“Dying to Be Free,” Jason Cherkis‘ long-promised story about drug treatment and addiction, appeared in the Huffington Post on January 28. The piece, some 20,000 or so words long (who counts after 19,000?) had been in the works for more than a year. And yet its impact–its thesis is that a promising chemical treatment for heroin addiction was being supressed by a rehabilitation structure built on 12-step programs–threatened to be overwhelmed by a report that Editor-in-Chief Arianna Huffington had held it up because she “objected to the portrayal of 12-step programs in the piece.”
Cherkis and Ryan Grim, HuffPost‘s Washington bureau chief, say Huffington’s hands-on-edness helped a lot, in fact. “All the editing that went into the piece was to its benefit,” Cherkis says by phone. The process “definitely made it a stronger piece,” Grim says. (N.B.: I’ve worked with both Cherkis and Grim.)
Cherkis began reporting the story in October 2013. Originally he thought it would be about the resurgence of heroin use in Kentucky, where he’d previously reported stories about Obamacare and the state’s 2014 U.S. Senate race. The Lexington County coroner “was sort of taken aback by what was going on in his county,” Cherkis said. He sent the reporter all the certificates for heroin-related deaths in his jurisdiction for 2013, and Cherkis went to work contacting families of victims.
In February he turned in a story about the culture of heroin in the region, but he and his editors got tripped up by the need for an explanation about why so many people had failed drug treatment. “I couldn’t figure out the reason,” he says. “It’s one of those paragraphs you need in a story that’s short and gets at the problem and then moves on.”
Philip Seymour Hoffman had just died, triggering a brief national conversation about how damn hard it is to beat addiction. Grim, Cherkis says, decided that was actually about treatment. “I said, OK, if we’re going to do this story, I’m going to have to learn about drug treatment,” Cherkis says. “I was pretty green.” He read about the history of 12-step treatment and Bill Wilson, the founder of Alcoholics Anonymous. “I felt like some of the criticisms of AA that I had read were kind of cheap,” he says. Still, he found most of the treatment directors he encountered were “steeped in that philosophy” and were reflexively opposed to using chemical treatments.
And much of the residential drug treatment Cherkis saw, he reports in the piece, used AA’s foundational text “not as a spiritual guide but as a mandatory text — contradicting AA’s voluntary essence.” Wilson, he writes, “intended AA to work with, not against or instead of, the latest and best medical science to treat addiction.”
Cherkis spent time in New York with Rockefeller University professor Dr. Mary Jeanne Kreek, who told him that “more than 90 percent of opiate addicts in abstinence-based treatment return to opiate abuse within one year.” Some drug-addicted people he interviewed said they preferred to go to AA rather than to Narcotics Anonymous, because “they didn’t hear the war stories about heroin, which made them feel uncomfortable — they felt like it could be a potential trigger for them.”
He traveled to Kentucky twice, to New York once, and to a methadone clinic in Baltimore for a section of the story he ultimately cut. (That reporting will probably become part of another piece, Grim says.) He accompanied Jim Cagey and Anne Cagey to a facility called Recovery Works, where they tried to get their dead son Patrick’s medical records and “was promptly thrown out.” He gave Jim Cagey his tape recorder to record the meeting “in the most obvious manner possible,” he says. “It was so pathetic.”
The facility staff was under orders to escort Cherkis off its campus, and he had to explain to security that the Cageys had driven him to its location in “the middle of nowhere.” They reluctantly let him serve his exile in the parking lot.
The in-person reporting added important texture to “Dying to Be Free,” but a lot of what makes it worth the time it takes to read is the detailed histories of people who died after abstinence-based rehab failed. Cherkis assembled those document by document, getting records from Kentucky and neighboring states, hitting up courts, coroners, and treatment facilities. And making many phone calls to families, through which he says he was able to identify another problem he didn’t know about: People overdosing after leaving jail.
“There were so many cases of kids that had left jail and then died within days or weeks,” he says. “If there was a system set up to have the highest rate of relapse and the highest rate of overdose deaths this was it.” People who OD’d have to get on a waiting list for treatment after detox, and often, he says, “They just died on a waiting list.”
One woman named Brianna Ballard, he notes, was arrested after she overdosed in 2011. She received no treatment in jail and OD’d three days after she was released in 2013.
Once he’d gathered enough material, Cherkis started writing and, he says, fact-checking and adding material as it moved through the edit process. “The questions that Arianna asked were vital questions that really needed to be answered,” he says. One issue she raised: “diversion” of the drug, Suboxone, to a black market for addicts who can’t get it any other way.
Grim wrote a 2010 book about drug use, This Is Your Country on Drugs: The Secret History of Getting High in America, but it didn’t have much on treatment, he says, “so much of this was new to me.” But while reporting it he met Time journalist Maia Szalavitz, who he says was an excellent resource. “I also think having written the book I was less susceptible to the kinds of bogus arguments that trip up much of drug reporting–the confident assertions of judges or law enforcement that turn out to be nothing more than superstition.”
Cherkis’s story got a lot of traffic from social media, the most for any reported story in HuffPost‘s politics section for two weeks in a row, Grim says. And a week after the story appeared, US drug czar Michael Botticelli announced that drug courts that ban medication-assisted treatments will be ineligible for federal dollars. Botticelli cited Cherkis’s story on a call making the announcement.
Cherkis says they got “dozens and dozens of emails” from people who were either going through addiction and recovery or their families after the story ran. He’s working on some follow-ups. “I’m going through those stories and reaching out to some of those people,” he says.