Rehab: An American Scandal

On-site overdoses, abusive disciplinary methods, and patients outsourced as unpaid labor are some of the shocking revelations levied against the U.S. addiction treatment industry in this stunning debut investigation. Pulitzer finalist Walter shines a light on the “$53 billion per year” network of mismanaged treatment centers and “overcrowded” sober-living homes—some “infested with bed bugs”—that are concerned mainly with maximizing profit. Particularly galling is that seemingly positive policy changes—like the Affordable Care Act’s expansion of Medicaid’s coverage for rehab and new rules for sentencing low-level drug offenders to treatment rather than prison—have rendered the industry more lucrative and rife for exploitation. Walter tracks individuals navigating the industry, among them a mother whose son died at a sober-living home and an addict sentenced to a notorious Baton Rouge in-patient facility, where he endured such punishments as the “verbal haircut,” in which another patient screamed at him for every “minor rule infraction,” and suffered a devastating workplace injury while being compensated only in cigarettes. The book also sheds light on the government’s mishandling of Suboxone, a vital treatment for opioid addiction that the DEA instead treated liked a narcotic—even arresting as some sort of drug kingpin (“the Pablo Escobar of... Indiana”) a doctor who prescribed the life-saving drug to his many opioid-addicted patients. It adds up to a horrific indictment of America’s profit-driven healthcare system. (Aug.)