Drew Pinsky, <EM>Celebrity Rehab</EM> Drew Pinsky, Celebrity Rehab

Approximately 72 hours into the harrowing 21-day treatment regimen that is now playing itself out as Celebrity Rehab with Dr. Drew on VH1, an amazing thing happened, even more shocking than the sight of Crazy Town's Seth "Shifty" Binzer smoking crack while cameras rolled, incapacitated former Taxi star Jeff Conaway's horrible, convulsive withdrawal symptoms, or even the confiscation of porn star Mary Carey's sex toys.

Behind the scenes, VH1 executives, who were on location last August at the Pasadena Recovery Center, made an unprecedented decision: Instead of manipulating the action in the standard reality-show way — by introducing artificial dramatic elements to make sure the storylines stayed interesting — they decided to let the treatment process unfold on its own, organically, just as Dr. Drew Pinsky had been urging them to do from the start.

"They did have a whole script they wanted to play out," says Dr. Drew, whose even-keeled, no-nonsense bedside manner has set the tone for the show. "I kept telling them, 'Just let it happen.' I knew that whatever they were planning would not be necessary."

Because the executives listened, abandoning whatever "celebreality" tricks they might have had up their producing sleeves, Celebrity Rehab has become that rarest of things in reality television: a glimpse of actual reality, a far cry from the train-wreck television of previous VH1 shows like Breaking Bonaduce and Shooting Sizemore, where watching the deterioration of semi-famous people was almost done for sport.

"Say what you want about VH1's reputation for creating a certain kind of television," says Dr. Drew, a licensed physician who has specialized in addiction treatment for more than 20 years and who admits he had reservations about being involved in the show. "But as it pertains to this project, they just really stepped it up."

Stark and straightforward as the show might be — and it is unsparing to the egos of the celebrities involved, showing them vomiting, stumbling and admitting to all manner of childhood trauma and personal failings — it has been criticized for exploiting the conditions of the patients, including former American Idol contestant Jessica Sierra and several veterans of previous VH1 celebrity sideshows (Daniel Baldwin from Celebrity Fit Club, Brigitte Nielsen and Joanie "Chyna" Laurer from Surreal Life) for profit.

"We not exploiting these people," Dr. Drew responds. "In some cases, we saved their lives. When I turn on the TV right now and I watch Fox News, CNN, every news agency focusing their cameras on Britney Spears, that is disgusting, because we are literally participating in her demise. But in this show, you are participating in these people's recovery. How is that bad? You may tune in for a train wreck, but what we're giving you is recovery. We're doing a bait and switch."

Although the treatment in the show lasted only three weeks, almost all of the participants have continued in some form of rehabilitation program. Binzer, still sober, is in a residential program in Beverly Hills and sees Dr. Drew for weekly follow-ups. Nielsen, who quit drinking and smoking and has moved to Palm Desert to avoid the temptations of Hollywood, has no regrets about her treatment being televised, no matter how unflattering it has been.

"Looking at myself [on the show] now, I go, 'Oh, my god, I look so scary, I'm so awful-looking,'" Nielsen says. "But I didn't have a problem with the cameras. I had done so many shows drunk, been seen in bad situations, so why not be seen on TV getting better?"

Binzer, who says his on-camera crack-smoking was shot only a few days before entering rehab, makes no apologies for showing how deep his addictions had become. "I just felt like if I was gonna do the show then I was really gonna hang my dirty laundry out and just go there," he says. "I wanted people to know that I was coming from a really dark corner. For me, it really was a life-and-death situation."

For those who have been unsettled by the show's early-withdrawal scenes, Dr. Drew urges they continue to watch. "These people do get better," he says. His worry now is not that the celebrities will be shamed by what they went through, but rather that the attention from the series may tempt them back into their old, destructive patterns.

"Let's say Seth becomes super-famous because of this or puts out another album," he says. "What do you think the first thing he's going to do when he gets a paycheck? I want them to focus on recovery right now."

Even as she talks about how well she's doing, Nielsen is already showing some danger signs. "I'm afraid I'm never going to get a job again, 'cause I'm so boring," she says. "People wonder, 'Where's that crazy Danish Viking?'"

"Just so you know," Dr. Drew says, when told of Nielsen's remark, "that's her disease speaking directly to you. That is her disease building a case to go drink. That's typical celebrity drug-addict thinking."

See all the intense Celebrity Rehab action in our Online Video Guide.

Get all five of our collectible Lost covers, then go behind the scenes on the set for our exclusive preview of the new season. Plus: Take a sneak peek at this year's hot new Super Bowl ads. Try four risk-free issues of TV Guide now!

Send your comments on this feature to online_insider@tvguide.com.