Amy Winehouse - Dies at age 27

Amy Winehouse and the Pain of Addiction
By Maia Szalavitz Sunday, July 24, 2011

Another addiction death comes at age 27, with Amy Winehouse joining Jimi Hendrix, Jim Morrison, Kurt Cobain and most aptly, Janis Joplin among the rock icons who died from their disorder at the same point in their young lives. And sadly, her passing also presents another occasion for well-intentioned people who misunderstand addiction to push counterproductive solutions.
Janis Joplin once said that she made love to 25,000 people at her concerts, but went home alone. It's that yearning for love and acceptance, that aching but unanswered need for connection that underlies both the drive for fame and the pain of addiction, which may be why the two are so often found together.

The pain that infused Winehouse's voice seemed inextricable from her talent and was one thing that allowed her to move so many so profoundly. In counterpoint, her joyous sounds seemed that much more uplifting. It's that deep and complex mix of feelings that helped her fans connect to her even as she herself never benefited from that connection. That paradox is at the heart of the addiction.

(PHOTOS: The Life and Times of Amy Winehouse)

Here's why: a key pillar of addiction is often self-hatred and an inability to see oneself as worthy of love. In songs like “You Know I'm No Good,” and “Back to Black,” Winehouse made those feelings painfully plain. If you're an addict, that belief has probably always been with you. You may make a desperate attempts to pile up evidence otherwise—Look at my million-selling songs! My stadiums full of adoring fans! My husband who tolerates whatever I dish out! But it can't possibly be enough. You know that if they really knew you, they'd hate you.

For obvious reasons, this makes relationships almost impossible. The stress of being unable to take in love and social support feels unbearable and can warp the personality. Indeed, research suggests this may be one of the worst forms of stress we can experience, since our emotional systems are designed to be buffered by social contact and cannot balance themselves without it.

Is it any wonder then that drugs seem like the answer? Physiologically, alcohol and opioids like heroin replicate the chemistry of relational connection, with opioids acting directly on the brain's bonding systems and alcohol having a more indirect effect. The relief and comfort that children get in their parents' arms is mediated by the body's natural opioids; this same attachment system later creates the bonds between lovers and friends.

Cocaine and stimulants like methamphetamine, in contrast, produce a sense of power, motivation and worthiness. Put them together, as Winehouse seems to have done and as I did during my own period of addiction, and you get moments of intense euphoria and satisfaction interspersed with simple stress relief and the ability to comfortably tolerate being in your own skin.

(MORE: An Addict's Battle With Painkiller Addiction Reveals Outdated Rehab Tactics)

That is, of course, when you can get the drugs, get enough of them and they work, before chasing tolerance, legal hassles or other circumstances interfere. Contrary to popular belief, however, it's not the euphoria that hooks you. Instead, it's the ability simply to feel OK, the silencing of that voice of self-hate and the small sense of adequacy that comes in those quiet moments.

Only if an alternative method of reaching that state can be achieved is recovery possible. For me, that came in learning that my belief in my own unlovability was a delusion and that my pain could be reduced by sharing it. Unfortunately, you can't forcibly teach this. Even if Winehouse hadn't said “no, no, no” to many rehabs, no therapy would be able to reach her if she couldn't first come to believe that her intolerable pain could end without self-medication.

And that's why rehabs that use coercive tactics are often so counter-productive and why trying to force abstinence can backfire. We know that the British system of addiction care offers more access to “harm reduction” programs that don't require abstinence — but we don't know whether Winehouse was offered this approach, what the circumstances of her death were and whether anything could have prevented it.

Over the next few weeks, I'll continue to cover policies and practices that might reduce overdose deaths, and they do exist. One thing, however, is certain. Blaming drugs or Winehouse's “enablers” for her death misses the point: what she needed was compassion, most of all from herself.