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Why do we imprison people who are addicted to illegal drugs instead of treating them for their addiction? That question is at the heart of David Sheff's new book Clean: Overcoming Addiction and Ending America's Greatest Tragedy. It reports the latest medical and scientific research about addiction and recovery, which, Sheff says, shows that drug addicts are gravely ill, afflicted with a chronic, progressive and often terminal disease.
Sheff's research is motivated by having watched his son Nic's addiction nearly destroy him and the family. Nic started smoking marijuana when he was 12 and eventually moved on to shooting heroin and crystal meth. He became homeless, living on the streets, in cars, in parks, and when he did come home, he stole from and lied to the family. Sheff wrote about how the family lived through his son's addiction in the best-selling memoir Beautiful Boy. Nic wrote about his addiction in two memoirs and has been clean for five years.
David Sheff joins Fresh Air's Terry Gross to talk about his family's experience and why he feels the nation's approach to drug treatment failed his son.
On the first time his son got high
"Nic describes the first time he used in high school as transformative. It wasn't so much about being high — it was about feeling OK for the first time in his life. He said that he didn't know it was possible to feel an absence of the intense anxiety that he felt, the intense depression. So when he got high, it was just life-changing."
Addiction is a disease like anything else. It's like cancer, like heart disease, like diabetes. And we know that at the first signs of serious illness, we want to seek treatment.
On why we shouldn't wait for a person to hit rock bottom before getting them help
"I've heard over and over again, we're told that they had to let their kids, you know, their husbands, their wives, whoever it was, they had to stand back, not to intervene, let them hit bottom so they would crawl into a treatment and say, 'Please help me.' That idea, it is so dangerous. It has killed so many people. The other problem with it is that this is a progressive disease, which means that as long as it's not being treated, it gets worse. So the longer we stand back and allow this to happen and allow the drug use to continue and allow the behavior that is caused by the drug use to worsen so that someone is going to use more drugs and it's just a cycle, the harder it is to treat them. So addiction is a disease like anything else. It's like cancer, like heart disease, like diabetes. And we know that at the first signs of serious illness, we want to seek treatment. If someone in our families had early warning signs of any of those diseases, we would bring them to a doctor to figure out what is going on. We would not wait until the disease progressed."
On his son's most recent relapse
"He'd been sober for a long time. It was after Nic and I talked to you on your show and, you know, one day we were together and he said, 'I cannot believe what I did. I was at someone's house. Just almost automatic, I opened up the medicine cabinet. There was a bottle of Vicodin. I thought to myself, 'Just one,' which is common for addicts. That's the first thing that they'll say to themselves and to us, and soon the bottle was gone and he said, 'I woke up this morning and realized that if I don't do something I am going to be back on the streets within a week.' So this was the first time I didn't have to say a word. He got on the phone, he called the Hazelden treatment center in Minnesota. He was on a plane that day. To me, it's possible to look back on that and say all the treatments before that were a failure: Here he was sober for such a long time, and he relapsed again. But for me, it's the opposite: It shows that the treatments had helped him so much that he was able to recognize that he was in a free fall."
On one of the problems he has with the 12-step program
"The 12 steps are a completely profound treatment for so many people, but not most people, and that's the problem that I have. It's not with the 12 steps. It's only in the programs many, many rehabs are based on, this idea that the 12 steps are the key, are the only way to stay sober. That's my problem. You get people in treatment — especially teenagers — I mean, what is it to be a teenager? It is to feel, you know, this powerfulness, and part of the 12 steps is that you have to admit that you are powerless over your addiction. You have to turn your life over to a higher power, you know. Teenagers, some do, of course, but part of being a teenager is [that] you're not going to turn your life over to anyone."