The passing of Presley Gerber at the age of 27 has reignited conversations surrounding the inherent dangers of addiction, the intricacies of withdrawal, and the safety protocols within recovery programs. Gerber, son of supermodel Cindy Crawford and businessman Rande Gerber, died on Sunday at a California rehabilitation center, according to records from the Los Angeles County Medical Examiner’s Office.
While the precise cause of death has not yet been officially determined, audio recordings obtained by a media outlet indicate that a 911 call was placed on Sunday morning, reporting a cardiac arrest at a facility located in the 1000 block of Berkeley Street. A separate dispatch communication identified the incident as a potential overdose. The Los Angeles County Medical Examiner’s Office later confirmed that an autopsy had been conducted, but the cause of death remains pending further toxicology and diagnostic tests.
Over the years, Gerber had openly discussed his personal struggles with substance use and mental health challenges.
Investigation into the Cause of Death
As the official cause of Presley Gerber’s death has not been publicly disclosed, a medical expert, who has no involvement in Gerber's case and has not treated him, cautioned against making assumptions solely based on the fact that he died within a rehabilitation setting.
Potential explanations for a death in such circumstances could encompass an acute medical or cardiac event, an undiagnosed underlying health condition, or complications related to medication, the expert suggested. Individuals admitted to residential treatment facilities often present with intricate medical histories, and some conditions might not be immediately apparent upon their entry into a program.
"Younger people can sometimes die suddenly, and we don’t know whether they had an underlying medical issue," the expert noted.
"It’s not impossible to have a medication-related event, particularly if someone has an underlying heart disorder," he continued. "Certain medications can trigger a cardiac episode."
Entering a treatment program does not signify that a person's struggles are resolved or that all danger has been eliminated, the expert emphasized. "People are in rehab because they’re struggling with addiction. It doesn’t mean they’re cured of their addiction," he stated.
While treatment facilities strive to maintain a controlled environment, they cannot entirely eliminate every risk associated with addiction, the process of withdrawal, potential relapse, or unforeseen medical complications. "Facilities take great pains to make sure substances don’t come in, but it’s not a perfect system," he added, stressing that this is a general observation about treatment environments and not a specific comment on Gerber’s situation.
The Dangers of Withdrawal and Post-Detox Relapse
Another significant risk during the rehabilitation process is withdrawal itself. Depending on the specific substance involved and the individual's level of physical dependence, withdrawal symptoms can range from merely uncomfortable to potentially life-threatening.
While opioid withdrawal, for instance, can be intensely uncomfortable, it is generally not fatal on its own, according to the expert. However, benzodiazepine withdrawal presents a more severe risk, capable of inducing seizures, delirium, and other life-threatening complications. The U.S. Food and Drug Administration (FDA) has issued warnings that abruptly discontinuing or rapidly reducing medications like Xanax or Valium can lead to serious withdrawal reactions, including seizures.
"Someone might disclose heroin use but not mention that they’re also withdrawing from a benzodiazepine, such as Valium," the expert pointed out. "If they don’t receive medication to treat that withdrawal, they can have a seizure that can lead to fatal complications."
One of the most perilous periods for an individual with opioid use disorder often occurs after detox. During this time, a person’s tolerance to the substance may have significantly decreased, thereby increasing the risk of an overdose if they revert to consuming a quantity they previously used.
"If someone relapses after rehab, they may use the same amount they were using before treatment — but their tolerance has gone down, and that amount can now be fatal," he cautioned.
Unregulated Treatments and Emerging Therapies
Gerber had previously shared on social media about undergoing an ibogaine treatment in Mexico. The medical expert noted that ibogaine is not approved by the FDA for any medical use within the United States. Although it has been studied experimentally as a potential treatment for opioid use disorder, its overall safety and effectiveness remain uncertain. The expert categorized ibogaine alongside other psychedelic or psychoactive substances that have garnered public attention.
"Ketamine, ayahuasca and ibogaine are psychoactive or psychedelic treatments that have become increasingly popular," he explained. "There is some research indicating potential benefits, but they remain largely unregulated."
While ketamine is FDA-approved as an anesthetic, it is not approved for treating psychiatric disorders, though some clinicians utilize it off-label in mental health contexts. Both ibogaine and ayahuasca are not FDA-approved treatments in the U.S., and the scientific evidence and regulatory oversight for these substances vary considerably. Overall, the expert characterized this evolving field as unsettled, describing it as
