Back to Black is a new biopic about the life of musician Amy Winehouse. It covers the time from when she gets her record deal, aged 18, until her tragic death from alcohol poisoning in 2011, at the age of 27.

Ahead of the film’s release, reactions to promotional material suggested the critical response could be mixed. This was borne out in early reviews, which ranged from resoundingly positive to somewhat scathing.

Others have and will discuss the filmmaking, musical performances and storytelling, or compare Back to Black’s retelling against existing accounts of Winehouse’s life. As someone who researches alcohol and its effects, I was interested in how Winehouse’s addiction to alcohol and other substances would be portrayed.

Winehouse died in 2011 of alcohol poisoning and an inquest into her death found that she had a blood alcohol level of 0.416. This level of intoxication is life-threatening, and is associated with loss of consciousness and suppression of vital life functions.

Amy Wine house biopic Back To Black reviewed by an alcohol expert

The film focuses on Winehouse’s (Marisa Abela) relationship with Blake Fielder-Civil (Jack O’Connell). His substance use is first shown in opposition to Winehouse’s (him: “cokehead”, her: “drinker”), but their behaviours come to mirror each other. Fielder-Civil talks about “toxic co-dependence” in one scene, when Winehouse visits him in prison.

More striking than the co-dependency, though, is the lack of agency Winehouse seems to have, despite her talent and success. In her relationships with Fielder-Civil and her father (Eddie Marsan), she is almost deferential. Her manager and label hold power over her career. But most shocking of all is how normal life is made impossible by the intrusiveness of the paparazzi.

Depicting Winehouse’s addiction

Alcohol is present in the film from the first scene, a family party that introduces us to Winehouse’s close relationship with her nan, Cynthia (Lesley Manville). Before it becomes an overt part of the storyline, viewers are given clues about Winehouse’s relationship with alcohol.

She is shown drinking neat vodka in a pub with her soon-to-be manager, and drinking a murky-looking “Rickstasy” (Southern Comfort, vodka, Bailey’s and banana liqueur) cocktail alone the day she meets Blake Fielder-Civil for the first time. In one scene she tells her nan that she’d had “a couple of drinks” for courage before appearing on the Jonathan Ross show.

Less clearly signposted, however, are her concurrent mental health problems. It is well documented that Winehouse experienced mental health difficulties, including depression and bulimia.

There is a strong link between substance use and mental health problems and they often coexist.

The filmmakers’ choice not to show Winehouse’s other mental health problems too heavily is arguably a fair one, as the director, Sam Taylor-Johnson, has said she wanted the film to “joyfully honour” Winehouse. But the result is that Winehouse’s relationship with alcohol and other substances lacks nuance on the screen.

The complexities of addiction

There is extensive research on how social stressors, parental conflict, interpersonal trauma and complicated grief are related to substance use.

Viewers are reminded of what Winehouse has lost or does not have (her parents’ marriage, Fielder-Civil, her nan, a baby), in ways that validate the notion of “drinking to cope” or self-medication.

Most of us understand the idea of self-medicating intuitively. But depictions of it on screen should not be too simplistic. Research into post-traumatic stress disorder and alcohol use disorder found there was a lack of good evidence for the self-medication model. Alcohol use and mental health also have relationships that go in both directions, with evidence that mental health drives alcohol use and vice versa.

Towards the end of the film, Winehouse’s request to go to rehab comes as a rapid acceleration through the psychologists’ classic “stages of change” theory of behaviour, which claims that people move through six stages of change: precontemplation, contemplation, preparation, action, maintenance and termination. We see little of her time in rehab and, while we later get a sense of the chronic and relapsing nature of addiction, viewers are left to fill in the blanks at the end.

On the whole, while Back to Black succeeds in avoiding harmful and stigmatising representations of addiction and mental health problems, viewers don’t get a deep insight into the realities and complexities of addiction.

The writer is a Head of Research at the Institute of Alcohol Studies and Visiting Researcher at King’s College in London in the UK

Republished from The Conversation

Published in Dawn, ICON, April 21st, 2024