Movies like this you don't give five stars because they're warm and cuddly and safe. I give it five stars for the honesty of its portrayals of the various downward spirals of addictions to heroin and speed. Add dazzling and substantial direction and editing by Darren Aronofsky which really puts you in the head and wasted bodies of addicts to four of the most stunning performances I have seen all year. The result is a film to love and appreciate for its high quality and absolutely unflinching honesty. At one point, watching a drug addict shoot up in a car, I absolutely could not watch. Any movie that makes me squirm usually has performances that engage me so much I am moved beyond being lackadaisical. In, say, Scream by contrast its like Oh gee, he cut a stomach open. Kudos especially to Ellen Burstyn who can out-act nearly everyone else on the planet. Unforgettable as a diet-pill addict desperate for a shot on national tv. 