Demi Lovato's Recovery Plan

Source: marcen27/Wikimedia Commons (CC BY 2.0)

After listening to Joe Rogan’s interview with Demi Lovato that aired on March 27, 2021, I wanted to take some time to form both my personal and professional opinion of their current recovery path. I am a therapist who specializes in addiction treatment, and I am also a person in long-term recovery from alcoholism.

I listened intently for 2.5 hours to the interview and I appreciated their honestly about past traumas, family issues, mental health conditions, eating disorder, and substance use disorder (SUD). There is no doubt that whether or not they are a celebrity with a complicated clinical. Through the years, I have learned about their advocacy work with addiction treatment and recall vividly her 2020 Grammy performance when they sang a song, “Anyone,” about their cry for help prior to their 2018 overdose. I was truly stunned about the acuity of that drug overdose, as it led to their nearly dying from having “three strokes and a heart attack” and vision loss that has continued to this day.

But to me, the most shocking thing about all that Demi has been through is their recent public disclosure of being "California Sober.” As a therapist, I have learned to be open-minded about a variety of recovery paths for clients, including abstinence and harm reduction plans. I do my best to meet clients “where they are at” and would prefer that they continue to get support as they navigate their way through the often non-linear recovery process.

Demi has stated that they feel abstinence “sets me up for failure.” However, they had maintained six years of sobriety from 2013-2018. They explained to Rogan that they are finally in recovery from an eating disorder after struggling with it since they were 8 years old, through a moderate approach to eating. They then decided that it made sense to apply that same philosophy to their SUD. They stated they had been sober for several months and felt deeply depressed. They then stated that they “passed the idea by my treatment team” and the team agreed to support them in the pursuit of finding a middle path in their SUD recovery.

It is important to understand that the treatments for eating disorders and for SUDs are different. Those in recovery from an eating disorder need to learn to find a healthy balance in their food intake because they need food to live. However, those with SUDs can find a way to abstain from their addictive substance because they do not technically need that substance to stay alive.

In listening to Demi's interview, I wanted to ask if they were receiving any help for mental health issues. They reported a history of bipolar disorder and has been chronically suicidal throughout their life. It is imperative that those with a dual diagnosis (having both a SUD and another mental health diagnosis), are treated for both conditions concurrently.

What is the main risk of Demi’s recovery plan?

The issue is not their personal choices regarding a recovery path that they are working on with a treatment team. Everyone has a right to engage in the recovery process in a way that works for them and their loved ones. However, this process involves a plan that goes against American Society of Addiction Medicine guidance suggesting that abstinence tends to be the most reliable treatment plan for those with SUDs when opiates are involved. Additionally, with 102 million Instagram followers and millions of other fans, they have the ability to influence so many teenagers and young adults simply with a social media post or a comment in an interview.

Demi’s drugs of choice were reportedly heroin and cocaine. They stated that they are presently smoking marijuana and drinking alcohol “in moderation.” This “California Sober” plan would seem to fall under the harm reduction category. The thinking behind this is likely that if one uses substances that appear more benign than cocaine and heroin, that reduces the chances of incurring harm from cocaine or heroin use and/or overdose. This harm reduction plan may or may not work for Demi; They also have a different level of access to treatment and their own unique life circumstances. For many other people with SUDs, these are the possible dangers of using this type of plan:

1. When a person with a SUD is intoxicated on a substance other than their drug of choice, they may experience impaired judgement and control and return back to using their drug of choice.

2. The line is blurred about what is and is not a relapse, which can make a relapse back to using the drug of choice more easily justified.

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3. The individual could start self-medicating with the new substance and not address underlying issues nor treat them comprehensively.

4. A person could develop a new addiction to the substance that they are using for harm reduction.

5. A person could lose confidence in their ability to maintain complete abstinence.

Demi said during her interview that for the first time they feel they are "living in my truth." There are parts of my own recovery process in the past that may be considered high-risk for relapse. However, I do not share about them publicly, because I do not want to encourage others to try those approaches, despite their working for me. I fully support individuals in the pursuit of finding out the truth of who they are, as it can bring about the best quality of life and self-confidence. However, it was risky for Demi to talk publicly about this type of recovery plan given the influence it might have on others.

*Addendum: It should be noted that it was reported on December 2, 2021 Demi had stated that she was now completely sober from all substances. See article below.

https://www.today.com/health/demi-lovato-renounces-california-sober-say…

Image credit: marcen27/Wikimedia Commons (CC BY 2.0)