What is the psychological fate of little Ava-Monroe?

Ronda Kaysen: Casey Johnson might have been a billionaire heiress, but she reportedly died alone in a filthy, rat-infested apartment with her 3-year-old daughter in her parents' custody. The death of Casey Johnson is not only a story of a spoiled rich girl gone wild, but also a cautionary tale of just how much havoc addiction can wreak on a family and the children left behind.

Casey's end -- she presumably died of a drug overdose complicated by diabetes, her body not found for a week -- is tragic in its own right. Add her adopted daughter Ava-Monroe to the equation and you have a sad story of a little girl orphaned not once, but twice.

"It's really tragic. [Ava's] psychological development and wellness will really depend on how she is cared for," says momlogic expert and New York City psychiatrist Dr. Janet Taylor.

Casey adopted Ava in 2007 from Kazakhstan after her godmother, Diandra Douglas (Michael Douglas's ex-wife), adopted her own child from there. Earlier, Casey had tried to adopt a child from Cambodia, but the country had cracked down on international adoption. When she met her godmother's child, she was smitten.

"She's the most beautiful baby I've ever seen," Casey told MTV. "She's blond-haired, blue-eyed, looks just like Diandra, and I thought, 'Oh, my gosh! This is what I'm going to do.'"

Casey brought her own little girl home from Kazakhstan and named her Ava-Monroe, after Marilyn Monroe, with whom she deeply identified. She planned to raise Ava as she had been raised: with all of her material desires met. "Obviously I want her to look the best that she can, the cutest that she can," she said. "So I'm going to buy her a lot of clothes."

It's exactly that attitude of reckless indulgence that can lead to addiction, says momlogic expert Jennifer Ginsberg, a Los Angeles-based addiction specialist. "When parents overindulge their children, thinking that's an effective form of parenting, it just creates an empty space because none of that stuff fills you up."

Casey, who talked about never learning financial limits and having every materialistic whim indulged, had a long history of drug and alcohol abuse. Her family pressured her to go into treatment, but she refused. Even motherhood couldn't straighten her out. She reportedly woke Ava up in the middle of the night to play with her when she was high. And, according to reports, she spent as little as 10 minutes a day with her, the rest of the time leaving her in the care of nannies.

"The people who suffer the most typically are the children," Taylor said. "All addicts care about is getting the drug, so they don't take care of their kids. All they care about is their next high."

In recent months, Casey's life tumbled out of control. Child Protective Services was called on numerous occasions, according to reports, and eventually Casey's mother, Sale Johnson, took custody of Ava. The Johnsons cut her off, shutting her out of her hefty trust fund.

"Her family couldn't handle her behavior and lack of respect, so they cut her off," a friend of Casey's told People magazine. "They thought it would teach her to turn things around."

Casey and her fiancée, reality TV star Tila Tequila, went to New York in September to win back custody. They returned empty-handed.

Once Ava was out of her care, Casey spiraled more out of control. "Just a few months ago, she was living like a crazy person," the friend told People. "Super-erratic behavior. People could barely be around her."

Casey's body was found six days after her last Twitter update in an apartment filled with dirty dishes, rats, and trash. The daughter she left behind has an uncertain emotional future. Her life until now has likely been chaotic and unstable. She was adopted when she was roughly a year old, meaning she spent her first year in at least one other person's or institution's care. By 3, she's already lost at least two families. She's also being raised by the woman who raised Casey, and it's possible Sale could repeat the same mistakes that sent Casey down such a tragic path.

"She's had a lot of transitions at a very early age. She's had a lot of disruptions from birth to now, and who knows what chaos she experienced," said Taylor. "It's more trauma. It's another loss."

This isn't the first drug-related death in the Johnson family. In 1975, Woody Johnson, Casey's father and the owner of the New York Jets, lost his 25-year-old brother Keith to a cocaine overdose. At the time of his death, police found hypodermic needles, a spoon, and a plastic bag stuffed with white powder in Keith's closet. A month later, Woody's 22-year-old brother Billy died in a motorcycle accident.

By all accounts, Casey was spoiled by her parents. She was showered with lavish gifts at an early age, like a Chanel bag when she was 12 and a $17,000 gold Cartier watch when she was 15.

"I have so much stuff that, you know, it's almost embarrassing, it really is," she told the New York Post in 2008. "I have nothing left to want."

Diagnosed with diabetes at age 8, her parents turned her into something of a poster child for diabetes when she reportedly only wanted to be a normal kid like everyone else. She struggled with depression and mental illness. Rather than feed her spirit, her vast wealth only fed her propensity for addiction.

"I don't think she wanted to be a poster child. She wanted to be a healthy, normal kid. But she always felt she was different. She was very sad and searching to be loved," a family friend told the New York Daily News.

Perhaps with Ava, Sale and Woody can have a second chance to do right by their daughter. It's a good sign that Casey's parents finally cut her off -- even if it was too late for her. And it's good that they took Ava out of her home. Both of these actions are signs that Sale and Woody have come to their senses about their daughter, says Ginsberg, and speaks highly of Ava's prospects.

"I'm very hopeful that the grandparents love her and that she'll just get loved and nurtured and her emotional needs will be met rather than her material desires," Ginsberg said.

Ronda Kaysen is a freelance writer. Her work has appeared in the New York Times, Washington Post, BusinessWeek.com, Architectural Record, Huffington Post, New York Observer and AM New York. She lives in Brooklyn with her family.