Sara Goldfarb, an elderly woman, becomes addicted to amphetamines in her quest to lose weight and fit into a red dress for a television appearance. Her addiction leads to severe psychological and physical deterioration.

Her son, Harry Goldfarb, dreams of a new life with his girlfriend Marion Silver. Both struggle with heroin addiction, which jeopardizes their plans and deepens their problems.

Harry’s best friend, Tyrone Love, shares in the addiction, and his efforts to escape their bleak existence only compound their troubles.

As their dependencies spiral out of control, their dreams unravel, culminating in tragic outcomes for each character.