The “Nurse Jackie” star, herself a recovering addict, discusses her sobriety and her role as TV’s preeminent pill-popper.

For the first three tense seasons of Nurse Jackie, Edie Falco’s Jackie Peyton was a woman on a high wire. The supremely capable ER nurse spent her life snorting painkillers, subverting hospital rules, and saving lives. She lied to just about everyone—her husband and their two daughters; her lover, the hospital pharmacist; the other nurses and the doctors at All Saints’ Hospital. She reserved the truth for the patients she helped, doling out information—and sometimes drugs and treatment—the hospital didn’t want them to have. Still, she always seemed to be on the verge of being busted as a drug addict, a cheating spouse, and a breaker of hospital rules.

When the Showtime series returns on Sunday, April 8, Jackie’s fallen off that high wire. She’s headed for rehab; the struggling Catholic hospital where she works is being taken over by a for-profit company; and her family’s collapsing. For the first time in many years, Jackie Peyton has to face life and work stone-cold sober. (For a limited time, you can watch a bowdlerized version of the Season 4 premiere here.)

Slate talked with Edie Falco about acting, addiction, and who would win a fight between Carmela Soprano and Jackie Peyton.

Slate: At the New Yorker Festival last October, you said you felt bad about how much Jackie had gotten away with so far, because you’re a mom. That surprised me, given your previous TV roles on Oz and The Sopranos—Diane Wittlesey and Carmela Soprano weren’t exactly role models. What was it about Jackie that made you want her to get her comeuppance for the sake of your kids?

Edie Falco: Not just for my kids; for the sake of people in general. Addiction has had such an impact on my life and the people I love, and there really is not a lot about it that is funny. So the last thing I wanted was to give the impression that it’s all fun and games, and isn’t it funny what she gets away with. It’s important that we are accurate as far as showing the ramifications of this kind of behavior.

Slate: You’ve mentioned in interviews over the years that you’ve been sober for 20 years. I know Nurse Jackie’s two showrunners, Liz Brixius and Linda Wallem, are also in recovery. Was that what attracted you to the show?

Falco: I think it was the woman rather than her behavior. She’s a bit of a vigilante. She’s always working around the rules to get whatever she needs. She wants to be a good nurse. That was what attracted me to the role.

Slate: She’s addicted to work in a way.

Falco: For sure.

Slate: That’s interesting, because although there are lots of portrayals of addiction—of varying degrees of realism—on television, there’s not much else that talks about being addicted to working. Do you consider yourself a work addict?

Falco: An addict is an addict. If they’re not acting out in one area, it tends to come out in another. I think there was a time when I considered myself a work addict, but that’s no longer accurate. My life has changed so dramatically over the last number of years, especially having a family now. My priorities have shifted. But I think in her case, work is how she manages her inner life. It’s how she identifies herself, and she has delusions of grandeur in terms of her capabilities. To walk away from that is probably scary.

Slate: Change is the big theme of this new season. After rehab, when Jackie gets in touch with her feelings, she’s crying, she’s hurt. In the past, your acting style has always been very subtle. This season, you’re moving from very slight facial gestures to a much more open style of acting. Was that a different kind of challenge?

Falco: It was different for this show. I wanted to get to show that what’s underneath a lot of the hardness in everybody is tremendous softness and a fear that they’ll be hurt and taken advantage of. I think it’s important to show that there’s a person under there—a woman, and a vulnerable one. I was pleased that we get to see more of that this year.

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