Everything You Think You Know About Addiction Is Wrong

David Sheff’s previous best-selling book, Beautiful Boy, told the story of his son Nic’s addiction to drugs. Now, Sheff’s newest book, Clean, goes beyond the story of one family to tackle nothing less than the entire subject of addiction in the U.S.—cause, prevention, treatment—with a goal, he says, of “ending America’s greatest tragedy.”

Simply put, Sheff is out to convince many more of us that, as he writes, “using drugs is not about willpower or character. Most problematic drug use is related to stress, trauma, genetic predisposition, mild or serious mental illness, use at an early age, or some combination of those.” So how do we move away from the stigma of addiction, and from the idea that if addicts just tried hard enough, or were made of stronger stuff, they could conquer their addiction?

“Before I was immersed in this world I had many of the same prejudices, especially about addiction,” said Sheff in an interview with TakePart. “We know that no one forces someone to take drugs…my son was lying to me, breaking into our house, doing unconscionable things. It appears to be a choice, and we judge it and people who become addicted.”

But Sheff’s deep immersion in the scientific research around addiction completely changed his point of view. “I came to understand that there is no argument about the fact that addiction is a brain disease,” he says plainly. “So when you understand that these people aren’t making a choice—no one chooses to be ill—obviously it is a choice at first, but most people do that and go forward with their lives and use moderately, but certain people are addicted. So people have this illness; and when you understand that, all of a sudden the blaming stops and you shift so that these people are seen as sick. So instead of anger and blame we can feel compassion. That to me is huge.”

It’s also the first step toward a genuine cure and an end to this epidemic, he believes. (And if you doubt it is an epidemic, here are a few shocking facts: More than 20 million Americans are addicted to drugs [that includes alcohol]; drugs kill more people than any other non-natural cause; and one in 12 of us over the age of 12 is addicted to drugs. Sheff says the total cost of drug abuse in the U.S. is more than $400 billion a year.)  Explains Sheff, “If we stopped looking at people as criminals or degenerate or weak-willed, and we started looking at them as ill, we would treat them and treat them early. When you have cancer or diabetes, the sooner you can catch it, the better.”

We’ve had plenty of chances to “win the war on drugs,” but we’ve screwed it up pretty much every time. The current thinking on addiction wasn’t always the way Americans thought, either, notes Sheff. “About a hundred years ago, it was the culture in America to treat addicts in the healthcare system. It was terrible in terms of treatment, but still, people were sent to medical care because there was an assumption that these people were sick.” With the passage of the Harrison Narcotics Tax Act 1914, addiction got taken out of the hands of doctors, Sheff explains, and “put into the hands of the police and the justice system. Since then, we’ve had a war on drugs and treated addiction as a criminal problem and people get thrown in jail.”

The emphasis on stopping the supply of drugs in the U.S. is misguided and naïve, too. “It completely denies what addiction is,” he explains. “In the book I tell the story of Luke who, when he was deprived of Ecstasy and pills, would go into the garage and huff—breathe gasoline to get high. You can deprive him of heroin, and he’ll use prescription pills. The reality of addiction is that people on drugs will get them.”  If nothing else, we’d do well to start thinking about addiction as related to problems in people’s lives. Some people are better built to withstand life’s trials; others aren’t, and may be more vulnerable to the lure of drugs and drink. “If you take a person who’s on a relatively okay course with relationships, a job to sustain them or school, but because they transgress—they try some pot or pills or drink, which happens to many, many people—the people who do this are suddenly thrown into a situation” where they’re being punished, Sheff says. “This adds to their stress immeasurably. Maybe the kid gets kicked out of school and maybe thrown into the criminal justice system. I can’t even describe the exponential levels of stress they feel, which leads to more addiction.”

Which is not to say some kind of “war” on drugs couldn’t be useful—just that focusing on the stemming the tide of incoming drugs isn’t the best place to put our money and effort. “One of the things changing that’s huge is the founding of an organization [for addiction] that is equivalent to the American Cancer Society,” tentatively now called the American Addiction Society, says Sheff. “The American Cancer Society has done more to change how we think about cancer, how we treat cancer, and the dangers of smoking. For the first time there will be an organization uniting people around the country.” The Affordable Care Act should also make a difference, now that health insurance companies are required to cover treatment for mental health issues and addiction.

If you’re interested in learning more about the American Addiction Society—also called Brian’s Wish to End Addiction, after the son of the founder who was lost to drugs through suicide—Sheff suggests signing up to get more information from the group; they’ll soon be launching a campaign to stop prescription drug misuse (Sheff says the number-one accidental killer is overdose on prescription meds). The Clinton Foundation has also just launched a campaign to end prescription drug abuse in adults 18 to 25.

Sheff says that most cities and towns have something going on to end addiction at the local level. “In every community there are people who are just fed up with the number of people who are dying; these organizations are often started by people whose kids did die,” he says, noting that St. Louis is focused on the heroin problem there, while north of San Francisco, where Sheff lives, community groups want to end prescription drug abuse. He cautions against assuming that drug programs that are already in place at many schools are enough, though. “DARE [short for Drug Abuse Resistance Education, a ubiquitous anti-drug education program] has been proven not to lower drug use among kids, but it actually increases use,” he says, adding that Drugfree.org and the National Institute on Drug Abuse have information on drug prevention programs that have been proved to reduce drug use. “People can also petition the Obama Administration to end the war on drugs and allot money that’s being misspent on this war to research and treatment,” he adds.

Sheff sees addiction as similar to another epidemic that started about 30 years ago. “I live in San Francisco and I was there in the early ’80s when AIDS was sweeping the city,” he remembers. “There was the stigma that it was a gay disease, and people didn’t want to talk about it. Activism completely changed the way that disease was viewed in our community. We viewed it as a plague that hit and there was tons of money raised and now it is looked at as a condition with which people live.” Sheff also remembers the most powerful call to action for these AIDS activists: Silence equals death. “It is,” he says, “the same with addiction.”