There is no such thing as an “accidental drug overdose.”

The Sunday, February 10, 2008 LA Times Calendar section opened with an article about the death of actor Brad Renfro on January 15, 2007, at age25.

It referred to Heath Ledger, Brittany Spears, River Phoenix, Eva Mendes, Balthazar Getty, Ben Affleck and Juliette Lewis; asking, “Has Hollywood become an incubator of [drug] abuse or a mirror of society? Or are we all just more aware of its troubled denizens because of the hyper 24/7 coverage?"

The article quotes Dr. Drew Pinsky, who appears on VH1’s “Celebrity Rehab With Dr. Drew.” "I think what we see in young Hollywood is reflective in what we see happening in young America -- the pandemic of drug addiction." He says we are losing ground to pharmaceutical drug addiction. Apparently overdoses kill more people than guns and are second only to car accidents. The man is unquestionably an expert in pharmacology, but his input offers no answers about why Heath died.

The article contains intimate details about Renfro's life just before he died – but nothing about why. “Why” seems to have mystified the writer. I tried, but could bear to watch only a few minutes of some Dr. Drew shows. They hovered in a misty area of group therapy, concerning the recent past. Unlike Dr. Phil, he is free of rant and rage, and seems like a humble physician with a genuine desire to heal.

But I saw on his show nothing of what I would call "treatment," just a lot of painful and convoluted talk. I wanted to step in and ask questions which might at least lead the participants on the terrifying journey back to where their addiction began. As did the writer of the LA Times article, he offered no actionable idea about why so many attractive, talented and successful people are falling prey to “accidental" drug overdose.

Heath Ledger was videotaped at a party taking drugs. According to Dr. Drew, who saw the video, Ledger seemed highly intoxicated, extremely guilty and agonized -- concerned that his wife and daughter were upstairs. This speaks again to the non-accidental nature of his death. He was out-of-control, and no one was helping, because no one really understood what was going on. I can find no information anywhere about the nature of Ledgers early childhood.

Dr. Drew says he has a treatment for drug addiction and his treatment works. He says he's treated 10,000 patients and can absolutely cure addiction. He sounds like he knows what he's talking about, but how many of the 10,000 remain cured? You cannot cure addiction with drugs. But that seems to be all Dr. Drew understands. I know a young man hooked on legal methadone -- as addicted to that as to heroin. How is he being helped?

Perhaps there are people, otherwise mentally healthy, who become addicted by mistake, who have no abuse history or personality tendencies towards being drug addicts. Perhaps those are the ones Dr. Drew can cure. Perhaps using more drugs will cure patients from needing to take them. But I believe any such cure is only superficial. You cannot treat addiction without treating the underlying cause. The premise of these blogs is that it arises as a result of early childhood abuse.

By my definition an accident is something entirely unforeseen and unpreventable. The recent Heath Ledger tragedy was no accident -- any more than it would be an accident if any of the satellites revolving around Britney Spears or the star herself, were injured or killed. Heath died from a combination of powerful prescription drugs, painkillers and tranquilizers that suppressed his respiration -- drugs he should never have been taking together. It was a willful act of a man in terrible pain.

The Veterans Administration is finally waking up to the fact that soldiers abused in their early childhood are subject to far more powerful, and difficult to cure, Post Traumatic Stress Disorder than those raised in a supportive, loving environment. Though we are not in combat this fundamental medical finding applies to each of us. Our ability to surmount loss of love, unpleasantness, disorder, frustration and disappointment seems to be directly related to the conditions of our early childhood.

There is no way to prevent job failure, relationship breakup or divorce. But my belief is that our reaction to severe emotional stress as adults, which none can avoid, is conditioned by our prenatal environment and first six years of life. When I physically absorbed and mentally understood and what had happened to my mother while she carried me, my ability to cope with a challenging life path dramatically improved. In a lifelong process of healing I've encountered only two therapists, thankfully recently, who understood this.

There is no way to have an automobile accident without getting in your car. There is no way to overdose on prescription drugs unless doctors prescribe them, or you get them illegally. In Ledger’s case no one doctor could have prescribed what he took. He apparently did not take the trouble to understand how the combination of drugs, possibly prescribed by more than one doctor, might have affected him. He apparently had a drug abuse history. Others knew about it. Does a sane Doctor prescribe powerful and dangerous drugs to someone who also has or had a major drug habit? Again -- no accident.

Did any one of these doctors consider before prescribing poison, that this young patient consider a safer course of treatment? Probably not. It is much easier to arrogantly prescribe a miracle drug custom designed to put a bandage over a festering wound -- than to seek inside and laboriously heal it.

If a doctor decided there were other treatments available for a young man who could sleep only an hour at a time and thought he required heavy-duty painkillers, where would he turn? How many therapists are able to treat emotional disorders like the one that probably was the underlying cause of Ledger’s death? The training most therapists receive precludes their understanding the importance of early life emotional injuries, or being able to treat them. How many doctors are aware of the usefulness of Somatic Experiencing, Craniosacral, EMT and Acupuncture therapies?

Even now the therapy most therapists must receive in order to become therapists rarely deals with their early trauma. From the days of Freud therapists have been unwilling to look at their own pre-birth and early life conditions. Updated versions of "The Drama Of The Gifted Child" carry Alice Miller's reaction to this common therapeutic failure. She is furious that her therapists consistently tried to talk her out of memories of childhood abuse -- convincing her they were fantasies.

Perhaps emotionally and psychologically oriented prescription medication is not dangerous of itself. Perhaps there are reasons dangerous drugs must be prescribed by an ingrained and blind medical community, with an eye cocked to the bank account. Sorry to be cynical, but I've been on the receiving end of too much careless medical treatment based on doctor’s money hunger. I do not believe FDA approval of dangerous drugs makes them safe. Too much lobbyist’s money changes hands. Clearly the pharmaceutical industry, in its greed, killed Ledger.

You will not find Dr. Drew saying this on television. By the time a severely damaged adult, without a clue to what is driving him, arrives at the psychiatrist's office he is desperate for anything to ease the pain. And it must work quickly. So it falls upon the prescribing physician to make sure he is not subjecting his patient to unnecessary risk. Used with care, guided by consistent and informed medical attention, and other competent therapy, psychotropic drugs may be lifesavers. But experience tells me there are other ways that produce a satisfactory results without risk.

Is an investigation underway to determine how many doctors were involved in Heath’s death? Did each know about the prescription medications of the others? Did they consider the possibility that this troubled young man might take a lethal combination, and warn him strongly? I've been the victim of many doctors with troubled emotional equipment, who were in too much of a hurry. The waiting room was full and the cash register was clicking.

Heath must have been in unbearable emotional pain, unable to sleep, and struggling to survive each day. He was young and suddenly famous. No one could say no to him. That’s intoxicating in itself. He had separated from the mother of his child. Perhaps this was the first time he had encountered the psychological material which produced the overwhelming feelings he was trying to suppress with drugs. I've been in such pain and I know how difficult life becomes from minute to minute. Just breathing in and out seems impossible.

It did not matter that my films were successful, I had plenty of money and glamorous friends, or that every day was filled with excitement and adventure. It did not matter that I was tall, attractive, and physically fit. I had beautiful, custom-made clothes, motorcycles, fast cars and airplanes. I moved fast and with style! Yet my soul was crushed and still. It did not matter that I derived enormous satisfaction from talents that were gifted to me from birth. It did not matter that virtually every film I made received praise. I would go outside my door in the morning and find storyboards for fabulous television commercials, with no-bid offers, outside my door.

But I derived no pleasure from any of this. I was half dead. Crippled. My hidden inner self was in excruciating agony, struggling back in the time when I was being physically tortured and in actual danger of being killed. I was in therapy with an eminent therapist, who made it worse. The therapist, I later learned, was so caught up in his own ancient wounds that he could not heal.

The danger to people like Heath Ledger and Britney Spears is: connection to “forgotten” old abuse can pop up unexpectedly, out of nowhere. In order to become a reasonably successful adult I had to suppress all memory of my first three years and most of the subsequent three. Every therapist I saw early in life failed to treat the original wounds. The recovery process, even under guidance of a skilled and compassionate therapist, later in my life, was arduous and debilitating.

This is what happens. One marches along, superficially happy and successful. Heath fell in love with his costar, fathered a child, acquired dozens of fascinating friends, was on his way to a huge acting career. Then events triggered old, suppressed memories. Memories his parents, those who were there and experienced with him, are not likely to bring forth. The physical feelings and images lie in waiting, hidden under the soil of every day life, like a land mine. Then fate intervenes.

Fairly recently circumstances led me to a woman, a control freak, who had suppressed bisexual tendencies. We had a short, unpleasant relationship. After we broke up, she began sleeping with women. To my shock it tore me apart. I had feelings associated with her that didn't exist while we were going together. I didn't love her. We had known each other only briefly and had, I thought, almost no emotional relationship.

Soon after, in the middle of writing “Backlight” 10 or 12 hours each day, I was at the dog pound in Camarillo (a place that brings out the most vulnerable in us all) wandering around in terrible pain, talking to myself for hours while my new girlfriend and I chose dogs to foster. Compassionately, she acted as if nothing was happening. I was experiencing a full-blown psychotic break during what should have been a joyous and productive time.

Within days, events I only dimly remembered came to me. When my sister was born, I was a year and a half old. My parents hired a nurse for her, who sexually assaulted, beat and tortured me. I was black and blue half the time and my mother "didn't notice." I recovered these memories while writing “Backlight,” and because I could flow them out through my fingers and voice (and was seeing a properly trained and compassionate therapist), they passed. The agonizing experiences found their way into the novel and give it some of its power.

When I was four or five the nursemaid took me to see her girlfriend, leaving me alone on a dangerous street. I looked into the window and saw them doing something. I only realized later they were making love. I recovered this memory this while writing the scene for the book. From this raw material I recreated my childhood abuser, and placed her in “Backlight.” Before then I had been creating out of dim memory. She was someone foggy, who never came across as a real character. Now I had her (she even had a name) – and she leapt from the page, alive as she was then.

I continue to experience abnormal stress around being a creative person, who, as most of us have, has passed in and out of relationships. I have never been able to do it without enormous psychic distress. My career has been impacted because none of my artistic films were realized with my full, willing psyche. I only succeeded at making TV commercials, because, as I now understand, that did not conflict with the notion of my father being the only genius in the family.

So I sympathize with Ledger -- but am infuriated that apparently no one really sought to help him. Prescribing dangerous drugs and abandoning him is not help.

Ledger said his art came from a place of discomfort. "I like to do something I fear. I like to set up obstacles and defeat them. I like to be afraid of the project. I always am. When I get cast in something, I always believe I shouldn't have been cast. I fooled them again. I can't do it. I don't know how to do." Sounds familiar.

Facing the unknown, the film artist feels helpless. He must produce an ephemeral result, on-demand, on a schedule determined by hundreds of people, whose income depends on the success of a mysterious process. Famously, a painter or novelist who feels blocked can walk away and wait for the inspiration to arrive again.

Most artists feel helpless and uncomfortable, and perhaps it is what drives them to excel. One of the jobs of the director is to comfort, providing a stable, safe place from which to work. Elia Kazan understood this well. Creating anything original is a high wire act. We will probably never know, but the notion that Ledger was lethally distressed because of a part he had played in a film is absolute nonsense. More likely his separation from his wife and child and other relationships triggered an old and terrifying in him he was not able to contain.

My guess is that Michelle Williams could provide many of the answers, if she were willing to tell. In the interest of preserving everyone's privacy we can only assume. I write so you may consider what might have happened to Heath Ledger if someone capable had been allowed access to treat his original wound.