Michael Jackson's Alleged Addictions: Experts Weigh In

Doctors Drew Pinsky, Arnold M. Washton discuss Jackson's alleged psychological and pharmaceutical problems.

It's the ultimate American dream: a meteoric rise from obscurity and struggle to worldwide fame and adulation. Untold riches, palatial estates, a fiercely loyal crew of hangers-on, private jets, screaming fans and limousines come with the territory. But so does seclusion, paranoia, loneliness and access to any and all vices the heart and mind can imagine.

It's a dark side of celebrity that has come into focus all too well recently, from Eminem's admitted struggles with painkillers to Britney Spears' very public difficulties and, last Thursday, Michael Jackson's death at age 50 after decades of isolation, plastic surgery, multiple allegations of impropriety with young men and an allegedly fierce addiction to prescription medications.

How does superstardom so quickly turn into a life-threatening fall from grace?

By many accounts, Jackson, 50, was a lonely man, one whose lifelong fame had resulted in a secluded life inside a childlike fantasy world of his own making that few could understand. From his fascination with his own lost childhood and a Peter Pan-like existence to a proclivity for plastic surgery that had radically altered his facial features and skin color to the point where he barely resembled his former self, Jackson publicly struggled to find peace in a world where fans and the media incessantly thirsted for a peek into his mysterious kingdom.

Dr. Drew Pinsky, star of VH1's "Celebrity Rehab" and an addiction specialist, said he has done extensive research on the link between celebrity and addiction, and said his findings indicate that being a superstar has little impact on someone's addictive tendencies.

"It's the kind of person who strives to be a celebrity who has a high incidence of childhood trauma, addictive and narcissistic tendencies and who surround themselves with people who support that narcissism," he told MTV News. "And when that addiction emerges, it gets out of control and there's no way to cut it out. They spiral into severe consequences and situations where, if it was the rest of us, we would have someone who would tell us to stop."

Pinsky said his research has shown that people who are addicted to the kind of opiates that Jackson allegedly struggled with — painkillers and other strong prescription sedatives and antidepressants — are almost always survivors of abuse. Jackson had stated in several interviews that he was the subject of physical and emotional abuse from his father, Joseph, who often teased him about his looks.

"These people walk around every day feeling shattered, with an out-of-control sense of miserable worthlessness, and when they find their way to an opiate, for the first time in their lives they feel like everything is OK," Pinsky said, noting that patient confidentiality would not permit him to answer a question about whether he had ever treated Jackson, but that if someone had approached him about helping the star, he would "run for the hills" because he felt the situation might not have been treatable given the chaotic state of the singer's personal life. "But there's no doubt he was in pain."

In a touching postmortem essay, former Los Angeles Times pop music critic Robert Hilburn recalled a nearly two-decade-long friendship with Jackson that ended in the mid-1980s at the peak of Jackson's career. Speaking to him in 1981, before Thriller would make him a worldwide icon, Hilburn asked the then 23-year-old singer — who he described as anxious, possessing a "Bambi-like shyness" and speaking in barely a whisper — why he lived with his parents and not on his own like his brothers.

"Oh, no, I think I'd die on my own," Jackson reportedly said. "I'd be so lonely. Even at home, I'm lonely. I sit in my room and sometimes cry. It is so hard to make friends, and there are some things you can't talk to your parents or family about. I sometimes walk around the neighborhood at night, just hoping to find someone to talk to."

Hilburn said that Jackson was so embarrassed by his awkward teenage years — when his fame had tapered off a bit and, like many teens, he suffered from acne and physical changes that he told the reporter made him unrecognizable to some — that he vowed to do whatever it took to make people "love me again." The writer said that rejection fueled an ambition to be the biggest pop star in the world and to try to make his face "beautiful."

Those body image problems aside, Pinsky said the most serious problem with opiate addiction is that the drugs themselves can cause pain when the patient begins to feel that if they cease taking the medication they will be in even worse agony. "With chronic pain, once you start taking these medications, you are in constant pain," Pinsky said. "And when you have enablers around you who help provide the drugs, it makes it almost impossible to get off of them. It's like a crack addict living in a crackhouse."

On Thursday, an official confirmed for MTV News that the Drug Enforcement Administration had been called in by the Los Angeles Police Department to help in the investigation into Jackson's death. The LAPD has already removed several bags of medical evidence from Jackson's rented Beverly Hills-area mansion, and the DEA was reportedly called in to help the police investigate Jackson's doctors and possible drug use.

A number of Jackson's former friends have come forward since his death to say that they tried to help him kick his reportedly expensive, serious prescription drug habit, including spirituality guru Dr. Deepak Chopra, who has spoken about Jackson allegedly asking him for the highly addictive pain medication OxyContin, and mentalist Uri Geller, who said he tried to intervene and help Jackson get clean several times, according to The Associated Press.

"This is how my patients die," Pinsky said of the alleged prescription drug cocktail Jackson was taking, which also is reported to have included Diprivan, a surgical anesthetic that the singer was said to have sought as a sleeping aid and which is typically only available to licensed anesthesiologists and medical professionals for use in a clinical setting during outpatient surgery.

"You get to the point where you build up such a high tolerance to the opiates that you can't take enough to get the desired effect, or enough to keep you from painful withdrawal," said Dr. Arnold M. Washton, a New York-based psychologist with more than 30 years of expertise in treating addiction. "And chronic use makes it impossible to go to sleep, so the person using these drugs may use double or triple the dose, hoping to go to sleep, but no matter how much they use, they can't. So they need to switch to a drug that affects a different part of the brain, which are the sedative drugs."

Washton, who also said he had no firsthand knowledge of Jackson's case and had not treated the singer, told MTV News that Jackson's alleged drug issues and his equally disturbing proclivity for image-altering plastic surgery were signs of someone who was struggling mightily with poor self-image. "This is a man who had profound problems with his sense of self," he said. "He was struggling his whole life to feel OK about himself and despite his extraordinary talent, fame and riches, it's obvious he was never satisfied and was constantly trying to change himself."

While Washton differed with Pinsky about the correlation between childhood trauma and addiction, he agreed that addiction is more about the person and not the addictive nature of the drugs. "The biggest issue for people who collide with drugs is that some get a corrective relief from the drug for the pain inside them, whether that's from their sense of self or regulating their self-esteem or relationships with important people in their lives," he said. "And they find that the drug takes away that psychic pain, and opiates are more effective than any drug known to man to do that, and that relief from the bodily and emotional pain ... you take enough of a narcotic and you can't feel anything."

Washton, who wrote about "The Addictive Personality," in his 1989 book "Willpower's Not Enough," said another reason Jackson may have fallen into an alleged spiral of prescription drug abuse was a result of the rarified air the pop star lived in. "People like Jackson get far away from the free world and live an insular existence where one is not subject to the limits others deal with and they can often engage in behavior without consequence that others cannot," he said. "People are willing to do their bidding and give them things because of their fame and money, doctors will write them prescriptions. ... It's not hard for them to feel that the laws of the universe apply to everyone but them."

For complete coverage of the life, career and passing of the legendary entertainer, visit "Michael Jackson Remembered."

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