David Sheff characterizes the events and feelings surrounding addiction as “a world of contradictions, wherein everything is gray and almost nothing is black and white.” In doing so, he acknowledges the inherent ambiguity and complexity of addiction itself. David's world, colored by the reality of his son's drug abuse, is more confusing than he ever could have imagined. He highlights these contradictory experiences and feelings in his memoir to suggest that it’s wrong for outsiders to judge addiction without understanding the complexity of addiction as a disease. Many people are inclined to see addiction as purely a choice, and there is a tendency to cast blame on addicts (and their families) for what the public sees as personal moral failures. However, David's own experiences with Nic teach him that it’s very difficult to make moral claims about addiction, and he hopes to educate readers about the science behind addiction so that they can extend more understanding and empathy toward people who suffer from mental health conditions.

David's conception of his world as murky and ambiguous ties in with a later passage about the impossibility of truly knowing or accessing another individual’s experience. Here, he states that “we deny the severity of our loved one's problem not because we are naive, but because we can't know.” Here, he elucidates what he perceives as a fundamental limit to empathy and admits that he will never fully know his son or understand what he went through as an addict—no matter how hard he tries. Yet the acts of forgiveness and empathy, however imperfect, are still a powerful and heroic feat, inducing change in subjects like Nic who feel alienated by their disease and ashamed of their personal histories.

In his suicide note, Kurt Cobain wrote, "It's better to burn out than to fade away." He was quoting a Neil Young song about Johnny Rotten of the Sex Pistols. When I was twenty-four, I interviewed John Lennon. I asked him about this sentiment, one that pervades rock and roll. He took strong, outraged exception to it. "It's better to fade away like an old soldier than to burn out, " he said. "I worship people who survive. I'll take the living and the healthy.”

In this quote, David Sheff points out the tendency of pop culture to value “going out with a bang” rather than living a long, healthy life. Longevity and simplicity are undervalued and perhaps underappreciated. The opposing mentality, that of living fast and dying young, accepts and encourages the circumstances that lead to addiction. As David points out throughout his work, there are so many factors that lead to addiction as a disease. The conversation surrounding addiction must be reflective of the fact that it is a medical issue—not some “glamorous” choice that is made in pursuit of a so-called rockstar lifestyle.