The Lost Weekend is a novel which, though written over 70 years ago, is remarkably modern in its treatment of the subject of addiction.

Prior to—and even probably well into—the twentieth century, alcoholism and substance abuse in general were seen as moral failings and usually were not examined in clinical terms. By those earlier standards, the protagonist of The Lost Weekend, Don Birnam, would have been found "deficient" in "moral character." He can't get his life together and is dependent on his enabler brother, Wick. Evidently, Wick's reliability and standing in their Manhattan neighborhood is such that Don, in his brother's absence, is able to borrow what were at the time large sums of money from the merchants in the area in order to support his addiction.

Don is, unsurprisingly, irresponsible and disregarding of others. He makes a date with a girl who works in the bar he frequents, then stands her up because he has forgotten about her in his alcoholic haze. He takes advantage of his actual (though evidently platonic) girlfriend Helen, another enabler who appears to have made it her mission in life to take care of him in a selfless and self-effacing way. Yet Jackson depicts these failings in a non-judgmental way, and we are given to understand that just as in our modern view today, Don's problem is an illness, a medical condition. It's also clear that Don is gay (though, like nearly all gay people at the time, closeted) and that the conflict between his suppressed identity and society's expectations is at least one of the reasons for his addiction.

Most people familiar with The Lost Weekend have known it from the famous film adaptation directed by Billy Wilder in 1945, a year after the novel was published. As good as the film is, by examining its differences from the book, we can possibly focus on the most significant elements of the novel. Due to the Hollywood production code of the time, Wilder eliminated the theme of Don's being gay. In addition, the movie ends hopefully, with Don turning his back on liquor. In the close of the novel, we see no such positive outcome, with Jackson realistically making the point about how difficult it is to conquer the disease of substance abuse.