Some unsettling things came to light recently in federal court in Alexandria. A nationally recognized drug treatment program, Straight Inc., was found to have held a 20- year-old college honor student against his will for almost five months. He went to the facility to visit his younger brother, a resident there. Within a couple of hours he found himself diagnosed by a group of other residents, some younger than he, as a "druggie" in need of residential treatment in the facility. He was locked in, held by the belt, not allowed to be alone, even in the bathroom, and was sequestered in this fashion until he escaped by smashing a window of one of the "halfway houses" and running away four months later.
During the trial, the jury heard testimony that this program had at times kept its clients awake for 72-hour marathon groups, exercised inmates in overheated rooms until they passed out, and had engaged in other extreme psychological and physical harassment of recalcitrant clients. Compounding matters, the parents and inmates themselves generally supported the program and its methods. In a separate suit against Straight by a 22-year-old, his father admitted tying his son up and delivering him to Straight Inc.
Curiously, all this engendered few questions. In the Alexandria case, experts came forward for the defense to justify the procedures on the basis that the plaintiff was in fact drug-involved--a claim he denied. An eminent psychiatrist and sometime talk- show host, who had never met or interviewed the plaintiff, felt compelled to make an arm's-length diagnosis of him as an "addictive personality." The premise seemed to be that if, in fact, the young man had used drugs, the measures employed by Straight Inc. were appropriate and justified.
The question, really, is whether a questionable diagnosis--or any diagnosis--alone can compel the kinds of violence-tinged coercion that increasingly characterize many of the so-called self-help drug treatment and "therapeutic communities" that have sprung up as a response to a very real social problem affecting our young people.
A few months back, the press was obsessed with "deprogramming"--parents kidnapping their adult-aged children away from groups like the "Moonies," the Scientologists and the Hare Krishnas. Here again, civil liberties concerns took a back seat to the practicality of frantic parents. But there have always been "practical" coercive means for dealing with social problems or for obtaining conformity. Happily, they have until recently been considered by thoughtful people as not worth the risk to personal liberty in a society that rightfully treasures individual freedom above most all else. These same issues will emerge as we look more closely at the hundreds of drug- treatment programs that dot the nation.
Many, maybe most, of these drug treatment programs have a dark side. The fundamentalist-like testimonials of inmates ring just a bit hollow--and should be taken with reservation. The rush to support these programs by politicians not otherwise recognized for their understanding or compassion for youthful drug users should give us pause. Some drug-treatment programs seem designed less to "cure" the client than to coerce him or her into reassuring the rest of us--parents, law enforcement agencies and political leaders. The "cured" inmate, (I'm tempted to say "converted") is programmed and at times brainwashed.
Nowhere is it written in the book of treatment outcome that success, even with the drug addicted, must rest on such authoritarian coercion. Precisely the opposite: the most respected programs, even those with a large "non-professional" emphasis, never moved away from commitments to care, recognition of differences and, above all, respect for individual choice and responsibility. Treatment programs that deny basic freedoms, that shut off personal access to others, that pressure and cajole through group threats and that redefine reality in group terms--all should be suspect in a democratic society, even if they did "work."
We are told that many such programs have a 90 percent or better success rate. Yet, controlled studies by disinterested researchers are either noticeably absent or unsupportive of such claims.
We might learn from the tragic experiences of other "treatment" programs that rested on Spartan obedience to group pressure--or were responsive to guru-like leadership. One self-help drug treatment program, the granddaddy of them all, recently found a number of its members convicted of the attempted murder of a lawyer who had criticized the program. The founder and leader of the program was subsequently hospitalized for psychiatric reasons.
In our society, there are legitimate times to deny freedom, as with those convicted in a court of law of violent crime. But to cloak denial of freedom in a "treatment" mantle and to spread it ever more widely under a banner of "care" is dangerous to us all. The fact that, over the long haul, such measures don't work all that well offers us all some reason for hope. The problem will be more obvious when the technology for coercion will be able to deliver on its promises. We should therefore ask the difficult moral questions while we can.