The documentary is narrated by Flaherty, who identifies as in recovery from alcohol addiction and attends AA meetings. He captures on film what the writer Shoshana Walter revealed in her shocking book, Rehab: An American Scandal. Sober homes create an ecosystem of extraction that profits off of vulnerable human beings and if some of them die, that’s just the cost of doing business.  

Flaherty profiles three people ensnared in the infamous “Florida shuffle.” Corey, Daniel and Nicole cycle through a series of harrowing events for which they’ve been set up. Nicole—by turns funny, sarcastic, angry and desperately looking for purpose—has been in 36 different sober homes. In a powerful scene, she tells Flaherty how she wrote in a notebook the names of hundreds of people she’s known who overdosed and died. She starts reading them out.

AJ is a conflicted “body broker” whose livelihood depends on convincing people with “good insurance” to go into rehab. He has to meet a quota, and he passes on cash kickbacks.

Cory has become a full-time patient, and we watch as he criss-crosses the country by plane on his way to yet another “destination rehab.” Daniel, a quiet and sensitive young man, gets lost in the shuffle. He’s from rural Kentucky but ends up in a sober home in California. Daniel’s not used to being around a lot of people and the fast pace of urban life.

To understand how the system works, Flaherty interviews AJ, a conflicted “body broker” whose livelihood depends on convincing people with “good insurance” to go into rehab. He has to meet a quota, and he passes on cash kickbacks from facilities to those who enroll to seal the deal. He recruits patients on social media.

Flaherty also interviews Lauren, an insurance claims analyst who discovers massive “urine fraud.” Urine testing, often conducted daily, is a lucrative revenue stream for the owners of sober homes and rehabs.

A smoking gun in Shuffle concerns A. Thomas McLellan, who served as deputy director of the Office of National Drug Control Policy in the Obama administration. McLellan wrote the requirement in the Affordable Care Act for mental health and substance use disorder services to be considered “essential,” with no limits on coverage. These services are essential. The problem is, some greedy investors used the no-coverage-caps to commit fraud and get rich.

Enter McLellan’s son, Andrew. He was part owner and a board member of Liberation Way, a former treatment program in Pennsylvania. A lawsuit accused both men of “earning” millions of dollars from what was called a “criminal, sham”  rehab. While the McLellans weren’t criminally charged, the former CEO of Liberation Way was sentenced to three years in federal prison over an illegal patient brokering scheme. Andrew walked away with $5 million.

Despite one big problem, the film shines much-needed light on an inhumane, profit-driven industry.

My one serious criticism of Shuffle is the way it portrays Suboxone (buprenorphine)—something I put to Flaherty in our interview. In part because of McLellan Senior’s association with the medication, through his ties to Indivior and Groups Recover Together, the documentary often makes it seem that it’s just another money-making scam, or another drug to “abuse.”

A newspaper headline flashes on the screen: “Are Suboxone clinics the new pill mills?” Daniel took buprenorphine and his mother wonders why a treatment program would put someone on “an addictive medication.” At the end we learn that Cory, who was on Suboxone for 15 years, has stopped taking it. 

Flaherty does include a title card correctly stating that Suboxone is effective and is used safely by many, but it doesn’t balance out all the misleading negativity. Because of massive stigma against medications for opioid use disorder, buprenorphine is underprescribed—and many rehabs and sober homes either don’t allow people to be on it or force them to taper off. There are not enough prescribers, which leaves thousands of people without access to an evidence-based, lifesaving medication.

Despite this big problem, the film shines much-needed light on an inhumane, profit-driven industry. Shuffle premiered in 2025, and is currently screening at venues around the country. Filter’s interview with Benjamin Flaherty has been edited for length and clarity.

Helen Redmond: Could you explain how sober homes make profit? I think it’s confusing by design. 

Benjamin Flaherty: It’s one of the things that confused me the most. In South Florida, there were these people, “body brokers,” who were recruiting struggling “addicts” off the streets and then bringing them back to sober homes.

The people that they picked up had good insurance. The owner of that sober home would say, “Okay, you’re going to go to this outpatient treatment center while you live here.” And that sober homeowner is going to get a kickback from the treatment center for sending the person there. I didn’t quite understand that at first, because when I heard this, I was living in a sober home and insurance doesn’t have anything to do with a sober home, those are all cash-pay. 

The kickbacks are what this scam all revolves around. The reimbursements for treatment are very lucrative for them. There’s going to be drug tests at the sober home. Those are done through a lab, and that lab will give a kickback. So now a sober home owner is getting kickbacks from the urine test because it’s a billable service. Anything you’re prescribed is a billable service and they really want to exploit that. The owner is getting all these kickbacks and getting rent for the apartment. Now here’s what he’ll do to sweeten the deal. He won’t charge rent and say, you can live here for free because I’m making so much money off the kickbacks.

“Before Corey got any real treatment, he was already being sent out to AA meetings and other treatment centers to recruit people.”

HR: What is “body brokering”? 

BF: These guys are called body brokers, brokers or marketers. They are middlemen who are often in recovery themselves. They can speak the language and they serve as middlemen for treatment centers. They want people who have good insurance and they look for them online, like on Facebook, and they offer help. It all looks potentially legitimate to some degree. And that’s the scary part about it, especially when you’re vulnerable. It’s like someone’s offering you help and you assume that that’s well intended. So they bring in an insured, struggling person to a treatment center or to a sober home and that broker might make $3,000. That’s how they make money. 

HR: Talk about the hustle culture, because I think it’s related to body brokering?

BF: Corey shows the hustle culture pretty well. He called a one 800 number looking for treatment and was flown to a treatment center. And once he got there, I’m pretty sure they understood that Corey can speak the language, he’s been around the block. He knows how to work the streets and a lot of these places will recruit from within.

And so before Corey got any real treatment, he was already being sent out to AA meetings and other treatment centers to recruit people. And I think that’s another danger of this. It’s a system that can take advantage of people who are vulnerable. It’s a system that allows people to continue to hustle, which is a big part of the life of people who struggle with addiction. I say that as one of them. I had to hustle to get what I needed every day. There’s a lot of chaos and being drawn to chaos. And I think that when you allow that hustle, that chaos to continue, you’re putting a roadblock to recovery in place. 

“AJ verified a lot of what I had assumed was happening, like the scale of it. He’s like, ‘You have no idea.'”

HR: How did making this documentary affect you as a person in recovery? At one point you say that you had to put the camera down for a year. 

BF: That was due to a lot of things. It affected me differently than I expected that it would. I wasn’t necessarily concerned about my sobriety in the sense of going back to drinking, or using a substance. And I think maybe part of that was because what I was dealing with was not my substance of choice. Watching people stay sick is really hard, watching people struggle, being present for it, you know, sort of bearing witness to it. That’s tough. And, you know, I want to help those people, but at the same time, I’m well aware that that’s not why I was there. And I think I also naively thought maybe the camera would protect me, like because I was looking through a lens I was removed. But that wasn’t true. I went to a lot of meetings while I was on the road shooting. 

HR: You had an intense relationship with AJ, and he plays an important role in helping you understand how sober homes work. In the documentary his face and voice are disguised and he ended up working as an informant for the FBI. That was scary!   

BF: Our first contact was a phone call. He’s a body broker and he tries to make amends for that. He started as a person who went through recovery and he was speaking at AA meetings and in high schools. He’s a great speaker, and someone saw him and recruited him as a broker. At first, he thought he was helping people get into treatment in a legitimate way. Then he quickly found out it was a scam.

We ended up meeting in public a few weeks later and I didn’t know what this dude was gonna do to me. We chose a street corner in the Boston Commons to meet. and we sat on a brownstone stoop for two hours and he just told me everything. AJ verified a lot of what I had assumed was happening, like the scale of it. He’s like, “You have no idea.”

“I am not advocating for abstinence as the only way. I think medication has been of tremendous use. I think it also has the potential for misuse and manipulation in treatment, because I’ve seen it.”

HR: I thought that Shuffle came down against the use of medication for opioid use disorder. And I think that because of the way people in the film talk about Suboxone—that it’s trading on addiction for another, and if you do take it, you need to get off it at some point. In a way the documentary was saying abstinence is the best way to get “clean.” So I’m wondering how you explain that?

BF: I hear that, and we’ve heard some feedback related to that before. I think the first couple of things I would say is, the film is pretty exclusively based on the experience that I had. It was my experience of this situation and a very specific context. So I didn’t go into this trying to explore harm reduction or Suboxone or medically assisted treatment in any way. In fact, I knew very, very little about any of that. So what is expressed in the film is narrow and through the lens of the experience that I had. So I am not advocating for abstinence as the only way. I found that works for me but I don’t think that that’s the only way. I think medication-assisted treatment has been of tremendous use.

I think it also has the potential for misuse and manipulation when used in treatment, because I’ve seen it. Like with Daniel. He was prescribed Suboxone when he had 90 days clean. He didn’t need the medication. They put him back on Suboxone and then withheld it from him so he would get sick and then relapse. It’s another revenue stream.

I think Suboxone is a tool, and I support the ethical prescribing of any of these medications. We mention Corey at the end of the film. He wanted to get off Suboxone. Corey was someone who didn’t want to have a need for any substance and I think that some people who struggle with addiction feel that way. I know I do.

“When I heard the story of sober homes I was enraged, and I want the documentary to enrage people.”

HR: What are you hoping that the documentary can do? You’ve talked about Shuffle helping to make changes in the drug treatment system. 

BF: I want to make a ton of noise. That’s what I want to do. I’m pissed off. When I heard the story of sober homes I was enraged, and I want the documentary to enrage people. We’re trying to get Shuffle into the hands of all state legislators. In Kentucky, we’ve been working with a state rep there. We’ve gotten it into the hands of people at Gavin Newsome’s office in California. We’re trying to create a conversation across specialties.

The team I work with have put a ton of time and effort into our impact campaign. We want to provide information to folks to help them find safe drug treatment. You can go to our website, Stop The Shuffle. There’s a resources link with questions, some things to keep in mind if you’re looking for help.

We have a financial ecosystem hiding behind what we’re calling treatment and recovery and that needs to be addressed, because the current situation creates a lot of wealth and not a lot of recovery.

Top image courtesy of Shuffle

The post “Shuffle” Exposes the Corrupt, Abusive Sober Homes Industry appeared first on Filter.

The book builds on Walter’s years of in-depth reporting for Reveal, the investigative radio show and podcast, which made her a finalist for a Pulitzer Prize. In American Rehab, she exposed how mandated drug treatment forced hundreds of people to work for corporations for no pay! Her riveting exploration of “work-based rehab” programs showed that there is no such thing; it’s slave labor and wage theft.

In Rehab: An American Scandal, Walter describes a world of “desperate and addicted people who had been lured to rehab with the promise of a cure … only to repeatedly falter and fail inside a system that treated them like dollar signs.”

The book follows four individuals, each vulnerable in their own way to a dysfunctional system. Chris Koon and April Lee are trapped inside brutal treatment programs that offer nothing but work for no pay, punishment or prayer. Larry Ley, a physician who prescribes Suboxone, is harassed by the Drug Enforcement Administration. And Wendy McEntyre is a grieving mom turned uber-activist, whose son died of an overdose in a sober living home.

Koon is a young, white man from Pineville, Louisiana, with opioid use disorder (OUD). A drug court judge offers him rehab at Cenikor or five years in prison. It’s an easy choice, so Koon thinks. Cenikor is a program based on the therapeutic community model that uses confrontation and punishment. Soon, Koon has to sit in the “verbal chair,” as Walter writes, “with arms locked, his knees bent at a 90-degree angle, staring at the wall, not speaking, not making eye contact. Anyone could scream at him and he couldn’t do anything about it.”

Why? Because his shirt was untucked. Koon is soon employed, and forced to do back-breaking, dangerous labor for 80 hours a week. His only compensation is a pack of cigarettes each week! Koon can’t complain, because if he doesn’t complete the program and follow all the rules, he’ll go to prison. Walter’s writing about his harrowing two years at Cenikor reads like a horror novel depicting a violent cult. I feared for Koon’s life until he finally got out.

April Lee is a Black mother of three who lives in Philadelphia on a low income. She becomes homeless on the streets of Kensington, but she is tenacious and motivated to stop using drugs. Walter chronicles how Lee faces down one soul-destroying obstacle after another to get into rehab, belying the prevalent idea that “addicts don’t want treatment.”

When Lee enters a 28-day inpatient program, all her belongings are taken and she isn’t allowed to use her cell phone, mouthwash or razors. She attends 12-step groups. Walter writes:

“Look around,” a teacher said during one of her groups. “Only one out of 100 of y’all are going to make it.” Excuse me? April raised her hand. “That’s bullshit,” she said. How good is your fucking program if only one out of 100 make it? she thought. “It’s like you’re prepping people for failure.” 

Dr. Larry Ley loves to prescribe Suboxone (buprenorphine). He sees how the medication transforms and saves the lives of his patients with OUD in Carmel, Indiana. The DEA does not love his prescribing practices. Ley bristles against patient caps—first it was 30, then raised to 100—and prescribes Suboxone off-label for pain, in order to treat more patients. The DEA sends an undercover agent into his clinic to find evidence that he’s running a “pill mill.” Ley is eventually arrested and goes on trial. 

Vitally, readers will be left with an understanding of how drug treatment fails people with addiction—not the other way around.

Walter explains in granular detail how the DEA at every turn makes the prescribing of Suboxone a bureaucratic nightmare. How doctors’ fear of losing their license means many refuse to prescribe it, and how patients pay the price with their lives. This section made me so mad that my margin notes read, Fuck the DEA!

If you own a sober living home, watch out for Wendy McEntyre—she could be coming after you. The overdose death of her son Jarrod, 20, at Safe House in Van Nuys, California, triggered her years of investigation into these facilities. Walter explains how McEntyre discovered, “Safe House was part of a growing industry of sober-living homes … Anybody could buy or rent a property, and then stick three or more people into a bedroom at $600 a month each. There were virtually no regulations or oversight … clearly, it was a moneymaker.”      

Rehab is a must-read whistle-blower, demonstrating how many rehabs and sober living homes in the United States offer punishment for profit, not treatment. Vitally, readers will be left with empathy, and an understanding of how drug treatment fails people with addiction—not the other way around. 

Filter’s interview with Shoshana Walter has been edited for length and clarity.

Helen Redmond: What shocked you the most as you did the reporting to write this book?

Shoshana Walter: I’m an investigative reporter and I’ve been doing this kind of reporting for many years now, but I’m also an optimist. But I’m still shocked when I discover that people are being mistreated. It’s horrible. I think the other thing that I was shocked by is reading these studies that show that someone who completes a 30-day treatment program is much more likely to overdose and die in the year following treatment than someone who failed to complete a program. It’s even worse for people who are formerly incarcerated.

It really shocked me because that is by and large how we’re treating addiction in the United States, with these short-term bursts of treatment that are actually placing people at higher risk of relapse and death. It’s just not working.

HR: Can you explain the difference between a rehab facility and a sober living home?

SW: A rehab is where someone goes to get treatment for their addiction and related services. It might include therapy or detox where they might receive medications to help with the withdrawal symptoms. It might include group therapy sessions, coursework, often based on the 12 Steps. A person learns the skills they need in order to enter recovery. And then a sober living home is a place where the person goes to live, ideally among other sober people, where they learn to use those skills that they have learned in rehab.

Rehabs tend to be licensed by the state and have staff who have been certified or qualified to provide services. In sober living homes there’s no oversight or regulation. There could be some programming, church services, Bible study or vocational training, which in many cases, involves uncompensated work by the participants.

“The DEA called Larry the ‘Pablo Escobar of Suboxone.’ All his patients were suddenly cut off. Some died. Larry went to trial and was acquitted.”

HR:  In your book you talk a lot about buprenorphine. Can you explain the politics and the problems people experience in accessing the medication?

SW: France was experiencing a heroin epidemic and the country made Suboxone as widely accessible as possible, and that had significant results. Overdose deaths declined by more than 79 percent over four years. When the United States was considering making Suboxone available, the conversation was totally different. There was a lot of interest among certain lawmakers, particularly Senator Joe Biden. He referred to the medication as a cure. The interest among lawmakers was in finding a magic pill that will just end the problem.

When lawmakers were considering making this treatment available they had to pass legislation, and there was a huge amount of resistance from the methadone industry and from the Drug Enforcement Administration. The DEA was concerned about the drug being diverted or misused and sold on the black market. The legislation that ended up getting passed significantly restricted access to buprenorphine. Doctors had to get special training, apply for permission, and they were limited to 30 patients. And then, once they did all these things, they were subject to surveillance by the DEA. When Suboxone first came out in the United States, you had this perfect storm of scarcity caused by patient limits and law enforcement oversight.

Dr. Larry Ley, one of the characters in my book, was one of the earliest Suboxone prescribers. He had a history with alcohol addiction. Larry was one of the first doctors to get that special permission to prescribe Suboxone. He was an interesting, nuanced person. Larry passed away a couple years ago, so unfortunately, he wasn’t able to see this book come to print. He wanted to help people. He saw that there was this tremendous unmet need for addiction treatment for people struggling with opioid addiction. There were so many people banging down his door to get this medication, and he found a loophole to prescribe more medication to people than was technically, legally allowed under the law. 

That drew the scrutiny of local law enforcement and the DEA. At that point, the DEA was doing regular, routine inspections of Suboxone prescribers and that led to a criminal investigation and eventually the DEA raided all of his clinics, shut them down, and arrested Larry and his entire staff. They had a press conference where they called Larry the “Pablo Escobar of Suboxone.” All his patients were suddenly cut off from their medication. Many of them couldn’t find alternate prescribers and many of them relapsed. Some of them died. Larry went to trial and he was acquitted.

“She’d poke her head into his room after a long day at work and say, ‘How are you?’ He’d say, ‘Fine.’ Then she’d mark that off as a counseling session.”

HR: Cenikor exploits people experiencing addiction. Can you talk about how the program operates, and Chris Koon’s experience?

SW: When Chris went into the program, he learned it would be for two years and there was counseling and medical care available. He’d be able to live and work there and save up money for after he left. And then, soon after he arrived, he discovered that actually the vast majority of his time would be spent working, sometimes up to 80 hours per week. And really, really tough, excruciating manual labor like laying asphalt in the broiling Louisiana heat, building scaffolding at chemical plants, cleaning up after LSU football games. And he wasn’t going to get paid for this work, except for a pack of cigarettes per week.

There were hardly any counselors on staff for the number of people who were at the facility. There was barely time for him to attend counseling because he was working so many hours. I remember speaking with his counselor at the time, and she told me she would poke her head into his room after a long day at work and say, “How are you?”

He’d say, “Fine.” And then she’d mark that off as a counseling session. That was called treatment. 

HR: It really scared me when I read about how Chris was treated. I thought: Oh my God, he’s going into a cult and he can’t get out! He’s court-mandated, and if he leaves he’ll go to prison, and that makes him extremely vulnerable to all kinds of abuse.

SW: What you’re describing is also one of the most chilling aspects of this for me, too. Chris felt like he was a fuck-up. Then he comes into this program that is really designed to just break people down to their very essence and then build them back up into model citizens. But the building back up just was not happening for most people, and for Chris. These practices designed to break him down really gave him this feeling of complete worthlessness, like he had no future, he had no power, no sense of control.

That made it much easier to exploit Chris for unpaid labor. He was totally at the mercy of this program. I’ve learned about treatment and recovery, and there is one essential element for recovery and that is for people to feel a sense of self-efficacy, that they have the power and control to make changes in their lives and the confidence to execute those changes and envision a future for themselves. And I think that is one of the most disturbing things to me in learning Chris’s story.

“April just wanted to stop using and to be there for her children, and she was just stymied in so many different ways.”

HR: It was infuriating and heartbreaking to read about April Lee’s many attempts to get treatment.

SW: April experienced a lot of childhood trauma and ended up developing an addiction. She had three children and was taking care of them when she was sexually assaulted. April could have attended therapy at that time or gone into treatment, but she faced the predicament that so many single mothers face—which is that she has three children who are counting on her, she is their sole means of financial support and she couldn’t just take time off from doing that. Who would take care of her kids? There are few drug treatment programs that accept women with children.

So for various reasons she was unable to enter treatment at that time, and things just got worse. Child Protective Services came and took April’s children away, and then her addiction just escalated. She gave up after her children were removed, and ended up homeless on the streets of Kensington.

The only way that April could find to stop herself from using was to get arrested. So that’s what she did. She got taken to jail, and then from there she begged to be placed in a treatment program. By a stroke of luck, a person at the jail that she talked to heard of a program that might have room for her, and she jumped at the chance and made her way there. And it was just an incredible uphill battle for April every step of the way. She just wanted to stop using and to be there for her children, and she was just stymied in so many different ways.

This is one of the bigger takeaways that I had when reporting this book. I thought that I was writing a book about our addiction treatment system. But ultimately, what I found is that it’s often what happens after treatment or surrounding treatment that is more important than the treatment itself. For example, if April had child care, that would have allowed her to attend treatment and her addiction might not have escalated in the way that it did.

I learned while reporting this book about a concept called recovery capital. It’s a mixture of external and internal resources that people need in order to enter and sustain recovery. That could include community support and social networks, housing and financial security, transportation, a job, food, all the basics that everyone needs in life in order to survive. And I think this is where structural inequality just places people like April at a huge disadvantage, because she went into treatment lacking a lot of these basic necessities, and then once she entered the most serious phase of her addiction, she lost even more.

I think the longer someone remains in their addiction, the less recovery capital they have and the harder it is to accrue it. And so the punishment and marginalization that accompanies addiction can become almost as much of an obstacle to recovery as the addiction itself. And I think that is something April faced again and again, and it’s why it made it so much harder for her to enter recovery.

Top image shows detail from the cover of Rehab: An American Scandal, published August 2025 by Simon & Schuster. Photographs used with permission.

The post Blowing the Lid Off the Scandal of US Rehab appeared first on Filter.

Between 2012 and 2020 I went through 17 psychiatric and substance use disorder inpatient programs, and at none of them was I ever safe.

In 2013, I had to define “transgender” and “gender dysphoria” to providers at one of Philadelphia’s mental health crisis response centers. I even learned later that they’d classified me as at higher risk for suicide not because I was trans, but because I was “male.”

She said I’d be housed with women, but upon arrival I learned that I would be housed with men.

After that, I was sent to a hospital that was purportedly LGBTQ+ friendly. The Human Rights Campaign had given it a high score on its Healthcare Equality Index. During intake they asked to see my genitalia. I was immediately isolated into a room by myself, with no roommate. Other patients were allowed to walk around the halls, to mingle and make friends, but I wasn’t allowed to leave my room or interact with anyone else for more than a few moments at a time. When I asked why these rules were in place for me and no one else, they wouldn’t give a straight answer.

They brought in Alcoholics Anonymous members to talk to us about recovery. Which is not inherently a problem of course, but it was the same people every time, at every meeting for the two weeks I was there. They wanted to address me separately from the group. They would talk at length about how God could solve my “problem”—not my alcohol or opioid use, but my gender identity. They asked me to stop my hormone-replacement therapy. They asked me to pray to God to “restore me to manhood.” They said that’s what would help with my other problems.

After I was released, I went to their AA intergroup and told them about my experience, but they ignored me. I didn’t go to any 12-step meetings for a while after that.

Behavioral health patients have the right to receive treatment in the least restrictive setting necessary, as well as to not be subjected to harsh or unusual treatment. Trans patients should have access to private rooms if they’re concerned about their safety, but they shouldn’t be forced into them or cut off from social settings without reason. 

When I expressed that I needed to be in women’s housing in order to stay, they said I would need to arrange my own transportation to get home.

A few months later I was trying to get into recovery housing. A caseworker who worked with LGBTQ+ populations referred me to an organization that owns several recovery houses in the Philadelphia area. They asked about whether I’d had surgery. They asked whether I masturbated, and how often, and by which method. I decided not to stay there.

In 2017, an outpatient program counselor recommended I try a luxury rehab that’s since closed. She said I’d be housed with women, but upon arrival I learned that I would be housed with men. Despite all the legal paperwork clearly documenting my gender identity, and medical paperwork clearly documenting my gender dysphoria and treatment history, the facility staff never mentioned anything about housing me with men until I got there. When I expressed that I needed to be in women’s housing in order to stay, they said I would need to arrange my own transportation to get home. I saw a patient who was discharged for bringing drugs into the facility still get offered their car service to get home.

So I had to stay. I was there for the full 28 days. Male patients made lewd comments and asked me for sexual favors. One tried to enter my room; another tried to enter the bathroom where I was showering. Fortunately both were locked. After I aired this out during a group meeting, the women unanimously asked for me to be housed with them, a request they made several times. Nothing was ever done.

I’ve had some positive experiences, but trans people are basically left to try to recover on our own.

As we neared the end of our stays and our counselors prepared to transfer us to recovery housing, the facilities they contacted would only house trans residents according to gender assigned at birth. My counselor made it clear she wasn’t going to help, so I refused to go and said I just wanted to go directly home. She berated me in public.

Monikers like “LGBT-affirming facilities” don’t really mean anything. In 2025, there are still very few trans-supportive facilities and even fewer dedicated to trans patients specifically. I’ve had some positive experiences, like the clinic where my buprenorphine provider made sure no one harassed me, but those have been few and far between. We’re basically left to try to recover on our own. I’ve been working on compiling a list of clinics, rehabs and recovery housing groups that are supportive, but it’s slow going to confirm things.

Like prisons and jails, recovery spaces house trans people according to their gender assigned at birth, with no regard for their safety. Trans women frequently receive the worst treatment, at the hands of people who view us as men. Any behavioral health facility that denies someone’s gender identity is incapable of providing them the equitable treatment they need to recover.

I’ve been fortunate to know many cis allies who’ve stepped up when I needed them. Whether or not they were actually able to help me, when they called out transphobia during meetings, or to their providers, they were still being agents of change. Recovery facilities serve so many people who already face medical stigma—queer people, disabled people, people of color—which is compounded by the stigma of being associated with drugs. If trans people are liberated in this field, if we can safely and freely access drug treatment and recovery housing, it will free all people who need these services.

Image via New York City Health and Hospitals Corporation

The post The Systemic Transphobia of the Drug Treatment and Recovery Industry appeared first on Filter.

The Salvation Army has a troubling history of denying treatment at its rehabilitation centers to anyone taking medication for opioid use disorder (MOUD). “This is an access case,” Lucy Bansal, counsel at Justice Catalyst Law, told Filter. “People with opioid use disorder who receive [MOUD] shouldn’t have fewer options available to them for rehabilitation than people who don’t.”

In addition to urging the Salvation Army to reverse its exclusionary policy, the lawsuit also asks the organization to compensate Tassinari and thousands others who have been denied a spot at its rehab facilities for taking MOUD, or denied their medication while they were there, the Boston Globe reported. According to state data, opioid-involved overdose fatalities increased by 5 percent in Massachusetts last year.

“Because of the Salvation Army’s close relationship with the prison and probation system, a simple policy change could potentially save thousands of lives.”

The Salvation Army serves thousands of formerly incarcerated people in its Adult Rehabilitation Centers and Programs each year. For many of them, it’s their only option—in some regions, Salvation Army ARCs might be the only rehabs available. 

“Because of the Salvation Army’s close relationship with the prison and probation system, a simple policy change—ending [MOUD] discrimination—could potentially save thousands of lives and make a significant, lasting impact on re-entry outcomes,” Bansal said.

The exclusionary practice makes it even more difficult for LGBTQ drug users to access services. The Salvation Army has a documented history of discrimination against queer and trans people—its affiliated drug clinic has blatantly refused trans people as patients or tenants. Even longtime corporate cheerleader Chick-fil-A has been pressured into pulling its donations to the organization. 

“I remember being locked up and we would all joke about the Salvation Army,” Michael Cox, executive director of Black and Pink Massachusetts, told Filter.

Cox said that the organization can be a last resort for those in dire need of support for housing or medical care, even if they’re LGBTQ. “We’re looking at disproportionate rates of homelessness, substance use and incarceration [in our community] that is usually coupled with release [from prison] at some point,” he explained. “All of these pathways lead to needing services that the Salvation Army provides.”

Multiple community-based organizations do serve LGBTQ populations in some parts of the state, including people impacted by incarceration and addiction. Whose Corner Is It Anyway is a western Massachusetts mutual aid and harm reduction group led by low-income sex workers who use criminalized drugs, led by the same current and former sex workers who also run the DecrimMA coalition alongside Black and Pink Massachusetts. Other prominent organizations serving people impacted by the state’s carceral system include Justice 4 Housing, Families for Justice as Healing and Massachusetts Bail Fund.

Recently, the Salvation Army has been attempting to redeem itself by claiming to “love and serve everyone.” But how inclusive can it really be if it rejects people for accessing evidence-based medical treatments like MOUD?

“[The Salvation Army] has the capacity to offer services and volume that a lot of [community organizations] don’t offer,” Cox added. “They have the potential to polish what could be a diamond in the community, but instead, they just fall back on this antiquated thinking that causes more harm.”

Photograph via Salvation Army

The post Salvation Army Faces Lawsuit for Bupe Discrimination in Its Rehabs appeared first on Filter.

As SanPa recounts, what began as a small, family-run farm soon grew into a self-contained town. It housed businesses, homes, a canteen and a hospital. Such growth was made possible by huge donations, but also by the unpaid labor of its scores of young drug users—many of whom tried to escape, only to be thwarted by community security.

In 1984 there were 500 guests; by 1986, 800. Within a few years of its foundation, Italian celebrities began to send their drug-using children to Muccioli’s community, rapidly increasing its popularity. 

Muccioli was a farmer and dog rancher with a passion for parapsychology, spiritualism, séances and natural medicine. He claimed to be a medium, and the reincarnation of Jesus Christ. 

In the ’70s and ’80s, Muccioli was beloved by ordinary Italians, who believed he was the only answer to rising rates of drug use and fatal overdose. His legacy later came under fire as brutal, unscientific and based on human exploitation.

A Legacy of Abuse

Muccioli used to refer to the community “an enlarged family,” said Paulo Severi, who stayed in San Patrignano from 1992 until 1996, when he was forced to leave after being convicted for a minor crime he had committed before entering. The scores of young drug users who populated San Patrignano were referred to as “guests” —though not all of them stayed willingly.

As early as 1983, five years after its inception, San Patrignano was rocked by the so-called “Chains Trial.” Muccioli was accused of kidnapping and mistreatment for having physically chained young people in the community as they went through substance withdrawal. Muccioli was eventually acquitted in 1990, but evidence mounted that the Chains Trial illuminated a cruel practice that had been implemented repeatedly, rather than just in that single case.

“The Chains Trial changed many things in San Patrignano,” Severi told Filter. “In 1993, one year after the moment I entered, physical violence had almost disappeared because the community was under the watchful eye of the national press 24/7.”

“Psychological violence, such as public punishments, were ordinary routine. I suffered them a lot.”

Yet it still persisted, as did psychological abuse. “I remember a girl and a boy being beaten [for] different silly reasons,” Severi said. “The boy, for example, was physically punished for using the toilet for an excessively long time. Episodes of psychological violence, such as public punishments, were ordinary routine, and I suffered them a lot. It was often subtle and underhand violence … because the Maranzano case was booming.” 

In 1989, community guest Roberto Maranzano was found dead near Naples, wrapped in a San Patrignano blanket. He had been reported missing after running away from the community. An autopsy showed that he had been beaten to death. In 1993, an audio tape emerged revealing that Muccioli had been aware of the crime from the beginning and had failed to notify police.

In the tape, Muccioli can be heard referring to another guest of the community who was threatening to reveal the facts, saying, “It would take an overdose … two grams of heroin and some strychnine … you have to operate with surgeon’s gloves. Or you’d have to shoot him with a dirty gun.”

The case raised a huge media interest in Muccioli and San Patrignano in 1993, and prompted other guests to report beatings and violence. During the trial, a former San Patrignano employee told the police that for years he had been in charge of finding and beating those who escaped from the community. As SanPa shows, mysterious suicides that took place during solitary confinement began to come to light. 

In 1994, Muccioli was sentenced to eight months imprisonment for aiding and abetting in Maranzano’s death. Maranzano’s son Giuseppe said, “My father was killed in the place that was supposed to save him.”

Powerful Connections

During Severi’s time there, San Patrignano was at the height of its notoriety in the media. “It was a big village, with more than 2,000 [drug users] who were employed for free in many different activities such as the laboratory, the butcher’s shop and the stable. At the head of the village was the guru, King Muccioli, who was revered by everyone.”

“Muccioli was ahead of his time,” Severi said. “He was already making a simple argument: ‘You’re a shitty junkie who has to be isolated, and you gotta thank those who give you even the smallest thing.’”

San Patrignano guests “had everything taken away from them,” he continued. “There was an iron discipline. Whoever made a mistake was shamed in public … Muccioli’s approach tended to replace dependence on drugs with dependence on the leader and his community.”

“There was this bizarre idea that people could be rehabilitated simply by having them work from morning to night.”

Muccioli and San Patrignano were very close to many famous and powerful people—actors, politicians, singers, journalists. Throughout Italy, Muccioli was seen as the only player capable of tackling the problem of drug addiction, which in those years was dramatically rising. “Politicians of all stripes visited San Patrignano in search of votes,” journalist Stefano Trasatti, who has covered the Italian drugs, addiction and harm reduction field, told Filter.

Getting into San Patrignano was no easy feat for those without wealthy or celebrity connections. “You had to stand for days or weeks in front of the entrance gate in order to aspire to have introductory interviews with Muccioli and some of his collaborators,” Severi recalled. “One exception was trying your luck on Christmas night, because on that occasion Muccioli made a concession in front of the cameras and let in whoever was at the door.”

But “rehabilitation”—if it can be called that, given that Muccioli rejected evidence-based treatment protocols—was free for all participants.

“There was this bizarre idea that people could be rehabilitated simply by having them work from morning to night, in this kind of ‘city’ divided by production sectors,” Severi said. “They called it ‘The City Effect.’ But the city was basically a fake place where people could sleep, work, eat and repeat for free.”

“Individuals weren’t as important as the group. Letting individuals down when they were opposing the community’s society was okay with Muccioli. That’s why violence was a part of their toolbox.”

Lasting Harm

“San Patrignano was a community built around Muccioli, who was some sort of guru,” Trasatti said. “His figure fueled the typical Italian need for a strong man in charge. In television debates, and even during the trials, people were crazy about him and organized protests in his favor.”

In Italy, as in many parts of the world, the main narrative of drug use revolves exclusively around crime and overdose. “Nobody cared about Muccioli’s methods, nor the rights of [people who use drugs],” Trasatti said. “They needed someone who was willing to … get them out of people’s sight, segregate them somewhere far away.”

Today, drugs in Italy are regulated by a law called Iervolino-Vassalli. According to that law, penalties for people charged with possession of drugs involve extended incarceration. As a result, one-third of the 60,000 people incarcerated in Italy are held on drug-related charges.

According to Trasatti, “San Patrignano explicitly produced the Iervolino-Vassalli of 1990”—so much so that the law is sometimes called Iervolino-Muccioli. The resulting cultural mindset was that people who use drugs deserve punishment, for no other reason than that they use drugs. 

There are very few studies on the impact that Muccioli’s and San Patrignano’s methods had on the health of the guests. The best known of these found that 90 percent of the guests found a stable job after their experience in rehab. “The problem is that the sample they used was very small and, in any case, carefully selected by the community itself,” Trasatti said.

“Certainly in San Patrignano some people were saved,” Severi said. “But I believe that they were saved not thanks to San Patrignano, but in spite of it.”

Photograph via Netflix/YouTube

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