Pain, Tears, Vomit, Relapse: the Realities of Rehab Hit Celebrities, Too

For down-and-out stars, one getaway seems to be more popular than the Caribbean, Cabo and the Côte d'Azur combined: Rehab.

Looking at last year's photos of Lindsay Lohan leisurely riding horseback at Utah's Cirque lodge and a bald Britney Spears strolling the grounds of California's Promises facility, it's easy to assume that for celebrities, a stint in rehab is no more grueling than a trip to Starbucks or the nail salon.

Dr. Drew Pinsky wants to flush that notion like a bottle of black-market barbiturates.

"People think celebrities are going to some kind of spa treatment program when they go to rehab. They don't understand how hard it actually is," said Pinsky, who attempts to shepherd nine celebrities from drug and alcohol addiction to sobriety in "Celebrity Rehab With Dr. Drew," premiering on VH1 tonight.

"People somehow believe celebrities are different from everyone else," he continued. "They don't understand how much mental disease there is among the famous."

Series like A&E's "Intervention" and HBO's "Addiction" have turned the spotlight on drug and alcohol abuse before. VH1's show is the first to bring a group of addicts together and follow their treatment.

"Celebrity Rehab" begins with nine stars checking into the Pasadena Recovery Center. Among them: actor Daniel Baldwin, former pro-wrestler Chyna, VH1 reality series alum Brigitte Nielsen, Crazy Town singer Seth "Shifty" Binzer, and a celeb who recently fell off the wagon again, "American Idol" finalist Jessica Sierra.

Unlike many addicts who are forced into rehab by family, friends or the law, the "Celebrity Rehab" participants came to the program on their own.

"I was past due for needing help," said Binzer, a cocaine addict who freebases crack in a home video featured in "Celebrity Rehab." "I took it to that level where it became a really scary thing to me."

Cameras, Paychecks Help Keep Celebs in Check

Smoking joint after joint, snorting cocaine, vomiting into a toilet, "Celebrity Rehab" shows its stars at rock bottom. Though Pinksy may be best known for sex advice doled out on the radio and TV call-in show "Loveline," he's no Dr. Phil -- he has the medical chops to administer real treatment.

An addiction and recovery specialist, Pinsky's the medical director of the department of chemical dependency services at Southern California's Las Encinas Hospital. He considers "Celebrity Rehab" a documentary about him treating a group of patients -- not a typical reality show. But as is often the case in Hollywood, cameras and a weekly paycheck for the patients helped the process.

"Cameras sort of hold people accountable -- they motivate them to keep them going," Pinsky said. "I was able to do more intensive work because these people were getting paid by the week. They wanted to get paid and they wanted to be on TV."

"Celebrity Rehab" wrapped production in August, which means its stars have been out of Pinsky's watch almost six months. For some, sobriety has stuck.

"I've been sober now for six months. And I stopped smoking Sept. 4," said Nielsen, who checked in for alcohol addiction. "This is forever. This is a change of life completely. It's not easy but it's the only way to become normal again."

For others, sobriety hasn't been so easy. Last month, Sierra was arrested for disorderly intoxication and resisting officers. In lieu of prison, a judge sentenced her to three years probation and another stint in rehab under Pinsky's supervision -- this time for one year, no cameras rolling.

"People look at her and say, 'See, treatment doesn't work.' That's not true. Jessica did not have the kind of funds for the kind of treatment she needed," Pinsky said. "She is not a resistive patient. She actively engages in treatment. She just needs a lot more."

Would Pinsky be willing to take the Winehouses and Dohertys of the world under his wing for another season of "Celebrity Rehab?" Only if the "public exposure doesn't have a net adverse affect" on the stars he just treated, who know that the pressure's on to keep the gossip about them good.

"I think it'll stick if I do the work it takes to stick," said Binzer, who's in talks to do a separate reality series about trying to stay sober. "If I wanted to keep doing drugs, I shouldn't have done this show. People are going to be looking for the least bit of intoxication in my eyes."