Not By Choice, But By Genetic Chance: A Dread Disease


Beautiful Boy


It was a stunning community event. Sam Quinones, the author of Dreamland, which focuses, largely, on the devastation the opioid epidemic had on Portsmouth, Ohio, a community not so far from here, was speaking at the city’s auditorium. He had spent a day talking–talking to doctors and parents and residential care workers, to case workers and students, to everyone and anyone connected with the seeping stain that black tar heroin is painting in southern and central Ohio.

Now he addressed a crowd that almost filled the auditorium, which seats, without irony, 1,776. His talk was moving and compelling, and a panel of people whose lives were directly and irrevocably tied to opioids followed him. Theirs were the stories that hushed the crowd, that brought tears and anguished questions.

There was a mother who knows her son is safe now: he’s in prison. There was a pastor who has made fighting addiction and poverty his twin missions. There was a man who runs residential homes for recovering addicts. And there were four addicts in recovery who stood and told their stories:

Didn’t ever intend to get hooked, but couldn’t help it. Had to have it. Bad company. Started stealing–from stores and  public places, then from friends, and then finally, from family. Relationships cracked and shattered; the kids, taken away. The legal system. Jail time. Rehab and relapse. Trying again and again.

The loss of trust. It was a theme each of them spoke to. Some, further away from the addiction’s hold, were loudly encouraging. “It’s hard! But it can be done! Don’t give up hope!”

Others, still fragile, talked about the future:

“I love my parents. I hope they can trust me again one day.” 

“In a year, I’ll still be clean, and I hope to get my children back.

Their messages were like prayers written on scraps of prayer and flung into the wind: let this be true. Let this be true.

In the aftermath of this event, in a community where the problem races, I went looking for things to read and found David Sheff’s beautiful boy (2008, Houghton Mifflin.)

Sheff writes about his son, Nicolas, a child of his first marriage. Nic is a bright, creative spirit. Nic, without his father’s knowledge, gets drunk for the first time at age 11–on a family vacation, during a wholesome outdoorsy family time, with a friend they’d brought along so the boy wouldn’t be bored. Nic slides into other experimentation, and winds up firmly and defiantly addicted to methamphetamine and heroin.

Sheff details what a child’s addiction does to a family, and what it does to a parent. He dissects all of his failings–his immaturity during his first marriage; the times he brought strange women home when Nic was a tiny child–women the boy would never see again. The fighting.

Sheff remarried, to a a woman who cared deeply about Nic; the new family produced a boy and a girl, little people whom Nic, the book tells us, adores. He told his little siblings stories–they had a whole imaginary world that they explored together. He took them to playgrounds; he was a protector and a confidante.

And he stole eight dollars from his little brother’s piggy bank when he was desperate to score.

Sheff’s is a story of anguish and desperate hope: the rehab program that promises a way out. The call that his boy has checked out, disappeared, given up. Nic’s resurfacing, in a dingy apartment, with a girlfriend who uses, too. Sheff writes about going to see his son who can barely rouse himself to answer the door. He writes about standing in the doorway of the apartment and not entering. The floor, he writes, was covered in some kind of brown liquid.

Another rehab, a surge of hope, a year of sobriety. A relapse, and despair. The cycle repeats often enough that Sheff’s family gives up, and Sheff finds himself on the brink of that tough love pronouncement: You’re on your own. I just can’t do this anymore.

But he and Nic’s mother decide to try one more intervention. They get Nic into a different program in a different place. This one seems to work. The book ends with Nic’s recovery.

I look Nic up to see if he is still okay, and I find that he himself has written two books about his addiction, and that he and his dad are on the lecture circuit, talking about the addiction, what it does to people, what it does to families. It’s a relief to see he’s doing well.

David and Nic Sheff

Because a man I know, a social worker who works with recovering addicts says that relapse is part of this illness. And addiction IS an illness, he stresses. Maybe, yes, the addict did make that first choice–chose to smoke it or pop it or shoot it into a vein–for whatever reason: loneliness, desperation, acceptance, daring. But after that, says this man, biology kicks in. This was not the person to experiment: this person had an addict’s genes.

Like mental illness–with which it often cohabits–addiction is a disease with unsavory and odd behaviors attached, and so, instead of sympathy and help, society often offers judgement and condemnation. It’s hard not to react bitterly when someone you trust steals from you. Or threatens–and sometimes follows through–to hurt you.

I think of all the programs Sheff tried to get his boy into, and of his reluctant acquiescence to therapy for himself and his wife.  I think of the people on the stage, passionately sharing, after Quinones spoke. And I think this is an illness, a problem, an epidemic, that people cannot handle themselves. Addicts cannot tough it out to personal recovery, and families cannot hide their woe.

It’s takes a village: that’s Quinones’ message. If I had to boil Sheff’s message down, I would say it is this: Don’t give up hope, But get help, get help, get help.


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