LOS ANGELES (AP) — Philip Seymour Hoffman suffered from a chronic medical condition that required ongoing treatment. An admitted drug addict who first sought professional help more than two decades ago, Hoffman apparently succumbed to his affliction with an overdose despite a return to rehab last March.
A father of three with a thriving career, the Oscar winner died Sunday with a needle in his arm and baggies of what appeared to be heroin nearby. New York City medical examiners were conducting an autopsy on Hoffman's body Monday as investigators scrutinize evidence found in his apartment.
His death, which came after a long period of sobriety that ended last year, "epitomizes the tragedy of drug addiction in our society," said Dr. Nora Volkow, director of the National Institute on Drug Abuse.
"Here you have an extraordinarily talented actor who had the resources, who had been in treatment, who obviously realized the problem of drugs and had been able to stay clean," she said, adding that Hoffman's case shows how devastating addiction can be.
Success has no more bearing on drug addiction than it does on heart failure, doctors say: Both can be fatal without consistent care. And while rehab may be part of treatment, it's no antidote. Amy Winehouse and Cory Monteith had both been to rehab before eventually dying from overdoses.
"Addiction is a chronic, progressive illness. No one can be cured," said Dr. Akikur Reza Mohammad, a psychiatrist and addiction-medicine specialist. "If someone is suffering from addiction, they cannot relax at any time. The brain neurochemistry changes... so these people are prone to relapse."
The younger a person begins using drugs, the more likely they are to become addicts, Volkow said. Hoffman wasn't specific about his poisons or when he discovered them when he told CBS' "60 Minutes" in 2006 that he used "anything I could get my hands on" before cleaning up with rehab at age 22.
Hoffman said in interviews last year, with his career in full bloom, that he sought treatment for heroin addiction after 23 years of sobriety.
Addiction causes chemical changes in the brain that remain long after a person stops using the substance, said Volkow, who described the condition as "a chronic disease with a very long duration."
Just as someone who hasn't ridden a bike for 20 years will still know what to do with a bicycle, an addicted brain exposed to its drug after a long period of abstinence will relapse to its old levels.
Studies have replicated this in animals, Volkow said: "Give them a tiny amount and they immediately escalate to the same levels of drug taking as before" — which is why addiction is considered chronic and overdose is common.
Hoffman's "is a story that unfortunately is not infrequent." she said, "to have an individual who takes drugs in their 20s and stops for 20 years, relapse in their 40s and overdose."
It's not clear what motivated the actor's return to drugs and what, if any, ongoing treatment he received after his rehab stint in 2013.
Director Anton Corbijn, who was with Hoffman at the Sundance Film Festival last month to promote the film "A Most Wanted Man," said the actor "seemed in a good place despite some issues he had to deal with." Corbijn did not elaborate.
Hoffman spoke to The Associated Press about the film at the festival, where he was dogged by paparazzi but otherwise calm. The actor, who could transform so convincingly into such varied characters on stage and screen, was generally a private person — something he said went with the job.
"If they start watching me (in a role) and thinking about the fact that I got a divorce or something in my real life, or these things, I don't think I'm doing my job," he said in the "60 Minutes" interview. "You don't want people to know everything about your personal life, or they're gonna project that also on the work you do."
Because addiction has a genetic predisposition, celebrities are as likely as anyone else to suffer.
"Addiction does not discriminate, the same way high blood pressure and diabetes do not discriminate," Mohammad said, adding that 100 people die in the U.S. each day from drug overdoses. Those numbers are increasingly fueled by prescription painkillers, which tend to be opiates, like heroin.