Addiction Doesn't Discriminate: What Presley Gerber's Death Teaches Every Family

On Sunday, September 20, Presley Gerber died. He was 27 years old. He was the son of Cindy Crawford and Rande Gerber, he had money, he had a family that loved him openly, and he died inside a rehab facility. The Los Angeles County coroner scheduled an autopsy for the following day and the death is being investigated as a suspected overdose. A cause has not been released, and this article is not going to pretend to know one.

His family asked for privacy, and they should have it. But there is something in this story that I need Northwest Arkansas to hear, because I get the phone calls at two in the morning and I know what people believe about how this works.

The part people get wrong about who this happens to

Every week somebody sits in my office and says some version of the same sentence. I'm not the kind of person this happens to. Or, about their son or their wife, we're not that kind of family.

There is no kind of person. Presley Gerber had access to any treatment on earth. He had a mother who spoke about his struggle publicly, a sister who talked about what it did to their family, and he had himself talked openly about his mental health in the months before he died. He was already in a facility, which means somebody had already done the hardest thing — he had already said yes to help.

He still died. Not because his family failed him, and not necessarily because the facility failed him either. He died because opioid use disorder is a medical illness with a body count, and it does not check your bank balance, your zip code, or how much your family loves you.

If you have been telling yourself that your situation is not serious enough to call a doctor about, that story is the most dangerous thing you own.

The days after someone stops are the deadliest days

This is the part almost nobody outside medicine knows, and it is the reason I am writing this at all.

When a person uses opioids regularly, their body builds tolerance. When they stop — in a detox, in a residential program, in jail, or just in a determined week at home — that tolerance falls away fast. The mind still remembers the old dose. The body can no longer survive it. If that person uses again at anything near the amount they were using before, the same dose that used to get them through the day can stop their breathing.

The research on this is not subtle. In a study following patients through a 28-day inpatient detoxification program, every one of the overdose deaths in the four months after discharge happened among the patients who had lost their tolerance. A large international review found that people on buprenorphine — the medicine in Suboxone — died of overdose at a rate of 1.4 per 1,000 person-years while they stayed in treatment, and 4.6 per 1,000 once they were out of it. In the first four weeks after leaving buprenorphine treatment, that overdose rate jumped to 10.8 per 1,000 person-years.

Read that again, because it is the whole point. The month after treatment ends is far more dangerous than the month before it started.

That is true whether treatment ended because someone finished a program, walked out of one, got discharged from one, or simply decided they were fine now. And it is why "he was in rehab" is not the reassurance people think it is. Being in a facility is the beginning of safety, not the proof of it.

What actually changes the odds

Not willpower. Not a family intervention, though those matter. Not a 30-day program by itself.

What the evidence supports is staying on medication — buprenorphine or methadone — continuously, for as long as it takes. In that same review, people taking buprenorphine died of all causes at 4.3 per 1,000 person-years while in treatment, and 9.5 per 1,000 out of it. Methadone showed the same pattern: 11.3 per 1,000 in treatment, 36.1 out. The medicine is not a stepping stone you graduate from. It is the thing holding the floor up.

And yet only about 1 in 5 American adults with opioid use disorder actually received any of these medications, according to federal survey data — roughly 22% of an estimated 2.5 million people. Four out of five got nothing, or got something that does not lower the death rate.

Nationally, about 65,700 people died of drug overdose in the twelve months ending April 2026. That number has been falling, and it is still a stadium full of people a year. Arkansas recorded 389 overdose deaths in 2024, down from 516 the year before — real progress, and still more than one Arkansan a day.

If someone you love is in treatment right now, do these three things

1. Put naloxone in the house. Narcan is available over the counter — no prescription, no conversation with a doctor required. Buy it at any pharmacy, keep one box at home and one in the car, and make sure somebody besides the patient knows where it is. Nobody has ever regretted owning it.

2. Find out what the plan is for the day they come home. Not "aftercare." Specifically: what medication will they be on, who is prescribing it, when is the first appointment, and what phone number do they call at midnight on a Saturday when it goes sideways. If the answer to that last one is a voicemail box, the plan has a hole in it.

3. Say the part out loud. Tell them plainly: your tolerance is gone, and the dose you used to take could kill you now. People who relapse are often not trying to die. They are using what they used to use. That one sentence has saved lives.

Why my clinic is built the way it is

I answer my own phone. Not a service, not a nurse line — me, at any hour, seven days a week, holidays included. If someone needs to be seen at 3 a.m., I come in and see them. A scheduled visit is $200. An unscheduled after-hours visit is $300.

I did not build it that way to be dramatic. I built it that way because the moment somebody decides they are done almost never lands between eight and five on a Tuesday, and because the gap between deciding and being treated is exactly where people die. When a patient leaves a facility on a Friday afternoon and the next available appointment anywhere is a week out, that week is the whole problem.

I also do not bill insurance, which means nothing about your treatment travels to an insurer or an employer's plan administrator. For a lot of the people who call me — nurses, teachers, contractors, people with a professional license to protect — that is the only reason they called at all.

I lost my own career to this illness. I was an orthopedic surgeon. I know precisely how respectable a person can look while they are drowning, because I was that person, and I got it back. That is not a marketing line. It is the reason I pick up the phone.

If you are reading this because of your own situation

Call 479-856-1505. Any hour. You do not need to have a plan, a speech, or a clean day behind you. You do not need to be at the bottom of anything. Tell me what you are using and how much, and we will go from there.

If you are reading it because of somebody else, the same number works, and you can ask me questions about them without them knowing you called.

Presley Gerber was 27 and had every resource a person can have. The lesson is not that treatment does not work. It is that treatment has to be the kind you can reach on the night you need it, and it has to not stop.

More on this: Medical detox vs. Suboxone treatment · Starting Suboxone after fentanyl · Recognizing opioid use disorder in someone you love · What the first visit looks like · Where we serve in Northwest Arkansas