Dear Gov. Newsom: Here’s a real California story for you. Ronald Reagan, Frank Sinatra, Phyllis Diller and Bob Hope are immortalized on Palm Springs’ Walk of the Stars — and so is reality TV celebrity Ken Seeley.
Seeley gained the national spotlight as a real-life superhero on A&E’s gut-wrenching “Intervention,” sweeping in as users spiral into addiction’s dark depths and often, against all odds, helping yank them out. His star power lent a special sheen to Seeley’s addiction treatment facilities — Ken Seeley Communities or KSC, doing business as Intervention911 — and attracts folks seeking similar miracles.
And so it was for Susan Rea of San Juan Capistrano. Despite repeated brushes with death, emergency room ordeals and stints in rehab, her 22-year-old son Dean just couldn’t shake perhaps the most dangerous addiction of all: to fentanyl. As you well know, Gov. Newsom, this synthetic opioid is some 50 times stronger than heroin and 100 times stronger than morphine. Just two milligrams of it — think a dozen or so grains of table salt — can kill.
Dean was more than his addiction. A skateboarder who loved the ocean. A surfer who taught kids to ride waves at Doheny Beach. A jokester with a gift for helping others see their own worth. A young man who had trouble seeing his own. He was diagnosed with bipolar disorder, generalized anxiety, ADHD and depression. It was 2021 and Rea was desperate to save her son’s life.
An acquaintance told Rea about Seeley and his operation in Palm Springs. Intervention911 could treat people with complex issues, routinely drug-tested clients and accepted her medical insurance.
They signed on and Rea drove Dean to Palm Springs herself. “I was looking for professionalism,” she said. “We all wanted Dean to get better.”
Dean entered detox at Intervention911 on March 13. Less than six weeks later, he was dead.
And this, Gov. Newsom, is where you — and California’s insurers and rehab regulators — come in. Dean’s compulsion to keep using despite the risks was very well-established. Therapists opined that he might actually have a death wish. Shocking details in Rea’s wrongful death suit against Seeley and Intervention911 suggest that so very many parts of California’s (tract-home-based, private-pay) addiction treatment system failed here — but as a parent, we get stuck on this:
If only California and its insurers required people like Dean Rea to see an addiction medicine specialist before checking in to non-medical facilities … if only a doctor had prescribed him buprenorphine, the gold-standard for managing opioid addiction, which cuts those compulsive cravings … if only he was encouraged, cajoled, convinced, even bribed to take it and keep taking it … if only, when things went dangerously south, he was taken to a hospital rather than allowed to wander off alone to die behind a gas station.
If only the private-pay piece of California’s addiction treatment system performed more like the public sector.
If only California bolstered oversight and professionalism along the Rehab Riviera.
If only, if only… Dean Rea might still be alive today.
Rea’s wrongful death suit just wrapped up in Riverside Superior Court with a confidential settlement agreement. Seeley and Intervention911 denied the allegations and admitted no wrongdoing. Its attorneys didn’t respond to our requests for comment, but in court documents, Intervention911 argued that Dean’s “own negligence was the sole and proximate cause” of his death.
Hundreds of pages of court documents vividly suggest weakness in the system itself. You can change that, Gov. Newsom. As you lobby us to approve a $6 billion initiative to expand mental health treatment, we implore you: Make sure California expands what works, rather than what doesn’t. Pay attention to the painful lessons embedded in Dean Rea’s story.
It was a life-or-death story. As all addiction stories are.
Missed opportunities
There are three main steps in the rehab world — detox, residential treatment, then outpatient treatment/sober living. Dean spent much longer than usual in that first, intense, detox phase — about 10 days.
He had “dangerously lethal” substance abuse disorder, bordering on passive suicidality, staffers noted. Without a “contained” treatment environment, he was at the highest risk of relapse and lethal overdose on fentanyl.
“I don’t want to die,” Dean said, according to court documents.
But rather than following the familiar three-step script — sending Dean from detox to residential treatment, where he’d still be watched — Dean skipped from step one to step three, a sober living-type home called The Amado. There, he had far greater freedom to do as he pleased than if he were in that middle step, residential treatment.
At The Amado, he continued using fentanyl, court documents say. But that didn’t show up on his drug tests because, as Susan Rea would later learn, Intervention911 did not test for fentanyl.
Veils drop and souls are bared in these settings. Intense bonds form. Dean fell for Meredith Voelkel, a young nurse who struggled with alcohol, and she fell right back. But Dean continued to “struggle with high-intensity agitated depression” and habitually self-medicated with lethal doses of analgesics, case notes said. More than a month in, “post-acute withdrawal symptoms” — hopelessness, anxiety, recklessness, impulsivity, irritability, mania, worthlessness — continued to plague him. He reported “high craving levels.” He was “easily triggered and reactive” for wanting to use drugs.
Where a more medical rehab model might have gotten him to a doctor or a higher level of care, Dean got a visit with his mother. He felt closest to her because she was always there for him.
It was April 22, 2021, the day before his death. Rea treated him to a fancy dinner at a Japanese restaurant. They ate, they laughed, they talked about his plans for getting a license and a job. “He thanked me,” Rea said. “He said, ‘You’ve been hard on me because you love me.’ “
The next day, Intervention 911 was taking clients to Laguna Beach for sun and sand. Dean wanted to go — but he wanted to spend time with his mother more. After his friends left for the beach, mother and son went to breakfast at the nearby Denny’s, then had a family therapy session. Dean texted Voelkel a photo of him kissing Rea on the head. ““I’m so happy you and your Mom are good and you get to spend time showing how well you are doing,” Voelkel texted back.
Dean had a hankering for some shrimp and a Monster Energy drink, so Rea stopped at a supermarket and arrived with the goods around noon. She called for Dean at his bedroom door.
“He did not answer her, but she heard gurgling noises,” the suit said. “She tried to open the door, but the door was locked.”
Susan pounded on the door. Dean still didn’t respond.
She intercepted a staffer. He didn’t have a key and didn’t know where one was.
The worker broke down the door. Dean was sprawled on the bed. Next to him, tin foil stained with brown marks. Susan called 911 while the worker tried to revive Dean. “Don’t die,” Susan said, squeezing his hand. “Please don’t die. Come back.”
Dean stirred and was conscious by the time paramedics arrived, about 12:30 p.m. Dean needed to go to the hospital, the paramedics said. Dean refused; he didn’t want to pay for an ambulance.
The executive director told emergency workers he’d take Dean to the hospital himself.
Rea was in shock. “I had just seen my son turn gray,” she said. “I never experienced anything like that in a rehab facility. He had never gotten to that point in front of me.”
“What do I do?” she asked the staffers.
Leave, they said. They’re trained to handle these situations. They’d take care of Dean.
And so, at about 12:50 p.m., Rea left. She would never see her son alive again.
‘Loaded gun’
The executive director demanded that Dean hand over whatever drugs remained.
Dean refused. They argued. “I’ve had enough of your (expletive), I’m leaving,” the director said, storming off and leaving the marketing and admissions guy to deal with Dean, according to documents.
You can go to the hospital or you can get kicked out, the marketing guy said. There was no offer to drive Dean to the hospital. No way for Dean to get there safely on his own. No other options presented — such as a return to detox — and no one summoned Rea to help, the suit said.
If only, if only. “I would have turned right around,” she said. “I would have crawled over fire for him.”
The marketing guy told Dean to pack his bags. Dean’s phone buzzed as he obliged; it was his girlfriend, Voelkel, calling from the beach. He had overdosed and was leaving KSC, he told her.
Voelkel was stunned. She asked if anyone was with him, and the marketing guy said he was there. Voelkel assumed Dean was going to the hospital. “She did not believe KSC would kick him out when he was high and unable to make rational decisions,” court documents say.
But that’s what happened, the suit said. KSC “kicked Dean out to the street all alone and with a lethal dose of fentanyl in hand. … KSC essentially gave Dean a loaded gun and told him to shoot himself.”
In Laguna Beach, Voelkel started to cry. A counselor sat her down. “Look at that trash can over there. Do you see that piece of trash? You need to leave the trash in the trash can.”
Dean wound up behind the gas station just around the corner from KSC. He called Jon Wan, a friend on the beach outing. Dean was speaking nonsense, Wan said in court papers, and admitted to smoking fentanyl by the dumpster. Wan assured Dean they’d help as soon as they returned to Palm Springs.
Meanwhile, Rea was calling multiple people, multiple times, for updates. She couldn’t reach anyone.
Dean stopped answering phone calls and texts sometime after 2 p.m. Concerned, a staffer asked the executive director to check on Dean. “I’m no (expletive) babysitter,” the executive director responded, according to the suit. “He’s been kicked out.”
It was after 5:30 p.m. when Dean’s friends returned from the beach. Wan beelined to the gas station and found Dean lying on the ground. Wan rolled Dean over. Blood leaked from Dean’s eyes. His face was gray. Ants crawled on him and flies buzzed around him.
Wan called 911 and raced back to The Amado to grab Narcan, the opioid-overdose antidote. Others came with him to help. But it was too late.
The executive director said Dean was not a client when he died. No one was to contact Rea. They’d let the coroner deliver the devastating news.
‘Breach of duty’
In dry legal language, it’s this:
“KSC breached its duty to Dean by kicking him out of its facility knowing his strong addiction and overdose history with fentanyl; his suicidal ideation; his diagnosis of having several mental health disorders; his prior use of fentanyl that day which resulted in paramedics being called to attend to him; knowing he continued to possess fentanyl; knowing he did not have any safe transport to a safe location; and knowing he was homeless,” the suit said.
“His death was highly foreseeable under the circumstances.”
The lock on his bedroom door. The lack of supervision. The failure to test for fentanyl. “Below the standard of care,” the suit said.
In declarations to the court, more than a dozen people laid the blame for Dean’s death at KSC’s feet. They should have gotten Dean to a higher level or care, or called police, or tried to put him on a 5150 psychiatric hold if he refused to hand over his drugs, they said. You never discharge someone in that condition without referrals.
“Some of the main lessons here are the importance of making sure people are in the appropriate level of care, and the importance of having trained, experienced people in charge,” said Christina Denning, Rea’s attorney, after the case closed.
“There’s so much turnover in these facilities. Important decisions were made by the marketing admissions guy and the executive director — management people, marketing people. They’re not doctors. They’re not therapists.”
We applaud California’s Bridge program, helping emergency departments become primary access points for addiction treatment. We applaud California’s hub-and-spoke system, increasing the availability of medication-assisted addiction treatment to people who need it. But it’s astonishing that close to half the state’s treatment providers — 41%, according to federal data — still eschew life-saving medication like buprenorphine. They equate a drug that can save your life with one that can kill you.
Might buprenorphine maintenance have spared Dean’s life? Dr. Randolph Holmes, who deals with government and public policy for the California Society of Addiction Medicine, counsels us not to be naïve.
“Many people resist treatment, even from doctors, and I spend a lot of time every day trying to convince people to start life-saving medications,” Holmes said.
But public providers funded by MediCal must either have medical providers, or be able to refer patients for medication-assisted treatment. There’s no such requirement for the private sector.
“CSAM has been trying for years to get legislation passed and signed to mandate access to medications for all,” Holmes said. “It is paradoxical that a person can get better access to evidence-based care in the public sector than in the private sector.”
If only, if only. Gov. Newsom, raise the bar for this industry in California.