Dr. Drew, Suicide and Addiction

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Dr. Drew Pinsky, host and producer of “Celebrity Rehab with Dr. Drew,” announced earlier this month that the series would not be renewed for another season.

"It's very stressful and very intense for me," Pinsky said. "To have people questioning my motives and taking aim at me because people get sick and die because they have a life-threatening disease, and I take the blame?"

Pinsky is referring to criticisms of his show, both because it exploits addicts (showing them at their worst) and because five “cast members” have died after appearing on it. Two of the deaths were from overdoses: Mike Starr and Joey Kovar (opiates); one was from health complications of addiction (Jeff Conaway); one an accident while intoxicated (Rodney King); and the latest death, that of Mindy McCready, a suicide.

Suicide Risk Factors

The link between addiction and a higher risk of suicide is well known but actual numbers are difficult to come by. Partly, this is because an overdose (especially of injectable narcotics) is assumed to be accidental when it may have been deliberate. While in treatment, addicts and alcoholics can have their suicide risk assessed, giving us some insight into the association.

Suicidal behavior in alcohol-dependent subjects has been the subject of many studies that try to understand the genesis.

Alcohol use and misuse are strongly linked to suicide risk. The estimated lifetime risk for completed suicide among individuals with alcohol dependence is 7 percent, and those with alcohol dependence are at a 6.5 times greater risk for attempted suicide compared with those without alcohol dependence. Consequently, many patients seeking alcohol dependence treatment have a prior history of suicide attempts. Research on patients treated for drug and or alcohol problems indicates that these patients remain at a high risk for suicidal behaviors following treatment.

A study in “Alcoholism: Clinical and Experimental Research” listed the following risk factors:

  • Previous suicide attempts - both alcoholics and heroin addicts.
  • Suicide ideation - thinking about killing oneself (also for both types of patient).
  • Violence- particularly difficulty in controlling their own violent behavior (alcoholics).
  • Depression or psychosis- a general risk factor in the population.
  • Poly Drug Use- for both alcoholics and opiate addicts.
  • Youth and unmarried status- was a risk factor in alcoholics.
  • Social isolation- was a risk factor in opiate addicts.

Treatment Outcomes

Because the risk of suicide is so high in the addiction community (4 percent of those out for a year reported a suicide attempt in the previous month), evaluating those in treatment for risk factors and providing care directed at suicide prevention is warranted.

The study cited above found that when patients more closely participated in substance abuse treatment (especially cognitive behavioral therapy) their overall risk of taking their own lives decreased. Getting better is then best seen as improving overall mental health, rather than simply a statistic about abstinence.

“It sucks to be on drugs and it sucks to be off drugs.” That’s the unfortunate reality for many with a substance use disorder. They are caught between two difficult options and some never find a way out. Those who treat addiction have the tough task of instilling hope in the hopeless and helping them see a better future when the present is pretty bad.

In the end, Celebrity Rehab showed us the reality of addiction and treatment – all the warts and disappointments, and yes, the failures. Pinsky can’t be blamed for taking on a task that, at times, is impossible.

"These are really sick people, that's why they die," Pinsky said. "These are people with life-threatening addiction."

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