Monopolies, Self-Referral and Shell Games: The Need for Antitrust Investigation of Physician Health Programs and their “PHP-Approved” Assessment and Treatment Centers

Screen Shot 2015-03-06 at 4.38.05 AMThree shells and a pea–ASAM, FSPHP, and LMD.

“PHP-Approved” Assessment and Treatment Centers

On the above list  can be found the Medical Directors of a number of drug and alcohol rehabilitation facilities.

Talbott, Marworth, Hazelden, Promises, and another two-dozen or so “PHP-approved”  assessment and treatment centers are represented on this list.    State Physician Health Programs (PHPs) refer doctors to these facilities for evaluations.  PHPs are non-profit tax-exempt organizations.  They do not evaluate or treat patients.   If a physician is referred to a PHP for a suspected problem the assessment must be done at an outside facility which will invariably be linked to a name on the list of Like-Minded Docs.

What most people do not know, however, is that this is an exclusive arrangement.    Evaluations are constrained to one of these facilities.   It is mandated.   No bargaining.  No compromises. No choice.  In other words it is a coercion.

“What’s wrong with that?” one might ask.   These facilities are all recognized as top-drawer and first-class.  Perhaps they were hand-picked on objective criteria and the PHPs are just making sure that doctors get the best assessments money can buy– decision making by experts based on knowledge and experience–picking a winner so you don’t have to.

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No documented Policy for Selecting Treatment Centers.  Criteria for “PHP-Approval” Unknown by those “Approving”

What objective criteria are used in selecting “PHP-approved” assessment and treatment centers?    According to a  Performance Audit of the North Carolina Physicians Health Program done by State Auditor Beth A. Wood that’s a good question.

The North Carolina State  Audit specifically noted the predominant use of out-of-state treatment centers.   In addition to “creating an undue burden on” those being evaluated the audit states that:

 “Program procedures did not ensure that physicians received quality evaluations and treatment because the Program had no documented criteria for selecting treatment centers and did not adequately monitor them”

In fact the audit found no documented policy for selecting treatment centers.  The very organizations demanding documentation of policy for approval and charged with approving the treatment centers could not even give a comprehensible, plausible or even simple explanation for what any of  these things even mean.    

Screen Shot 2014-05-07 at 5.38.23 PMThe auditor also noted this lack of concrete criteria goes against both The Federation of State Physician Health Programs (FSPHP) and the Federation of State Medical Boards (FSMB) requirements that physician health programs use established guidelines to select evaluation providers and treatment centers.

In its “Physician Health Program Guidelines,” the FSPHP established: • “Characteristics of Evaluation Providers Appropriate for PHP referrals,” and • “Characteristics of Treatment Programs which are appropriate for PHP referrals.”  And in its “Policy on Physician Impairment,” the FSMB states : • “PHPs should employ FSPHP Guidelines in selecting the providers/facilities to provide treatment of physicians with addictive and/or psychiatric illness.”

When the NC PHP was asked to define these characteristics they explained that they learned  of “new treatment centers through professional networks and other informal sources” and used the “treatment centers’ reputation as a basis for establishing a referral relationship.”      Staff credentials, quality of care, treatment methods and modalities, patient choice, follow-up data, outcomes and other objective information apparently took a back-seat to what appears to be ill-defined and subjective word-on-the-street.   Screen Shot 2014-03-15 at 7.33.14 PM

This  “failure to use FSPHP  recommended criteria to select treatment centers,” the Audit concluded “could cause the Program to enter into referral arrangements with service providers that do not meet quality standards”

Ironically the  NC PHP failed to follow guidelines they themselves introduced and demanded be followed.  They could produce no documentary evidence these criteria even exist or even provide plausible criteria.   “Professional networks”, “reputation” and other informal sources are fine for some choices.  That’s how I picked out my first skateboard.

Resources such as these can play in important role in choosing a shirt, buying new sneakers or even purchasing a car but they do not constitute selection criteria for an assessment in which the consequences and recommendations made for the person being assessed are significant, potentially life-altering and possibly permanent!

And to top it all off the  Medical Director of the North Carolina PHP,  Dr. Warren Pendergast,  was the  President of the national organization for state PHPs, the Federation of State Physician Health Programs (FSPHP) at the time of the audit!

PHPs are not clinical providers but monitoring agencies.  They meet with, assess and refer doctors for evaluations and then monitor doctors through drug and alcohol testing and periodic reports of supervisors, co-workers and others.        As such the PHP is tasked with just two jobs-referring doctors for evaluation and then monitoring them after they have been evaluated in a contractual agreement.  The fact that the state PHP 0r FSPHP could not produce the facts and reasoning  behind the mechanics and mentality of the very reason for which they exist is incomprehensible.  It is, in fact, ludicrous beyond belief.    The President of the FSPHP being unable to define the selection criteria for approved and mandated facilities is like Anthony Bourdain being unable to explain the ingredients of an omelette.

To summarize, doctors in North Carolina were being forced by the PHP  to have evaluations at “PHP-approved” assessment and treatment centers but the PHP was unable to explain anything substantive in defining any of it.  Why?  Because no qualitative objective selection criteria exist.

“Reputation” obfuscates and confuses.  It does nothing to support or justify.    It is like answering “numbers” to the question “what is 9 x 9?”

And this is especially concerning when it is realized that these evaluations are limited to facilities and people  tied financially and ideologically to the groups and individuals who are mandating the referral.

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All of the “PHP-approved” assessment centers are represented by medical directors who belong to “Like-minded docs”-an admittedly  12-step steeped conservative fundamentalist faction of the American Society of Addiction Medicine (ASAM).   And all of these facilities are private-pay rehabilitation centers that recommend doctors be treated three-times longer than the rest of the population–another medical “urban legend” that should have been debunked from the get-go.

Limiting assessment and recommendations to this close-knit  group of evaluators is a monopoly of force.  It is unethical if not criminal. And the fact that these are all heavily indoctrinated 12-step facilities also makes it a violation of the Establishment Clause of the 1st Amendment.  Moreover,  many of the medical directors at these facilities are also graduates of the same program in “recovery.”

And if it is looked at from this vantage point it is a system of  self-referral.  Self-referral harms patients and society as a whole.

It is a shell game that removes all choice and removes freedom, objectivity, fundamental fairness, autonomy and choice.

Antitrust law

American antitrust law was “designed to be a comprehensive charter of economic liberty aimed at preserving  free and unfettered competition as the mule of trade. It rests on the premise that the unrestrained interaction of competitive forces will yield the best allocation of our economic resources, the lowest prices, the highest quality and the greatest material progress, while at the same time providing an environment conducive to the preservation of our democratic political and social institutions” (29, p 4).

In this case it is a safe assumption that all doctors desire the “best possible” care and this requires objective and unbiased assessment and treatment when requested by Physician Health Programs.

Congress and the Supreme Court have made clear is that the “best” services are selected by  consumers when their choice is made in an open market free of restraints. Eventually the marketplace will determine the best medical care, not judges, juries, or even doctors (30, p 904).

PHPs are clearly bypassing patient choice.  In 2011 the American Society of Addiction Medicine (ASAM) issued a Public Policy Statement on coordination between PHPs, regulatory agencies, and treatment providers recommending  that  only “PHP approved” treatment centers be used in the assessment and treatment of doctors.  The state Medical Boards have accepted and adopted this policy and denying doctors requests for assessments at non “PHP-approved” facilities. Many have been sanctioned for resisting, protesting or even questioning this unlawful monopoly.  It is prohibition of patient choice.

The N.C. PHP is representative of most PHPs. This is not an exception but a rule.      PHPs are mandating assessments only at facilities they approve but cannot define or explain how these facilities are “approved”  Yet The ideological and financial conflicts of interest between the PHPs and their referral centers are self-evident.  Connect the dots.  

State medical boards are enforcing this mandate under threat of loss of licensure.   Your money or your life.

Federal Trade Commission

For these reasons an investigation by the Federal Trade Commission and Office of the Inspector General of the DHHS is necessary.  For those who have been abused by this unholy alliance I urge you to look at this list to see if the medical director of the facility at which you were evaluated is represented.

If so note it here.   My guess is almost everyone will find this correlation and representation in numbers would necessitate both state and Federal investigation.  If this were done it  could quickly transform a system of institutional injustice into one that allows choice.

Applying Antitrust law to the linkage of  PHPs  and “PHP approved” assessment and treatment centers is consistent with free-market law and theory.   Demanding accountability would provide a powerful deterrent to this type of unfettered abuse.

1. Northern Pacific Railway v U.S., 356 US I (1958).

.2.  Koefoot v American College of Surgeons. 652 F Supp 882 (ND Ill 1986).



The Plan to introduce non-FDA approved drug and alcohol tests into the Healthcare system and require doctors drug-test ALL PATIENTs including students and kids!


The Plan to introduce non-FDA approved Laboratory Developed Tests (LDTs) into the Healthcare system and require doctors drug-test ALL PATIENTs including students and kids!

The ASAM plans to introduce non-FDA approved “forensic”  Laboratory Developed Tests (LDTs) into mainstream healthcare via a loophole.    This same group introduced most of these tests through a loophole and now they want to drug-and alcohol TEST EVERYBODY including STUDENTS AND KIDS through another loophole!   These tests are of unknown reliability and accuracy.  The LDT pathway does not even require proof that the test is even valid  (i.e. that the test is actually testing for the substance it claims to be testing) but with no FDA oversight or regulation the labs can claim anything they want in marketing it and they do.

If a doctor collects a test on a “patient”  the test is rendered “clinical” rather than “forensic” and by deeming this drug-testing  “clinical” rather than “forensic”  they can then call the consequences of a positive test “treatment” rather than “punishment.  ” It is via this loophole they plan to introduce and unleash the panoply of junk-science tests currently being used on other groups who have no say in the matter (probationers, parolees, private professional monitoring groups, etc. ) onto the general population at large.    A boon for the Drug and Alcohol Testing Industry Association and the assessment and treatment industry but a bane to the rest of society.    And to prevent this from happening more people need to be talking about this.

Disrupted Physician 101.5: The American Society of Addiction Medicine (ASAM) uses (or misuses) Alcoholics Anonymous (AA)


 The goal of the ASAM has always been to get the medical establishment to accept 12-step spiritual recovery.

AMSA evolved into the ASAM

AMSA evolved into the ASAM

According to the American Society of Addiction Medicine The ASAM Principles of Addiction Medicine is the “go-to textbook in the specialty of addiction medicine” and:

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The 4th Edition of The ASAM Principles of Addiction Medicine contains an entire section entitled “Mutual Help, Twelve Step, and Other Recovery Programs” containing three chapters entitled “Twelve Step Programs in Recovery,”1 “Recent Research into Twelve Step Programs”2 and “Spirituality in the Recovery Process.”3

Despite the all-encompassing title of this 31-page section (pages 911-942) no “other recovery programs” are described. In fact, no other programs bar 12-step ideology are even mentioned.

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I have read through each chapter word-for-word three times just to be sure; and although the chronic relapsing brain disease model of addiction requiring lifelong abstinence and spiritual recovery is described, trumpeted and proselytized in great detail, not one other model of addiction is even named.

As with anything I write I encourage you to fact-check this. My goal here is to present my opinions with facts and evidence that can be checked and verified. Point out any errors of fact and I will promptly remove and correct them. 

If a Cardiology textbook had a section entitled “Cholesterol, Statins and other Lipid Lowering Agents” with three chapters that only described Lipitor it would be correctly lambasted from every angle by the entire field of medicine as soon as it hit the shelves.

The lack of evidence-base and conflicts-of-interest would be recognized and dealt with immediately and when it was realized that many of the authors not only profited from, but  based their very own cardiac health on Lipitor they would rightly be held accountable. Such is not the case in Addiction Medicine.

The validity and reliability of opinions lie in their underlying methodology and evidence base. Reliance on the personal authority of any expert or group of experts is the fallacy of appeal to authority.

An appeal to Authority is a fallacy with the following form:

  1. Person A is (claimed to be) an authority on subject S.
  2. Person A makes claim C about subject S.
  3. Therefore, C is true

The fallacy is committed when the person (or group) in question is not a legitimate authority on the subject. If person A is not qualified to make reliable claims about subject S then the argument will be fallacious.   Since this sort of reasoning is fallacious only when the person is not a legitimate authority it is necessary that acceptable standards be set and the following standards are widely accepted.

  1. The person has sufficient expertise in the subject matter in question.
  1. The claim being made by the person is within her area(s) of expertise.
  1. There is an adequate degree of agreement among the other experts in the subject in question.
  1. The person in question is not significantly biased.
  1. The area of expertise is a legitimate area or discipline

With the exception of number 5 the ASAM fails on all counts, but policy makers, members of the press, politicians and others have been successfully bamboozled into believing the ASAM are indeed “experts” in Addiction Medicine.   imgresOver the years, the American Society of Addiction Medicine has continued to promote the AA position that alcoholism (and by inference any other addiction) is an illness which only a “spiritual experience will conquer.” All addictions are believed by ASAM to be caused by a lifelong chronic relapsing brain disorder that can only be treated by complete abstinence from all mood-altering substances (with the apparent exceptions of tobacco and caffeine interestingly) and the vast majority of ASAM doctors believe that the only effective treatment for addiction must include surrendering one’s “will and life over to the care of God.”

Because addiction is defined as a disease, addicts must be “treated” (often coerced) and “cured” (which is defined as remaining abstinent).

The medical profession needs to reexamine its role in Addiction Medicine.

Confusing ideological opinions with professional knowledge is unacceptable.   Presenting it as textbook science is not only dangerous but fosters negligence, abuse of power, self-interest and prejudice on the part of the medical community with respect to the treatment of all patients.

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To be clear, just as Lipitor may be the best treatment for some individuals with elevated cholesterol, AA and 12-step may be the best treatment for some individuals with addiction and substance use disorders. If it works for them, then more power to them. I have no problem with that.

What I do have a problem with is imposing and mandating any treatment on others.

Under a dictatorship everything else becomes subordinated to the guiding philosophy of the dictatorship.   Corresponding doctrine replaces professional guidelines, standards of care, and evidence based medicine.  And unfortunately in the case of Addiction Medicine the guiding philosophy often trumps autonomy and ethics.

Inherent in the current chronic brain disease model of addiction is the importance of external control over individuals.  Political correctness and the oversimplified medicalization of addiction is allowing it.   Demanding scientific literacy and discriminating good science from bad science would prohibit what is occurring and In order to save American Medicine this problem needs to be clearly recognized. Otherwise we will become a profession that is essentially defined by the false dichotomies and grand illusions defined by the impaired physicians movement.

  1. Schulz JE, Williams V. Twelve Step Programs in Recovery. In: Ries R, Fiellin D, Miller S, Saitz R, eds. Principles of Addiction Medicine. Baltimore: Lippincott Williams & Wilkens; 2009:911-922.
  2. McCrady BS, Tonigan GS. Recent Research into Twelve Step Programs. In: Ries R, Fiellin D, Miller S, Saitz R, eds. Principles of Addiction Medicine. 4 ed: Lippincott Williams & Wilkens; 2009:923-937.
  3. Galanter M. Spirituality in the Recovery Process. In: Ries R, Fiellin D, Miller S, Saitz R, eds. Principles of Addiction Medicine. 4 ed. Baltimore: Lippincott Williams & Wilkens; 2009:939-942.
Please donate to here to keep this blog running.  It is expiring in 21 days and any contribution would be appreciated.   We are making significant gains with articles such as  Physician Health Programs Under Fire .     These issues may seem small in the current turbulence, a small whirlpool in a maelstrom, but in reality they have enormous implications for all of us.  Please help out if you can-ML


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Physician Suicide, the “Impaired Physician Movement” and ASAM: The Dead Doctors at Ridgeview Institute under G. Douglas Talbott


Gentlemen, it is a disagreeable custom to which one is too easily led by the harshness of the discussions, to assume evil intentions. It is necessary to be gracious as to intentions; one should believe them good, and apparently they are; but we do not have to be gracious at all to inconsistent logic or to absurd reasoning. Bad logicians have committed more involuntary crimes than bad men have done intentionally.”–Pierre S. du Pont (September 25, 1790)

“It is easier to believe a lie one has heard a hundred times than a truth one has never heard before.” –Robert S. Lynd

Ridgeview Institute was a drug and alcohol treatment program for “impaired physicians” in Georgia created by G. Douglas Talbott, a former cardiologist who lost control of his drinking and recovered through the 12-steps of Alcoholics Anonymous.

Up until his death on October 18, 2014 at the age of 90, Talbott  owned and directed a number of treatment facilities for impaired professionals, most recently the Talbott Recovery Campus in Atlanta, one of the preferred referrals for physicians ordered into evaluation and treatment by licensing boards today.

G. Douglas Talbott is a prototypical example of an “impaired physician movement” physician–in fact in many ways he may be considered the”godfather” of the current organization.  He helped organize and serve as past president of the American Society of Addiction Medicine (ASAM) and was a formative figure in the American Medical Association’s (AMA’s) Impaired Physician Program.


G. Douglas Talbott (center), with sons Mark (left) and Dave (right). (image: Ham Biggar)

The cost of a 28-day program for nonprofessionals at Ridgeview in 1987 was $10,000 while the cost was “higher for those going through impaired-health professionals program,” which lasted months rather than 28 days.1

In 1975 after creating the DeKalb County Impaired Physicians Committee for the Medical Association of Georgia, Talbott founded the Georgia Disabled Doctors Program for the assessment and treatment of physicians. Founded in part because “traditional one-month treatment programs are inadequate for disabled doctors,” and they required longer treatment to recover from addiction and substance abuse.   According to Talbott, rehabilitation programs that evaluate and treat the rest of the population for substance abuse issues are incapable of doing so in doctors as they are unlike any other of the inhabitants of our society. Physicians are unique. Unique because of their incredibly high denial”, and he includes this in what he calls the “Four MDs,” “M-Deity”, “Massive Denial” “Militant Defensiveness” and “More Drugs.”2   And these factors set doctors apart from the rest.

According to Talbott, “impaired doctors must first acknowledge their addiction and overcome their ‘terminal uniqueness’ before they can deal with a drug or alcohol problem.” “Terminal uniqueness “ is a phrase Talbott uses to describe doctors’ tendency to think they can heal themselves.

“M-Deity” refers to doctors “being trained to think they’re God;”3 blinded by an overblown sense of self-importance and thinking that they are invincible-an unfounded generalization considering the vast diversity of individuals that make up our profession.   Although this type of personality does exist in medicine,  it is a small minority -just one of many opinions with little probative value offered as factual expertise by the impaired physician movement and now sealed in stone.

Former Assistant Surgeon General (Ret) Admiral (Ret) John C. Duffy

Former Assistant Surgeon General (Ret) Admiral (Ret) John C. Duffy

This attitude, according to some critics, stems from the personal histories of the treatment staff, including Talbott, who are recovering alcoholics and addicts themselves. One such critic was Assistant Surgeon General under C. Everett Koop John C. Duffy who said that Ridgeview suffered from a “boot-camp mentality” toward physicians under their care and “assume every physician suffering from substance abuse is the same lying, stealing, cheating, manipulating individual they were when they had the illness. Certainly some physicians are manipulative, but it’s naïve to label all physicians with these problems.”1


LeClair Bissell

American Society of Addiction Medicine (ASAM) President (1981-1983) LeClair Bissell was also highly critical of Talbott’s approach. Bissell, co-author of the first textbook of ethics for addiction professionals4 when asked if there was any justification to the claim that doctors are sicker than other people and more vulnerable to addiction replied:

“Well, based on my treatment experience, I think they are less sick and much easier to treat than many other groups. I think one reason for that is that in order to become a physician…one has to have jumped over a great many hurdles. One must pass the exams, survive the screening tests and the interviews, be able to organize oneself well enough to do examinations and so on, and be observed by a good many colleagues along the way. Therefore I think the more grossly psychotic, or sicker, are frequently screened out along the way. The ones we get in treatment are usually people who are less brain-damaged, are still quite capable of learning, are reasonably bright. Not only that, but they are quite well motivated in most cases to hang on to their licenses, the threat of the loss of which is frequently what puts them in treatment in the first place. So are they hard to treat? No! Are they easy patients? Yes! Are they more likely to be addicted than other groups? We don’t know.”5

“I’m not much for the bullying that goes along with some of these programs,” Bissell commented to the Atlanta Journal and Constitution in 1987.3

The constitution did a series of reports after five inpatients died by suicide during a four-year period at Ridgeview.6 In addition there were at least 20 more who had killed themselves over the preceding 12 years after leaving the treatment center.1

Bissell, the recipient of the 1997 Elizabeth Blackwell Award for outstanding contributions to the cause of women and medicine remarked: “When you’ve got them by the license, that’s pretty strong leverage. You shouldn’t have to pound on them so much. You could be asking for trouble.”3

According to Bissell: “There’s a lot of debate in the field over whether treatment imposed by threats is worthwhile…To a large degree a person has to seek the treatment on his own accord before it will work for him.”3

A jury awarded $1.3 million to the widow of one of the deceased physicians against Ridgeview,7 and other lawsuits initiated on behalf of suicides were settled out of court.6

The Constitution reported that doctors entered the program under threats of loss of licensure “even when they would prefer treatment that is cheaper and closer to home.” 8 The paper also noted that Ridgeview “enjoys unparalleled connections with many local and state medical societies that work with troubled doctors,” “licensing boards often seek recommendations from such groups in devising an approved treatment plan,” and those in charge are often “physicians who themselves have successfully completed Ridgeview’s program.”8

In 1997 William L. White interviewed Bissell whom he called “one of the pioneers in the treatment of impaired professionals.” The interview was not published until after her death in 2008 per her request.   Noting that her book Alcoholism in the Professions9 “remains one of the classics in the field”, White asked her when those in the field began to see physicians and other professionals as a special treatment population; to which she replied:

“When they started making money in alcoholism. As soon as insurance started covering treatment, suddenly you heard that residential treatment was necessary for almost everybody. And since alcoholic docs had tons of money compared to the rest of the public, they not only needed residential treatment, they needed residential treatment in a special treatment facility for many months as opposed to the shorter periods of time that other people needed.”10

Talbott claimed a “92.3 percent recovery rate according to information compiled from a five-year follow-up survey based on complete abstinence and other treatment.”11 A 1995 issue of The Federal Bulletin: The Journal of Medical Licensure and Discipline, published by the Federation of State Medical Boards, contains articles outlining impaired physician programs in 8 separate states. Although these articles were little more than descriptive puff-pieces written by the state PHP program directors and included no described study-design or methodology the Editor notes a success rate of about 90% in these programs and others like them 12 and concludes:

“cooperation and communication between the medical boards and the physician health programs must occur in an effort to protect the public while assisting impaired physicians in their recovery.” 12

No one bothered to examine the methodology to discern the validity of these claims and it is this acceptance of faith without objective assessment that has allowed the impaired physician movement through the ASAM and FSPH to advance their agenda;  confusing ideological opinions with professional knowledge.

“There is nothing special about a doctor’s alcoholism,” said Bissel

“These special facilities will tell you that they come up with really wonderful recovery rates. They do. And the reason they do is that any time you can grab a professional person by the license and compel him or her into treatment and force them to cooperate with that treatment and then monitor them for years, you’ll get good outcomes—in the high 80s or low 90s in recovery rates—no matter what else you do.”10
“The ones I think are really the best ones were not specialized. There were other well-known specialty clinics that claimed all the docs they treated got well, which is sheer rot. They harmed a great many people, keeping them for long, unnecessary treatments and seeing to it that they hit their financial bottom for sure: kids being yanked out of college, being forced to sell homes to pay for treatment, and otherwise being blackmailed on the grounds that your husband has a fatal disease. It’s ugly.”10

Stanton Peele’s “In the Belly of the American Society of Addiction Medicine Beast” describes the coercion, bullying, threats and indoctrination that are standard operating procedure in Talbott’s facilities.13  Uncooperative patients, “and this covers a range of sins of commission or omission including offering one’s opinion about one’s treatment,” are “threatened with expulsion and with not being certified-or advocated for with their Boards.”13

The cornerstone of treatment is 12-step spiritual recovery. All new patients are indoctrinated into A.A. and coerced to confess they are addicts or alcoholics. Failure to participate in A.A. and 12-step spirituality means expulsion from the program with the anticipated result being loss of one’s medical license.

In May 1999 Talbott stepped down as president of the American Society of Addiction Medicine (ASAM) as a jury awarded Dr. Leonard Masters a judgment of $1.3 million in actual damages and an undisclosed sum in punitive damages for fraud, malpractice, and the novel claim of false imprisonment.14

The fraud finding required a finding that errors in the diagnosis were intentional. Masters, who was accused of overprescribing narcotics to his patients was told by the director of the Florida PHP that he could either surrender his medical license until the allegations were disproved or submit to a four-day evaluation.

Masters agreed to the latter, thinking he would have an objective and fair evaluation. He was instead diagnosed as “alcohol dependent” and coerced into “treatment under threat of loss of his medical license. Staff would routinely threaten to report any doctor who questioned any aspect of their diagnosis or treatment to their state medical boards “as being an impaired physician, leaving necessary treatment against medical advice,”14  the equivalent of professional suicide.

Masters, however, was not an alcoholic.

According to his attorney, Eric. S. Block,  “No one ever accused him of having a problem with alcohol. Not his friends, not his wife, not his seven children, not his fellow doctors, not his employees, not his employers, No one.” 15

He was released 4 months later and forced to sign a five-year “continuing care” contract with the PHP, also under continued threat of his medical license.

Talbott faced no professional repercussions and no changes in their treatment philosophy or actions were made. They still haven’t.  They have simply tightened the noose and taken steps to remove accountability.

Up until his recent death, Talbott continued to present himself and ASAM as the most qualified advocates for the assessment and treatment of medical professionals for substance abuse and addiction.16

ASAM and like-minds still do.

In most states today any physician referred for an assessment for substance abuse will be mandated to do so in a facility just like Ridgeview.

There is no choice.   In mechanics and mentality, this same system of coercion, control, and indoctrination has metastasized to almost every state only more powerful and opaque in an unregulated gauntlet protected from public scrutiny, answerable and accountable to no one.  Laissez faire Machiavellian egocentricity unleashed.    For what they have done is taken the Ridgeview model and replicated it over time state by state and tightened the noose.  By subverting the established Physician Health Programs (PHPs) started by state medical societies and staffed by volunteer physicians they eliminated those not believing in the mentality of the groupthink.   They then mandated assessment and treatment of all doctors be done at a “PHP-approved” facility which means a facility identical to Ridgeview.  This was done  under the scaffold of the Federation of State Physician Health Programs (FSPHP).  They are now in charge of all things related to physician wellness in doctors.

  1. Durcanin C, King M. The suicides at Ridgeview Institute: Suicides mar success at Ridgeview with troubled professionals. Atlanta Journal and Constitution. December 18, 1987, 1987: A13.
  2. Gonzales L. When Doctors are Addicts: For physicians getting Drugs is easy. Getting help is not. Chicago Reader. July 28, 1988, 1988.
  3. King M, Durcanin C. The suicides at Ridgeview Institute: A Doctor’s treatment program may be too tough, some say. Atlanta Journal and Constitution. December 18, 1987a, 1987: A12.
  4. Bissell L, Royce JE. Ethics for Addiction Professionals. Center City, Minnesota: Hazelden; 1987.
  5. Addiction Scientists from the USA: LeClair Bissell. In: Edwards G, ed. Addiction: Evolution of a Specialist Field. 1 ed: Wiley, John & Sons, Incorporated; 2002:408.
  6. Durcanin C. The suicides at Ridgeview Institute: Staff members didn’t believe Michigan doctor was suicidal. Atlanta Journal and Constitution. December 18, 1987, 1987: A8.
  7. Ricks WS. Ridgeview Institute loses $1.3 million in suit over suicide. Atlanta Journal and Constitution. October 11, 1987, 1987: A1.
  8. King M, Durcanin C. The suicides at Ridgeview Institute: Many drug-using doctors driven to Ridgeview by fear of losing licenses. Atlanta Journal and Constitution. December 18, 1987b, 1987: A1.
  9. Bissell L, Haberman PW. Alcoholism in the Professions. Oxford University Press; 1984.
  10. White W. Reflections of an addiction treatment pioneer. An Interview with LeClair Bissell, MD (1928-2008), conducted January 22, 1997. Posted at 2011.
  11. Williams c. Health care field chemical dependency threat cited. The Tuscaloosa News. January 16, 1988, 1988: 16.
  12. Schneidman B. The Philosophy of Rehabilitation for Impaired Physicians. The Federal Bulletin: The Journal of Medical Licensure and Discipline. 1995;82(3):125-127.
  13. Peele S. In the Belly of the American Society of Addiction Medicine Beast. The Stanton Peele Addiction Website (accessed March 28, 2014)
  14. Ursery S. $1.3M verdict coaxes a deal for doctor’s coerced rehab. Fulton County Daily Report. May 12, 1999b 1999.
  15. Ursery S. I was wrongly held in alcohol center, doctor charges. Fulton Count y Daily Report. April 27, 1999a 1999.
  16. Parker J. George Talbott’s Abuse of Dr. Leon Masters MD ( ). Medical Whistelblower Advocacy Network.

    There is enormous inertia—a tyranny of the status quo—in private and especially governmental arrangements. Only a crisis—actual or perceived—produces real change. When that crisis occurs, the actions that are taken depend on the ideas that are lying around. That, I believe, is our basic function: to develop alternatives to existing policies, to keep them alive and available until the politically impossible becomes politically inevitable.-Milton Friedman

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The High PROFITS of the 12 Step Cult Religion and Bain Capital

“The belief that there are such things as witches is so essential a part of the faith that obstinately to maintain the opposite opinion manifestly savors of heresy.”

So begins Malleus Maleficarum , a witch hunters manual published in 1486 that launched a new paradigm for all those concerned with the identification and extirpation of witches. Used as a judicial case-book the Malleus set forth definitions of witchcraft, rules of evidence and the canonical procedures by which suspected witches were tortured and put to death. Written by Inquisitors for Inquisitor, the Malleus construct came to be regarded as irrefutable truth and contributed to the identification and execution of as many as 60,000 “witches”, predominantly women. The 29th and last edition was published in 1669.

Because of the nature of the enemy the evidentiary standard was lowered and any witness, no matter what his credentials, could testify against the accused.

Using the nebulous “witch label” anyone with a grudge or suspicion could accuse anyone of witchcraft .

From the 15th century through the early 17th century a confederacy of “authorities” calling themselves “demonologists” existed and made money off the misery of others.

Identification of witches was detailed in the Malleus including both physical and behavioral clues. Physical signs included things such as bushy eyebrows and thin lips. The Malleus declared that witches have a “Devil’s mark (stigmata diaboli) or Devils seal (sigilum diaboli) which was usually a scar, birthmark, or blemish. An extra nipple (polythelia) was a tell-tale sign. Behavioral manifestations included living alone, cultivating strange herbs in the garden, public singing or dancing and saying hello to a neighbors cat.

Physician oversight of witch persecution was standard.  So too was the involvement of “witch-prickers” who were able to provide their expertise and “medical” testing in the assessment and diagnosis of the witch.

Pricking them with needles, awes, and bodkins to prove they were indeed nefarious and non-human was a surefire way to line one’s pockets but for the pedophiles and pervs there was an added bonus—a thorough searching for that stigmata diaboli on someone else’s dime.

Through the witch trials clerics, doctors, and lawyers used their expertise as witnesses to increase their prestige. Witch hunts developed into a means of economic profit. Some gained a lot of money from the witch trials. The witch or her relatives paid for the salaries of those who worked the witch trials including judges, court officials, torturers, physicians, clergymen, scribes, guards, attendants.

Even the people who made the stakes and scaffolds for executions gained from the conviction and death of each witch.

“Witch hunting,” wrote the historian Rossell Hope Robbins, “was self-sustaining and became a major trade, employing many people, all battening on the savings of the victims.” The costs of a witch trial were usually paid for by the estate of the accused or their family.

And what my friend Laura Tompkin’s describes here in no different; except in place of “demonologists” we now have “addictionologists.”

Both faulty paradigms with a lot of people making money hand over fist.

In 1592 Father Cornelius Loos wrote:

“Wretched creatures are compelled by the severity of the torture to confess things they have never done and so by cruel butchery innocent lives are taken; and by new alchemy, gold and silver are coined from human blood.”

And this is no different. No different at all.

12 Step Cult Religion Exposed

The following article will educate you on the annual profits made by the 12 step industry.  Whenever steppers claim that their cult is free, you now have proof that it is most certainly not in any way, shape or form, free.  Just because people are too lazy, ignorant and/or brainwashed, is no excuse for perpetuating dangerous lies.  Please note that anything in parentheses is my addition and anything bolded is also mine.  This author is misinformed, as is the general public, and classifies alcohol disorders as diseases.  However, this misinformation does not disqualify the facts here about rehab profits and Bain Capital.

Bain Capital’s grip on addiction – The profit of 12-step treatment

By Jamie Wendland

Last year nearly 2.5 million people 12 years of age or older sought treatment for substance abuse in the U.S., according to the National Survey on Drugs and Health. 2.3 million Americans…

View original post 1,696 more words

The Medical Profession, Moral Entrepreneurship, Moral Panics, and Social Control

The Medical Profession, Moral Entrepreneurship, Moral Panics, and Social Control.

As a society governed by organizations, associations,  institutions and regulatory bodies, the medical profession is not immune to “moral panics” and “moral crusades.”

A threat to patient care or the values of the profession can be identified and amplified.   A buildup of public concern fueled by media attention ensues creating a need for governing bodies to act. Medical Professionalism and the Public Health has been assailed.

Unbeknownst to the general population and most members of the medical profession at large, certain groups have gained tremendous sway within organizational and regulatory medicine. Through  moral entrepreneurship they have gained authority and become  the primary definers of the governance of the medical profession and the social control of  doctors.  To benefit their own interests they have fostered and fueled “moral panics.” Exhorting authorities to fight these  threats by any means necessary  they have successfully made and enforced rules and  regulations and introduced new self-serving definitions and tools that neither help doctors nor protect the public.

State Mandated 12-step –Establishment Clause Violations Run Amok- (Anonymity and Moral Inventories Optional)

V0011377 A quack doctor selling remedies from his caravan; satirizing

“The surest way to work up a crusade in favor of some good cause is to promise people they will have a chance of maltreating someone. To be able to destroy with good conscience, to be able to behave badly and call your bad behavior ‘righteous indignation’—this is the height of psychological luxury, the most delicious of moral treats.” Aldous Huxley -Chrome Yellow 1921

A letter of agreement with the BORM, drafted at the behest of Physicians Health Service Inc., and signed by me 1/20/12 under threat of loss of my medical license specifically mandates participation “in a minimum of three 12-step meetings per week” and submit proof to PHS, “develop an “active 12-step sponsor relationship with someone who is not a healthcare professional.”

These requirements were made because I requested an independent evaluation at a non-biased  non-12-step assessment center not affiliated with the ASAM.    The choices PHS gave me were all 12-step facilities with Medical Directors who can be seen on this list.   My request for an independent evaluation was justified as the MRO for PHS is on the same list.  The same MRO who allowed PHS to misrepresent the positive EtG tests and fabricate a confirmatory positive PEth.

The PHS monitoring contract states that positive laboratory reports will be reported to the Board “with the exception of those medications that have been properly prescribed for a legitimate medical purpose and of which PHS has been informed in advance or of which PHS has approved” and that positive drug results are reportable to the Board “unless PHS is provided with advance verification of such medications.”

PHS claimed that I had been told to discontinue medications used to control and treat lifelong asthma.   I had not.   I provided the Board with multiple documents contradicting PHS claims.

An August 24, 2009 from Dr. Luis Sanchez, M.D. to the Board states:

“Dr. Langan has informed PHS that he is being prescribed two asthma inhalers. By FDA mandate, the inhaler manufacturers changed to ethyl alcohol propellants in January of this year. Dr. Langan has provided documentation of this medication. Physician Health Services (PHS) will be working with Dr. Langan to determine whether there are alternative options for asthma treatment that do not utilize ethanol as a propellant. Meanwhile, PHS has advised him to continue to use this medication as needed and as directed by his treatment providers.”

After discussing alternative options with my PHS associate director, John Knight, M.D., it was decided to continue them as prescribed. This decision was based on the history and severity of my asthma and the good control and treatment these mediations provided. As a child and young adult I had multiple emergency room visits and was hospitalized several times for asthma, but the medications had prevented any serious asthma attacks for the previous 10 years.

A letter dated January 1, 2010 from Louis Sanchez acknowledges continued use of the asthma inhalers. He writes: “Dr. Langan has provided PHS documentation of this medication. PHS has concluded that there was no evidence of relapse at this time.”

The documentary evidence shows that PHS acknowledged the prescribed medications, considered me compliant, and advised I continue to use them.

A February 10 2010 letter to my Chief, Dr. Kenneth Minaker, M.D. acknowledges the relationship between the medication and the alcohol biomarker Etg and affirms compliance with my PHS contract:

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No EtG tests were done until June 20 and June 30, 2011. PHS reported these as “positive” by claiming I was told to discontinue my asthma medications. I provided the Board with multiple documents that contradict this claim and suggested that Dr. Knight be contacted to verify this was untrue.   I also requested written documentation to support PHS claim. The Board ignored the contradictory documentation, did not contact John Knight, and neither PHS nor the Board could provide any documentation to support the claim that I was told to discontinue the medication.  They still haven’t.

Reporting a positive test to the Board for a prescribed and acknowledged medication would be in violation of the PHS monitoring contract. Claiming the medications were discontinued allowed PHS to report these tests as true positives and also do a “confirmatory” test. The Etg was used as a stepping-stone to order a blood being used by Physician Health Programs to differentiate “incidental” exposure from drinking.

They were aware of the medications, aware they contained ethanol, and aware that they caused positive Etg levels but reported it anyway under the pretext that I was told to discontinue the medication.   This misrepresentation was then “confirmed” by fraud.

There is no known cutoff level for Etg to differentiate incidental exposure from drinking. It should be noted that the use of ethanol containing metered dose inhalers is not “incidental” exposure but “direct” exposure and reporting them as positive violates all established protocols and guidelines.  PHS then used forensic fraud for confirmation.

On July 1st, 2011, Dr. Gary Chinman of PHS informed me that I had positive EtG tests on June 20th, and June 30th, 2011. I was told to go to Quest Laboratories to obtain a confirmatory blood test.   On July 19th, 2011 I was informed that the test was positive at a markedly high level of 365. The cutoff level of PEth is 20 and a level of 365 suggests heavy sustained alcohol use. Common sense would have dictated this to be erroneous at this point based on my appearance, work performance, and all collateral information.

I immediately requested evaluations from my PCP and the Chief of Addiction Medicine at MGH. They both did full evaluations (including speaking with my supervisors and colleagues,  physical exams, and laboratory tests ) and wrote letters to the Board contradicting PHS claim. The Board was well aware that no other pretext existed to suggest alcohol use except for these tests. The Board ignored all outside information and continued to support PHS.

Suspecting the test was fabricated I requested the “litigation packet.” PHS initially refused. I persisted in obtaining the results and PHS finally agreed but threatened me with “unintended consequences.”   I received the “litigation packet” in December of 2011 and it revealed fraud. A fax dated July 19, 2011 from PHS to USDTL requested that my ID # (1310) and a chain-of-custody be added to an already positive specimen 19 days after it was collected.

This evidence of fraud was provided to the Board in December of 2011. This was followed by a letter from the Chief of Toxicology at MGH opining that the positive test was an intentional and purposeful act by PHS to misrepresent an invalid test as valid.11:5:12-Dr. Flood Letter–Ignored by PHS:USDTL:BORM

The test has since been invalidated as a result of a complaint filed with the College of American Pathologists (CAP), an accrediting agency for the labs.

To sum this up I knew that the test was fabricated at the time and  it was subsequently verified as fabricated ),  I simply wanted a fair and objective evaluation from an assessment facility with no conflicts of interest.  Marworth, Hazelden, or Bradford were the three choices given–all heavily indoctrinated ASAM facilities with close ties to the state Physician Health Programs.

Both PHS and the Board denied this request in violation of the Establishment Clause of the 1st Amendment.   The Board’s Complaint Committee found I was in violation of my Letter of Agreement because I did not immediately enter into one of the three programs offered.  On December 21st, 2011 the Board concurred that I was in violation of my LOA and chose to  “resolve the matter” by extending my contract by two years and “fortifying certain provisions” including

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BORM 12:22:2011

Interestingly, PHS had mandated thrice weekly 12-step meetings for a duration of three months.   The Board took it upon themselves to extend it from three months to 2-years–an ultra vires act outside the scope and power of the Board and an obvious Establishment Clause violation.     The Board also gave PHS carte blanche managerial prerogative to “submit proof of said participation” at the thrice weekly 12-step meetings.     PHS chose names and telephone numbers of fellow attendees at anonymous meetings as the burden of proof!    I informed the Board that obtaining unique identifiers such as names and telephone numbers to provide to a State substance abuse monitoring agency would be a tall order as “anonymous” is half its name.   They did not take this into consideration.  PHS also mandated under threat of my license that I could no longer use the asthma inhalers that had been controlling my asthma for the past decade.

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PHS Letter 12:6:11-phone numbers:claims lab will support test

PHS Letter March 2012 Requesting Signatures

But the requirement that I humiliate myself by attending meetings at which I don’t belong and try to convince anonymous attendees to breach their anonymity wasn’t enough.   I had to do it while wheezing.    The Board forbade me from any of my asthma MDIs and essentially all of the propellants were replaced with ethanol by Federal mandate to protect the Ozone.   Dr. Knight and I looked into alternatives previously and decided that due to the severity of my asthma and the control achieved by my current medications I would continue them as prescribed.  As cold and exercise were two major contributors to asthma attacks I had to stop going to the gym and I had 19 major asthma attacks during that winter.  My PCP documented the wheezing and shortness of breath at my checkups.

And to kick a wheezing fellow asking inappropriate requests at A.A. while he’s down, the  Board extended PHS requirement of thrice weekly mandated AA meetings from 3 months to 2 years on their own accord.   This is an inappropriate ultra vires act by the Board.  It is outside the scope of their authority and an obvious Establishment Clause violation.

PHS had fun with the phone numbers.  This is all documented in multiple e-mails such as these:Screen Shot 2014-10-14 at 1.31.49 PMScreen Shot 2014-10-14 at 1.29.20 PM Screen Shot 2014-10-14 at 1.27.34 PM

It soon became apparent that my attorney was doing nothing.   At a meeting with PHS I told them that getting names and phone numbers at 12-step meetings was inappropriate and that Dr. Chinman was asking personal questions.  My attorney turned to me and said “Well they have to ask questions. They need to make sure you’re not just paying somebody to say you were at a meeting?    It then dawned on me that he had insisted on blaming the positive PEth test on my asthma inhalers and never even contacted the labs.    He also refused to call Hazelden to verify that they had not made the request for phone numbers.   I was told that this is the case  with most PHPs.  They refer you to a few attorneys who they know well and give a lot of business who will not bite the hand that feeds them.    Another component of this rigged game.

On October 9th I received the following e-mail from my attorney:Screen Shot 2014-10-14 at 1.44.23 PM

And on October 23, 2012 PHS formally reported my “noncompliance” with 12-step meetings to the Board

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It has now become clear why this occurred at this time.  Nevertheless the Board has outlined the decision making process from beginning to end right here in the February 6th, Board Order.

The modified Letter of Agreement specifically states that I must attend 3 “12-step” meetings per week and obtain a “sponsor.” No alternatives were offered and it is well established that mandated AA or 12-step by the State is in violation of the 1st Amendment.   The Board then suspended me for allegedly not complying with the 12-step requirement.   My suspension was, in fact, an Establishment Clause violation.

On April 8th, 2013, Attorney William Burgess of the Appignani Legal Center wrote a letter to PHS and The Board identifying the Establishment Clause violations and requested written response in how they would be remedied.  This can be seen here:Secular_substance_abuse_treatment_options_for_MA_doctors

Board attorney Barbara replied on April 19th, 2013 with “the physician who you named in your letter currently has an open matter with the Board and, therefore it would be inappropriate for the Board members to receive your letter.   Additionally, as you are not the attorney of record for the physician, I am unable to comment on the assertions you have made regarding the physician and his interaction with the Board and PHS.”  The letter can be seen here:  boardresponse5:1:13

This non-response is unacceptable.   The Establishment Clause violations have been pointed out to the Board. Whether or not I have an open matter with the Board is irrelevant. Who identifies the violation is irrelevant as the law is clear on this matter.

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The Proof PHS required was the name and phone number of a fellow attendee who they could call to verify my attendance.   PHS mandated thrice weekly 12-step meetings per week for 3 months then once per week. The Board then again violated the Establishment Clause by taking it upon themselves to lengthen my sentence. and extended it from 3 months to 2 years.

A “12-step” program is a set of guiding or “spiritual principles” outlining a course of action for recovery from addiction, compulsion, or other behavioral problems. Originally proposed by Alcoholics Anonymous (AA) as a method of recovery from alcoholism.1 The Twelve Steps were first published in the book Alcoholics Anonymous: The Story of How More than One Hundred Men Have Recovered from Alcoholism in 1939.2 The 12-step ideology has been adopted by other groups such as Narcotics Anonymous and Overeaters Anonymous and that, except for the identified problem source, are carbon copies of one another

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The proof of attendance at 12-step groups, as documented in the attached letters from PHS, mandated that I “provide PHS with the phone number of a consenting meeting participant” which is against the “suggested Alcoholics Anonymous (AA) policy regarding “cooperation with the courts.” The suggested AA policy is to sign “first name only to a card,” and even this “is not always accepted.”

According to Alcoholics Anonymous General Services3 “while most meetings will sign your court card, some will not. It is up to each individual group to decide. Since AA is not allied with the court system, AA is not required to do the courts work. We are not court employees.   If a meeting chairperson or group member offers to sign your court card they will probably just sign their first name or initials. We are personally anonymous,” and “regardless of an A.A. member’s vocation, reporting on the “progress” of another A.A. member is strictly outside the scope of what A.A. does.”

The act of obtaining phone numbers at anonymous meetings not only violates the rights of the person being forced to do it but the rights of the other attendees. The basic tenet of AA is that it is for people who desire to be there and the spiritual foundation of is anonymity. Anonymity, by definition, refers to an individual’s personal identity, or personally identifiable information, being unknown. Signing a first name to a card provides anonymity. Providing a first name and a telephone number most assuredly does not as it is a unique identifier, not unlike a social security number or driver’s license number, and can easily be used to uniquely identify that person. Consequently, trolling for phone numbers to be given to an unfamiliar non-governmental state affiliated agency from anonymous members of a categorically anonymous group that considers anonymity as the spiritual core of its existence, presents a tall order.

Nevertheless, despite being half of its name, the BORM accepted the statement from PHS that obtaining names and phone numbers at 12-step meetings was accepted without question and I was not allowed to challenge or question the decision before the BORM.

Difficult as it was, I was able to provide them with phone numbers despite PHS’ attempts to make it as difficult as possible as documented in the attached e-mails and letters that include my concern that this Sisyphean task was merely designed as a failsafe to deem me noncompliant with the BORM should the need arise. It was.

In addition to coercion PHS continued to engage in threats, intimidation, and “torture” (an act committed by a person acting under the color of law specifically intended to inflict severe physical pain or suffering upon another person within his custody or physical control).

On 11/8/2012 the BORM found I was in violation of this agreement and referred the case to the full Board for sanction based on alleged “noncompliance” with the ordered attendance.

The First Amendment states in the “Establishment Clause that “Congress shall make no law respecting an establishment of religion.”  Acts of direct coercion, threats backed by legal sanctions, are barred by the Establishment Clause.

Legally, Alcoholics Anonymous is established as a religious organization.  And so is Narcotics Anonymous.  This is well established and as far as United States courts are concerned AA and NA are, beyond a doubt, organizations that engage in religious activities and their meetings qualify as religious services.

Applying a standard three-part test to determine whether my constitutional rights have been violated

  1. Has the state acted?
  2. Was there coercion?
  3. Was the object of the coercion religious rather than secular?

As to point one the answer is clearly affirmative.  PHS’ recommendations to the BORM were that I do the following:

  • Participate in a minimum of (3) PHS approved 12 step meetings per week for the next 3 months including at least 1 physician meeting a week and document your participation with the signature of a consenting attendee and a phone number for the consenting attendee.  After 3 months you must attend at least 1 PHS approved support meeting a week and 1 physician meeting a month
  • Develop an active sponsor relationship and provide consent for this sponsor to confirm twice a year with PHS that he/she is your sponsor.

The Board wrote this up in the letter of agreement without offering any other options.

Coercion-point two—also is clearly present by force of law and threat of penalty.   The elements of coercion are 1. A forced choice,  2. Threat of sanction, 3. Coercive ijntent.

The BORM states if I attempt to negotiate or dispute PHS’ recommendation I will be “immediately suspended.”  Your money or your life.

Point three is now well established. (see notes below)

Mandating phone numbers as proof of attendance makes this particularly egregious as they inappropriately demanded I engage in a religious based program and violate the basic principles of the program (anonymity).

Moreover, the request for mandated 12-step attendance was not made out of “good faith” or beneficence. It was a retaliatory act designed to punish me because I questioned the results of a drug test that was done on July 1st, 2011 and reported as a confirmatory positive for alcohol use.

As a result of this test PHS requested an evaluation at a facility of their choosing. They were all -12-step facilities with medical directors they knew well. All ASAM/LMD and in 12-step recovery themselves

Because PHS had previously (2008) misrepresented the results of a drug test to justify sending me to an out of state facility for an evaluation where the facility fabricated neuropsychological testing to support “denial and cognitive impairment” resulting in forced inpatient rehabilitation I requested that the BORM allow an evaluation at an independent facility that did not have a referral relationship with PHS (and the inherent conflicts of interest that exist).4   The BORM would not consider the requests, said I had to go to one of the choices I was given, and added to more years to my contract because I had the audacity to request an alternative.

I also requested the laboratory (USDTL) “litigation packet.” Considered a legal document, this record is generated in any forensic (as opposed to clinical) laboratory -testing, and records the collection, shipping, handling, and testing of the sample. It is done to document that a drug test was done correctly on the person it was supposed to done on. It follows a specific protocol that involves strict chain of custody followed by MRO review.

PHS was resistant to my request for the “litigation packet,” but I eventually got it and, as Dr. Flood’s opinion letter shows, the test was fabricated. Chain of custody was nonexistent. The BORM refused to look at it. I filed a complaint with the College of American Pathologists (CAP) and an investigation was done which showed that the test was manipulated. Although the lab was sanctioned under threat of losing accreditation by CAP, as a non-governmental organization with no regulations and accountable to no one, PHS continued to support the validity of the test.

On December 4th, 2012 I got the following e-mail documenting that the laboratory issued an amended report mandated by CAP that showed the external chain of custody was not followed and thus making it an invalid test.

The amended report was issued on October 4th, 2012. I called Linda Bresnehan at PHS to ask for a copy of the amended report. She said she just got the report that day and issued a letter to the BORM December 11, 2012 stating that they just received the revision to the lab test but they “did not make a determination of relapse following the positive test,” they were not “aware of any action taken” by the BORM, and that they would continue to “disregard it.”

The BORM did not consider the logic that the very basis for my forced attendance at AA meetings and all of the other negative consequences thrown at me was this very test. Nor did they take into consideration the fact that the amended report was issued in October and the temporal relationship to them finding me out of compliance with AA meetings.

Instead, the BORM found me out of compliance with PHS which is essentially a lie (noncompliance) based upon a lie (saying that Hazelden recommended 3x per week AA meetings with phone numbers) based upon a lie (a fabricated test).

But the forensic fraud,  “color of law” abuse, Civil rights violations, harassment, intimidation, and abuse qualifying as criminal harassment  under 42 U.S.C. § 1983 -subject to a systematic scheme of harassment and intimidation   Personal humiliation, embarrassment and mental distress) and arguably a violation of the Bill of Rights under cruel and unusual punishment are irrelevant. So too is the arrogant over-the-top bizarrely inappropriate request for phone numbers. Even without these factors entering the picture the Establishment Clause violations are clear.    And the fact that they ignored the request to remedy a Civil rights violation is indefensibly unconscionable.    They acted with malice, willfulness, and callous and reckless indifference to the safety and rights of my family and me.  The “Right to be secure in one’s person” is an aspect of liberty protected by the due process clauses of both the Fifth and Fourteenth Amendments.  And “Liberty” is Constitutionally protected by both the Fifth and Fourteenth Amendments, and also a protectable deprivation of due process. The liberty interest is violated and actionable by any conduct of persons acting under color of law that “shocks the conscience” (Massachusetts Civil Rights Act is M.G.L. c. 12 § 11I).  

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The First Amendment states in the “Establishment Clause that “Congress shall make no law respecting an establishment of religion.” Acts of direct coercion—threats backed by legal sanctions—are barred by the Establishment Clause.

Three federal courts have held that coerced participation in 12-step programs like AA and NA violates the First Amendment. In Kerr v. Ferry, 95 F.3d 472 (7th Cir 1996), the Seventh Circuit held that requiring an inmate to attend NA meetings or risk suffering adverse effects for parole eligibility violated the Establishment Clause. The Second Circuit reached a similar conclusion in Warner v. Orange County Department of Probation, 115 F.3d 1068 (2d Cir. 1997), striking a probation condition requiring attendance at AA meetings.

In 2007 the Ninth Circuit Court of Appeals held that a parole officer’s demand that a convicted drug offender attend Narcotics Anonymous violated the First Amendment rights of the offender who claimed to be a Buddhist (Inouye v. Kemna, 504 F.3d 705 (9th Cir. 2007)).

Moreover, the case ruled that “any coercing authority” can be held individually, civilly liable for the First Amendment constitutional rights violation that they perpetrate on people unwillingly and involuntarily forced to go to 12-step programs and the offender was free to sue the parole officer for damages, even though state officials are often immune form such suits.

In both the Warner and Inouye cases, the courts found the law sufficiently clearly established to abrogate the officer’s qualified immunity. Qualified immunity shields government officials from liability for civil damages “insofar as their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known. (Harlow v. Fitzgerald 4567 U.S.C. 1983)

Warner and Inouye were able to go forward with lawsuits against their officers for damages for violation of their constitutional rights under 42 U.S.C. 1983. (Civil action for deprivation of rights). Numerous federal and district courts and state supreme courts have reached the same conclusion.

What this means is that you can sue a judge, a prison warden, a parole officer, a “counselor, a medical board member, or anyone else in a position of authority who forces you to go to AA meetings.

In cases like this the courts found that the government had forced the person to attend AA or NA. In other cases, where state of local officials simply made participation in AA one option for substance abusers, courts have no found any Establishment Clause violation.

[29] “For the government to coerce someone to participate in religious activities strikes at the core of the Establishment Clause of the First Amendment, whatever else the Clause may bar.” Inouye v. Kemna, 504 F.3d 705, 712 (9th Cir. 2007). The Ninth Circuit articulated the following test in Inouye v. Kemna “with regard to determining whether [Plaintiff] was [subject to] governmental coercion of religious activity . . . : ‘first, has the state acted; second, does the action amount to coercion; and third, is the object of the coercion religious rather than secular?’” Id. at 713. “First, [Crofoot] acted in his official state capacity as a parole officer to order [Plaintiff into a 12-step program that contained religious components]. That the state did not run the program itself is ‘of no moment.’” Id. (quoting Kerr v. Farrey, 95 F.3d 472, 479 (7th Cir. 1996)). It is undisputed that Crofoot, Wilding, and Jallins were acting in their official state capacities when they required Plaintiff to participate in the 12-step drug treatment program as a condition of his parole, and subsequently removed and incarcerated him for not participating in the program.

[30] Further, the Parole Defendants’ “action was clearly coercive: [Plaintiff] could be imprisoned if he did not attend and he was, in fact, ultimately returned to prison in part because of his refusal to participate in the program.” Inouye, 504 F.3d at 713 (emphasis added). The Parole Defendants argue Plaintiff was returned to prison because he was “disruptive” in the program. This argument rings hollow in light of the undisputed facts showing Plaintiff was only “disruptive” in the program “‘in a congenial way’” and “was ‘sort of passive aggressive.’” (Partial Mot. SUF ¶¶ 12, 13.) It is also undisputed that Plaintiff communicated his objection to participation in the Empire program and that Crofoot told Plaintiff he “should continue to participate in the Empire Program or he would be returned to prison.” (Id. ¶ 10.) It is further undisputed that Crofoot and Wilding concluded that “the right thing to do” was to refer Plaintiff to the Board of Parole Hearings “on a parole violation for failing to participate in the BPH-ordered program.” (Id. ¶ 15.) It is also undisputed that Deputy Commissioner Jallins authorized Plaintiff to be returned to prison because of Plaintiff’s failure to participate in the program. (Id. ¶¶ 18-19, 24.)

[31] “The final element requires somewhat more discussion.” Kerr, 95 F.3d at 479. It is undisputed that “Empire used a 12-step program that included references to God and a ‘higher power.’” (Partial Mot. SUF ¶ 3.) Further, Plaintiff’s following averments in his declaration have not been controverted:

[32] Shortly after arriving at Empire, I discovered that Empire used a “12-step” recovery program based [on] the principles of Alcoholics Anonymous (“AA”) and Narcotics Anonymous (“NA”), which contains religious components. Among other features, the “12-step” method used by Empire made references to God, involved acknowledgment of a “higher power,” and included prayer. [¶] I am an atheist, and was one in 2007. The substantial religious components to the “12-step” program administered by Empire conflicted with my beliefs. Prior to my release on parole, I had notified correctional authorities of my Atheism, and requested placement in a treatment facility that did not contain religious components.

[33] (Hazle Decl. ¶¶ 2, 3.) The Parole Defendants do not dispute that the Empire’s 12-step program contained religious components. “As such, on this summary judgment record and given the lack of dispute between the parties in question, . . . the third prong of [Plaintiff’s] Establishment Clause test has been met as well.” Inouye, 504 F.3d at 713-14. Therefore, “the program runs afoul of the prohibition against the state’s favoring religion in general over non-religion,” because of the program’s use of a religious concept of a Higher Power through references to God and prayer. Kerr, 95 F.3d at 480. Accordingly, Plaintiff’s partial motion for summary judgment against the Parole Defendants is granted.

[34] B. Plaintiff and Westcare’s cross motions for summary judgment on Plaintiff’s Establishment Clause claim

It is beyond dispute that, at a minimum, the Constitution guarantees that government may not coerce anyone to support or participate in a religion or its exercise (Lee v Weisman 505 U.S)

Legally, Alcoholics Anonymous is established as a religious organization. And so is Narcotics Anonymous. This is well established and as far as United States courts are concerned AA and NA are, beyond a doubt, organizations that engage in religious activities and their meetings qualify as religious services.

Applying a standard three-part test to determine whether my constitutional rights have been violate

  1. Has the state acted?
  2. Was there coercion?
  3. Was the object of the coercion religious rather than secular?

As to point one the answer is clearly affirmative. PHS’ recommendations following my evaluation at Hazelden (See PHS letter dated 10/27/2011) include:

  • Participate in a minimum of (3) PHS approved 12 step meetings per week for the next 3 months including at least 1 physician meeting a week and document your participation with the signature of a consenting attendee and a phone number for the consenting attendee. After 3 months you must attend at least 1 PHS approved support meeting a week and 1 physician meeting a month
  • Develop an active sponsor relationship and provide consent for this sponsor to confirm twice a year with PHS that he/she is your sponsor.

Coercion-point two—also is clearly present by force of law and threat of penalty.   The elements of coercion are 1. A forced choice, 2. Threat of sanction, 3. Coercive intent.

Motion to Take Judicial Notice of Adjudicative Facts Pertaining to Violation of the Establishment Clause of the First Amendment

Motion to Take Judicial Notice of Adjudicative Facts

Motion to Take Judicial Notice of Law

BORM 11:8:2012 12:4:12-BORM Letter 12:21:11-BORM Board Order 12:22:11-BORM Violation LOA 12:27:2011-BORM LOA American Humanist Letter to BORM boardresponse5:1:13 BORM 12:22:2011 BORM Agreement Emergency Petition to Return to Practice.011013 letter re secular substance abuse treatment options for MA doctors (reply to PHS) v2-1 Liebert Letter to BORM 11:14:2011– Ltr JLH to Harvey.122812.01 Secular_substance_abuse_treatment_options_for_MA_doctors  EMAILSLIEBERT