Demi Lovato, what we know, what we’ve learned, and how she can win her fight

Sep 17, 2018
By Sarah Church, Ph.D.

Countless fans, well-wishers and music lovers all over the world were waiting to learn more and understand what happened to Demi. Was it heroin? How close did she come to death? Will she enter treatment? What really happened?

Demi finally made her first public statement on Instagram following her hospitalization due to her reported overdose. Her heartfelt post honestly acknowledged her ongoing struggle with addiction and thanked her fans for their love and support. She finished with the promise, “I will keep fighting.”

Many people ask….why do relapses happen? People also wonder if there is a way to keep people like Demi safe and “protected” as they face this struggle. These are important questions to answer especially for people who are trying to support someone they care about who has relapsed.

Why do people continue to relapse?

Addiction is complex and the issues that lead people to use drugs are complicated. Often people that struggle with addiction, struggle in other areas of their lives. They are in relationships that are not working, they have jobs that are not fulfilling or that are very stressful, and they may have a history of trauma which haunts them or depression which drags them down. Drug use may be seen as an escape, a way to turn off the noise. Getting high might be their refuge, the way to stop the madness for a while. If they don’t engage in therapy to learn new coping skills and strategies and to deal with the underlying issues that initially drove them to use, the most expensive and exclusive rehab stint will not prevent them from seeking out drugs the next time they are home and are stressed.

What does it take to be successful in overcoming opiate addiction?

I get this question all the time and the answer is simple. To be successful, patients need ongoing individualized care provided by mental health professionals that is evidence based and that combines both psychotherapy and medication.

Demi wisely mentioned in her post “What I’ve learned is that this illness is not something that disappears or fades with time. It is something I must continue to overcome and I have not done yet.” She is right, addiction is a chronic health disorder and must be treated in an ongoing way, just like hypertension and diabetes. There is no cure for addiction yet, so we have to continue to treat it.

Can you prevent people from overdosing when they continue to use opiates?

Patients like Demi who have had a history of overdose should consider taking one of the three FDA approved medications for opioid use disorder (methadone, buprenorphine or naltrexone) all of which reduce the chance of overdose.

For people who have been tapered off opioids, the best option is naltrexone (also called Vivitrol). This is a medicine that when given as an injection lasts an entire month. Naltrexone blocks all of the opioid receptors in their body and prevents people from feeling the effect of opioids. No matter how much heroin they shoot or snort or how many painkillers they take, they can’t get high. Think of it as car being parked in a spot when another car is looking to park, the spot is taken, so the second car cannot be parked in that spot. When someone is taking naltrexone and they use heroin, the receptors are taken and the heroin can’t get to the receptors to take effect. This medicine provides a safety net that can give patients a chance to engage in therapy and it protects them from overdose if they relapse.

Patients should also have a narcan overdose prevention kit on hand in case they overdose. Narcan is a medication that can be administered by lay people who have been trained to provide it. In case of overdose, it can be given intranasally, just like Afrin for a stuffy nose. Anyone with a history of opioid misuse and anyone who cares about someone who has this history should keep a kit on hand, just in case.

Hope for the future

Demi will certainly not be the last person or celebrity to struggle with addiction and to overdose. Astonishingly, more than 60,000 people died from overdoses in the US in 2016. The good news that everyone needs to know, is that effective treatment is available, and the first step starts with a phone call.

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