It seems that almost every week there's a new celebrity, another story of substance abuse, or one more humiliating mug shot pulling back the curtain on a member of America's royalty. Substance abuse itself knows no borders of wealth or fame. From Camden, N.J., to Beverly Hills, Calif.; it reaches all races and classes. Yet the hot pops of the paparazzi cameras leave no celebrity embarrassment uncovered. Flipping through the tabloids, Hollywood looks like a town that revolves around clubbing, drinking and, when the celebrities are caught, drugs.
There's Lindsay Lohan's vicious circle of addiction, arrest, rehab and relapse. Britney Spears is teetering on the edge for the entire world to see, rumors of drug use and mental instability swirling around her. Never has a hamburger been given so much attention as when David Hasselhoff comically mangled it after a night of drinking in a moment that shot to viral stardom. But when his daughter's voice can be heard behind the lens, pleading with her slurring, shirtless father to get help, it doesn't seem that funny any longer.
Imagery like that is all too familiar and indelible. Just this week Bon Jovi lead guitarist Richie Sambora was the latest star to get snared for drunk driving.
"We're seeing it explode," Dr. Drew Pinsky said to ABC News. "It's a pandemic right now. We're seeing younger people get more serious addiction, more rapidly with multiple substances."
Pinsky is a radio host and a doctor, who has treated and studied celebrity addicts for more than 20 years.
He says that a dangerous cocktail of money, power and the ability to give both to others particularly puts celebrities at risk for not getting help for addiction.
"There's not a boss, not the legal system, there's not a family there to capture them and contain them and refer them for treatment or to help contain their behaviors," Pinsky said. "They have too much money and power, and it spirals out of control."
Hollywood has always been a place where drugs and fame intersect at disaster. The list of those who made the ultimate sacrifice for their addiction is long and tragic: Marilyn Monroe, Elvis Presley, Jimi Hendrix, John Belushi, Chris Farley, River Phoenix, to name a few. In the past year alone Anna Nicole Smith, Ike Turner, Brad Renfro and Heath Ledger, all had their lives cut short.
Ledger died of an accidental overdose of six different prescription drugs. Unlike other celebrity drug users, his problems were not widely known. For Pinsky that was a major factor in Ledger not getting the proper help.
"You're adding to the stigma by shrouding it in secrecy," he said. "You're as sick as your secrets when you have addiction and it is fueling other people to keep their secrets and end up where he ended up."
At the opposite end of that spectrum is Amy Winehouse. Her battles with drug addiction were daily tabloid fodder, all of which came to a head when a video of her reputedly smoking crack, and openly talking about taking too many tranquilizers, hit the Web.
"Amy Winehouse has severe, profound, life-threatening addiction," Pinsky said. "She has made a career out of resisting treatment. I don't know what it's going to take to turn her around. I really fear for her life."
Former teen heartthrob and actor Corey Feldman talked to ABC News about his own public struggles with addiction, problems that sank a skyrocketing career when he was only a teenager.
"I was 15½, I think 15 the first time I smoked weed, and by 19 I was clean," Feldman said. "So the actual addiction lasted from about 16½ to about 18½.
"It shattered my career to be completely brutally honest. Shattered it into pieces."
Feldman said he's grateful for the way things turned out, forcing him to face his demons and get help that has kept him sober for close to 19 years.
"Thank God that I fell into the barricades and the problems and the pit holes that I did, because had I not fallen into those pit holes at such an early age, it would've followed my career and it would've followed my life," he said, adding that for many of today's celebrities the repeated "second chances" and lack of accountability give them little reason to get sober.
"The problem with the children today is they keep getting opportunities over and over and over. So every time they get into trouble, somebody is willing to bend over and hand them another opportunity."
For stars like Lindsay Lohan and Robert Downey Jr., second chances seem to be waiting after every trip to rehab, and, even when they actually do seek help, places like the Meadows in Arizona, or Promises in Malibu, Calif., all including spa treatments and lush grounds, sound like vacation spots that many people could only hope to visit.
But for Pinsky, the public perception that a trip to the rehab clinic is akin to a week at a luxury spa was exactly the reason he wanted to show the public what really goes on behind the gates of treatment centers. After rounding up a group of willing low-end celebrity addicts, he created Celebrity Rehab With Doctor Drew.
The show has been an instant hit for VH1, featuring actors Daniel Baldwin, who left the show in midseason, Jeff Conaway and former porn actress Mary Carey, to name a few. The show has also raised questions about whether putting addicts on television is really in their best interests.
"My question really has to be, what is their real motivation? Is their motivation money or fame -- or sobriety?" said Dr. Howard Samuels, clinical director of the Wonderland Treatment Center in Los Angeles.
"I'm a recovering addict," Samuels said. "No one paid me to go to rehab. I went to rehab because I hit a wall of pain. I went to rehab to save my life. I didn't go to rehab to get a check."
But Pinsky contends that his cameras don't capture the intense and real treatment his patients are getting and the entertainment aspect is worth the risk to give the public a very real look at addiction treatment.
"What people are reacting to is the parts they're seeing, not the recognition that the treatment itself was 14 hours a day," Pinsky said. "They don't know what kind of treatment we did. You don't see that on TV. They had thorough and excellent treatment. Their outcomes were unusually good. The cameras seemed to have a positive effect on them. How is that exploitation?"
"I'm sick and tired of the media -- and as my staff was -- sick and tired of people talking about treatment as though it were some sort of spa experience," he said. "It is serious medical treatment. It is a life-threatening illness. It is worth the risk. And these people were willing to take it."
The chances that Pinsky's celebrities will relapse are high, cameras or not. As Pinsky knows all too well, rehab is a low-percentage business. He hopes that the controversy and harrowing images of public figures battling addiction will spark greater interest in a problem that stretches far beyond Hollywood Boulevard.