The first step to conquering any addiction is admitting the problem.

Only then can you begin to address the underlying causes of your dependency – drugs, booze, gambling – and understand the desires, which threaten to consume you.

Adapted from the nihilistic novel by Chuck Palahniuk, Choke is a black comedy about a 30-something sex addict who happily acknowledges his yearnings and willingly attends rehabilitation meetings because it allows him to prey upon and sleep with fellow sufferers.

Victor Mancini (Sam Rockwell) is a costumed guide at a colonial village tourist attraction, where he dons the period dress of an Irish servant alongside best friend Denny (Brad William Henke) to recreate scenes of 18th century life.

When he’s not infuriating his boss Lord High Charlie (Clark Gregg) or propositioning other addicts, Victor makes regular visits to hospital to see his demented mother Isa (Anjelica Huston), who has almost completely relinquished her grasp on reality.

In the process, Victor encounters attending physician Dr Paige Marshall (Kelly Macdonald) and develops a crush on the sexy medic.

Yet when mutual admiration turns to lust in the hospital chapel, for the first time in his life, Victor cannot rise to the occasion.

At first Victor puts down his uncharacteristically poor performance to the location, joking to Denny that anyone would wilt in the direct eye-line of Jesus on the cross.

But the self-crazed misfit gradually accepts that Paige has touched him like no other woman and to move forward, he must reconcile with his shady past.

Choke is a quixotic slice of life, which retains the anarchic spirit of Palahniuk’s book through some hysterical comic interludes.

One of the most amusing strands is Denny’s burgeoning romance with a ditzy stripper called Cherry Daquiri (Gillian Jacobs), who dyes her hair brunette "because of what you said about blondes getting skin cancer."

Rockwell’s anti-hero struggles to lasso our sympathy, by virtue of his treatment of almost every woman in the film and his potentially life-threatening hustle, which gives Clark Gregg’s directorial debut its title.

Huston tugs the heartstrings from her hospital bed, restored to her raven-haired former glory in flashbacks, which reveal the strange bond between mother and son.

A sly narrative twist is well concealed by Gregg as the characters stumble from one disaster to the next, clinging desperately to any scrap of hope that comes their way.

There aren’t many.