David Sheff is the author of Clean: Overcoming Addiction and Ending America’s Greatest Tragedy, the follow-up to his New York Times #1 best seller, Beautiful Boy: A Father’s Journey Through His Son’s Addiction. On March 13, we will welcome David as a featured speaker in an opiate addiction forum.
Phoenix House: Clean is very different from your first book, Beautiful Boy. Did you plan to start with a memoir and move to more science-based writing?
David Sheff: The first book wasn’t even planned. It was the outcome of confronting my son’s addiction. That was a horrific experience, and my son, Nic, almost died many times. When he finally started doing better, I decided to write our story. Parents don’t realize that their child could be vulnerable to addiction; I wanted people to know that. I wrote a piece in The New York Times Magazine, and everyone’s reaction was, “Thank god someone’s talking about this.” So I went on to write Beautiful Boy—both for my own healing and to educate others. The main things I learned through that process were: how pervasive and ubiquitous addiction is; how little we know about it; and how few good treatment options there are out there. So for Clean I then spent five years instead trying to understand addiction—the science behind it and the policies. It was about trying to dissect and expose in a call-to-arms sort of way, to encourage conversation and to say, “This isn’t working. We’re losing too many kids to this disease.”
PH: In Clean you argue the importance of a science-based approach to addiction. Why do you think so many people continue to view this disease as a “moral failing”?
DS: That was the most surprising thing about this book. People were actually angry at the assumption – at the fact – that addiction is a disease and we need to treat it with a medical model. “No!” they cried, “We have free will, it’s a choice!” These misconceptions are huge. On one hand I understand it; you see somebody with leukemia and think “disease,” whereas you see an addict breaking into your home and you think, “How selfish, how morally reprehensible.” I’d think, “How could my son be doing this to me? To my wife and his little brother and sister?” Only later did I understand that he wasn’t doing it to us. He was doing it to himself.
With Nic it didn’t look like a disease, it looked like a choice. But what struck me was the fact that I knew him. I knew he was a moral person and that the explanation for his actions had to be some kind of mental illness. So I looked at the research and brain scans and came to understand that addiction is incontrovertibly a disease. There’s still no magic bullet, but at least we know how to go forward, stop blaming, and become compassionate.
PH: You’re absolutely right that addiction is a mental health issue. What about folks who struggle with additional mental health diagnoses on top of that?
DS: For Nick the dual diagnosis seemed so clear; he would get so depressed he could barely function, which would lead to crazy impulsivity and relapses. So after seeing many, many doctors, one of them finally suggested psychological testing – which we hadn’t even heard of – and Nic was diagnosed with bipolar disorder and serious depression. We finally got him the right medication and therapy focused on dual diagnosis, and he’s been in recovery ever since. About four million Americans struggle with addiction alongside a serious co-occurring mental health disorder, which makes sense because if you’re depressed or anxious you’re likely to get high in an attempt to self-medicate. So it’s important to treat people with addiction and mental illness in a controlled, healthy way. You can’t just treat addiction in a vacuum.
PH: What do you know now that you wish you’d known when Nic was just beginning to use drugs?
DS: I wish I hadn’t shrugged off pot and alcohol as “normal,” “a rite of passage,” and “not a big deal.” I wish I had known that 10% of people who try pot get addicted. It’s not a gateway drug for most people, but it is for some and it was for Nic—and soon after, he was shooting heroin. I wish I’d known that kids who start using drugs at age 11 or 12 are more likely to have problems later on. If I’d known all this I would have intervened much more dramatically. I would have gotten him to a therapist earlier. I would have paid closer attention.
PH: It’s notable that Nic started with marijuana. What do you think about the legalization debate and President Obama’s comments?
DS: I agree 1,000 percent that we shouldn’t say marijuana is harmless—because it’s not. There is so much evidence about the cognitive damage it can do, the memory and IQ harm, and the possibility of addiction. It’s serious. That said, it’s not a criminal problem—it’s a medical problem, and needs to be treated as such. Putting addicts in jail is only going to steer their lives downward, and it’s clear that the policies we’re using are failing. We need to help people – especially children – manage the stressors in their lives in a healthy way and with real information.
PH: You’re coming to the Phoenix House Academy in Westchester next month to speak to our teens. What advice do you have for kids who are currently in treatment?
DS: My first message is that drug use and addiction is not about “good” vs. “bad.” Even very young kids get the idea that good kids don’t use and bad kids do. That’s just not true, and kids with the disease of addiction shouldn’t be made to feel like “bad kids” who are selfish. Instead we should help them understand the underlying reasons for their use. It’s not about morals. Based on surveys of thousands of kids, the number one reason they use is because of stress—social or family or otherwise. And if they have a propensity for addiction, they keep using. Once we understand that, the conversation becomes very different. Which leads me to my second message, which is that this is absolutely treatable. It’s tricky, but kids need to know they have every reason to be hopeful. Nic is living proof that even the worst addiction can be treatable. The problem is how hard it is to find a really good, science-based treatment program like Phoenix House. We need more of these programs, and hopefully the Affordable Care Act will help with that. Plus, pricey treatment doesn’t equal better treatment—even Elton John will tell you that. Think about it: if you have cancer, you’re not looking for the hospital with the five-star restaurant. You’re looking for the best doctors. There are rehabs that charge $100K a month and their patients never even see a psychiatrist; that’s not OK, and it’s not the case at Phoenix House. These kids are in good hands.Back to Index