As patients pile up at the city’s only public detox center, the medical director busies himself at two private practices.
The first person signed in on Thursday morning’s waiting list at 1:23 a.m. Many of the others in the room have been waiting since 5:30 a.m. That’s the time the staffers at D.C.’s Addiction Prevention and Recovery Administration’s (APRA) detox unit advise clients to arrive, despite the fact that they won’t start admitting anyone until 9 a.m. And, as dawn rises, still more customers stream in.
By 8 a.m., in fact, the dingy blue waiting room is mobbed with people, parkas, and bags of clothing. Three women and nine men have schlepped here, past the emergency room, the morgue, the sexually transmitted disease clinic, the TB clinic, and the emergency psych ward in search of relief from various addictions. This squat little building on the grounds of D.C. General Hospital constitutes one of the two main entry points into the city’s drug treatment network—and the only free detox program available for the city’s homeless and indigent addicts.
The sign at the entry to the waiting room says the waits may range from one to three hours, but a quick glance at the snoring and shaking bodies strewn around the room suggests that even that estimate may be wishful thinking. By 10:30 a.m., there are still 10 of the original 12 people waiting, and more have started to arrive. Sitting on a plastic bucket next to the Coke machine, a booze-scented guy wearing dreadlocks, headphones, two pairs of peed-on jeans, unlaced combat boots, and a Mighty Ducks windbreaker talks to himself. “Bet you I drink more than anybody in here,” he mutters.
The man, who lives in a park near D.C. Superior Court, says the police brought him here at 9 last night. If he has to wait much longer, he says, “I’m going to go out and get me a drink and come back.” He laughs maniacally before stretching out on the floor and fishing an old sandwich out of the trash bucket.
Long waits, of course, are just one of the maladies plaguing the city’s only free detox center. Several months ago, a treatment counselor was forced out after officials learned that some of his counseling credentials had been forged. The man, Ferdinand Harris, has a long criminal record that includes a 1992 guilty plea to heroin possession charges. Harris declined to comment on the record for this story.
Then, in early January, Department of Health Director Ivan C.A. Walks, who oversees APRA, forced the detox administrator, David Hailes, to retire after a female client alleged that Hailes had taken her from the clinic to his house and had sex with her, according to sources inside APRA. (Hailes could not be reached for comment.)
At the time of Hailes’ departure, Walks promised a new age of efficient, humane care for the city’s 80,000 addicts. But a month later, the detox clinic still suffers from myriad problems ranging from broken beds to nonexistent therapy sessions. And the clinic is still run by Dr. John Bedeau, the medical director who is paid $101,570 a year to run the clinic full time—but spends many of his working hours in private practice far away from the smelly folks in the detox waiting room.
While dozens of people wait Thursday morning for a detox bed, the Washington City Paper finds Bedeau working in a small private medical office on Georgia Avenue NW, where the waiting room is filled only by a couple of prim senior citizens. And according to a receptionist at a second Bedeau private practice—in Largo, Md.—Bedeau usually spends Thursday afternoons out there.
According to current and former APRA staff, Bedeau spends only about two days a week at the detox clinic—a few hours each on Monday and Saturday—despite being paid by the city for full-time work. Last year, Bedeau even got a little bonus from the city, which paid him $5,500 for treating D.C. Medicaid patients in his private practice during the day, according to the Medicaid office. Sources in APRA say that in his absence, Bedeau left the day-to-day operation of the detox clinic to Hailes.
Councilmember David Catania (R-At Large), a longtime APRA critic who would like to see the detox unit privatized, becomes furious when told Wednesday about Bedeau’s private-practice work. “That’s outrageous!” he says, promising further investigation into the matter.
Bedeau refuses to answer many questions for this article, saying, “I’m not in the mood for a negative article,” before hanging up. Later, when pressed about his work hours, he replies furiously, “That’s none of your business.” Bedeau insists that other city doctors have private practices and that the City Paper has no business questioning his work habits. “I work more than 40 hours a week,” he fumes, leaving off with a threat: “If you come after detox, I come after you.”
Bedeau’s moonlighting is well-known within the agency that is only now starting to recover from a series of deep budget and service cuts over the past several years.
Karen Dale, a senior deputy at the Department of Health, says that there are no rules barring Bedeau from working another job so long as it does not interfere with his government service. However, she says, “Dr. Bedeau is a full-time government employee. It is our expectation that he would be there full time.” Dale says any allegations regarding Bedeau’s working hours would typically be handled by the Office of the Inspector General.
From the looks of it, detox could certainly benefit from a little more full-time management. A half-dozen counselors and drug treatment providers interviewed for this story all report that they have difficulty getting clients admitted to detox—even when they know beds are available. One social worker, who asked to remain anonymous, says he once referred a man to detox, only to have his client forced to wait in the lobby for three days. At the end of the wait, the man said, the staff told him to leave. Since he had waited in the room so long, they said, he was detoxified and therefore no longer needed to be admitted.
Darryl Colbert, program administrator for the substance abuse network at Catholic Charities, says detox staff also hold beds for people referred by the court, which limits the number of walk-in slots available.
Indeed, on Monday morning, a woman referred to detox by her HIV counselor at D.C. General and a man under court order to get treatment are both told by a staffer that the clinic has six empty beds. But, says the staffer, the beds are reserved for people who are supposed to have shown up hours earlier, and they will have to wait. The difficulty in getting admitted to detox is reflected in its client numbers. Despite having a capacity of 50 clients a week, detox has seen a paltry average of 38 a week over the past three years, according to data provided by the Department of Health.
In a phone interview, Bedeau admits that detox is understaffed and does not always have a doctor on site, as is necessary to admit patients. The clinic, he explains, has “coverage by pager” should any medical emergencies arrive, and the staff calls 911 if things get really bad.
The detox bottleneck is a serious one—and its effects go far beyond D.C.’s public health-care system. For instance, it’s almost impossible for people to get into other treatment programs without a few days in a detox program.
And once clients do manage to get into detox, there’s not much there to encourage them to continue treatment, according to former staff and other referral agencies. Bedeau says his staff provides a full range of support groups during the day and evening for clients. But Marcia Richardson, executive director of the nonprofit drug-treatment provider Safe Haven Ministries, says her clients routinely tell her that at detox, “All [they] do is walk around with a gown all day doing nothing.”
Sources familiar with the program say that detox clients have so much free time that they often leave without finishing or find less constructive ways of entertaining themselves—like having sex with each other, getting in fights, smoking in bed, and destroying the furniture.
Richardson says her clients have told similar stories. “We’ve had clients come back and tell us there are all kinds of things going on in the bathrooms—trysts,” she says. “It’s not much of a therapeutic setting. It just puts three or five days between them and their last drug. People are really just being herded through.”
Despite the clinic’s troubles, however, detox has its defenders—many of them people who’ve started their own recovery there. Throughout Thursday morning, a couple of men pass through the waiting room on their way out of 12-step meetings at Karrick Hall, the residential treatment facility next door. They say they like to come by and “uplift the people” who are just starting their journey into sobriety.
“This place really helped me,” says Eric Jones. “I don’t want to judge anything today. I’m just thankful by the grace of God that I’m clean and sober. When you come in here, you are financially and spiritually bankrupt. Sometimes you have to get treated bad to get something good out of it. I think I got the best treatment I could get for not having any money for insurance.
This isn’t Betty Ford.” CP