Dr. Phil reviews Star's daily pill usage with Dr. Masterson. "She says she's taken as many as 30 Vicodin a day, 12 Darvocet, 10 Klonopin, and if she has them, eight Percocet, three OxyContin, three Valium, Effexor, Wellbutrin " it just goes on and on," Dr. Phil says, consulting his notes. "I've calculated that she's taking about 23,250 milligrams of pills a day. What is she up against physically?"
"You could have respiratory distress. You could die that way. You could die of cardiovascular arrest. You could have a heart attack. You could have a stroke. You're really affecting your health now and down the line," Dr. Masterson warns Star. "We know that you started [taking pills] with postpartum depression, which I see as an OB all the time, and it's very important to get treated for that."
"What would happen, at this point, if, as Isaac would like her to do " as anyone with common sense would like her to do " she just stopped all of a sudden, just stopped taking this, just went cold turkey and didn't take another pill?" Dr. Phil asks.
Dr. Masterson says that Star could face grave medical consequences. She turns to her. "You could go through withdrawal symptoms; it could actually shut down your some of your organs," she says, as Star grimaces at the thought. "You cannot do this on your own. You absolutely need help. You may need medications to stop, to replace the ones that you're on, until your body starts to adjust. This is a physical dependence as well as emotional."
"So she could have extreme agitation, vomiting, tremors, seizures, insomnia," Dr. Phil adds. "It could start spiraling down, if she just quits this. She could die from it."
"That's why you have to do it gradually, or with other medications, but definitely under supervision," Dr. Masterson tells Star. "I know you want to be around for your kids."
"I do," Star replies through tears.
"What happens when people just, on their own, without physician supervision, start mixing these medications like she's doing?" Dr. Phil asks his colleague.
"They could interact with each other, and they can make them even more powerful," Dr. Masterson replies. She addresses Star. "When you mix them together, it can be equal to 30 or 50 times. You are playing Russian Roulette here. At any one point in time, that could be it, and you could stop breathing. Your heart could stop. Each day that you have done this, you have been gambling your life, and your child's life, away."
Star weeps at the dire prognosis.
"I hope you haven't been breastfeeding with your 10-month-old," Dr. Masterson says.
"No, I'm not," Star says.
"Good, because that passes on to the baby, and that's really, really important not to do," Dr. Masterson warns.
"In terms of motor skills, judgment, reaction times, taking 23,000 milligrams of Vicodin, Darvocet, Klonopin, Percoset, OxyContin " how do you suppose that would affect her ability to operate a motor vehicle?" Dr. Phil asks.
"Absolutely, it's going to affect it," Dr. Masterson replies. "They have put out some warnings about antidepressants, and even the pain medications, about whether or not people should be driving or working while they're on them. We know they impair the ability; we don't know to what extent. That should be looked into, but obviously, when you're taking care of small children or just doing daily things, you're not going to be doing them the way you should. You really need to be there 100 percent for [your children]."
Dr. Phil piggybacks on Dr. Masterson's last point. "You have driven with the kids in the car, under the influence," he notes.
"Yes, I have," Star replies.
Dr. Phil says Isaac has some difficult decisions to make. "Your marriage is in trouble. You strike me as somebody who is full up to here with all of this, but you seem torn," he observes. "I believe you love her, I believe you love the family, but yet she's lied to you, she's deceived you, she's cheated on you, and that's an issue that's going to be dealt with."
Dr. Phil addresses Dr. Masterson. "You believe her life is in danger, right?"
"Absolutely," Dr. Masterson replies. She addresses Star. "With the dosages that you're taking it, it's a wonder you're still sitting here, alive, right now. Somebody's watching over you."
"You may decide you want to get a divorce, you may want to kick her to the curb, you may want to take your kids and run for the hills," Dr. Phil tells Isaac. "Right now, your wife's, and the mother of your children's, life is in danger."
Dr. Phil says the only option is for Star to check into a rehabilitation program.
"I choose to get help," she replies.
"Can you support her doing this?" Dr. Phil asks Isaac. "Are you prepared to take care of your children if she goes away?"
"Yes, I am," Isaac says.
"Yes, I am, Dr. Phil," Star says, her face contorted in pain. "Thank you, and I want the help."