Celeb Rehab: Are Genes or Fame to Blame?

June 3, 2008 — -- Actress Tatum O'Neal, who was arrested Sunday after allegedly buying cocaine on a New York City street corner, says the cops who arrested her may have saved her life.

"I'm still sober!" O'Neal told The New York Post after she was released from jail Monday. "Just when I was about to change all that and wreck my life, the cops came and saved me."

Tatum, whose battles with addiction have been well chronicled in the tabloids and in her own memoirs, is another in a long conga line of celebrities who have attributed their drug addictions, in part, to the struggle to adjust to the pressures of childhood fame.

Tatum won an Oscar at age 10 for her role, opposite her father, in the movie "Paper Moon."

But O'Neal's struggle with substance abuse suggests that her rescue from a repeat encounter with drugs may only be the beginning of a larger battle, and may have as much to do with genes as it does with celebrity, experts say.

O'Neal described her trajectory from child stardom to treatment for addiction in her 2004 memoir, "A Paper Life." As the youngest person to win an Academy Award, the daughter of an alcoholic actress and child sidekick to her father, famous party-boy actor Ryan O'Neal, she may seem typecast for the part of a star struggling against tough odds to stay clean.

But is an alcoholic family and fame really a recipe for drug addiction?

Dr. Timmen Cermak, president-elect of the California Society of Addiction Medicine, tends to think of inheriting an addiction as an analogy of sunburn risk. In short, he says, a person with fair skin only needs a low amount of sun exposure before burning, while a person with darker skin could be exposed more before he or she is burned.

"It's no different than sunburn," says Cermak. "Every one of us has a limit to how much we can use, or be exposed to, before we become addicted — that risk is different for different people."

It's Over by the Gene Pool

Famous or not, O'Neal was right that her parents' being addicted increased her own risk of becoming addicted, Cermak says.

"We have very good evidence that heredity plays a significant role," says Cermak, who explains that even if a biological child of an alcoholic was adopted and raised by non-alcoholics, statistically that child is four to nine times more likely to become an alcoholic than the general population.

Thomas Kimball, associate managing director of the Center for the Study of Addiction and Recovery at Texas Tech University in Lubbock, Texas agrees.

"The best research that we have to date suggests that there's a strong genetic influence that is concerned," says Kimball. "But it's complicated because the genes that have to line up are complex: If your mother is an addict, it doesn't mean you're going to be an addict, but there's a higher probability."

As the experts increasingly describe addiction as a disease with both environmental and genetic components, looking to both a person's blood and his or her social situation can help explain why addictions form.

"Anytime a disease process is manifest, it's going to have genetic, environmental, or social factors feeding it," says Kimball.

Thus enters the social factor, and as the child of Hollywood stars, O'Neal had a unique experience. The actress described the drug culture that influenced her childhood in an interview with CNN's Larry King.

"It was not just my father, but it was around where I was growing up. I mean, it's always been around me," O'Neal says about growing up around drugs and booze.

If high drug use and alcohol become the social norms, Cermak says, conceptions of limits become skewed. "It's the same question that all of us have: What is my limit and am I willing to live within that limit."

"Clearly if you are socialized in a family, in a community that is a high-drinking or high drug-use, then that becomes the norm to you," Cermak says.

High Susceptibility, But Low Responsibility

One kink in the childhood-star-to-drug-addict story is that while stars may be more susceptible to drug addiction, they also have the means to get themselves help.

And it's not just about the money. Statistics show that the more success a person enjoys in his or her career, the more likely it is that the person can successfully seek treatment for their addiction.

The Substance Abuse and Mental Health Services Administration (SAMHS) reports that "Employment is among the best predictors of successful substance abuse treatment, it is also considered an important measure of success in substance abuse treatment."

People with jobs are also less likely to repeat rounds of rehab unsuccessfully. The SAMHS reports that 13 percent of unemployed people surveyed in treatment centers had gone through five or more previous drug treatments. However, only 4 percent of employed people went back to rehab five or more times.

As a psychiatrist involved in helping people recover from addiction, Cermak has seen similar outcomes in his career. But, he notes, there exists an interesting paradox when it comes to those who come into a great deal of wealth.

"Wealth can both open the doors of treatment," says Cermak, but he adds, "it can also protect people from the consequences. … They get a DUI, they hire a great lawyer."

Of the stars he's treated, he's noticed an entourage of people — agents, publicists, or even family — who are profiting from the success of the Hollywood stars and will protect them from facing the downfall most people with a serious drug addiction would.

As for O'Neal, who says she has been sober for years, she told the Post she went into a tailspin about three weeks ago.

"There is no excuse for what I did," O'Neal said. But added, "I lost my Scottish terrier Lena … that sort of set me off."

Not a surprising revelation for those who deal with addiction, like Cermak.

"It's often hard when you're young and enjoying massive success and notoriety to think that you're powerless or incapable of dealing with the powers of addiction," he said.