Addiction is a hard thing to face for addicts – and even more for those who love them.

Science on addiction is evolving – Dr Carl Hart at the forefront of publicizing it, but many voices and study results are showing that addiction is not all about chemistry. Addiction is, in fact, not what we think it is.

Of course I’m all for discoveries that help us better understand the nature of addiction but would also appreciate knowing on an individual level: if addicts lack connections and relationships and a sense of community and connectivity – and that partially explains what they are doing – how can an individual help? How does an individual, the non-addict in the addict’s life, cope? Every study in the world, every book in the world that explains what addiction is does not change the day-to-day challenges of living with, loving or trusting an addict.

In the many seasons of Nurse Jackie, at once dramatic and comedic, we have seen a flawed but high-functioning addict in the form of Jackie Peyton (Edie Falco). Other than her hidden identity as an addict, we only know Jackie as a nurse, a wife and a mother – but mostly a nurse, and as we go into this final season, we can see her struggling against losing this key piece of her identity. She is willing to fight for it – harder and stronger than she ever fought for her family or her sobriety.

I have written before about Nurse Jackie, first with regard to the increasing difficulty of relating to or sympathizing with Jackie.

“I used to have a lot more sympathy for and interest in Jackie, but like most users – users of drugs and of people – Jackie has become extremely hard to like. Some of the antics in the hospital where she works are still interesting enough, and the cast is still a joy to watch, but it is painful to watch how people are affected by and duped by her lying (which grows worse and worse, despite a brief moment of sobriety). It’s hard to say where this will go in its next season, as last season ended with an unexpected revelation from her husband.”

At the time I had very little direct experience with this sort of thing. This changed last year. As someone who loved and cared for an addict, it was not like anything I imagined. But, as a recent article about Nurse Jackie described, the show is one of the few accurate portrayals of addiction. It’s rough, somehow unpredictably painful even if the pain and challenges are predictable, and it opens a door to caring unconditionally for the recovering addict even if never quite being able to trust them again. Addicts sometimes feel a bit like the walking dead.

And where the early seasons of Jackie offered a bit more comedy (the show was never necessarily designed as a comedy, even if it had its moments), showing unbelievable events with few, if any, consequences, each subsequent season has escalated with its drama and equally escalated consequences.

Taken as a whole, the earlier parts, where Jackie is managing the balancing act of nurse, wife, mother along with addict and girlfriend/affair partner with her hospital’s pharmacist (direct source to her poisons), show the “good part” where the addict thinks they can and will manage flawlessly. Every season, she takes bigger risks to maintain her high and continue to conceal her growing addiction. And things inevitably spiral out of control. In the background of Jackie’s personal travails, we also see the challenges of the American healthcare system, its understaffing problems, its bureaucratic problems, humanity versus automation and the general frailty of human relationships when strained by outside forces. I am sorry this is the last season, even if it feels like the right time for it to go.