David Sheff wrote a book in 2008 that became a kind of landmark. Beautiful Boy was a painful, personal story of the battle he tried to fight with and alongside his son, Nic, who was addicted to methamphetamines. The book became an international best-seller and made David Sheff one of the country's most prominent voices on addiction — not as a doctor, an addict or an academic expert, but as a father.
Sheff has continued to try to figure out a road that can lead out of addiction, and he presents that route in his new book, Clean: Overcoming Addiction and Ending America's Greatest Tragedy. He joined NPR's Scott Simon to talk about prevention, treatment programs and the legalization of marijuana.
On the biggest misconception about addiction
"I guess it's this very deeply ingrained idea that addicts are choosing to get high and so they are reprehensible and they're weak. But what we know now is that addicts aren't immoral, they aren't weak; they're ill. They have a disease. And for me, when I finally realized that about Nic, that he was sick, and that's what explained this unconscionable, crazy behavior, it allowed me to look at him with compassion, and to figure out, instead of with anger, just, how do I help him? How do we save his life?"
On why it's crucial to catch addiction early
"This is one of the most complicated diseases there is because this is a brain disease. So the nature of this disease — the thinking is impaired, the self-preservation mechanisms — everything is about getting drugs. It's a biological force. Drugs shift the way that we think. So, yeah, the logical thing would be to get help, but that's not the way addicts operate, which is why it's really, really hard to get someone to understand that they need treatment. If we catch this early, it's not as difficult to get someone into treatment."
On whether addiction is preventable
"I know it's preventable. I mean, the way we've done it in the past doesn't work. 'Just say no' doesn't work. ... Instead, we know that fact-based education works. ... If we learn about the risk factors: stress; certainly if someone has a mental illness, they're more likely to use drugs; if they've experienced some trauma, divorce, in their lives. We have to help kids through those things, and also we have to pay a lot of attention. A doctor that I interviewed said, 'If you think something's wrong, something's wrong.' And that's the time to figure it out, you know, get help. Drag a kid to therapy, if that's what it takes."
On whether legalizing marijuana is a good idea
"Well, actually, I support legalization. But there are a lot of people that support legalization who say things that are just wrong. They say that marijuana should be legalized because it's harmless, you know, it's natural, and no one has ever died from marijuana, you can't get addicted to marijuana — those things are all untrue. Marijuana is not innocuous. There's a lot of research — again, this especially pertains to teenagers. Their brains are developing, marijuana changes the development. ... The effects include problems with their cognition and memory and motivation and there's some evidence that it even lowers IQ. So, I think that we need to legalize pot so we can start a new conversation and deal with this for what it is. It's not a criminal problem and shouldn't be treated as a criminal problem. It's a health problem. So we need to focus on education and not punishment."
On why so many treatment programs fail people
"The only credentials that rehab counselors have in some places is that they're an addict who's in recovery. You want to go into programs that are accredited because they use evidence-based treatments, and so few do. It's really, really hard. And it's why we're losing so many people — 350 people a day are dying from this disease. It's tragic, and it's even more tragic because it's preventable."
On Nic's slow recovery
"When Nic, my son, got addicted — when it was clear he was disappearing, he was stealing from us, he was lying — I got a call from the emergency room, you know, 'Mr. Sheff, you'd better get here. Your son isn't going to make it.' I had no idea what to do. I called people I knew who'd been through this. I looked on the Internet, completely overwhelmed. I ended up making the best decision that I could. It was relying on a friend of a friend of a friend who told me that their child had gone into a program and had done well. I sent Nic there, and at least it got him off the streets. I mean, it didn't stop him from relapsing — he relapsed many times over the course of the next 10 years — but he was off the streets, he got some help. They call this sort of a treatment 'trajectory.' It takes a lot of time for some people, and it takes multiple treatments. Every relapse is dangerous, but often it takes multiple relapses before someone finally gets sober for good."