Survivor's guilt and post-traumatic stress disorder may have triggered a drug relapse

Credit: Miguel Aguilar/INF

When DJ AM survived a fiery plane crash last September, he suffered severe second- and third-degree burns on his scalp and arms. But the accident left him with more than physical scars – the popular deejay struggled with the mental and emotional side effects until the end of his life.

A few weeks after the crash in 2008, DJ AM (real name: Adam Goldstein) told PEOPLE, “I had a terrible nightmare … there was someone with an aerosol can trying to light me on fire. I woke up and I was like, ‘Oh my God. This is going to happen forever.’ ”

Goldstein sought therapy, but his survivor’s guilt and post-traumatic stress never went away, according to friends and colleagues. Indeed, they may have ultimately led the recovering drug addict – who was found dead Aug. 28 in his Manhattan apartment with illegal and prescription drugs – to a critical relapse.

“There’s no doubt in my mind that the injuries Adam suffered in the plane crash caused last Friday’s events,” Goldstein’s lawyer Matthew McNicholas said after the deejay’s death. “Without the plane crash, we’d still be enjoying his musical talents. He lived with the trauma everyday.”

Fear of Death and Burning

Signs that Goldstein was still battling the psychological impact of the plane crash were never far from the surface. The deejay, for instance, had difficulty working at Rain, a Las Vegas nightclub known for its pyrotechnic displays, where Goldstein had a regular Friday night gig.

“They rarely shoot off the flames [during his night] and when they do, it’s toned down,” says a club source. “He got really nervous when they shot off the fire because you could feel the heat.”

Three months after the accident, Goldstein filed a $20 million lawsuit against Learjet, the pilots’ estates and others for “pain and suffering, mental anguish, psychological and emotional distress, disfigurement and pre-impact fear of death and burning,” according to papers filed in court.

(A spokesperson for Learjet had no comment Tuesday regarding DJ AM’s death.)

Stress and Addiction

Goldstein’s cause of death has not been officially determined. But according to multiple sources, the celebrity deejay’s addiction spun out of control in his final days and led to his final crisis.

Could memories of the plane crash have contributed? Psychiatrist Dr. David Sack, an expert in drug and alcohol abuse, says that, in those already struggling with addiction, relapse can often be triggered by an earlier, unresolved trauma. “It significantly increases the risk of relapse,” he says.

Another common symptom of post-traumatic stress, says Sack, an addiction specialist and CEO of Promises Treatment Centers who did not know Goldstein personally, is increased trouble with sleeplessness – another potent trigger for drug relapse. “People who have insomnia are at least three times a greater risk for relapse than people who aren’t having insomnia,” says Sacks.

Not all of Goldstein’s friends recall a change in behavior in recent weeks. “I saw him two months ago and he was in a good state,” says a source. “Sober and just Adam – happy, lovely, nice. I’d heard that he has had a tough few months, but no one saw this coming.”

But another friend who remembers DJ AM fondly says there is little doubt that a combination of survivor’s guilt, anxiety and PTSD took its toll.

“His death was a direct result of the plane crash,” the friend tells PEOPLE. “It was something he fought daily. If that crash hadn’t happened, he would be alive right now.”