Amy Winehouse can Remind us of Those who Died With Less Fanfare

13/09/2011 00:02 BST | Updated 12/11/2011 10:12 GMT

What are we to make of Amy Winehouse's struggles? We might never know why she died so suddenly, and maybe the details are less important than the attention to addictions that has been generated. Perhaps we can respond with an echo, and think of so many others: drug addicted women who were not so famous yet who died just as tragically, whose parents and loved ones shed just as many tears.

And Amy's famous song about not wanting to go to rehab is, for me, an echo as well: I recently wrote and published a book in response to two overdose deaths of women very dear to me. Why weren't they in rehab? Why didn't they want to go? While I can't speak for Amy Winehouse, I can tell you about two close friends: one whom I found dead in my bathroom, and another I watched being removed from life support after all efforts to save her had failed.

These girls also had an aversion to rehab, and I know a bit about why. They weren't pop stars, but drug addicted working girls, turning tricks and doing whatever they had to do. They had little use for a recovery machine that told them how, if they weren't ready to abstain, it was because they had not yet "hit bottom". For these women, this bottom would obviously entail repeated beatings and sexual assault. How could they respect a treatment culture stupid enough to suggest that such abuse will render a woman - any woman - less likely to get high?

Yet throughout the 20th century, the story was that a "bottom" is what every addict needs. Too bad if it has been proven time and again that people are more likely to leave an addiction in response to positive developments, and less likely to recover in response to tragedy and abuse. Forget the evidence, forget the facts - let's get tough fellas!

And even after the so-called bottom has been reached, the system persists with all kinds of nonsense, from tough love (which really means no love) to an uncompromising abstinence principle (which really means blind intolerance).

One thing the recovery machine, professional and grassroots, overlooks is that abstinence is simply not feasible for most addicts -- at least not right away. For an adult who has been self-medicating since early adolescence, complete abstinence is often destructive. In normal medical practice, professionals work with -- rather than against -- a patient's tendencies. Yet with addiction, an immediate 180 degree reversal is expected. In most cases, this "solution" is a violent, dangerous assault on a person's entire being.

But there's more: most people leave their addictions without rehab or 12 Step groups. It's a natural process. So if you throw 20 people at an abstinence-oriented intervention, statistically one might turn out well - that's the one who probably would have achieved it without treatment. Then the system will take credit for the success story it didn't cause, and brag about how it abandoned the ones who actually needed help - "if you're not ready to change completely, we got no time for you!"

That's how warped and backward-ass the 20th century approach to addictions has been. In the early 21st century, we are starting to move past that approach, though not nearly as fast as we should. The approach is a malicious, ignorant joke - and the time has come to leave it in the dust.

We need a better way. Not for Amy Winehouse and others like her who no longer need our help, but for the ones struggling right now, and for the ones yet to come.