Dr. Drew Pinsky on treating celebrities, his own struggles with codependency, and being confused with Dr. Phil.
Do people ever confuse you with Dr. Phil?
I hope not.
It’s just unfortunate that the general public doesn’t always know who on TV is actually a medical doctor.
What fascinates you most about addiction these days?
I’m really interested in trauma and its effects on addiction. If you have a serious enough addiction that you need to see me, there is a virtual 100 percent certainty that you have childhood trauma—either sexual, physical, or emotional.
Another thing that keeps me up at night is the irresponsibility of many of my peers, who prescribe opiates and benzos to addicts without realizing what the hell they’re doing. Any prescribing of the wrong thing to an addict, and their life is in danger. Many of my peers don’t understand this. They don’t truly get addiction. They will buy into what their addict patients tell them. “Oh, I just need a little help to sleep” or “I’m really in pain, doc.” The end result? Turn on the nightly entertainment television shows. Every week someone new is dead.
Why don’t we look at addiction for what it is—our costliest and deadliest public health problem?
That’s a great question. Addiction is more likely than the vast majority of cancers to kill you. It wreaks more havoc on work, on relationships. Go to any criminal court, and 80 percent of the cases will be about drugs, about addiction. There’s still all of this controversy about what addiction is and how to treat it. We’re deeply steeped in two heritages. One is a moralistic view of addiction. Somehow an addict is a bad or weak person doing bad or weak things. The other is that we have a real problem in this country coming to terms with disorders that deal with our free will. We really have a hard time accepting that many of us don’t have free will when it comes to certain behaviors or substances.
Are we making progress with addiction research?
Yes, although one of the problems with researching addiction is that—unlike with many other illnesses—you can’t rely on your research subjects to tell you the truth. They will lie to you. You can check their urines, but even in locked facilities, they can get around it. Unless you can follow them around 24/7, you have meaningless data.
You have been criticized by some for shows like Celebrity Rehab with Dr. Drew and Sex Rehab with Dr. Drew, which some argue have sensationalized addiction recovery. Do you have any regrets about televising the recovery of celebrities?
There are two questions. Is it exploitative, and does it sensationalize? Let’s take the sensationalism charge first. It’s funny, because we did these shows as a reaction to the sensationalism and inaccuracies that we saw when it came to how addiction and recovery were being portrayed on television. We got sick and tired of people making light of addiction, or people believing that treatment was some sort of spa experience.
Is it exploitative? Let’s be clear. The patients on the shows are getting paid more than me in most cases. They’re all there to be on TV and make money, and most come in to exploit us in some way. And despite that motivation, they end up participating, and many end up taking recovery seriously.
So you’re essentially paying people to stay in treatment? Is that a good idea?
The average person in treatment, if I push too hard, they leave. In the case of these celebrities, if they want to be on TV and get their paycheck, they can’t leave. And that proves to be a great motivator to keep them in treatment. We’ve had many people say to us after, “Oh, I was just doing this for the money, and I thought I would bullshit my way through this. But this recovery process actually saved my life.”
Are celebrities more prone to addiction than the average person?
Yes. I have the only published literature on this question. The kind of person that is driven to become a celebrity is at a higher risk for addiction, and is significantly more likely to have experienced childhood trauma. Celebrities arrive at the celebrity status with intense pathologies that they most often haven’t dealt with.
Do you believe Americans are more addicted than people in other countries?
Yes and no. Kids learn to drink at a younger age in Italy in France, and there’s this misconception that because of that they actually have fewer addiction problems. The idea is that somehow they learn at a young age to have a healthy relationship to drinking. But go look at the data on deaths from alcoholism there. Their alcohol problems are astonishing. But they are in denial. Their problems are swept aside with cultural platitudes that are completely false.
Having said that, we have three things that make our drug problem worse in this country in my opinion. Money, availability, and trauma. I’m convinced we have more trauma in this country. Sexual abuse, emotional abuse, neglect. There’s no doubt that we went for a period of 30 years where sex abuse was out of control in this country. Physical abuse has been in our culture forever. And neglect is rampant in our families. Our families have been so sick that we’ve been transmitting trauma that way. At the same time, we’ve gone through a period where we’ve developed and distributed more addictive compounds.
Do we know if men are more addicted than women?
The data is all over the place on that, although men are more likely to identify as addicts. We reserve a special hatred for addict women, so they identify less. Look at the words we use to describe addict women—tramp, lush, whore. Meth mom rolls off your tongue. I haven’t heard the term meth dad.
You’ve been talking a lot about sex addiction lately. What interests you about it?
Well, it’s a relative of codependency, which is something I suffer from and that I’m contending with all the time, especially on Loveline. Many people, especially young people, struggle with codependency and variations of sex, love, and relationship addictions.
Do you believe sex addiction is an addiction in the same way alcoholism is an addiction?
I’m somewhat ambivalent on that, and I certainly understand the unwillingness that some people have in calling it a true addiction. The reason that I embrace the term sex addiction is because it’s useful from a treatment perspective.
What are you addicted to?
I’ve been fortunate to not struggle with any serious addictions, although I am a severe codependent.
On Sex Rehab with Dr. Drew, you seemed to almost tear up as you listened to the sad childhood stories of some of the celebrities going through treatment. Is it difficult to keep an emotional distance?
Yes. I’m treating addicts early in recovery, and many have never had someone sit there and be in tune to their emotions in a deep way. Without crossing boundaries, I try to stay with them without being truly overwhelmed. I’m trying to go as far as I can with them emotionally, while at the same time staying separate and whole. That took a lot of personal work. That’s a right-brain, non-rational skill. It took years of my own therapy and study.
Are you a big crier?
I cry a lot at movies.
From which of your mistakes have you learned the most?
I make mistakes all the time, and I really try to make a point of learning from them all. One big mistake that I feel guilty about is having waited so long to ask my wife to marry me. What I learned there is that I need to trust my instincts more.
Would you say you’ve been more successful in public or private life?
I probably don’t have enough close friends in my life, although I am OK with that. I have an incredible family life, and I am so grateful for that. I have a wonderful wife and three amazing kids.
What advice would you give teenage boys trying to figure out what it means to be a good man?
1) You need to understand that humans with two X chromosomes are very, very, very different. You can hurt them very easily, so be careful.
2) Cultivate the ability to appreciate your partner’s point of view.
3) Get clear about what a good life is. You can want to be a good man, but what is a good life? A good life is being of service to other people.