For years, a drug rehab program in North Carolina sent people with addictions to work for free as caregivers for elderly and disabled patients, often with disastrous results, a new Reveal investigation has found.
Participants at Recovery Connections Community bathed patients, changed diapers and sometimes dispensed the same drugs that sent them spiraling into addiction, according to interviews with dozens of former participants. Rather than getting treatment, they worked 16-hour days at care homes across the state, with little training or sleep, internal documents show.
"It's like slavery," said Denise Cool, who was addicted to crack cocaine when a judge ordered her to the rehab in 2011, "like we were on the plantation."
North Carolina regulators were well aware of the abuse at Recovery Connections but for years did little to stop it until reporters with Reveal from The Center for Investigative Reporting started asking questions.
Amid a nationwide opioid epidemic, the poor and desperate have become easy prey for rehabs that promise freedom from addiction - for free. To pay for their stay, participants must work full-time jobs and surrender their wages. But many programs cash in on the free labor and turn their participants into indentured servants, an ongoing investigation by Reveal has found.
Recovery Connections was started in 2011 by Jennifer Warren, a disgraced addiction counselor who was stripped of her license for fraud and other ethical breaches. She has turned her rehab into her personal empire.
Warren put participants to work baby-sitting her children and cleaning her home while she vacationed in Paris and New Orleans, records show. She used the nonprofit's money to buy hundreds of exotic pets, according to former participants and state records. She diverted donations - salon appointments and concert tickets - to herself and used participants' food stamps to stock her own kitchen, interviews and documents from two state probes show.
Some former participants told Reveal that the program helped them get clean. Others left the program worse off than when they arrived or turned to drugs to cope. Many participants told Reveal that they fled into the mountains, sometimes in the rain or snow or in the middle of the night.
Warren declined to answer questions but defended her program on Facebook.
"Because of the structure of this kind of program, many people leave with resentments and are disgruntled," she wrote. "I have spent the majority of my adult life trying to give back."
Participants worked at nine adult care homes over the years. Some worked as janitors and cooks, but the majority worked as personal care aides.
In North Carolina, personal care aides must receive at least 80 hours of training , learning how to safely feed, lift and bathe patients. But many rehab workers said they never received the required training.
At least seven rehab workers have been accused of sexual misconduct or assault of patients at the homes, dozens of former participants and employees said. Former employees said none of the allegations were reported to authorities, as required by law. Reveal could find no mention of the alleged assaults in thousands of pages of police reports, Adult Protective Services records and county and state inspections. The accused continued working or were transferred to other facilities.
One male rehab worker was accused of sexually assaulting a disabled elderly woman in the shower at Candler Living Center in 2016. In response, Candler barred male rehab workers from bathing female residents, according to seven current and former employees and participants. As of mid-May, the man still was working at the home.
Drug thefts also were common. Participants snorted prescription pain pills, swallowed droplets of morphine from used medical syringes and peeled fentanyl pain patches off patients and sucked them to get high, according to former participants and employees.
"Lots of people relapsed and got high that way," said Charles Polk, a former participant.
Chris Damiani, chief executive officer of the company that owns Candler, said no assault was reported to management. He said that all workers are properly trained and that his company was investigating the allegations.
"We do not take any report of abuse, neglect, assault, theft or drug use lightly," Damiani said.
The state Department of Health and Human Services, the agency that oversees rehab programs, received complaints beginning in 2011 that Warren was illegally operating an unlicensed program. But rather than crack down, an investigator told Warren how to avoid oversight altogether.
If she described Recovery Connections as a "12-step, self-help" program, Warren would qualify for a licensing exemption, the investigator told her, according to state reports.
The complaints - forced labor, self-dealing and abuse - continued to pour in. But each time, the department declined to investigate, citing the exemption.
After Reveal questioned officials about the program, the department ordered Recovery Connections on Wednesday to stop sending participants to work at the homes, potentially cutting off the rehab's main source of funding.
Other agencies also neglected complaints.
For years, people sent to Recovery Connections by the courts have complained to the state Department of Public Safety. Probation officials called it "toxic" and "run by dangerous people " in internal emails. But they continued to allow probationers to attend.
Whitney Richardson was addicted to heroin and facing prison time for burglary when a North Carolina judge ordered her to complete the two-year program in 2014 as part of a plea agreement.
Richardson fled four months later. She was so scarred by the experience that she vowed never to attend rehab again.
"It's not right to take advantage and subject people to abuse like that when they're trying to better their lives," she said.
On May 8, probation officials barred probationers from attending the program following Reveal inquiries.
But, so far, hospitals and short-term treatment centers continue to send people to the program. So do social workers at state-funded detox and psychiatric facilities.
This article was provided to The Associated Press by the nonprofit news outlet Reveal from The Center for Investigative Reporting. Reporter Amy Julia Harris can be reached at firstname.lastname@example.org, and reporter Shoshana Walter can be reached at email@example.com. Follow them on Twitter: @amyjharris and @shoeshine .