Whitney Houston's death last month from accidental drowning and the effects of cocaine use and heart disease throws a bright light on a dark corner of the world of celebrities who wrestle with substance abuse.
The toll of celebrity addiction -- to street drugs, prescription medications, alcohol or a mix -- is long and mournful, and it seems particularly heavy right now because of the deaths of Houston, 48, and Amy Winehouse, 27.
And not just them: In recent years, Michael Jackson, Heath Ledger and Anna Nicole Smith have succumbed to overdoses; going back further, the list includes John Belushi, Marilyn Monroe, Elvis Presley and Judy Garland.
Americans these days can't escape the steady stream of news about celebrities and their controlled substances. Take Lindsay Lohan, 25. After years of erratic behavior, multiple arrests and five stints in rehab, Lohan says she has cleaned up her act. She promised to stay away from drugs and alcohol, and she completed her comeback gig as host of Saturday Night Live March 3 (ratings were good but reviews were mixed).
Recent weeks also brought news that actor Gerard Butler (300), 42, and comedian Artie Lange, 44, both completed rehab for addiction and are back working. Yet actress Demi Moore, 49, who was hospitalized after smoking something that gave her convulsions, sought "professional assistance" for her problem. And actor Alex O'Loughlin, star of CBS' Hawaii Five-0, has announced that he would take time off to get "supervised treatment" for pain medication prescribed after a shoulder injury.
This sort of thing is not uncommon in Hollywood: Actress Tatum O'Neal, 48, who has long battled to overcome substance abuse, also is in "supervised treatment" to prevent a recurrence of addiction, to painkillers prescribed for back surgery. "She will always seek supervision when taking prescription medication that has addictive potential," according to a statement issued by her manager, Angela Cheng Caplan.
But it's fair to ask: Is there a fatal attraction between celebrities and controlled substances? Why do some survive and some die?
"It's that caustic mix of sudden celebrity and being strung out and it being condoned by the people around you," says Duff McKagan, 48, the original bass player for rock band Guns N' Roses and a longtime drug and alcohol addict who had to nearly die from an exploding pancreas in 1994 at age 30 before he was motivated to get help. His mother weeping in her wheelchair over her youngest child, and his eventual discovery of the physical and spiritual strengths of martial arts, also helped, he says.
A painful reminder
Houston's death brought up painful memories for daytime talk-show host Wendy Williams, who walked away from her secret cocaine addiction years ago because she wanted a better life.
"Whitney and I, same age, and both plagued with the demon of substance abuse," Williams said tearfully on her show shortly after Houston's death. "It's been almost 15 years since I smoked last from a crack pipe. It's been almost 15 years since I waited on Jerome Avenue in the Bronx for my drugs."
Williams, 47, whose 3-year-old talk show has been renewed for two more years and is syndicated in more than 150 markets, started dabbling in drugs when she was in college, and fame and success later did nothing to stop her escalating habit. She looks back on those years with her signature mix of humor and self-awareness. A middle-class girl with middle-class values, she says she could not have survived the "TMZ era" of salacious attention on celebrity addiction.
"I never wanted to shame my family, so I just stopped," she says. "The unspoken disappointment of the people closest to me was tearing me apart. That girl who went through that, it made me the woman I am today, but I would have ended up dying. And if I hadn't died of dying, I would have died of embarrassment. I would have lost my job or been written up in the New York Post."
Addiction experts say celebrities are not more prone to addictive behavior: Anyone can inherit that DNA.
"Addiction does not discriminate," says Kevin Hill, addictions psychiatrist in charge of drug abuse treatment at Harvard Medical School's McLean Hospital. "People use according to psychosocial stressers. Celebrities might have slightly different stressers, such as fame, but they use drugs like regular people -- they just use better drugs."
What actors, singers, athletes, even CEOs have that regular people might not have is more access to drugs, more time to indulge, more money to pay for the addiction, and often a horde of enabling hangers-on who are financially dependent on them and thus more motivated to supply substances for them.
It all adds up to a lifestyle that is hard to walk away from, McKagan says.
"Some can do (drugs) and move on and some do it and get stuck. In the last year before ending up in the hospital, I had given up. I said, 'I can't stop this,'" says McKagan, author of the memoir, It's So Easy (And Other Lies). "I had to be scared to death."
Winehouse's death in her London home last July probably was caused by accidental alcohol poisoning, according to the coroner's report. Her parents are setting up a foundation in her memory to help people overcome addiction.
Houston was found submerged in a Beverly Hills hotel bathtub last month with bottles of prescription pills in her room. Her family said she was taking anti-anxiety drugs, and she was seen drinking the night before.
On CNN last month, Republican presidential candidate Rick Santorum said celebrities such as Houston are "the royalty of America" who set a bad example by their drug use.
"Ridiculous," Hill says. "He implies that she chose to suffer such a fate, when in fact she made multiple efforts to treat it. To say that someone makes a conscious decision to have her life go down the drain is preposterous."
Yet one of Houston's close friends, R&B legend Chaka Khan, herself a recovering drug addict, said on CNN that her best memories of Houston involve getting high with her and Houston's ex-husband, Bobby Brown. "Talking crazy and having a really, really, really good laughing, and a really, really good time," she said.
With coverage of Houston's death and Michael Jackson's drug overdose death in 2009, it's easy to forget that there are more survival stories than tragedies among celebrity addicts.
Rocker and American Idol judge Steven Tyler, 64, who came close to dying from drug abuse, appeared with the other members of Aerosmith on 60 Minutes , talking about the ravages of addiction on bodies, band and relationships. But after 40 years, and lots of rehab, they're still rocking, about to tour and about to record another album.
Actress Kirstie Alley, 61, was "way into drugs" when she was Lohan's age, she recently told Access Hollywood. "If you don't die doing them, you just screw up your life sort of royally," she said.
Actor Robert Downey Jr., 46, may be Exhibit A for the celebrity comeback from addiction. Not so long ago, he was being sentenced to jail for drug-related offenses; now he's out, he's recovering and he's a bigger star than ever with lead roles in the Iron Man and Sherlock Holmes movies.
Actress Mackenzie Phillips, 52, was once so drug-addled that she spent hundreds of thousands of dollars on cocaine, lost jobs and lovers, used drugs while pregnant with her son, watched as close relatives died from drug abuse, and says she was even reduced to a years-long incestuous relationship with her equally addicted father, musician John Phillips of The Mamas and the Papas.
She should be dead, she says, and she gives herself credit for battling back from the brink. True, most of her family cut her off because of what she says about her late father, but she feels she has finally escaped her past. "At last I'm living the health and happiness that I always described but never experienced," she wrote in her 2009 memoir, High on Arrival.
There's nothing new about celebrity addiction. Billie Holiday, the great jazz singer who died in 1959, may have been one of the first major celebrities to go to her grave too early (she was only 44) because of the effects of alcoholism and drug addiction.
Nor is there anything new about addiction among non-celebrity Americans. According to the government's Substance Abuse and Mental Health Services Administration, 23.5 million people 12 or older needed treatment for a drug or alcohol problem in 2009, but only 2.6 million actually were treated at a specialty facility (aka rehab).
As for addiction deaths, those happen among ordinary people, too, but we don't hear about them because they're not celebrities.
A new addiction
What is new is that increasingly Americans are getting hooked on prescription drugs, and ending up dead or close to it by accidentally taking too much or mixing them with alcohol. The number of overdose deaths from painkillers more than tripled from 1999 to 2006, to 13,800 deaths that year, according to Center for Disease Control statistics released in 2009.
Conservative radio king Rush Limbaugh, 61, was pescribed powerful painkillers after back surgery. He ended up hooked in 2003, was caught trying to acquire them illegally, was arrested and spent a month in rehab.
Prescription drug addiction has become "an epidemic," says psychiatrist Marc Galanter, director of alcoholism and substance abuse treatment at NYU Langone Medical Center/Bellevue.
"There's a whole new raft of (narcotic) drugs available that will compromise you, and you don't have to be a celebrity to afford them -- middle-class people can afford them," Galanter says.
Why do people who are rich, famous, beautiful and talented feel the need for drugs and alcohol? Life coach and family advocate Lisa Nkonoki, who says she helped Ray Charles Jr. overcome his addictions, has offered her services to her longtime friend, Brown, father of Houston's teen daughter, Bobbi Kristina, who as the child of addicts is at risk of stumbling down the same path. Nkonoki says celebrities, like anyone else, can become addicts because they don't feel strong or good about themselves at some level.
"It's an escape (from) the persona people want them to be instead of the person they truly are," she says. Stepping away from addiction, she says, comes only after accepting that it's a disease.
"When you get this disease, you have to deal with it, manage it, emerge from it and move on."
The key factor in treating addictions, celebrity or otherwise, is recognizing that there's usually an underlying mental-health problem, says Kathleen Bigsby, CEO of The Canyon at Peace Park, an exclusive and ultra-private comprehensive treatment center in Malibu that has treated celebrities (no names, she says) for addiction and "co-occurring disorders."
Actress/writer Carrie Fisher, 55, was addicted to drugs and drink (and food) almost from the time she became a star playing Princess Leia in Star Wars. Was it fame that made her a mess? Probably not, because she's also bipolar and her childhood as a Hollywood princess (daughter of Debbie Reynolds and singer Eddie Fisher) left her plagued by insecurity and despair, she says. Fame didn't help.
Fisher turned her difficulties into successful comic memoirs and stage shows, writing in her latest book, Shockaholic, that she tried everything to cure herself over the decades -- therapy and retreats, overeating and fasting, 12-steps, meditation, rebirthing, walking over hot coals, jumping out of airplanes, climbing mountains, floating down the Amazon, speaking in tongues you get the picture.
And yet, "I still did not feel -- how shall I put this -- mentally sound," she writes.
The problem for celeb addicts is they have to struggle and recover in public, in the glare of social media and the 24/7 celebrity-media industrial complex, Bigsby says. Nowadays even D-list celebrities are in the spotlight.
Meanwhile, tragic deaths can teach grim lessons, but sometimes not, addiction expert Galanter says.
"It alerts people to the danger, but can also make it attractive, because if a celeb is doing it, people think maybe they can risk it, too," he says.
"Deaths might sober people up, but it depends on how sensible people are. I hope so."
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