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‘Beautiful Boy’ Has a Dual Diagnosis Problem

David Sheff (Steve Carell, right) helps his meth addict son Nic (Timothee Chalamet) into rehab in Beautiful Boy. (Official web page)

Films based on true events, whether personal stories or great historical moments, are nevertheless often factually challenged. Such films—A Beautiful Mind, Hidden Figures, Argo, Lincoln—tend to embroider the facts for dramatic purposes. Beautiful Boy—still out in some theaters—about how Nic Sheff’s crystal methamphetamine addiction affected him and his family, particularly father David Sheff—seems to have been pretty faithful to the facts.

Probably we can credit the real Sheffs—David is a journalist, Nic also is a writer and a copious diarist, and their respective memoirs Beautiful Boy and Tweak—and possibly Oprah Winfrey (after the James Frey A Million Little Pieces debacle, her team performed a deep fact-check on Nic’s book before an interview appearance). 

Even so, some details were left out that might aid our understanding of drug addiction and drug rehab. 

The film Beautiful Boy doesn’t show us the beginnings of Nic’s addiction, its causes, or much about the rehab centers he attended or how they treated him. It is largely told through the viewpoint of David, a father trying to understand his son’s crystal meth addiction and how it affects the family and their relationships. It ends with David and his wife, Karen, attending an Al-Anon-type support group for the families of drug addicts and refusing to let Nic come home and try to overcome his meth addiction on his own without rehab. A title card tells us that Nic has been sober for more than a year. 

What the film doesn’t tell us is that the events of the film took place at least eight years ago. Nic, by his own admission, relapsed twice after the events of the film, including while on a book tour for his recovery memoir Tweak. Most importantly, it doesn’t tell us that Nic has bipolar disorder (BPD) in addition to his addiction, which means he is a case of dual diagnosis or co-occurring disorders. It’s not clear when Nic was diagnosed with BPD, but in interviews, he admits he didn’t always take the medications for it, which no doubt made recovery much harder and less likely.

Part of the reason may have been that Nic confesses that he thought that he was resigned to his drug use killing him. And it wasn’t just meth. He smoked marijuana and drank alcohol from about the age of 11, and stole prescription drugs from his mother.

In interviews (and possibly in his second memoir, We All Fall Down), Nic credits his last (or latest) rehab with helping him by explaining he wasn’t in rehab because of his drug addiction but because of the underlying causes of his drug addiction, including his BPD. Now he says he is on two medications, including lithium for his BPD. (The other may be medication-assisted treatment.)

He also says that he learned that recovery is a jigsaw puzzle but everybody needs a different combination of pieces to achieve it. The 12-step model was one piece for him, once he got past the “Higher power/God” aspect (he didn’t have a religious upbringing), but also medication, therapy, and fellowship. Nic attended rehabs voluntarily and involuntarily, and said he saw no difference in their effectiveness

Nic Sheff had advantages most meth addicts don’t, but it still took at least five stints in rehab to get and stay clean. That should be a lesson for how we regard and treat less fortunate addicts during relapse.