on April 14, 2013
What I appreciate most about this book is that it is the first I have read that does not claim to hold the only way to sobriety, or the only truth about addiction. I appreciate the nod to parents who lose their minds when a child is dying, that we not compound the indignity by taking fire at the parents as "co dependents".
But we have a long way to go. I wish I could put this book in the hands of our local judges, probation officers, jailers and police, and insist that they read it. They continue to mete out punative sentences, or insist upon ineffective treatment, too much or too little, that can especially ruin young lives.
Two of my children have suffered severe addiction lasting over 15 years. I have seen them through Hazeldon (four times), Caron Foundation, Michael's House, Bishop Gooden (3 times)and at least five other top-name facilities... in and out of ICU, chasing paramedics to hospitals after overdoses, into long term in-patient and out-patient treatment facilities for years. I hate to say this... by far the best rehab has been jail. That's not to say anything positive about jail except that it did essentially the same thing as all the rehabs... it bought them time away from the environment and allowed them time to detox (horribly, without any medical attention... but, it is what it is.) In terms of effectiveness, though, they always relapsed again eventually. It is clear to me that there is no punishment strong enough to "cure" addiction.
One of my kid's came through it--the one everyone thought wouldn't live another day and he has been five years sober. It just happened when it was ready to happen. My other son is still struggling addiction with everything he's got, but holds a great job, smiles, is kind, loving and always thoughtful. He has chosen Methadone treatment, and because of that, there is no hospital, rehab or other treatment facility that will accept him. If he wants to finally get totally clean, he will have to do it by himself... cold turkey. My thought at this point is that we are buying him time, and praying for the miracle. Harm reduction is the thing I humbly appreciate. I never thought I would wind up praising the run down, miserable looking Needle Exchange (I used to find these clean needles in his room and toss them out, until the day he explained that all that would do is cause him to take worse chances with his using)... because of these folks, my son doesn't have HIV on top of heroin addiction. I have learned to be grateful where I never thought I would.
David Sheff has been through all of this, and is still fighting the good fight. His son, Nic, must be one fine son--and I have read both of his great books. "Clean" can't make big proclamations about what treatment to seek or where because at this time the science is still too new, the statistics aren't all in. I am SO GRATEFUL he acknowledges that white-knuckling it through AA is not the way for everyone. My son has gone to hundreds of AA meetings, and I honor that he hung in there, continuing to try when it was so obviously NOT a fit. Maybe the thing David contributes the most in this book is humility... and trust in the goodness of those who are struggling with addiction.
I never saw my sons having any fun with this. I have held my younger son's head while he threw up, went through withdrawals, dozens of times. I've watched him sit suicidally alone in his room, while trying to detox before going to jail. I haven't seen the partying everyone imagines. And by far the worst (for me) is the abandonment I have felt, for them and for myself, when things go so terribly wrong.
Thank you, David, for your great book. And I expect that you will write another ( or Nic will!) as newer and more potent resources become known.
on March 12, 2013
David Sheff not only pulls the curtain back, he blows it off the rod so we all can get a real look at addiction and what is NOT working. He demonstrates how we are 40 years behind on addiction therapy. If you have children, YOU HAVE TO READ THIS BOOK. Addiction can happen anywhere to anyone and it does.
Mr. Sheff was the author of Beautiful Boy - his son's own journey into and through the landscape of drug addiction.
One of the most important take-aways I got from this book was the fact that 9 our of 10 addicts started before 18. Can you even believe that? So, if you could somehow devise a way to keep your kids from trying before they turn 18, 90% of your battle would be won. Anyway - I thought that was some real food for thought.
Another take-away - this one too heartbreaking - just when an addict falls down and off his program - that is when the system fails him and throws him out of the program, the halfway house. JUST when this support and help is needed so much.
A big chapter is devoted to AA. Totally non-judgmental. Just the facts, descriptions. Interesting.
A thorough review of therapies, which ones have the best results and why. Following a daily schedule, chock full of habits - can really help. This seems so simple and yet is so profound.
And Dear G*D - - - the COST of some of these programs - and insurance doesn't help - HOW CAN regular people help their family get this kind of help?!? WHY can't we have more effective treatment programs at better costs, why isn't insurance helping with this?? Lots of food for thought there.
Okay - what I thought could be done a little better:
1. A one page - WHAT DO I DO NOW - for the parent/loved one/etc. when my son/daughter/person - is in trouble - I don't have time or attention to read the 350 pages - I need a one page cheat sheet.
2. A simple glossary in the back of the book. CBT - means what again? You could use a glossary in the back to look it up - OH YEAH - Cog. Behavior Therapy...
Those were my two little shortcomings comments.
Great book - so much to think about - to discuss - long overdue.
on April 7, 2013
I am buying copies for friends with teenagers, my baby's high school principal, and a colleague who is parent of tweens.
Important book. Easy (but very hard) read. Compassionate, thoughful, to the point.
A profoundly different book because it seeks to debunk the junk science and myths about addiction, making a compelling case that addiction is a treatable disease and not a moral failure. It is very readable as it is full of stories to illustrate the terrible cost and failure to deal with addiction in the US today. Through these stories, the book shows that the Hollywood view of addiction, with its high drama interventions, 12-step programs and punishment of those too weak to stick with the program is just plain bunk.
But it could be so much better. There are some really important points about how addiction can be effectively approached and treated, but they are strewn throughout the book in between all the stories. At times, I found myself dreading the next story of failure and wishing the author would get to the bit where he talks about what works. This book desperately needs to pull all these threads together into a "What works" chapter. A no-nonsense, here's what you can do.
So mixed feelings. A powerful book, but one that could be more helpful to those in need.
David Sheff presents a book full of information about addictions but offers little in the way of solutions or encouragement which reflects the nature of addictions in our culture. The book seems to accurately diagnose the current climate of addictions in this country: frustrating. Clean is full of research, interviews, statistics and anecdotal stories of addictions -- some leading to recovery and others to deaths.
I appreciate Sheff's passionate hope for ending the tragedy of addictions. In the Epilogue of the book, Sheff writes, "It's reasonable to envision a time not too far away when fewer people will try and use drugs, when more addicts will be effectively treated. And in the long term? We just might end addiction." Unfortunately, there is absolutely no evidence for such a vision in Sheff's book. This would take a miracle, and sadly, in Sheff's analysis miracles are not included because God is not included, except negatively.
Sheff presents in several ways the huge drug problem in America and the overwhelming nature and plethora of addictions. He has experienced first hand the trauma of drug addiction and has written about it in his previous book "Beautiful Boy" about his son Nic's addiction. Sheff writes intimately about addictions in this book, too. This is a bulk of information about addictions. Sheff emphasizes again and again that addictions are a disease and not a character or moral problem or a choice for the addict. He is heavy on the disease aspect but completely ignores the invidual's responsibility in the equation of addictions. The addict is never responsible in Clean; it is always the culture, the treatment, the doctors, the schools and the government that are at fault. I think overcoming addiction requires that both sides of the equation are equally weighed. In Sheff's model, he focuses on only what deals with the biochemical physical disease part of addiction which is the medical treatment and science of addictions. As a result, he glosses over key revelations in addictions research and recovery that I think are key elements in overcoming addictions the Twelve steps included.
Sheff cites a quote from a research finding that the following elements in a child's life protect him or her from becoming addicted to drugs, "A strong bond between children and their families; parental involvement in a child's life; supportive parenting that meets financial, emotional, cognitive, and social needs; and clear limits and consistent enforcement of discipline." Research shows that parents with strong values and a stable family environment fortify children against addictions. Teaching healthy stress-managment techniques also contributes to addiction prevention--it also lessens kids' depression and anxiety which both contribute to drug use/abuse. All of the above ought to suggest that in addition to education encouraging a healthy faith in God and participation in a faith community would be beneficial to preventing and overcoming addiction; however, Sheff ignores faith and only mentions religion as a "problem" along with superstitions that hinder treatment. He devotes a chapter to AA and for the most part maligns the program due to its "religious" element that he sees as offensive. He minimizes family systems theory and relies heavily on doctors making diagnoses and effective treatment decisions; however, he asserts several times that doctors are poorly trained regarding addictions treatment.
For Sheff, addiction treatment doesn't require "people to seek forgiveness for harm they've caused others. Redemption of one kind or another isn't needed to treat an illness." He only mentions a spiritual awakening or epiphany as something that isn't necessary. Yet, he continually returns to the correlation between stress and drug abuse. Nothing can reduce stress like forgiveness, redemption and a spiritual awakening! But Sheff emphasizes again that progress is slowed by problems such as "the roots of treatment in superstition and religion rather than science." Sheff strongly opposes programs involving "tough love" or "contrition" elements.
In my experience and awareness, treatment works best when science and faith are combined--this should be the avenue of emphasis rather than pitting one against the other. Sheff rejects faith as helpful and therefore offers little hope to readers truly looking for ways to overcome addiction. I have worked in medically-based addiction treatment centers and have had significant interaction with faith-based addiction treatment programs. The faith based programs are profoundly effective in helping residents maintain sobriety in comparison. I would heartily recommend the faith-based programs following medical detox for addicts. Sheff completely rejects faith-based treatment programs, and actually advises people to avoid them.
What will be frustrating for readers looking for solutions is that the programs recommended are the types that cost at a minimum of $6000-$10,000 per month and have no guarantees. Sheff offers hope that some of these programs will accept insurance; however, I think that is rare and will be minimal even when accepted. Many of the faith-based programs will work with clients on payment methods and are often supported by charitable donations; however, these are off-limits for Sheff. Too many addicts have already lost their financial means and are not candidates for private pay models he often discusses like Hazelden or Betty Ford or Menninger.
Despite offering a heartfelt look at addictions, I think Sheff's views are too skewed by his own biases to be an accurate or effective guide to overcoming addictions. While he cites research that shows that 90% of addicts begin their abuse as teenagers, he offers little in the way to help families prevent their children and teens from seeking alcohol or drugs. This is a statistic that ought to be a huge wake up call for parents to make their children their number one priority along with creating a stable family life. Sheff focuses most of his solutions on legalizing marijuana and getting the government to spend more money on research. He runs through family and school education without going into any depth.