DISCLAIMER: While all the details aren’t yet known about the possible overdose Demi Lovato recently suffered, what IS known is that the 25-year-old singer and actress has a long and well-publicized personal history of substance abuse and mental illness. Using that information, this is an attempt to provide context to her struggles in the hope of educating and helping others who might be dealing with similar issues. “…this is definitely a medical emergency for her.” ~ 911 dispatcher, July 24, 2018 At 11:22 am on July 24, singer and actress Demi Lovato was found unconscious and unresponsive in an upstairs bedroom of her Hollywood Hills home. The night before, she had been out partying, celebrating a friend’s birthday in West Hollywood. An emergency call was placed, and paramedics quickly arrived in response to her apparent overdose. While both Lovato and her guests refused to disclose precisely which substances might have been involved, multiple sources report that Lovato’s friend administered Narcan, the emergency medication that can reverse an opioid overdose. Although the initial news reports circulated that Lovato had overdosed on heroin, the New York Daily News quoted a source saying that “a nurse at the hospital told police Lovato was using some type of methamphetamine in the time leading up to the incident.” According to a Fox News story, Lovato’s past addictions include alcohol, cocaine, and the opioid painkiller OxyContin. The announcement of the incident elicited a strong response from Lovato’s fans, many of whom identify with and draw inspiration from her public battles with addictive and behavioral disorders. Some even credit Lovato as the reason that they were able to regain their own sobriety. For others, however, Lovato’s apparent overdose is just the latest sad chapter in the story of her life. Unfortunately, this incident didn’t simply come out of nowhere. Not only does Lovato have a history of substance abuse that started in her teens, but there were also warning signs that her recovery wasn’t completely successful. Let’s take a closer look at how Demi Lovato reached this point. Perhaps by examining her life, we can give some meaning to the near-tragedy that could have taken her life.
Success at a Young Age
“Go on and try to tear me down. / I will be writing from the ground./ Like a skyscraper.” ~ Demi Lovato, “Skyscraper” Born in Albuquerque, New Mexico, in 1992 and raised in Dallas Texas, Demetria Devonne Lovato exhibited talent early. At just seven years old, she was playing the piano, and she picked up the guitar at age 10. She competed in beauty pageants, took acting and dancing classes, and by 2002, she was a regular on the children’s program Barney & Friends. But what else should you expect from the daughter of a musician and a former Dallas Cowboys besides a penchant for performing? Lovato’s big break came courtesy of the Disney Channel, with roles in Camp Rock and Sonny with a Chance. Work on Camp Rock’s soundtrack gave Lovato the musical exposure she needed to release her own debut album, Don’t Forget, when she was still only 16 years old. After selling over 500,000 copies, the album was certified “Gold”. Her music career was officially launched. Since that time, Lovato has released five more albums—four of them reaching Gold status – and headlining five successful tours. Lovato has kept busy with film and television appearances, including a two-season stint as a Judge and Mentor on the popular talent show, The X Factor. She has also won a number of awards, including 13 Teen Choice awards, five People’s Choice awards, and an ALMA for her contributions as a Latina American to the performing arts industry. As of 2017, Lovato had a personal net worth of $33 million dollars.
Parental Divorce and Teenage Substance Abuse
“Father, I’m gonna say thank you / Even if I’m still hurt. I’m gonna say bless you / I wanna mean those words / Always wished you the best / I prayed for your peace / Even if you started this whole war in me.” ~ Demi Lovato, “Father” But everything wasn’t as wonderful as it looked from the outside. Lovato’s parents divorced when she just two years old, and from 2007 until his death from cancer in 2013, she was completely estranged from her father, Patrick. In interviews, Lovato has described her father as “mean” and “abusive”, and while she has said that she had no interest in forging a relationship with him, she also admitted that she struggled with her feelings towards him and was “conflicted” about his passing. Notably, Patrick Lovato waged his own battles with mental illness and substance abuse. There are all sorts of psychological implications about Demi Lovato’s relationship with her father, especially in the light of her future and current problems. As a child of divorce, Lovato was at elevated risk of emotional, social, and substance abuse problems. Among young people ages 14 through 22 with divorced parents:
- 14% increase their alcohol use
- 13% use or think about using more drugs
- 39% of girls smoke
- Girls with close relationships with their mothers are more likely to use marijuana.
Children of divorce are often lonely and at greater risk for anxiety, depression, and self-esteem issues, causing them to seek comfort in intoxicating substances. The timing of her parents’ divorce also matters, because the absence of a parent during the “formative years”—the first five years of life—can impact the areas of the brain associated with the ability to form emotional bonds. For people who are genetically vulnerable to addiction—like Demi Lovato—drugs and alcohol also affect those same areas. This means that intoxicants chemically fill the role of the missing personal attachments, satisfying a real biological need.
An Unbearable School Experience
“I had a really tough time when I was in middle school. People would write ‘hate petitions’ [about me] and send them around to be signed. They’d have CD-bashing parties of my demos. They’d come to my house, stand across the street and yell things. It was a very emotional time for me, and all I wanted to do was get away…Back then, there were times I didn’t think I’d be able to move on.” ~ Demi Lovato, in a 2012 PEOPLE interview Lovato has talked extensively about how she was targeted almost unmercifully by bullies when she was younger, to the point that she quit going to middle school and began homeschooling. This was significant for Lovato’s future because a 2012 study conducted by researchers at Ohio State University determined that middle and high school students who are involved in bullying—either as perpetrator OR victim—are more likely to use substances. For example, while only 1.6% of middle schoolers not involved with bullying use marijuana, the rate jumps to 2.4% among victims. And among middle-school students who are both bully AND victim—which Lovato admitted she sometimes was—it climbs to 6.1%, nearly QUADRUPLE the rate for non-involved youths. In high school, the marijuana use rates are even higher—13% of non-involved students, 17% of victims, 29% of bully/victims, and 32% of bullies.
Childhood Trauma Leads to Substance Abuse
“While psychological trauma is characterized by disruptions in a person’s sense of control, addiction can also be viewed as a disorder of control, or more accurately, an inability to control. The loss of control is insidious, often unrecognized by the addict until, in Alcoholics Anonymous terms, life becomes unmanageable.” ~ Psychological Trauma and Addiction Treatment, by Dr. Bruce Carruth, PhD, LCSW, (editor) By her pre-teens, Lovato had already experienced several traumatic events—divorce, alienation, parental substance abuse, domestic violence, and bullying. Each of these potentially affected her own issues. A 2012 study determined that childhood trauma can strongly influence the likelihood of developing addictive or depressive disorders as an adult. Traumatic experiences when young—referred to as Adverse Childhood Events—change the areas of the brain associated with emotional regulation and impulse control. According to the National Child Traumatic Stress Network, approximately one-fourth of US children experience at least one ACE. Of special relevance, research shows that for every ACE experienced or witnessed, the risk of initiating drug or alcohol use rises by up to 400%. So, a child with 5 or more ACEs has a risk of substance use that is up to 2000% greater than a child who has experienced zero. Young Demi Lovato experienced at least FIVE types of events and an unknown number of individual incidents. Trauma and substance abuse coincide frequently:
- Teenage victims of physical or sexual abuse/assault are at TRIPLED risk of substance abuse.
- More than 70% of teenagers in rehab have histories including trauma.
- Nearly 60% of adolescents with PTSD will develop Substance Use Disorder.
- Likewise, teens who abuse alcohol or drugs are at DOUBLED risk of developing PTSD after trauma, compared to their abstaining peers
- In up to 66% of cases, traumatic experiences were preceded by substance use.
Struggling with Body Image
“I remember being 3 years old in a diaper and rubbing my hand over my stomach. I remember thinking in my head, ‘I wonder if one day this will ever be flat?’” ~ Demi Lovato For most of her life, Lovato has expressed concerns about her looks, especially her weight. Like a lot of young stars, she believes that her fans expect her to always look her best – always thin, always fit, always perfectly healthy. And according to an unnamed source quoted by Entertainment Tonight, Lovato was putting “added pressure on herself” during the months leading up to her overdose. But an actively-substance-abusing lifestyle doesn’t exactly support looking one’s best. In fact, Lovato’s recent partying had caused her to gain weight, and she was feeling extremely self-conscious. And her concern about her appearance was a bigger priority than anything else. “Three weeks ago, a close friend of Demi’s tried to sit down and talk to her. They were so worried. They wanted to help her slow down and live a cleaner lifestyle, but all she cared about was her weight gain. She didn’t want to talk about her drug or alcohol use, she wanted to discuss dieting. Demi started gaining weight in the last few months, and her friends knew she was partying way too much and was in a terrible place,” says the source. It is extremely relevant and significant that the same source says that, “… she wasn’t willing to give up partying for weight loss.” Continuing to drink or use drugs despite negative consequences – in this case, an undesired weight gain – is one of the major warning signs of addiction. It’s also important to note that dissatisfaction with one’s body has long been associated with higher rates of substance use among young people, especially girls. But a 2005 study conducted by researchers at Arizona State University concluded that Latina girls report a greater dislike of their bodies than Whites or non-Latinos, regardless of how acculturated they are. A 2007 Internet survey found that 15% of respondents admitted to using cocaine or amphetamines to lose weight. Poignantly, Lovato once told the magazine Glam Belleza Latina, “You can be the most beautiful woman in the world and see yourself as hideous.”
The Impact of an Eating Disorder
“I was performing concerts on an empty stomach. I was losing my voice from purging.” ~ Demi Lovato, speaking to ABC News in 2011 When interviewed by Seventeen magazine in 2011, Lovato admitted that she began compulsively overeating at a very young age. Then, when she was fat-shamed by classmates in middle school, she almost stopped eating altogether. She also struggled with bulimia, the eating disorder characterized by compulsive overeating, followed by elimination by purging – self-induced vomiting or the taking of laxatives. Eating disorders are NOT about food. Most often, they are a response to some emotional pain resulting from:
- Poor self-esteem
But in addition to these factors, recent studies have discovered a possible genetic component. In fact, the risk of anorexia or bulimia is magnified up to 12 times in individuals with a relative with these conditions. Significantly, both Lovato’s mother and grandmother had eating disorders. “Even though I was 2 or 3 years old, being around somebody who was 80 lbs. and had an active eating disorder it’s hard not to grow up like that,” she says. But there is also a surprising connection between eating disorders and substance abuse disorders:
- 50% of individuals struggling with an eating disorder also abuse drugs or alcohol.
- That rate is FIVE TIMES that of the general population.
- Likewise, 35% of alcoholics and drug abusers have a co-occurring eating disorder.
- For comparison, that is ELEVEN TIMES HIGHER than the rate for the general population.
- 70% of women being treated for alcoholism also have a personal history of binge-eating.
- 25% of people with a binge-eating disorder also abuse substances.
Why Do Eating Disorder Co-occur with Substance Abuse?
“When I was about 15, I was only eating two meals a week, but I wasn’t losing any more weight because my body adjusted to that. So, I tried new things: laxatives, fasts – nothing was working. I decided maybe I should start throwing up. At my worst, I was doing it five times a day. I threw up so hard and so much, it was just blood in the toilet.” ~ Demi Lovato There are a number of theories as to why the seemingly-unrelated disorders present together so often. Theory #1: Binge eating and excessive drinking both trigger the reward pathways of the brain. People perform these unhealthy actions because they receive an immediate (if temporary) pleasurable reward. Theory #2: Many people over-drink and overeat as a way of “self-medicating” their depression, anxiety, or emotional pain. Theory #3: There may be a genetic link. In 2013, researchers at the Washington University School of Medicine discovered that up to 53% of the risk of either condition is determined by one set of genes. Theory #4: Both disorders have been linked to impaired impulse control. Relevant to Lovato’s situation, women with both conditions score higher on a clinical scale measuring impulsivity than those women with only one disorder.
Demi Lovato and Depression
“The very first time I was suicidal was when I was seven. I had this fascination with death. I have experienced things that I have not talked about, and I don’t know if I ever will talk about. But at seven, I knew that if I were to take my own life, that the pain would end.” ~ Demi Lovato, speaking on the Dr. Phil Show Lovato has also spoken extensively about her battles with depression and suicidal thoughts. Her personal history put her at an increased risk, and she possessed many of the known risk factors:
- Parental divorce
- Separation from a family member
- Stress tied to expectations and performance
- Substance abuse
- Death of a loved one
But Lovato was at even greater risk because of her gender, age, and ethnicity.
- 20% of teenage girls experience major depression, compared to just 6% of boys.
- Depression is most prevalent among teenagers between the ages of 15 and 17.
- Multi-racial teens have the highest rates of depression.
Depression is MORE Than Just Sadness
Although anybody can feel temporarily “down” emotionally, depression goes far beyond this. This medically-diagnosable disorder is characterized by persistent negative emotions that interfere with normal functioning.
Per the National Institute of Mental Health, depression is very common among US adolescents. In 2015, roughly 3 MILLION Americans aged 12-17 suffered at least one episode of major depression. This equates to 1 out of every 8 adolescents. That is a dramatic increase from 2005, when less than 9% of teens experienced a depressive episode. The risk among teenagers is so elevated that the American Academy of Pediatrics has made the recommendation that people between the ages of 11 and 21 should receive extra screening.
Dual Diagnosis: Depression and Addiction
Depression and Substance Use Disorder are closely-related illnesses – each can cause or worsen the other, and their co-occurrence is extremely common:
- Two-thirds of alcoholics also suffer from clinical depression.
- Having one disorder DOUBLES the likelihood of having the other.
When depression and SUD manifest together, they create a self-perpetuating downward spiral. A person will drink or use to self-medicate the painful emotions associated with depression, but then the consequences resulting from alcohol abuse create situations that worsen depression. What’s more, chronic drug use or heavy drinking affects the emotional and cognitive centers of the brain, thereby increasing the person’s vulnerability to depression. As there is with several other mental illnesses, there is also a biological component to depression’s comorbidity with SUD. Both conditions are associated with the amygdala – the area of the brain that regulates how someone responds to stimuli. In people with depression, the amygdala is overactive when responding to negative stimuli, and underactive in response to positive stimuli. Similarly, the amygdala of someone with SUD is triggered when they encounter anything that they associate with drinking or using. For example, even merely watching a video containing drug or alcohol use can cause strong cravings. In 2012, researchers with University College London discovered a rare gene variant present in individuals with major depression, alcohol or opioid dependence, bipolar disorder, or schizophrenia. People possessing this variant are up to three times more likely to develop an addictive disorder. Significantly, Lovato’s father was schizophrenic, bipolar, and abused alcohol and drugs.
“It was a way of expressing my own shame, of myself, on my own body. I was matching the inside to the outside. And there were some times where my emotions were just so built up, I didn’t know what to do. The only way that I could get instant gratification was through an immediate release on myself.” ~ Demi Lovato Self-harm—intentionally cutting one’s self—is not usually a suicidal gesture, in and of itself. For most, it is an attempt to regain the control lost due to trauma, mental illness, or problematic substance use. 1 out of every 200 teenage girls cuts themselves. Surprisingly, even though cutting hurts at the site of the injury, it actually feels good within the brain. Self-harming actions trigger an immediate neurochemical rush, similar to the effect of intoxicants. According to a 14-year study conducted by Oxford University, about 9% of people who engage in Non-Suicidal Self Injury abuse illicit drugs. Over the course of the study, the rate of drug abuse increased among females, but not among males. Noteworthy to Demi Lovato’s situation the study also found that the rates of marijuana and cocaine use also went up.
Underage Drinking and Drug Use Leads to Multiple Future Problems
“We have limited real estate in the brain, and this shows how drugs dominate what its users think about. Drug exposure fuels drug use, potentially at the expense of other priorities.” ~ Dr. Linda Wilbrecht, Assistant Professor of Psychology and Neuroscience, UC Berkeley Lovato started drinking and misusing Adderall at a young age, and she tried cocaine at 17. This is significant because the human brain does not finish maturing until the early-to-mid-twenties. And that incomplete development leaves the brain at increased vulnerability. For example:
- Adolescents who start drinking before they turn 15 are at SIXFOLD lifetime risk for Alcohol Use Disorder, compared to those who wait until they are 21 or older.
- Smoking marijuana before age 18 results in:
- The abuse of prescription stimulants such as Adderall or Ritalin is strongly associated with cross-addiction. People who misuse these ADHD medications are far more likely to also abuse other substances than the rest of the population.
- 8X more likely to misuse benzodiazepines, 15% to 3%
- Nearly 8X more likely to use cocaine, 29% to 4%
- 5X more likely to abuse opioids, 45% to 9%.
- 3X more likely to use marijuana, 80% to 27%.
Again, relevant to Demi Lovato’s situation, cocaine begins changing the user’s brain from the very first use. This means that a cocaine user learns addiction from the onset.
The Link Between Bipolar Disorder and Addiction
“For years, people said I was depressed, and I actually didn’t know myself why I was so upset and why I would have these episodes of mania—what I now know is mania…Looking back it makes sense. There were times when I was so manic, I was writing seven songs in one night and I’d be up until 5:30 in the morning Sometimes I felt invincible, and it was these moments when my mind would go all over the place. When you don’t know what’s happening, why you’re feeling certain ways, and you don’t have the answers yet, people tend to self-medicate, which is exactly what I did.” ~ Demi Lovato In 2011, Lovato was diagnosed with bipolar disorder. For her, the diagnosis answered a lot of questions—her sometimes-unexplained depression, her manic bursts of energy, and her need to have something to even her out. It shouldn’t have come as too much of a surprise. Her father, Patrick, was also bipolar, and up to 85% of the risk of BPD is genetic. As she’s admitted, Lovato would self-medicate to deal with the symptoms of her illness. In that, she wasn’t alone, because up to 60% of people with BPD abuse alcohol or illicit drugs at some point. But what she didn’t know is substance abuse makes bipolar disorder WORSE.
- The use of alcohol and opioids such as OxyContin can worsen episodes of depression.
- Marijuana, on the other hand, can trigger mania.
- Stimulants such as methamphetamine and cocaine can produce the energetic highs and debilitating crashes that resemble BPD.
An Overwhelming Combination of Risk Factors
“I felt out of control the first time I did it. My dad was an addict and an alcoholic. Guess I always searched for what he found in drugs and alcohol because it fulfilled him and he chose that over a family.” ~ Demi Lovato Despite all the other risk factors present in Demi Lovato’s life, perhaps the biggest single contribution came from her father, who was himself an alcoholic and drug addict. Between 50% and 60% of the likelihood of drug or alcohol dependence or addiction can be attributed to genetics. Let’s review all of the possible contributing factors that may have played a role in Demi Lovato’s development of SUD:
- Family History
- Parental Divorce
- Lack of Attachment
- Multiple ACEs
- Performance-Related Stress
- Self-Harming Behaviors
- Early Initiation of Use
- Polydrug Use
- Eating Disorder
- Poor Self-Image
- Bipolar Disorder
When so many issues came together, it put Demi Lovato in a situation that left her with no margin for error.
Not Her First Close Call
“There was one night when I used a bunch of coke and popped a few Xanax bars and I began to choke a little bit. My heart started racing and I thought to myself: “Oh my God, I might be overdosing right now.” ~ Demi Lovato Not surprisingly, Lovato’s 2018 overdose was not the first time that she had come so close to the edge. Part of the inherent danger of the particular way that SUD manifests in her life is the fact that Lovato uses multiple substances – depressants, stimulants, opioids, and tranquilizers. Polydrug abuse is present in 75% of drug overdoses and in up to 98% of those that are fatal. This is especially true when the drugs used are some combination of alcohol, opioids, and benzodiazepines.
- 80% of fatal overdoses involving methadone, heroin, or buprenorphine also involve “benzo” tranquilizers.
- Opioid/benzo abuse TRIPLES the chances of psychiatric hospitalization.
- It also DOUBLES the likelihood of needing a prescription to deal with suicidal ideation.
- Between 2005 and 2011, there were almost 250,000 emergency room visits for opioid/benzo adverse interactions.
- Alcohol/benzo combinations resulted in another 164,000 ER trips.
- And when all three substances were used, another 43,000 trips to the ER occurred.
- Close to 40% of those ER visits ended with a “serious outcome” – long-term hospitalization, serious injury/disability, or death.
Substance Use IS a Choice – In the BEGINNING
“Some people can smoke and drink recreationally. I’m not one of those people. If I do that, it will spiral out of control very quickly.” ~ Demi Lovato
Every day millions of people drink alcohol and even use drugs recreationally, without crossing the line into abuse or addiction. They are able to keep their habit in perspective and can choose when to partake and when to abstain. Why can’t Demi Lovato and others like her do the same? That’s just it—addiction is NOT a choice. It’s a DISEASE. Consider how a SUD develops: Whenever any action necessary to survival—eating or sex, for example—is performed, the brain releases a surge of dopamine, the neurotransmitter responsible for reward, pleasure, learning, and motivation. The action is performed, and the person is rewarded with pleasurable sensations. They learn to associate the action with the reward and are thus motivated to repeat the behavior. This a biological mechanism. Alcohol and other drugs of abuse also trigger a pleasurable response, but to a much greater degree. After the substance is consumed, the body is hit with a flood of dopamine. In the case of Lovato’s two main substances of choice:
- Cocaine temporarily locks the signal to release dopamine in the “on” position, boosting levels to TRIPLE what is normal. Over 20% of cocaine users will eventually become dependent.
- Drinking spikes dopamine levels by over 40%. And among chronic drinkers, that increase can be up to 360%. Alcohol is so addictive that over 20% of people who try it will eventually develop a dependence. As with cocaine, there is research that suggests that the brain starts “learning” to be addicted to alcohol after the very first drink.
Here’s the thing – in the beginning, the person does have a choice. They drink or use drugs at this point to feel GOOD. But over time, the brain’s dopamine receptors become fatigued with the constant and artificial over-stimulation caused by substance use. As a result, there is a diminished response to drugs and alcohol, to the point that the person must consume increasingly-larger amounts in order to achieve the same pleasurable effects. This is known as tolerance.
The Choice Is Taken Away
But as a tolerance grows, it also impairs the natural production of dopamine. In other words, it interferes with the person’s ability to enjoy other normal activities. In fact, they may become completely unable to feel pleasure or motivation except when they are under the influence of alcohol or drugs. This explains why addicts lose interest in everything except their substance of choice. This is known as dependence. But this disease is progressive – it only gets worse. Eventually, this dependence will be so severe that whenever the person tries to quit, or the substance isn’t available, they will experience harshly-unpleasant symptoms of withdrawal, with symptoms such as:
- Overpowering drug cravings
- Acute anxiety
- Severe depression
- Wild mood swings
- Agitation and irritability
- Muscle spasms and pain
- Abdominal cramps, nausea, vomiting, and diarrhea
- Tremors in the extremities
- Persistent insomnia
- Elevated body temperature
Withdrawal can be so physically and psychologically painful as to push a person immediately back into active use, regardless of intent or willpower. At this point, it is no longer a matter of choice – it is a compulsion. The person must now drink or use drugs to keep from feeling BAD. And what’s worse, they will keep on drinking and using NO MATTER WHAT – despite the consequences to their relationships, their career, their freedom, and even their health. This is known as addiction. One more thing about withdrawal – in most cases, it is not particularly dangerous, despite the discomfort. However, in the specific cases of alcohol – one of Lovato’s primary drugs of choice – and benzodiazepine tranquilizers like Xanax, severe withdrawal can be EXTREMELY risky. It can even be fatal. For this reason, alcohol and benzodiazepines should NEVER be discontinued abruptly or “cold turkey”, and withdrawal from either of these substances should ALWAYS be done under the close supervision of trained medical professionals.
Why Meth, Cocaine, and Adderall May Hold a Special Allure for Demi Lovato
“I couldn’t go 30 minutes to an hour without cocaine and I would bring it on airplanes. I would smuggle it basically and just wait until everyone in first class would go to sleep and I would do it right there. I’d sneak to the bathroom and I’d do it.” ~ Demi Lovato In addition to the euphoric high, increased energy, and the other “positive” effects, there may be another reason why stimulant drugs such as Adderall, cocaine, and methamphetamine appeal to certain individuals. They suppress the appetite. For some people suffering from poor body image or who struggle with an eating disorder, stimulants provide an “quick fix” that will give them the illusion of control. They figure that an increased metabolism and a decreased appetite is just what they need. But a “speed diet” can be extremely dangerous – and even potentially deadly. Unhealthy, too-rapid weight loss can result in such dangerous health conditions as:
- Malnutrition – This is especially true for people who also abuse alcohol. Chronic drinking causes vitamin and mineral deficiencies and impairs the body’s ability to derive energy from food.
- Electrolyte imbalance
- Disrupted menstrual cycle
- Cardiac arrest
Rehab at 18
“I think when someone gets to rock bottom and they need a way out of that hole, the only way to get out is to surrender and ask for help.” ~ Demi Lovato In early November 2010, 18-year-old Demi Lovato checked into a residential treatment center in Illinois, citing the need to deal with “physical and emotional issues”. She completed the 90-day program successfully and then returned home. After rehab, Lovato appeared to make several positive choices that were supportive of her continued sobriety, such as:
- Reducing her stress by ending her television show Sonny with a Chance, so she could focus on her music
- Finding new ways to have fun that didn’t involve going out and partying with alcohol and drugs
- Eating healthier
- Residing in a sober living home for over a year
- Starting an exercise program – “The gym really helps, and I know that I would be in a very dark place without it. Anytime I’m able to take my mind off of any of my addictions, it’s very beneficial to me.”
As part of her recovery, Lovato realized that she could help others by sharing her story. To that end, she starred in Demi Lovato: Stay Strong, a documentary chronicling her struggles with addiction and mental health, her efforts at recovery, and her return to the music industry. “I’ve decided to tell my story because there are a lot of young teens, girls and boys, that are dealing with the same issues that I’ve been through. If I’m able to use my voice to do good in the world then I definitely want to do that,”, she said on the Today show.
Celebrating 6 Years of Sobriety—But Was She REALLY Sober?
“I wasn’t working my program. I wasn’t ready to get sober. I was sneaking [drugs] on planes, sneaking it in bathrooms, sneaking it throughout the night. Nobody knew.” ~ Demi Lovato Unfortunately, like a lot of people who claim to be in “recovery” Lovato wasn’t completely successful at maintaining her sobriety. And one of the biggest reasons why this happened is that she apparently stepped away from the idea of addiction as a disease and instead took the stance that it was a personal choice that she could control. Speaking to PEOPLE, one insider source said, “Demi began to feel that the belief that total abstinence is the only way to deal with addiction is false…She essentially said that she felt it wasn’t the only way and that she can handle her addictions, and she would rather attempt controlled consumption. She felt that she could drink in moderation and she believed she wouldn’t return to harder drug use, and that alcohol was never really a problem as much as other things.” Although that sounds like it might be an achievable goal for some, the reality is that most people who attempt “Moderation Management” are really just looking for a way to rationalize their continued drinking or drug use. This is similar to the argument used by people who want to justify marijuana use during recovery. But attempting to “bargain” or “set limits” on one’s substance consumption is one of the major warning signs of addiction. And ANY person with a SUD who believes that they can control their disease is living in denial.
A Tragic Story of Moderation Management
In 1994, Moderation Management was founded by Audrey Kishline, who believed that it was possible –with support—for problem drinkers to learn how to control their consumption. Sadly, Kishline was wrong…at the very least, about herself. In 2000, Kishline was driving the wrong way down a highway and crashed head-on into another vehicle, killing a father and his 12-year-old daughter. At the time, her blood alcohol level was TRIPLE the legal limit. Kishline spent three-and-a-half years in prison, but when she was released, she suffered numerous relapses. Because this was against the terms of her parole, at one point, Kishline was sent back to prison. For the next decade, Kishline battled her alcoholism, but she also struggled mightily with overwhelming feelings of remorse and guilt over the lives she had taken while drinking. Her alcoholism worsened, and her disease progressed to the point where she lost all hope. In 2015, Audrey Kishline committed suicide.
“Anybody who was with Demi last night and actually calls themselves a friend should actually be disgusted with themselves. SICK!! You can never trust anyone. Never can know if your “friends” are truly on your side or not.” ~ Mike Manning, Lovato’s long-time guitarist It’s obvious that Demi Lovato had some people around her who were just there for a good time – the bright lights, the parties, and the glamour of being seen with a beautiful young star. How do we know this? There are reports that videos have surfaced of Lovato and her friends out partying the night before the overdose. Other sources say that the group was on a “binger” the entire night. PEOPLE quotes a source as saying, “The people she has been hanging around lately aren’t her real friends – they don’t have her best interests at heart. She’s pushed her real friends away… She had to find creative and sneaky ways to get drugs because her team and those that really care about her try to keep a close watch on her.” Unfortunately, Lovato’s story is not unique among people with SUD. Every alcoholic or addict has so-called “friends” whose only real connections are the drugs and alcohol. During recovery, these are the people who are dangerous, because they are the first to say things like:
- “Come on! Just one won’t hurt…”
- “Nobody’s going to find out…”
- “This is good stuff, and I know you like to party…”
- “You deserve to blow off some steam and have some fun…”
Early in recovery, one of the first lessons learned is the need to avoid “triggers” – the people, places, things, emotions, thoughts, and behaviors that we associate with substance use. Science has proven that exposure to such cues can trigger an immediate brain response, including powerful drug cravings that can lead to relapse.
Narcan was On Hand—A Good Idea with Disturbing Implications
“One of her friends had Narcan in case something like this happened. Her friends knew this was coming because she’s been using so much again.” ~ PEOPLE According to multiple sources, two of Lovato’s friends tried to revive her and reverse the overdose by administering Narcan. It speaks volumes about the situation that they felt the need to have the emergency drug close by and available. But here’s the thing—if the offending drug WAS methamphetamine, as reported, Narcan would not have helped. It only works on opioids– heroin, prescription painkillers like OxyContin or Vicodin, and, to a lesser degree, powerful synthetic opioids such as fentanyl. So, this means that either the people around her didn’t know that Narcan was ineffective against other substances, or they didn’t know what drugs she was taking and acted out of desperation. The good news for Lovato, her loved ones, and her fans is that her friends did remember to call 911. But among habitual opioid abusers, there is a disturbing new trend that must be mentioned. According to a new study just released in March 2018, the availability of Narcan may be encouraging an increase in reckless opioid use. The authors of the study argue that since all 50 states have passed laws increasing access to Narcan, there has been:
- Increased opioid-driven criminal activity.
- More ER visits caused by opioid use.
- NO decrease in opioid-related mortality.
- Increases in mortality in some areas. For example, the Midwest saw a spike of 14%.
Jennifer Doleac, an Assistant Professor at the University of Virginia, and one of the co-authors, says, “Broad naloxone access doesn’t seem to be helping and might be making things worse.”
Does Relapse Mean Failure?
“I don’t think I’m fixed. People think that you’re like a car in a body shop. You go in, they fix you, and you’re out. It takes constant fixing.” ~ Demi Lovato In the immediate aftermath of a relapse, it’s all too easy for people to throw up their hands and say that recovery has failed. That way of thinking is part of the stigma surrounding substance abuse and mental health issues. But mental health professionals and addiction specialists have heard the mantra – “Relapse is part of recovery”. While this doesn’t mean that resuming drug or alcohol use is in any way acceptable, it DOES recognize the inescapable reality that, because SUD is an incurable disease brain, MOST people in recovery will relapse at least once at some point in their lives. Take a look how relapse rates for substance abuse compares to those of other chronic illnesses:
- SUD: 40%-60%
- High blood pressure: 50%-70%
- Asthma: 50%-70%
- Diabetes: 30%-50%
Each of these conditions are incurable, and each will progressively worsen over time without proper care. But that progression can be halted, and the harmful effects of the disease can be managed with specialized intervention, lifestyle changes, proper medication, and support from others. And in each case, when those measures are taken, the person can live a full, active, and satisfying life. A relapse from one of these diseases, on the other hand, is characterized by noncompliance with the treatment plan and a return to the behaviors that negatively impact the person’s health. But consider this – if a diabetic went off their diet plan and ate sugary and starchy food for a week and raised their blood glucose levels, no one would call their treatment plan a failure and give up on them. No, they would work with the person and help them return to healthier eating habits. So it is with addiction. When someone has “fallen off the wagon” – whether it is a very temporary “slip” or a full-blown relapse – that is the time for positive action:
- A rededication to healthier habits that support sobriety.
- Additional lifestyle changes
- An adjustment to or reinstatement of professional treatment – inpatient rehab, intensive outpatient programs, sober living, etc.
- A review of anti-addiction medications, with adjustments as necessary
- Better communication with one’s support system – sponsor, family members, sober coaches, counselors, etc.
What We Can Learn from Demi Lovato’s Overdose and Battle with Substance Abuse?
“Demi is awake and with her family who want to express thanks to everyone for the love, prayers and support.” ~ A representative for Demi Lovato The most important lesson we can take away from the overdose of Demi Lovato is that addiction and mental health struggles can touch ANYONE even someone who, from the outside, appears to live a wonderful and glamorous life. Demi Lovato is young, beautiful, talented, rich, famous, and incredibly adored by her millions of fans, but none of those positives matter to the terrible disease of addiction. Next, after reviewing her life, we should have a deeper understanding of empathy for people who struggle with substance abuse and mental illness. In some ways, Demi Lovato was facing a “perfect storm” of contributing conditions – stress, self-harm, poor self-esteem, family issues, depression, bullying, bulimia, and bipolar disorder. Finally, we should have a greater awareness of the real possibility of relapse during recovery. There is no such thing as an “ex-addict” – there are only addicts who are working their treatment programs and in successful recovery, just for today. Moving forward, Demi Lovato has a long and difficult road ahead as she spends time working on herself. Reports say that she will be going back to rehab to get the help she needs. Good for her, and the thoughts, prayers, and love from millions of people around the world will go with her. How beloved is Demi Lovato? On the Thursday following her hospitalization, Lovato had been scheduled to perform at Atlantic City Beach. But when the event was canceled, fans showed up anyway. At one point, a large group got together and held their own impromptu concert, singing the words of Lovato’s all-too-apropos song, “Sober”:
“Mama, I’m so sorry
I’m not sober anymore.
And Daddy, please forgive me
For the drinks spilled on the floor.
And I’m sorry for the fans I lost
Who watched me fall again.
I wanna be a role model
But I’m only human.
I’m sorry that I’m here again.
I promise I’ll get help.
It wasn’t my intention.
I’m sorry to myself.”
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