Addiction Specialist on Demi Lovato's Possible Next Steps After an 'Emotional and Destructive' Relapse

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Demi Lovato's road to recovery after her apparent drug overdose on Tuesday will be a serious emotional struggle, addiction specialist Dr. Howard Samuels tells ET.

Samuels -- the CEO of The Hills Treatment Center, a substance abuse treatment facility in Los Angeles -- sat down with ET on Wednesday to talk about relapse and recovery. Samuels isn't treating Lovato, but aside from his role at the Hills Treatment Center, has experience with addiction himself -- he's been 33 years sober, and suffered a relapse after five years. 

"I have a lot of hope for Demi. Relapse is a part of recovery, unfortunately," Samuels tells ET. "Now, the important thing about recovery or relapse is you've got to get through it alive. Thank God, she got through it alive. So, I think because of how extreme this relapse was for her, it's like a slap in the face to wake her up, to re-engage in her recovery."

"Now, the important thing is, she gets back into the room, she gets back into recovery, and she learns the steps that she made that led up to this relapse," he continues.

According to the dispatch call obtained by ET on Tuesday, Lovato was unconscious when paramedics arrived. Multiple reports stated that Lovato was treated with Narcan -- an emergency treatment for narcotic overdoses -- at her home in Hollywood Hills, California. Multiple emergency medical technicians in Southern California tell ET that as of the beginning of this month, EMT crews can and usually do carry Narcan and will administer it in the case of opiate overdose. In emergency situations, it only works for opioids -- such as heroin and fentanyl -- and basically blocks the opiates from bonding to opiate receptors in the brain, jolting one's sympathetic response and bringing the patient back to life. EMTs typically deliver Narcan in two ways: a spray up the nose or an injection in the shoulder.

Samuels explains that Narcan is now being used by paramedics and law enforcement officials throughout the country because of the heroin epidemic and fentanyl that is laced in the heroin. 

"So, her friends probably didn't know what she took and to play it safe, they probably applied that, which is probably, really, the smart thing to do, not knowing what someone has taken," he speculates. "I deal with that all the time in my personal practice and at the Hills Treatment Center, is that, a lot of times we don't know what's going on. All we know is that the person's unconscious, and we need to take drastic measures to make sure they don't OD."

As for what causes those struggling with addiction to relapse, Samuels says a strong support system is key to maintaining sobriety. Lovato had proudly been six years sober before her relapse. But sources told ET that prior to her apparent drug overdose, Lovato had "pushed away people" and was "in a dark place."

"Well, first of all, we don't really know how strong her support system was in the last six months," he muses. "Now, obviously, she had a strong support system in the last five or six years, but in the last six months? ... And that's where the issue is really in the last six months, and her starting to disengage slowly from recovery and then, obviously, using to this extent."

"The process to relapse for any individual is that you start to lose touch with your support system, you start to not go to 12-step meetings, you aren't able to connect to other people in recovery, and slowly you start to isolate and then what you do," he continues, "you go back to your old ways, you go back to people who are drinking a lot, who may be doing a little drugs here, you think you can handle that, so you think you can handle drinking normally, and then one thing leads to another to another to another, until eventually you OD and if you're lucky to get through it, you're alive."

Samuels says it is now critical for Lovato to deal with her emotions in a healthy way. 

"It is hard to come back from a setback, because you have so much shame about it, personally, and the only way for it to go away is for Demi to sort of talk about it," he says. "She's gotta talk amongst her close friends, other recovering people, and because she's such a public figure, it'd probably be healthy for her to talk about it publicly, because that's the thing I really respect about Demi. She tells it like it is, and she's such a leader and advocate for us in this field."

On Wednesday, a source told ET that Lovato's family is making plans to get the singer straight into rehab.

"It really depends upon what she needs emotionally," Samuels says of Lovato's possible next steps. "I don't treat Demi, so I don't really know her emotional state right now. I am sure that she is probably fairly depressed. She's got a lot of shame, a lot of guilt over the relapse. She's a public figure, so that adds more pressure to it. ... I do believe that because Demi has gone through such an emotional relapse and a destructive relapse, I do believe her going into a treatment center would probably actually be very positive, so she can deal with all the emotions and feelings this relapse has created, for her to become more emotionally stable."

Samuels says what Lovato is currently dealing with in the hospital is probably more emotional than it is physical.

"They want to be safe with her, so they're not going to release her until they feel she is mentally and physically stable, and that's probably where it's important for her to then check into a treatment center, so she can have some privacy to recover and work through the feelings that this horrible episode has created," he says.

Above all, Samuls praises Lovato for being so outspoken throughout her career about her issues with addiction, noting how many fans she has likely helped.

"I really think the most important thing is, you know, the respect that Demi has in the country today, is that she is so respected because she is so honest about her recovery, her relapse, and I think that that, to me, is an example of how great of a person Demi is," he notes.

"I don't really believe that Demi's involvement in helping so many people with addiction and mental health and her being a vocal advocate hurt her at all," he also stresses. "In fact, I think that streghtented her recovery, because she was being of service. She wasn't selfish with her personal advice, she wasn't selfish with her personal experience, she was able to lay it out there. I think, if anything, that contributed to her actually getting six years."

A source told ET on Wednesday that Lovato's apparent drug overdose has been a "wakeup call" for the singer.

"The overdose has been a wakeup call to Demi that she needs to get more serious about her sobriety and is telling friends and family she will do everything it takes to get back to the amazing place she was in before she slipped," the source said. "Demi feels like she has let a lot of people down, including herself, but she's confident she won't let her addiction win, she will come out on top."

For the latest on Lovato's health, watch the video below:

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