Clean: Overcoming Addiction and Ending America’s Greatest Tragedy
By David Sheff. Houghton Mifflin Harcourt, 400 pp, softcover

Learning one’s child is using drugs ranks among the most frightening moments a parent can experience. For those families, David Sheff has written Clean: Overcoming Addiction and Ending America’s Greatest Tragedy.

The New York Times contributor presents years of exhaustive research on prevention strategies, methods of intervention, and seemingly countless options for treatment and rehabilitation.

He insists that addiction is not a result of moral weakness, covering genetic predispositions, childhood trauma, stress factors, and what’s going on at a neurological level inside the brain of a drug user. Addiction is a disease and should be treated as such, he emphasizes.

He’s also not afraid to tackle popular misconceptions in ways that might irritate conservative sensibilities.

D.A.R.E.—the prevention program most widely adopted in North American schools—is astonishingly ineffective, Sheff reveals. Confrontational interventions popularized by reality-television programs often backfire. Treatment facilities’ zero-tolerance policies are counterproductive to the point of being criminal. “The War on Drugs has failed,” he writes. “We lost.”

It’s the result of a search through conflicting information that’s deeply personal. For years, Sheff’s son Nic struggled with an addiction to methamphetamine. “Part of me feels solely responsible,” Sheff conceded in a 2005 essay for the New York Times Sunday Magazine.

But while Sheff is aptly suited to the task he’s assigned himself, Clean’s strength as a guide for parents is also a weakness. Some sections read like an introduction for families who just discovered drugs in a teenager’s backpack. That risks leaving readers without children feeling like they can’t relate to problems framed this way.

And while confronting uncomfortable truths like those noted above, Sheff is careful not to stray too far outside the accepted discourse of conservative America. Clean is unabashedly a book about addiction within the borders of the United States, but even a single chapter examining other cultures’ attempts to deal with drug problems would have been a valuable addition.

Vancouver and its harm-reduction programs receive three paragraphs. Countries moving toward an end to prohibition, such as the Netherlands and Portugal, receive a couple of pages between them. But that’s it. These jurisdictions’ alternative approaches to drugs are in many ways successful, Sheff notes. And yet he doesn’t discuss them beyond brief mentions.

Omissions aside, Clean is a valuable addition to a nonfiction genre crowded with bold claims and questionable evidence. It’s a tour of addiction in America that relies on science, providing objective information about a disease that’s much more common than we like to admit.