Yesterday TMZ broke vital news, reporting that Demi Lovato is being hospitalized after suffering an alleged drug overdose. Lovato’s overdose comes a month after she revealed, through her emotionally charged and heartbreaking single “Sober”, that after celebrating six years of sobriety in March, she had—somewhere between then and now—relapsed. It was a raw, authentic signal that surely inspired anyone touched by addiction.
Since her hospitalization, TMZ has reported there were "warning signs" of overdose for weeks, on the singer's alleged refusal to divulge which drugs she used and how much, and friend's and—at this point—acquaintances' feelings on her overdose and pleas for her recovery. It's a news cycle that's toxic, triggering to those struggling with addiction, and that shames Lovato—the victim—whether it's deliberate or not. But reading about her struggle weeks before her overdose, as TMZ uses stigmatizing language such as "fallen off the wagon," it feels intentional and hurtful. Page Six sunk so low as to publish a piece about her forgetting the words to ‘Sober’ days before the overdose, as if it were some sort of omen. (For at least an ounce of comic relief here, Billy Joel forgets the lyrics to his songs on every stage he sets up his baby grand at and nobody blinks. Going forward there will be no comedy.)
The rest of the media accountable for publishing responsible celebrity news is not guilt-free, either, as digital publications rush to judge exactly which drugs the star was taking the night of her overdose. Page Six speculated Lovato may have been taking meth on Monday night. Publishing this headline is profoundly irresponsible, as no drugs were present in her home when paramedics entered, and Narcan was confirmed to be utilized by first-responders and reportedly administered to Lovato upon arrival—a drug used specifically to revive those who have overdosed on opioids. This noxious news cycle is evocative of that which followed Amy Winehouse and her alcohol addiction for years in the early 2000s, consequently furthering the stigma of substance use and no doubt playing role in her passing at 27-years-old, seven years ago this week.
Publications should never have automatically suspected heroin was at fault for Lovato's overdose solely because Narcan was administered. And at Lovato's refusal to disclose information relating to her overdose, and sources claiming it was not heroin, TMZ changed their headline to "OD Not From Heroin." However, they kept insipid headlines such as "Justin Bieber Stunned by Lovato's OD ... 'I Thought She Was Sober.'" It seems like such a gross, yet classic media tactic to ask an old friend—who is recently very prominent in the news—to comment on the sobriety of someone they likely haven't spoken with in years, no less listened to her most recent single. For clicks.
While it's clear the media has not learned how to sufficiently comprehend or report on celebrities’ substance use, it's also clear people are plainly uneducated.
Lovato has never been bashful about her struggles, openly sharing her decision to enter rehab at 19 for what she called "alcoholic behavior" in a candid 2013 interview with Access Hollywood. She mentions she knew it would leave fans shocked and confused, but in the same interview she went on to confess her inability to go "30 minutes to an hour without cocaine," and her critical habit of carrying coke on airplanes, as well as water bottles full of vodka.
After hitting what she calls her rock bottom, Lovato remained sober for six years and her sobriety both enhanced and engulfed her brand. Is there more pressure to stay sober when it could feel that your brand has become dependent on it? Lovato faced backlash for coming forward regarding her addictions to cocaine and alcohol as well as her eating disorder, and was more or less made to assure her fanbase she wouldn't fail them. The founder of Alternatives Behavioral Health, LLC—an outpatient treatment center for addictive behaviors—and UCLA lecturer Adi Jaffe, Ph.D., believes "pressure to stay completely abstinent, rather than pressure to work on and improve your well-being, is misguided." He continues, "They can go hand in hand but are not the same thing."
As a woman, sobriety is also harder, according to Theo Krzywicki, a paramedic and founder of End Overdose. "It's common for newly sober women to come to the rooms of AA and NA and have a male target the women and use them as opposed to helping them." He adds "trust is a big issue" and because there are fewer women in recovery than men, "women have fewer options from who to seek help, and if you're famous, you cannot trust a common stranger. It's not practical."
Then, on top of being a woman, Lovato has to handle fame alongside her addiction. According to Jaffe, "the incredible stress of tour and recording life (constant travel, sleepless nights, being surrounded by strangers and 'yes' wo/men) and the ridiculous availability of opportunities to use" can all shake a person's sobriety. Jaffe has "worked with a number of performers and celebrities for whom using was either heavily encouraged even when it had caused problems previously or simply ignored because it supported their ongoing performing, which supported everyone around them." For those on social media wondering why someone with a great deal of money and privilege can't "just stop," or "just say no," as Nancy Reagan so stupidly suggested, there's your answer.
Jennifer Sharpe Potter Ph.D is a University of Texas associate professor in psychiatry. She insists that Lovato's resilience and honesty surrounding her substance use, addictions, rehabilitation, sobriety, and even the breaking of her sobriety are likely hugely "helpful in exposing the struggles that many of us face," as "there is good that comes from that because it is imperative we focus on the critical need to get health services for substance use disorders to those in need."
It's entirely possible Lovato didn't overdose on heroin. As Krzywicki tells Playboy, "Opioids are drugs that produce morphine-like effects; they can be natural or synthetic. Percocet, fentanyl, etc. are all opioids." You could innocently consume a substance laced with fentanyl, which, according to the Centers for Disease Control and Prevention, is up to 100 times more potent than morphine and many times that of heroin, and overdose. Fentanyl reached an epidemic level in the U.S. years ago: Out of 42,249 instances, 45.9 percent of opioid-related overdoses that resulted in death involved fentanyl in 2016, according to the National Institute on Drug Abuse. You could carelessly pop a Xanax, or snort a bump of cocaine, and would still be at risk of consuming fentanyl, from the same pressed composite found in the Xanax breakout Soundcloud star Lil Peep grievously passed from while using on tour in November 2017.
Whatever happened on Monday night isn't truly our business—what Lovato used or "why" she used is no one’s business but her own. We don't know her, her pain, or her daily struggles. We're merely onlookers and admirers of her celebrity from a distance. Our real obligation in media lies in admonishing the stigma surrounding any type of substance use, especially opioids. As we saw from yesterday's news cycle, plus the barrage of tweets scolding Lovato for "heroin use" and breaking her sobriety, we have no idea how people start using certain substances, what overdosing on opioids means, what "relapse" indicates, or how to handle, and potentially alleviate, an overdose.
Jaffe explains that "many people start with other drugs and stop there" but "some progress to heavier drugs because they are now included in circles that use them and have access to the substances (through drug dealers and friends)." With heroin specifically, "there is an increasing occurrence of people simply starting with opiate pills, eventually developing such a tolerance/habit that pills become too expensive and then switching to cheaper and more efficient alternatives like heroin. Many will start out by smoking or snorting it and then move to injecting."
Krzywicki says when someone tries heroin, "The deciding factor or influencer won't be the drug they use" that ultimately leads them there: "The deciding factors are people and personalities."
Moving on to the next stigma. An opioid overdose, as told to me by Jaffe, is "simply an occurrence in which too much of an opiate (or an opiate mixed with another depressant like a benzo/sleeping-pill or alcohol) is absorbed by the body, slowing down breathing and heart function to a dangerous level where they simply come to a stop. No cardiovascular activity means no oxygen to the cells in the body, including the brain and, unless resuscitated, you die."
And as for relapse? "Relapse is a tricky word. There are slips, stumbles, and trips along the way to any meaningful life change," Sharpe Potter explains. And she continues, echoing Jaffe's prior sentiment on mixing depressants, "If exposed to an opioid after a period of not using, it is relatively easy to unintentionally overdose, particularly if other substances are used concurrently." And relapse is tricky, indeed. Jaffe says "many experts recognize that it is an incredibly common part of nearly 100 percent of recovery experiences, the public still considers it a 'failure' and many professionals and treatment providers use it as an opportunity to shame and corner those who are struggling." Sharpe Potter concedes, "there is no failure and no judgment,"—recovery is truly a process.
"Relapse" is, as I’ve learned, such a stigmatizing, demeaning word to those struggling with addiction that Krzywicki doesn't use the word at all: "I don’t use the word relapse. I use slip. Something happened in her life that was so significant that she slipped up for a moment and that’s all it takes. Choices happen moment to moment. She didn’t lose her sobriety time, her experience, the work that she has done—this was a blip in the big picture of her recovery." Jaffe agrees that slips such as these can be "learning opportunities," and isn't a fan of "sending people to the back of the 'newbie' line to be shamed and embarrassed."
So what's this Narcan stuff that allegedly saved Lovato's life? Well, it's literally a lifesaver. Jaffe describes Naloxone (known to many by the brand name Narcan) as a medication "that can be used to prevent or reverse overdose by essentially clearing the body's opiate receptors and reversing this action." Krzywicki describes Naloxone in a more ass-kicking way, saying the medication "finds where the opioids are and knocks them off the opioid receptor sites that are causing the drug overdose."
However, Narcan is a lifesaver enveloped by stigma that Krzywicki says "oozes of lack of understanding." The people who say it promotes [drug] use do not understand how this medication works. It's not something you can take to reduce your high and use more." Narcan, then, for example, isn't an upper or a downer that replaces the high or low from the substance you've consumed. In Krzywicki's words." Naloxone is classified as a competitive antagonist. What this means is that if you administer naloxone you are no longer high." It's also easy to administer, as an intramuscular injection into the muscles of arms, thighs or glutes, or with a nasal spray device that's as easy to use as a saline spray. It kicks in within five minutes. No more high. It's actually that simple. And this is how we destigmatize it. start to sway those who are wary.
Remembering the years Lovato spent sober, Krzywicki says, “She is crushing it. She has already surmounted every statistic.” Her slip, as I now intend to label a relapse, and hope you all do, too, is nothing more than a roadblock in her recovery process. She’s weathered a lot and deserves love and support—not resentment and guilt—while she builds herself up from the impending grief of the media’s never ending cycle of ridicule and observation. We shouldn’t shame or resent her for one choice. She’ll find the resilience she’s always possessed and continue to be someone to look up to, not despite but because of her struggle and her openness, so as to further shed light on issues women face not just in the limelight, but in real life.
As a final word from Krzywicki, “If you relapse you don't need to apologize, you need a hug, some love and some support.” And as someone who has lost a loved one to the opioid crisis, I can say I’m here for that.