The Difference Between Keith Richards & David Arquette

There are many levels of addiction, and as such there are many different approaches to control and sobriety

With the release of Keith Richards' autobiography, "Life," the reader is brought into the life of a habitual drug user who has weathered the storm of addiction over his entire lifetime.

Contrary to a life of drug abuse, consider the problems of David Arquette — who has chosen to face his demons before the facial crevaces, tattoos, piercings and deathly pallor that we see marking the face of Richards finds its way to Arquette's youthful appearance.  

From Richards' book:

"I did a couple of cleanups with Gram Parsons at this time – both unsuccessful.  I've been through more cold turkeys than there are freezers. I took the f*cking hell week as a matter of course. I took it as being a part of what I was into. But cold turkey, once is enough, and it should be, quite honestly. At the same time I felt totally invincible. And also I was a bit antsy about people telling me what I could put in my body."

Richards was perhaps the first “Harm Reductionist,” who weighed the artistic and economic benefits against the potential cost to his body. To be frank most people with substance abuse problems do a very similar cost benefit analysis. Particularly, artistic people of all kinds that acknowledge that the substance is seen as central to their creativity. This is why so many writers for example become addicted during their most creative and productive years.

How many commercials do we see for prescribed medications that warn "taking this may cause heart attack, stroke, tendency to gamble, suicidal feelings, etc." With such dire warnings, we still flock to these medications because, on a physical level, we need them and are told to take them by our physicians.

We know the consequences, yet we still consume. The parallel is obvious for the addict. In the case of an artist on the level of Keith Richards, his drug use was not a symptom of his lifestyle as a rock God. It was intrinsic to it.

Keith's 'Harm Reductionist' approach was to take only the best heroin, or snort the purest cocaine. In all likelihood, his drug use was shared to some extent by other members of the Stones. Consider the possibility that the Stones would fracture if Keith became sober during the '70s and '80s, and started to practice and preach sobriety.

His personae of a man that allegedly went through drugs like the rest of us go through fast-food burgers supported his music, and obviously, that outweighed the forces of those who were afraid for his life. The only difference being that Keith avoided the fast-food versions of his drugs, and instead imbibed in Michelin-rated smack, coke and pills.

On the other hand, you have a man like David Arquette who seems to be rehabbing at a very early stage of his addictive behavior. He's not part of a band, and instead of being surrounded by enablers who worried that his sobriety might dull his "edge," he is surrounded by TMZ and a concerned public that cries out for his safe return to society.

That's the difference. Going to rehab would put too much at risk for Keith. Not going to rehab would put too much at risk for David. Both could benefit from the help that a trained addiction specialist could bestow.

The point is, there are many levels of addiction, and as such there are many different approaches to control and sobriety. Would Keith benefit from a 12-step approach? Would David? Maybe, but also maybe they would benefit from alternative treatment modalities that have a greater success rate than AA, NA or CA — without the social and religious overtones.

I often ask my patients to tell me about the “pros” and “cons” associated with giving up their addiction. As would be expected, their typical answers about their worst fears associated with giving up alcohol for example would be, "I won’t be able to fall asleep" or, "I won’t be able to hang around my old friends" or, “I just can’t imagine watching a football game without a beer."

But very recently I asked this same question of a very bright, insightful, entrepreneurial women. After a seemingly long contemplative time, where she seriously looked inside for her deepest, truest fear associated with giving up alcohol, she said, “I will lose my brilliance."