Whether tangential or close to the core of things, the subject of drugs is handled in one of two ways in current films. Either substance abuse is basic, a cruel determining factor among African-Americans, Hispanics and marginalized whites or, increasingly, a humorously treated adjunct in the lives of middle- or upper-class, often suburban, whites. The latest in the latter, disturbing trend is graphic artist, commercial and music video director Mike Mills’s nastily titled first feature, Thumbsucker.

Scripted by the director from Walter Kim’s “no bestseller, by any means” novel, the story unfolds in Beaverwood, surrounded by Oregon forest but no less a neurotic surface of appearances than its more developed East Coast brethren. All else failed, through his unprepossessing orthodontist Perry Lyman (a wooden Keanu Reeves) and a hodgepodge of New Age holistics, animal totems and hypnotism, high school senior Justin Cobb (Lou Pucci) quickly and rather painlessly weans himself from a lifelong, seventeen-year habit of secret “oral gratification” sucking his thumb.

Soon, his Attention Deficit Deficiency channeled into genius by the school shrink’s prescribing the all-American panacea of Ritalin, he reads Moby Dick at one sitting, stars on the debate team, semi-lies his way into acceptance by the college of his choice -- a late five-second run through Midtown Manhattan illustrates that success and freedom -- tries pot, alcohol and teasing sex, and becomes wise and strong enough to self-stop the pills. This despite the cold fact that, fed like breakfast candy to nearly four million U.S. youngsters, or ninety percent of the world’s users,  Ritalin is “just three molecules different” from cocaine and similar to amphetamines or “speed.” It's addictive and causes severe withdrawal symptoms.

Nor does the film treat with the least seriousness, but with comedy, the thousand-dollar-a-day habit of any and all hard drugs of earringed TV idol Matt Schramm (Benjamin Bratt), who periodically is sent to rehab at Maple Glen and just as regularly emerges cheerfully unchanged, charming and wildly successful.

The gritty reality of dependency and pharmaceuticals is sidestepped, unrealistically and insultingly. As Justin’s RN mother (Tilda Swinton) philosophizes, “We’re all addicted to something. Success, failure, ourselves.” To which her clay-footed idol assents, “We’re all scared little animals.”

Though their teenage son is taught to address them by their Christian names Audrey and Mike (Vincent D”Onofrio), so they won’t feel old, mom and dad are fortyish and in plain midlife crisis. She can’t communicate with her older son and is more concerned with career satisfaction, anyway; and, sales manager at Gart Stores, he can’t communicate with his older son, is insecure, lives with the what-if his knee hadn’t blown out on the way to gridiron fame, and finishes a perennial second to D.D.S. Lyman in local foot and bicycle races. Little brother Joel (Chase Offerle) is not often seen; too young for anxieties, he nevertheless complains about having to act “normal,” because everyone worries so much about Justin’s supposed weirdness.

Predictably in this sort of thing, Justin at least finds a path and, it would seem, himself. He sees through resigned mediocrity Lyman, leaves behind the weak, ridiculously permissive teacher and debate coach Mr. Geary (Vince Vaughn), and matures beyond confused environmentalist and school love interest Rebecca (Kelli Garner). When the child grows up and goes off to university, his parents are perhaps brought closer together, perhaps will treasure the still little-boy-chubby Joel.

But despite Justin’s adventure into adulthood, ushered in by a dream of media fame and a real girl on the flight east (Dakota Goldhor), nothing fundamental has altered. If Thumbsucker would say that it all lies in our attitudes, in our set of mind, that's easily mouthed but awfully hard to act on. 

(Released by Sony Pictures Classics and rated "R" for drug/alcohol use and sexuality involving teens, language and a disturbing image.)