The following contains spoilers for The Substance, now playing in theatersThe Substanceis a great addition to the body horror genre, with the serum (and its mysterious creator) working in some effective and unsettling ways.The Substanceis largely about Elisabeth, an aging celebrity who finds herself given a fresh chance at youthful stardom thanks to the titular compound. The serum has some very clear rules and the true scope of the world process behind it remains purposefully mysterious, allowing the film to highlight what it can by keeping the focus onThe Substance’s tight cast.
Across the course of the film, audiences are shown the concept behind the serum, the process by which it’s used, and the horrifying ways in which it can backfire. The film also teases out how the unspoken rules of the rules work in theDemi Moore-led movie, carefully avoiding too much detail about the actual truth behind the serum. Here’s everything known aboutthe serum fromThe Substanceand how it works.

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How The Substance Serum Works
The Serum Creates An Entire Second Body
The serums inThe Substanceare the catalyst for the film’s plot, setting off the horrifying events of the film. The first serum is a unique compound that is administered through an activator shot. By duplicating certain elements of the user’s DNA, the serum can force the user to create a “perfect” copy of the original body. This body is in perfect physical health and condition, as Elisabeth discovers when she painfully spawns “Sue” out of her back. Notably, the mind and memories are the same, with the original body remaining comatose while the copy is active and awake.
While in the younger body, the original comatose body produces a substance dubbed the “Stabilizer.” The double must take this stabilizer daily. It’s stressed repeatedly that the user cannot occupy the younger body for more than seven days. While the reasoning is initially vague, Elisabeth discovers her original body ages at an advanced rate when comatose for too long.The process can only be ended with a specific final administrationof the mysterious substance. It won’t undo any advanced aging of the original, but it requires administration to the duplicate as well to effectively kill them.

Who Created The Substance’s Serum?
The Person Behind The Serum Remains A Major Mystery
One of the big mysteries ofThe Substanceis the identity of the serum’s creator. Elisabeth never meets the creator or the company that produces the serum. She only learns about it after a chance encounter with a nurse who believes she’d be an ideal candidate for the procedure. Elisabeth later meets an elderly man who is heavily implied to be the nurse in his old body, although it’s unclear if he’s simply another user of the serum or if he’s involved in the actual process of making it.
The creator and the company behind it remain a mysterythroughout the entire film, although they seem very well-funded. The company moves in secrecy, only communicating through phone calls and flash drives. They are straight-forward, blunt, and unyielding. They can hide a clean drop-off zone in plain sight, suggesting a larger organization instead of a smaller operation. The process feels perfected, even if the dangers have not been eliminated, suggesting the creator is a larger force. However, their identity and motivations remain a mystery, allowing the film to remain focused on Elisabeth and Sue’s story.

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How Elisabeth Gets The Substance Serum
A Chance Encounter With A Nurse Brings Elisabeth Into The Plot OfThe Substance
Part of what suggests that the serum creator has vast resources is the lengths that Elisabeth has to go through when she picks it up initially and what she has to go through to get refills of the serum. After being secretly informed about the procedure, an initially skeptical Elisabeth decides to try the process and contacts the company. She’s then forced to go through downtown Los Angeles and go through a derelict-looking area to gothrough a secret garage door.
Harvey
Dennis Quaid
Taking this path leads to a pristine clean room, where people can go through drop-boxes to pick up their respective restock. All of this underscores the secrecy of the process, as not once during the errand does Elisabeth actually encounter someone who’s responsible for the serum. The entire process remains a well-funded and efficient mystery.This opens up the idea that the serum has been quietly available for some time, long enough at least for a system to be put into place for its maintenance and spread.
What Happens When The Substance Is Misused
HowThe SubstanceEmbraces Body Horror
The serums inThe Substanceare fairly straightforward andhave horrifying results when used incorrectly. It’s repeatedly stressed to Elisabeth that she can’t spend more than seven days in the duplicate body. However, as the divide grows between Elisabeth and Sue, the latter ends up spending too much time awake. The comatose state of the original body then amplifies the aging process. Initially, Sue only abuses the system a little and remains in her body for slightly too long — resulting in one of her fingers aging and decaying at a rapid rate.
However, prolonged periods where Sue doesn’t return to Elisabeth’s bodyresult in the latter aging at an increased rate. Within months, she has severely withered away. However, it’s even more dangerous for the duplicate to take the activator, which Sue does after killing Elisabeth and using up all the natural stabilizers created by her body. Literally falling apart without the stabilizer, Sue uses the activator to try and create a new copy. This hybrid form is a gruesome piece of body horror, highlighting the true risks of using the titular substance.

Why The Substance Is So Scary
There’s A Lot Of Unsettling Elements AboutThe Substance
The titular compound inThe Substanceis an effective horror. There’s a surface level of horror associated with the sheer amount of body horror that it puts characters through in the film. From the movie’s initial bloody birthing scene to the slow subsequent sequence of Sue having to stitch up the unconscious Elisabeth’s back,The Substancekeeps the focus on the human body in an uncomfortable and blunt manner. The actual process of extracting setup is creepy given the human source of it, and the results of misuse are classic horror film transformations.
The fact that the substance is seemingly so well-funded is unsettling alone. The existence of others who use the serum creates an uneasy tension around who could be involved in the process. Any number of people could be using the substance, and whoever controls it wants it kept a secret. There’s even some psychological horror baked into the concept, as Elisabeth’s splintering psyche as she becomes more resentful and distant from her alternate persona adds a cerebral level to the concept.The Substanceis a great horror concept and one that only gets scarier the more layers it gains.

The Substance
Cast
Elisabeth Sparkle, a fading celebrity, turns to a mysterious drug that promises to restore her youth by creating a younger, more beautiful version of herself. But splitting time between her original and new body leads to horrifying consequences as her alternate self, Sue, begins to unravel her life in a disturbing body-horror descent.

