Drug Abuse Treatment or Drug Treatment Abuse

By Maia Szalavitz, AlterNet. Posted July 25, 2001.

"I experienced five point restraint, sleep deprivation, denial of privacy, denial of my right to freely practice my religion, no contact with my family, peanut butter and jelly diets, urinating in milk jugs, being locked away in a private prison each night and the ever-dreaded relapse of 'thought.' There was a constant drive to discover the deepest darkest thoughts in my head and [make me] publicly confess them."

"They served fish and I told them that I was allergic to fish. They said I was lying. I was made to carry the fish around and eventually I was put on the floor in four-point restraint for several hours. They put the food in my mouth and my face became swollen, I started gagging, I could feel my throat closing up. They refused to take me to the hospital. They gave me Benadryl. For a while, I was unable to walk ... [Due to another medical condition] my abdomen became swollen. They told me it was intentional and made me wear a diaper when I could not [control my bodily functions At one point,] someone spat in my face and shoved a soiled diaper in my face."

"They slammed people so hard against a paneled wall, I could see it move from the other side. The guy had bruises all across his shoulders, all over his body. And they kept telling us, 'This is life, this is the boot camp of life.' I heard about a girl who had attempted suicide by drinking Quell shampoo [used for delousing] so I found a bottle. If this is what life was about, I didn't want to be a part of it. I drank half the bottle."

Are these stories from the Gulag? Extracts from accounts of prisoners of war? Tales of torture victims from repressive regimes?

No, they are stories of teenagers who were abused in mainstream American programs for troubled youth. Some of the programs are still in business; others have shut down.

Nancy Reagan’s "favorite," Straight Inc., was endorsed by the first Bush administration until state regulators and bad publicity finally closed its last official site in 1993. A founder of Straight Inc., Mel Sembler, has just been nominated by President Bush II to be ambassador to Italy in spite of the millions of dollars in judgments against his program for the tortures endured by some of its victims.

An affiliated program in New Jersey wasn't shuttered until 1998 and similar programs with many of the same staff are still up and running in Tennessee and Florida. Their methods have spread to the popular "boot camps" and "behavioral modification" programs which now treat thousands of children across the country, despite research showing that they are less effective than other treatments and despite some three dozen deaths in the last decade from things like dehydration, untreated medical problems and improper restraint.

The survivors' stories were told at a ground-breaking conference held in Bethesda, Maryland this weekend. Titled "Saving Our Children from Drug Treatment Abuse," it was sponsored by the Trebach Institute, a drug policy reform organization. About 50 people attended, mostly victims of abusive programs. It was the first time abusive treatment survivors from different programs and locations had met in person to organize towards protecting others from harm. A second conference is planned for December in Florida.

While the survivors told their stories, there was total silence in the generic hotel conference room. Three of the four speakers on the first panel broke into tears at some point while recalling what had been done to them.

Said Kimberly Fee, who entered a spin-off program of Straight Inc. in 1988, "I still have nightmares. I have friends that left these programs after spending 15 years in them. To know that this still goes on anywhere..."

She cried openly, then continued, "I have kids now, I can understand the desire to protect them at any cost. 'She has a booboo, oh my God.' If my kid was doing the things that I was doing, I would do whatever it takes to get help. We need to guide these parents in a better direction. They are just as much victims as we are."

In a second panel, Kamal Manoly, an Egyptian immigrant and father of two, was clearly anguished as he spoke. "I find it absolutely incredible that such programs could exist and thrive today in this 21st century, in the land of freedom that I fought to come to 32 years ago to escape from the tyranny I was subjected to under a totalitarian regime ... How could we be critical of human rights abuses practiced by third world nations, while we still allow organizations such as SAFE [the program his son attended] to destroy the very fabric of our society under the guise of helping our children?"

Manoly's marriage of 27 years broke down just months after his son Chris started treatment at SAFE in 1999. Manoly, Chief of Civil Engineering and Mechanics for the Nuclear Regulatory Commission, had become skeptical of the program, while his wife wanted to follow its instructions "to the letter." When Chris fled after being denied the "privilege" of being able to write a card saying "I love you" to his father for Christmas, Manoly refused to return him to SAFE.

As a result, Manoly became estranged from his wife and daughter, who refuse to see him. They continue to be involved in the program, which preaches that anyone who does not support the treatment process encourages drug use and is harmful. Many families are torn apart by the program’s rigid refusal to accept contradictory viewpoints.

"In some ways, I truly feel sorry for my ex-wife, as I [see] her being torn between her desire to see her beloved son clean from drug use and beginning to lead a normal life, and her desire to see him fail so that she can justify her blind faith in SAFE," said Manoly. Chris is now doing well and preparing to attend college.

The next panel was devoted to possible legal remedies for victims of treatment abuse. The first speaker, New Jersey attorney Philip Elberg, won a $4.5 million medical malpractice judgment in late 1999 against KIDS of North Jersey, a spin-off of Straight run by its former national clinical director.

The woman who brought the suit, Rebecca Ehrlich, had been subjected to complete lack of privacy (participants were monitored even while on the toilet), extreme dietary restrictions and countless assaults and restraints for six years. During that time, she'd been unable to hold a private conversation, speak to her family privately, listen to music, watch TV, read a book or newspaper or even the back of a cereal box.

The program claimed to treat behavioral problems, however Ehrlich was never professionally evaluated or treated for her bipolar disorder.

Elberg was not encouraging about the prospects for similar payoffs in future cases. For most of the survivors at the conference the statute of limitations (which is two-three years after discovery of the injury in most states) has run out. Also, according to Elberg, by the time most of the lawsuits come to trial, the programs have been bankrupted by resultant bad publicity and insurance and tax judgments, so few lawyers are willing to pursue them.

Elberg and the other lawyers suggested that victims determine whether their goal is money, or to ensure that these programs are shut down. If the latter is the objective, negative publicity may be a better weapon than litigation.

However, publicity can be a double-edged sword. The media, in a quest to be fair, plays "success stories" from program supporters against the horror stories of victims.

"Until the Ehrlich case," says Elberg, "the story was framed as whether KIDS was a good or a bad program – 'Is Tough Love the Best Way?' -- and even when you mentioned assault, people figured maybe the kid deserved it or it was an isolated incident." Elberg stressed that it was crucial to rely on standards of medical practice. Research shows that kind, empathetic and supportive treatment is both more effective and less likely to cause harm. The abusive approach can potentially create greater long-term damage. Says Elberg, "[These programs] have the potential to be a breeding ground for sociopaths."

Summing up what he believed the conference had achieved, Trebach Institute founder Arnold Trebach, Professor Emeritus at American University, said, "The conference served as a wake-up call, even a firebell in the night, to the entire drug policy reform movement and to the nation that the slogan 'treatment, not jail' is full of anguish. A great deal of work has to be done to define the borders between good and bad treatment. Too often, drug abuse treatment turns out to be drug treatment abuse."

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