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Interview with David Sheff, Author of Clean

In 2008, Sheff’s New York Times bestselling memoir, Beautiful Boy, detailed his son Nic’s descent into methamphetamine addiction and provided a firsthand parent’s perspective on teenage addiction.

Many of our readers will fondly remember your memoir of your son Nic’s addiction. How is Clean different, or similar, to Beautiful Boy?

David Sheff: Beautiful Boy was the story of my family. Anyone who has a child or other loved one who’s addicted knows the hell we endured. Not only are we terrified and horrified by what’s happening to a person we cherish, but we’re overwhelmed. We don’t sleep, can barely function. Sometimes I couldn’t function. My wife and I did our best to be present for our other children, but it was traumatic for them, too. My daughter Daisy, when she was in 7th or 8th grade, was asked to write a short biography of her family. She wrote about the terrible times when her brother was using, and how her “pillar parents crumbed.” And we did.
At the time we went through this, at first I kept it a secret. I was confused, but also ashamed. I thought, what will people think of me that my son is an addict? What will they think of him? But after Beautiful Boy was published, I learned that openness is a great relief. I realized that we weren’t alone. In fact, I realized that there are millions of us—millions of addicts and millions of family members and friends who love them that are affected/effected. I also realized how lucky we were. After multi-treatment programs when we were hopeful, and then multiple relapses, when we were once again terrorized and terrified, Nic was doing great—now he’s been sober for 5 years. But I met so many people, and heard from so many more, whose kids didn’t make it. We’d been lucky. People were failed by the treatment system. They were failed by the prevention system. At the time, I’d planned to go back to write a business book I’d begun earlier, but I realized that I couldn’t. There is too much suffering, too many deaths. So I went forward to learn what I could about the science of addiction—what’s known, what isn’t known. What works preventing and treating addiction and what doesn’t. And what needs to be done to change the current system. The result is Clean.

What surprised you most as you researched for this book?

Sheff: I guess the most surprising was the wide gap between what’s known to be effective treating addicts and how little it’s used. That is, this disease is treatable, but we’re just not treating it. I was also surprised when I finally figured out how much the stigma is the cause of so many problems with addiction prevention and treatment. There’s no judgment when people get other diseases, but we continue to think of addicts, and treat them, as if they’re selfish, immoral—bad people. We think of kids who use drugs, we think of them as bad kids. But these aren’t bad kids, they’re our kids. Addicts aren’t dissolute or weak willed, they’re ill.

You are first a journalist. What grade would you give the media for their reporting/portrayal of addiction, and why?

Sheff: Most media portrayals of addiction are simplistic and feed the dangerous, and inaccurate, stereotypes. However, I see signs that this is changing. More journalists are writing about addiction as a medical problem. There is good coverage of breakthroughs in treatment. This shift is critical, because the stigma disappears only when people are educated—when they understand that addiction is a disease, and when they understand that it’s not a disease of the “other” – people still think it could never happen to them and their families – but no one is immune. It’s also critical, because it shows people who may have given up that treatment can work.

For a disease that impacts so many families in the United States, addiction gets surprisingly little attention from policy makers. How can we change that?

Sheff: I envision a grassroots campaign of people who no longer will accept the silence about addiction. It’s America’s number one tragedy, not only effecting addicts and their families, but every other problem you can name: the economy, criminal justice system, overburdened emergency rooms. It costs America’s companies over $200 billion a year in lost productivity. Unfortunately, it seems that only people who have experience with addiction understand the severity of the problem. We must educate everyone, including our legislators. But there’s a confluence of forces that suggest change. People are tired of hiding, tired of being ignored. There are organizations in many American cities that are working on this. Some policymakers and people of influence are taking this on. President Clinton has launched an Initiative to work on drug problems among college-age kids. Some business leaders are calling for an end to the war on drugs—Richard Branson, George Soros. Former politicians like Jocelyn Elders, Patrick Kennedy, and Jimmy Carter. We must send letters, circulate petitions, have marches. Politicians respond to numbers. We must get hundreds of thousands and eventually millions of people to call for change.

What do you want to accomplish when people read your book, and did that goal change in the course of your writing process?

David Sheff: I hope when people read Clean they 1) know – I emphasize the word “know,” differentiated from the word “think” … that addiction isn’t a choice, and addicts aren’t immoral and weak. Addiction is a disease, and addicts are afflicted with a terrible illness. 2) I want them to know that this disease is treatable, and it must be treated as early as possible, because it’s a progressive disease that gets worse over time. 3) I want them to know that it’s preventable if we reject scare tactics and “just say no” tactics and reach our children, because most drug addiction begins when people are in their teens, in ways that have been tested and shown to be effected. 4) I want people to understand the risk factors for addiction — that addiction is more likely if there’s addiction in a family. Those who have experienced trauma have a higher risk of addiction. Those who’ve experienced divorce, people with learning disabilities, those with psychological disorders. 5) Finally, I want people to know that everyone of us is impacted by addiction, and everyone of us is responsible for ending this catastrophe.

What advice would you give other parents whose kids are going into treatment?

Sheff: Buckle your seatbelts. Given the state of the current treatment system, there’s no easy course forward. This is a complex disease, and it’s hard to find good programs. Even when you find one, the process is trying. Sometimes treatment works the first time. But sometimes progress is interrupted by regression. Relapse can be part of this disease. This fact can be discouraging. Parents must do what they’d do if their child had any disease—everything they can to get their kids the best treatment possible. They must understand that it’s a complex problem and usually takes time to treat it. They also must recognize the unique aspects of this disease. They must realize that their kids are ill, so we must treat them with compassion and love. And they must get support, because it can be… it almost always is hell. Try Al-Anon. Give it a chance. Try multiple meetings. See a therapist who has experience working with parents who are dealing with a child’s addiction. Be open with your friends and family. Take care of yourself. If you fall apart, you can’t be good for anyone, including your addicted child.

Similarly, what advice would you give to others whose family member has relapsed?

Sheff: The same advice: Get support. And don’t give up hope.
Parents often say – “I did drugs in high school, so what’s the big deal?” What’s your answer to that?

Sheff: Many parents do believe that teenage drug use, especially of marijuana and alcohol, is inevitable and acceptable. Some say, “I smoked and it wasn’t a big deal,” or “I began drinking when I was sixteen and it’s never been a problem. A beer or two is fine.” This is a risky assumption because, first of all, it doesn’t allow for the fact that their children might use drugs in different ways and for different reasons than they did. It also ignores the fact that today’s kids aren’t growing up in the same culture, with the same influences and pressures, as their parents did. Nor are modern kids using the same drugs; even the marijuana isn’t the same. Now that growing marijuana has become a fine art, laboratory tests have detected three to ten times more THC, the drug’s active ingredient, in today’s pot than in marijuana from the 1980s.

There are a lot of problems with America’s system for preventing and treating addiction, but what is going in the right direction?

Sheff: There is a movement for our prevention and treatment systems to move away from a paradigm based on blame and morality and toward a science-based approach to prevent drug use and treat addiction for what it is, a health problem. We have so far to go, but there are incredible scientists, completely dedicated, taking this on. There are devoted practitioners dedicated to saving addicts’ lives. There are organizations of people – The Partnership at Drugfree.org is probably the most effective — who are working tirelessly to prevent addiction—to help kids grow up healthy. I’m hoping that pressure on politicians will help dramatically increase the budgets for organizations devoted to preventing and treating addiction. Money for research is critical. Money to get the programs into the hands of people who need them. It’s a slow process, and there are setbacks, but I’m hopeful.

Where does “hope” belong in the equation of addiction?

Sheff: There’s always hope until there isn’t. There are stories of addicts who have themselves felt hopeless and whose loved ones have given up on them who, after what can sometimes be many many years, get and stay clean. There’s also hope because we’re learning more about the disease of addiction, and the more we learn, the better prevention and treatment.

Say there’s a march on Washington tomorrow of families of addicted children. What should they march for? What would you march for?

Sheff: They should march and demand a national dialogue about addiction. Everyone is talking about guns, diabetes, and the economy. They’re all important, but addiction can no longer be ignored. Politicians must understand that this is a problem that affects every other problem in America. Politicians must be forced to take this on—to recognize it and plan a new course forward. They should march for specific initiatives, too. The Parity Act was a great step forward to get insurance companies to cover addiction treatment, but there’s a long way to go. I often hear stories of people being denied treatment who need it. Many are children. And many — too, too many have died. We should march to end the war on drugs and instead of treating addiction as a criminal problem, treat it as a heath crisis. A specific goal is earmarking much more money currently targeting interdiction and prosecution of suppliers to curtailing demand. The National Institute on Drug Abuse receives only $1 billion to spend on research into prevention and treatment and to help put effective programs into practice. Imagine if they got even $5 billion – five times more – of the $15 billion currently spent on a failed effort to curb the supply of drugs. The war doesn’t work; we’ve lost. It’s because addicts, unless they’re treated, will find drugs.

Finally, how is Nic doing? How are your two younger kids? Do you worry about them as they enter high school?

Sheff: Nic’s doing great. He’s five years sober, which feels like a miracle. There was a time when I didn’t think he’d make it to 21. He turned 30 this past summer. My younger kids are both teenagers. Being a teenager has always been complex, but I think it’s harder now. There’s enormous stress. It’s a scary time for kids. I worry about my kids like almost every parent I know worries about their children. I do what I hope other parents do: talk to them, educate them with facts, and pay close attention as much as possible so I know what’s going on in their lives, so if problems emerge, I can help them…at least try.


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