The view that drug use is a moral choice is pervasive, pernicious, and wrong. So are the corresponding beliefs about the addicted — that they're weak, selfish, and dissolute; if they weren't, when their excessive drug taking and drinking began to harm them, they'd stop. The reality is far different. Using drugs or not isn't 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. Even in their relentless destruction and self-destruction, the addicted aren't bad people. They're gravely ill, afflicted with a chronic, progressive, and often terminal disease.
People also believe that addicts can't be treated; at best, they can muster their willpower and manage their compulsion for a short time. But while it's true that addicts who seek treatment are seldom cured, their disease is treatable when we reject the pseudoscience, moralizing, and scare tactics that characterize the current system. The disease of addiction can be prevented, and when we treat it the way we treat other diseases, those in its thrall can be freed to live long, full, healthy lives.
The mission of Clean is to describe the scope of America's drug problem and explain how and why we've failed in our efforts to combat it. I show why we must waste no time in rejecting the existing paradigm that got us into this catastrophic mess. I provide scientific evidence that will change the way we think about drugs and addiction. Finally, and most important, I present the hopeful news that we can now effectively prevent drug use and treat addiction. When we do, we do more than help those with drug problems and their families. We also start to remedy America's single greatest problem, one that affects almost every other problem you can name — the quality and availability of health care, the national and international economic crisis, poverty, spousal and child abuse, suicide, U.S. competitiveness in the world economy, property crime, violence, shattered families, decimated neighborhoods, and many others.
As a young child, my firstborn son, Nic, was happy and excited about everything, kind and sincere and funny. Parents like me monitor external barometers to tell us how our kids are doing, and according to those, as Nic grew older, he did well. He had friends; he was a good student, an athlete (on the varsity swim and water polo teams), and a lauded student journalist. Most important, he seemed so joyful. But, beginning when he was twelve years old, he was also using drugs, initially smoking pot.
A decade later, I still look back and ask, How did it start? How does it start for any of our children, our husbands or wives, partners, parents, siblings, friends — for anyone who becomes addicted? Nic says he tried drugs because he was curious, and everyone seemed to be using, "at least, everyone who was cool." When he tried them, he felt fantastic. He used more and then more. He graduated from high school, but he also graduated to other drugs. He began college but didn't last long there. Instead, he became homeless, sleeping in cars, abandoned buildings, and city parks. He lied to his family and stole from us. He took pills (psychedelics, ecstasy, uppers, downers), used cocaine, and — inconceivably to me — began shooting heroin, crack, and crystal meth.
I wrote about the years our family lived through his addiction in the book Beautiful Boy. Readers of it and of Nic's own books — a pair of memoirs, Tweak: Growing Up on Methamphetamines and We All Fall Down — know many of the gory details. Over the course of a hellish half a dozen years, Nic dealt drugs, was beaten up, and was wanted by the police. Once, a doctor informed him that he would probably have to amputate Nic's arm because it had become infected after Nic shot heroin and crystal meth. (Miraculously, the doctor was able to save it.) There were many times when Nic nearly died. I'd think, This cannot be happening to my son. Not to Nic. I thought he'd be protected by his intelligence, his education, us — his family. Nic didn't look like the addicts I'd see on the streets. I'd walk by those hollow-eyed, trembling wraiths and avert my gaze. I thought it was impossible that Nic would become one of them, but he did.
From Clean: Overcoming Addiction and Ending America's Greatest Tragedy by David Sheff. Copyright 2013 by David Sheff. Excerpted by permission of Houghton Mifflin Harcourt. All rights reserved.