How did Frankie Taylor overdose in a state-licensed addiction treatment center?

Third in a regular series. See Dear Gov. Newsom: People are dying in the Rehab Riviera. Do something. and Dear Gov. Newsom: Their daughter’s been swallowed by California’s rehab monster

Hey, Gov. Newsom:

Today’s story is hard to hear, but terribly important. It’s about Frankie Taylor, who was all of 19 when he overdosed at the Lighthouse Treatment Center in Anaheim.

His parents want you to know that Taylor is far more than how he died. The sweet, sensitive type, Taylor loved the stage. He did magic tricks. In fifth grade, delivered a dramatic reading of Rudyard Kipling’s “If,” entirely from memory. Bought an electric guitar 10 days before the school talent show, taught himself to play Johnny Cash/9 Inch Nails’ “Hurt,” and performed it (in black top hat!) to riotous applause.

He was Peter Pan in the community play. Poured himself into original folk-rock songs that detailed a painful, but hopeful, journey. Volunteered with the church youth group. He was an incurable romantic, always had a girlfriend, and consulted his parents on the most thoughtful gifts to bestow upon his paramours.

Taylor, of Oregon, was found unresponsive in his closet shortly after the morning therapy session at a Lighthouse facility on Pearl Street. The official cause of death was “acute polydrug intoxication,” due to the combined toxic effects of fentanyl, narcotic analgesics and anti-depressants, according to the autopsy. That he died of drug poisoning in a state-licensed addiction treatment center — where his dad urged him to go for help — is, to his parents, the cruelest irony.

Seems that since 2014 at least two other deaths have happened at Lighthouse facilities, according to state documents. His parents didn’t know that because California keeps this information buried. There’s no simple, quick way to figure out if a provider has been connected to a death, or deaths, or has been the subject of complaints, or how a provider might have responded to any issues. The records the state released to me (months after they were requested) about deaths at licensed facilities were so heavily redacted it would be laughable if it wasn’t so tragic.

Anyway, Taylor’s dad and stepmom aren’t angry, but they’re plagued by questions.

How, exactly, did deadly drugs make their way into an addiction treatment center? Do dealers loiter nearby, watching for window curtains to part, waiting for a patient’s will to crack? Did someone inside the facility sell to him? Or, perhaps, did he find something in a well-hidden crevice, where a long-gone patient stashed it for a later that never came?

And why won’t anyone – from our state agencies or otherwise, Governor – help them find out?

The Taylors have been trying to get details from Lighthouse since that dreadful day, July 31, 2021.

“We are aware that Lighthouse has done an internal investigation,” his dad, Brad Taylor, wrote to Lighthouse executives nearly a month after his son’s death.

“We feel that we deserve to read the findings. Our hope is that you discovered how the drugs made it into your locked facility and we feel we deserve to know if you have. We also deserve to know how and why our son died. And if you were unable to discover how the drugs made it inside, I would suggest that your current residents are not safe.”

Details were not forthcoming.

The Taylors hoped for a criminal investigation into where the drugs came from. A growing number of prosecutors, including Orange County’s, charge fentanyl dealers with crimes akin to murder. The Anaheim PD was “compassionate,” the Taylors said, but didn’t feel a criminal investigation was warranted.

Grief remains a constant companion.

“For the past two years we have encouraged our son to enter into a locked residential treatment program to fully address his addiction,” Taylor’s dad wrote to Lighthouse officials in 2021. “July 13th he agreed to admit himself to Lighthouse. Just under three weeks later he died. It aches my heart to know that he died following my advice. Please help me understand the circumstances that led to his death.”

He still doesn’t have an answer.

“Mr. Taylor, we received a formal request from your attorney for certain records,” Lighthouse CEO Timothy J. Salyer wrote back after months of these pleas. “Therefore, we have turned the matter over to our attorney. … They have instructed us not to discuss this matter with anyone, including family members. That is why you have not received any response from us. We are truly sorry for your loss…. we would ask that you please refrain from contacting our employees and staff further. How information is provided is out of our hands at this time. We hope you can understand.”

‘Not a healthcare facility’

They don’t.

Frankie Taylor’s parents filed a wrongful death lawsuit against Lighthouse and its corporate parents, saying it failed in its duty to properly support and monitor their son to ensure he wouldn’t come into contact with drugs.

“Frankie realized that his disease of active addiction meant that he could not trust himself to make choices about substances,” his dad wrote in testimony for a recent public hearing. “He traded his freedom away and locked himself into a secured residential program so that he did not have to make choices about substances. He bravely exposed his vulnerabilities in daily groups and tore down his walls to try and get to the root of his disease. He was in the safest place he could find.”

Don’t picture some slick medical office; the Pearl Street “facility” where Taylor overdosed is a perfectly ordinary tract house, built in 1979, surrounded by a stubby white fence. His belongings were “thoroughly searched” and all medications were “logged and stored safely by staff” upon his arrival, the suit says. He wasn’t allowed to leave unsupervised. He couldn’t have any visitors. He had to submit to regular drug testing.

But after he left the morning group session on July 31, 2021, and went to his room, “he was somehow presented with an opportunity to make a decision about substances. And being given that choice in your facility led to his death,” Brad Taylor wrote to Lighthouse.

Taylor was taken to the Anaheim Regional Medical Center. An emergency room doctor said Taylor received nine shots of epinephrine, but they were unable to save his life. Taylor, 19, was pronounced dead at 1:40 p.m.

“Frankie Taylor should have had absolutely no access to drugs, prescription or otherwise, without staff administering them to him,” the suit says. Lighthouse “knew or should have known if narcotics were brought into the facility.”

It’s clear what happened, said Darren O. Aitken, attorney for Frankie Taylor’s parents. What the family so dearly wants to understand is how it happened, and stop it from happening again.

Salyer, CEO of the Lighthouse, said he can’t speak about ongoing litigation, and didn’t express great faith that this columnist would accurately relay his message or reflect what he called Lighthouse’s 24 years of service to the community.

But in court filings, Lighthouse said it acted in good faith, did not engage in any willful or intentional misconduct, and did not act negligently at any time. Rather, the company argues, it was Taylor’s fault.

Taylor “failed to exercise the degree of care and caution that a reasonable person would have exercised in similar circumstances,” Lighthouse’s response to the suit says. He “had a duty to use reasonable care to provide for his own well-being.”

Lighthouse is “not a healthcare facility and did not owe a duty to plaintiffs to provide skilled nursing services, acute hospital services, or other medical care,” it said.

Let’s repeat that so we’re clear: California’s addiction treatment facilities, licensed by the state Department of Health Care Services, are not health care facilities and do not owe a duty to provide skilled nursing services, acute hospital services or other medical care.

That’s a vital distinction that largely escapes folks who put faith in websites touting “24/7 treatment staff” and “medical supervision” and the ability to handle “dual diagnosis” on various pages, as Lighthouse’s does.

Not health care facilities. Seems crazy, right? “If addiction is a brain disease,” Dr. Walter Ling, professor of psychiatry and founding director of the Integrated Substance Abuse Programs at UCLA once mused, “where are all the doctors?”

‘Mistakes’

That’s a question California’s regulators should ponder. Hard.

The addiction treatment programs licensed by DHCS are mostly glorified 12-step programs providing group support (and, sometimes, excellent chefs and yoga and horse-petting) and charging health insurers a pretty penny. There’s no hard data anyone can point me to on their long-term effectiveness.

The point we’re trying to make here, Gov. Newsom, is that addiction treatment has been cleaved from the larger medical health care system – even as treatment centers charge rates more frequently associated with medical care, and bill those fees to health insurance companies and desperate out-of-pocket payers. Those billings can run thousands of dollars a day, for a stay in a tract house with no doctor present on staff. Everyone’s the poorer for it.

Why doesn’t California require folks to see a bona fide addiction medicine physician before checking in to a state-licensed rehab?

Why doesn’t it push the gold standard of addiction care — drugs like buprenorphine, which bind to the brain’s opioid receptors to essentially block a high — in the private-pay, insurance-money fueled sector of the treatment universe (where Frankie Taylor landed) as hard as it pushes that gold standard in public programs?

It bends the brain a bit, but, “If you’re in the public behavioral health system because you don’t have insurance, or you’re in Medicaid, you have a better chance of getting recovery-based treatment than you do in a private program,” Steve Fields, the Progress Foundation’s executive director, recently said.

We understand that addiction is often a fatal condition. People die. But there’s clearly a better way.

“I can accept that a mistake was made that resulted in my son coming across fentanyl while living in a secure facility. I do not, however, accept that his life and his death are not worth learning from,” Brad Taylor wrote.

“As a career social worker who has worked with hundreds of individuals who manage the disease of addiction, I do not expect any system or facility or staff member or person to be perfect. But if we want to improve our world and help those with addiction disorders to improve their lives, we need to raise our standards of care, eliminate the barriers of access, address the stigma that is assigned to those with the disease, and provide clarity and transparency when our systems, our facilities, our staff, our loved ones, and ourselves make mistakes.

“I am willing to let my experience as Frankie’s father inform and strengthen our community’s ability to support those who are sick,” Taylor wrote. “I call on treatment programs, and our community leaders, to do the same.”

Listen to Frankie Taylor’s original songs, “All Up From Here” and “A Good Life“