Demi Lovato is 'California sober': What it means and why it's controversial

Demi Lovato is “California sober,” but what does that mean?

The singer, who has struggled with drugs and alcohol, has been opening up about a variety of issues recently, including her sexuality, weight loss and near-fatal overdose in 2018.

Now in recovery, she was asked by CBS Sunday Morning whether she was trying moderation — still drinking and “smoking a little bit of weed” — and Lovato agreed that was the case.

“I think the term that I best identify with is California sober," Lovato said. "I really don't feel comfortable explaining the parameters of my recovery to people because I don't want anyone to look at my parameters of safety and think that's what works for them, because it might not.”

The “complete abstinent method isn't a one-size-fits-all solution for everybody,” she added.

Her approach has caused a stir, but what do experts think about it?

TODAY asked Dr. Brian Hurley, director of addiction medicine for the Los Angeles County Department of Health Services and director-at-large at the American Society of Addiction Medicine; and April Marier, an administrator for substance abuse prevention and treatment programs at Riverside University Health System in California.

What is California sober?

There’s no technical definition for it in the medical literature, Hurley said. But popular culture references, such as the Urban Dictionary, define it as abstaining from alcohol and drugs, except marijuana. One of the first references to “California sober” seems to have come from a 2019 Vice article.

The definition is fluid, with some people also including the use of psychedelics as acceptable. Expanding on her philosophy in her YouTube docuseries, “Demi Lovato: Dancing with the Devil,” Lovato appeared to include some alcohol intake in her version of California sober.

"Telling myself I can never have a drink or smoke marijuana is setting myself up for failure because I am such a black-and-white thinker," she said. "I had it drilled into my head for so many years that one drink was equivalent to a crack pipe."

Strong reaction:

Some have criticized the approach, with Ken Seeley, a registered addiction specialist and founder of the Ken Seeley Communities in Palm Springs, California, saying there is no moderation for people who struggle with addiction.

"I think the term 'California sober' is quite disrespectful to the sober community," he told Entertainment Tonight. "I know a lot of people that work really hard to hold their abstinence and fight for their lives in recovery, and to bring up this new term, 'California sober,' is so inappropriate."

Continued use of alcohol and marijuana is "nowhere near sober,” Seeley warned, adding he was worried people could potentially overdose and die thinking that they're California sober.

Other headlines have called the concept "delusional and dangerous."

Expert take:

Marier didn’t have any opinions or judgment about anyone's recovery journey, agreeing there's not a one-size-fits-all approach. But she was concerned about the potential for problems.

“I feel that the challenge with California sober for someone with an actual substance use diagnosis is the risk of developing an addiction to another drug,” Marier said.

“There’s a term I've used when counseling somebody: It’s like switching seats on the Titanic — it's not going to save you; you’re still going down.”

Related:

Hurley wanted all of his patients struggling with addiction to achieve full remission, meaning their substance use was no longer compulsive and wasn’t causing harmful consequences in their lives.

For most of his patients, that means full abstinence, but “it is possible to be in remission from a substance use disorder and not fully abstain from all intoxicants,” he said.

Can anything short of complete abstinence be considered sobriety?

Each person has to determine that themselves, Marier said. Hurley agreed, noting that sobriety isn't a medical term, so people have all kinds of understandings about what it means for them. That's why he uses the term remission rather than sobriety.

The American Society of Addiction Medicine doesn't "demand some threshold for abstinence" in order for somebody to count as a sober, Hurley noted.

Still, recovery is often abstinence-based. For many patients for whom alcohol made their lives unmanageable, any amount of alcohol is too much, he added, but addiction is about the disease and not the substance.

Related:

“I'm less interested as an addiction physician in focusing on whether somebody is completely abstinent from every substance ongoing forever, and I'm more interested in: How have their lives changed in response to treatment? How are their behaviors improving?” Hurley said.

“I think that people can get better with treatment even if they don't necessarily stop using all substances.”

If you are looking for help with substance use, the American Society of Addiction Medicine offers patient resources, including a directory of addiction specialists.