White wine and lorazepam: the ‘innocent’ face of addiction

“I don’t even have my lorazepam. I’m going to have to drink myself to sleep.”

It’s one of the most viral lines from the third season of The White Lotus, and it’s turned Victoria Ratliff—a North Carolina socialite played by Parker Posey—into a pop culture icon.

For this wealthy, middle-aged woman, Thailand’s finest spa retreat isn’t enough to curb her reliance on anti-anxiety meds.

But this moment of social satire has prompted doctors to caution against the misuse of benzodiazepines – sedatives including lorazepam which reduce brain activity.  

Professor Helen Keane, a sociologist at the Australian National University (ANU), says prescription drug dependence today is a wicked problem.

“In Australia, there has been a significant increase in the prescription of pharmaceutical opioids since the 1990s, and alongside this has been an increase in overdose deaths since the 2010s,” she says.

“Similarly, benzodiazepine prescriptions have declined, but related deaths have increased quite significantly.

“Both of these medications can be harmful and can lead to overdose, especially when combined with alcohol. What’s worrying is that many people with prescriptions don’t think of themselves as drug users and don’t think of their medications as powerful drugs.”

In 2022, opioids and benzos were linked to the deaths of 1,523 Australians.

These chilling figures hide an even deeper problem.

‘Innocent’ addicts

A recent study from Keane and Dr George Dertadian and Harriet Sherlock from the University of New South Wales found that Australian media tends to portray pharmaceutical drug dependence far more sympathetically than illicit drug use.

Analysing the language used in news coverage between 2018 and 2023, the authors identified a concerning trend.

“Pharmaceutical dependence was written about as a different kind of problem and presented as a hidden public health issue impacting people suffering from genuine physical pain, who had been failed by medicine and systems of care,” says Keane.

“We can’t say this isn’t the case, but it is a stark contrast to the dehumanising way so-called ‘drug addicts’ are often represented – as threatening and dangerous ‘others’ who are to blame for their own predicament.”

“Stigmatisation does not decrease drug use, but rather increases harm.”

The researchers found white, heterosexual, middle class individuals were often profiled as ‘innocent’ addicts.  

“The stories usually highlight this cohort’s respectability, their previously productive and happy lives, and their distance from the stereotypical world of drug use,” says Keane.

“These individuals are depicted as ‘unlikely’ and ‘innocent’ addicts because their dependence is attributed to medical mismanagement of pain, rather than character flaws or desire for intoxication or pleasurable psychoactive effects.”

Such portrayals, Keane warns, can have unintentionally dangerous ripple effects.

“These moral distinctions influence public opinion and political responses,” she says.

“Previous research shows that stigmatisation does not decrease drug use, but rather increases harm, acting as a barrier to health care and harm reduction services.

“Less obviously, the construction of pharmaceutical dependence as completely different from ordinary illicit drug dependence means that patients who are prescribed opiates are less likely to access harm reduction tools such as take-home naloxone, a medication that has proved to be life-saving for people who use opioids.”

Same substance, different narrative

The social double standard associated with addiction isn’t accidental.

“If we look at the history of drug classification and regulation, distinctions between kinds of substances and kinds of people are often racialised or politically motivated,” says Keane.

“For example, in 19th century Australia, the first legislation criminalising opiate use targeted ‘opium suitable for smoking’, which was specifically associated with Chinese migrants, and excluded Laudanum, which was a liquid form of opium widely used by white Australians at the time.”

Even to this day, the stigma surrounding illicit drug use persists.

“Just think about the language used, ‘drug abuse’ versus ‘medication misuse’ – these two terms communicate very different levels of moral judgement, blame and social ‘othering’,” Keane says.

“‘Drug abusers’ and ‘addicts’ have been imagined by governments and the public as deviant, immoral and corrupt, undeserving of care and compassion. They are contrasted to legitimate users of prescription medications, even if the substances being consumed are fundamentally the same.”

This divide can be seen in people like the character of Victoria Ratliff in The White Lotus. She is shown looking polished and happy, mixing her evening lorazepam with a glass of wine without alarming her adult children.

To them, she doesn’t fit the narrative of addiction society’s been taught to fear. But addiction doesn’t care about how you dress or speak.

In real life, people like Victoria are vulnerable.

“Harmful drug use is still associated with young people. But over the past two and a half decades there’s been significant increases in unintentional drug-induced deaths in those over 40, including in the 60-69 age group,” Keane says.

“In Australia, people aged 50 and over accounted for 36.3 per cent of unintentional drug-induced deaths involving pharmaceutical opioids in the five years to 2022, while those aged under 30 only accounted for 13.7 per cent.”

Reframing addiction

A more nuanced and inclusive approach to covering drug use in the media could help humanise addiction.

Keane explains how: “I think careful use of language is important –avoiding outdated terms such as ‘drug abuser’ or ‘addict’. These terms construct the individual as defined by their substance use, as if it is their whole identity,” she says.

“Also, more media stories could seek expert commentary and input from people with lived experiences – rather than these individuals being exclusively framed as subjects who are spoken about by others and have no insight into their own needs.”

“This issue requires more attention from national media outlets, but we should also be aware that opiate painkillers and benzodiazepines can improve people’s lives when appropriately used. Coverage shouldn’t throw the baby out with the bathwater by demonising them.”

Clips of Victoria Ratliff have reached millions of views on TikTok, and Parker Posey’s campy, Southern accent will no doubt live rent-free in the heads of many viewers.

@drlongstoryshort

#stitch with @The White Lotus Loraaaazepam from a family physician’s perspective. #familymedicinedoctor #doctorsoftiktok #whitelotusseason3 #lorazepam #victoriaratliff

♬ original sound – drlongstoryshort

But in a world where virality drives the narrative, it’s very easy to forget what’s behind the memes.

Pharmaceuticals kill more people than illicit substances every year, and no amount of good television should distract us from this uncomfortable reality.

If you or a loved one are struggling with drug addiction, please call 1800 250 015 for free and confidential advice about alcohol and other drugs.