ARI SHAPIRO, HOST:
People in need of drug rehab have a few options. For those with money or insurance, there are residential programs that cost thousands of dollars. Otherwise, there are programs that promise treatment for people willing to work full-time and give up their pay. Sometimes the state sends people there instead of jail.
Investigative reporter Shoshana Walter has spent months looking into these programs for Reveal from The Center for Investigative Reporting. She has uncovered what she describes as a new class of indentured workers - people who do hard labor for no money, often with serious health risks and minimal addiction counseling. Her latest report digs into a program that sends addicts to work as caregivers for elderly and disabled patients.
Shoshana Walter, welcome to the program.
SHOSHANA WALTER: Thanks so much for having me.
SHAPIRO: Many drug offenders come to these rehab programs from the criminal justice system. Explain how that process works.
WALTER: Absolutely. So in recent years, states have experienced a huge amount of overcrowding of the prison system. And so what many courts have started trying to do is to send people instead of prison into other alternatives like rehab or treatment. And that's where a lot of abuses tend to come in. A lot of these programs are unlicensed, and there's really no one checking to make sure they're not abusing participants.
SHAPIRO: Your series on this has looked into problematic programs in Oklahoma and Arkansas, and this latest story looks at North Carolina. You write about a program called Recovery Connections. How does it work?
WALTER: Recovery Connections is a two-year-long program near Asheville, N.C. Participants don't have to really pay anything to stay in this program, but they do have to work. And they actually are sent to work at assisted living facilities where they take care of elderly, mentally ill and disabled patients. They don't really get any training. They work 16-hour days or longer every single day. And they're doing things like bathing patients, changing diapers, sometimes even dispensing the same medications that led to their addictions in the first place.
SHAPIRO: Which is a real temptation for somebody in recovery.
WALTER: Right, exactly. They're constantly surrounded by drugs in this program. A lot of program participants stole drugs from patients in the facilities. They've peeled fentanyl pain patches off of patients' backs or arms and sucked them to get high. We also found some disturbing accusations of sexual assault and misconduct between rehab participants and patients. And those allegations were never reported. And so it was simply kind of covered up.
SHAPIRO: And so in this series that you've reported for many months, you've documented many instances of people in rehab being taken advantage of. This is in some sense almost a double whammy because you have the people who are supposed to be getting treatment not getting treatment, and they are working in assisted living facilities without the training, which puts the people in those facilities at risk.
WALTER: Right. And for the participants who are in this program, it's very abusive - I mean, basically working over a hundred hours per week and also forced to take care of the founder's children, clean her house and meanwhile hardly had any food or any kind of rehab services at all.
SHAPIRO: You've reported on so many of these problematic drug rehab programs in a handful of states. How much more do you think is out there that we still don't know about?
WALTER: Well, we're currently trying to quantify that ourselves. We've assembled a lengthy list of tips about similar programs across the country. In Oklahoma, we found that there are at least seven programs that operate along this same model. One of those we wrote about last year that sends people to work at chicken processing plants. So I think we found just the tip of the iceberg, and we're likely to find a lot more.
SHAPIRO: Shoshana Walter is a reporter for Reveal from The Center for Investigative Reporting and PRX. She reported this story with her colleague Amy Julia Harris. Shoshana, thanks so much for joining us.
WALTER: Thanks so much for having me, Ari. Transcript provided by NPR, Copyright NPR.