Amy Winehouse’s song “Rehab” helped me grapple with a pesky reality.

Sadly, not everyone suffering from addiction gets better. The narrator of the song wants us to believe that she has her life under control. With a voice full of sass and defiance, she dismisses the notion that any program could offer her more than she’d learn from her musical heroes like Donny Hathaway.

Because I lost a former boyfriend to alcoholism, I feel a kinship with anyone who’s struggled to get their loved ones help for an addiction. Even those willing to go to rehab can sometimes relapse. My Sensitive New Age Guy participated in five different detox programs before he moved away. I desperately wanted to believe that each one would give him a fresh start like a new pair of shoes with magic springs in them. Unfortunately, none did.

As an optimist by nature, I like to cling to hope. If Plan A doesn’t work, I always have a Plan B, C or D up my sleeve.

However, in the case of my late boyfriend, Plans C and D didn’t work any better than Plans A or B. I’m far from alone in believing that once our loved ones hit rock bottom, they’ll seek help. But bottoms have a funny way of getting lower and lower.

Intellectually, I’ve always known that alcoholism was a disease. But wasn’t it also a treatable one?

Unlike Fred, who had suffered from an untreatable, incurable degenerative neurological disease, my boyfriend had a chance to make a full recovery, or so I wanted to believe. He had the odds in his favor. Shouldn’t a strong support system be enough to will someone into recovery?

Certainly, we all want to think so. After all, substance abuse is a treatable disease in ways other illnesses aren’t. There are medicines to curb cravings. There are programs to help. There’s living proof that some people recover for good.

But, for every Stevie Nicks, there’s an Amy Winehouse. I used to think the victims of such sad endings had chosen self-destruction over health. But was it really a choice?

Well, maybe not. Sometimes, for whatever reason, people aren’t able to fight The Disease.

My guy once told me how he felt like nothing mattered. I tried to get him to see the light. People loved him. He was a talented therapist. The world needed more kind and gentle souls like him.

We could say much the same about Amy Winehouse. Fans adored her. Her musical talented rocketed out of this stratosphere. The universe craved her voice.

Still, in the end, The Disease won. We can stage interventions. We can be by their sides. But, ultimately, substance abuse can rob its victims of free will, which is why it’s called a disease.

Diseases can be easier to accept when there’s physical proof behind what’s causing the symptoms. CT scans show degeneration of nerve cells. DaT scans target a deficiency of dopamine. But tests for alcohol and drug abuse can be less clear about what’s causing physical and emotional disturbances.

Never in a million years did I think my guy’s behavior had anything to do with the way alcohol had eaten away at his liver. But then I began to read about how addiction affects the body. When the liver is unable to filter out toxins, poisons get into the bloodstream and go to the brain, impacting cognition and mood.

Because alcoholics and drug addicts often hide their substance use from everyone, including their doctors, the evidence of liver damage might be overlooked until it’s too late. Would it have made any difference if my guy had learned early on that his drinking was damaging his liver, heart, esophagus and brain?

Maybe not. Cigarette smokers smoke, drinkers drink, and drug users use even though they know that such vices are bad for their health.

However, for loved ones like me, knowing the physiology behind the symptoms might make it easier to understand substance abuse as a disease. When I first heard Winehouse’s “Rehab,” I had a picture in my mind of Amy Winehouse having too much fun drinking and drugging to give them up.

Now, when I hear the song, I have an image of toxins in the blood stream. To be sure, it’s not a pretty picture. But it’s one I hope helps us understand the difference between a stubborn temperament and a disease. It’s what’s going on when someone like Amy Winehouse is offered rehab and tells us “no, no, no.” No matter how much we might want to say “yes, yes, yes,” sometimes it’s best to find our own peace.

Joan Axelrod-Contrada is a Florence-based writer working on a collection of essays called “Rock on: A Baby Boomer’s Guide to Life after Loss.” Reach her at joanaxelrodcontrada@gmail.com

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