Not long ago, I watched a documentary about Amy Winehouse that you’ve probably already seen. It’s called Amy and came out in 2015. I’d wanted to watch it for awhile, but never get around it.
It carries a really sad message that we are all too familiar with.
Some of the most fun parts are watching Amy Winehouse performing at the beginning of her career. Her songs are esoteric, talky, and full of clever jabs. Her guitar is sparse and her voice is unmistakable. In the video footage she records with her friends from that time, she’s full of swagger and insecure at the same time. She’s a teenager. But the overall effect of the movie is, of course, sad. That she’s lost, she’s gone, and that she suffered so much. Like so many young people whose deaths are related to their addictions, Amy Winehouse’s story begs the question of what we could do differently.
Maybe she would’ve died no matter what. But there’s something absolutely grotesque about her up on stage for years singing “Rehab” at the behest of the music industry machine while her addiction remained inadequately addressed. I believe we could have done better than that.
It’s a low bar.
The thing about Amy Winehouse is that she didn’t “just” struggle with addiction: she had a serious eating disorder. Although there was some public acknowledgement of her addiction—and she did, in fact, go to rehab—there was absolute silence around her bulimia.
Although the corner’s report listed the cause of death as alcohol intoxication, the organ damage precipitated by years of bulimia had reduced her body’s ability to withstand heavy alcohol use. That combination led to her death.
For more on Amy Winehouse’s death—and bulimia’s contribution to it—read the Pitchfork article, “We Need to Talk About Amy Winehouse’s Eating Disorder and Its Role in Her Death.”
Substance Use Disorders & Eating Disorders Overlap
Amy Winehouse was not unusual. Research shows that substance use disorders (SUDs) go hand-in hand with eating disorders (EDs), particularly binge eating and purging behavior. One analysis found that people with bulimia are 4.6 times more likely to be diagnosed with an SUD than the general population. Researchers have had trouble entangling the how and why of this connection (is it genetic? are there shared personality traits?) but the evidence points to a strong connection.
Not unexpectedly, the presence of an ED is linked to poorer recovery outcomes in SUD treatment, and vice versa.
Treatment Providers Need to Address Both
Although there have been calls for integrated treatment of SUDs and EDs, these services are rarely available. What’s more feasible is that treatment centers for either condition effectively screen, recognize, and provide referrals for the co-occurring disorder. Surveys indicate that somewhere between one half and three-quarters of addiction treatment providers are screening for EDs, which is not enough.
According to SAMHSA, addiction treatment centers can use the following validated screening tools for EDs:
- The SCOFF
- The Eating Attitudes Test
- The Bulimia Test—Revised (BULIT—R)
As ED symptoms may emerge over time in addiction treatment, it’s important to perform regular screenings and assessments, rather than just at intake.
In order for a treatment center to provide an effective referral to patients with EDs, the program should have information about ED treatment programs, in addition to local support groups. Overeaters Anonymous and Eating Disorders Anonymous are both open to all, and free.
Finally, treatment centers should provide psychoeducation about the specific risks of disordered eating in the context of an SUD.
Non-Treatment Providers Need to Pay More Attention
As we know, only about 10% of people with diagnosable SUDs will receive specialized addiction treatment. Therefore, the impact of ED screening in treatment facilities (while important) will only affect a minority of people with co-occurring EDs and SUDs. Which means it’s up to the rest of us to pay attention.
First, we need to pay close attention to adolescents. As health or human service providers, educators, and community members, we should be aware that adolescence can be a perfect storm for SUDs and EDs.
Gregorowski et al. (2013) describe adolescence as both a time of “increased susceptibility to socio-cultural pressures towards thinness” and “risk-taking behaviour including substance use.” They observe that for adolescents, both substance use and disordered eating can be a strategy to regulate emotions. All of this occurs in the context of reduced parental support.
“The high rates of concurrent EDs and SUDs found in adolescents…highlight the importance of accurate assessment and intervention for this population,” they conclude.
Parents and anyone who works with youth can pay close attention to the development of EDs or SUDs, and be aware that overlap is common. Amy’s mom, Janis, recounts in the documentary that her teenage daughter had made a casual remark to her one day about food. She’d told her mother that she’d figured out a brilliant way to avoid gaining weight: throwing up after meals.
Janis said she hadn’t taken the comment especially seriously. She’d thought it was a phase. If she had it to do over again, she could have responded to Amy’s comment more directly and made an effort to continue having conversations about emotions, weight, and eating. During those conversations, she could also have touched on alcohol and drug use, including the risks of substance use on an empty stomach. Over the course of time, she could have connected to support for Amy, as well as herself.
Second, we need to remember that just because something looks good, doesn’t mean there isn’t a problem. As a society, we celebrate people whose behavior comes right up to the edge of both SUDs and EDs, which is a dangerous game to play with ourselves and each other. Like many young women, Amy Winehouse liked to party. She was also very thin. We celebrate those traits in our society.
When we don’t like how something looks, we’re more likely to assume there’s a problem. For example, when Amy began using heroin and crack cocaine, her behavior became erratic and her appearance unkempt. The world took notice, often viciously. But no one paid enough attention to her alcohol use and her disordered eating. And those are what eventually killed her.
Amy Winehouse’s struggles with addiction and eating disorders provide important lessons for society about the complexities of these issues and the need for greater awareness, support, and compassion for individuals who are struggling.
One of the key lessons is the importance of understanding addiction as a disease that requires treatment and support, rather than a moral failing or a choice. Amy Winehouse’s struggles with addiction were widely publicized, and the media often portrayed her as a wild and out-of-control party girl. However, addiction is a complex and multifaceted issue that is influenced by a range of biological, psychological, and social factors. By recognizing addiction as a disease, we can help reduce the stigma and shame that individuals struggling with addiction often face and ensure that they receive the support and treatment they need.
Another lesson from Amy Winehouse’s experiences is the intersection of addiction and mental health issues, such as eating disorders. Amy Winehouse struggled with both addiction and bulimia, highlighting the need for comprehensive and integrated treatment that addresses both the physical and psychological aspects of these issues. This also highlights the need for greater awareness and education around the links between addiction and mental health, and the importance of addressing both issues in a holistic and compassionate way.
Amy Winehouse’s experiences also underscore the importance of social support and compassion for individuals struggling with addiction and eating disorders. Rather than vilifying or judging individuals who are struggling, we need to provide empathy, understanding, and support. This can include providing access to treatment and support services, reducing stigma and discrimination, and promoting greater awareness and understanding of these issues.
Amy Winehouse’s struggles with addiction and eating disorders highlight the need for greater awareness, support, and compassion for individuals who are struggling with these issues. By recognizing addiction as a disease, addressing the links between addiction and mental health, and providing social support and compassion, we can help reduce the harm caused by these issues and support individuals in their journeys towards recovery and healing.
It is important to note that while discussing the struggles of celebrities with addiction can help raise awareness and reduce stigma, it is also important to avoid sensationalizing or glorifying these issues. Addiction is a serious and complex issue that affects individuals from all walks of life, and we should strive to provide empathy, support, and resources to all individuals who are struggling.
That being said, here is a non-exhaustive list of some well-known celebrities who have publicly struggled with addiction:
- Whitney Houston – struggled with addiction to drugs and alcohol
- Heath Ledger – died from an accidental overdose of prescription drugs
- Philip Seymour Hoffman – died from a drug overdose
- Prince – struggled with addiction to prescription painkillers
- Cory Monteith – died from a drug overdose
- Mac Miller – died from an accidental drug overdose
- Demi Lovato – has been open about her struggles with addiction and mental health
- Robert Downey Jr. – struggled with addiction to drugs and alcohol
- Lindsay Lohan – struggled with addiction to drugs and alcohol
- Robin Williams – struggled with addiction to alcohol and cocaine
- Charlie Sheen – struggled with addiction to drugs and alcohol
- Drew Barrymore – struggled with addiction to drugs and alcohol
- Angelina Jolie – struggled with addiction to drugs
- Elton John – struggled with addiction to drugs and alcohol
- Eminem – struggled with addiction to prescription drugs
- Matthew Perry – struggled with addiction to prescription drugs and alcohol
- Jamie Lee Curtis – struggled with addiction to prescription painkillers
- Ben Affleck – struggled with addiction to alcohol and gambling
- Kelly Osbourne – struggled with addiction to drugs and alcohol
- Russell Brand – struggled with addiction to drugs and alcohol
- Robin Thicke – struggled with addiction to drugs and alcohol
- Shia LaBeouf – struggled with addiction to drugs and alcohol
- Chris Farley – died from a drug overdose
- Anna Nicole Smith – died from an accidental drug overdose
- River Phoenix – died from a drug overdose
- John Belushi – died from a drug overdose
- Janis Joplin – died from a drug overdose
- Jim Morrison – died from a drug overdose
- Kurt Cobain – died from suicide, with addiction being a contributing factor
- Amy Winehouse – died from alcohol poisoning after struggling with addiction to drugs and alcohol
There are many other celebrities who have publicly discussed their struggles with addiction. It is important to remember that addiction can affect anyone, regardless of their background, wealth, or status, and that everyone deserves access to treatment and support. Millions of people who struggle with addiction every year and should strive to provide compassion, support, and resources to all individuals who are struggling with addiction, regardless of their background or status.
We need to normalise addiction and recovery for everyone.
Conversations about addiction and mental health should be normalized and destigmatized in our society. These are real and common issues that affect many people, and it’s important to recognize that these struggles are not a personal failure or weakness, but rather a complex health issue that requires understanding, support, and resources.
Unfortunately, there is still a significant amount of stigma and shame associated with addiction and mental health, which can prevent individuals from seeking help and lead to further isolation and suffering. Normalizing the discussion of these issues can help to reduce stigma, raise awareness, and provide support and resources to those who need it.
By having open and honest conversations about addiction and mental health, we can help to break down the barriers that prevent people from seeking help and create a more compassionate and supportive society for all. This can involve sharing our own experiences, listening to the experiences of others, educating ourselves and others about addiction and mental health, and advocating for policy changes that support better access to treatment and resources.
It’s time to break the silence and start talking openly and honestly about addiction and mental health. By doing so, we can help to reduce the shame and stigma associated with these issues and create a more supportive and compassionate society for all.
