Dealing With Addiction

Wednesday, February 05, 2014

Memorial outside of Philip Seymour Hoffman's apartment in the West Village. Memorial outside of Philip Seymour Hoffman's apartment in the West Village. (Stephen Nessen/WNYC)

Phillip Seymour Hoffman struggled with drug and alcohol abuse at the age of 22, then relapsed 23 years later, dying of a heroin overdose this past Sunday. Carrie Wilkens, clinical director of the Center for Motivation and Change and the co-author of Beyond Addiction: How Science and Kindness Help People Change helps lead a discussion about addiction, support, and treatment. If you've struggled with addiction, or have a loved one who has, what lessons can we draw from Hoffman's death? Call 212-433-9692...


Carrie Wilkens

Comments [54]

TheCMC from New York


In response to your question, there is no simple answer. I would refer you to Anne Fletcher's excellent book, Inside Rehab, which discusses different treatment options, who would benefit from different treatments, why rehab is often not an appropriate first-line treatment for people, and what questions to ask of any treatment program. You can find her book at

Feb. 05 2014 03:16 PM

@ Tamar Maccallan-finkelman:

The book "Beyond Addiction" talks about addictive disorders and compulsive behaviors. The principles and strategies in this book apply to any kind of compulsive behavior problem, from drugs and alcohol to binge eating, shopping, gambling, and Internet pornography. Take a look at an excerpt:

Feb. 05 2014 02:07 PM
Gio from Gowanus

The kindness aspect is something I need to embrace and as soon as I heard it I texted my family member currently in rehab to ask how she was feeling. Thank you.

Feb. 05 2014 12:56 PM
John A.

Note now much of the discussion here is diverging from a solution. My observation of many other discussions of addiction, at other websites, as well. Oftentimes the way to a solution is to get off of such websites.
It could be this simple:
The web is just an escape for people who can't face reality.
Google 'suicide tumblr', get 60 million hits. Not converging on a solution.

Feb. 05 2014 12:55 PM
Mr. Bad from NYC

@ Elsie from Brooklyn

Wow, you "speak out on behalf of those people"? Are you serious or just running scared? "Projecting"? You can do better than that. This is an internet message board where people communicate to each other, you aren't "speaking out" and if you are it's on your behalf and nobody else. That sort of grandiosity and borderline psychotic utterances like "People who abandon addicts do not kill addicts. Addicts kill themselves." are self serving and transparently false. You're basically saying that messed up people are either born broken (mentally ill) or broke themselves. In the latter case that is no doubt soothing to your conscience and I encourage you to keep living that "truth". It must be hard to live any other way but for myself and most people it's better to have some basic human empathy and take responsibility rather than emulate the pristine conscience of a psychopath. Good luck with that, too.

Feb. 05 2014 12:36 PM
Amy from Manhattan

Shame is part of the problem. As long as addicts feel they have to hide their addiction, it will be extremely hard for them to accept help. The more this issue is out in the open, the more chance there is that addicts will get into rehab or similar programs.

I'm glad there's more discussion of opiate (& other) addiction--it may be the only good thing to come out of Mr. Hoffman's death. But why does it so often take the death of a famous person to get anything to happen?

Feb. 05 2014 12:13 PM
Elsie from Brooklyn

Mr. Bad - nice use of projection (another common characteristic of addicts).

Look, I don't know what your beef is here. Nothing I wrote in my previous posts were hostile - and yet you saw fit to attack me (another characteristic of addicts). Yet you claim you're not an addict, so what gives? I can't imagine why you are posting at all, in that case.

I'm posting because it's important to me that people who have suffered from the abuse of addicts start speaking up. There are plenty of people out there trying to help addicts, but very few who are trying to help those damaged by addicts - I speak out on behalf of those people. I'm not sure who you're speaking out on behalf of, or why you saw fit to start this personal attack against me just because I wrote about the inadequacies of 12 step programs - inadequacies that you seem to agree with. So what's up? Just a lot of free time?

I've got to get on with my day, so I'll let you continue the conversation on your own. Good luck with that.

Feb. 05 2014 11:59 AM
62express from New York

War on drugs is a farce - as they claim to help addicts on one end they are importing and supplying drugs on the other... it's a big money-maker and no business reason for them to stop what they are doing. Research these claims if in doubt.

Feb. 05 2014 11:57 AM
62express from New York

dboy - thank you for the stats. You forgot to mention who is the largest importer of illegal drugs to the US. I find it interesting how the popularity and potency of heroin has increased since the US invaded Afghanistan...

Feb. 05 2014 11:48 AM
Mr. Bad from NYC

@ Elsie from Brooklyn

I agree, 12 steps looks like a cult to me which is why I never considered it as an option. You're the one who has spent a "lifetime" in 12 step programs and it has obviously informed your thinking. You are permanently scarred, no doubt, but it is more likely by the knowledge that you're partly or wholly responsible for the emotional or physical damage visited upon this mysterious "person" in your life. I've been around a lot of self destructive people and you can predict with 100% certainty who is going to turn into a full blown hard case and who isn't once you've met their family.

Feb. 05 2014 11:46 AM
Elsie from Brooklyn

Ha ha. Oh the old "You're angry and bitter" argument. That's a 12 step favorite. Funny you go to meetings, you use the same anger and attack methods used by addicts when confronted by people who question the 12 step cult, but you yourself are not an addict? Hmmm. If it looks like a duck, walks like a duck, sounds like a duck…...

Feb. 05 2014 11:39 AM

Why use heroin to begin with?

It may be as simple as curiosity. A single thought that won't go away. "I wonder what it feels like to..." You can fill in the blank. Most people are content to wonder and leave it at that. Perhaps the soon-to-be addict is simply compelled to find out regardless of the risks.
The question is, why?

If you believe in "addiction" as a physical condition, you can explain
all the subsequent behavior to the first use. But the idea of addiction
doesn't explain that first use.

Feb. 05 2014 11:38 AM
Mr. Bad from NYC

@ Elsie from Brooklyn

Son or daughter? You should watch Atom Egoyan's classic "The Sweet Hereafter", a terrific performance by Ian Holm in a role you can undoubtedly relate to.

Feb. 05 2014 11:37 AM
Mr. Bad from NYC

@ Elsie from Brooklyn

What? I have never been except to accompany friends at their request. You're the one who has "spent a lifetime around addicts". Please tell us more. If people want to use a 12 step program and it works, good for them, I'm not defending it just pointing out that by merely substituting "science" for "faith" you're still making the same argument for the disease model and that puts you in the same 12 step mold. You can't counsel someone with a horrible life into "health", you can't prescribe a pill that will "fix" a terrible, empty existence. Doesn't work. You're just embittered and angry (obviously) and defensive about your clear lack of empathy deep seated guilt.

Feb. 05 2014 11:33 AM
Elsie from Brooklyn

If you needed further proof of the type of "emotionally stable" people that 12 step programs churn out, please see Mr. Bad's comments below.

Feb. 05 2014 11:27 AM
Mr. Bad from NYC

@ Elsie from Brooklyn

ROFL, you're obviously a confirmed 12 stepper social clubber... everybody is in denial, everybody is a hypocrite except YOU, right? At least most of the hard luck losers I've known knew better than to toss around "the truth" as if they alone had a pure, personal knowledge of it.

Feb. 05 2014 11:24 AM
elsie from Brooklyn

To Peg et al

People who abandon addicts do not kill addicts. Addicts kill themselves. To blame the loved ones for being unable to live with the constant lying, manipulation and abuse handed out by addicts is to blame the victim. And people who have had to deal with addicts on an intimate level are victims. Period.

Addicts either get clean or they die. That's the reality. You can blame other people all you want, but that is what addicts normally do - blame other people for their issues. This attitude helps no one get clean or stay alive. And it certainly doesn't help the loved ones of addicts who are so often permanently scarred by having an addict in their life.

Feb. 05 2014 11:23 AM

To Whatwhat and everyone:

I know 3 people who took suicidal overdoses because their families deserted them with the "tough love" theory. Don't desert your addicted friends and family members. They NEED your support, unconditional love and attention.

Feb. 05 2014 11:18 AM
Elsie from Brooklyn

This constant refrain of "shaming" addicts, is actually a key sign of being an addict. This argument is what addicts use against people who call out the addict for being an addict. People who have to deal with addicts on an intimate level need to understand that this is nothing more than standard addict manipulation to avoid the truth. Gaslighting anyone who speaks the truth is a key part of most addicts' personalities.

Feb. 05 2014 11:13 AM

To Jay

After the show is over, go to Click on "Shows," scroll to Brian Lehrer show and then you'll be able to choose whatever show/segment you want to listen to again.

Feb. 05 2014 11:11 AM

This guest was part of the problem. Although she correctly pointed out the need for kindness and the harm caused by shame, her sense of superiority to drug users, veiled but potent, was emblematic of shaming.

And that is to be expected from any and all drug rehab personnel, because their economic success requires a constant stream of drug users coming in for treatment, a profound conflict of interest, similar to that of law enforcement, which should not be allowed to pass unchallenged in any serious discussion.

Contrary to the guest’s basic tenet, the use of hard drugs is not the same as the abuse of hard drugs. And Brian Lehrer seems to share her bias. Why else, when she airily dismissed the very thought that anyone could benefit from any heroin use, wasn’t she reminded that today is the centennial of Wm S. Burroughs, whom many New Yorkers knew personally as a fine and productive gentleman? As were many other writers using heroin, etc, not to mention the pantheon of jazz greats.

Legalization, with honest education and the clearing out of all institutional players benefitting economically from the demonization of drug use, is the only rational way forward to cure drug abuse and to best reduce the pain and harm being caused to so many people by the ongoing, half-century-long law enforcement / rehab crusade.

Feb. 05 2014 11:07 AM
Mr. Bad from NYC

Feb. 05 2014 11:04 AM
Jay from Brooklyn

Dear John Aallain,
Thanks for your help. OK so I will just wait for it to show up and in the meantime get so damn work done !! :-) Have a good one to you and to all..

Feb. 05 2014 11:03 AM
Peter from Newark

I continue to find the paternalism of drug policy and debate frustrating. Mr. Hoffman's death should not have sparked a debate about addiction, this is a perfect example of government intervention aimed at "helping" others leading to their deaths. If people want access to opiates they are forced to either pay a high price for regulated (safe) opiates or a low price for unregulated heroin. Let people do what they want, allow them to use a product that wont kill them if they need that product. If drug users wish to quit, then the exploding rehabilitation industry should be well adapted to help. However, forcing people who use drugs into rehab programs is more likely to enrich a few skilled motivational speakers while robbing adults of their dignity and freedom. Would it be considered acceptable to send obese people to boot camp against their free will? People don't become obese from simply overeating a little, it is because they seek the high from excessive food consumption. Hamburgers, and subsequent cardiovascular disease kill many many more people than heroin. Just because drug users choose a poppy flower over a beef patty doesn't mean they are morally different. In Newark, people are marginalized and treated as if they are immoral or weak because they choose to use drugs. The solution is to compete with these drugs as Carrie mentioned briefly, but didn't elaborate on. The difficulty with this is that $5 for hours of entertainment is significantly cheaper than going to a movie nowadays. Making our communities more enticing and entertaining is a noble cause that will not only help lower drug use (through competition) but make the U.S. more competitive.

Feb. 05 2014 11:00 AM
Morty Sklar from Jackson Heights, Queens

My last shot of heroin was November 3rd, 1966. I'm clean since. I'd attempted to quit at least six times previously, and only succeeded when I became involved in a program that came to be known as Phoenix House, named after a newsletter that another resident and I started in March, 1967 titled The Phoenix. What helped me and others was the therapeutic community concept there, where you lived, worked and interacted with other residents, all helping one-another as well as being helped and guided by a staff of ex-addicts. Changing ourselves is what made the difference, rather than just ridding our bodies of the heroin. My own personal change had to do with learning to live and relate to people. I'd always been a loner and avoided social contact except for a couple of friends. I didn't begin using heroin until I was twenty-four, and quit seven years later.

Feb. 05 2014 10:57 AM

Amount spent annually in the U.S. on the war on drugs: More than $51,000,000,000

Number of people arrested in 2012 in the U.S. on nonviolent drug charges: 1.55 million

Number of people arrested for a marijuana law violation in 2012: 749,825

Number of those charged with marijuana law violations who were arrested for possession only: 658,231 (88 percent)

Number of Americans incarcerated in 2012 in federal, state and local prisons and jails: 2,228,400 or 1 in every 108 adults, the highest incarceration rate in the world

Proportion of people incarcerated for a drug offense in state prison that are black or Hispanic, although these groups use and sell drugs at similar rates as whites: 61 percent

Number of states that allow the medical use of marijuana: 20 + District of Columbia

Estimated annual revenue that California would raise if it taxed and regulated the sale of marijuana: $1,400,000,000

Number of people killed in Mexico's drug war since 2006: 70,000+

Number of students who have lost federal financial aid eligibility because of a drug conviction: 200,000+

Number of people in the U.S. that died from a drug overdose in 2010: 38,329

Tax revenue that drug legalization would yield annually, if currently-illegal drugs were taxed at rates comparable to those on alcohol and tobacco: $46.7 billion

The Centers for Disease Control and Prevention found that syringe access programs lower HIV incidence among people who inject drugs by: 80 percent

One-third of all AIDS cases in the U.S. have been caused by syringe sharing: 354,000 people

U.S. federal government support for syringe access programs: $0.00, thanks to a federal ban reinstated by Congress in 2011 that prohibits any federal assistance for them

The "War" On Drugs - MORONIC!!

Feb. 05 2014 10:52 AM
John Aallain

Jay from Brooklyn,
A download link should appear when you refresh this page sometime before an hour from now. It takes then a little bit to digitize the show.

Feb. 05 2014 10:45 AM

Even the diminished realize.

AP IMPACT: After 40 years, $1 trillion, US War on Drugs has failed to meet any of its goals

Feb. 05 2014 10:44 AM

Addiction is such a complex issue that a 30 minute segment only skims the surface of the subject. I have fought alcohol abuse my entire life. I have been in recovery now for 14 months--the longest period of sobriety in my life since I was probably sixteen. My personal feeling about the disease is that the best treatment includes, inpatient rehabilitation, intensive outpatient care, private counseling, participation in group discussions, whether they are AA, Safe Recovery, NA, or SOS, and loving and supportive family and friends. Scientific research that is comparable to the work being undertaken to identify the root causes of cancer, diabetes and other diseases should also be part of the effort to help individuals attain long term recovery.

Feb. 05 2014 10:44 AM

War on drugs a trillion-dollar failure:

Feb. 05 2014 10:41 AM
Mr. Bad from NYC

I think this woman is on the right track. I enjoyed "hard" drugs casually for many, many years and then stopped when I developed a medical condition (unrelated) that would have made it dangerous to continue to use them. I did experience some problems breaking the habits but it took less than a month and never again after that. That says nothing about me, my character or "will". It's simply a cost benefit analysis that takes place subconsciously in the mind of any person who uses drugs. Most of the real hard luck "addicts" including people who I've known to use drugs in a self destructive way have other far more serious emotional issues underlying their "addiction", usually some sort of abuse and estrangement from family. No drug, no matter how great it makes your feel (and I have done them all) surpasses the love and affection of family/friends, success in chosen profession, etc. If your life is screwed in some serious way drug and those great things are absent or never existed addiction is a choice that is made and I believe it is a perfectly moral one. I wouldn't deny someone their poison, it's cruel and shows a distinct lack of basic humanity, a pseudo-morality designed to relieve the guilt and fear of others not improve the life of the drug user.

Feb. 05 2014 10:39 AM
KO from New York, NY

I absolutely agree with Elsie from Brooklyn. As a long-time member of Al-anon, I have definitely experienced what she/he describes. As the child of an alcoholic and ex-fiance of one, I have seen firsthand the havoc and devastation that addicts' behavior causes. I "worked" my own Al-anon program, was suportive the addict, but in the end I had to cut them off to save myself. Addicts are the best liars and fool even professional caregivers, addiction specialists, doctors, etc. WIth the recidivism rate so high, I wonder, is there truly any hope for the majority of addicts.

Feb. 05 2014 10:36 AM

The addicted need help, NOT jail!

Legalize ALL of it. Remove the profit from illegal trafficking, reduce or eliminate the violence. Take the BILLIONS spent on the RIDICULOUS "War" On Drugs™, The Incarceration/Industrial Komplex® and INVEST in education and MENTAL health!!!

The net result is a huge savings of lives and $$$!!!

There is ZERO collation between legalized drugs and rates of addiction. ZERO. The same percentage of the population remain addicts either way.

Feb. 05 2014 10:36 AM
Jamie from NYC

As suggested by callers and Ms. Wilkens, I request a segment on harm reduction as well as one on a recently introduced Naloxone bill (Naloxone is the drug that can reverse an opiate overdose)
This is a hot topic and I'm sure your listeners would appreciate more information and examination of the issue.

Feb. 05 2014 10:35 AM
Jay from Brooklyn

I came in late listening to this show but I want to listen from the beginning. I'm trying to figure out how but this is my first time trying. Can someone point me in the right direction? Thanks!

Feb. 05 2014 10:32 AM
John A

as to the top-line headline that oxycodone is the gateway drug to 'skyrocketing' heroin use...
Giant frown to the FDA for approving the mainstream use of oxycodone. I was prescripted it and noticed it's danger almost immediately, by day 3. It's a sledgehammer, and, yes addictive.

Feb. 05 2014 10:26 AM
anon from Brooklyn

I think a lot of friends and family want to be helpful to our loved ones that are in recovery, but constantly reassuring what feels like selfish behavior... not the addiction, but the constant need to reassure them of your friendship and being there at all the mini-crisis is exhausting. How can you talk to a loved one about this without making them feel like you are not being supportive.

Feb. 05 2014 10:21 AM
Brianne from Brooklyn

How can you help a relative who lives far away?

Feb. 05 2014 10:21 AM
Elsie from Brooklyn

I have spent my life around addicts - alcoholics, heroin addicts, crack addicts, sex addicts, you name it. I have also spent much of my life in and out of 12 step programs that were supposedly for people who have to deal with addicts. In my experience, the denial fostered by 12 step programs (sit in a circle and ask your Higher Power to take over) has been a large part of the problem. The 12 step program shuns science of any kind, favoring the idea that addiction is a spiritual "disease". For what disease would sitting in a circle and asking your Higher Power to step in be an acceptable cure? Would we recommend cancer patients sit in a circle and talk about God? If addiction is a disease, then they need real medical attention, period. Many of the people in these 12 step programs are using to hide larger mental illness problems; notably, borderline personality disorder, bi-polar, etc. 12 step programs ignore these mental illnesses and tell people they are sober if they are not using. This is not sobriety - people need serious counseling as to what got them using in the first place. And in the case of mental illness, they also may need medication which the 12 step program shuns entirely. Finally, the reality: AA has a 95% recidivism rate. This fact is kept under wraps for obvious reasons. AA alone does not work.

Here's the truth of the situation: Until we accept that the American way of life creates addicts, we will continue to fight an uphill battle with addiction. Our society is addictive - we like addicts. They are exciting - especially when they're hitting bottom. Addicts take risks, and American society values these types of people. If you're someone with low self esteem (a considerable portion of Americans), then you're ripe for addiction. Until we deal with this fact, nothing will change. And as inequality increases in our society, so too will addiction.

Feb. 05 2014 10:18 AM
MRG from Manhattan

I grew up in the midwest, in an affluent community and school. My older brother died of heroin and alcohol-related illness. This so-called epidemic shines a light on how the denial that takes place in America about the source of drugs and who is using always spotlights the working class and poor neighborhoods, when in reality, if drugs are going to be curtailed, especially among youth, then the wealthy areas need to experience stop and frisk as equally as poor.

Feb. 05 2014 10:15 AM
Tamar Maccallan-finkelman

I am curious about if this book talks solely about substance abuse, or other types of addiction, too. There are so many other types of addiction, as well, these days, like sex, porn, gambling or eating. Is that a different problem, or are they really the same skills that the families and addicts should use?

Feb. 05 2014 10:15 AM
ann from NYC

you make it sound easy to help. well, it isn't. because i feel i'm "enabling" i've completely cut off my sister. I feel [crappy] but after years of effort, i stopped trying.

Feb. 05 2014 10:14 AM

it all comes down to the addict

Feb. 05 2014 10:13 AM
Liz from Manhattan

For insight into the struggle of staying sober, I highly recommend Russell Brand's piece in The Guardian:

He's been clean for 10 years, and he writes, "The last time I thought about taking heroin was yesterday"

Feb. 05 2014 10:12 AM from Pelham Bay

Just leave them do it. If they want to cut themselves, let them cut. Go out for drugs on their money, so they do it. Eventually, they will either seek treatment or die. If someone is cutting him/her self in your place, bleeding on your furniture...hide or toss the knives or buy sliced meat.

Feb. 05 2014 10:12 AM
Dennis from West Village

PSH was a good man. He helped a lot of people with their recovery. He raised his hand after winning an oscar and offered to help the next addict.
This is all extremely sad.

Feb. 05 2014 10:12 AM
Laurie from Princeton

My husband died in 2008 of an overdose of prescription and other drugs. He had been in and out of rehab and counseling. He hid his relapse. I found him dead. I have not recovered yet; but addicts don't base their decisions on what will happen to their loved ones. I don't think any amount of "kindness" can help someone who doesn't want to be helped.

Feb. 05 2014 10:12 AM

We work with clients struggling with addiction, as well as their families.

Can the guest speak about the science of who may benefit from outpatient treatment vs. inpatient (residential rehab programs) and when families/clients/clinicians should consider inpatient treatment?

J. Ryan Fuller, Ph.D.
Clinical Director
New York Behavioral Health

Feb. 05 2014 10:11 AM
Rachel from upper west side

The first woman who called may need some reassurance that, even though she could have said something to her brother, she is not the cause of her death. Is she getting help in dealing with the aftermath of his addiction and death? Does kindness extend to friends and family left behind?

Feb. 05 2014 10:11 AM

I wonder if the widely accepted "tough love" approach really is effective in helping people with addiction problems? Are there stats on how helpful isolating people who are addicted really is? I understand some situations are so difficult that separation is the best option for everyone involved, but is this more of a remedy that should be reserved for violence/theft situations? Setting someone out on their own without their loved ones seems counter-intuitive....

Feb. 05 2014 10:10 AM
Kate from Manhattan

Can your guest talk about how to help loved ones change with kindness. I have a sister who is not a drug addict, but suffers from terrible behavioral and personality disorders and is resistant to help and change and is super angry. So we all avoid dealing with her. But she is struggling and hurting herself (cutting) and we don't know what to do.

Feb. 05 2014 10:07 AM
Jerry from NYC

dope stronger than his three kids

Feb. 05 2014 10:06 AM

I did heroin once, in Tijuana in 1963, and remember it vividly. I remember thinking,

"Oh my God, I'd better never do this again in my entire life. Because if I do--this will be what my life is all about."

I have no idea how people ever get off heroin at all.

Feb. 05 2014 10:04 AM

PSH was a casualty of our society’s insane “drug war”, a victim of the refusal of our society to address drug use rationally
No one who knows the history of Prohibition could ever have rationally believed the “drug war” would do anything but multiply drug use and devastated lives. Treating drug use as a law enforcement problem not only put the power of capitalism (the strongest economic engine the world has ever created) behind spreading drug use, but also gave the use outlaw cachet that would appeal to young people, and made any effective educational approach impossible.
For law enforcement and for drug rehabilitation programs, drug use is an enormous economic boondoggle; it is contrary to their deepest vested interests to cure the problem.
What has to be done, as has been obvious since at least the ‘60s, is to legalize all drugs, including heroin. Overdoses can be quickly reversed if an antagonist is quickly administered, but because of illegality, heroin users often hide themselves away, and so die when they could easily have been saved. Furthermore, illegality makes it impossible for users to know the potency and purity of the drugs they buy, and also precludes effective education both in the dangers of drug use and in the safest ways to use the drugs.
Given how obvious it is that hard drug use is never going to be eliminated, there is no excuse for our society refusing to work in the context of that reality to reduce the harm it causes. It is a shame and a pity that the great career of PSH, a kind and gentle man who gave so much to so many, should be cut off in midcourse by the failure of our society to address drug use rationally. One can only hope that his death will lead more people to address the drug issue rationally.

Feb. 05 2014 10:02 AM

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