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Epilogue
Themes
Key
LitCharts assigns a color and icon to each theme in Beautiful Boy, which you can use to track the themes throughout the work.
Addiction, Ruin, and Redemption
Responsibility and Blame
Parenthood and Control
Support vs. Enabling
The Disease Model, Stigma, and Treatment
Summary
Analysis
David writes an afterward to the book in October 2008. Tweak, Nic’s book, is published in February 2008. David is breathless reading it, learning about Nic’s self-destruction from his own perspective. Nic had nearly died many times, and David learns that Nic also nearly lost an arm due to an infection from shooting up. But reading also helped David understand how Nic’s biggest victim was himself. David, Karen, Jasper, and Daisy were simply “collateral damage.”
Reading Nic’s book gives David a glimpse into Nic’s perspective on his own addiction. While it is true that Nic’s addiction had had a deeply negative impact on the rest of his family, David becomes even more aware of how Nic’s addiction, and the havoc that it wreaked, brought most of the ruin down on Nic himself.
Themes
Beautiful Boy is published in February as well, and David and Nic go on tour to talk about the books. They meet hundreds of people, many of whom break down as they speak about their own stories. Many of them have more tragic endings: children or loved ones who died. Hearing this, David is flooded with gratitude that Nic is alive.
Speaking about the book tour, David reinforces how stories help people to understand their own situations better and perhaps to find some support. Even though many others’ stories had tragic endings, they feel supported in hearing David’s account and in being able to share their own with him and Nic.
Themes
There are also stories of hope: people who have been in recovery for three days to 37 years and everyone in between. One girl says she spent her last $20 on Nic’s book instead of meth. People tell one another not to give up hope. One woman talks about her daughter, a heroin addict who disappeared for a year, was raped, and spent time in jail, but who is now three years sober.
The girl’s story, of spending money on Nic’s book instead of meth, shows how the books can make a tangible difference in the lives of addicts. Reading about how much damage addiction can do to a person’s life helps them to feel understood and supported, and it perhaps even provides an incentive to stay off drugs.
Themes
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The last leg of the tour brings David and Nic back to California. Nic then returns to Savannah, Georgia, where he’s lived for the past two years. Three months later, he moves back to Los Angeles. Later in the summer, Nic reveals that he had relapsed a few weeks earlier, more than two years after he had stopped using the last time. But this time, he stopped his relapse before it led to catastrophe and immediately checked himself into a residential program.
This incident, of Nic relapsing once more, shows how much progress Nic has made. The story acknowledges that addicts can sometimes be compelled to relapse even after long periods of recovery. What is important, however, is the ability to prevent oneself from succumbing to the same self-destructive tendencies that exacerbate an instance of relapse, and to seek help from the necessary people and programs.
Themes
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David then writes about addiction more broadly: in 1971, President Nixon began the war on drugs. It has cost hundreds of billions of dollars, while the use of drugs has risen steadily. First-time users are younger, and the drugs are stronger and more widespread. More than 20,000 people die each year of drug overdoses alone, and there are related tragedies—like crime, accidents, suicide, illness, lost productivity—that also harm the nation.
In the last part of David’s afterword, he takes some time to address addiction on a national level and argue for why drastic reform is needed. The statistics he cites here indicates the scale of the problem and prove how even though the government is treating addiction as a serious issue, the way in which they are trying to address it is not actually leading to progress.
Themes
Health insurance companies, Medicare, and Medicaid often refuse to pay for treatment of illness or injuries caused by drugs or alcohol. Payment of life insurance may be denied if drug or alcohol abuse led to death. Addiction also remains a secret because of the deep shame associated with it. Addicts are often viewed as having a character deficiency rather than a serious illness. Besides criminalizing addiction, society tends to overlook the issue.
David highlights specific policies used by insurance companies and other government programs that discriminate against addiction in contrast to other diseases. This bolsters his argument that if addiction were thought of as a regular disease and not stigmatized as a failure of morality or willpower, it could be treated more easily.
Themes
Stigma and prejudice also curtail financial support for research into addiction, and thus few effective treatment options have been developed. Costs for the best treatment programs may run at $30,000 to $50,000 a month, and therefore addicts very rarely get the treatment they need. Caregivers are also often less likely to want to treat addicts because of their belligerence and the persistence of their illness.
David catalogues other reasons why it is important to destigmatize addiction: without a stigma and with more support for research into treatments, better treatments might be made available. Additionally, he notes that addiction is a disease that affects people of all income levels, and for people without wealth or insurance, it is difficult to get the proper treatment.
Themes
In 1971, Nixon also declared a war on cancer, which is now much more treatable than it was in the past. In contrast to addiction, the incidence of cancer began dropping in 1990 and has fallen every year since then. David argues that a similar war on addiction is needed: it must be organized and heavily funded. He writes that we spend more than $10 billion a year researching cancer, and each year we misspend more than $50 billion on the war on drugs. We spend billions on prisons, but the annual budget of the National Institute on Drug Abuse, which conducts almost all drug-related research and development, is less than $1 billion.
David again emphasizes how thus far, the government’s attempts to curtail addiction have largely focused on the wrong avenues. Criminalizing addiction merely adds to the stigma of it, whereas David argues that it needs to be treated as a disease. He contends that money is better spent on research into treatments and educational programs than on jails. These serve as far more effective methods of deterring addiction in the future.
Themes
More money will allow for better medications, cognitive and behavioral therapies, and combination treatments. Insurance companies should be required to cover comprehensive addiction treatments. RAND Corporation’s research found that for every dollar spent on treatment for addiction, taxpayers save more than seven dollars in other services through reduced crime and medical fees and increased productivity.
Here, David provides astonishing facts about how treating addiction as a disease is not only a more empathetic and life-saving way of looking at the problems—it can actually cut down the cost of addiction on society.
Themes
The other necessary step is prevention: intervening early and preventing the progress of addiction. Some addictions may resist treatment, just like cancer. But cancer treatment has still made dramatic progress, relieving suffering and saving millions of dollars and millions of lives. A war on addiction would do the same: reduce crime, reduce homelessness, reduce emergency room visits and prison populations, and alleviate “immeasurable suffering.”
David’s conclusion ties together all of the arguments for why it is important to treat addiction as a disease and emphasizes how reforming our views and policies on addiction can tangibly benefit the country. For a book that tries to understand the complicated issue of responsibility for addiction, David illustrates how the country itself is responsible for its addiction epidemic and is therefore also responsible for taking steps that can reduce that epidemic.
Themes
