Yes, Aranofsky knows what he's doing, but he only deals with human beings when he's run out of trick shots. The only heart he's interested in is one that's stopped by an overdose. You can get the same vibe, with far more economy and a devastating emotional undercurrent, in any number of Lou Reed records. Leto has a pus-filled, infected track mark on his arm. Connelly vomits directly into the camera lens.
People snort, smoke, and inject anything they can get their hands on.
Wayans is shown having sex with his nude girlfriend. A drug dealer gets shot point-blank in the face. And, of course, Burstyn gets snapped at by her refrigerator. In this case, torrents of profanity can be viewed as a welcome relief. Rated NC-17. 102 minutes.