Why Years of Sobriety Don’t Mean Someone Is Cured

Demi Lovato is in the hospital after an apparent drug overdose, according to People and other media outlets that broke the story yesterday. Audio of an emergency call obtained by TMZ reveals that the 25-year-old pop star was unconscious when paramedics arrived to the area near her Los Angeles home, and that she was revived with Narcan—an emergency medication used to reverse the effects of a narcotic overdose.

The singer’s publicist said today that Lovato is awake and with family but did not reveal any details about the events that led to her hospitalization. Lovato battled addiction and mental illness for years and released a song in June called “Sober” in which she apologizes to her fans and loved ones for a recent relapse. A source close to Lovato tells People that an overdose is “absolutely what so many people feared.”

Just a few months ago, though, Lovato was portraying quite a different public image. In March, the star commemorated her sixth year sober with a tweet: “So grateful for another year of joy, health and happiness,” she wrote. “It IS possible.” A year earlier, she Instagrammed an image from a Twelve Steps app showing her five-years-sober anniversary.

For Lovato’s fans and loved ones who celebrated those milestones with her, her overdose can seem shocking. And for those struggling with addictions of their own, it may be extremely discouraging to watch someone with so many days, months, and years of sobriety slip back into such a dangerous situation.

Unfortunately, relapses are common—and they do happen, even after years (or even decades) of clean living. But that doesn’t mean that permanent sobriety isn’t attainable, says Sherrie Campbell, PhD, an addiction specialist and author of Success Equations: A Path to Living an Emotionally Healthy Life. (Campbell has not treated Lovato.) Here’s what addiction experts want you to know.

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Relapses can happen for a variety of reasons

“Being sober for years can be a tricky thing, because it is easy to convince ourselves that we’ve got it handled, and we may falsely assume that we are now safe to dabble again—that we will be able to handle it,” says Campbell. Relapses can be triggered by a variety of events or emotions, she says, including stress, boredom, exhaustion, or pressure from other people or situations.

Campbell says that loneliness can also be a big factor when recovering addicts return to drug use. That may be true in Lovato’s case, she hypothesizes, since the singer has been single for some time.

“It seems that Demi is the most balanced when she’s in a relationship, which is nearly all of us as human beings,” she says. “When we are lonely we feel without love, and nothing can pick you up quicker than a fast-acting drug.”

The longer a person is sober, the better his or her chances of staying away from drugs permanently, Kenneth Leonard, PhD, director of the Research Institute of Addictions at the University of Buffalo told Health last year, after actress Carrie Fisher died. (Fisher battled addiction for many years.) But addiction causes long-lasting changes in the brain, he added, and even years later, “people continue to experience those desires to want to take their drug of choice.”

Genetics and mental-health conditions can make the struggle even harder

Lovato has spoken in the past about how her father was an addict, and that she “always searched for what he found in drugs and alcohol.” For her and for many others who struggle with addiction, genetics may play a significant role, says Campbell.

Psychological conditions can also make people more vulnerable to drug addiction and to relapses after seeking treatment. Lovato was diagnosed with bipolar disorder at age 18, and she previously sought treatment for bulimia and self-harming behaviors.

These conditions often go hand-in-hand with addiction, says Campbell. “Although they are shortcuts to happiness, they reward the person with immediate change,” she says. “The problem is that true and lasting happiness can only come from hard work, commitment, and daily self-examination, so that we have the best chances at living our lives with responsibility rather than rebellion.”

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Getting sober a second time can be harder than the first—but it’s possible

“The hardest part of getting sober the second time around is getting over and through the disappointment and shame of relapsing,” says Campbell—especially for public figures who may feel like they “let the world down.” But, she adds, “it is possible for anyone to get sober permanently.”

Leonard told Health that recovering from an addiction requires the support of friends and family, but that it may also require medication and behavioral and psychological counseling. Lovato is no stranger to structured addiction treatment: In 2011 she entered a treatment center, and later spent a year in a sober living facility.

Campbell gives Lovato credit for speaking so openly the past few years about her addiction and her recovery, and for bringing awareness to a problem that so many people struggle with. “If Demi can continue to be open about her issues and use her pain for positive,” she says, “that would be a driving and motivating force for her to get sober and stay sober once again.”

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