The autopsy results regarding Cory Monteith’s unfortunate passing were released last week: the Glee star died as a result of “a mixed drug toxicity involving heroin and alcohol.” His death is a reminder that this tragedy happens all too often.
With chemical dependency, particularly with opiates and opioids like heroin, users develop a large tolerance and need to consume increasingly greater amounts to achieve the desired effect. This occurs with both alcohol and other drugs, but particularly with opioids. The initial need for one 80-miligram Oxycontin pill, fentanyl patch or bag of heroin increases over time to an amount that would be lethal to most people if they didn’t have that tolerance.
We may never know how much heroin was in Monteith’s system at the time of his death. However, we do know that it can be lethal when an addict returns to the same dose of a drug after he or she had previously been clean for a period of time, especially if the drug is mixed with alcohol or other substances. Their body no longer has a tolerance for the drug and it may shutdown in response.
The media has also reported that Monteith seemed to be functioning well in advance of his death. Unfortunately, we do see addicts relapse after having a few months of sobriety under their belt while they are in a positive emotional state. Having gotten their lives back, some individuals in early recovery are doing so well and feeling so good, they end up wanting to “celebrate” by “rewarding” themselves with a drink or a drug.
However, by doing so, the reward center of the brain is activated. If the person lives through it, that door is once again open to repeating this behavior. Usually, it is not long before the person is using as much or more than when they had stopped using or drinking previously.
Experiencing a desire to drink or use (an urge or craving) is not unusual for an addict and quite understandable. The danger lies in not being open and honest with yourself and sharing that thought or feeling with another person, like your sponsor, in order to take the power away from it. Over time, the person may impulsively act on those thoughts, especially if they are kept a secret.
In early recovery, it can be extremely dangerous for a person to become super busy again with family, work, and other responsibilities because he will not be able to stay focused on actively working a program and staying connected. What can easily happen is the person’s priorities shift. Initially they have consistent meeting attendance and connection with a sponsor, take time to work the Steps, and develop relationships within the Fellowship.
Later on, however, these priorities begin taking a back-seat and become sporadic. All the while, the person has no desire to drink or use, but is gradually walking away from that safety net. Life gets busy and seemingly out of the blue, they end up experiencing that “strange mental blank spot” where having “just one” cocktail, glass of wine, beer, pill, hit, etc. seems innocent enough. Again, that door is once again open and it’s not long before they experience exponentially worse consequences, including potentially an accidental, tragic death.
It’s highly likely Monteith didn’t mean to take his life; he had many things for which to live. Media reports indicate that he had three projects in the works, was involved in a serious relationship, and was in an optimistic mood.
Celebrities in recovery or those who have been in treatment have added pressure because they’re in the public eye. They may also frequently find themselves in environments where people are drinking and taking drugs. There were reports that Monteith may have recently been associating with friends with whom he had used drugs in the past. Other reports said friends had been in his hotel room earlier that night. The question arises as to whether or not his friends were supportive of his recovery.
Celebrities (and all drug users) must really embrace recovery for the best possible outcome. According to the National Institute on Drug Abuse (NIDA), relapse rates for drug addiction are similar to those of other chronic illnesses. People need to surround themselves with sober friends and actively work a program.
In February, the Journal of the American Medical Association reported that drug overdose deaths were on the rise for the 11th straight year. The U.S. is experiencing an epidemic of prescription pill abuse, and in some areas around the country, including more and more in affluent suburbs, this is leading to an increase in heroin use; a drug which is readily available for much less than prescription painkillers.
NIDA research holds that men relapse more often than women, partly because more women attend counseling. At Caron, we offer gender-specific treatment because we find that getting men together, for example, allows them to share similar concerns with other men and focus on their recovery more productively. This also works well because occasionally people in early recovery have entered into relationships too quickly, taking their focus away from where it needs to be, which has led them back to their chemical use.
We have a coed program for those who relapse. If people in this unit become focused on the opposite sex, we approach this as a clinical issue and address it as part of their relapse prevention program.
Unfortunately, societal norms can make it difficult for a man to ask for emotional help. We want to remind everyone that addiction is a disease and not a moral failing or character flaw. If you or someone you love is struggling with mental health or addiction issues – please remember not to shame or blame them. Instead, help empower them to get the care they need to lead a healthy and productive life.
Marty Ferrero is the Senior Clinical Director of Adult Services at Caron Treatment Centers.