Addict’s Father, Now Advocate

“Beautiful Boy” was a page turner, a dark fable that spoke to worried parents everywhere. “Clean” is a reference work and a manifesto, an annotated map of the same frightening territory where dragons still lurk at the edges.

In “Clean,” Mr. Sheff changes perspective, writing as advocate and journalist rather than distraught father. Still, his story line recreates that of “Beautiful Boy,” tracing the trajectory of addiction from cradle to rehab and beyond with the same question in mind: How does a promising cleareyed kid from a good family wind up in an inconceivable sea of trouble?

His answer, bludgeoned home with the repetitive eloquence of the missionary, is entirely straightforward: The child is ill. Addiction must be considered a disease, as devoid of moral overtones as diabetes or coronary artery disease, just as amenable as they are to scientific analysis, and just as treatable with data-supported interventions, not hope, prayer or hocus-pocus.

This perspective is easy enough to articulate but very difficult to sustain — hence Mr. Sheff’s determined reiterations. The symptoms of this particular relapsing illness, after all, include deceit, denial and the betrayal of near and dear. Cardiac patients stop to rest halfway up a flight of stairs not because they want to, but because they have to. Similarly, addicts lie and steal, over and over again, not because they want to but because they must.

Wrapping the mind around this formulation requires an enormous act of will, and it is Mr. Sheff’s foremost achievement that his arguments are likely to influence even the angriest and most judgmental reader.