Why Philip Seymour Hoffman’s Death Is So Scary [View all]

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http://www.slate.com/articles/health_and_science/medical_examiner/2014/02/philip_seymour_hoffman_s_drug_death_the_science_of_addiction_recovery_and.html?wpisrc=burger_bar



I cried when I heard about Philip Seymour Hoffman. The news scared me: He got sober when he was 22 and didn’t drink or use drugs for the next 23 years. During that time, he won an Academy Award, was nominated for three more, and was widely cited as the most talented actor of his generation. He also became a father to three children. Then, one day in 2012, he began popping prescription pain pills. And now he's dead.

The root causes of addiction, like those of many multifactorial diseases, are frustratingly elusive, a nebulous mixture of genetics, exposure, and environment. Addiction runs in families, but plenty of addicts come from families with no history of the disease. Availability plays a role, too—but having access to crack doesn’t make someone a crack addict. The science about recovery is also hazy: Alcoholics Anonymous, the most widely used form of treatment in the country, has no set structure or methodology, which makes it tough to evaluate its effectiveness. (There’s also the fact that its core principle—that members never publicly acknowledge their presence in the program—makes broad longitudinal studies difficult, to say the least.) In-patient treatment centers, like the one Hoffman checked himself into last May, have been accused of obfuscating their success rates.

If anything, the science on relapses is even more slippery. (We do know that relapse rates for drug and alcohol addiction are comparable to people’s inability to control other chronic illnesses, such as type 2 diabetes, asthma, and hypertension.) The challenges are as basic as agreeing on a definition for long-term sobriety. In a graphic titled “Extended Abstinence is Predictive of Sustained Recovery,” the National Institute of Drug Abuse says, “After 5 years—if you are sober, you will probably stay that way.” I unconsciously added a “forever” to the end of that sentence—but the study that chart is based on ran for eight years, a bar Hoffman cleared easily.

My first attempt at recovery came in 1991, when I was 19 years old. Almost exactly two years later, I decided to have a drink. Two years after that, I was addicted to heroin. There’s a lot we don’t know about alcoholism and drug addiction, but one thing is clear: Regardless of how much time clean you have, relapsing is always as easy as moving your hand to your mouth.