Drugstore Cowboy takes place in the early 1970's, in the wake of the cultural revolution when recreational drug use was more widely tolerated. The film stars Matt Dillon as a young man named Bobby who becomes addicted to opioids, including hydromorphone, at a young age. The movie features him traveling the country with his wife and another couple, stealing prescription drugs from local pharmacies and hospitals in search of the next high.

This movie depicts many of the hallmarks of substance use disorder, including persistent opioid abuse despite social and interpersonal problems stemming from the abuse. To the characters, the idea of working a normal job seems inconceivable since their only desire is to obtain and use drugs. This recurrent theme leads to many social problems as their desire to use opioids always trumps their desire to contribute to society. Near the beginning of the film, this is demonstrated when Bobby is visiting his mother but is turned away because she says he will steal from her to get money for drugs. It is clear that he cares about his mother, but his desire to get high created a rift in their relationship. The characters show small glimpses of awareness that their lifestyle is destroying them, but the immediate gratification always seems to outweigh the consequences. Later in the movie when one of their young female companions, Nadine, dies from overdose, Bobby seems more upset about the lost drugs than the death of the girl. At this point, it becomes clear to the audience and to Bobby himself that the drugs have changed his character.

Eventually, Bobby must reflect about the road he is going down and decide whether he will continue his life as an addict or do his best to contribute to society. He decides to leave his companions and join a methadone program. Despite still having cravings, he seems to be satisfied with the new path he has chosen, though it is less exciting than his previous life. This movie is valuable for student pharmacists to watch as it shows the whole cycle of substance abuse, including the decisions that a patient must eventually make in order to stop abusing substances. Many times, this means giving up the one thing he or she still enjoys in order to change. Drugstore Cowboy helps provide the viewer with an understanding of the internal struggle that substance abusers face on their path to abstinence and remission. Understanding the barriers to remission will hopefully provide viewers with empathy towards substance abusers and may assist them when supporting family, friends, or patients in recovery.

In Drugstore Cowboy, substance abuse is portrayed in a unique manner, in terms of setting and character qualities, as compared to other films that feature this issue. The individuals in this movie aren't living in shabby, unpleasant conditions, as is the case for many depictions of addicts in Hollywood. Bobby and his friends live in homes or hotels as they make their way to different pharmacies throughout Oregon and Washington. Bobby is a very clever addict and his use of narcotics hasn't seemed to wreak havoc on his intelligence just yet. He provides well for himself and his wife and makes a dysfunctional family of sorts with the other couple, Rick and Nadine.

The portrayal of addiction in this movie is sometimes spot-on with what would be seen in reality and closely parallels much of the DSM-V criteria for opioid use disorder. Bobby is no longer interested in acts, such as sex, that would normally bring pleasure to a human being. Instead, it seems as if the drug addiction and quest for more substances has taken over the pleasure-reward aspect of his life to the point that previous desires are no longer present. Bobby also exhibits psychological consequences of drugs including paranoia and ritualistic behaviors. He revolves a lot of his actions around the superstitious belief that bad omens are rooted in the simple act of placing a hat at the foot of a bed. He seems to be in search of signs that will indicate whether or not there will be bad times ahead. These beliefs and actions serve to highlight the compulsive behavior of addicts that surround procuring and using substances.

While there is a feeling of despair that comes with the depiction of addiction and death that can result, there is also a feeling of hope. Bobby eventually confronts his own substance abuse by enrolling in a methadone program and gaining employment. Both of these events are major indications of Bobby's journey towards remission and a return to occupational functioning. While in recovery, he renews his relationship with an elderly junkie, who happens to be a priest, named Father Murphy. This character illustrates the dire straits Bobby could have been in during his remaining days if not for his life-changing decision to come clean.

The characters in Drugstore Cowboy create perspective for the viewer on the qualities and attributes of substance abusers. The movie illustrates the clever nature of these patients in undertaking any means necessary to obtain their drug(s) of choice, no matter the social or occupational consequences. Such a quality can be very dangerous and lead down a road including jail time or death. Bobby's story demonstrates that there is hope for addiction with the right information, support and resources. The fact that Bobby was able to achieve remission largely on his own is a testament to what is possible. Ultimately, Bobby's drive to attain his own goals helped him eventually achieve remission.