I have worked with alcoholics and addicts for many, many years, and I worked for the Hazelden Foundation, the treatment program the author indicates he attended. His description of the events in treatment never could have happened. All treatment centers are strictly regulated by a licensing board called the Joint Commission as well by state laws. What James Frey describes is in gross violation of these strict standards of accreditation. The treatment center would have been severely disciplined or shut down. Hazelden is one of the finest treatment centers in the world and is the pioneer of treatment as we know it today. Their treatment program is centered on respecting the dignity of each patient and preserving the safety of all who are admitted.
James Frey would not have been admitted into treatment in such terrible medical condition without first being sent to a hospital for care and then admitted only after the hospital staff granted medical clearance. He wouldn't have been given stitches in his face at the treatment center, because treatment centers aren't licensed to give that level of medical care. Yes, recovering people can use anesthetic. Anesthetic is not an addictive drug, so no one needs to endure painful dental work or stitches or surgery without masking the pain. Pain medications (which are addictive) are used when necessary, such as after major surgery.
There are no men in white coats with syringes tackling people who misbehave. People in treatment don't behave in ways the author describes. People are mostly kind, caring and thoughtful. Disagreements are generally mild in nature, and mood-swings are usually the worst we must contend with. When someone behaves in an unacceptable manner, they are asked to change their behavior or be discharged. Treatment romances are never tolerated because they are a precursor to relapse and disrupt the entire unit. Physical violence always results in discharge, as does destruction of property. A patient would be asked to leave immediately if he destroyed a room full of furniture, for example. (Accomplishing this feat, by the way, would be extremely difficult because the furniture is made of heavy wood, built for endurance.)
The author's assertion that a doctor left the ER without treating him and then drove him to an airport is equally astonishing. Putting a patient on an airplane, where he cannot access emergency medical care while suffering from severe head injuries is unthinkable. That the airlines allowed James Frey on the plane is impossible to believe. These things simply aren't allowed to happen for very obvious and good reasons.
It goes without saying that counselors don't drive patients to crack houses-or anywhere else-while they are in treatment. Doing so would result in immediate dismissal. Never have I heard people screaming in detox, nor would someone be left lying on a floor overnight. Patients are well monitored and vitals are checked on a regular basis to be certain that blood pressure isn't dangerously high due to the body coming off alcohol and/or drugs. Without close monitoring, we would risk strokes or heart attacks. It is also surprising that almost everyone the author went through treatment with has died or disappeared in rather unorthodox ways. I've never know of this to happen and none of my colleagues, whom I've asked, have ever heard of this either. We sometimes hear that one individual out of a treatment group dies, but even that is fairly rare. People do relapse after treatment, but that happens primarily because people don't follow their aftercare plan.
I hope if you read this book, you will keep in mind that this description of treatment is fiction. No one who is thinking of going into treatment to seek help should be afraid, thinking they will experience things similar to what the author has described. All reputable treatment centers offer caring support, preserve patients' dignity and will not allow one person's behavior jeopardize the wellbeing of all others. As for the author's assertion that he has stayed sober without the help of AA or other 12 step groups, that may be true, but only about 2% of addicted people find this method successful. And of that 2%, most continue to behave in much the same way they did when they were drinking or using drugs, only without the alcohol or drugs in their systems. Sometimes they are so unhappy and angry being "dry" because, without a recovery program, they haven't learned to find contentment in sobriety, and their behavior becomes more intolerable than before. The main purpose of AA isn't just to quit drinking or taking drugs, but to become a better person in recovery.