for doing so, is designed to help people who are ambivalent about seeking treatment.
激勵性訪談是一種，諮詢師與患者討論，他們需要改變的原因及他們這樣做之原因的諮詢方法，旨在協助那些對尋求治療，懷有矛盾心理的人。
This strategy might make sense for someone like Rue, who walks out of rehab in the series premiere and declares, “I had no intention of staying clean.”
就類似Rue (於系列首映中，走出康復並聲明：「我沒有徹低保持的打算。」)的人而言，這種策略或許有意義。
Changing behavior can be an especially “hard sell” for a teenager like Rue, says Dr. Kevin Gray, a professor of psychiatry and behavioral sciences at the Medical University of South Carolina, so motivational interviewing programs can help by “driving them toward motivation, rather than waiting for them to be motivated.”
美國南卡羅萊納醫學大學精神病學及行為科學教授，Kevin Gray博士表示，對於像Rue的青少年來說，改變行為或許是一件，特別“難被接受”的事。因此，激勵性訪談計劃能藉由“推動他們朝向激發積極性，而不是等待他們被激勵”。
Just as different causes lead people to drug use, different motivations can help individuals recover. Mirza says the key is to find the treatments—and health care providers—that work for each person.
正如不同的原因導致人們吸毒一樣，不同的激發積極性能有助於個人康復。Mirza表示，關鍵是找到對每個人發生作用的治療法(及醫療保健提供者)。
“I could be Harvard trained, and I could have degrees and publications and books and everything like that, but if I can’t connect with the kid that’s in front of me, it doesn’t mean anything,” says Mirza.
Mirza宣稱：「我能接受哈佛訓練，及擁有學位、出版物、書籍與類似那的一切。不過，倘若無法與在我面前的孩子溝通，則沒有任何意義。」
At the end of the season two finale, Rue says in a narration that she stayed clean for the rest of the school year. But psychiatrists who watch Euphoria agree that Rue’s longer path to recovery will not be easy—nor would it be if she were a teen in the real world.
在第二季最後一幕結束時，在一段陳述中，Rue表示，她在整個學年的剩餘時間裡，皆徹底保持。不過，觀看《欣快症》的精神病學家們一致認為，Rue更長期的康復之路不會是輕易的。即使在現實世界中，她仍是一名青少年，也不會是輕易的。
People like Rue face many obstacles that make it difficult for their condition to improve, or even for them to survive. For many people, drug use disorder is a chronic condition with which they must continue to cope throughout their lives.
像Rue的人面臨諸多，使其病情難以改善，或甚至難以存活下來的障礙。對許多人來說，吸毒障礙是一種，他們必須終生持續克服的慢性病。
“There are some young people who get into really serious trouble with substance use who are able to recover quickly and maintain lifelong sobriety,” says Gray, but others struggle with lifelong addiction. “Just like if somebody had hypertension or diabetes, we don’t expect them to enter a treatment, and then stop the treatment and forever be cured.”
Gray宣稱：「有些在物質使用方面遇到非常嚴重麻煩的年輕人，能迅速康復並保持終生節制。」不過，其他人與終身成癮搏鬥。「就像，倘若有人罹患高血壓或糖尿病，則我們並不期待，他們接受治療，然後停止治療，而永遠被治癒。」
One of Rue’s triggers for substance use issues is her struggle with anxiety, panic attacks, and other mental health issues, Fiellin points out. Mental illness and drug use can create a “vicious cycle,” she says: mental illness can push people to use drugs, which in turn can make the condition worse.
Fiellin指出，引發Rue物質使用問題的諸多原因之一，是她與焦慮、驚恐發作及其他心理健康問題搏鬥。精神疾病及吸毒會產生一種“惡性循環”，她表示：精神疾病會促使人們使用藥物，依序這會使病情惡化。
That means it’s especially important to find ways to treat both issues. “Mental health and addiction are so tightly linked, and there’s so much overlap, that you really cannot address one in a vacuum.”
這意味著，找到解決這兩問題的方法，特別重要。“心理健康與成癮如此緊密相關聯，且有如此多的重疊，以至於人們真的無法完全脫離，而實際地解決一個問題。”
The show also hasn’t explored another major risk for Rue and drug users of all ages in the U.S.: the danger of a drug supply that is contaminated by the highly potent opioid fentanyl, which has been linked to a surge in opioid overdose deaths in the U.S.
該節目也沒有探討，於美國所有年齡層中，Rue及吸毒者的另一項主要風險：藥物供應遭強力之類鴉片藥物，芬太尼污染的危險性，這已經與美國類鴉片藥物過量死亡的激增，被聯繫在一起。
While Rue is shown taking fentanyl intentionally, she is likely to also encounter it mixed in with another drug without her knowledge, which means that she wouldn’t be able to control her dose.
儘管，顯示Rue故意服用芬太尼。她很可能也在其不知情況下，偶然碰上它與另一種藥物混合在一起。這意味著，她將無法控制其劑量。
Rhana Hashemi, a researcher who promotes harm reduction education in schools, is critical of Euphoria for making the drug supply seem so simple: Rue and other characters don’t question what they’re taking or selling, and there doesn’t seem to be much concern for whether drugs are mislabeled or adulterated.
敦促於學校中，推行減少傷害教育的研究人員，Rhana Hashemi批評 《欣快症》，使藥物供應似乎很簡單：Rue及劇中其他角色，不會質疑他們服用或銷售的是什麼東西，且似乎也不太擔心藥物，是否貼錯標籤或摻假。
Though they’re not explored in the show, harm-reduction methods, like Narcan and fentanyl test strips, can help make drug use safer. “[Many illicit] substances have fentanyl, and dosing the fentanyl is really difficult,” says Hashemi. “That’s why it’s so important to never use alone, to test your drugs, and to have Narcan on hand.”
在節目中，雖然沒被探討。不過，減少傷害的方法，諸如納洛酮及芬太尼試紙，能有助於使藥物使用更為安全。Hashemi宣稱：「【很多違禁品】皆含有芬太尼，而很難將芬太尼配分成適當劑量。那是為何絕不單獨使用、測試你的藥物及手頭有納洛酮，如此重要的原因。」
One other major challenge for Rue is that she is a teenager. Access to high-quality treatment can be a major problem for adolescents—especially if, like Rue, they live outside of a city and their family isn’t wealthy.
Rue的另一個主要挑戰是，她是個青少年。獲得高品質的治療或許是，青少年們的主要問題。特別是，倘若像Rue，他們住在城外，且家境並不富裕。
That’s compounded by all the other typical challenges of being a teen: dealing with a developing brain, limited impulse control, and the drive to figure out identity. For anyone, being a teen can be difficult. Layering on substance use disorder can make it seem impossible.
那是由身為青少年之所有其他典型挑戰混合成的：處理發育中的大腦、有限的衝動控制及弄清楚身份的動力。對於任何人而言，作為一個青少年或許很困難。對物質使用障礙進行分層，會使其似乎不可能。
However, the silver lining is that teens are still growing and maturing, and their youth gives professionals an opportunity to intervene early in their drug use. Even for someone like Rue, “there’s still so much potential,” Gray says.
不過，一線希望是，青少年仍在成長及成熟中。因此，他們的青春為專業人士提供了，早期干預其吸毒的機會。即使對像Rue的人而言，Gray宣稱：「仍有很多的可能性。」
網址：https://time.com/6152502/euphoria-hbo-teenage-drug-use/?utm_medium=email&utm_source=sfmc&utm_campaign=newsletter+brief+default+ac&utm_content=+++20220301+++body&et_rid=197621499&lctg=197621499
翻譯：許東榮
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