PBS高端访谈:战胜毒瘾 结束美国最大的悲剧

 　　JEFFREY BROWN: And finally tonight, a new book argues that blaming addicts 1 for their addictions 3 could hurt people's chances for getting clean.

　　Judy Woodruff has our conversation.
　　JUDY WOODRUFF: Drug abuse and substance addiction 2 costs the United States nearly $600 billion dollars a year. They kill at least 320 Americans a day. And 90 percent of addicts start using drugs or alcohol before the age of 18.
　　That is despite a long battle launched by President Richard Nixon more than 40 years ago and decades of subsequent efforts and numerous programs to tackle the problem.
　　In a new book, writer and journalist David Sheff argues that many of our failed efforts stem from the wrong approaches and a misunderstanding of the disease. His book "Clean: Overcoming Addiction and Ending America's Greatest Tragedy" is a follow-up to his bestselling memoir 4, "Beautiful Boy," which documented his own son's struggle with addiction to heroin 5 and crystal meth.
　　David Sheff, welcome.
　　DAVID SHEFF, "Clean: Overcoming Addiction and Ending America's Greatest Tragedy": Well, thank you, Judy.
　　JUDY WOODRUFF: So you did write this earlier book about your son. Why the second book?
　　DAVID SHEFF: Well, the—when my son became addicted 6, we were blindsided.
　　And we thought—it was such a horrible, horrible experience. My son was dying. He was on the streets. This was this great kid who every parent can relate to. He was this great student, this athlete. And suddenly he wasn't only smoking some pot, which is pretty common, and having—drinking, but before I knew it, he was shooting crystal meth.
　　He was on the streets. He was breaking into our house. So, something had happened, and it was baffling. We had no idea what to do. And we tried to get help. And it took us 10 years how to figure out how to help someone with this problem. And I realized the system was a mess.
　　JUDY WOODRUFF: You say in the book that one in every 12 Americans over the age of 12 is addicted. That is astonishing.
　　And yet we're not hearing about drug addiction that much anymore. And you say the approach that this country is taking is all wrong. Explain.
　　DAVID SHEFF: It is all wrong.
　　Part of the reason—and you're right—we don't talk about it and we don't acknowledge it, and part of the reason is because people with this disease are judged and they're blamed, and it's seen as a moral failing. It's seen as a choice.
　　If you're having problems in your life because you're using drugs or you're drinking, stop. Well, people who are addicted would stop if they could. So they hide. And there's this enormous shame and this guilt 7 and this blame around this problem, which doesn't exist with any other disease.
　　So, we don't talk about it. And, in the meantime, there are 20 million Americans who are addicted and 100 million family members. And part of the reason is that we look at this, and as a culture and as a society, we treat if it's as a criminal problem, as if it's a problem about morals.
　　And there's a stigma 8 around it. But, in fact, this is a health problem, and it's a health crisis.
　　JUDY WOODRUFF: You go on and you talk about the approach that's needed, that it needs to be a much more evidence-based approach. And yet so much of what we're familiar with is programs like AA, Alcoholics 9 Anonymous 10, Narcotics 11 Anonymous.
　　And yet you say those programs help some addicts, but they don't help many others.
　　DAVID SHEFF: One of the big problems with the treatment system is not that AA is available and that it's prevalent. It saves the lives of many people.
　　One of my dearest friends is alive only because of AA. But it doesn't help a lot of people. And everyone is different, and everyone needs different kinds of treatments. And so what happens now is since most of the rehabs in America are based on this one paradigm 12, people go into treatment, it doesn't work for them. They are blamed for it. They're kicked out. They go back and they relapse.
　　They think—they have this—it's a self-fulfilling prophecy. They're not going to get well. They feel like they're not going to get well. They won't get treated. They use more drugs, and it's a cycle that ends up killing 13, as you said, 320 people a day.
　　JUDY WOODRUFF: You do make a point—and you just said it again a couple of times—that addiction is not a moral failing or a shortcoming.
　　There are reviewers of your book who say that you—that there should be some weight put on this argument that people make a choice. When they first go, turn to drugs, turn to alcohol, they're making that choice, and, therefore, they bear some responsibility for what's happened.
　　DAVID SHEFF: I totally get that.
　　The problem with that is think about 10 kids who go out after school and they go to the playground, or wherever they go, and they all smoke a joint 14. One of those kids is going to become addicted. So all of those kids made that choice. That one kid didn't make the choice to become addicted.
　　The reason that he becomes addicted is because his brain is different. His neurological system is different. It responds to drugs. It doesn't process them the same as everybody else. So that's not a choice. And it's—and that's the problem, is that we look at it—many of us look at it as a choice, and, therefore, we blame people for becoming addicted, and we blame them when they don't get well.
　　JUDY WOODRUFF: What do you say to individuals who have an addiction problem or their loved ones, their family members who—while we're waiting for the system to get better to treat them, what do they do now? Where do they turn?
　　DAVID SHEFF: Well, it's hard.
　　And, first of all, the first thing I tell people that are going through this is to get support. Just ...
　　JUDY WOODRUFF: Where?
　　DAVID SHEFF: Well, if you're a parent, there are—there is a 12-step organization, Al-Anon.
　　Also, there's therapy. I—my wife and I were in therapy, family therapy. We wouldn't have survived it. But if you need treatment for somebody, because the system is in such disarray 15, the one place to start is, if you had cancer, if you had heart disease, you know where to start. You go to a doctor.
　　Well, you need to go to a doctor here. And there are doctors who are trained in addiction medication -- in addiction medicine. That's where you have to go. There's a listing on the Web at the American Society of Addiction Medicine. That's where you go. You get assessed. Find out, is there a problem, how serious is the problem, what to do about it.
　　JUDY WOODRUFF: Call a doctor, go to the Web, get information, get help.
　　DAVID SHEFF: That's right.
　　JUDY WOODRUFF: Reach out.
　　DAVID SHEFF: Yes. It's a disease.
　　It's what you would do—once we understand that this is a disease, it's a brain disease, then we have a—we know what to do. When you're sick, you call the doctor.
　　JUDY WOODRUFF: David Sheff, author of the book "Clean: Overcoming Addiction and Ending America's Greatest Tragedy," thank you.
　　DAVID SHEFF: Judy, well, thank you very much.