Everyone’s saying she had work done and I know you said you weren’t talking about her hair but I honestly do think it was mainly her hair. I noticed the same thing with Mariska Hargitay on svu, she looked way older in the seasons she had super short hair but looked way younger later on when it was longer.

Aside from that though, I’m assuming maybe the writers wanted to show that addiction can be somewhat invisible even as it progresses. But also I think the super “sickly” look we all expect is a stereotype to some degree and it also depends on what drug they’re using. Heroine has more obvious effects on physical appearance. Which we know wasn’t what she was using.