David Sheff. Clean−Overcoming Addiction and Ending America's Greatest Tragedy. New York: Mariner Books, 2014.

• Published date: 01 June 2016
• DOI: http://doi.org/10.1002/wmh3.180
• Date: 01 June 2016
• Author: Gary R. Potter

Book Review

David Sheff. CleanOvercoming Addiction and Ending America’s Greatest Tragedy.

New York: Mariner Books, 2014.

To claim it as “America’s greatest tragedy” is somewhat hyperbolic (racism,

socioeconomic inequalities, gun violence, and environmental degradation all

spring to mind), but addiction is undoubtedly a signif‌icant problem for

contemporary U.S. society. Of course the problem is not new—the history of the

use of psychoactive substances and the benef‌its and problems associated with

such are as long as the history of humanity (as well as being found in a number

of other species). But epidemic levels of drug use, with increasingly large

numbers of people exhibiting addictive patterns of behavior, does seem to be a

def‌ining feature of our age, particularly (but by no means exclusively) in the

United States. Nearly 50 years of the American-led “War on Drugs” has not

solved this problem, and David Sheff, with Clean, joins a growing chorus of

voices calling for a fundamental change in approach.

Although there are many other aspects to the contemporary drug problem,

Sheff’s focus is specif‌ically on addiction and the way U.S. society responds to

this. His argument, in a nutshell, is that problematic drug use should be dealt

with primarily as a medical problem rather than one of criminal justice—to quote

the opening sentence of the back-cover blurb: “Addiction is a preventable,

treatable disease, not a moral failing.” Criminalizing drug users not only fails to

help but arguably worsens the situation, exacerbating the diff‌iculties of those

struggling with addiction and making it harder for them to engage with

treatment—and also to change their life situations for the better (e.g., with

employment being much harder to f‌ind for those who f‌ind themselves

with criminal records). Sheff argues strongly for the medical model of addiction

to come to the fore in the way we understand and respond to drug use; for

treatment and support to replace punishment and stigma.

A critique of criminalization is presented: not only do current approaches fail

individual addicts, often reinforcing both problematic drug use and associated

anti-social behaviors (such as involvement in other forms of crime), but they also

place a huge strain on the criminal justice system, contributing to overcrowded

World Medical & Health Policy, Vol. 8, No. 2, 2016

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1948-4682 #2016 Policy Studies Organization

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