‘Rehab’ exposes the dark underside of U.S. drug treatment centers
A new book investigates how rehab programs can impede addiction recovery
Journalist Shoshana Walter's new book examines the systemic pitfalls of U.S. rehab programs, including barriers to access and sometimes unethical practices.
FG Trade Latin/Getty Images
Rehab
Shoshana Walter
Simon & Schuster, $29.99
A doctor, a mother, a pregnant teen, an adolescent boy who broke his ankle.
All have had lives irrevocably influenced by drugs and their aftermath, and all are portrayed in Shoshana Walter’s hard-hitting new book, Rehab: An American Scandal. Walter, an investigative journalist at the criminal justice news organization the Marshall Project, weaves together their stories with the evolution of drug treatment programs in the United States.
Walter spent hundreds of hours interviewing doctors, patients and their families about their experiences navigating the twisting and often dead-ending channels available for drug treatment in the United States. “Treatment helps people recover,” she writes. But people frequently can’t access it for a number of reasons, including program scarcity and a lack of child care. Even if people can find a program, it’s “often prohibitively expensive and short-lived, punitive and transactional.”
That was the case for Chris Koon, who first used opioids at 15 years old after breaking his ankle and then got hooked on heroin and meth. Years after his injury, he ended up at Cenikor in Louisiana, a rehab program truly mind-boggling in its cruelty. Walter and a colleague published the first of a series of stories exposing Cenikor’s misdeeds in 2019. The program hired participants out to oil and gas companies, big-box stores and factories that used them as labor sometimes 100 hours a week — without pay and at times in sweltering heat. Koon worked on an assembly line at a spice factory and shoveled gravel for a construction company, among other jobs.
Walter lays out a convincing case that unethical rehab programs are more common than you might think. The exploitation of patients for profit is one of the book’s common themes. Rehab programs sometimes bill thousands of dollars for unnecessary tests and services, and trap patients in a cycle of relapse and treatment, Walter writes. She describes one sober living organization in California that took on more patients than it was allowed to, housing people in the backyard, as a way to maximize profits. Several chapters tell the story of Wendy McEntyre, a mother who spent years investigating that and other rehab facilities after her son’s overdose during the program.
Even reputable programs face significant hurdles. One is that insurance companies often pay for limited stays. That treats “recovery and complete abstinence like something that could be achieved in a matter of weeks,” Walter writes. In reality, recovery requires continued support, which means access to food, housing, jobs and medication. Lacking any one of these can impede recovery. Suboxone, for instance, a medication for treating opioid use disorder, was hard to come by after it came out in 2002 because doctors could legally treat only a limited number of patients, as Walter details in the story of physician Larry Ley. In Indiana, Ley did big business prescribing the drug and was arrested and tried for dealing a controlled substance. He was later acquitted.
Some patients, like Koon, had access to Suboxone and a supportive family that helped pay for housing and bills. Despite his stint at Cenikor, Koon ultimately recovered from his addiction and went on to graduate from welding school. Other patients, like April Lee, had much less help. Lee lacked family and financial support and didn’t have an education or a job — and she had children to care for. Lee got pregnant at 15, had a mother addicted to crack cocaine, and developed her own addiction to heroin. She bounced in and out of treatment programs for years but eventually went back to school and earned her GED.
Walter delves deep into the lives of Lee, Koon and others to craft a story that’s both heartbreaking and illuminating. At the core of her book are hardworking people trying to pull themselves away from the grasp of addiction. As Walter makes clear, it’s a feat that could be attainable for more people with just a little more support.
People dealing with addiction can get left behind by a society that turns its eyes away. Walter’s book forces us to look. She gives voice to those in recovery, portraying them as whole people, worthy of respect and the chance to rebuild their lives.
Buy Rehab from Bookshop.org. Science News is a Bookshop.org affiliate and will earn a commission on purchases made from links in this article.
