As <i>Celebrity Rehab 4</i> Begins, Dr. Drew Speaks Out About Dating, Addiction, Fame and Adam Carolla

The last five years, Dr. Drew has pushed forward at full-speed, writing a best-selling book, treating addicts at Huntington Memorial Hospital in Pasadena, teaching psychiatry at USC's medical school, and producing his VH1 reality show.
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Dr. Drew Pinsky is lost.

He's wandering around a Pasadena parking lot looking for his new car. He clicks his automatic car door opener. And again. In the distance, a faint beep. "I can hear it... but I can't hear it," he says.

It's an odd predicament for a man whose hearing has earned him national acclaim: as co-host of Loveline, the sex and relationship advice show, Pinsky has displayed an uncanny ability to detect sexual abuse by the pinch in a young caller's voice, drug addiction by the breathy drag of a caller's laugh. For over a decade the doctor applied those skills alongside his snarky sidekick Adam Carolla, with whom he had a crackling chemistry comatose shows like Parker Spitzer can only dream of.

The last five years, minus his comic companion, Pinsky has pushed forward at full-speed, writing a best-selling book, treating addicts at Huntington Memorial Hospital in Pasadena, teaching psychiatry at USC's medical school, and producing his VH1 reality show Celebrity Rehab, the fourth season of which begins tonight. This month he'll also enter his 26th year behind the Loveline mike, now with the help of a new co-host, "Psycho Mike" Catherwood.

His car finally found, Pinsky took a moment behind the wheel to talk about Carolla, dating, addiction and the big idea behind Celebrity Rehab.

Pinsky: Well, Celebrity Rehab wasn't my idea. Let's start there. It was somebody else's. And when I heard it, I thought, "That's interesting. But it can't happen." There are way too many practical and legal complications to showing people going through in-treatment rehab. But I hadn't pitched a show in a while, and I figured, what the hell: I'd give it a shot. Suddenly VH1 showed real interest, and I thought, "Oh shit, we might actually have to pull this into a real show." Bob Forrest, the drug counselor in the hat, he came to me and said, "We're treating a lot of celebrities, and it's being portrayed in the media like this is a vacation, like we're providing a weekend retreat. We need to show how patients — rich or poor, famous or not — struggle with this illness." I still had grave doubts about the logistics. But I wanted to shine a light on this too. Addiction really is the medical problem of our time. It's so destructive. And yet it's so common.

Kors: But isn't Celebrity Rehab just adding to that sense that rehab is a vacation, perhaps even a career-making break? You're rewarding addicts with celebrity. Celebrity is what people want.

Pinsky: That's true. Most of them do want to exploit us for the celebrity they'll get from being on the show. And you'd think that would work against the success of their treatment because, absolutely, you could look at them and say, "They're not really here to get clean. They're here to get famous." But it's very interesting: what happens is the tables get turned. Most drug addicts leave when you start to squeeze them, but these people, because they feel that pull to stay on camera and get famous, they stay and go through the steps it takes to get clean. I never would have predicted it would work that way, but it does. Once they get clean, they feel motivated to go out and help other people get clean. And because they're now celebrities, they have this platform to do that.

Kors: Don't you have to ask yourself, though: what kind of person would want to go through a painful, private process like rehab on camera? I mean, my mom, I had to drag her kicking and screaming into getting a Facebook page. Just to get her to put her picture up there. She kept saying, "Why do people on the Internet need to know what my face looks like?"

Pinsky: [Pinsky laughs.] Right. There's a generational shift in this, no doubt about it. You know, I originally wanted to do the show with celebrities and regular people, to show that being in treatment was the same for everybody. But as I was interviewing regular people, I noticed they were confused about the cameras, the recording, just the whole process. I realized: an average person can't consent to do this. They simply can't understand what it means to live in front of the camera, what the repercussions of that are. So we did it with celebrities. And even then I was nervous. I remember in the first season, we had porn star Mary Carey. I kept coming to her, saying, "Is this okay? If we show that, will that be okay?" Finally she told me, "Relax. I've done just about everything in front of a camera you can imagine. Doing this is not a problem."

Kors: Do you think being a celebrity causes addiction?

Pinsky: No. Absolutely not. And I have the data to prove it. Every weeknight for decades we've had celebrities on Loveline and given them surveys about their family, fame, upbringing, drug use. And the addiction rates are exactly what you'd see in society at large.

Kors: Because that's what they said about Michael Jackson, that being intensely famous from such an early age messed him up.

Pinsky: No, it wasn't his fame. It was the abuse in his upbringing. With Jackson specifically, you have to remember too, he had no regular social development because he was taken away from his peers. And from an early age, he had an incredible amount of both stress and power, which is an explosive mix. My data's very clear: celebrity has no affect on psychopathology. Although once addiction is there, the trappings of celebrity can cause addiction to blossom. Famous addicts make all the money they need to feed their addiction. They have enablers who can get them the drugs and assistants who are making too much money off them and don't want to step in. So the addiction grows.

Kors: How is celebrity affecting you? You used to be a regular guy.

Pinsky: [Pinsky laughs.] I'm still a regular guy.

Kors: No. You know what you are? You're a man with two million Twitter followers and an official blue check next to your photo... I'll tell you a funny story. I used Photoshop to put a blue check next to my Twitter photo, and when I tried to load it in, the site immediately shut my profile down. I removed offending pic right away, and thank God they let me back on. But they must have a mechanism for detecting if you load that blue check mark.

Pinsky: That's funny. So, okay, I'm a public figure. I didn't set out to be one, though I do think the direction of my career comes from two qualities I see in myself: I want to be where the action is. If I were living in Greek times, I'd want to be in Rome. And as far as I'm concerned, media is the Rome of our day. I want to participate in that and do some good. The other thing is I tend to get interested in the medical issues of the day. In my eyes, today, it's addiction. When I started in the '80s, it was AIDS. It wasn't even called AIDS back then. It was called GRID: Gay-related Immune Deficiency. Disease-wise all people were talking about back then was herpes. That made me angry. I said to people, "Herpes may be bad, but it's just some bumps. This thing will kill you." And back then, it would kill you right away. This was before there was even a term for "safe sex," you had to ask for condoms because they were only available behind the counter, and no one ever gave detailed information about sex and disease to kids because the presumption was kids weren't having sex.

Kors: You're excellent at helping parents with teens who are addicts. I'm wondering, what can parents do when their adult children are addicts?

Pinsky: If they really want to help, go to Al-Anon; get a sponsor; do the steps. If family members aren't going to Al-Anon, or at least a therapist, then they don't really want to help.

Kors: Yeah, but if the addict is messing up his life, why do you have to spend your time in a 12-step program?

Pinsky: You don't. But then don't say you're helping. If you're not going, you're not part of the solution. You're part of the problem. Because addiction, it sucks the addict in, and it sucks in those around him. You know the blood-eating plant in Little Shop of Horrors?

Kors: I do.

Pinsky: To me, that plant is the perfect model of addiction. If you're in the room, just by putting yourself there, you're feeding the addiction. Even me, who has treated thousands of patients with addiction, when I go into a room with an addict, I don't go in alone. I have a nurse with me. If you're there alone, you're going to get sucked in.

Kors: Do you have any personal or family experience with addiction?

Pinsky: Not in my immediate family. I did have some extended family members with alcoholism. But there was nothing I could do.

Kors: Nothing you could do? But you're the expert.

Pinsky: Yeah, but they were adults. Older adults. And at that point, it's their choice. I mean, you can stage an intervention. Or can pull out of their lives.

Kors: I like your definition of addiction: when using causes definitive consequences but you keep using anyway.

Pinsky: That's right. Consequences in four realms: finance, health, legal status and work. If you face consequences and you keep going, you have a problem.

Kors: I saw you on The View promoting the Rx Locker, which safety locks your prescriptions. If you need to lock your prescriptions to keep your son from breaking in, aren't your problems a lot larger than "Where's my medication?"

Pinsky: The locker is about preventing a problem. But sure, once you have an addict in the house, a lock like this isn't going to do shit. If he needs to, an addict will use small explosives to break through a lock. The point of the Rx Locker is, long before you get to that point, protect your kid. If you let your drugs sit next to the sink like toothpaste, there's a real opening there for your child to get his hands on them and become an addict.

Kors: Your dating advice has been extraordinarily helpful to me. You say, instead of going out seeking a relationship, you should go to the gym, study a topic, hone a skill—work on becoming a better person—and in the course of that, you'll naturally meet people who want to be with you. It's like your career advice for people who want to be on TV and radio. You say, "Study a topic. Know something. Do anything but study media."

Pinsky: That's right. I'm glad you got both of those messages. And it's true: If you're a good person with a lot of talents and a lot to say, you'll be attractive to people. They'll find you, or you'll find them. It's the way life works. As for the media, I've never seen anyone in front of the camera who studied media. All the people I've worked with studied medicine, engineering, philosophy. The skills of actually operating the media mechanisms: you can pick those up just being on the job.

Kors: For years I was also so focused on meeting a woman I could relax around, someone I could hang out with and just be myself. Listening to your show, I realized that's not a woman: that's a stage. Everybody is nervous and uncomfortable when they first meet someone.

Pinsky: Absolutely. It's especially true for adolescents. In addition to the date itself, they're dealing with issues like: how do I fit into adulthood? How are the ghosts of my past going to affect this potential relationship? It's a lot to juggle.

Kors: I'll pass on to you the best wisdom I picked up all year, from my sister-in-law: that to be successful on a first date, you have to triangulate — keep the discussion on the topic at hand, on the event you're doing: the museum exhibit you're looking at, the movie you just saw. She says a first date is both of you enjoying an event. It's not about learning the details of her life and her past. And it's certainly not about sharing the details of your life or your past.

Pinsky: That is so smart. And really, that's what a good relationship is: sharing experiences. That's what real intimacy is.

Kors: Yeah. Because I used to go on these dates and share stories about myself. So women thought I was ego-centric. Then I figured, well, I'm more interested in her anyway — I already know about myself — so I started asking questions about her. Then one girl told me she felt like she was on a talk show.

Pinsky: [Pinsky laughs.] That's funny. Yes, by asking questions, you're violating her boundaries. It's too soon for that kind of stuff.

Kors: What's funny to me is that to be a good date, I've had to realize dating is exactly the opposite of being a good reporter. For example, I uncovered this shady technique the military is using to deny soldiers wounded in Iraq and Afghanistan disability and medical benefits by diagnosing them with phony pre-existing conditions. To get the Army Surgeon General to comment, I literally had to call 64 times. Which was fine with me: my finger wasn't going to fall off. In dating, though, you call three times, and you're a stalker.

Pinsky: Yeah, your tenacity doesn't pay off.

Kors: No. Not at all... I wanted to ask you about that military scandal. I'm wondering if you heard about this. Since 2001, the military has pressed over 25,600 soldiers into signing these fraudulent documents saying they had a pre-existing condition, a "personality disorder," making them ineligible for benefits. It's saving the military $14.2 billion in disability benefits and medical care. Congress launched an investigation in September, and I was there as a medal-winning sergeant described for the Congressmen in graphic detail how he was tortured by U.S. Army officials for over a month until he signed the phony personality disorder documents.

Pinsky: My God. That's awful. I never heard anything about this.

Kors: Hmm. I wondered if you'd heard about it—and if you had worked with the military community in general. With personality disorder discharges specifically, it's devastating because not only are the soldiers denied disability and medical benefits, but they also have to give back a chunk of their signing bonus. So thousands of wounded soldiers from Afghanistan and Iraq are coming home with a bill to pay the Army, which slides them directly in debt, which is a direct path to addiction and homelessness.

Pinsky: That's definitely troubling... I have to say, veterans' issues are a little off my radar. There's no doubt that trauma — like the trauma of war — is an inciting cause for addiction. If a soldier is genetically predisposed, when he's traumatized in battle, he might turn to drugs for relief, and the drugs in turn will start causing another major set of problem. But I haven't worked with soldiers in years. Decades ago, when I was still in training, I did some work with veterans. And back then the VA system was bad. Really bad. My sense, though, in recent years was that the system had gotten better.

Kors: Every time I watch SportsCenter I see an ad for that book, The Alcoholism and Addiction Cure.

Pinsky: Yes. Chris Prentiss from Passages Malibu.

Kors: What do you think about him?

Pinsky: It's b.s.

Kors: It is.

Pinsky: Oh, yeah, absolutely. You know I've debated him on shows before. And I said, if this is true, if this approach you have works, publish your data. We want to know what you're doing. That's what medicine is: you share your experiences, so others can follow your lead. But he won't do it. He has no training either. And I've talked to people who have worked there. It's just a sham.

Kors: I really enjoyed A Million Little Pieces. Did you read it?

Pinsky: No, I didn't.

Kors: Well, the turning point of the book is when the author, who's in an in-treatment facility, rejects the idea that addiction is a disease and embraces the idea that the disasters in his life were caused by his own doing, and it's time for him to take responsibility for those lousy decisions and his addiction.

Pinsky: Yeah, I did hear that. And I knew when I heard it that the book was either bogus or the author wasn't really an addict. Because that's not how addiction work. It's how addicts wish it worked. But it's not how it actually works. But then, that's part of the brain disorder, their messed-up processing of what they think they're in control of. We call it "stinking thinking."

Kors: You definitely think there's a genetic component to addiction, that addiction occurs when the addictive genes are activated and create havoc.

Pinsky: There's no doubt. I've treated 10,000 addicts, and all but four of them come from a line of addicts.

Kors: But doesn't that show that people from messed up families end up addicts?

Pinsky: No, because a large percentage of those 10,000 addicts weren't raised around the addicted relative. Over and over we see cases where, for example, the father was addicted, and the child was raised by his maternal grandparents. And then becomes an addict nonetheless.

Kors: So what happens if someone without the addictive gene gets drunk or does drugs?

Pinsky: They don't become addicts. They might have consequences from their actions, like missing school or work, but they don't get a progressive disorder that eventually takes over their lives. Science is getting close, too, in closing in on exactly what those addictive genes are. A colleague of mine has done some research on two particular genes, showing that if you have both of the genes, your chance of becoming an addict is virtually 100 percent.

Kors: Let me ask you one last ridiculous question: What do you think of Dr. Phil?

Pinsky: He does good TV. Beyond that, I don't know. He's a psychologist who isn't even licensed to practice anymore. I'm troubled by the way the term "doctor" gets thrown around nowadays, so much so that people don't even know exactly what a doctor is anymore.

Kors: People who aren't paying attention, they sometimes mistake you for him. I told people I was going to interview Dr. Drew, and they said, "Ask him why he's gotten so bald and fat."

Pinsky: Well, all I can say is, if they listen to my show, if they hear me speak, they'll be able to tell the difference pretty fast.

Kors: If you like what I write, will you Tweet about it?

Pinsky: Sure, I'd be happy to do that.

Kors: Good. I spoke with Adam Carolla a few weeks ago, and he wrote me to say he liked our Q&A — then, despite nudging from several people on his team, absolutely refused to Tweet the link.

Pinsky: That's funny. You know he just wrote this new book. And until recently, he couldn't even read that well.

Kors: I know. He mentioned that to me. That's why I asked him during our interview the most embarrassing question of all: whether he actually wrote the book himself or hired some ghostwriter to do it for him. He said no, he actually wrote it. He said he dictated it to someone who wrote it.

Pinsky: Dictated. That I believe.

Kors: Well, what do want from him? He dropped out of Los Angeles Valley Junior College. Not everybody, like the two of us, got the chance to go to Amherst.

Pinsky: True. His story is amazing. You know when we started working together he couldn't even read the cue cards. He's such a good guy. And he's come a long way.

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