"The Business of Recovery": Putting Profits Over People Hurts Public Health
By Eleanor J. Bader, May 2015 Truthout | Film Review
The 12 Steps of Alcoholics Anonymous
AA was not originally intended to be court mandated or to cost a fee.
The Business of Recovery, produced by Greg Horvath, April 2015
Filmmaker Adam Finberg's The Business of Recovery makes a bold claim, arguing that the many purveyors of addiction treatment are doing little more than selling false hope to people who are desperate.
Whether a loved one is hooked on alcohol, barbiturates, heroin or crystal meth, the film presents addiction "specialists" as marketing a one-size-fits-all solution: the idea that 30, 60 or even 100 days away, coupled with attending 12-step meetings morning, noon and night, is all that is needed to cure their addicted friend or family member. Of course, some people do get and stay clean after attending an in-patient program, but as the many medical experts and researchers interviewed in The Business of Recovery attest, the vast majority - upward of 90 percent - do not, relapsing at some point in their sobriety.
Dr. Lance Dodes, author of The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry and a professor at Harvard Medical School, argues that many of the foundational ideas about ending substance abuse are wrong. Take the notion of addiction as disease.
"The disease idea used to be useful to destigmatize addiction," he says in the film. "It can help people feel better about themselves, but as a scientific idea, it has little merit ... Addiction is a compulsion, a feeling of being trapped or helpless," and unless those underlying feelings are addressed in intensive psychotherapy, relapse, he says, is more likely than not.
University of New Mexico Professor Emeritus William R. Miller, Ph.D., agrees with Dodes, adding that where the prevailing wisdom once dictated that there was nothing to do until the addict hit bottom; this too, has been proven false. "You can help people increase their readiness to change," he says, "by finding in them that which wants to change." Often, he adds, this happens during a moment of crisis, when the internal motivation to stop using is at its peak. But it is never easy, because people have to grapple with depression, anxiety, relationship problems, sexual trauma, physical abuse or bipolar disorder, and address the many complex and uncomfortable feelings that made getting high so appealing in the first place.
The 12-step model, developed in 1935 by alcoholic businessman Bill Wilson and alcoholic medical doctor Bob Smith, comes in for a harsh smackdown in The Business of Recovery, but Dodes concedes that the program is often misused.
"Attending AA was never supposed to be forced," he says, "but now courts and the legal system mandate AA treatment. It's not that AA is bad, but that we have to see it accurately." It also should never be mandated; study after study, says Dodes, has shown that recovery works best when it is entered voluntarily.
Nonetheless, high-end treatment programs including the Betty Ford Center, the Hazelden Foundation, One80 and New Directions for Women are strict adherents of the AA model. In addition, the $34 billion - yes, that's billion with a B - industry has taken AA, which anyone can attend without charge in their home communities, and incorporated meetings into fantastically beautiful settings that look more like elite spas for the ultra-rich than medical treatment centers. And it has paid off - handsomely. For example, 30 days in Betty Ford costs $53,000. Shockingly, according to the film, this is not an anomaly. Most in-patient rehab centers, we're told, charge between $25,000 and $44,000 a month.
Parent Jeff Tanner speaks eloquently in the film about the exorbitant cost of treatment. Upon learning that his daughter Jenna had developed a drug addiction, Tanner says that he quickly contacted New Directions for Women. Staff at the highly touted center assured him that "they could take care of any and all problems," so Tanner quickly liquidated his children's college fund and maxed out his credit cards to come up with the $25,000 needed to get Jenna placed. He was assured that treatment would begin immediately and that Jenna would be examined by a psychiatrist within 24 hours.
Slightly more than 48 hours later, however, Tanner was stunned to return home and see Jenna sitting on his living room couch. "They had not noticed that she'd left the facility," he reports. Worse, in the two-plus days she'd been at New Directions, Jenna had seen one movie and been transported to one AA meeting, but had not had a psychosocial evaluation.
Although Tanner eventually sued and got most of his money back, his incredulity is palpable. Thankfully, the story has a relatively happy ending. Jenna began outpatient psychotherapy, got clean and is now studying to become a nurse.
Not every story ends so positively. One reason, the filmmakers suggest, is that licensed and trained medical professionals are rarely employed by rehab centers. People in recovery are commonly hired to fulfill all functions; their sole credential is that they have been through treatment themselves. On the other hand, peer support is often effective, and the film ignores the many ways that people in recovery routinely help one another, offering an ear, a shoulder or the sage advice of someone who has been in a similar predicament. Needless to say, licenses or diplomas are no indicator of efficacy, compassion or connection.
They do, however, indicate the earning of humongous professional salaries: The film reports that the CEO of Betty Ford earns $558,950 a year; the CEO of Hazelden, $746,277; and the CEO of High Watch in Connecticut, $336,812.
They're not the only ones cashing in.
The Business of Recovery also highlights the existence of more than 60,000 sober living houses located throughout the country. Michael Colasurdo, a 23-year-old man who was addicted to heroin and died of an overdose three months after being interviewed, was placed in a sober house early in his presumed recovery. He described the facility as a joke, blaming a lack of supervision. His death is tragic. But while offering better supervision and on-site counseling sounds rational, it is not clear what measures could actually be taken to prevent residents of sober living houses from using.
That said, the film notes that sober living houses are unlicensed and makes a case against them by zeroing in on Rick Schoonover, a Californian who owns and operates three facilities. According to filmmaker Finberg, one of the homes is severely overcrowded, with 24 men sharing a three-bedroom, two-bath unit. Most appalling? Schoonover's take for the three residences is a whopping $42,000 a month.
Tom Horvath, Ph.D., president of SMART Recovery, a nonprofit, non-12-step program, calls sober living houses a "cash cow business," run by "modern day slumlords ... To me, it's a conspiracy of greed, preying on the backs of vulnerable people."
What's more, we should all be alarmed by the fact that the entire recovery industry is largely unregulated. Dr. William R. Miller notes that the programs can "do anything, say anything and charge anything." Sadly, people pay - sometimes mortgaging the proverbial farm to get needed "help" for the people they love.
It's a story rife with avarice - a terrible tale about those who feed at the trough of others' misery.
Needless to say, the process of recovery should not be about money, a point emphasized again and again throughout the film. Instead, advocates highlight that it should be about science and the study of evidence-based treatment modalities to learn what works in getting people to stay drug- and alcohol-free.
This is certainly true, but it should also be about more than this; a truly caring society would recognize that you can't force people onto the straight-and-narrow. Instead, policies that help folks minimize their risk - allowing them to use safely until they are ready to stop - are imperative. At the same time, we need to challenge the stigma that surrounds drug and alcohol dependence - the perception of moral weakness that persists - and develop health systems that are humane rather than punitive, and pro-people rather than pro-business.
Copyright, Truthout. May not be reprinted without permission.
ELEANOR J. BADER
Eleanor J. Bader teaches English at Kingsborough Community College in Brooklyn, NY. She is a 2015 winner of a Project Censored award for "outstanding investigative journalism" and a 2006 Independent Press Association award winner. The coauthor of Targets of Hatred: Anti-Abortion Terrorism, she presently contributes to Lilith, RHRealityCheck.org, Theasy.com and other progressive feminist blogs and print publications.
Mental Health Movement Resists Chicago Austerity Measures
By Paul Jay, The Real News | Video
Addiction, Mental Health, Safe Spaces and Stigmatization
By Kelly Hayes, Transformative Spaces | Op-Ed
"Drugs Aren't the Problem"
Neuroscientist Carl Hart on Brain Science and Myths About Addiction
2014 By Amy Goodman, Democracy Now! |
As we continue our conversation on the nationwide shift toward liberalizing drug laws, we are joined by the groundbreaking neuropsychopharmacologist Dr. Carl Hart. He is the first tenured African-American professor in the sciences at Columbia University, where he is an associate professor in the psychology and psychiatry departments. He is also a member of the National Advisory Council on Drug Abuse and a research scientist in the Division of Substance Abuse at the New York State Psychiatric Institute. However, long before he entered the hallowed halls of the Ivy League, Hart gained firsthand knowledge about drug usage while growing up in one of Miami’s toughest neighborhoods. He recently wrote a memoir titled High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. In the book, he recalls his journey of self-discovery, how he escaped a life of crime and drugs and avoided becoming one of the crack addicts he now studies.
This is a rush transcript. Copy may not be in its final form.
AMY GOODMAN: As we continue our conversation on the nationwide shift towards liberalizing drug laws, we’re joined now by the groundbreaking neuropsychopharmacologist Dr. Carl Hart. He’s the first tenured African-American scientist at Columbia University, where he is an associate professor in the psychology and psychiatry departments. He’s also a member of the National Advisory Council on Drug Abuse and a research scientist in the Division of Substance Abuse at the New York State Psychiatric Institute. However, long before he entered the hallowed halls of the Ivy League, Carl Hart gained firsthand knowledge about drug usage while growing up in one of Miami’s toughest neighborhoods. He recently published his memoir called High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. In the book, he recalls his journey of self-discovery, how he escaped a life of crime and drugs and avoided becoming one of the crack addicts he now studies.
Dr. Carl Hart, we welcome you to Democracy Now! The title of your book almost was the song we were just playing, "Trouble Man"?
DR. CARL HART: That was my vote, Trouble Man, but the publishers thought that it wasn’t 1973, so we should go with something more modern.
AMY GOODMAN: Both your research findings will surprise many and also your own path in life. Let’s start by talking about, well, where you come from.
DR. CARL HART: Well, I come from—as you said, I grew up in the hood. And so, when we think about these communities that we care about, the communities that have been so-called devastated by drugs of abuse, I believed that narrative for a long time. In fact, I’ve been studying drugs for about 23 years; for about 20 of those years, I believed that drugs were the problems in the community. But when I started to look more carefully, started looking at the evidence more carefully, it became clear to me that drugs weren’t the problem. The problem was poverty, drug policy, lack of jobs—a wide range of things. And drugs were just one sort of component that didn’t contribute as much as we had said they have.
AMY GOODMAN: So, talk about the findings of these studies. I mean, you’ve been publishing in the most elite scientific journals now for many years.
DR. CARL HART: Yes. So, one of the things that shocked me when I first started to understand what was going on, when I discovered that 80 to 90 percent of the people who actually use drugs like crack cocaine, heroin, methamphetamine, marijuana—80 to 90 percent of those people were not addicted. I thought, "Wait a second. I thought that once you use these drugs, everyone becomes addicted, and that’s why we had these problems." That was one thing that I found out. Another thing that I found out is that if you provide alternatives to people—jobs, other sort of alternatives—they don’t overindulge in drugs like this. I discovered this in the human laboratory as well as the animal laboratory. The same thing plays out in the animal literature.
AMY GOODMAN: What do you mean? You’re saying that crack is not as addictive as everyone says?
DR. CARL HART: Well, when we think of crack—well, we have a beautiful example now, the past year: the mayor of Toronto, Rob Ford, for example. The guy used crack cocaine, and he did his job. Despite what you think of him and his politics, but he came to work every day. He did his job. The same is true even of Marion Barry. He came to work every day, did his job. In fact, he did his job so well, so the people of D.C. thought, that they voted for him even after he was convicted for using crack. But that’s the majority of crack cocaine users. Just like any other drug, most of the people who use these drugs do so without a problem.
AMY GOODMAN: Compare it to alcohol.
DR. CARL HART: Well, when we think about alcohol, about 10 percent of the people—10 to 15 percent of the people who use alcohol are addicted or meet criteria for alcoholism; for crack cocaine, about 15 to 20 percent—the same sort of thing when we look at the numbers. And we’ve known this in science for at least 60 years. We’ve known—I’m sorry, at least 40 years, we’ve known this sort of thing, but we haven’t told the public.
AMY GOODMAN: So, you’re saying someone who has wine every night for dinner would not be considered an alcoholic in the same way if you take crack every day?
DR. CARL HART: Exactly. So, the criteria, to me—the way we judge whether someone is an addict is whether or not they have disruptions in their psychosocial functioning. Are they going to work? Are they handling their responsibilities? Or are they overindulging in the activity? And when we think about drugs like alcohol, wine every day, people can drink alcohol every day and still meet their responsibility. The same is true with crack cocaine. The same is true with powder cocaine. The same is true with marijuana. Think about it this way. The three most recent presidents all used illicit drugs, and they all have met their responsibilities. They’ve reached the highest levels of power. And we would be proud if they were our children, if they—despite the fact that they’ve all used illegal drugs.
AMY GOODMAN: But they are saying they didn’t use them in a regular kind of way. I mean, who knows?
DR. CARL HART: Well, when we say "a regular kind of way," for example, I use alcohol. I may use it once a month, twice a month, four times a month. It may vary, but that’s certainly regular. And so, when we think—I think the public, when they think of regular, they think of overindulging. And when people overindulge, like every day multiple times a day, it’s going to disrupt some of your psychosocial functioning. Now, that is a small number of people. Only a few people engage in behavior like that. And I assure you that if they engage in behavior like that, that’s not their only problem. They have multiple other problems.
AMY GOODMAN: So why do some people get addicted to crack, and some people don’t?
DR. CARL HART: That’s a great question. People get addicted for a wide range of reasons. Some people have co-occurring or other psychiatric illnesses that contribute to their drug addiction. Other people get addicted because that’s the best option available to them; other people because they had limited skills in terms of responsibility skills. People become addicted for a wide range of reasons. If we were really concerned about drug addiction, we would be trying to figure out precisely why each individual became addicted. But that’s not what we’re really interested in. We are interested, in this society, of vilifying a drug. In that way, we don’t have to deal with the complex issues for why people really become addicted.
AMY GOODMAN: Talk about brain science.
DR. CARL HART: Yeah, so we talk about—"talk about brain science," that’s a real good question. Brain science, at some level, in terms of drug abuse, has become voodoo, in a sense, because people think—I mean, that’s not to be disrespectful, because that’s my favorite sort of science, by the way. But the way we have been thinking about brain science is that people show you pretty pictures, pretty images, and you think that that tells you something about how they behave. It doesn’t. And so, from that perspective, it concerns me deeply. But on the other side, I am—I marvel at what we are learning about how the brain works, in general. And so, we are not anywhere near being able to explain drug addiction with our brain science yet. But that doesn’t mean that we shouldn’t continue to try and figure out what’s going on in the brain.
AMY GOODMAN: You’ve been testing humans. How does human experiments compare with rat and animal experiments?
DR. CARL HART: Depends on the question that you’re asking. For example, if you’re asking a question about simple neurochemistry. When we think about dopamine, and you’ve heard a lot about that neurotransmitter, it’s in the brains of rats, it’s in the brains of humans. If you want to know what dopamine—what cocaine does to dopamine, you can use a rat brain to figure that out as well as a human brain, and that’s pretty close. But when you start to talk about drug addiction and the complexities, drug addiction is a human sort of ailment, not an ailment in rats. What you can do in rats is maybe model one component, maybe two components of drug addiction, but understand that that model might be quite limited.
AMY GOODMAN: Last year, one of the nation’s most prominent doctors announced he had shifted his stance in support of medical marijuana. That’s Dr. Sanjay Gupta, the chief medical correspondent for CNN, openly apologizing for his past reporting dismissing the medical uses of the drug.
DR. SANJAY GUPTA: I have apologized for some of the earlier reporting, because I think, you know, we’ve been terribly and systematically misled in this country for some time. And I—I was—I did part of that misleading. I didn’t look far enough. I didn’t look deep enough. I didn’t look at labs in other countries that are doing some incredible research. I didn’t listen to the chorus of patients who said, "Not only does marijuana work for me, it’s the only thing that works for me." I took the DEA at their word when they said it is a Schedule I substance and has no medical applications. There was no scientific basis for them to say that.
AMY GOODMAN: Your response to Dr. Sanjay Gupta, Carl Hart?
DR. CARL HART: On the one hand, I applaud Sanjay. But on the other hand, I might be embarrassed if I was a physician and I’m this late in the game. The evidence has been overwhelming for quite some time. And if you read the literature and have been reading the literature, this position or this change should have come earlier. But still, it takes some courage to say you were wrong. But I think that it’s been overstated how much praise he deserves.
AMY GOODMAN: Dr. Carl Hart, can you talk about your life’s journey, how you ended up being the first African-American scientist to be tenured at Columbia University?
DR. CARL HART: Well, that’s a question that society should answer. I mean, when we think about the numbers of African Americans who are in neuroscience and why—they’re low—and why the numbers are low, that’s an issue that the society hasn’t grappled with. And it’s related to some of this marijuana talk that we’re talking about. You played something about Kennedy earlier. Those kind of people, they sicken me, quite frankly, when we think about the role that racism has played in our drug enforcement, and those people don’t knowledge that? Those kind of—those types of practices have played a role in why African Americans are not in many areas in the United States.
AMY GOODMAN: I want to go back to that clip right now. This is—you’re talking about former Congressmember Patrick Kennedy, who battled addictions himself, you know, through his time in Congress. He was on Cross--
DR. CARL HART: Which does not give him any sort of special qualification. That’s one thing we want to make clear. Because you are an addict does not give you some special insight about addiction.
AMY GOODMAN: So let’s go to what Patrick Kennedy said on CNN last week.
PATRICK KENNEDY: Well, I’m also concerned about the minority community that’s now going to be targeted by these marijuana producers, because you look at the alcohol industry in this country. I’ll tell you what. More, you know, alcohol distributors are in minority neighborhoods by a factor of 10. I can’t even begin to tell you what the latest numbers are. You’re from the West Coast; you know what L.A. looks like.
VAN JONES: Absolutely.
PATRICK KENNEDY: Forget about it. There isn’t an equal—you know, and so, they have—it is insidious.
AMY GOODMAN: That’s former Congressmember Patrick Kennedy, who co-founded the group Smart Alternatives to Marijuana. Dr. Carl Hart?
DR. CARL HART: So, when I think about what Patrick Kennedy says, if he was really concerned about the minority community, one thing that he would be talking about is this fact: Today, if we continue the same sort of drug enforcement policies, one in three African-American males born today will spend some time in jail. I have three African-American males; that means that one will spend some time in jail. If he was really concerned, he’d be worried about those kind of numbers. If he was really concerned, he’d understand that African-American males make up 6 percent of this population, 35 percent of the prison population. That is abhorrent. And you never hear those people talking about those numbers.
And when we think about the dangers of marijuana from a scientific perspective, let’s really evaluate this. When we think about the dangers of marijuana, they are about the equivalent of alcohol. Now, I don’t want to somehow talk about the dangers of alcohol or to besmirch the reputation of alcohol, because I think that every society should have intoxicants. We need intoxicants. And every society has always had intoxicants. So alcohol is fine.
AMY GOODMAN: Why do we need intoxicants?
DR. CARL HART: Makes people more interesting, decreases anxiety. Alcohol is associated with a wide range of health-beneficial effects—decreased heart disease, decreased strokes, all of these sorts of things. The same can be true of a drug like marijuana—helps people sleep better, can decrease anxiety at the right doses. All of these beneficial effects, we know.
And so, when we think—think about it this way. We have automobiles. They are potentially dangerous, particularly if you’ve been in New York City in these past couple of days, the icy roads and so forth. Now, in the 1950s, automobile accidents were relatively high. We instituted some measures—seat belts, speed limits, all of those sorts of things. That rate, even though we have more cars on the road, has dramatically decreased. If people are really concerned about the dangers of marijuana, we’d be teaching people how to use marijuana and other drugs more safely, because they’re not going anywhere.
AMY GOODMAN: Go back to your life story, so how you ended up going from a real tough neighborhood in Miami to--
DR. CARL HART: Yeah, so, when we think about--
AMY GOODMAN: —Columbia University and being an adviser on some of the most elite drug policy panels in the country.
DR. CARL HART: Yeah, so, when we think about how one comes from point A, in the hood, to point B, where I’m at now at the highest levels of academe, there are some things that I point out in my book that are clear, if we were serious in this society. One thing was we had welfare. We had this safety net for families like mine. I had seven siblings, and all of us are taxpayers today, but we were raised on welfare. Make no doubt about it: Without welfare, I wouldn’t be here. Without some of the programs that the government instituted for minorities in science, by—in medical science, that helped me get a Ph.D., those kinds of programs. I had mentors, a wide range of mentors. And they were white, black; they were men, women—a wide range of mentors. And I had a strong grandmother, and I had five older sisters who made sure that I stayed as close to the sort of beaten path as possible, so I didn’t stray too far.
AMY GOODMAN: You’ve talked about really recognizing racism, not when you lived here, but when you lived outside the country. So, where did you go to college?
DR. CARL HART: I went to college in the Air Force, and I went to college at the University of Maryland, who had college campuses on Air Force bases.
AMY GOODMAN: Why did you go into the military?
DR. CARL HART: I went into the military because I didn’t get a scholarship, a basketball scholarship I thought that I would get. And so--
AMY GOODMAN: You were a big basketball player.
DR. CARL HART: I was a big basketball player. I played on some of the best all-star teams in Miami and so forth. Yeah, so, I didn’t get the basketball scholarship that I thought I should get, and so I went to the Air Force. It was the only option. And while—my time in the Air Force primarily was spent in England. And while in England, I got quite an education about American racism. In England, they have programs on a regular basis like the U.S. PBS series Eyes on the Prize. And I learned a lot about the U.S. sort of civil rights movement and history while in England. And the British were not bashful in their criticism of American racism, because they didn’t have to look at their own. And so, I learned—well, more importantly, my reality was corroborated while I was in England.
AMY GOODMAN: So you come back to this country, and how did you end up at Columbia?
DR. CARL HART: So I came back to this country, finished off my undergraduate degree at the University of North Carolina in Wilmington, went to the University of Wyoming to do my Ph.D.—it was the only program that accepted me in the neuroscience Ph.D. program—got quite an education from Charlie Ksir about not only neuroscience, about society, and did a number of post-docs from—at the University of California in San Francisco, at Yale, at Columbia. And this is how I came to Columbia.
AMY GOODMAN: You begin your book talking about a human experiment that you recently did. Explain it.
DR. CARL HART: Yeah, so, this particular experiment was featured in The New York Times recently. I had read the literature, the animal literature, showing that when you allow an animal to self-administer, self—press a lever to receive intravenous injections of cocaine, they will do so until they die. But then, when I looked at the literature more carefully, if you provide that animal with a sexually receptive mate, with some sweet treats like sugar water or something of that nature, they wouldn’t take the drug. They would engage in those other activities. So I thought it would be interesting to find out whether or not crack cocaine addicts could also have their drug-taking behavior altered or changed by providing an alternative. And in that experiment, we used as low as $5 cash. And when you do that, you can see that they will take the cash on about half of the occasions--
AMY GOODMAN: Wait, explain the scene.
DR. CARL HART: OK, when you explain the scene, you have a person, you bring a person into the laboratory. They’re seated in a chair in front of a Macintosh computer, so they can indicate their choice. On the left would be drug; on the right would be money. And they would have five opportunities, separated by 15 minutes, for example. So, every 15 minutes, a nurse will come in and ask them to indicate their option.
AMY GOODMAN: Who are these subjects?
DR. CARL HART: These participants are people who meet criteria for crack cocaine addiction. These are people who smoke crack cocaine on five days a week about. They spend about $200 to $300 a week on the drug. They are committed cocaine users. And we pass all of the ethical requirements to bring them into the laboratory. They have physical examinations. They’re carefully monitored by a nurse, a physician, and so forth.
AMY GOODMAN: So, you have them sitting in front of the computer.
DR. CARL HART: They’re sitting in front of the computer, and every 15 minutes a nurse will come in and ask them to indicate their choice. And once they indicate their choice, the nurse will bring in the option that they selected, whether it’s crack cocaine, whether it’s the $5 option. And when you provide an alternative like $5, they’ll choose $5 on about half of the occasions and drug on the other half. But if you increase the alternative amount to something like $20, they will never take the drug; they’ll always take the money.
And so, people say—sometimes people say, "Well, they’re only selecting the money so they can use drug when they leave the hospital." Now, one thing that was said about crack cocaine users is that they couldn’t make rational choices once they have cocaine on board or once they’re faced with the choice to take cocaine. Well, they demonstrate—if that’s even what they’re doing, they demonstrate that they can display, or do, a delayed gratification, which is a good thing. But I know that most of the people in those studies did not simply take the money to go buy drug when they left the study, because we paid some of their bills. They asked us—they saved up the money and asked us to write a check for certain bills and that sort of thing.
AMY GOODMAN: Were you surprised by your findings?
DR. CARL HART: I was absolutely surprised, when I started collecting these data in 1999, 2000, because I had been fooled or hoodwinked, just like the American public, that crack cocaine addicts, they—if you present them with a choice to take crack cocaine, they would take every dose, and they’d be crawling on the floor looking for more. And that’s just absolutely false. That’s a myth.
AMY GOODMAN: Finally, Dr. Carl Hart, your assessment of the media in dealing with the issue of drugs?
DR. CARL HART: You know, since I’m a professor, so I give people grades, I would say a D, D-minus, and I’d say scientists deserve maybe a D-plus to C-minus, because it’s not only the media. Scientists also contribute to this misinformation, in part because scientists are so afraid that whatever they say will be interpreted as being permissive, and therefore they say very little. Scientists’ first goal is not communication, it seems. It seems like their first goal is not to be wrong. And we’re missing an opportunity to help educate the American public about how to decrease harms related to drugs.
AMY GOODMAN: You just talked about your three boys, that you have three sons.
DR. CARL HART: Yes.
AMY GOODMAN: What do you say to young people about drugs and alcohol?
DR. CARL HART: Well, so, I think of these things just like I do any other potentially dangerous behavior, like driving an automobile. I make sure that I educate my kids on how to be safe in driving their car, how to be safe when they have sex. The same is true with drugs. I make sure I let them understand the potential positive effects, the potential negative effects, and how to avoid the potential negative effects. I’ve written about this on AlterNet.com, a letter to my son about how to use drugs safely or what you need to be aware of.
AMY GOODMAN: Dr. Carl Hart, I want to thank you for being with us. He is the author of the new book, High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. Dr. Carl Hart is associate professor of psychology and psychiatry at Columbia University.
This is Democracy Now!, democracynow.org, The War and Peace Report. We’ll be back in a minute with the first Socialist city councilmember in decades in Seattle, Washington. She’s being sworn in today.
The War on Drugs: The ‘root’ of all evil.
The “War on Drugs” technically started in the 1870s when the federal government outlawed opium bars in their attempted resolution to the influx of Asian-American population (Drug Policy. “A Brief History of the Drug War.” 2014. drugpolicy.org/new-solutions-drug-policy/brief-history-drug-war).
According to a Stanford University study, “The Harrison Narcotics Act, passed in 1914, was the United States first federal drug policy. The act restricted the manufacture and sale of marijuana, cocaine, heroin, and morphine.”
Although the first federal drug policy wasn’t actually enacted until 1914, there were three key components to this evolving “war”: Time, Tension, Race.
In the 1900’s cocaine was outlawed in efforts to stigmatize and racially profile black men (Drug Policy. “A Brief History of the Drug War.” 2014. drugpolicy.org/new-solutions-drug-policy/brief-history-drug-war).
From early on the federal government used the criminalization of drugs as a way to criminalize race itself, too.
Some would say that capitalism is bred this way. Now that the government, state, and corporate crimes remain dominant in todays trending scandals, we must stay conscious of where harm and crimes are concerned, too.
But, long ago was when this battle between the power elite and the few who have few had begun. The battle between race and the power elite has been a growing tension for far too long.
Race and the War on Drugs intersect in absorbent amounts throughout this case study. They intersect in our daily workings, our lives, and even our thoughts, too.
People aren’t inherently born racist, but the federal government did declare a war on drugs for one reason: To breed a criminal… not to mention the power aspect may have contributed to the narcissistic attitude, too.
I argue that the forced misery will bring to an eventual uprising of the lower and bottom classes—which are growing bigger in amount—leaving the upper class—who are now the very few power elite left—to fight for their survival.
I think that Marx would agree to this fact. Marx defined the essence of what it meant to be the ultimate “capitalism.” Marx predicted America’s downfall from the very beginning.
The least we can do is give Marx some credit!
For more, check out Karl Marx’s brief biographic discussion at: “http://www.egs.edu/library/karl-marx/biography/” and read the testament of his “Immiseration Thesis.”
Marx didn’t leave a lot to wonder when he had the theory all figured out from the get go.
But, what it can lead to is more theological debate in the area of the “War on Drugs,” and race as an intersectionality.
Moving on with the case study, I want to show you a progression of how the administrations throughout the federal government link the war on drugs to race and government crime.
According to pbs.org in 1968 the “Bureau of Narcotics and Dangerous Drugs” is founded by the Johnson administration. Next, PBS claims in the study by Psychiatrist Dr. Robert DuPont in a D.C. jail system in August of 1969 links crime and heroin addiction.
DuPont provided a 44% test “positive” rate for heroin addiction within the area of his study.
With these key and crucial findings DuPont convinces the city’s, Mayor Walter Washington, to allow him to provide methadone treatment to heroin addicts. Take into account this is a Federally linked government sanctioned action, and links methadone treatment to the first Federal Government trials by DuPont.
This is the very study that links heroin addiction and the treatment and use of methadone to tens of thousands (maybe more) people. There is also a problem with the way pharmaceuticals go about methadone use, too.
For instance, the website you find called “TheTrialLawyers.com” or “MethadoneLawyer.com” claiming lawsuits for the overdose and/or malpractice of methadone patients, linking studies to deaths. Why would we need such legal entities to represent something the government originally made for us? Why is methadone raising so many issues.
In one final case representation a “Colorado man has filed a lawsuit against a local pain clinic which he says negligently prescribed a fatal dose of the drug methadone to his wife,” quoted by “Heygood Orr and Pearson” on July 25, 2012.
So, not only has the Federal Government been supplying their own doses of methadone to our nation, but they provide the capabilities for smaller businesses to use their manufactured drug to “dose” people.
This problem started with the Federal Government from the long ago, 1969 study by DuPont.
I would now like to focus my attention on the founding on the “Narcotics Treatment Administration” in 1970, fund provided by the Nixon administration to Doctor Robert DuPont to expand his methadone program.
PBS goes on to state that, “The program is controversial because some believe methadone to be nothing more than a substitute for heroin, and others feel there are racial undertones behind the effort.”
Great point PBS!
We think of all is a cause of the funding from the Federal Government to such programs, as a way to criminalize a race. It’s also a control of a population that are deemed stigmatized and labeled for life.
With this all being said, there was a final straw for Nixon, and his forceful call to the declaration of the “War on Drugs.”
Nixon’s last straw was in 1971 when heroin strikes again. As stating PBS as a reputable holder of this information, I quote one more time:
So, we see the war on drugs progression took all the way from the 1870s to grow taller than John Dillinger. Drugs are now in 1972 America’s number one enemy, and classified as an official, “war.”
Throughout the upcoming years of Nixon’s administration he forms “The Office of Drug Abuse Law Enforcement.” The Office of Drug Abuse Law Enforcement was created to fight the drug trade at a street level. This happened in 1972. Only a year previous did Nixon declare the war on drugs. Now Nixon has taken enforcement to the streets to fight against the very people he governs. Again, another point being, “Who is deemed a criminal?”
According to PBS, in the following year (1973) “The Drug Enforcement Administration is established” where “President Nixon sets up this ‘super agency’ to handle all aspect of the drug problem.” This is the first official establishment of the DEA in America. The DEA work along side the “BNDD, Customs, the CIA, and ODALE.” Heading this operation is John R. Bartels.
After Nixon’s takeover and the firm establishment of the “War on Drugs” in 1971, Nixon resigns due to the “Watergate” scandal. But, Nixon’s reformation and establishment of the super-power “DEA” still remains in high priority to the Federal Government in their task of fighting the “War on Drugs.”
Taking the debate further, I will now focus on the establishment of the DEA, along side the DEA’s commission in the “War on Drugs” and how they have enacted many federal and corporate crimes throughout their reign of terror.
The DEA is the agency put into place for persecuting and putting on trial the “offenders” in the war on drugs. The offenders in the war on drugs are the very people that the DEA is set to protect. THE REST OF US.
The DEA is an entity of the Federal Government, too.
If the Federal Government is raging a race war against minorities and those of less status and socioeconomic standing, this is by far one of the biggest government crimes that we see today. This phenomenon is what most perceive as “colorblind racism,” defined by Michelle Alexander best in “The New Jim Crow” (2010).
The DEA is raiding homes and forcing families onto the streets. The DEA is taking the war as far as to stigmatize celebrities (who are already stigmatized enough) and set up drug raids in efforts to catch everyone.
Take for instance this article by “The Associated Press” publicist Jim Litke stating that, “DEA agents raid NFL medical staffs after games.”
Raiding NFL medical staff is an impediment on human rights, and violates corporate social status (Such as the NFL’s reputation).
Litke states, ““DEA agents are currently interviewing NFL team doctors in several locations as part of an ongoing investigation into potential violations of the (Controlled Substances Act).”
To go on stating further about the Federal Government and regulations placed upon the “normal man,” the “Controlled Substances Act” states on FDA.gov that, “The Attorney General may delegate any of his functions under this subchapter to any officer or employee of the Department of Justice.”
This above provision gives the Federal Government, and the President of the United States himself liability to all actions and crimes committed in the war on drugs. You could argue it with the best of them, I bet!
To reiterate my previous fact Fda.gov states, “The Attorney General may promulgate and enforce any rules, regulations, and procedures which he may deem necessary and appropriate for the efficient execution of his functions under this subchapter.”
The second above provision proves all oversight and action taken by the DEA (which is a federal agency) is seen by an organizational leader (the President of the United States of America).
Now seen that the Federal Government is taken into account for the incarceration of a people—as Michelle Alexander so easily hints in the New Jim Crow—we can now focus our attention on “mass incarceration” and the “privatization of prison systems.”
This is a system where minorities are unequally represented as a total population, and shown as the victims of War on Drugs today (as compared to Asian-American’s in the 1870s).
Chasing the Scream
review – taking on the war on drugs
A convincing, if flawed, exploration of the futilities and stupidities of draconian drug laws
John Harris ----- @johnharris1969
Around halfway through Johann Hari’s new book, he recalls visiting a conference in Sweden organised by the World Federation Against Drugs– as its own blurb puts it, “a multilateral community of non-governmental organisations and individuals” which rather optimistically claims to “work for a drug-free world”. The WFAD’s position on the so-called “war on drugs” is the opposite of Hari’s: he favours liberalisation and decriminalisation, the Federation support prohibition. In that sense, his visit to Stockholm is a behind-enemy-lines exercise that you would have thought would produce no end of anecdotes.
But no: oddly, the whole trip is over and done with in five brisk paragraphs. Moreover, though Hari credits the conference’s keynote speaker, Robert DuPont, with being “the man who created many of the metaphors that help us to understand drugs today”, an interview with him results in quotes that run to a mere 52 words. Hari describes DuPont, the first director of the US government’s National Institute on Drug Abuse, delivering “the knockout speech” of the Swedish event, “summing up a conference that warned that chemicals can hijack your brain and cause chemical slavery”. One hundred and seventy pages later, this oration is referenced in the book’s extensive notes. “Du Pont himself did not use the imagery of hijacking or chemical slavery in his speech, and does not like these metaphors,” Hari admits, “but they recurred at the conference many times.”
With any other writer, awkward moments such as this might not seem terribly important. But, as is well known to a crowd of media-watchers who tend to look at the world through Twitter, Chasing the Scream arrives three years after Hari was discovered to have plagiarised other people’s work, misrepresented the material he got from interviews and, under an alias, to have spread malicious falsehoods about other journalists via Wikipedia. What that entails for any reviewer is obvious enough: though it might be nice to set aside the events of 2011 and allow him a fresh start, his misdemeanours inevitably colour your experience of the book.
Hari well knows this, hence explanatory notes that stretch to nearly 60 pages, and the fact that all the recorded interviews for the book will be available online (from the publication date onwards, apparently). But what Chasing the Scream betrays is a little more complicated than the zero-sum stuff of truth and fiction. He took the very modern career path of becoming a high-profile polemicist before he had done much reporting, and perhaps as a result his writing is too melodramatic, a little naive, and reluctant to give a fair shout to the other side of the argument – things reflected in a tone that too often falls into being either shrill, or over-emotional. Some of this, I dare say, may shine some light on how he landed himself in all that trouble.
That is not to deny that Chasing the Scream is an important and largely convincing book, nor that Hari has done an incredible amount of work on it. His aim is to recount the history of the “war on drugs”, report on its serial absurdities and perverse consequences, and then explore the alternatives to prohibition. With real skill, he establishes the essential triad that defines any scenario involving the use, sale and policing of any illicit substance, via portraits of three celebrated figures: Harry Anslinger, the first commissioner of the Federal Bureau of Narcotics, who placed a completely neurotic view of drug-taking at the heart of US public life, where it remains; the New York master criminal Arnold Rothstein, whom Hari credits with the invention of the modern drug gang; and Billie Holiday, whose awful personal history was of a piece with her alcoholism and addiction to heroin. These interrelated stories serve as archetypes: though the text moves swiftly to the present day and flips through an array of other case studies, it is these three lives that show just how monotonously unchanging – and therefore futile – the essential rules of the “war on drugs” have always been.
Hari’s run of compelling latter-day characters takes us from a transsexual reformed dealer in Brooklyn to a bereaved mother in Mexico, and on in turn to an array of would-be reformers who have tried to offer an alternative to the war’s self-defeating logic. Most breathtaking is the tale of a punitive anti-drug regime in Arizona that took the life of Prisoner 109416 – aka Marcia Powell – a fortysomething crystal meth addict who in May 2009 was left outdoors in a metal cage for four hours in searing heat by prison officers encouraged to believe that addicts had rendered themselves subhuman. Her terrible treatment underlines what across-the-board prohibition and the cruelties that often come with it do to users: as Hari points out, under these conditions, people drawn to drugs because of emotional stability or a profound lack of self-esteem have their core problems made immeasurably worse, whereupon the spiral of addiction only deepens.
As the book nears its polemical climax, he deals very well with places – Switzerland, Uruguay, the US states of Colorado and Washington, and particularly Portugal – where liberalising measures have pointed to a way out of the drug wars’ current stupidities. The last country in particular is a revelatory case study: since 2001, to be busted is to be subject to a process aimed at separating genuine addicts from recreational users – with the former offered help, up to “a job with a decent wage, away from the world where you used drugs”. It is some token of the draconian approaches used elsewhere that in the context of a lot of what Hari has seen, such modest measures seem almost visionary.
Some of the text is let down by a taxonomic expedient Hari shares with the authorities he rails against: talking in general terms about “drugs”, when the difference between, say, a weekend marijuana habit and a life ruined by crystal meth suggests that as catch-all term, the “d” word can be all but useless. “Drug use is deeply widespread,” he writes, “and mostly positive.” What this last word is intended to mean is not made clear. I am as much of an advocate of liberalisation as he is, but there is not much that is “positive” about meth, heroin or crack – nor, come to think of it, skunk weed, or the pick-me-up that is powdered cocaine, which makes casualties of plenty of users and hyperventilating bores of those who snort it recreationally. Hari half-acknowledges some of this, but too often glosses over what the concerted use of particular drugs sometimes entails. That issue need not diminish the merits of pro-liberalisation arguments, but it has to be tackled.
His biggest problems, though, are a tendency to insert himself into the cracks between his stories, and his often histrionic turn of phrase. No one, it seems, has explained to him the strengths of the show-don’t-tell school of non-fiction writing. He tells the grim story of a cop’s rape of a heroin-addicted woman and the resultant birth of a child who went on to be a dealer, but then ends it with a real clunker: “a child of the drug war in the purest sense – he was conceived on one of its battlefields”. Bemusingly, the same character is described as “an electrical storm with skin”: in the notes Hari makes it clear to the reader he has “used this phrase before, in a column for the Independent, describing Bette Davis”. Later, when he compares the compulsion to gamble with drug addiction, he superfluously points out that “you don’t inject a deck of cards into veins; you don’t snort a roulette wheel”.
Chasing the Scream is a powerful contribution to an urgent debate, but this is its central problem: in contrast to the often brutal realities it describes, it uses the gauche journalistic equivalent of the narrative voice found in Mills & Boon novels. Amid Mexican sand dunes, he tells us, Hari thought about the drug wars’ endless downsides as he “ran my fingers through the prickly hot white sand” and crassly imagined the joyous lives of local teenagers in a world free of gangsters (“Juan, stripped of his angel wings, is chatting with Rosalio about World of Warcraft”). By the end, as he discusses the details of taxing marijuana with a civil servant from Colorado, he says that he is “bored at last, and I realise a tear of relief is running down my cheek”. Thanks to such melodrama, and the book’s slightly excitable tone, one conclusion is all but inescapable. The title of Chasing the Scream is a reference to the young Harry Anslinger’s experience of hearing a drug-addicted woman howl for a fix, but it might easily apply to the sensibility of the author himself.
it is despicable the manner in which we treat people who use drugs... 'a victimless crime'
The Rehab Racket: The Way We Treat Addiction Is a Costly, Dangerous Mess
Ryan Rogers was a 28-year-old alcoholic who entered a posh rehab facility to stop drinking; 17 days later he was dead. --
By John Hill
ON DECEMBER 30, 2012, as part of a series called Drugged, the National Geographic Channel aired an hourlong documentary about a 28-year-old named Ryan Rogers. It appeared to be a classic tale of a drunk trying against the odds to sober up, albeit with especially harrowing footage and an unusually charismatic protagonist, often shown with a radiant smile on his handsome face. In one scene, Ryan, in the midst of another day of drinking vodka straight out of the bottle, vomits into the trash can next to his armchair as his distraught grandfather looks on. In another, he roils around the passenger seat while badgering the elderly man to drive him to the liquor store.
"I apologize, you guys," Ryan says to the camera crew in the backseat. Without a drink, "I can't even focus or think or even understand anything."
These scenes of craving and self-ruin unfold along the idyllic shores of Ryan's home near Lake Tahoe, with a cheerful, late-spring alpine light dancing in the pines. During the rare moments of relative calm, Ryan's warmth and a loving, if fraught, relationship with his family reveal someone who might have a shot at kicking addiction.
This episode of Drugged focused on the medical consequences of alcoholism, so the British production company, Pioneer Productions, followed Ryan until he entered a recovery program, which the company arranged in exchange for his willingness to lay bare his inner turmoil. Ryan's first stop was a Texas medical clinic, where he underwent a comprehensive evaluation. After palpating his pancreas and liver, the doctor told Ryan that parts of his body were "screaming and dying" as a result of all the alcohol. The hip he broke when he fell off his bike, drunk, while pedaling to the liquor store never healed, leaving him with a rolling limp and in constant pain. At one point Ryan had permission from a psychiatrist to alleviate his withdrawal with some vodka, which he knocked back with an orange soda chaser in the men's room. Then came the pivotal moment, a staple of addiction reality shows: the interview when the psychiatrist asked if he was willing to go into rehab.
Ryan said he was terrified, but vowed, "I want to amaze people, to let them know: I was gone, but here I am."
The next day, Ryan arrived at Bay Recovery, a luxurious San Diego center where treatment ran about $1,800 a day. In a baggy white T-shirt, sagging jeans, and a blue bandanna, he carried his navy-blue duffel bag from a taxi to the front door of his new residence, one of several Bay Recovery houses in a neighborhood overlooking Mission Bay and SeaWorld. His room was in a tree-shaded four-bedroom house, set back from the road.
Ryan looked at the ocean and the verdant lawn. "I might not want to leave," he said. The frame froze on his smiling face.
"Ryan took a courageous step," the narrator intoned. "But 17 days into rehab, he died. He was only 28 years old."
But things weren't quite that simple. A look at the government records surrounding Ryan's case—and the rest of the poorly regulated rehab industry—suggests that it might not have been just the drinking that killed him: It was the treatment, as well.
THE DOCUMENTARY touched a chord with viewers. "I'm sitting here just fucking devastated," one wrote on Reddit after the film was posted on the site. "Good God, that was absolutely crushing," another wrote. "I was rooting so hard for him."
Ryan's story is a very specific tale of addiction and loss. But it's also a case study of the fragmented, expensive, and poorly regulated rehab system. Desperate families struggle to find affordable treatment. Those who do all too often discover facilities subject to minimal standards, with regulators who do little to track what happens to patients or to assure that programs are following evidence-based best practices.
At the time of Ryan's death, California's medical board had opened the latest of four cases against Bay Recovery's executive director, Dr. Jerry Rand. Among the concerns that they cited was the death of another patient several years before. And yet the center had been allowed to stay in business, leaving Rand responsible for Ryan and scores of other vulnerable addicts.
Of America's estimated 18.7 million alcoholics, only 1.7 million—8.8 percent—are treated in specialized facilities, according to a 2012 report by Columbia's National Center on Addiction and Substance Abuse. That five-year study reviewed more than 7,000 publications, analyzed five national datasets, conducted focus groups and surveys of addicts and treatment professionals, and investigated how rehab centers are licensed. Its conclusion: "Despite the prevalence of these conditions, the enormity of the consequences that result from them, and the availability of effective solutions, screening and early intervention for risky substance use is rare, and the vast majority of people in need of treatment do not receive anything that approximates evidence-based care." Nine out of 10 people with alcohol or drug addiction, it said, get no treatment at all.
A major study of the rehab industry found that in many states, clinics are barely regulated and offer "unproven therapies" at "astronomical prices."
Compounding the problem is the fact that treatment is often not covered by insurance, but paid out of pocket by addicts and families. Traditionally, private insurance has covered 54 percent of Americans' health care costs, but only 15 percent of alcohol addiction treatment. Obamacare—which requires many government-subsidized health plans to cover treatment—stands to improve matters, but quality of care remains a serious problem. While residential treatment programs must be licensed at the state level, standards vary widely. "For no other health condition are such exemptions from routine governmental oversight considered acceptable practice," the Columbia report concluded.
A great deal of research supports modern evidence-based approaches to addiction, often involving medically supervised withdrawal, medication to help with withdrawal symptoms, support groups, and cognitive behavioral therapy. But because there are no national standards, the Columbia study notes, "patients face a patchwork of treatment programs with vastly different approaches; many offer unproven therapies and little medical supervision," even at centers pushing "posh residential treatment at astronomical prices."
Part of the problem is that alcohol and drug abuse have been seen less as medical conditions than moral failings requiring self-discipline, according to Scott Walters, a University of North Texas psychologist who has studied addiction treatment. The model popularized by Alcoholics Anonymous, though effective in many cases, is not based on modern science or medical research. One result are clinics staffed by "counselors" who in many states are required to have only minimal training in responding to the serious medical problems that addicts like Ryan often face.
"There's really no quality control," Dr. Mark Willenbring, a former director of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism, told me. "The consumer is hard-pressed to know what's what."
RYAN'S MOTHER, Genene Thomas, and his father, Tim, met when she was 16, he was 18, and they were both working at restaurants in the casinos that line the southern shore of Lake Tahoe. When she was 20, they married, and went on to have four sons.
Now 51, long divorced and remarried, Genene welcomed me into the living room of her cozy ranch house, filled with Western memorabilia and sepia-toned photos of her family wearing cowboy outfits. Genene has a tendency to smile when other people might cry. Some viewers of the documentary said she came across as cold, but she confesses that she just shuts down when confronted with overwhelming emotions. Since Ryan's death, she's filled stacks of notebooks with thoughts about her son.
When Ryan was growing up, the family moved a dozen times, across the country: Tahoe to New Jersey, back to California, Colorado, and even Hawaii. "Everyone would ask if we were in the military," she said. "But Tim was just restless."
He was also dangerously unpredictable and seriously mentally ill: Diagnosed with paranoid schizophrenia, he drank and heard voices. Some days he organized scavenger hunts for his kids; others, he'd smack them around. Once Tim hit Genene for refusing to give him the bullets he wanted to use to commit suicide. When Ryan was 10, Genene had had enough and took the children to live in a safe house. After about two years of moving around, she took the boys to Las Vegas, where her parents lived.
Ryan grew into a cheerful teen, so skilled on a skateboard that a local dealership offered to sponsor him. Like many kids in his high school, he drank and experimented with marijuana. He even dabbled with meth, but it didn't seem out of control. When he was 19, his paternal grandparents asked if he wanted to live with them to help care for his grandmother, who'd always doted on him.
Clockwise from left: Ryan at 15 months old; 10-year-old Ryan relaxing; the Rogers family with parents Tim and Genene, Ryan, Keith, Jason, and Sean; Ryan as a Boy Scout, winning the top award for earning the most merit patches; Ryan, Jason, and Sean camping with their father
There, in South Lake Tahoe, Ryan met Shaleen Miller, an outspoken 28-year-old single mother with a Bettie Page vibe. Her interests ranged from the British occultist Aleister Crowley to ribald jokes, and it was love at first sight. "There was just something about Ryan," she said. "Anyone who met him loved him. He had this light to him I'd never seen before." Shaleen's two daughters adored him, and they would make up stories together. Soon Shaleen and Ryan were engaged.
But when Ryan's grandmother passed away, he began drinking more heavily. A year and a half later, in 2008, his father—who had sobered up and reengaged in the lives of his sons—died of a blood clot at age 47. Ryan helped his grandfather clear out Tim's room in a Carson City hotel and soon spiraled further out of control. These two deaths marked a turning point in Ryan's life. Genene grasped the scope of the problem when she found him unconscious on his filthy bed, surrounded by more than 50 empty vodka bottles of all shapes and sizes. She couldn't wake him up.
In 2009, Ryan secured a free charity bed at a 30-day treatment program in South Lake Tahoe. He liked it, but once he returned to his familiar surroundings, he started drinking again. (The National Institute on Alcohol Abuse and Alcoholism notes that 90 percent of alcoholics will experience at least one relapse during their first four years of sobriety.) Over the following two years, he was hospitalized several times for alcohol poisoning, including a stint lasting more than a month in intensive care.
In an attempt to jolt Ryan from his addiction, Shaleen broke off their engagement, but she remained determined to try to save him from himself. The average wait for subsidized treatment was six months, she and Genene were told, and Ryan would have to call every morning until a spot opened up. This was what he had done to get into the South Lake Tahoe program, but now he was too far gone to pick up the phone.
Desperate, Genene talked to a police officer she knew, and learned that her best shot might be to get Ryan arrested to force him into treatment. It was reasonably well-founded advice: The 2012 Columbia report found that 44 percent of addicts in publicly funded treatment programs are referred by the criminal-justice system, but only 6 percent come in via health care providers. When Genene heard that Ryan had tried heroin, she called the police. But his grandfather bailed him out, and the case stalled.
Then Shaleen stumbled upon a Craigslist ad from Pioneer Productions, a London television production company that was looking for severe alcoholics willing to be filmed in return for free treatment. Shaleen wrote an email and got a call the next day.
Pioneer declined to answer questions about the case, but Ryan's family says the crew told them that they chose Bay Recovery because the clinic treated chronic pain as well as addiction, making it a good fit for Ryan's twin struggles with alcoholism and his damaged hip. The clinic's website boasted of its association with reality television producers like Lifetime and A&E and of the "unequaled" care provided by its medical director, Jerry Rand. Genene never found out who covered the cost of Ryan's treatment.
Shaleen and one of the Pioneer crew dropped Ryan off in San Diego. "I just lost it," she told me. For two years, she'd been emotionally preparing for him to die. Now, she allowed herself to take heart.
"Hope can be a bastard," she said.
EVEN AS RYAN arrived at Bay Recovery, Rand was fighting for his professional life. In 1988, when he was a general practitioner in Huntington Beach, the Orange County Superior Court had temporarily ordered him to stop practicing. The case came about after a woman whose daughter he was treating for a possible ear infection bolted out of Rand's office and told a state medical board investigator—who happened to be sitting in the waiting room—that Rand was so impaired that his speech was slurred, his eyes were bloodshot, and he couldn't even stand up straight. Though Rand sought treatment for his addiction to the pain pills he'd been prescribed after a back injury, the state medical board moved ahead and put his license on probation for seven years. By 1990, he had found work at a recovery center, and in 1992, he launched his own. By 2002, he was an associate director at Bay Recovery.
In 2003, Rand was barred from practicing for 60 days and put on seven years' probation for what the medical board deemed gross negligence and incompetent treatment of a homeless patient. The board's report does not detail what ended up happening to the patient, but in 2009—the same year Rand became Bay Recovery's executive director—the medical board moved to revoke his license entirely. This time, the accusations included gross negligence in treating a 29-year-old woman who drowned in the bathtub at Bay Recovery. Rand had engaged in "extreme polypharmacy," the board alleged, prescribing drugs to multiple patients with little regard for their interactions. Bay Recovery's operations were unaffected. The California Department of Alcohol and Drug Programs (DADP) investigated the drowning and ordered immediate steps to secure medications, but it did not issue any citations for 16 months.
What transpired at Bay Recovery is one example of why the rehab regulatory system is so often described as fragmented. DADP was responsible for licensing the facility, but it's unclear whether it knew about Rand's earlier probations. And while the medical board had charged that Rand was admitting patients who were too medically and psychologically unstable to be treated at his facility, DADP never addressed this issue while Ryan was alive.
In 2012, as a nonpartisan investigator for the California Senate, I wrote a report that exposed problems in drug and alcohol treatment facilities, including deaths that occurred when programs failed to monitor medically fragile clients or accepted addicts too sick to be in a nonmedical setting. My report found that DADP failed to pursue evidence of violations after deaths, and took as long as a year and a half to investigate the serious charges. At the time of Ryan's death, I had been asking the agency for several months why it was allowing Bay Recovery to continue treating clients. I also interviewed Rand about Bay Recovery's troubles for my report, but he was dismissive. The woman who died had hoarded drugs, he said, and had previously overdosed. He refused to talk about Ryan's death. I was not able to reach him for this story.
RYAN DID NOT have a cellphone with him, but he borrowed other residents' phones to update Shaleen. He told her that detox—the first 72 hours without a drink—was not as bad as he had feared. He said he was "eating like a pig," putting on weight, and could not remember when he'd felt so well. He joked that he was having a tough time sitting in a hot tub overlooking the ocean. And he was making friends with staff and fellow patients. "Everybody loved him," Kanika Swafford, a residential technician at Bay Recovery, told me. "He never felt sorry for himself. He never blamed anyone for the choices he made."
Clockwise from left: Ryan, 13, was a champion skateboarder; Ryan, at 14, on the top with his cousin Jared and brother Keith; Ryan goofing around with his brothers and their stepfather Glen Thomas; 15-year-old Ryan holding his baby cousin Jennifer
On May 30, 10 days after Ryan arrived, Rand started him on buprenorphine, or "bupe," which is often used to treat opiate addicts and may also help those who suffer from chronic pain. But it is not for everyone, and it came on top of a whole cocktail of other medications.
The day after starting on bupe, Ryan began to feel sick, according to a later report by the San Diego medical examiner, and in the following days he rapidly deteriorated. Sweaty and disoriented, he now could not hold a conversation. He urinated on the floor and tried to set things on fire. He grabbed at objects that were out of reach and tried to light a nonexistent cigarette. He told a staff member, "Thank you for the sandwiches; my ride is here." One resident filed a complaint to Bay Recovery's management, stating that Ryan was "hallucinating, talking to himself, stumbling about and almost falling down the stairs" and had turned a "gray-white color." A residential technician told a counselor and one of the managers that Ryan needed medical attention.
The evening of June 5, a 20-year-old medical assistant named Giselle Jones heard banging from Ryan's bedroom and found him on the floor of his closet, digging frantically through his things. She and a resident named Robert tried to put him back in bed, but he kept falling out, getting so agitated that he tried to crawl out a window. Jones tried to reach Rand and his brother Mitch, who was a manager of Bay Recovery, several times.
When Rand finally responded to the call, he prescribed more Ativan, an anti-anxiety medication, and Risperdal, an antipsychotic. Jones hesitated. The charts noted he'd already had two prior doses of both drugs earlier that evening. Was Rand certain she should give Ryan more? Even after he said yes, she called her manager, who told her to follow the doctor's orders. She did, and 20 minutes later Ryan became listless. Jones tried to get him into bed, but every time she managed to move him, he collapsed. She watched as Ryan's breathing became more labored. His pulse stopped for five minutes. Jones tried to reach Rand again, but there was no answer. Then she called her manager. Finally, at 3 a.m., she called 911. Robert, the other patient, performed CPR on Ryan. They waited for an ambulance.
At 3:40 a.m., Ryan was pronounced dead.
LATER THAT MORNING, Shaleen tried to text Ryan via one of the other residents' phones and eventually she got a response: "I'll have the director call you back." She left more messages, one more urgent than the next. She finally got a call back. "I could get in trouble if they knew I had contacted you," the person said. "But we all loved Ryan so much."
"I heard 'loved' and I just collapsed," Shaleen said. She dropped the phone. Soon after, a police officer, whom authorities in San Diego had asked to contact the family, appeared at Genene's door.
The San Diego medical examiner found that Ryan had died of acute respiratory distress syndrome, in which damage to the lungs prevents oxygen from reaching the blood. The deterioration apparently began around the time Rand started him on bupe, which—along with some of the other medications he'd prescribed Ryan—can depress breathing. While the evidence was not conclusive, "the suggestion is somehow that the treatment played a role in the development of the condition," Dr. Jonathan Lucas, who certified the cause of death, told me.
Twenty days after Ryan's death, officials from the Drug Enforcement Administration, the medical board, and the state licensing agency raided Bay Recovery and Rand's home. They had already found that Rand had had employees illegally call in prescriptions for him under the name of another doctor. The state suspended Bay Recovery's licenses in July 2012.
On September 6, 2012, the California medical board ordered Rand to surrender his medical license and "lose all rights and privileges as a Physician and Surgeon in California." Police investigated Ryan's death, and while no charges were filed against Rand, the state did find Bay Recovery "deficient" for failing to get Ryan to a hospital. Residents told state investigators that Rand excessively prescribed drugs with little regard for their interactions. One patient said he hadn't been on any medications when he arrived, but now was taking at least 10. The state finally revoked Bay Recovery's licenses and closed the facility in late 2012.
Pioneer Productions sent flowers and paid to have Ryan's body cremated. It also gave Genene $1,020—money it had raised to help pay for Ryan to get his hip replaced. Pioneer wanted to arrange a memorial service, and a few weeks later family and friends gathered at Monitor Pass, an open slope south of Lake Tahoe with a dizzying view of Nevada's basins and ranges, to scatter Ryan's ashes. The crew filmed one last scene.
About a month after the memorial service, Pioneer told Genene that the company was sending someone from London to show her the film. A lawyer appeared a few days later and left Genene alone to watch the documentary on his laptop. She did—twice. The lawyer returned with a form for her to sign that stated she had seen the film and wanted it to run. Genene, feeling strong-armed so soon after losing her son, refused, but when the lawyer called from London a few days later to say that Pioneer had decided not to air the film on the National Geographic Channel, she was heartbroken. Genene and Ryan's other relatives and friends saw the documentary as his legacy.
Clockwise from left: Ryan at 23 with his brother Sean, his uncle Brian Thomas, and his maternal grandparents, Pat and Philette Thomas; Ryan hugs his mother Genene after his first hospitalization when he was 26; Ryan with his paternal grandfather, Bob Rogers; Ryan right before he entered Bay Recovery; Ryan and the love of his life Shaleen Miller; in high school Ryan composed songs and played the guitar
Eventually, things were resolved and Ryan's documentary aired. Many viewers responded, expressing grief as well as concern. "I find this very strange, folks," one posted online comment said. "The danger zone for any addict is the first 5 days at most. 17 days in he should have been feeling great and refreshed...I don't think this documentary is telling the honest truth about what really happened to poor Ryan."
To this day, Shaleen still gets Facebook messages from all over the world, and the shared grief has helped her cope. "That's just an amazing thing to be able to hold on to," she said. "Knowing his story made it out there. It gave some kind of purpose to it."
But Genene continues to write in her notebooks the questions that plague her. Did Pioneer really want to help Ryan, or was it just about ratings? How could the state have allowed Bay Recovery to stay open after the death in the bathtub and the medical board's case against Rand? Someone was bound to die there, she believes: "If it wasn't Ryan, it would have been somebody else. And my son had to pay the ultimate price for trying to do the right thing."
The Center for Investigative Reporting teamed with CNN to expose fraud in California's taxpayer-funded drug and alcohol counseling program.
CIR and CNN have uncovered widespread fraud in California's taxpayer-funded drug rehabilitation programs. See how millions of dollars have gone to waste.
Part 1: California rehab clinics bill taxpayers for fake clients, addictions
Part 2: Lax oversight leaves California drug rehab funds vulnerable to fraud
Case study: Clinic leaders tied to fraud in LA reap taxpayer funds in Riverside County
Video: Watch CNN's three-part series "Rehab Racket."
You can read the full investigation on The Center for Investigative Reporting's website here.
PSYCHIATRY’S DRUG SCAM
What hope is there?
Wouldn’t a universal, proven cure for drug addiction be a good thing? And is it possible?
First, let’s clearly define what is meant by “cure.” For the individual a cure means complete and permanent absence of any overwhelming physical or mental desire, need or compulsion to take drugs. For the society it means the rehabilitation of the addict as a consistently honest, ethical, productive and successful member. In the 1970s, this first question would have seemed rather strange, if not absurd.
“Of course that would be a good thing!” and “Are you kidding?” would have been
Today, however, the responses are considerably different. A drug addict might answer, “Look, don’t talk to me about cures. I’ve tried every program there is and failed. None of them work.” Or, “You can’t cure heredity; my father was an alcoholic.” A layperson might say, “They’ve already cured it; methadone, isn’t it?” Or, “They’ve found it’s an incurable brain disease; you know, like diabetes, it can’t be cured.” Or even, “Science found it can’t be helped; it’s something to do with a chemical imbalance in the brain.”
Very noticeable would be the absence of the word, even the idea, of cure, whether amongst addicts, families of addicts, government officials, media or anywhere else.
In its place are words like disease, illness, chronic, management, maintenance, reduction and relapse. Addicts in rehab are taught to refer to themselves as “recovering,” never “cured.” Stated in different ways, the implicit consensus that has been created is that drug addiction is incurable and something an addict will have to learn to live with—or die with.
Is all hope lost?
Before considering that question, it is very important to understand one thing about drug rehabilitation today. Our hope of a cure for drug addiction was not lost; it was buried by an avalanche of false information and false solutions.
First of all, consider psychiatrists’ long-term propagation of dangerous drugs as “harmless”:
The failure of the war against drugs is largely due to the failure to stop one of the most dangerous drug pushers of all time: the psychiatrist.
The sad irony is that he has also established himself in positions enabling him to control the drug rehab field, even though he can show no results for the billions awarded by governments and legislatures. Governments, groups, families, and individuals that continue to accept his false information and drug rehabilitation techniques, do so at their own peril. The odds overwhelmingly predict that they will fail in every respect.
Drug addiction is not a disease. Real solutions do exist.
Clearing away psychiatry’s false information about drugs and addiction is not only a fundamental part of restoring hope, it is the first step towards achieving real drug rehabilitation.
Sincerely, Jan Eastgate
President, Citizens Commission
on Human Rights International
The Ultimate Survivor
Mass pharmaceuticals can take mental illness, slap a pill and an advertisement on it, and call it a good cause.
The addicted do not have such luxuries to have media and propaganda on their side. We are looked at like monsters. Grovelers.
We are looked at like beggars and thefts. We become into an almost gravel like state in our spot in the world. This is how we are seen. It’s never fair or just. It’s just how it is.
The mood becomes altered. “I just want to forget.”
Did I choose to live in this broken home? Did I choose to live a life of poverty?
Did I choose to not have good food on my plate?
Do you think I like feeling worthless? Helpless?
I didn’t choose the things given to me, the hand was dealt.
You say I may make choices, but if all that we have is the past, what else is left for judgment of our life from here on out?
Did I choose for my father to beat my mother?
Did you have to fight like a ‘dawg’ for your food?
Or, sell drugs to pay the rent?
This isn’t safe. I didn’t choose this.
The hand was dealt.
Background doesn’t matter you say?
What happens to the one left with no choice?
What would Karl Marx say to this? What do people who live in constant misery do?
They don’t just ‘compensate’, they survive.
Addicts are stronger than they are given credit for. Most being dealt unsubstantiated circumstances to live or even prove to function. The hand I was given was just, dealt.
Although addicts dwell out a large amount of pain, we do inflict a lot concurrently and co-currently to ourselves.
Always living with a mask to cover your face. It can get exhaustive!
This isn’t the life I chose.
The hand was dealt!
“We might not be able to change what happened but, we just need to move forward. Why not just forgive?”
As if it were that easy.
Do you think that I chose to get her pregnant with twins at 17?
What chance do I have with a system that doesn’t believe me or in me? This is failure from birth. I just didn’t know it yet.
What happens when my babies runs out of diapers?
Or formula? Or grow out of their clothes?
How am I supposed to pay for college with this hand? My children’s college. MY college!
The hand wasn’t just dealt, it was stacked from the beginning. The dealer hates me, making me deal out more than just my own misery, forcefully so.
We aren’t beggars. We certainly aren’t thefts. We just live in a time of obstructions.
Obstructions are barriers in our life that control us from moving forward.
We could debate for hours on how society or the government screw you. But, I ask you again…
What chance do I have when, the only chance to survive is getting out of this constant misery?
Not having a choice makes for a heck a life. I feel like a puppet as the puppet master being the powerful rich white man manipulating our economy, minds and lives!
Could you blame me? I mean, what choices do I have but to conform to the only escape I know. I become addicted not by choice. I just simply cannot live like this anymore.
How can I support others who rely on me if I can’t help myself? Thanks for YOUR help, those who are powerful enough to do something!
This isn’t a question anymore, I’m telling you.
What other choice do I have?
Sometimes with the drug trade you have no other option. Whether it’s doing them or dealing them, what choice do YOU give me world?
I’m simply just surviving at this point.
I am an addict.
I am the ultimate survivor.
there has never been a culture or society in human history where people did not 'enhance' their experience on earth with some form of 'intoxication'...
We might rather call it the “War against Races.” Or just someone bullying the less fortunate around… take your pick?
We can even go as far to say it is “The New Jim Crow,” as stated by Michelle Alexander (published 2010).
In a short summary of “The New Jim Crow,” newjimcrow.com goes on to state, “The New Jim Crow is a stunning account of the rebirth of a caste-like system in the United States, one that has resulted in millions of African Americans locked behind bars and then relegated to a permanent second-class status—denied the very rights supposedly won in the Civil Rights Movement.”
For laymen terms: A lot of unequal laws are putting a lot of people in situations of inequality, and putting a lot of people in prison for lot of petty drug crimes, because the man in charge says so.
This is a crime against humanity. This is a crime against those struggling who need real help, versus being thrown into a system and locking away the key! Where does the true answer lie in this idea between Jack and the Giant?
This is all a result of the DEA and their War on Drugs, which started in the 1800’s, and progressed through, unto the declaration of the war in 1971.
This is a scientific approach behind the war on drugs. This could be where a lot of questions come from.
But, does this have true insight on a ground level?
It shows some historical aspect, which is where we should start an argument and incur our own social hypotheses. We must also look at this on a personal level, too. And, this is where self-help and addiction awareness sites come in handy for the true understanding, and inner workings, of an addiction, and it’s cycle.
We know this is where the term, “War on Drugs,” originated. But, the roots lie so much deeper than that. The war of any drug, or person, or “thing” cannot be broken down to true science, when there is so much more emotion and anguish from the devastation that it has caused.
The war is rooted deeper than Nixon or 1870s opium bars. The root of addiction lies in the very social fabric we live in. You can make the change, and the time… is now!
- “Heygood Orr and Pearson. Colorado man filed methadone overprescription lawsuit against pain clinic. July 25, 2012. .”
- “PBS. Thirty Years of America’s Drug War: A Chronology. 2014. ”
- “Drug Policy. A Brief History of the Drug War. 2014.”
- “Stanford University. History of U S Drug Policy. 2015. ”
- Trebach, Arnold. 1982. The Heroin Solution. New Haven, CT: Yale University Press
- Wisotsky, Steven. 1990. Beyond the War on Drugs. Buffalo, NY: Prometheus Books
- “Michelle Alexander. The New Jim Crow: Mass incarceration in the age of colorblindness. The New Press. 2010.
- Jim Litke. DEA agents raid NFL media staff after games. The Associated Press. Nov 17, 2014. ”
- “ U.S. Food and Drug Administration. FDA. “Controlled Substances Act.” 06/11/2009.