“Heroin is a preservative,” said Doug Rosen, explaining, tongue in cheek, why he looks almost exactly as he did seven years ago when he was a rising Hollywood producer with a healthy

six-figure salary, a spanking new Audi A4, a $3,000-a-month, one bedroom apartment and, oh yes, an $80,000-a-year drug habit. Wiry in a black T-shirt, cargo pants and a green cap, the

32-year-old Rosen, now a family therapist trainee at Beit T’Shuvah, a no-frills residential drug rehab clinic on Venice Boulevard, confessed that he never was particularly interested in

making movies or television. He just wanted to _be somebody_ -- the guy with the girls, the cars, the expense account and the trappings that accrue to a entertainment industry power broker.

seen as more important than the actual work of acting, directing, producing or writing -- collides with the rejection, failure or limited success that is the reality for the vast majority

in the industry. Patients suffer from the mistaken assumption that that showbiz glory will somehow insulate them from emptiness or the mundane hardships of day-to-day life. It’s a condition

as old as the talkies, but, according to many practitioners interviewed for this report, it’s growing more prevalent in the age of reality TV and “American Idol,” when stardom appears more

accessible than ever and a sense of entitlement seems rampant among younger generations. THE DIAGNOSIS Dr. Todd Zorick, a psychiatrist and professor at UCLA’s Semel Institute, calls the

condition “Hollywood Not Otherwise Specified,” or Hollywood NOS. The unofficial term is a wry reference to the “NOS” designation in the Diagnostic and Statistical Manual of Mental Disorders,

the bible of psychiatric ailments, which refers to a condition that impairs a patient but doesn’t fit with any specified, recognized disorder. Hollywood NOS describes a negative pattern of

behavior for the sole purpose of achieving validation. The patients usually display a combination of symptoms: impulsiveness, anxiety, poor self-esteem and some personality disorder traits.

Zorick coined the phrase, with colleague Daniel Goldin (this reporter’s brother-in-law), while working at a rehab clinic on Hollywood Boulevard, where he saw a constant stream of flailing

Hollywood types, like the girl who was always starting her band between bouts of suicidal depression, or the screenwriter who’d sold a screenplay for a lot of money but sabotaged his career

with drugs. Most had migrated to Hollywood specifically to become a star. “One of the central things was a lack of connection to a more permanent reality and an orientation to an internal

fantasy life,” said Zorick, who continues to see patients at UCLA. Clinically, they suffered from a “mix of different categories of illnesses and they were never very severe,” he added.

“They’d have discrete periods of mania or hypomania,” but it wouldn’t last long enough to merit a diagnosis of bipolar disorder. “Our patient would have an afternoon of doing crazy stuff.”

Other mental health professionals don’t use the exact term Hollywood NOS, but they all recognize the patterns. Sufferers, they say, often exhibit personality traits that are endemic to the

industry: an overall fixation on their hierarchal status in the Hollywood system, a very rich fantasy life about what other people are thinking of them, and an opportunistic analysis of

relationships, where every connection is evaluated on its usefulness in getting a job, a deal, or simply another leg up the Hollywood mountain. HIGHLY ADDICTIVE BUSINESS “It’s my opinion

that Hollywood attracts these people,” says Zorick. “Who’s crazy enough to think they’re going to out-compete everyone, beat out thousands of people to become the next big screenwriter or

actor?” “The idea of making it in Hollywood is like a drug,” says Rabbi Mark Borovitz, the spiritual leader of the Beit T’Shuvah congregation, which runs the rehab facility. “People are

looking for outside validation to make them OK. And the emptiness will never be solved, really solved, by just psychiatric help or therapy because the emptiness is an emptiness of the soul.”

“Hollywood is a fantasy,” adds Dr. Reef Karim, an assistant clinical professor at UCLA who is also executive director of the Control Center, an outpatient treatment center for behavioral

and lifestyle addictions. He points out that almost all behavioral addictions have a fantasy component. “A lot of these people, I have to put them on meds to decrease their obsessional

thinking in regards to their fantasy or do therapy to look at the fantasy,” he says, adding that many “basically hit the pause button from emotional growth and development to be in the

industry.” One psychiatrist, who would only speak anonymously because of his high-profile patients, described a session with a moderately well-known actress whose career was fading as she

hit her 40s. The doctor told her that the “magic” part of her work life probably was over and that she would need to adjust. His patient looked out the window onto the flat white stucco

building outside and said dully, “You see the way the sun is shining on the building? When I hear what you’re saying and see the flatness there, I want to kill myself. The mundane life, I

don’t want any part of it. The work of it. The adversity of it, the lack of fame and specialness. I’d rather be dead.” “You’re this egomaniac with an inferiority complex,” says one rising

young talent manager, who asked for anonymity because she spent months in rehab for her addiction to crystal meth and cocaine, as well as the rush she used to get from being a fixture in the

club scene. It was a shot of pure adulation, being able to cruise by a line 500 feet long to get into the latest hot spot. “It’s this feeling, ‘Look at me. This is who I am. I’m important.

You’re not,’ ” she explains. Karim sees two distinct subgroups of Hollywood-holics: those who simply crave the glitz and status of a high-powered life, and those who are compelled to

perform, who desire artistic glory. For both, “the drive is so strong that they don’t feel they could do anything else.” Yet, Karim and many mental health professionals point out that

despite the myth that Hollywood is a meritocracy, the reality is that it’s a bit of a crapshoot, and artists in particular are dependent on agents, connections and fate to break through. The

constant sense of hope, often intermittently reinforced, can become debilitating. “They have a false sense of themselves,” said psychiatrist Charles Sophy, medical director of the Los

Angeles County Department of Children and Family Services, who also has a private practice. “It’s not always reality-based. They live more in the fantasy where they hope and hope, and that

prevents them from dealing with who they are and what they’ve been able to achieve or not achieve and why, and that translates into being comfortable with who you are.” Actors, in

particular, feed on a daily diet of brutalizing rejection. “You pay the price to enter the world of the Hollywood machinery,” said Karim. “Your self-esteem is now predicated on the

acceptance of other people who are part of the Hollywood machinery. You lose yourself in the process. I have so many people who come into my office and they don’t know who they are. They

know what age range they can play, and what their look is for casting, but they can’t tell me who they are. They’ve just been inundated with what they’re supposed to be.” FEVERED RECESSION

Psychotherapist Rebecca Roy has coined a slogan for her whole practice: “Staying Sane in an Insane Industry.” “I see a lot of depression,” she said. “The rejection creates a huge amount of

self-esteem issues that leads them into plastic surgery, drugs, sexual acting out until they finally burn out.” Mental health counselors say that the number of Hollywood NOS sufferers

appears to be growing during the recession. “I was talking to an agent and he said. . . . ‘You can hire people today for half of what you could get them for three years ago,’ ” said

Borowitz. “More people in general are sicker but they can’t afford to come,” said Karim, who has begun to do more pro-bono work. Roy started holding confidential group therapy sessions just

for industry people who can no longer afford her private rates and are often desperate to cloak their unhappiness. “They don’t want anyone to know how depressed they are because they won’t

get work,” Roy said. But Borowitz also notes that crisis can be the catalyst for change. That was the case for Rosen, whose heroin and prescription drug use spiraled as he climbed the ranks

of young Hollywood, addicted to the nonstop action, the 12-hour work days and glamorous late-night clubbing. Drugs helped with his growing dismay with Hollywood’s culture of mendacity, the

pressure to lie on the job. “Not being able to necessarily tell the whole truth up front to somebody else that I had developed a good relationship with really ate at me. I felt guilty about

that,” Rosen said. “The amount of drugs that I would do to deal with my internal feelings of emptiness and the void and not being a good person, it just completely progressed.” He was able

to keep his drug use mostly secret, still functioning at work until that day when his contract wasn’t renewed. With the status job gone and his money running out, his family finally had some

power in his life again. When he asked to move home, his parents refused unless he went into rehab. He was 27. He spent nine months living at Beit T’Shuvah. When Rosen got out, he had to

decide whether to go back to Hollywood or try something else. “The rabbi talked to me about it. I had been clean for almost a year but he said, ‘My concern is that your attitude toward it is

still like a drug,’ ” Rosen explained. That was true. “Any time I thought about getting back into the world, my mouth would salivate in the same way that it would if I was about to get

high,” said Rosen, who now spends much of his time speaking about drug prevention to school groups. “I knew right then with a clear and content soul that I had to go in the opposite

direction . . . The drug was still there, and it’s a very powerful one.” [email protected] MORE TO READ