Presley Gerber’s death has put a harsh spotlight on addiction treatment, the risks of unproven therapies and the danger of letting patients steer their own care. Dr. Drew Pinsky says the real warning sign is not just the tragedy itself, but the way severe substance use disorder can keep advancing even when someone is inside a treatment setting. Experts also point to the especially fragile period during rehab and the need for evidence-based care that does not trade medical discipline for trendy fixes.
Gerber’s case is unsettling because it cuts against the comforting idea that access alone can solve addiction. Plenty of people can enter a facility, talk about recovery and still be in grave danger if the underlying disorder is not being treated with the right tools. That is where Pinsky says the trouble starts, especially when the patient is allowed to shape the treatment plan too much.
“When I listened to [Gerber’s] video, what struck me and concerned me was that the patient seemed to be determining some of the care,” Pinsky said on his podcast, “Ask Dr. Drew.” “That’s never good.”
He also took aim at Gerber’s reported trip to Mexico for an “ibogaine flood,” a high-dose approach built around ibogaine, a psychoactive compound from an African shrub that has drawn interest as a possible addiction treatment. The problem, Pinsky said, is that a lot of these options get sold as breakthrough medicine when they are really just another detour that can end in relapse.
“I’ve had patients using ibogaine or ayahuasca for decades, and there’s nothing magic about it, I assure you,” Pinsky warned, adding that many patients who tried such alternatives ultimately returned to opioids. He also said some came back changed in troubling ways, which is a reminder that addiction treatment is not a place for wishful thinking.
Ibogaine is not approved by the FDA in the United States, and federal health agencies have warned about serious risks, including fatal heart rhythm problems. That matters because addiction recovery is already a high-stakes lane, and adding untested methods can make a bad situation even more dangerous.
That concern lands even harder when a death happens inside a rehab center. A lot of families assume a treatment facility is a safety net, but experts say that is not how severe opioid addiction works, especially if the underlying dependence is still active.
Pinsky said the larger lesson is that patients with serious substance use disorder should not be bounced around from one alternative idea to the next while proven care sits on the shelf. The best outcomes usually come from structured treatment, closely supervised medical care and therapies that have actually been studied.
“Opioid addiction” is progressive and it ends in death,” Pinsky said. “Even with good treatment, it has a worse prognosis than most cancers … If they are not moving toward recovery, they are moving toward demise.”
That kind of blunt language may sound grim, but addiction specialists say the realism is necessary. When people cycle through treatment and relapse, their tolerance can drop fast, which means the same amount of a drug can become deadly after even a short break.
Dr. Nicholas Kardaris, CEO of the New York Center for Living, said the time spent in rehab or just after leaving it can be one of the most dangerous stretches in the whole process. A person is not cured simply because they entered treatment, and a relapse during that window can turn into an overdose before anyone has time to react.
“People are in rehab because they’re struggling with addiction. It doesn’t mean they’re cured,” Kardaris said. That is why experts keep pushing families toward licensed providers that use evidence-based methods instead of chasing flashy promises or relying on a patient’s instincts alone.
Those evidence-based options can include FDA-approved medications for opioid use disorder, such as buprenorphine, methadone and naltrexone when appropriate. For families facing addiction up close, the message from specialists is clear: the safest path is usually the least glamorous one, with real medicine, careful supervision and no shortcuts that pretend severe addiction can be outsmarted with a miracle.
