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Amy Winehouse Died Clean?

WARNING: Video depicting severe alcohol withdrawal below.

Well, maybe. The latest report is that there were no illegal substances in Amy Winehouse’s system when she died.

Amy Winehouse Portrait

Toxicology tests have found that “no illegal substances” were in singer Amy Winehouse’s system at the time of her death last month, her family said Tuesday.

“Results indicate that alcohol was present but it cannot be determined as yet if it played a role in her death,” the family said in a written statement, citing test results provided to them by authorities.

The 27-year-old singer, beloved for her talent but infamous for erratic public behavior, arrests and drug problems, was found dead at her apartment in London on July 23.

Alcohol was present, but we don’t know yet if drink had anything to do with her death. No surprise, since there are plenty of reports that Amy was still drinking in her final days. Still, that leaves at least one theory about what killed Amy Winehouse, which remains viable even in the light of this recent news.

It wasn’t alcohol that killed Amy Winehouse, but the lack thereof. She died from alcohol withdrawal. Can that happen?

Yes. While alcohol withdrawal symptoms are often mild—pronounced sweating, hand tremors, and nausea, for example—more severe cases can critically damage the nervous system. That can lead to seizures, heart attack, and other life-threatening conditions. Symptoms of alcohol withdrawal generally stem from the fact that heavy drinking forces changes in the brain’s sensitivity to key neurotransmitters. When someone stops drinking all of a sudden, the rebound effect can be deadly.

The most severe effect of this rebound is known as delirium tremens, meaning “shaking frenzy” in Latin. This develops in about 5 percent of patients hospitalized for alcohol withdrawal and kills about 5 percent of those who develop it. (Timely diagnosis and treatment, however, can reduce the mortality risk to around 1 out of every 2,000 hospitalized patients.) Symptoms of delirium tremens, also known as “the DTs,” include floating in and out of consciousness, hallucinations, seizures, nausea, and diarrhea. The condition also impairs the autonomic nervous system, and a history of other drug use increases the risk for alcohol-related seizures.

It’s not pretty.

According to Amy’s dad, she had been trying to kick alcohol towards the end. There were also reports that she suffered from seizures. The last one happened about two weeks before her death.

A source told the Sun that Winehouse’s most recent seizure had been just two weeks ago, when she was found collapsed on a London street and taken to a private clinic. She had been admitted to the hospital by ambulance on a regular basis suffering seizures. Her nervous system was shot to pieces, the source was quoted as saying.

But she seemed to have it together enough when she made her last public appearance with her 15-year-old protégée, Dionne Bromfield, two nights before her death.

Her last stint at rehab lasted just one week. That leads me to think that Amy didn’t get the kind of rehab she needed not only in the sense of dealing with the psychological and emotional side of addiction, but also the very real physical consequences of long term or particularly intense addiction.

In that sense, Amy didn’t really die of a lack of alcohol. She died of a lack of medically supevised detox.

Abruptly stopping the use of any psychoactive substance results in withdrawal symptoms, but the lengthy use of certain drugs results in a physical addiction and upon cessation of use, a more difficult or dangerous period of detoxification.

You will likely need a medically supervised detoxification if you are addicted to:

  • Alcohol
  • Benzodiazepines (Xanax, Valium, Ativan, etc.)
  • Opiates (such as heroin)
  • Opioids (such as OxyContin or hydrocodone, etc.)

The physical withdrawal symptoms for alcohol or benzodiazepines can be dangerous. The brain adapts over time to the frequent and regular use of these sedatives by “speeding up” to fight the “slowing down” caused by the drugs or alcohol. If you suddenly stop taking these drugs, the brain can speed up dangerously, causing potentially life-threatening symptoms such as convulsions.

The long-term use of opiates or opioids changes the brain’s endorphin systems. Opiate addicts have much less of the feel-good chemicals in the brain that regulate pleasure and pain. An opiate addict needs drugs just to bring their endorphin levels back up to normal, and without the continual use of the drug, low endorphin levels cause a very uncomfortable period of withdrawal. Supervised withdrawal and/or the medication management of an opiate addiction is almost always necessary.

What Amy probably needed was a medically supervised detox — with a nurse or doctor keeping close watch on her condition, vital signs, etc., until she was out of withdrawal — follwed by a rehab program. If I were to guess, I’d say she needed a 90-day inpatient program at the very least. Why she didn’t get it is anybody’s guess. Maybe she didn’t want it, and there was no way anyone could make her do it.

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