In Hollywood these days, driving in the wrong direction on a freeway, being caught "under the influence," or shaving your head in public and then racing off to rehab are just as likely to get you on the cover of a magazine as a big opening at the box office.
The list of headline-grabbing celebrities is long: Britney Spears, Lindsay Lohan, Whitney Houston, Robert Downey Jr., Nicole Richie, Kate Moss and Marc Jacobs are among the stars who've gone public with their drug and alcohol problems and who are trying to walk the road to recovery.
Addiction specialist Drew Pinsky says the death of Anna Nicole Smith, an alleged drug abuser, was a wake-up call in Hollywood.
"She dies and then all of a sudden everybody goes into treatment. And that is typically what happens with addicts," says Pinsky, who runs the Department of Chemical Dependency Services at Las Encinas Hospital in Pasadena, Calif.
"When someone really has a consequence, they recognize themselves in that and try to get help," Pinsky said.
Drug abuse and the creative arts are longtime co-stars of the celebrity high-wire act. In the 1940s, leading man and tough guy Robert Mitchum did jail time for marijuana possession.
In the 1950s, Billie Holiday and Charlie "Birdman" Parker made all that jazz with heroin flowing through their veins. In the 1960s, box office giant Gary Grant extolled the virtues of LSD as therapy and Marilyn Monroe overdosed on prescription drugs.
The toll was high in the 1990s. Rock star Kurt Cobain shot himself after leaving a treatment center in Los Angeles. Funnyman Chris Farley and actor River Phoenix overdosed on cocaine and morphine.
Not Everyone in Hollywood Has Heard the Call
Despite the spate of recent high-profile celebrity meltdowns, some wonder whether a cavalier attitude toward substance abuse remains pervasive in Hollywood. After being arrested for an alleged DUI in the fall, Paris Hilton didn't seem to see what all the fuss was about.
"It was nothing," she reportedly told "American Idol" host Ryan Seacrest. "I was just really hungry, and I wanted to have an In-N-Out burger."
Drew Barrymore, George Clooney, Johnny Depp, Angelina Jolie and Justin Timberlake are quoted in the latest issue of Us Weekly magazine as openly having admitted to abusing drugs in the past.
Do stars believe they are above conventional norms or the law? "I treat lots of celebrities," Pinsky said. "Their stories are always replete with trauma and drugs and narcissism. People with these issues are drawn to becoming celebrities."
And Pinsky says celebrities don't always have the same brakes on their behavior as people without "starpower."
"It is not that the celebrity status develops these phenomenons, it's that there's not so many boundaries or so many consequences that the rest of us would come up against," Pinsky said.
But there are consequences. While audiences seldom shun a star at the box office because of "bad behavior" in their real lives, studios are nowhere near as tolerant.
"It becomes prohibitively expensive to insure a movie production that has a drug user in the cast," said Tatiana Siegel, who covers the film industry for The Hollywood Reporter.
Last year, Lohan was blasted by Morgan Creek, the film company backing "Georgia Rule," in which she starred. The ingenue's tardiness and no-shows prompted CEO James G. Robinson to write a letter that found its way to the Internet.
"We are all well aware that your ongoing all night heavy partying is the real reason for your 'exhaustion.' We refuse to accept bogus excuses for your behavior," wrote Robinson.
He threatened to hold her "personably accountable" for actions the Morgan Creek chief said had "resulted in hundreds of thousands of dollars in damages."
"Lindsay Lohan has not signed on to any studio films in a while," Siegel said, "and I don't think that is a coincidence."
Downey's battles with drugs and the legal system for two decades dimmed a brilliant career hinted at by stellar performances in "Less Than Zero" and "Chaplin," for which he received an Oscar nomination.
"For years he was not making any studio movies. He was making independents," Siegel said. "He has just started to land high-profile roles."
Downey has received critical acclaim for his role in the recently released "Zodiac," and he will star as a superhero in the big budget action drama "Iron Man," scheduled to begin filming this month.
Young people take their cues from popular culture and from celebrities.
Marketers rely on that dynamic. So it is troubling for some to note that the headlines made by entertainers in the throws of addiction have an eerie echo in a startling new report about college kids.
Almost half of all full-time college students (4.8 million) binge drink and/or abuse prescription and illegal drugs, according to the National Center on Addiction and Substance Abuse at Columbia University.
The comprehensive study also found that more than one-third of the students did not seek help because they feared the social stigma attached to substance abuse.
With more and more celebrities turning to treatment and admitting they have a problem, perhaps there is a message really worth marketing to young people.