I actually watched the first episode of this real world (19!) on demand when I was jetlagged last week. Uh wow. The only thing that's changed (I haven't watched any eps since Hawaii) is that instead of taking a token black person and making them look insane by putting them in a group of whites who have some serious race issues thus making the black person look "angry" they now take a token sane person (the Persian chick from NYC) and stick them in a group of vapid/insane douches and make the decent person look like they have issues. Nice work MTV.
FWIW Dr. Drew was brought in during one of the seasons (Hawaii I think).
Drew was in the San Diego series, when that red head chick was sawing on herself. At least they showed a "this is dangerous and we should all learn from this" thing at the end of an episode where Drew spoke on the dangers of cutting.