Okay, if you want the observations of a former IV narcotics addict, here's one.

Rating: 10/10 (7 January 2001)

Though I am pleased to see that most people have given this film very positive reviews, I had to laugh at some of the negative ones questioning the validity of Aronofsky's presentation of drug addiction, including those alluding to the film being anti-drug 'propaganda'.
Hello, all you deep thinkers. This former IV narcotics addict can verify that "Requiem for a Dream" comes closer than any film I've ever seen (that's a whole lot of celluloid, folks) in portraying what addiction -- no matter what the chemical -- is really like. With all due respect to good efforts such as "Clean and Sober" and "Trainspotting", none of those films takes us into the inner desperation, insanity (literally), anger, isolation, shame and hopelessness that addiction ultimately becomes, nearly as well as "Requiem" does. If you haven't stolen or otherwise degraded yourself repeatedly to get a drug "one last time", used to overdose levels knowingly without wanting to, used drugs you hate just because they're there and something awful is better than nothing at all, become capable of hurting others you love intentionally when having to choose between them and the drug, lost the ability to function as a friend, worker, family member or citizen, and kept coming back for more because the compulsion and obsession overwhelmed everything you knew or wanted to do, then please do not pretend to be able to say whether this film is an accurate representation of drug addiction. Thank you.
As for technical merit, the acting performances especially by Burstyn and Leto were absolutely brilliant. I knew Burstyn was that talented, by Leto totally surprised me and gave one of the very best male lead performances of Y2K. The script was flawless, the camera work inspired, the frequent flash sequences representing the process of getting loaded were cut to the bone. This is an exceedingly important film. It's been over eleven years since I touched any mood-altering chemical, nor do I crave to use, but this film brought all that pathetic, degrading, relentless, bleak hopelessness right back. All you nice little suburban dope smokers who think you know better, please keep your pleasant little self-delusions about the harmlessness of drug use to your pleasant little addled brain numbed selves. This film shows what it's really like in the big time. It sucks.