Points Roundtable: “American Rehab” from Reveal

In July, Reveal, the broadcast channel of the Center for Investigative Reporting, released its eight-part series American Rehab, which centered on an investigation into the drug treatment program Cenikor and the group’s emphasis on “work therapy.” Examining how Cenikor was able to transform “tens of thousands of people into an unpaid, shadow workforce,” Reveal traced Cenikor’s development, struggles, and ultimate success as it placed “patients” into difficult, and often dangerous, jobs across Texas and Louisiana, keeping the money these workers earned and providing little else in terms of actual therapy or rehabilitation. Led by reporters Shoshana Walter, Laura Starecheski and Ike Sriskandarajah, the series is based off Walter’s previous reporting on the issue, which was a finalist for a Pulitzer Prize in 2018 for national reporting.

American Rehab’s early episodes deal extensively with the history of a group that directly influenced the formation of Cenikor: Synanon. In doing so, the reporters reached out to several members of the Alcohol and Drugs History Society for advice and assistance on the history of addiction treatment. We’re really useful people to ask: roundtable participant Nancy Campbell’s book, co-authored with JP Olsen and Luke Walden, The Narcotic Farm: The Rise and Fall of America’s First Prison for Drug Addicts outlined the history of the Lexington Narcotics Farm, where “work therapy” got its start, and panelist Claire Clark’s book The Recovery Revolution: The Battle Over Addiction Treatment in the United States deals extensively with the long and complicated history of how “therapeutic communities” like Synanon influenced addiction treatment and rehabilitation. These books, as well as Campbell, Olsen, and Walden’s series, “Lessons from the Narcotic Farm” from 2012 (click the links to see parts 1, 2, 3, 4, 5, 6, 7, 8) and contributing editor Jordan Mylet’s initial reaction to the series here, provide further details for those interested in how American drug treatment came to the disturbing point Reveal reveals. 

In response, now that the entire series is available, we decided to post a roundtable of reactions to the podcast. Participants include Nancy Campbell, professor and department head of Science & Technology Studies at Rensselaer Polytechnic Institute; Erin Hatton, associate professor of sociology at the University at Buffalo and the author of Coerced: Work Under Threat of Punishment; Claire Clark, associate professor of behavioral science at the University of Kentucky; Jordan Mylet, doctoral candidate in history at the University of California, San Diego; and me, Emily Dufton, managing editor of Points and author of a forthcoming book about the history of medication-assisted treatment in the US. Our responses focus on the long history of work therapy in addiction treatment, the concept of coerced labor, the promotional model at the heart of many treatment programs, further reflections on Synanon, and assessments of the series’s conclusion. 

We welcome your thoughts on American Rehab and thank the reporters for bringing ADHS historians into the conversation. We hope you’ll enjoy our thoughts on American Rehab, and that you’ll listen to this important and informative podcast. 

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Reflections on “American Rehab”

Editor’s Note: Today’s post comes from contributing editor Jordan Mylet, a doctoral candidate in history at the University of California, San Diego. She is working on a dissertation titled, “‘Dope Hope’: The Synanon Foundation, Grassroots Recovery Activism, and the Postwar Struggle over Addiction Rehabilitation, 1945-1980.”

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Synanon ad poster plastered in New York City subway stations, 1960s

When my grandfather moved into Synanon in Santa Monica in 1968, the organization had already inspired a Hollywood film, a jazz LP, numerous bomb threats and eviction notices, and kudos from the Kennedy administration. In the decade after his arrival, Synanon founded a multi-million-dollar enterprise, registered as a religion, and made headlines for placing a live rattlesnake in the mailbox of a rival attorney, who nearly died from its bite. By 1978—the year of the Jonestown massacre and the first federal charges brought against Church of Scientology leaders—Synanon had cemented its place in the ranks of America’s numerous bizarre and violent cults. 

Now, when my grandfather sat on a bench in Synanon’s Santa Monica clubhouse lobby, he didn’t know any of this. A few days earlier, his father had found him sitting in a street gutter in the Bronx, nodding off from recent heroin use. He asked his son if he would get on a plane to go to Synanon in California—the best place, everyone in their neighborhood said, for a heroin addict to get clean. So, my grandfather went. Before landing in Los Angeles, he shot up in the airplane bathroom with some supplies that he had smuggled onboard. After six years of heroin addiction, this would be the last time he ever used. He stayed in Synanon, along with his wife—my grandmother—and hundreds of others until its dissolution in 1990. 

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The Mark of a Criminal: “Vag Addicts,” Police Power, and Civil Rights in Postwar America

Editor’s Note: Today’s post comes from contributing editor Jordan Mylet, a doctoral candidate in history at the University of California, San Diego. 

In 1950, twenty-eight-year old Bettye Coleman, a black Los Angeleno, was arrested by police for being an “addict” in public. Bettye lived close to the downtown Temple district, a predominantly Mexican-American neighborhood—and one that the Los Angeles Police Department patrolled more heavily than nearly any other in the city, except for black neighborhoods south and west of downtown.

One afternoon, Bettye and her friends Ray and Manuel sat in a parked car, waiting to spot someone on the street who could sell them heroin. Suddenly, LAPD officers knocked on their door. “What are you doing here?” As Bettye stammered an excuse—“I think we’re having trouble with the car”—the officer reached through the window, grabbed her arm, and forcibly pushed up her sleeve. Revealed underneath were “fresh” hypodermic needle marks from an earlier fix. “Get out,” the officer said. Manuel took off running, but the police pinned Ray to the ground. Both Bettye and Ray were taken into custody. In the interrogation room, officers tried to flip Bettye against Manuel, whom they believed to be a distributor. After discovering that Bettye had no criminal record, the police let her go—with a warning that she should “get out of Temple Street” or would live to regret it. They would “get that little son of a bitch,” Manuel, another way. 

Two years later, Bettye was arrested on the same charge. That time, she went to jail for 90 days. 

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Recovery at the Grassroots: Addicts, Alcoholics, and Communal Living in Postwar Los Angeles

Editor’s Note: Today’s post comes from contributing editor Jordan Mylet, a doctoral candidate in history at the University of California, San Diego. This is Part 2 in a series on The Addict and Addiction Treatment Before the War on Drugs. 

In the early 1950s, just a few years after a group of patients at the federal narcotics prison-hospital in Lexington, Kentucky, started meeting under the guidance of a local Alcoholics Anonymous emissary, groups like Sun Valley’s Narcotics Anonymous sprung up all over the greater Los Angeles area. They went by all sorts of names: Habit Forming Drugs, Hypes and Alcoholics, Addicts Anonymous, or even the hyper-specific San Fernando Valley Alcoholics Anonymous and Addicts Anonymous. But they were bound by a shared genealogy, one in which the lessons of institutional treatment’s failure to effect a “cure” were merged with the communitarian tradition of alcoholic mutual aid networks in the mid-20th century. During the postwar years, while policymakers, law enforcement officials, and medical professionals debated whether the best way to treat addicts was compulsory hospitalization or providing them with drugs at state clinics, a movement of grassroots recovery groups—which would go on to revolutionize the system of addiction treatment in the United States—spread across Los Angeles. 

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“Typhoid Junkie”: Controversies over Contagion and Cure in the Mid-20th Century

Editor’s Note: Today’s post comes from contributing editor Jordan Mylet, a doctoral candidate in history at the University of California, San Diego. This is Part 1 in a series on The Addict and Addiction Treatment Before the War on Drugs. The next installment will come in March.

It is common today to think about drug addiction as an illness or disorder, and the opioid epidemic as a public health crisis that deserves a robust medical response. This framework is often paired with an implicit (or not) rebuke of past ways of dealing with addiction as a sin or a crime, something to be shamed and punished. The fact of mass incarceration, which has filled jails with hundreds of thousands of drug offenders, predominantly of color, since the early 1970s, has rightfully precipitated a renewed emphasis on treating addicts as people in need of treatment, not prison time.

However, if one looks closely at the long history of medicalizing drug addiction in the United States, they might conclude that applying a treatment framework to addiction does not necessarily lead to clear-cut or even humane solutions. In fact, the mid-twentieth century architects and enforcers of narcotics control policy—with its street-level raids and mandatory sentences—also espoused a belief in addicts’ sickness and need for medical treatment. When public concern about drug addiction skyrocketed in the postwar years, the dilemma facing policymakers and medical professionals was what was to be done with the addict, given that she was sick. In this way, debates over addiction and rehabilitation were also clashes about the responsibilities of the state to its citizens and the limits of individual liberty. 

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Magic Cures and their Discontents: The Belladonna Treatment in the Early Twentieth-Century

Editor’s Note: Today’s post comes from contributing editor Jordan Mylet. Mylet is a doctoral candidate in history at the University of California, San Diego. 

When Bill Wilson had the “spiritual awakening” at the upscale Charles B. Towns Hospital in New York City that would inspire the founding and program of Alcoholics Anonymous, he probably didn’t know the strange, at times sinister, history of the treatment that made his transcendent experience possible.

What he received was the Towns Hospital’s version of the belladonna treatment, which had emerged as a cutting-edge addiction treatment in 1900 and became the dominant method in public and private hospitals by the 1920s. Per its name, the treatment was derived from alkaloids of the belladonna and henbane plants in the nightshade family, which had been used for millennia as poison, cosmetic enhancement, and hallucinogen. They were known to be potent, psychoactive, and potentially fatal. As the belladonna treatment (or “hyoscine cure”) spread in American medical practice, physicians and medical researchers engaged in an unwieldy process of trial and error to control the volatile qualities of the drug mixture. In practice, this meant that poor addicts and alcoholics during the first decades of the twentieth century encountered a far more dangerous version of the belladonna treatment. The course of the hyoscine cure reveals the long history of the United States’ two-tiered addiction treatment (and healthcare) system, and the at times wildly experimental character of medicine and pharmacology in the early twentieth century, the same era in which the nation’s narcotics control laws were developed.

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Stories of Synanon, Part One

Editor’s Note: Today’s post comes from contributing editor Jordan Mylet. Mylet is a doctoral candidate in history at the University of California, San Diego. This is the first of a series of oral histories Mylet is working on with former members of Synanon. More will run on Points in the future. 

When Synanon is remembered at all today, it is as a “vindictive” and “violent cult,” whose methods still lie at the heart of destructive “tough love” programs for recovering drug addicts and problem teens. These exposés detail how Charles (“Chuck”) Dederich, who founded the group for alcoholics and addicts in 1958, forced his followers to shave their heads, switch romantic partners, and verbally abuse one another in a form of attack therapy called the “Synanon Game”—all of which, depending on your perspective, is one hundred percent true.

Nonetheless, supporters of Synanon throughout the 1950s and 1960s—among them senators and congressmen, famous movie stars and authors, renowned criminologists and psychologists, corporate leaders, and civil rights groups—would have been shocked by the way Synanon has been both forgotten and vilified. By the early 1970s, the organization had expanded to tens of thousands of members (including “dope fiends” and non-using “squares,” in Synanon lingo), partnered with state governments to manage semi-autonomous Synanon prison wings, produced a jazz LP, and donated truckloads of food and supplies to the United Farm Workers and Black Panthers. 

This summer, I interviewed one of the organization’s earliest members as part of an ongoing oral history project to capture the complexity of the Synanon story. Lena Lindsay moved into Synanon House in December 1959, when the group was operating out of an abandoned National Guard armory on the beach in Los Angeles. Much attention had been paid to drug addiction in California during the years before Lindsay joined Synanon. State lawmakers, responding to public outcry, introduced hundreds of narcotics bills, many of which recommended the first mandatory minimum sentences for drug offenses. In the mid-1950s, Camarillo State Hospital began publicizing its facilities to addicts, while the state’s Department of Corrections initiated plans to build facilities specifically for narcotics violators. Community resources for people struggling with drug addiction were basically nonexistent. 

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Synanon House, circa 1962

In this interview, Lindsay describes her experiences in and out of California institutions in the 1950s and her life in Synanon until she left in 1974, disillusioned and frustrated by the changes that Dederich was making in the organization. 

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How the Drug User Became a Junkie

Today’s post comes from new contributing editor Jordan Mylet. Mylet is a doctoral candidate in history at the University of California, San Diego. Her dissertation examines the emergence of addiction recovery communes in post-World War II United States, and centers the political activism of self-identified ex-addicts in the national struggles over the possibilities and boundaries of radical participatory democracy in the long 1960s. Welcome to Points, Jordan!

Screenshot 2019-10-10 at 8.36.11 AMFour years before William Burroughs’ Junkie was published, Norma Lee Browning, a reporter for the Chicago Daily Tribune, described how a middle-aged housewife had gone from a “pretty woman” to “an old time incurable junkie.”[1] Browning’s casual use of “junkie” reflects her mainstream audience’s likely familiarity with the term, whose usage in popular media to describe drug addicts (to use another loaded term) had skyrocketed in the late 1940s and early 1950s. The term was a type of shorthand for inevitable physical and moral devastation. To be a “junkie” or involved in “dope peddling” was to “descend into unimaginable levels of baseness” before death, if she was “unable to break the hold of drugs.”[2] Today, the word has the connotation of a slur, a dehumanizing epithet that paints a person as wild and dangerous. 

Yet a look at the term’s genealogy, along with its close associate, “dope,” reveals surprising conceptual and practical links to an industrializing Gilded Age and Progressive United States, a time when the most familiar “junkie” was the “junk man” who worked in the flourishing trade of old and discarded items, as American consumers and producers piled up more trash than ever before. Traces of this lineage appear even today, like in the character Bubbles from the famous HBO show The Wire, depicted as a “junkie” in both senses. 

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