Clean: Overcoming Addiction and Ending America's Greatest Tragedy

by David Sheff

Overview

Addiction is a preventable, treatable disease, not a moral failing. As with other illnesses, the approaches most likely to work are based on science — not on faith, tradition, contrition, or wishful thinking.

These facts are the foundation of Clean, a myth-shattering look at drug abuse by the author of Beautiful Boy. Based on the latest research in psychology, neuroscience, and medicine, Clean is a leap beyond the traditional approaches to prevention and treatment of addiction and the mental illnesses that usually accompany it. The existing treatment system, including Twelve Step programs and rehabs, has helped some, but it has failed to help many more, and David Sheff explains why. He spent time with scores of scientists, doctors, counselors, and addicts and their families to learn how addiction works and what can effectively treat it. Clean offers clear, cogent counsel for parents and others who want to prevent drug problems and for addicts and their loved ones no matter what stage of the illness they’re in. But it is also a book for all of us — a powerful rethinking of the greatest public health challenge of our time.

Product Details

ISBN-13:	9780547848655
Publisher:	HarperCollins Publishers
Publication date:	04/02/2013
Pages:	374
Product dimensions:	6.00(w) x 9.30(h) x 1.50(d)

About the Author

David Sheff is the author of the #1 New York Times -bestselling memoir Beautiful Boy . Sheff's other books include Game Over , China Dawn , and All We Are Saying . His many articles and interviews have appeared in the New York Times , Rolling Stone , Playboy , Wired , Fortune , and elsewhere. His ongoing research and reporting on the science of addiction earned him a place on Time Magazine 's list of the World's Most Influential People.Sheff and his family live in Inverness, California.

Table of Contents

Author's Note ix

Preface xi

I America on Drugs

1 This Is Your Brain on Drugs 3

2 This Is Our Nation on Drugs 12

II Why We Use

3 Everybody Does It 29

4 Helping Kids Grow Up 44

III When Drug Use Escalates

5 Use Becomes Abuse, and Abuse Becomes Addiction 77

6 Addicts Aren't Weak, Selfish, or Amoral-They're Ill 88

7 Don't Deny Addiction, Don't Enable It, and Don't Wait for an Addict to Hit Bottom - He Could Die 103

8 Intervention 114

IV Getting Clean

9 Finding Treatment 127

10 Detox 141

V Staying Clean

11 Beginning Treatment 149

12 Primary Treatment 170

13 Treating Drug Problems with Drugs 198

14 Where Does AA Fit In? 207

VI Treating a Chronic Illness

15 Treating Dual Diagnosis 237

16 Relapse Prevention 251

VII Ending Addiction

17 The Future of Prevention and Treatment 271

18 Fighting the Right War 284

Epilogue 306

The Clean Paradigm in Twelve Steps 310

Afterword 313

Appendix: Just Say Know 318

Acknowledgments 336

Notes 338

Index 358

Editorial Reviews

…Sheff is a skilled journalist on an urgent mission. He prevailed over the anger and hopelessness he felt at his son's affliction by calling upon great reserves of love and discipline to investigate what might help—first as a father and then, in this book, as a reporter and an advocate. His forbearance and clearheadedness could serve as an example for America as it confronts its drug problem. He has performed a vital service by compiling sensible advice on a subject for which sensible advice is in short supply.

The New York Times Book Review - Mick Sussman

Reviewed by Hunter R. Slaton. Sheff’s bestselling Beautiful Boy: A Father’s Journey Through His Son’s Addiction flipped the script on the traditional first-person addiction memoir, painting an agonizing portrait of what one family went through when its “beautiful boy,” Nic Sheff, descended into years of methamphetamine addiction, deceit, and relapse. By the final page, he had been clean for a full year. But while the story may have ended for Sheff’s family, the tragedy continues for the 20 million Americans who are currently addicted to drugs and/or alcohol. Thus, Sheff the elder is back; in his latest, he takes a macro look at the micro problem detailed in Beautiful Boy, to examine the state of addiction and addiction treatment—sadly lacking, he finds—in the U.S. today.As Sheff sees it, the chief impediments to preventing and treating addiction are the same ones that existed when Alcoholics Anonymous was founded 78 years ago: the stigma associated with addiction, and the belief that drug abuse is a choice, rather than a disease. Sheff once held this belief, but his thinking evolved over years of grappling with his son’s addiction. Clean is at its best when the author grounds his conclusions in real-life trials and tribulations, whether his or others’.Unfortunately, the book is at times too thinly peopled, descending into rote lists of best practices and expert opinions, as exemplified by the chapter “Beginning Treatment”: “All support staff working with patients should be well trained and closely supervised”; “Programs should evaluate whether it would be beneficial for family members to be involved in treatment”; and so on. These passages are a perfect illustration of why a writer should always “show” rather than “tell.”But when Sheff lets recovering addicts and their families make his case for him, the story is gripping and vibrant—Luke Gsell tells about finding himself in rehab on the night before his 15th birthday, gobbling down stolen Dramamine: “‘Everything snapped,’ Luke said. ‘I thought, This is my one shot and I’m getting high. I was tripping on seasickness pills in rehab... I recognized that I was an addict. I said, ‘I’m done with this.’” The book is not this vivid or cathartic throughout, but Sheff makes his case methodically and convincingly, finishing with a stark look at the failure of the War on Drugs—and a comparison to the far more effective wars on cancer and AIDS, fought with the weaponry of “education and prevention, changing public policy, and improving treatment,” rather than “interdiction, arrest, prosecution, and eradication.” “The war must be ended,” Sheff concludes—and a new, more benevolent approach, outlined in a set of cleverly rewritten “12 Steps,” begun. Hunter R. Slaton is an editor at the TheFix.com, an online magazine about addiction and recovery. He lives in Brooklyn, N.Y.

Publishers Weekly

Sheff triumphed with Beautiful Boy, a No. 1 New York Times best seller and Barnes & Noble Discover Great New Writers award winner that probed his son Nic's drug addiction. Here he addresses not just the addicted but family, friends, educators, and policymakers to suggest a new way of confronting both drug addiction and prevention, drawing on up-to-date research and his own experiences. The premise? Science, not shame, crossed fingers, or prayer, will make the difference. With a ten-city tour; indisputably important.

Library Journal

An enterprising treatise on drug abuse and addiction intervention. During the time when Sheff chronicled his son's "hellish" heroin and methamphetamine addiction (Beautiful Boy: A Father's Journey Through His Son's Addiction, 2008), his desperate attempts to gain a compassionate understanding of the nature of drug dependency educated him thoroughly. This follow-up to that research defines the roots of addiction with clean, accessible language, examining the classic patterns of abuse from the first hit to full-blown dependence and from denial ("anosognosia") to treatment and recovery. Sheff offers new, sustainable solutions to a problem that has reached epidemic levels in this country (nearly 1 in 10 Americans has a drug problem). Among the many precepts the author lists is a belief that the drugs themselves are a "symptom" and not the sole cause of an addiction. He addresses the sciences of drug dependency, risk factors, the broken addiction-treatment system in place today and a family's crucial role in prevention. In terms of recovery, Sheff compares drug (methadone) versus drug-free (AA) routes toward achieving sobriety and eliminating relapses. Particularly fascinating is the author's profile of a Chilean doctor's observational research on the relentless behavioral patterns of fruit flies and mice exposed to alcohol mist, which demonstrates the seductive and ultimately irresistible nature of drugs like alcohol and cocaine. Sheff veers away from labeling addiction as a lost cause and rather offers new models, strategies and alternative therapies for abuse intervention and promising reform. Intelligent and thought-provoking views into the complexities of addiction and recovery.

Kirkus Reviews

"Clean will change not only how you look at drug abuse, but also what you think should be done about it. This book is essential reading about one of our most important social problems." — Eric Schlosser, author of Fast Food Nation and Reefer Madness  "In Beautiful Boy, David Sheff gave voice to the silent — the millions of addicts and their families. Now in Clean, he offers them a path toward healing. Our nation is sinking into an epidemic. This book offers realistic hope for recovery from addiction for those who suffer the disease." — Drew Pinsky, M.D., host of Dr. Drew  "How do we prevent kids from using drugs, and how do we effectively treat addiction? Clean cuts through the technical jargon and marketing nonsense to summarize our best knowledge on these topics. The case studies illuminate the challenging process of treatment and the remarkable changes that occur with recovery. Clean is a major contribution to our understanding of this disease and how to fight it." — Richard A. Rawson, Ph.D., professor and associate director, Integrated Substance Abuse Programs, Geffen School of Medicine, University of California at Los Angeles  "Clean is an important exposé of a failed system; by replacing it, we will save countless lives, help people get clean and stay clean, and help the U.S. end its catastrophic war on drugs." — Sir Richard Branson, founder and chairman, Virgin Group, and member of the Global Commission on Drug Policy  "David Sheff is one of our strongest and most compassionate voices on the profound costs of addiction to the family and to society. Clean should be read by anyone affected by the number-one public health issue in America, which means it should be ready by everybody." — Christopher Kennedy Lawford, author of Recover to Live and Symptoms of Withdrawal  "David Sheff has written the most important book about addiction in a decade. Clean is a blueprint for thinking clearly — and empathetically — about America's costliest and most misunderstood public health crisis." — Benoit Denizet-Lewis, author of America Anonymous  "Indisputably important."  —  Library Journal "Gripping and vibrant."  — Publishers Weekly  "Intelligent and thought-provoking views into the complexities of addiction and recovery."  — Kirkus Reviews “Providing a wealth of information and practical advice, Clean is the best book on drug abuse and addiction to appear in years… Clean busts a mountain of myths… An extraordinarily valuable book.” – Glenn C. Altschuler, Cornell University, and Patrick M. Burns, Cornell University, reviewing for The Huffington Post   —

From the Publisher