Philip Seymour Hoffman

The tragic news of actor Philip Seymour Hoffman’s death by apparent heroin overdose, after more than two decades of sobriety, calls attention to the immense challenges faced by those dealing with addiction. We discuss drug addiction, relapse and the most effective methods of treatment, rehabilitation and prevention.

David Sheff, journalist and author of "Clean: Overcoming Addiction and Ending America's Greatest Tragedy" and the memoir "Beautiful Boy: A Father's Journey Through His Son's Addiction"
Keith Humphreys, professor of psychiatry and behavioral sciences at the Stanford School of Medicine and former senior policy adviser at the White House Office of National Drug Control Policy
Vitka Eisen, CEO of Health Right 360, a Bay Area-based group of health programs including Walden House and Haight Ashbury Free Clinics


    The decriminalization of the use of illegal drugs will play big role in fighting addictions ,only then we can treat addicts as patients who could be treated for their addiction as we currently do with other human illness….Another benefit of decriminalizing illegal drugs is to put an end to property crimes and violence and thousands of murders associated with the current so called war on drugs which is a farce.,as well as reduce the ever increasing number of Americans in prisons who were convicted of using drugs.

    • Ehkzu

      The war on drugs was started by the law enforcement establishment when the repeal of the Prohibition Amendment threatened the livelihoods of those in the prison-industrial complex. And it was presented to the public as something blacks did, exploiting American racism as a way to get legislatures to enact laws that produced numerous inmates–because it’s really a manufacturing operation whose product is prisoners.

      • EIDALM

        Please read my above note

    • geraldfnord

      Criminalisation also works to boost potency and binge use—when you can get equal prison terms for 1% THC cannabis and 15% THC cannabis, and the latter can be sold for five times the former (and grown for only twice the cost), you will grow the more powerful stuff, which (departing tremendously as it does from the cannabinoid distribution humans have evolved into the traditional plant) presents new dangers. It’s nothing new: the Temperance movement started by trying to get men to stick to beer over spirits; its descendant Prohibitionists ended up making hard liquor much more popular than it had ever been previously, at least above the lowest levels of society.

      • EIDALM

        I totally agree…Some identity is profiting from the current criminalization of drugs meanwhile the rest of us are hiding our heads in the sand.

    • EIDALM

      Now in the year 2014 we must demand an end to this for the sake of saving human lives and put an wend to prison industrial complex….Treat addicts don’t send them to prisons.


    The U S population is only 5% of the world population ,but Americans consume 60% of total illegal drugs available world wide ….By the way the strongest drug I have ever used is black tea.

  • Ehkzu

    You can’t understand addiction without putting it in the context of human evolution. We evolved to need certain things very strongly–sugar, fat, meat especially–because fruit and animal flesh was hard to obtain, and it took a powerful drive to get us to get what we needed.

    But evolution depends on selective reproduction, and once the substances we needed became abundant, the mechanism disappeared–but the drive remained. And it’s the mainspring of emotional addictions, not just ofovereating junk food, but also to things that didn’t exist in the past, such as alcohol, tobacco, and drugs.

    So what underlies addiction is a perfectly natural and necessary part of our evolutionary past–not a disease. The impulse is neither criminal nor a mental disorder. It’s still bad for us of course. But we should treat it for what it really is: a bad habit with natural origins.

    • geraldfnord

      Well, yes: we can be hacked. Personally, I’m a trans-humanist precisely because I believe the Serengeti Model to be inadequate to task, where the task were ‘live as well and as freely as possible without destroying ourselves’.

  • geraldfnord

    The drugs problem is a problem with our culture: how do you quash recreational and self-medicinal drugs use, and the desire to make huge sums of money selling the drugs, in a culture built on ‘Buy something and you’ll feel better (or at least avoid pain).’ and ‘”Success” mean that you make lots of money.’?

  • Sid Macomber

    Why are they NOT discussing what goes on in these programs: AA and NA indoctrination–a morally hideous practice.
    Any discussion of addiction and addiction treatment without addressing the iatragenic (physician-caused) effects of 12-Step programs is avoiding a big part of the problem.

    • Sid Macomber

      No mention that about 95% of “addiction treatment” is 12-

      • Mrdioji

        Well, I would hope that most treatment programs are recommending the most effective method of long-term treatment…
        Obviously, other methods need to be incorporated as well to help those people that won’t welcome a 12-step program.

  • RS

    Thank you for discussing this topic. My mother became addicted to prescription drugs in the 80’s, when no one talked about it. She was brilliant, beautiful, and talented, so her family and many friends were entirely in denial, leaving my father to wade through it with three young kids alone. She died when I was 15, a loss which still affects us all. I have often wished I had been older so I could have helped. Kudos to your guests and those in the healing community for dealing with such a heartbreaking issue with honesty and courage–that is what my mother needed, and I hope it will be a way out of the hell for those addicted today and in the future.

  • Matt Lawrence

    I know many people who struggle with marijuana dependency. They tell me often that they want to smoke less or quit but they can never shake it. They all have medical marijuana licenses, btw, acquired easily – but their use is almost exclusively recreational. Except they feel bad about their dependency. Any suggestions? Not nearly as bad as heroin, of course, but they are quite unhappy and, well, hooked.

    • Sid Macomber

      Absolutely. It’s a farce what is going on with America’s arms-open acceptance of marijuana, which is indeed very addictive.

  • thucy

    Thank you to the woman caller who correctly diagnosed the origin of the current craze for heroin: spillover from over-prescription of painkillers by the med-industrial complex. RX for painkillers in the US is nuts.

  • AK

    I’m afraid of seeking treatment as it would be on record against legally or for employment reasons me in the future. In this environment of no privacy with the NSA and all the security breaches.

    • AG

      AK- that’s simply not true. If you have a problem with drugs or alcohol, there are resources available that don’t require any information from you — just that you want to get clean. Don’t let your fear get in the way of getting clean and living a life that you can be proud of. I’ve been sober for over 3 years and it was the gift i could ever have given myself.

    • Sid Macomber


      It’s a valid fear.

      Also, what if you relapse, as most people do?

      Many people who are supportive, in a limited way, will not be supportive in the event of a completely normal relapse. Maybe that’s right, maybe that’s wrong. But it happens, so it’s something to worry about. It’s a question of priorities.

      This can also be a concern for people with “normal” mental health issues such as depression and anxiety. Why should they be stigmatized as mentally ill (in the sense of someone who has lost touch with reality), when most mental illness today is lifestyle-induced–induced by modern society, which is hard to escape in modern times?

      However, for most people there should be no problem with seeking treatment.

      Someone may be able to advise you on what you can expect privacy-wise.

      It may be better than you’re assuming.

    • Peter Loeb


      I’m a co-founder at Lionrock Recovery ( We provide addiction treatment online by securely encrypted video conference. You participate from the privacy of home.

      We don’t need to know your real name, unless you want to use your health insurance to pay for treatment. So even if the NSA hacks our video conference (and no one else can!), your name won’t be used.

      We’re HIPAA-compliant, accredited by the Joint Commission*, certified by the state of California. Confidentiality is a key component of all of these quality checks.

      Give us a call if you want to talk about it. No obligation or cost. Our admissions counselors are all in recovery themselves. No one else needs to know.


      *(our Joint Commission listing:

  • Celine

    I relapsed after 25 years sober bt 1979 and 2004. The most important aspect of addressing addiction, in my estimation, is recognizing the legitimacy of the disease. Changing the public’s all-to-often negative/condemning opinion of the addict’s struggle is crucial. Education in our schools would be a good step towards changing the zeitgeist which works to exacerbate the problem. So many of the comments I read in blogs after Hoffnman’s death blamed him and accused him of anything fr stupidity to corrupt morals.

  • Thank you for finally discussing the connection of drug addiction, especially heroin to
    prescription drug over use. When my 18 year old son was automatically given
    vicodin for a wisdom tooth extraction this past summer, we ended up just throwing it away. He did not even need it. The prescribed tylenol was enough. The kids talk about this opiate opportunity as part of the wisdom teeth extraction “experience”. Please,
    doctors, wake up and pay attention.

  • Joe Coughlin

    The ‘deterrent’ is your life blowing up.

  • sirius

    I want to emphasize what was said at the beginning of the discussion. “One size does not fit all”. As someone who has struggled with alcohol, I can say that there are many compassionate treatment programs based in science that do not get their due. Pharmacological treatments such as Naltrexone (which has helped me enormously and changed my life using The Sinclair Method) and Nalmefene (available by the NHS in Scottland) should be something more Doctors are educated about. A program that was started in the 1930’s does not serve many Women and people of color. We need to bring our system up to date and use current tools that can save lives. When one is ready and has access to many different options including what science gives us, it is more possible to find a way out of the hell that addiction can bring.

    • Sid Macomber

      What you say is true. The “target audience” of Bill W.’s AA was go-getter men who DID have big egos. Thus the perceived need to “knock them down a peg” and get them to accept God in their lives. The particular methods that Bill W. and other early AA’s developed to fix that problem owe a lot to a group called “The Oxford Group.” (No relation to the institution of higher learning.)
      The Oxford Group was a cult. As is AA when it says, in effect, “AA is the only way, and if you don’t like it, then go die in a ditch.”
      Very damaging psychologically to those new in recovery.

  • Sid Macomber

    Woman from the panel is clearly very pro-12-Step.

    She does not see how much damage 12-Step does to many, many people.

    A real pity.

    • Clarke

      What do you mean? How does 12-step damage people?

  • Ehkzu

    One side effect of the “war on drugs” has been its extension to a war on people in chronic pain. Doctors are afraid that if they prescribe drugs for people in constant pain, they’ll wind up in a federal prison for decades.

    Consequently many Americans lead lives of agony due to the criminalization of drug use.

  • Sid Macomber

    Funny that the woman panelist is so pro-12-Step, considering that it’s absolutely based on the idea that addiction is a moral issue–which it may well be! That doesn’t mean that 12-Step is the solution, but the 12-Steppers who are 95% of the staff in any recovery program, from Kaiser Hospital to prisons, who get to run your life while you’re in recovery, and to whom a new addict goes for guidance, will absolutely tell a new addict that s/he is a bad person if they don’t like 12-Step, and that they deserve their addiction. This is a fact, and happens every day. The elephant in the room who’s praised for its mildest success, and whose giant plops on the carpet are studiously ignored.

  • ResearchMama

    There is a lot of discussion about treatments, but what causes someone to become addicted? Why do certain people choose to try drugs and other say no? Why do some families have a higher rate of drug addiction than others? What education and intervention is done in early life to prevent these cycles of disfunction?
    I have read that boys whose fathers work long hours, which is very common here in Silicon Valley, are almost guaranteed to become delinquent, drug addicts, or depressed/suicidal. How do we as parents educate ourselves to prevent this before it ever happens? As a mom, I find myself trying to give my children all the love and support I can to counteract the forces working against them. I’m honestly scared – my cousin committed suicide in his 20’s last year after many years of addiction and rehab, and another cousin’s boyfriend just overdosed on heroin. My children didn’t know these people as I have tried to protect them from the disfunction, but knowing the family dynamics worries me. Would Non-Violent Communication and Attachment Parenting stop the dysfunction from being passed on to another generation?

    • geraldfnord

      Ronald Siegel, in his book Intoxication: The Universal Drive for Mind-Altering Substances, recounts an experiment in which rats were given free access to a lever that supplied them with cocaine-laced water.. Rats alone in bare cages with monotonous diets pressed the lever as often as the system’s timed cycle would let them, and quickly learned just how long that period were. Rats given a little rat-paradise—differing terrain, varying food, plenty of other rats with which to fight and/or mate—pressed the lever a couple of times per day.

      Just one experiment, and probably distorted by me in the remembrance and in the telling, but evocative nonetheless. It suggests that at least some people become addicted because the rest of their lives don’t offer enough to them…and being human, rather than rats, one of the things missing may well be the idea that things could get any better. Why avoid pleasure now in exchange for the future when you believe, perhaps with good reason, that you don’t have much of one?

    • Pjones

      Like ResearchMama- I wonder why some become addicted and others do not. (I see gerald’s response below). I have been using limited amounts of codeine or vicodin for almost 40 years when all else fails for my migraines. In the past I had ample supply available- yet I’ve never become addicted nor has my use escalated to ‘harder’ drugs. I also did my fair share of recreational drug use in my late teens and 20s but never became addicted. I smoked cigarettes as a teen and into early 20s but didn’t become addicted to nicotine. I have to believe that some people are born with a predilection to addictions (?)

  • jurgispilis

    What efforts are being made to slow the influx of drugs through our southern border? I fear the border is operated and controlled by the cartels and not by the ICE at all.

  • AB

    I think something I struggle with, not being an addict, and not being around any addicts,or knowing any, is that I want to remain empathetic, but I struggle with the idea of tax payers paying for the treatment of people who choose to enter the world of addiction. This idea of “choosing” addiction becomes more clear around prescription drugs that hook a user into addiction with what sounds like not a lot of choice. But with callers on the show like Kyle who call in sharing his story of smoking with his wife every day; it sounds selfish, it sounds dangerous and god forbid they get in a car and kill someone while using… why should I pay for that? There are a lot of people hurt by addicts, who act selfishly; why aren’t we asking them to pay back the cost of their treatment… A lot of questions, but I am looking for that one thing that can help me better understand and be more empathetic…

    • geraldfnord

      Part of the reason you should have some sympathy with people who have badly hurt their lives doing drugs is that they started-off much like you, and saw many people do these drugs without the terrible consequences of which you rightly write. Typically, no more than one-tenth of initial users of any drug become addicts—cigarettes only achieved their dominance only with enormous social pressure toward smoking, and many people found they could quit without the very real difficulty the residual addicts face.

      That is to say, as with poverty, there is a trap in the extent to which many people seem to think that addiction were a condition to which they were somehow constitutionally immune or have avoided solely by their own efforts or sheer inherent goodness, and so brook no sympathy with those obviously defective or deficient sorts who suffer from it.

      • AB

        I respect your framing of the issue. And you do highlight issues of poverty, etc, which are certainly relevant. I do think it is hard to put myself in the shoes of someone who is addicted and to see that in the end it is the addict that suffers the most… but it is a good reminder when discussing the issue . No one can deny the cost to everyone when addiction is as rampant as it is, I am learning that looking for someone to blame may not be the right course of action when trying to solve the problem.

    • Peter Loeb

      Dear AB,

      As a family member of people struggling with addiction, this idea of “choosing” long haunted me too. Over the years, I’ve learned a lot about the nature of addiction, so much so that I co-founded an online addiction treatment program, Lionrock Recovery, that provides treatment by secure video conference and smartphone application. A couple weeks ago, I tried to gather what I’ve learned to address your exact concern, because a lot of people have it. If you get the chance, please read about it here:



  • MattCA12

    I realize that opiate painkillers are being abused in this state. However, there are people out there who need them to live pain-free, are able to function in society perfectly well, and, most importantly, are under the care of a physician. My own relative lives with a chronic nerve condition, and has taken a low-dose narcotic pill 2-3 times a day for 10 years without any problems. These medications can be life-saving in terms of quality of life for chronic pain sufferers, and as long as they are taken under the care of a doctor, they should not be stigmatized.

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