Pinsky told TV Guide Magazine earlier this week that he found Sheen's recent erratic behavior to be troubling, and not the sign of someone in proper recovery.
"It's very manic, very grandiose," Pinsky says.
And that was before Sheen went rogue on Thursday, tearing into Two and a Half Men executive producer Chuck Lorre (making several derogatory comments toward Lorre, including an anti-Semitic taunt of his name).
"This contaminated little maggot can't handle my power and can't handle the truth," Sheen wrote in a letter sent to TMZ, referring to his boss.
Earlier this week, Pinsky had already noted that "the disease is starting to get away from him, and is starting to have consequences."
Pinsky was not a fan of Sheen's decision to conduct a rehabilitation treatment at home rather than at a facility.
"'Home rehab,' that term makes the hair stand on the back of my head," Sheen says. "'Rehab' is so grossly misused."
True rehab by definition must be immersive, Pinsky says. Someone can detox and stabilize their problems, but that only puts the lid on things for a few months, he says.
"There will be further trouble ahead," he says.
Red flags started to go off after Sheen began speaking to the press, including two calls to Dan Patrick's radio show (in which he blasted CBS and Warner Bros. TV for shutting Two and a Half Men down). Sheen also showed up at a UCLA baseball practice, warning teammates to "don't do crack" and drink chocolate milk instead.
After that, the tabloids had a field day with Sheen's behavior, as the star flew out baseball stars to watch Major League at his house, and headed to the Bahamas with his ex-wife and two girlfriends.
"People have no idea," says Pinsky, who believes Sheen's serious problems are still mistaken by the public for the mild ones exhibited by his character on Two and a Half Men. "After all these years watching these poor people manifesting their disease, people still think they're watching a cartoon."
A team of specialists approved by CBS, Warner Bros. TV and Lorre gave the greenlight to resume production on Two and a Half Men, which would have missed just four episodes this season had everyone gone back to work on Monday.
Pinsky notes that Sheen has consistently told interviewers that he's still functioning at work — "which is a clue there's something in his contract" that would require the show to remain in production, he believes.
"With male addicts particularly, the workplace is the last place impacted by addiction," Pinsky says. "By the time work gets affected, we know he's got a profound addiction on his hands."
Sheen's Thursday statements, however, gave CBS and Warner Bros. TV plenty of legal cover to keep Two and a Half Men shut down for the rest of the year — which means Sheen now won't be able to prove whether he really was capable to resume work.
"I'm deeply concerned," Pinsky says. "It's hard to watch."