I read the local Sun-Sentinel newspaper this morning regarding endorsements for Delray Beach local elections and was absolutely floored. What I read was straight-up discrimination, from a media source that would defend to the death its other Civil Rights – the right to free speech.
Of all the grounds upon which to suggest a candidate was unfit for office was the fact that Adam Frankel, a criminal defense attorney with a strong civic record for prior service to his city, should be discredited because:
“As an attorney, Frankel also represented defendants from the drug treatment industry. Given all the problems that industry has brought Delray Beach, Frankel’s decision was bad. His explanation is worse.”
Shame on you, Sun-Sentinel Editorial Board, made up of Rosemary O’Hara, Elana Simms, Andy Reid, and Julie Anderson.
Shame on you for perpetuating discrimination.
Shame on you for being ignorant.
Shame on you for pandering.
But I suppose that is why the paper’s competitor, The Palm Beach Post, has won award after award for journalism with integrity in balanced reporting in this space.
The Statistics:
According to the National Survey on Drug Use and Health[1] conducted by the Substance Abuse and Mental Health Services Administration (“SAMHSA”), a division of the U.S. Department of Health and Human Services (“HHS”), 21.5 million American adults (aged 12 and older) battled a substance use disorder in 2014 and almost 80 percent of individuals suffering from a substance use disorder struggled with an alcohol use disorder; over 7 million Americans battled a drug use disorder. One out of every eight people who suffered from a drug use disorder struggled with both alcohol and drug use disorders simultaneously.
At the same time, the Office on National Drug Control Policy (“ONDCP”) reported as far back as 2007 that Substance Use Disorders cost American society close to $200 billion in healthcare, criminal justice, legal, and lost workplace production/participation costs. In 2016, the U.S. Surgeon General released his comprehensive report: “Facing Addiction in America – The Surgeon General’s Report on Alcohol, Drugs and Health” which concluded that, “[a]lcohol misuse, illicit drug use, misuse of medications, and substance use disorders are estimated to cost the United States more than $400 billion in lost workplace productivity (in part, due to premature mortality), health care expenses, law enforcement and other criminal justice costs (e.g., drug-related crimes), and losses from motor vehicle crashes.[2]
Most recently, a Pew Research Center survey conducted in August 2017 found that 46% of U.S. adults say they have a family member or close friend who is addicted to drugs or has been in the past.[3] Globally, the World Health Organization (WHO) had declared addiction to be a “global burden” stating that “psychoactive] substance use poses a significant threat to the health, social and economic fabric of families, communities and nations. The extent of worldwide psychoactive substance use is estimated at 2 billion alcohol users, 1.3 billion smokers and 185 million drug users.”[4]
Notwithstanding these statistics, local governments are loathe to provide the real estate and resources in order for service and housing providers to exist. Our country holds in little regard the private sector providers, while we laud the efforts of the government-funded agencies (which are not funded to innovate and find solutions to addiction but merely to be glorified pharmacies these days). How’s that been working out for us?
Typical Response from the Public:
Public perception drives policymaking by informing and educating the policymakers (i.e., elected officials) as to our national priorities. The recent mass shooting at Marjory Stoneman Douglas High School on February 14, 2018, is but one stark example. But with regard to addressing the massive public health concern of Substance Use Disorders, including alcoholism, the American public continues to hold tight to the perception that people with Substance Use Disorders and those who support service providers have a moral failing and have a lack of constitution. By blaming the addict for not taking personal responsibility for their own mental health, the public was not prepared to have their elected officials spend necessary funds to build the required social and physical infrastructure deemed necessary to seize the rapid growth of this epidemic. Our local and national media feed off of this stereotype and propagate it as it is an inherent truth.
Contrary to popular opinion, these people did not “choose” to become addicted to substances. Some of them have found that the use of substances mitigates cortisol levels induced my extreme stress (for example, Post-Traumatic Stress Disorders, or “PTSD”)[5] which underlying mental disorder only became popular to address during the past 17 years since military service men and women would return home with active substance misuse, similar to when soldiers returned from Vietnam in the 1970’s.[6]
More recently, most Americans have become addicted to prescribed substances intended to control pain (Opioids) or anxiety-related disorders (Benzodiazepine), both of which were readily known to have highly addicted qualities. These chemicals were scientifically demonstrated to “hijack” the dopamine receptors in the brain causing a deadly cycle of increased dosages often times leading to overdose and death.
For these Americans and all persons who suffer from addiction, their substance misuse is caused by a brain illness and is not a choice. Notwithstanding data, evidence, and science, this “truth” appears to be somewhat irreconcilable with prevailing American culture which demands adherence to a Puritanical code of rugged individualism and self-responsibility. Truth be told, there is currently no evidenced-based approved cure for addiction; the patient must be a willing and active participant in their own recovery, for the remainder of their lives.
As a result, public policy arguments banter back and forth trying to find consensus on how to address Substance Use Disorders and co-occurring mental illnesses, without much success. This failure or refusal to address addiction and mental illness comprehensively and effectively is the product of a lack of education on the subject-matter and the inability of policymakers to let go of long-held prejudices and preconceived notions of “who” addicts really are.
All the while, the press and mass media are directly responsible for perpetuating myths and misunderstanding.
Why I Chose to Represent Treatment and Housing Providers:
I graduated from the University of Miami School of Law, with honors, in 1997. In 2010, I relocated my private law practice of representing individuals and corporations relating to private property rights, land use and zoning before governmental entities, to Delray Beach. Almost immediately, I found myself being approached by drug and alcohol treatment centers to represent them with regard to local government attempts to regulate them out of that city.[7] Key to this issue was a new term, a “sober home”, which I later came to learn was appropriately termed a “Recovery Residence.” The mere existence of these homes in local neighborhoods became the issue of the day, as residents were fearful of who was living in these homes and the inherent threat addicts posed to their children, as well as their property values.
As a lawyer, who was required to take an oath to uphold the mandates of the United States Constitution, no differently than Mr. Frankel, I wanted to understand the problem so that I could serve the entirety of the public, not just my clients. I wanted to educate myself on what the real issues were, so that I could best serve not only my clients, but also to protect both this vulnerable population who were receiving these services as well as the local communities in which such homes and treatment providers were located.
I quickly became aware of the most notoriously open secret in Delray Beach – the existence of a vibrant and cohesive “Recovery Community” which was an organically evolved gathering of disparate individuals from across the United States, seeking to live together in collective sobriety and recovery from past misuse of substances. For the first time in my 45+ years as a South Floridian, I felt a sense of welcoming from a “community” that I had never experienced before in my life. Almost instantaneously, I had a literal dual déjà vu moment that has remained with me ever since, flashbacks to two significant events in my professional life that I did not realize up until that moment which had an impact on me.
The first event was my experience as an Assistant City Attorney for the City of Boca Raton in which the City had adopted a local zoning ordinance mandating that recovery housing providers may only be located in specific commercial zoning districts of the City, rather than residential. As the City was litigating this matter, the U.S. Department of Justice as well as the American Civil Liberties Union (“ACLU”) interceded into the case on behalf of the plaintiff housing provider, declaring that: “No citizen should be refused an equal opportunity for housing in their community… The Fair Housing Act protects all Americans from housing discrimination, including those persons recovering from substance abuse problems.”[8] This was the first time I was exposed to the writings explaining the long-standing public policy behind the Fair Housing Act, which was part of the original Civil Rights Act of 1967. That case, Jeffrey O. v. City of Boca Raton, 511 F.Supp.2d 1339 (S.D. Fla. 2007), became a landmark case for housing rights. I became fascinated by the writings amongst intellectuals, housing rights advocates, federal judges, as well as the Congressional Record itself, relating to the adoption of the Rehabilitation Act of 1973; the Fair Housing Amendments Act of 1988; and the Americans with Disabilities Act of 1990. And I, too, realized, that I had harbored preconceived notions about “those people” which I never had the opportunity to explore, until then.
The second event, which happened almost concurrently in time, was the publication on November 16, 2007 of the front-page article in the New York Times entitled: “In Florida, Addicts Find an Oasis of Sobriety.” [9] This stellar piece of insightful journalism lauded the acceptance, tolerance, and seamless integration of people in recovery into the fabric of the City of Delray Beach, exactly as I was experiencing it in real time in 2010. It was a story about hope and community. However, while the article was intended to illustrate a shining example of how a community had transformed itself to support its residents (new and old) with past addictions, elected officials and other homeowners viewed the article as a Scarlet Letter of shame and as having a negative impact upon the tourism industry from the north that local businesses heavily relied upon in the winter months.
What once was tolerance and acceptance quickly devolved, right in front of me, to antagonism, vilification, and alienation. Just as quickly, service providers to this population began to contact me as a known local zoning attorney representing businesses and private individuals regarding property rights litigation, to see what I could do to protect them.
By 2010, new local laws were being adopted, endeavoring to restrict service providers for people afflicted with Substance Use Disorders as well as those who provided sober living environments. However, this was not entirely discriminatory or without basis. South Florida, as had the rest of the nation, was experiencing three events simultaneously – the explosion of “Pill Mills” (the sale of mass quantities of opioids from supposed pain clinics); the Great Recession of 2008 (in which housing prices plummeted); and the adoption of the Patient Protection and Affordable Care Act of 2010 (which mandated, for the first time, that insurance companies cover mental health and addiction-related disorders). All three events combined caused a virtual overnight rush of unscrupulous people into Delray Beach to buy inexpensive single-family homes, fill them with young people addicted to opioids including heroin, and drug test them under the guise of providing a supposed “sober living environment” for which treatment providers would pay a hefty sum to get easy access to their insurance benefits.
While cities like Delray Beach were trying to grapple with this new reality, the “straw that broke the camel’s back” for the City of Delray Beach was the purchase by the non-profit Caron Foundation of Florida of two luxury homes on the beachfront. “Those people” had crossed the imaginary “line in the sand” of the Intracoastal Waterway, and into the “protected neighborhood” of the wealthy and politically connected. In what ultimately became the federal case of Caron Foundation of Fla., Inc. v. City of Delray Beach, 879 F.Supp.2d 1353 (S.D.Fla. 2012), the court ruled, once again, just as it had in 2007 that local governments may not use its zoning authority to discriminate against a protected class of citizen – in this instance, those with disabilities, of which Substance Use Disorder was deemed to be a part.[10]
What came next was an unequivocal shock to my system. After being involved in that case, I quickly began to experience abandonment from my peers and colleagues. It was now I who was wearing the Scarlet Letter. I was ostracized and stigmatized by those who I considered to otherwise be very educated and enlightened people, simply because of “who” I was representing – service providers for people overcoming addiction. When I tried to educate and enlighten my peers, I found their minds to be closed as having predisposed ideas of what “addicts” are and how they were a “danger to society.”
As other similar zoning cases progressed before the City, members of the public would jeer me, physically assault me, and explain how they felt pity for my parents for who I had become. I, too, would be further ostracized, criticized, rejected, scorned, labeled, hated, jeered, and mocked. I had to make a choice – take the easy road of doing “something else” in the law (which, at the time, was unclear, as my local zoning law practice was now being attacked by the NIMBYs), or I could take the road less traveled, the one without the fanfare, the one without the security of income, but with knowledge that I was doing the “right” thing.
In a moment of quiet meditation, I was then reminded of the oft-quoted poem by Martin Niemöller, which today is posted prominently at the United States Holocaust Museum in Washington, D.C.:
First they came for the Socialists, and I did not speak out—
Because I was not a Socialist.Then they came for the Trade Unionists, and I did not speak out—
Because I was not a Trade Unionist.Then they came for the Jews, and I did not speak out—
Because I was not a Jew.Then they came for me—and there was no one left to speak for me.
That was enough for me to decide to choose the path less taken, the path of uncertainly and fiscal insecurity, if for no other reason, because if I did not stand up for these people, in these times of uncertainty, then who would?
Since August 2010, I have always made myself available to those seeking to provide Substance Use Disorder treatment and sober living residences so that they could be free from discrimination and serve a population that has always been in dire need of services, but only if they would agree to do so in an ethical manner. For many providers, understanding where ethics began and where laws were broken was not clear without guidance from a lawyer. There was NO guidance from the very agency that was to regulate them – DCF. None. Zero. Not until the Palm Beach County State Attorney’s Office began an earnest attempt to bring the law’s mere existence to the attention of the public was there any modicum of clarity for those who did not seek guidance from legal counsel. And for those who did, both the public and the media such as the Sun-Sentinel has no hesitation to besmirch their reputation, such as that of Mr. Frankel.
Through it all, I have maintained a very simple truth – the cure to addiction is not sobriety; it is community. Mental health issues and co-occurring Substance Use Disorders continue to be blamed as the root cause of an unsustainable American society. I assert that these are simply the symptoms and byproducts of a society that no longer sustains its citizens. Media such as the Sun-Sentinel, meanwhile, enjoy propagating the negative to shame addicts and people who represent their service providers to go elsewhere.
That foundational understanding has been shared across generations, long before the creation of social media, and yet it has persisted. But addictions and mental health continue to tear communities apart due to, in my long experience, a lack of education, understanding, and resources. One of the few resources of education and information is our press, which refuses to engage in progressive public dialogue about the role that Substance Use Disorder treatment has within our communities and the fundamental need and right to provide safe and affordable housing for those who are both in treatment as well as those who are established in their recovery. Because it doesn’t sell newspapers. Rather, such media outlets pander to the lowest common denominator, which is ignorance, fear, and stereotype, prejudice, and anecdotal conjecture, because they can quantify how many website links the public clicks through to read, and then sell that data to advertisers. For news outlets like the Sun-Sentinel, it’s not about fair reporting – its all about money. Their values are compromised.
That said, I know many fine reporters for that paper. But this isn’t about them. It’s about the business decisions made by media outlets that compromise the integrity of the First Amendment and the Freedom of the Press. They have abdicated the right to be a part of the enlightened culture in our community, at least for today, in my eyes.
There is no doubt that, in recent years, many terrible, highly publicized things have occurred within this industry, encompassing healthcare fraud, deceit, victimization, and numerous overdose deaths.[11] Though through it all, we have fought very hard to have Delray Beach maintain the moniker of “Recovery Capital of the United States,” because it is that sense of community that I experienced back in 2010 which brought others who needed that connectivity simply to survive. I, as well as others, saw that connectivity as the glue that binds any community. Entities such as the Delray Beach Drug Task Force have consistently endeavored to educate adults within our communities on how to support similar recovery communities so as to protect the vulnerable and at the same time maintaining the integrity of our communities. At the same time, the press continues to try to tear it down.
Confronting Addiction:
I woke up this morning reminded yet again about the preconceived notions and hardened temperaments about “those people” that are deeply engrained in American society and perpetuated by mass media. There is no denying that fraud in all of healthcare is a huge problem, for which Substance Use Disorder treatment providers are not immune. But the myopic focus on the recent negatives of the Recovery Community make educating and advocating for this population difficult at best. This remains particularly saddening for me as Palm Beach County and the City of Delray Beach, specifically, had a long and honorable reputation for being a welcoming “Recovery Community” for those who sought to “pick themselves up by their bootstraps” and start life anew. But with all the community backlash, as highlighted repeatedly in the press, we continue to face a national health epidemic for which a lack of open-minds as to education continues to obstruct readily achievable and cost-effective, evidenced-based solutions.
Our collective ability to formulate timely and effective local, state, and federal policy continues to be stymied due to ignorance and intolerance of others. Though State Attorney Dave Aronberg’s Sober Homes Task Force[12] has successfully recommended legislation adopted by the State to curb the same type of abuses found throughout healthcare nationally, I continue to find the ability to communicate with one another on this topic to remain frustrated by the failure of even the most educated amongst us to recognize how the truth about addiction and service providers can be applied in a collaborative framework.
A Refusal to Be Educated:
In my effort to be a part of the education movement, I have journaled my experiences and have lectured across the country at various professional conferences. But I have also found that my ability to effectively communicate and educate adults who are policymakers has been limited in part by their lack of willingness to unclench their fists and open their ears. Still, lawyers and people like Mr. Frankel move forward to find balance in our society yet remain chastised in the press for doing so. Large media outlets like the Sun-Sentinel suggest a fine lawyer like Adam Frankel, Esq., should not get elected because he associates with “those people.”
Shame on you Sun-Sentinel. Mr. Frankel is a fine attorney who has worked collaboratively with the Sober Homes Task Force. Rather than report on all of his efforts to clean up the industry from the inside, you quickly set aside journalistic integrity and resorted to muckraking.
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