Prior to her death in 2011, the talented singer Amy Winehouse received considerable attention due to her repeated relapses involving heroin and cocaine. She famously recorded a song about not wishing to enter rehabilitation treatment for substance use. She survived at least one overdose on a combination of heroin, crack cocaine, ecstasy, ketamine and alcohol. Along with her prominent tattoos, she also appeared with evidence of self-inflicted cuts to her arms. Her young death (age 27) followed treatment for substances, and her death is attributed to alcohol, which was the only drug found in her system, along with Librium (often prescribed to minimize alcohol withdrawal symptoms).

• What would you consider the risk factors contributing to Amy Winehouse’s substance use-related problems? • What would you consider her drug of choice? • To what do you attribute the emphasis placed on her use of illicit substances, rather than her alcohol use? • How might a bio-psychosocial approach have contributed to a better outcome?