Beautiful Boy: A Heartbreaking Memoir of a Father's Struggle with His Son's Addiction and the Journey to Recovery

by David Sheff

Addicts are in denial and their families are in it with them because often the truth is too inconceivable, too painful, and too terrifying. But denial, however common, is dangerous.

O God, that men should put an enemy in their mouths to steal away their brains! That we should, with joy, pleasance, revel, and applause, transform ourselves into beasts. —WILLIAM SHAKESPEARE, The Tempest

In 1987, the Partnership for a Drug-Free America launched the antidrug campaign “This is your brain on drugs.” But the human brain on meth does not look like fried eggs. It looks more like the night sky over Baghdad during the first weeks of the war.

“What is turned on here is exactly what turns on while people feel pain.” The operative word is while. She goes on, “A person stops using methamphetamine, and this is awaiting them.” Clinicians who work with meth addicts already know that addicts are often depressed, argumentative, anxious, and unwilling to engage in treatment—exactly

It led her to conclude that meth addicts may be unable, not unwilling, to participate in many common treatments, at least in the early stages of withdrawal. Rather than a moral failure or a lack of willpower, dropping out and relapsing may be a result of a damaged brain.

patients with extremely high levels of depression and anxiety, and who are suffering a type of “chronic agony,” as London describes it, are at a major disadvantage when taking part in cognitive and behavioral treatments.

After a month of abstinence, the depressive symptoms and pain following meth withdrawal are less severe in many of the abstinent meth users, but in a substantial number, they are far from abated. No wonder the odds are so bad—that is, no wonder the programs available in most rehab facilities in most communities fail most of the time.

Longer programs, especially inpatient programs, are prohibitively expensive for most people. But though a meth addict may become well enough in four weeks to understand the need for ongoing care, he or she may not become well enough to follow through on it. Dr. London’s pictures illustrate why programs most likely to be effective would last for many months. It probably takes at least a couple months for a patient to recover enough to engage in treatments in meaningful ways.

The images also suggest cognitive impairments. A blue patch in the medial orbitofrontal cortex is worrisome to London because activity in this area is related to decision-making ability. It is distinctly

blue, with a whitish center. Meanwhile, the posterior cingulate, related to pain and emotion, isn’t activated in the control subjects, but is brightly lit up in the meth users. It is logical that it would be harder to think when parts of the brain related to negative emotion are active.

Family members’ moods become dependent on how the addict is doing. People become obsessed. It’s understandable, but it’s harmful.

And yet cancer patients, for example, would be justifiably disgusted by this. All an addict or alcoholic has to do is stop drinking, stop using! There’s no similar option for cancer.

we must come to terms with the irrationality of this disease. No one who has not confronted it can completely understand the paradoxes. Since most people cannot fathom it, there’s no true understanding, just pity that may come with thinly veiled condescension.

“I’ve studied alcohol, cocaine, methamphetamine, heroin, marijuana and more recently obesity. There’s a pattern in compulsion. I’ve never come across a single person that was addicted that wanted to be addicted. Something has happened in their brains that has led to that process.”

Parents can only be as happy as their unhappiest child, according to an old saw. I’m afraid it’s true.

At Matrix-based programs, addicts are trained to interrupt their normal reactions to anger, disappointment, and other emotions. They are taught about components of addiction such as priming and cueing, which often lead to relapse. Priming (as in priming a pump) is a mechanism that launches a single or incidental drug use into a full-blown relapse.

Rather than responding to priming, an addict can stop the process at a “choice point.” The moment can be viewed as an opportunity to try an alternate activity.

“Don’t accept my promises. I’ll promise anything to get off the hook. But the nature of my illness prevents me from keeping my promises, even though I mean them at the time

want this to stop. I cannot bear it. I wish that I could expunge Nic from my brain. I yearn for a procedure like the one Charlie Kaufman invents in a movie he wrote, Eternal Sunshine of the Spotless Mind. A doctor provides a service for people who suffer from the pain caused by a traumatic relationship.

don’t think I will be so scared to die. I think it’s like today: the end of a vacation when you are ready to go home.”

Dumbledore says to Harry, “Numbing the pain for a while will make it worse when you finally feel it.”

It is still so easy to forget that addiction is not curable. It is a lifelong disease that can go into remission, that is manageable if the one who is stricken does the hard, hard work, but it is incurable.

Fortunately I have a son, my beautiful boy. Unfortunately he is a drug addict.

be enough for him to save himself. A friend whose mother was an alcoholic told me that he spent a decade hoping for a “near miss”—something dramatic enough to bring his mother into treatment for her illness, but not too dramatic—nothing permanently debilitating. The near miss never came.

“Addicts persist in their self-destructive, addictive behavior until something within themselves—something quite apart from anyone else’s efforts—changes so radically that the desire for the high is dulled and ultimately deadened by the desire for a better life.”

do whatever it takes—therapy, Al-Anon, lots of Al-Anon—for you to contain it. And be patient with yourself. Allow yourself to make mistakes.