Once upon a time, California’s jails were stuffed with low-level drug offenders.

This was wastefully expensive for the public and wholly ineffective for the drug offenders, reformers argued.

So in 2014, with the best of intentions, voters passed Proposition 47. This reduced a great many drug-related offenses from felonies to misdemeanors, and kept a great many low-level drug offenders out of jail. The money saved on incarceration would go into effective addiction treatment, among other things, reformers said.

Since then, there has been an interesting, and perhaps tragic, convergence of events:

• Drug offense arrests have plunged 85% — from 137,054 in 2014 to 20,574 in 2022, according to data from the California Department of Justice.
• While drug overdose deaths have more than doubled — from 4,519 in 2014 to 10,410 in 2022, according to data from the California Department of Public Health.

Is there any relationship between these numbers? There’s heated debate over that.

Some folks — notably law enforcement and parent types — lament the loss of jail time as a carrot-and-stick to prod users into drug treatment. There are essentially no consequences now, they say.

Others — notably policy experts — say jail time was always an ineffective and dangerous response to drug use, and lament the dearth of effective treatment and harm-reduction strategies that can actually save lives.

This all plays out on a terrifying backdrop: The migration of cheap, powerful, deadly fentanyl into just about every single street drug; a global pandemic that destroyed any semblance of normalcy for years; and doctors’ tepid embrace of buprenorphine, the gold standard for opioid treatment.

“A perfect storm,” Orange County Sheriff Don Barnes said.

Enlightening, perhaps, are the overdose death rates in two states with very different approaches to drug criminalization — California and Texas.

They’re the largest states in America, population-wise. Both border Mexico, where fentanyl-laced drugs enter the U.S., according to the U.S. Drug Enforcement Agency.

One of those states has a much lower overdose death rate than the other. Can you guess which one?

Fentanyl: primary force

“There are a bunch of moving parts here,” noted Andrew Noymer, epidemiologist and demographer at UC Irvine.

“In some sense, the two trends are explainable in a vacuum. You get fewer arrests because Prop. 47 is working as intended, quote-unquote, and more deaths because of fentanyl infiltration. It’s all a bit unfortunate. In some sense, it’s just inopportune timing.”

Fentanyl is the primary force propelling the spike in overdose deaths not just in California, but nationwide, agreed Maryanne Diaz, a lecturer in the School of Criminology, Criminal Justice and Emergency Management at Cal State Long Beach.

“The rise in overdoses is not a result of Prop. 47,” she said by email. “Arrests and short jail stays, as were utilized for low-level drug offenses prior to Prop. 47, are a considerable risk factor for overdose.”

When a person who uses drugs is arrested and detained, even for less than a day, their tolerance decreases, she said. If they use again after release, they’re more likely to overdose. It’s much the same with short-term detox and treatment.

California’s reluctance to embrace evidence-based policies and programs hasn’t helped, she said. Treatment is underfunded and can be hard to get. Last year, Gov. Gavin Newsom vetoed a bill that would have launched pilot “safe injection sites” in Los Angeles, Oakland and San Francisco. In New York and Vancouver, facilities like this are manned by medical staff and offer testing kits so users know what’s in their drugs. Overdose deaths have dramatically dropped in these neighborhoods. They boost access to treatment and improve public safety, she said.

Diaz has a study under review showing that the majority of California voters would support an overdose prevention site. In the meantime, more harm-reduction efforts like syringe exchanges, drug education, naloxone and fentanyl testing strips could help — but are repeatedly met with injunctions and legal hurdles.

Treatment should not be coerced, and should never be contingent on involvement in the criminal justice system, she said.

‘Reclassifying drug crimes because of Prop. 47 is not why we are seeing such high overdose rates,” Diaz said. “Fentanyl, an ever-changing drug supply and a lack of harm reduction programs are why we are seeing high overdose deaths.”

It’s sobering to consider that, but for the back-from-the-dead drug naloxone, which can reverse opioid overdoses, the death rate would be even higher.

‘Complete turnaround’

Law enforcement types and some parents don’t necessarily disagree, but feel hamstrung.

Using the corrections system as a cudgel — go to treatment, or go to jail — can inspire resolve that might otherwise be lacking.

“I never ever thought I would be OK with my child being incarcerated,” said a mom whose daughter cycled through myriad addiction treatment programs in California, then wound up convicted of possession in a Midwest state with tough drug laws. Behind bars, she had mandatory treatment.

“It’s such a complete turnaround,” said the mom, who we’re not naming to protect her daughter. “She’s been clean for a year now. We feel like we have our daughter back.”

Prop. 47 aimed to ensure that spending focused on violent and serious offenses, maximized alternatives for non-violent crime and invested savings in prevention and support programs for schools, victims services and mental health and drug treatment. It passed in 2014 with nearly 60% of the vote.

It can certainly be argued that there hasn’t been a vast expansion of quality drug treatment in its wake. There have been several legislative attempts to rein in Prop. 47 — or repeal it altogether — but those focused on an “explosion” of property crimes, smash-and-grab robberies and shoplifting that legislative analyses said were exaggerated and/or erroneous, and got nowhere. An online petition to repeal Prop. 47, though, has gathered 105,000 signatures.

“Criminals using dangerous drugs such as methamphetamines and heroin now face little or no repercussions from law enforcement officers,” says the petition by Debbie Rouser of San Pedro. “Unfortunately these same criminals that use drugs and commit ‘petty theft’ crimes are the same criminals that commit violent acts and home burglaries.”

Deon Joseph, a law enforcement consultant who has worked for the Los Angeles Police Department for a quarter-century, said, “I hate to say I told you so” shortly after Prop. 47 passed.

“We have chosen idealism over our safety. We have chosen to be test subjects in social experiments over common sense,” he wrote on his blog. “I actually agree with making mere possession a misdemeanor, but a misdemeanor with some teeth at least…. There is zero incentive now for addicts or dealers to stop their crimes or seek help.”

Long before Prop. 47, offenders had many alternatives to time behind bars, said Barnes, O.C.’s sheriff.

“You had to try really hard to go to jail. There were a lot of programs available, and a potential felony was a great incentive to get into treatment and sobriety. That no longer exists. Misdemeanor consequences just aren’t as high.”

That — coinciding with the arrival of fentanyl — has contributed to the significant rise in drug-related deaths, he said.

“I am not advocating for incarceration,” Barnes said, “but there’s no longer an opportunity for intervention. Accountability measures play in. Coupled with the fentanyl and lack of border security, it’s a perfect storm.”

It’s important to understand that drug offenders and/or dealers with significant rap sheets still wind up behind bars. On any given day, about one-quarter of the Orange County jail’s population — some 900 to 950 people — who are getting medication-assisted treatment, Barnes said. That’s methadone, naloxone, buprenorphine — drugs that manage opioid cravings and give users a much better shot at sobriety. Some 100 to 120 people are in medically supervised detox.

“What I don’t have is the off-ramping — the robust, post-custody sustained treatment system to hand them off to — so they don’t fall back into the criminal justice system,” he said. “I keep seeing the same faces over and over again.”

If Barnes could wave his magic wand, there would be robust systems in place to help people at the front end, tight border control to keep fentanyl out, education programs to address demand — and professional policing would get out of social work.

Crime and punishment

As we were running these numbers by the experts, UCI’s Noymer gave us homework.

You need to gather more stats on overdose deaths in other places, he said. He suggested Oregon, a state with similarly relaxed drug laws. We suggested Texas, a state with contrastingly tough drug laws.

Here’s what we found:

• In California, the overdose death rate is 26.6 per 100,000 people, according to the U.S. Centers for Disease Control.
• In Oregon, it’s a tad higher, at 26.8.
• And in Texas, with some of the nation’s toughest drug laws, it’s just 16.8.

There’s a lot to think about there.

“At face value, looking at how much less punitive California has become in the last decade, it seems to show Prop. 47 had the opposite effect of what Californians were hoping for,” said Barnes, O.C.’s sheriff.

But Diaz, of Cal State Long Beach, said there’s more than meets the eye.

“Yes, the overdose deaths in California and Oregon are higher than Texas,” she said. “But it’s important to look at that CDC data all together. California and Oregon, despite having more relaxed drug possession laws, have lower overdose rates than 33 other states, including more punitive states like Arizona, New Mexico and Florida…. The data just does not indicate that decriminalization and less punitive drug laws cause overdoses to increase.”

She’s happy to hear that the young lady who wound up in jail found her way to recovery, and Diaz empathizes deeply with what she went through. She also has immediate family members who struggle with substance use. “I used to rely heavily on the criminal justice system to try and force my family members to stop using. However, no matter how many arrests or jail stays they had, their substance use persisted. … I actually often saw my family member’s overall health (substance use, physical health, psychological health) deteriorate the more often they were arrested and incarcerated.”

Many people credit jail with attaining recovery, but the research is clear on mandated treatment, she said.

“Motivation for change is one of the biggest predictors of success. If a person is mandated to treatment, their likelihood of success is very low. So, it wasn’t necessarily the incarceration experience that was the conduit for change, but the individual’s shift in desire to use or not use while they were in jail. … This same change could occur outside of carceral spaces if treatment were more readily available and accessible.”

The criminal justice system is the nation’s largest mental health provider, providing one of the widest onramps to addiction treatment via drug courts, diversion, in-prison treatment, probation conditions and the like. Once involved with the criminal justice system, people can access treatment resources they didn’t have on their own, she said.

“The criminal justice system, though, is not the best place for this,” she said. “In an ideal world, we would have a system with the same resources and access as the criminal justice system that would be able to provide resources and treatment to people without the trauma and collateral consequences (criminal record, stigma, etc.) of incarceration.”

On that, she and Barnes certainly agree.

If addiction is a disease, a wise psychiatrist once asked, where are all the doctors?

We told you recently about an interesting, and perhaps tragic, convergence of events:

• Drug offense arrests in California have plunged 85% — from 137,054 in 2014 to 20,574 in 2022, according to data from the California Department of Justice,

• While drug overdose deaths have more than doubled — from 4,519 in 2014 to 10,410 in 2022, according to data from the California Department of Public Health.

A flood of fentanyl — a synthetic opioid far more powerful than heroin and morphine — into the nation’s illicit drug supply has driven the huge spike in overdose deaths, even as Prop. 47 reduced a great many drug-related offenses from felonies to misdemeanors, keeping a great many low-level drug offenders out of jail.

The money saved on incarceration was to pay for effective addiction treatment, among other things — which makes the tepid embrace of one of the best drugs for treating opioid addiction puzzling.

Buprenorphine binds to the brain’s opioid receptors, blunting powerful cravings, reducing withdrawal symptoms and providing safety in case of overdose. It’s considered the gold standard for opioid treatment — addiction being a medical condition, after all, which can be managed with medication — but data from the California Department of Public Health show that buprenorphine prescriptions dropped at several points over the last decade, even as deaths were skyrocketing. They’re picking up as of late, but doctors are still wary.

“If we want to know why buprenorphine isn’t well used, look at the federal government,” said an impassioned Dr. Matthew A. Torrington, an addiction medicine specialist in Culver City.

“We took the antidote to opioid withdrawal and craving and we put it behind a  glass door for 20 years,” he said. “Historically, if you want to prescribe this medicine, the doctor had to undergo eight hours of training, then the DEA will come to your office and scare the hell out of you, and after all that, you could only treat 30 patients.”

As of this year, the feds eliminated these barriers — barriers that don’t exist for prescribing actual opioids, mind you — but the damage is done, Torrington said.

“I have stable patients on this medication, trying to convince their primary doctors to continue the prescription, but the primary doctors don’t want to do that,” he said. “They’re afraid. There’s opioid hysteria surrounding all controlled substances.”

If Torrington could wave a magic wand, “I would enact true parity, where people could get access to comprehensive, individualized, multimodal treatment over time,” he said. “Primary care, psychiatry, addiction medication, shoes, socks, healthy food, mind-body activities. I would stop treating people like (expletive) because they have a psychiatric or addiction problem. I’d make sure they had a place to stay and get care as long as they need it — forever, if they need it.

“Some people can figure it out and make it work. Some can’t, and they die, and we seem to be OK with that.”

A spokesman from the CDPH said the buprenorphine prescription data doesn’t provide the full picture of who gets medication-assisted treatment, as it doesn’t track methadone or naltrexone, other drugs for medication-assisted treatment. The pandemic has also ushered in changes to prescribing that will increase access to these medications.

Torrington, who’s also opioid committee chair for the California Society of Addiction Medicine, expects to see a modest increase in buprenorphine prescriptions in 2023, the first year that the stringent requirement for doctors has been dropped.

But he rails that he must adjust care plans to what insurance companies will pay for — something ICU doctors don’t have to do — but he has hope nonetheless.

There have been giant steps forward in the last decade, he said: The Affordable Care Act ensures that everyone can access medication-assisted treatment (even if they’re still wary of using it). No one graduates from medical school today without training in addiction. And while we seem to be in something of a societal collapse, he’s confident that, too, shall pass.

Eventually, we’ll carve out a place for people who are broken and damaged. “I’m incredibly hopeful,” he said.

Dear Gov. Newsom: Here’s a real California story for you. Ronald Reagan, Frank Sinatra, Phyllis Diller and Bob Hope are immortalized on Palm Springs’ Walk of the Stars — and so is reality TV celebrity Ken Seeley.

Seeley gained the national spotlight as a real-life superhero on A&E’s gut-wrenching “Intervention,” sweeping in as users spiral into addiction’s dark depths and often, against all odds, helping yank them out. His star power lent a special sheen to Seeley’s addiction treatment facilities — Ken Seeley Communities or KSC, doing business as Intervention911 — and attracts folks seeking similar miracles.

And so it was for Susan Rea of San Juan Capistrano. Despite repeated brushes with death, emergency room ordeals and stints in rehab, her 22-year-old son Dean just couldn’t shake perhaps the most dangerous addiction of all: to fentanyl. As you well know, Gov. Newsom, this synthetic opioid is some 50 times stronger than heroin and 100 times stronger than morphine. Just two milligrams of it — think a dozen or so grains of table salt — can kill.

Dean was more than his addiction. A skateboarder who loved the ocean. A surfer who taught kids to ride waves at Doheny Beach. A jokester with a gift for helping others see their own worth. A young man who had trouble seeing his own. He was diagnosed with bipolar disorder, generalized anxiety, ADHD and depression. It was 2021 and Rea was desperate to save her son’s life.

An acquaintance told Rea about Seeley and his operation in Palm Springs. Intervention911 could treat people with complex issues, routinely drug-tested clients and accepted her medical insurance.

They signed on and Rea drove Dean to Palm Springs herself. “I was looking for professionalism,” she said. “We all wanted Dean to get better.”

Dean entered detox at Intervention911 on March 13. Less than six weeks later, he was dead.

And this, Gov. Newsom, is where you — and California’s insurers and rehab regulators — come in. Dean’s compulsion to keep using despite the risks was very well-established. Therapists opined that he might actually have a death wish. Shocking details in Rea’s wrongful death suit against Seeley and Intervention911 suggest that so very many parts of California’s (tract-home-based, private-pay) addiction treatment system failed here — but as a parent, we get stuck on this:

If only California and its insurers required people like Dean Rea to see an addiction medicine specialist before checking in to non-medical facilities … if only a doctor had prescribed him buprenorphine, the gold-standard for managing opioid addiction, which cuts those compulsive cravings … if only he was encouraged, cajoled, convinced, even bribed to take it and keep taking it … if only, when things went dangerously south, he was taken to a hospital rather than allowed to wander off alone to die behind a gas station.

If only the private-pay piece of California’s addiction treatment system performed more like the public sector.

If only California bolstered oversight and professionalism along the Rehab Riviera.

If only, if only… Dean Rea might still be alive today.

Rea’s wrongful death suit just wrapped up in Riverside Superior Court with a confidential settlement agreement. Seeley and Intervention911 denied the allegations and admitted no wrongdoing. Its attorneys didn’t respond to our requests for comment, but in court documents, Intervention911 argued that Dean’s “own negligence was the sole and proximate cause” of his death.

Hundreds of pages of court documents vividly suggest weakness in the system itself. You can change that, Gov. Newsom. As you lobby us to approve a $6 billion initiative to expand mental health treatment, we implore you: Make sure California expands what works, rather than what doesn’t.  Pay attention to the painful lessons embedded in Dean Rea’s story.

It was a life-or-death story. As all addiction stories are.

Missed opportunities

There are three main steps in the rehab world — detox, residential treatment, then outpatient treatment/sober living. Dean spent much longer than usual in that first, intense, detox phase — about 10 days.

He had “dangerously lethal” substance abuse disorder, bordering on passive suicidality, staffers noted. Without a “contained” treatment environment, he was at the highest risk of relapse and lethal overdose on fentanyl.

“I don’t want to die,” Dean said, according to court documents.

But rather than following the familiar three-step script — sending Dean from detox to residential treatment, where he’d still be watched — Dean skipped from step one to step three, a sober living-type home called The Amado. There, he had far greater freedom to do as he pleased than if he were in that middle step, residential treatment.

At The Amado, he continued using fentanyl, court documents say. But that didn’t show up on his drug tests because, as Susan Rea would later learn, Intervention911 did not test for fentanyl.

Veils drop and souls are bared in these settings. Intense bonds form. Dean fell for Meredith Voelkel, a young nurse who struggled with alcohol, and she fell right back. But Dean continued to “struggle with high-intensity agitated depression” and habitually self-medicated with lethal doses of analgesics, case notes said. More than a month in, “post-acute withdrawal symptoms” — hopelessness, anxiety, recklessness, impulsivity, irritability, mania, worthlessness — continued to plague him. He reported “high craving levels.” He was “easily triggered and reactive” for wanting to use drugs.

Where a more medical rehab model might have gotten him to a doctor or a higher level of care, Dean got a visit with his mother. He felt closest to her because she was always there for him.

It was April 22, 2021, the day before his death. Rea treated him to a fancy dinner at a Japanese restaurant. They ate, they laughed, they talked about his plans for getting a license and a job. “He thanked me,” Rea said. “He said, ‘You’ve been hard on me because you love me.’ “

The next day, Intervention 911 was taking clients to Laguna Beach for sun and sand. Dean wanted to go — but he wanted to spend time with his mother more. After his friends left for the beach, mother and son went to breakfast at the nearby Denny’s, then had a family therapy session. Dean texted Voelkel a photo of him kissing Rea on the head. ““I’m so happy you and your Mom are good and you get to spend time showing how well you are doing,” Voelkel texted back.

Dean had a hankering for some shrimp and a Monster Energy drink, so Rea stopped at a supermarket and arrived with the goods around noon. She called for Dean at his bedroom door.

“He did not answer her, but she heard gurgling noises,” the suit said. “She tried to open the door, but the door was locked.”

Susan pounded on the door. Dean still didn’t respond.

She intercepted a staffer. He didn’t have a key and didn’t know where one was.

The worker broke down the door. Dean was sprawled on the bed. Next to him, tin foil stained with brown marks. Susan called 911 while the worker tried to revive Dean. “Don’t die,” Susan said, squeezing his hand. “Please don’t die. Come back.”

Dean stirred and was conscious by the time paramedics arrived, about 12:30 p.m. Dean needed to go to the hospital, the paramedics said. Dean refused; he didn’t want to pay for an ambulance.

The executive director told emergency workers he’d take Dean to the hospital himself.

Rea was in shock. “I had just seen my son turn gray,” she said. “I never experienced anything like that in a rehab facility. He had never gotten to that point in front of me.”

“What do I do?” she asked the staffers.

Leave, they said. They’re trained to handle these situations. They’d take care of Dean.

And so, at about 12:50 p.m., Rea left. She would never see her son alive again.

‘Loaded gun’

The executive director demanded that Dean hand over whatever drugs remained.

Dean refused. They argued. “I’ve had enough of your (expletive), I’m leaving,” the director said, storming off and leaving the marketing and admissions guy to deal with Dean, according to documents.

You can go to the hospital or you can get kicked out, the marketing guy said. There was no offer to drive Dean to the hospital. No way for Dean to get there safely on his own. No other options presented — such as a return to detox — and no one summoned Rea to help, the suit said.

If only, if only. “I would have turned right around,” she said. “I would have crawled over fire for him.”

The marketing guy told Dean to pack his bags. Dean’s phone buzzed as he obliged; it was his girlfriend, Voelkel, calling from the beach. He had overdosed and was leaving KSC, he told her.

Voelkel was stunned. She asked if anyone was with him, and the marketing guy said he was there. Voelkel assumed Dean was going to the hospital. “She did not believe KSC would kick him out when he was high and unable to make rational decisions,” court documents say.

But that’s what happened, the suit said. KSC “kicked Dean out to the street all alone and with a lethal dose of fentanyl in hand. … KSC essentially gave Dean a loaded gun and told him to shoot himself.”

In Laguna Beach, Voelkel started to cry. A counselor sat her down. “Look at that trash can over there. Do you see that piece of trash? You need to leave the trash in the trash can.”

Dean wound up behind the gas station just around the corner from KSC. He called Jon Wan, a friend on the beach outing. Dean was speaking nonsense, Wan said in court papers, and admitted to smoking fentanyl by the dumpster. Wan assured Dean they’d help as soon as they returned to Palm Springs.

Meanwhile, Rea was calling multiple people, multiple times, for updates. She couldn’t reach anyone.

Dean stopped answering phone calls and texts sometime after 2 p.m. Concerned, a staffer asked the executive director to check on Dean. “I’m no (expletive) babysitter,” the executive director responded, according to the suit. “He’s been kicked out.”

It was after 5:30 p.m. when Dean’s friends returned from the beach. Wan beelined to the gas station and found Dean lying on the ground. Wan rolled Dean over. Blood leaked from Dean’s eyes. His face was gray. Ants crawled on him and flies buzzed around him.

Wan called 911 and raced back to The Amado to grab Narcan, the opioid-overdose antidote. Others came with him to help. But it was too late.

The executive director said Dean was not a client when he died. No one was to contact Rea. They’d let the coroner deliver the devastating news.

‘Breach of duty’

In dry legal language, it’s this:

“KSC breached its duty to Dean by kicking him out of its facility knowing his strong addiction and overdose history with fentanyl; his suicidal ideation; his diagnosis of having several mental health disorders; his prior use of fentanyl that day which resulted in paramedics being called to attend to him; knowing he continued to possess fentanyl; knowing he did not have any safe transport to a safe location; and knowing he was homeless,” the suit said.

“His death was highly foreseeable under the circumstances.”

The lock on his bedroom door. The lack of supervision. The failure to test for fentanyl. “Below the standard of care,” the suit said.

In declarations to the court, more than a dozen people laid the blame for Dean’s death at KSC’s feet. They should have gotten Dean to a higher level or care, or called police, or tried to put him on a 5150 psychiatric hold if he refused to hand over his drugs, they said. You never discharge someone in that condition without referrals.

“Some of the main lessons here are the importance of making sure people are in the appropriate level of care, and the importance of having trained, experienced people in charge,” said Christina Denning, Rea’s attorney, after the case closed.

“There’s so much turnover in these facilities. Important decisions were made by the marketing admissions guy and the executive director — management people, marketing people. They’re not doctors. They’re not therapists.”

We applaud California’s Bridge program, helping emergency departments become primary access points for addiction treatment. We applaud California’s hub-and-spoke system, increasing the availability of medication-assisted addiction treatment to people who need it. But it’s astonishing that close to half the state’s treatment providers  — 41%, according to federal data  — still eschew life-saving medication like buprenorphine. They equate a drug that can save your life with one that can kill you.

Might buprenorphine maintenance have spared Dean’s life? Dr. Randolph Holmes, who deals with government and public policy for the California Society of Addiction Medicine, counsels us not to be naïve.

“Many people resist treatment, even from doctors, and I spend a lot of time every day trying to convince people to start life-saving medications,” Holmes said.

But public providers funded by MediCal must either have medical providers, or be able to refer patients for medication-assisted treatment. There’s no such requirement for the private sector.

“CSAM has been trying for years to get legislation passed and signed to mandate access to medications for all,” Holmes said. “It is paradoxical that a person can get better access to evidence-based care in the public sector than in the private sector.”

If only, if only. Gov. Newsom, raise the bar for this industry in California.

Dear Gov. Newsom: Here’s a real California story for you. Ronald Reagan, Frank Sinatra, Phyllis Diller and Bob Hope are immortalized on Palm Springs’ Walk of the Stars — and so is reality TV celebrity Ken Seeley.

Seeley gained the national spotlight as a real-life superhero on A&E’s gut-wrenching “Intervention,” sweeping in as users spiral into addiction’s dark depths and often, against all odds, helping yank them out. His star power lent a special sheen to Seeley’s addiction treatment facilities — Ken Seeley Communities or KSC, doing business as Intervention911 — and attracts folks seeking similar miracles.

And so it was for Susan Rea of San Juan Capistrano. Despite repeated brushes with death, emergency room ordeals and stints in rehab, her 22-year-old son Dean just couldn’t shake perhaps the most dangerous addiction of all: to fentanyl. As you well know, Gov. Newsom, this synthetic opioid is some 50 times stronger than heroin and 100 times stronger than morphine. Just two milligrams of it — think a dozen or so grains of table salt — can kill.

Dean was more than his addiction. A skateboarder who loved the ocean. A surfer who taught kids to ride waves at Doheny Beach. A jokester with a gift for helping others see their own worth. A young man who had trouble seeing his own. He was diagnosed with bipolar disorder, generalized anxiety, ADHD and depression. It was 2021 and Rea was desperate to save her son’s life.

An acquaintance told Rea about Seeley and his operation in Palm Springs. Intervention911 could treat people with complex issues, routinely drug-tested clients and accepted her medical insurance.

They signed on and Rea drove Dean to Palm Springs herself. “I was looking for professionalism,” she said. “We all wanted Dean to get better.”

Dean entered detox at Intervention911 on March 13. Less than six weeks later, he was dead.

And this, Gov. Newsom, is where you — and California’s insurers and rehab regulators — come in. Dean’s compulsion to keep using despite the risks was very well-established. Therapists opined that he might actually have a death wish. Shocking details in Rea’s wrongful death suit against Seeley and Intervention911 suggest that so very many parts of California’s (tract-home-based, private-pay) addiction treatment system failed here — but as a parent, we get stuck on this:

If only California and its insurers required people like Dean Rea to see an addiction medicine specialist before checking in to non-medical facilities … if only a doctor had prescribed him buprenorphine, the gold-standard for managing opioid addiction, which cuts those compulsive cravings … if only he was encouraged, cajoled, convinced, even bribed to take it and keep taking it … if only, when things went dangerously south, he was taken to a hospital rather than allowed to wander off alone to die behind a gas station.

If only the private-pay piece of California’s addiction treatment system performed more like the public sector.

If only California bolstered oversight and professionalism along the Rehab Riviera.

If only, if only… Dean Rea might still be alive today.

Rea’s wrongful death suit just wrapped up in Riverside Superior Court with a confidential settlement agreement. Seeley and Intervention911 denied the allegations and admitted no wrongdoing. Its attorneys didn’t respond to our requests for comment, but in court documents, Intervention911 argued that Dean’s “own negligence was the sole and proximate cause” of his death.

Hundreds of pages of court documents vividly suggest weakness in the system itself. You can change that, Gov. Newsom. As you lobby us to approve a $6 billion initiative to expand mental health treatment, we implore you: Make sure California expands what works, rather than what doesn’t.  Pay attention to the painful lessons embedded in Dean Rea’s story.

It was a life-or-death story. As all addiction stories are.

Missed opportunities

There are three main steps in the rehab world — detox, residential treatment, then outpatient treatment/sober living. Dean spent much longer than usual in that first, intense, detox phase — about 10 days.

He had “dangerously lethal” substance abuse disorder, bordering on passive suicidality, staffers noted. Without a “contained” treatment environment, he was at the highest risk of relapse and lethal overdose on fentanyl.

“I don’t want to die,” Dean said, according to court documents.

But rather than following the familiar three-step script — sending Dean from detox to residential treatment, where he’d still be watched — Dean skipped from step one to step three, a sober living-type home called The Amado. There, he had far greater freedom to do as he pleased than if he were in that middle step, residential treatment.

At The Amado, he continued using fentanyl, court documents say. But that didn’t show up on his drug tests because, as Susan Rea would later learn, Intervention911 did not test for fentanyl.

Veils drop and souls are bared in these settings. Intense bonds form. Dean fell for Meredith Voelkel, a young nurse who struggled with alcohol, and she fell right back. But Dean continued to “struggle with high-intensity agitated depression” and habitually self-medicated with lethal doses of analgesics, case notes said. More than a month in, “post-acute withdrawal symptoms” — hopelessness, anxiety, recklessness, impulsivity, irritability, mania, worthlessness — continued to plague him. He reported “high craving levels.” He was “easily triggered and reactive” for wanting to use drugs.

Where a more medical rehab model might have gotten him to a doctor or a higher level of care, Dean got a visit with his mother. He felt closest to her because she was always there for him.

It was April 22, 2021, the day before his death. Rea treated him to a fancy dinner at a Japanese restaurant. They ate, they laughed, they talked about his plans for getting a license and a job. “He thanked me,” Rea said. “He said, ‘You’ve been hard on me because you love me.’ “

The next day, Intervention 911 was taking clients to Laguna Beach for sun and sand. Dean wanted to go — but he wanted to spend time with his mother more. After his friends left for the beach, mother and son went to breakfast at the nearby Denny’s, then had a family therapy session. Dean texted Voelkel a photo of him kissing Rea on the head. ““I’m so happy you and your Mom are good and you get to spend time showing how well you are doing,” Voelkel texted back.

Dean had a hankering for some shrimp and a Monster Energy drink, so Rea stopped at a supermarket and arrived with the goods around noon. She called for Dean at his bedroom door.

“He did not answer her, but she heard gurgling noises,” the suit said. “She tried to open the door, but the door was locked.”

Susan pounded on the door. Dean still didn’t respond.

She intercepted a staffer. He didn’t have a key and didn’t know where one was.

The worker broke down the door. Dean was sprawled on the bed. Next to him, tin foil stained with brown marks. Susan called 911 while the worker tried to revive Dean. “Don’t die,” Susan said, squeezing his hand. “Please don’t die. Come back.”

Dean stirred and was conscious by the time paramedics arrived, about 12:30 p.m. Dean needed to go to the hospital, the paramedics said. Dean refused; he didn’t want to pay for an ambulance.

The executive director told emergency workers he’d take Dean to the hospital himself.

Rea was in shock. “I had just seen my son turn gray,” she said. “I never experienced anything like that in a rehab facility. He had never gotten to that point in front of me.”

“What do I do?” she asked the staffers.

Leave, they said. They’re trained to handle these situations. They’d take care of Dean.

And so, at about 12:50 p.m., Rea left. She would never see her son alive again.

‘Loaded gun’

The executive director demanded that Dean hand over whatever drugs remained.

Dean refused. They argued. “I’ve had enough of your (expletive), I’m leaving,” the director said, storming off and leaving the marketing and admissions guy to deal with Dean, according to documents.

You can go to the hospital or you can get kicked out, the marketing guy said. There was no offer to drive Dean to the hospital. No way for Dean to get there safely on his own. No other options presented — such as a return to detox — and no one summoned Rea to help, the suit said.

If only, if only. “I would have turned right around,” she said. “I would have crawled over fire for him.”

The marketing guy told Dean to pack his bags. Dean’s phone buzzed as he obliged; it was his girlfriend, Voelkel, calling from the beach. He had overdosed and was leaving KSC, he told her.

Voelkel was stunned. She asked if anyone was with him, and the marketing guy said he was there. Voelkel assumed Dean was going to the hospital. “She did not believe KSC would kick him out when he was high and unable to make rational decisions,” court documents say.

But that’s what happened, the suit said. KSC “kicked Dean out to the street all alone and with a lethal dose of fentanyl in hand. … KSC essentially gave Dean a loaded gun and told him to shoot himself.”

In Laguna Beach, Voelkel started to cry. A counselor sat her down. “Look at that trash can over there. Do you see that piece of trash? You need to leave the trash in the trash can.”

Dean wound up behind the gas station just around the corner from KSC. He called Jon Wan, a friend on the beach outing. Dean was speaking nonsense, Wan said in court papers, and admitted to smoking fentanyl by the dumpster. Wan assured Dean they’d help as soon as they returned to Palm Springs.

Meanwhile, Rea was calling multiple people, multiple times, for updates. She couldn’t reach anyone.

Dean stopped answering phone calls and texts sometime after 2 p.m. Concerned, a staffer asked the executive director to check on Dean. “I’m no (expletive) babysitter,” the executive director responded, according to the suit. “He’s been kicked out.”

It was after 5:30 p.m. when Dean’s friends returned from the beach. Wan beelined to the gas station and found Dean lying on the ground. Wan rolled Dean over. Blood leaked from Dean’s eyes. His face was gray. Ants crawled on him and flies buzzed around him.

Wan called 911 and raced back to The Amado to grab Narcan, the opioid-overdose antidote. Others came with him to help. But it was too late.

The executive director said Dean was not a client when he died. No one was to contact Rea. They’d let the coroner deliver the devastating news.

‘Breach of duty’

In dry legal language, it’s this:

“KSC breached its duty to Dean by kicking him out of its facility knowing his strong addiction and overdose history with fentanyl; his suicidal ideation; his diagnosis of having several mental health disorders; his prior use of fentanyl that day which resulted in paramedics being called to attend to him; knowing he continued to possess fentanyl; knowing he did not have any safe transport to a safe location; and knowing he was homeless,” the suit said.

“His death was highly foreseeable under the circumstances.”

The lock on his bedroom door. The lack of supervision. The failure to test for fentanyl. “Below the standard of care,” the suit said.

In declarations to the court, more than a dozen people laid the blame for Dean’s death at KSC’s feet. They should have gotten Dean to a higher level or care, or called police, or tried to put him on a 5150 psychiatric hold if he refused to hand over his drugs, they said. You never discharge someone in that condition without referrals.

“Some of the main lessons here are the importance of making sure people are in the appropriate level of care, and the importance of having trained, experienced people in charge,” said Christina Denning, Rea’s attorney, after the case closed.

“There’s so much turnover in these facilities. Important decisions were made by the marketing admissions guy and the executive director — management people, marketing people. They’re not doctors. They’re not therapists.”

We applaud California’s Bridge program, helping emergency departments become primary access points for addiction treatment. We applaud California’s hub-and-spoke system, increasing the availability of medication-assisted addiction treatment to people who need it. But it’s astonishing that close to half the state’s treatment providers  — 41%, according to federal data  — still eschew life-saving medication like buprenorphine. They equate a drug that can save your life with one that can kill you.

Might buprenorphine maintenance have spared Dean’s life? Dr. Randolph Holmes, who deals with government and public policy for the California Society of Addiction Medicine, counsels us not to be naïve.

“Many people resist treatment, even from doctors, and I spend a lot of time every day trying to convince people to start life-saving medications,” Holmes said.

But public providers funded by MediCal must either have medical providers, or be able to refer patients for medication-assisted treatment. There’s no such requirement for the private sector.

“CSAM has been trying for years to get legislation passed and signed to mandate access to medications for all,” Holmes said. “It is paradoxical that a person can get better access to evidence-based care in the public sector than in the private sector.”

If only, if only. Gov. Newsom, raise the bar for this industry in California.

Dear Gov. Newsom: Thanks for the new laws. Thanks for the new inspectors. Thanks, I guess, for trying, even a little.

But — and isn’t there always a but? — it’s not working. And it’s maddening that the fraud and abuse still plaguing California’s addiction treatment industry aren’t being exposed by California’s regulators, or California’s attorney general, or its district attorneys or insurance commissioner, but by the federal Department of Justice and the insurance companies footing the bills. To wit:

Last month, Aetna filed a lawsuit against a slew of rehabs and their operators in Orange, Los Angeles and Riverside counties, claiming fraud, negligent misrepresentation, economic interference, conspiracy under the Racketeer Influenced and Corrupt Organizations Act and unjust enrichment.

“The various schemes perpetrated by Defendants here are particularly disturbing,” the Aetna suit says. “Since at least 2021, Defendants have targeted vulnerable Aetna members who suffer from alcohol and/or substance dependency issues as part of a concerted effort to profit at their expense. Defendants used the patients for health benefit payments under the lie of helping them, while doing the exact opposite.

“Defendants lured patients into their programs by offering them kickbacks in the form of … free or low-cost living arrangements in ‘sober living homes’ located in highly desirable locations throughout California. In reality, the sober living homes were little more than drug dens, used to ensure patients remained in Defendants’ treatment ‘programs’ for as long as possible…. ensuring reliance on treatment rather than recovery from treatment.”

In the rare instance where a patient progressed while still retaining benefits, Aetna said the operators encouraged drug use so the treatment cycle (and billings) could start anew.

“Defendants weaponized addiction and pushed relapse to prevent recovery,” the suit says. “Far from performing services for their patients, Defendants actively worked to harm their patients.”

Named in the suit are:

• Nathan Samuel Young, aka Pablo Lopez, of Rodeo Recovery (Rodeo Drive, Beverly Hills), Get Real Recovery (Rancho Viejo Road, San Juan Capistrano), Healing Path Recovery, Healing Path Detox (Amberleaf Circle, Huntington Beach), Sunset Rehab (Santa Monica Boulevard, West Hollywood), Natural Rest House (Ocotillo Drive, La Quinta) and Ocean Valley Behavioral Health (Mauve Drive, Santa Ana);
• David Young, aka Sancho Lopez, a family member of Nathan Young who “actively participates in the operations of the various entities, including Rodeo Recovery”;
• Marc Adler of Helping Hands Rehabilitation Clinic (North Highland Avenue, Los Angeles);
• Jose Ricardo Toscano Maldonado of Joser Forever (South La Cienega Boulevard, Los Angeles);
• Ani Mirzayan of Revive Premier Treatment Center (Ventura Boulevard, Studio City);
• Ali Beheshti, who operates the Zealie medical billing company in Laguna Beach, which submitted a majority of the bills to Aetna that resulted in what it calls wrongful payments.

Aetna paid nearly $40 million in fraudulent health care claims to these entities, most of it to Helping Hands ($20.8 million) and Joser Forever ($15.1 million), it said.

We reached out by phone and email to the treatment centers and those who’ve served as their lawyers. Most did not respond.

“We want to underscore at the start that the allegations against Zealie in the Aetna lawsuit are without merit, and we are actively pursuing the dismissal of all claims,” said attorney Aaron Goodman by email. “Zealie’s association with this client is solely limited to handling their billing, so the accusations do not pertain to Zealie. Zealie’s unwavering focus remains on their mission to administratively support behavioral health treatment centers in delivering optimal care to their patients.”

Several defendants requested more time from the federal court to file the required “answers” to Aetna’s suit, which typically deny wrongdoing.

Give ’em a license!

Now, Gov. Newsom, state regulators might have gotten in front of this alleged skullduggery back in 2020, when the city of Beverly Hills sued Nathan Young and Rodeo Recovery for violation of the Controlled Substances Act, being a public nuisance and engaging in unfair business practices.

“The Illegal Drug Rehab Facility Operated At The Subject Property Is A Haven For Drug Abuse And Other Criminal Conduct,” the suit said of the “flop house” on Rodeo Drive run by Young and Rodeo Recovery.

One resident described it as “a place to crash and smoke fentanyl,” where Young provided drugs such as black tar heroin and methamphetamines to residents at “significantly reduced prices.” Beverly Hills police responded to multiple reports of overdoses, illegal narcotics, armed robbery, vandalism, loud verbal altercations and marijuana use, according to the suit.

“Police also learned that 10-15 people live in the Subject Property. At any given time, there are multiple people sleeping in each room and the garage and living rooms are both used as sleeping quarters with mattresses on the floor,” the suit said. “….(E)ach ‘client’ … provides insurance to secure a ‘bed’ and submits to urine drug tests about three times a week.”

Expenses were completely covered by the insurance company, a resident told the city.

“State regulators have attempted to stem the proliferation of these illicit businesses but simply do not have the resources to adequately police them,” Beverly Hills said. “And, due to the ease of establishing a business, even if a program shutters it can spring up almost anywhere doing the same things in the same manner and in the same networks.

“The clients, whether they legitimately want to be sober or those just going through the appearance of doing so to satisfy legal or third-party requirements, are vulnerable to manipulation and abuse.”

Attorneys for Young and Rodeo Recovery denied wrongdoing. Their actions were at all times reasonable and taken in good faith, their response said.

The parties made their peace. The state granted Rodeo Recovery a license to operate an addiction treatment facility at the location. It is part of the web where Aetna alleges fraud.

The recipe

How did this alleged fraud work? You’ve read the recipe a billion times, Gov. Newsom. We’ve been harping on it since 2017, when our Rehab Riviera series began. Crusading lawmakers have channeled outrage over it as they embraced new laws to crack down on the fraud-plagued industry.

Suffice to say that laws without enforcement are worth diddly squat.

First, they find patients with good private insurance. “To continue growing, Defendants hired some patients as ‘body brokers,’ sending them out to find other addicts to cycle through their facilities,” the suit says.

No insurance? No problem. “If a patient lacked coverage, Defendants schemed to sign them up, such as by adding them as ‘dependents’ to the health plans of other patients with whom they had no familial relationship,” the suit says.

These private rehabs are technically “out of network,” meaning the insurer won’t cover the whole bill, putting patients on the hook for the extra. This cost-sharing is important because it sensitizes folks to the costs of care and leads them to seek out providers with lower fees, making medical insurance less expensive for everyone, Aetna argues. “When providers waive or forgive the out-of-network co-insurance, they undermine this important mechanism to limit healthcare costs and ensure quality. They are also committing fraud,” the suit says.

To avoid detection, the rehabs created multiple entities so they could spread charges across multiple providers and bill under various Tax Identification Numbers (TINs), which makes things significantly harder to track, Aetna says.

“They often shuffled patients throughout programs for seemingly no reason other than to prolong benefits payments. When Aetna flagged certain providers and sought more information to prove the medical necessity of each claim, Defendants moved the patients to other providers they controlled and continued to collect payments. Remarkably, nearly half of the Aetna members enrolled in Defendants’ treatment programs were treated through multiple organizations during their time in treatment,” the suit says.

Even worse, at least some patients were offered drugs, the suit asserts. “When benefits would run out, some members were forced to do a ‘pop’ test, which entailed the submission of a failed drug test and stay in detox, with the hope that the member could then restart their outpatient benefits over again…. Defendants placed them in situations to encourage relapse so they could milk more money out of them.”

This not only poses grave danger to patients and harms the insurer, but drives up costs for everyone, the suit says. Aetna asks for punitive and exemplary damages “in an amount sufficient to punish Defendants and deter other persons similarly situated from engaging in similar conduct in the future.”

Ground zero

This alleged conduct violates state and federal laws, Aetna says. The feds are trying to do something. Is the state?

The Department of Justice declared Orange County as America’s Ground Zero center for addiction fraud, and has pursued operators as part of a sting. California has held myriad hearings and passed myriad laws since our Rehab Riviera series published in 2017 — forbidding patient brokering, requiring rehabs to reveal financial ties to related businesses (like urine labs and sober homes), forbidding false advertising — but who has been sued or arrested or prosecuted under these laws? What has the state attorney general, its insurance commissioner, its district attorneys, done to help enforce them?

That provider database that’s supposed to be live right about now — allowing people to see inspection reports and complaints and licensing files without waiting the four to six months we now have to wait for public records — where is that?

“The story is that nobody in the state is doing anything,” said Laurie Girand of Advocates for Responsible Treatment in San Juan Capistrano, who has been following all this way longer than I have.

Action, she said, would require an investigator willing to take a tip and follow up on it — and a district attorney willing to bring charges. “There’s nobody, as far as I can tell,” she said. “The Legislature passed a bill with a $20,000 per brokered person civil fine. You’d think a D.A.’s office might be able to do something with that.”

Addiction treatment programs “often exist in environments with few barriers of entry into the marketplace,” Aetna notes in its suit. “Unfortunately, many unscrupulous actors have flooded into the … market, capitalizing on the most vulnerable of populations for their own gain.”

That’s been true since the Affordable Care Act passed and mandated mental health coverage. That’s where you lawmakers can, should and must do more. Acknowledge that addiction is a medical condition that poses grave risk of death. Put treatment in the hands of people who know something about medical conditions rather than people who once had one. I say this a lot, but I could open a rehab here in California, and that should scare the hell out of us all.

While many of the lawmakers who demanded a fundamental rebuild of the system have left office or gone eerily quiet, others are trying. In July, Assemblymember Diane Dixon, R-Newport Beach, asked for an audit of the Department of Health Care Services to determine if it’s properly licensing, regulating and enforcing state laws in this sphere. That audit is due out this spring, and folks with experience to share can share their stories directly with auditors, Dixon’s district director, Kristin Vellandi, said.

Assemblymembers Laurie Davies, R-Laguna Niguel, and Kate Sanchez, R-Trabuco Canyon, are active in the Mission Viejo-led  California Sober Living and Recovery Task Force, which is trying to push forward on these issues. This used to be a bipartisan thing; we hope the “Rs” after their names don’t doom their efforts.

In a landscape where vulnerable people are losing their lives to substandard care — and without attention and strong leadership from the top — it’s hard to be optimistic for change.

“Wash, rinse, repeat,” Melissa Delise Ruby, who runs the 6,600-plus member “It’s Time for Ethics in Addiction Treatment” group on Facebook, said of the scandals.

“Why aren’t things changing? If you peel all the layers away and you look at the root of the problem, it’s stigma,” she said. “The overall consensus is, ‘These people don’t matter anyway. Let them die. It’s easier that way.’ It’s investigated on the health care white collar crime level, not for the human trafficking, the deaths, the drugging, the horrific things that are happening to these people.”

The entire structure of how addiction treatment is licensed, credentialed and regulated needs to change, she said.

“Getting information out there on a massive level that can’t be ignored will push the hands of the powers that be to do something,” she said. “The way we fix it is step by step. Do we not have enough dead bodies?”

Back when we started writing about fraud and abuse and death in California’s private-pay addiction treatment centers in 2017, we had to wait months for copies of inspection reports and violations from state regulators.

Now, seven years later, we still have to wait months for those records!

Imagine being the parent of a kid in crisis, trying to find a safe place for them to get help, making life-or-death decisions based on slick websites and grand promises rather than official tallies of violations, complaints and, yes, deaths.

Enter now Assembly Bill 2081 by Assemblymember Laurie Davies, R-Laguna Niguel. It’s a simple plea for transparency, which would require state-licensed and/or certified programs to disclose, on their own websites, “if a legal, disciplinary or other enforcement action has been brought” by state regulators, and the program was found to be in violation.

The web disclosure would have to include the violation’s date and nature, and there’d be a $2,500 civil penalty for failure to comply.

Mind you, the state has been working to put this information online — for years now! — but Davies isn’t inclined to wait much longer.

“We’re looking for transparency,” she said. “The most important thing is ensuring the patients’ safety. There are bad actors out there. If there’s a violation, it’s on the website, you can see what their record is. Sometimes places look great on the website, but it’s very different once you get there.”

Deja vu again?

The Department of Health Care Services — which licenses and regulates addiction treatment programs in California — has promised in recent years to provide folks quick, online access to its public records on licensed treatment centers via a public dashboard.

This is not exactly groundbreaking stuff. The California Department of Social Services, which licenses and inspects group homes for disabled folks and kiddie daycares, has been posting inspection and complaint reports online for many years. It has many of the same privacy concerns to navigate as DHCS does, but manages nonetheless.

In marked contrast, getting public records for addiction treatment centers from DHCS is an agonizing process that can take months, rendering it useless to anyone who needs information right away. Which is most everyone who asks for it.

A year ago, DHCS told us the department was “actively working towards implementing an online directory to post inspection reports as well as complaint investigation reports, death investigation reports and counselor investigation reports. The project is currently in the development stage and DHCS estimates implementation in late 2023.”

It’s 2024.

Last July, outpatient treatment programs — which, unbelievably, didn’t need any state blessing to operate in California at all — were finally required to be certified by the state. Not licensed, mind you, but certified, which is a lesser bar, but better than nothing, right? And because of this change, the dashboard required more work.

DHCS published draft certification standards in October and asked these programs for feedback. DHCS is incorporating said feedback and now anticipates that the dashboard will premiere this summer, officials said.

Busy year

It will be a busy year.

DHCS’ mission prowess is currently under the microscope. The State Auditor is studying the agency to “determine if DHCS is properly licensing, regulating and enforcing state laws” regarding residential facilities that provide nonmedical recovery, treatment and detox services.

The audit, requested by the Joint Legislative Audit Committee, is expected to be done by spring or early summer. The request was refreshingly bipartisan, signed by Davies; Assemblymembers Cottie Petrie-Norris, D-Laguna Beach; Diane Dixon, R-Newport Beach; Tri Ta, R-Westminster; Kate Sanchez, R-Rancho Santa Margarita; and Senators Josh Newman, D-Fullerton; Janet Nguyen, R-Huntington Beach; and Dave Min, D-Irvine.

“It is regrettable how much these facilities are taking advantage of vulnerable people — people who actually need help,” Dixon said in July. “Unfortunately, these facilities advertise treatment for alcohol or drug abuse recovery or treatment services and more often than not provide limited care. We need more accountability on who is licensed and if the treatment programs provided are effective.”

The influential League of California Cities is on board as well. “In 2024, we want to see action on sober living homes,” said League rep Connor Medina at a recent California Sober Living Task Force’s meeting. “We want to sponsor legislation. We’re still crafting exactly what that looks like… we’re in lockstep with you on taking action.”

The Task Force is collecting personal testimony from folks who have experiences to share about living near, or in, these facilities. Submit your two cents at https://www.soberlivingtaskforce.com/jlac-feedback; it will be forwarded to the state auditor’s office.

Strength in numbers

Davies is co-chair of the Task Force, along with Mission Viejo Councilmember Wendy Bucknum. It’s where the idea for AB 2081 was born.

The group is a bipartisan coalition of local and state officials, law enforcement and residents working to raise the bar for the industry and the people who depend on it for their lives — as well as the neighbors of these facilities. Addiction treatment often happens in regular old tract homes in regular old residential neighborhoods, often devoid of any meaningful medical oversight (which is strange, if addiction is a disease, right?).

Davies’ bill would certainly help consumers navigate this confusing (and sometimes treacherous) landscape. It will be lovely when DHCS finally gets its records online. But even then, folks may not know where to look.

Requiring the basics to be posted by the facilities themselves, on their own websites, is a clever idea that could force facilities to try harder. It could give often-addled and desperate folks weighing treatment centers a much more objective snapshot of operations. And it could place more accountability squarely on the shoulders of the facilities themselves — which is, in the end, where it belongs.

“Licensed recovery homes provide a wide range of benefits to some of California’s most vulnerable residents, and it is critical that their needs are prioritized over profits,” said League of California Cities Legislative Affairs Lobbyist Caroline Grinder in a prepared statement. “Cal Cities is proud to support this commonsense, transparency legislation that protects residents and holds providers accountable for maintaining high quality treatment. It’s good for the community, good for the neighbors, and most importantly, good for those who are receiving care.”