This study examines how mainstream cinema portrays substance addiction through cinematography, sound design, and narrative structure, shaping public perception and policy discourse. Focusing on films such as Requiem for a Dream (Eric Watson; Palmer West in Oct. 6th 2000), Trainspotting (Andrew Macdonald; Christopher Figg in Feb. 23rd 1996, and Leaving Las Vegas (Lila Cazes; Annie Stewart in Oct. 27th 1995), it explores how aesthetic choices depict the psychological and physical toll of addiction. By applying formalist, psychoanalytic, and ideological film criticisms, this research evaluates the accuracy, ethical considerations, and societal impact of these portrayals. It also investigates whether these films reinforce stigma or foster empathy and awareness. Film Theory was used as its central theoretical framework to examine the cinematic representations of substance addiction through aesthetic and critical perspectives Ultimately, this study aims to bridge the gap between film studies and addiction discourse, highlighting the power of visual storytelling in shaping cultural attitudes toward substance dependence and recovery. Through our findings, all three films depict addiction with some degree of realism, only Trainspotting and Leaving Las Vegas offer consistent moments of empathy toward their addicted characters. We therefore recommend that scholars, film makers and mental health advocates should try and explore other aesthetic choices in shaping the public perceptions of addiction and more collaborations between filmmakers and health professionals in order to ensure accurate and balance portrayals of addiction.