Addiction
Amy Winehouse---What We Need to Know Know Know
We need accurate knowledge about addiction, not bromides.
Posted August 4, 2011
Amy, Amy Amy
Amy, Amy Amy
Amy Winehouse's death from as-yet unknown causes at the notoriously perilous age of 27 raised a chorus of received wisdom as predictable as it was heartfelt: "Terrible tragedy"; "so young"; "so vulnerable"; "such a waste of talent"; "addiction is a terrible disease"; "she should have gone to rehab"; "a shock but not a surprise."
Part of me, of course, can only agree with the public chorus: Yes, I wished to follow her career longer. I believe that she had more life in her than she ended up living. But I also find myself arguing with a lot of the assumptions now in play.
You Know I'm No Good
For example, what do we mean 'a waste'? Many of us could die happy having achieved as much as Winehouse did in our chosen fields. How much great work does an artist have to produce for the public not to deem the brevity of their time on earth is 'a waste'? Why are her achievements being described as "promising," when what she has delivered, like so many artists' early hits, are works that will deliver for decades to come?
Stronger Than Me?
In equating addiction with those aspects of it that obliterate free choice, her admirers seem to divest Winehouse of many of the choices she forcefully made. Her family speaks of a boyfriend leading her astray; other accounts, notably Richard A. Friedman in the New York Times stress that drug-saturated milieus can hook a novice even if she isn't biologically predisposed to addiction. But Winehouse walked into these high-risk situations as an adult. She chose to sample low-life feelings and states of abjection---the addict's willfulness, the romantic's desperation, the alcoholic's bathos---and to make brilliant popular music from them. As a student of the pas de deux between self-loathing and self love, (1) I found her dance particularly well-choreographed. Couldn't there be a reason she said "no" to rehab other than "the drug talking"? We wouldn't talk like this about a sky-diver or a battlefield doctor. Not all self-destructiveness is merely self-destructive.
Of everything I've seen written about Winehouse, the only piece I thought useful was Guy Trebay's encomium in the New York Times quoting the likes of John Waters and NPR's Ann Powers on the innovations and subtleties of Winehouse's bad girl style, what she did for the language of outsiderism, and her fusions of segregated subcultures like girl groups, jazz and pop, Jersey sluts and fashionistas. I think Trebay's (and Powers' and Waters') appreciation is important for one simple reason: it's hard to encourage creative people to stay alive if no one has any idea of what they might want to live for. It's critical to acknowledge the enormous value of art because the most powerful weapon of an addictive drug is to hijack the part of the mind that tells you, "This drug matters more than anything." As drug survivor Keith Richards explains in his autobiography, Life, his ability to quit drugs, like his desire to take them to begin with, hinged on his desire to keep playing music. (2)
Me and Mr. Jones
Another popular reflex that galled me was the media's eagerness to assume that Winehouse died from an "overdose" of drugs or alcohol even though police labled such speculation premature. Not that such fan mag fantasies were entirely baseless; Tabloids claim that she was seen scoring the night of her death; but the diagnosis dangerously truncates our understanding of addictive pathology. For example:
Excessive use isn't the only way to die of your addiction. Quitting a habit can fatally exacerbate latent health problems caused by previous substance abuse. Winehouse's family worried that her alcohol use had put such a strain on her system that quitting cold turkey caused her heart to give out on her. I knew a man in his forties who, having recently quit drinking and cocaine, started jogging like mad---and promptly died of a heart attack.
For a recovering addict a surprisingly modest dose can be fatal. Just as neurons become inured to intoxicants and require increasing dosages to produce the initial boost, so too, after a period of abstinence, may these neurons become hyper-sensitive. A relapsing addict taking drugs or alcohol at the same dosage she was taking before she quit may neurologically over-react to it. "Overdose" is too confusing a word to apply to relapsing addicts because it sounds as if they greedily consumed more than usual, rather than that their synaptical network changed. Being aware of the difference can be a life-or-death matter to addicts trying (and often failing) to stay clean, as Keith Richards also warns.
Shorthanding all drug fatalities as "overdoses" is like calling all sailboats sloops. Lives may depend on us all keeping in mind the diversity of the risks that attend recovery and relapse.
Back to Black
It's also dangerously inaccurate, though in a more oblique way, to assume that addicts' drug and alcohol abuse, untreated, is guaranteed to kill them. Ex-addict Russel Brand, in his moving and widely quoted tribute to Winehouse, articulated this beloved trope best: "Either way," he assured us of our addicted friends, "there will be a phone call," meaning that either your friend will call you for help, or you will hear some other voice on the phone telling you that your friend is dead, a victim of addiction.
Because addiction statistically shortens lives, for friends and intimates of addicts Brand's prediction feels true enough. But while the myth of an addict's inevitable demise may scare some people clean, or at least cautious, such hyperbole can alienate others. You can accurately tell your friend that substance abuse will damage her health and her mind, warp her personality and kill her chances of feeling real joy, in some cases permanently, but, like Russian Roulette, addiction is a gamble with life, not suicide, and many at-risk addicts are too enamored of long odds to take exaggerated warnings seriously. Besides: since addiction and depression often keep close company, don't assume that every user or potential addict will hear "It'll kill you" as a bug rather than a feature.
Tears Dry On Their Own
Which brings me to the last piece of information most clichés about drug use obscure. Most addicts have other demons on board. Regardless of how or why it happens (a chicken-egg debate), mental disorders like depression and bipolar personality frequently share the stage with substance abuse and shouldn't be ignored. For example, when depressives act on suicidal thoughts, they do not do it in the depths of despair, but in a period of feeling "better," like a recovery from substance abuse. For a depressive, a drug relapse can be used as a weapon.
Addicted
In an age of social media and tweets vague clichés proliferate because platitudes and media bytes create the illusion--- just as many drugs do---that real communication is easy. Received wisdom, however, while it can be both true and wise, doesn't prepare you to deal with the realities of addiction, either your own or others'. Should you need to, for any reason, it would be a good idea to kick the cliché habit.
NOTES
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(1) See my little book, Self-Loathing for Beginners
(2) See my summary of Rihards' celebrity drug addict survival guide at: http://www.psychologytoday.com/blog/dream/201102/the-devils-playthings