Following the release of a probation report that confirmed the list of prescription medications Lindsay Lohan is taking while she is under a strict no-drugs probation order — including Zoloft, Adderall and Dilaudid — addiction experts contacted by MTV News questioned whether the actress is pursuing a healthy path to sobriety.
"Adderall is an amphetamine and a powerful stimulant drug used to treat ADHD, and to someone who has a history of cocaine abuse, those of us who specialize in addiction treatment would be very cautious about giving someone with stimulant addiction another stimulant drug," said Dr. Arnold M. Washton, a New York psychologist with more than 30 years of expertise in treating addiction.
Though Washton has not treated Lohan and is not familiar with the reasoning behind the cocktail of drugs she has been prescribed, he said it is typically not a good idea to prescribe stimulants to someone with a history of cocaine use out of a concern that such medications could rekindle a desire for the illegal drug.
"For someone who has ADHD and is abusing cocaine, opiates and alcohol, you can't do an accurate diagnosis until they're off all substances for a while," he said. "It's too complicated a picture to add medications into the mix so soon because there may be conditions there that you can't see until the brain has had a chance to recover."
According to a copy of the report obtained by TMZ, Lohan is cleared to take the antidepressants Zoloft and Trazodone; Adderall, a stimulant used to control ADHD; the acid-reflux medicine Nexium; and the very powerful painkiller Dilaudid, whose effects have been compared to heroin and which she was originally prescribed after dental surgery several months ago.
Lohan is subject to random drug and alcohol testing, but because those drugs have been court-approved, positive tests for them are not considered violations. In fact, on May 27, she tested positive for amphetamines, but it was not considered a violation because of the Adderall prescription. She also tested positive for amphetamines and opiates on June 2 and June 7, but they were also not violations because of the Adderall and Dilaudid prescriptions. June 16 and June 24 tests also turned up positive for amphetamines; results of a June 30 test were not yet available.
Lindsay Lohan's father, Michael Lohan, has made several public pleas about his daughter in the past few weeks, including an open letter in court on Tuesday, in which he begged the judge in her probation case to get Lindsay the help she needs to avoid having her become "the next Hollywood statistic."
He specifically asked that Lohan's prescription-drug use be "carefully monitored" via random drug testing because "if prescription drugs are excluded from testing, Lindsay may use that loophole to become intoxicated and pose a danger to herself and others." Now, even as the troubled actress prepares to report to jail on July 20 for a 90-day sentence in connection with a probation violation from a pair of 2007 DUI cases, Washton said Lohan's brain might not have had time to recover from the "neurological insult" of suspected years of abuse of alcohol and drugs before being bombarded again by the prescription meds. He was particularly surprised by the presence of Dilaudid on the list.
"That is a very potent painkilling opiate that is generally used in hospitals and not prescribed on an outpatient basis," he said of the drug used to control post-surgical or chronic pain. "Especially in someone with a history of opiate addiction. There are many other drugs that are much safer in terms of relapse potential. It just doesn't hang together from a clinical perspective. It doesn't make any sense."
While in themselves the combination of drugs Lohan is taking is not necessarily lethal, Washton said there is always the danger of Lohan abusing the medications. "Is she on a course of recovery or on a course of having her substance abuse legitimized by prescription drugs?" he wondered. Washton also noted that it is not unusual for patients with a history of drug and alcohol abuse to suffer from anxiety, depression and insomnia, conditions that are typically treated by drugs such as Zoloft and the non-addictive Trazodone, which acts as a sort of sedative. But, he added, he cannot recall the last time he saw a patient getting Dilaudid by prescription. "It just doesn't happen," he said of the drug, whose effects are similar to those of the highly addictive morphine.
Human behavior expert and celebrity life coach Patrick Wanis said the situation Lohan is in reminds him of similar ones we've seen recently with other celebrities, such as Heath Ledger and Brittany Murphy, who were taking potentially dangerous mixes of prescription drugs.
"I don't agree with the cocktail of medications," said Wanis, who does not prescribe medicine and is not privy to the logic of Lohan's doctors. "I believe in going for the root cause instead of treating the symptoms." He noted that any time you put someone on multiple medications it can lead to multiple side effects, which could result in erratic behavior.
Based on his observations, Wanis said the medication can only make things worse for Lohan, who he said appears to lack stability and a support system in her life and who does not appear to be dealing with the core emotional issues that might be driving her addiction. "Lindsay's real issue is related to her dysfunctional relationship with her father and mother ... and maybe [jail] will allow her to look at her life from a different perspective, away from the glitz and glamour and Hollywood lifestyle," he said.
In addition to pointing to the example of Britney Spears, who gained control over her chaotic life by repairing her parental relationships, Wanis pointed to Robert Downey Jr., whose life and career were in serious jeopardy until 2004, when he finally admitted that he was powerless to control his abusive tendencies. "The difference was, he was aware it was destroying his life," Wanis said of Downey. "I'm not sure Lindsay knows it's destroying her life. ... When [she] keeps returning to parties, it shows you that she doesn't have the self-control and discipline and can't stop her own behavior ... that she is not in control of her life."