Shortly after the singer Amy Winehouse, 27, was found dead in her London home, the airwaves were ringing with her popular hit “Rehab,” a song about her refusal to be treated for drug addiction.

The man said “Why you think you here?”

I said, “I got no idea.”

I’m gonna, gonna lose my baby,

So I always keep a bottle near.

The official cause of Ms. Winehouse’s death won’t be announced until October pending toxicology reports, but her highly publicized battle with alcohol and drug addiction seems to have played a significant role. Indeed, her mother echoed a sentiment heard everywhere when she told The Sunday Mirror that her daughter’s death was “only a matter of time.”

But was it? Why is it that some people survive drug and alcohol abuse, even manage their lives with it, while others succumb to addiction? It’s a question scientists have been wrestling with for decades, but only recently have they begun to find answers.

Illicit drug use in the United States, as in Britain, is very common and usually begins in adolescence. According to the 2008 National Survey of Drug Use and Health, 46 percent of Americans have tried an illicit drug at some point in their lives. But only 8 percent have used an illicit drug in the past month. By comparison, 51 percent have used alcohol in the past month.

Most people who experiment with drugs, then, do not become addicted. So who is at risk?

By RICHARD A. FRIEDMAN, M.D.

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