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The following FAQ entries may contain spoilers. Only the biggest ones (if any) will be covered with spoiler tags. It is assumed that no one who is diligently avoiding spoilers will be visiting this page in the first place.
For detailed information about the amounts and types of (a) sex and nudity, (b) violence and gore, (c) profanity, (d) alcohol, drugs, and smoking, and (e) frightening and intense scenes in this movie, consult the IMDb Parents Guide for this movie. The Parents Guide for Requiem for a Dream can be found at http://www.imdb.com/title/tt0180093/parentalguide.
The novel Requiem for a Dream written in 1978 by Hubert Selby Jr. was the source used by Darren Aronofsky for the film adaption made in 2000.
Although Marion does not become a full-time prostitute, we see Marion sell her body three times throughout the movie to feed her addiction; once with her shrink, once with Big Tim, and finally in the ass-to-ass scene at Big Tim's party. It's a very safe conclusion, however, that she would go back to Big Tim as needed for more drugs-- and with Big Tim, her body is the ultimate currency.
At the end Harry's arm was amputated because of an infection from his heroin addiction. (he did not rotate the injection sites on his arm), and the infection spread.
Harry, Marion, Tyrone and finally Sara are each shown curling into a fetal position for their final scene; a symbol of how their lives have been lost in complete ruin and despair. Harry and Tyrone are in prison, with Tyrone subject to hard work detail under harsh supervision by racist guards, and Harry's arm amputated at the shoulder; Marion has a new regular drug supplier, but she must pay for her drugs through sexual favors, and Sara is trapped in her psychosis-induced world of appearing on the Tappy Tibbons infomercial and presenting a successful, engaged Harry to an adoring audience.
Being released in a special R-Rated version for retailers meant the scenes involving the sex implement were exchanged for less explicit material. The NC-17 version is available on DVD as well. A detailed comparison between both versions can be found here.
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