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.”
