Philip Seymour Hoffman is not a good symbol for the efficacy of American treatment. He was famously abstinent after having entered rehab at 22. Then, supposedly abstinent for 23 years, he took some pain medications and went completely haywire, progressing to rampant heroin use. According to this model, a person who is addicted to heroin who simply samples a painkiller is doomed to all-out relapse by this "cunning, baffling and powerful disease."
But what are we to make of the stunning, continuing findings over the decades that most people recover from heroin and other drug addictions? Corralled by the disease theory in rehab in his early 20s, writes Stanton Peele, Philip Seymour Hoffman failed to allow himself to mature out, to develop a realistic assessment of his own strength relative to pharmaceuticals and other drugs. As a result he was left vulnerable, not to a cunning, baffling and powerful substance, or disease, but to an emptiness and learned powerlessness, or helplessness.