LOS ANGELES • They enter through an unmarked store front, nestled between boutiques on Melrose Avenue. They gather in a circle, ready for the tough-love approach they have come to expect from Dr Howard C. Samuels, a clinical psychologist who runs the Hills, a drug rehabilitation centre.
A spot in the room is hard to come by, especially for the poor and anyone without the proper insurance. The Hills, which can cost around US$50,000 (S$70,000), serves a more privileged population, yet its mission is no less daunting.
In 2014, heroin became the most common reported drug of choice among those seeking treatment in Los Angeles County, surpassing marijuana and methamphetamine.
Dr Samuels began with what he called a reality check. "How many of you have been to at least five treatment centres?" he asked. Nearly every one of the 19 clients in the room raised a hand.
"How about 10?" Still half of the clients raised their hands.
One of them, Mr Jordan, agreed to tell his story only if his last name was not disclosed. This is only his third time in rehab, a relative rookie at 33 years old. This was his 118th day sober. He had smoked pot, taken ecstasy and snorted cocaine. But heroin seemed off-limits to him, a college-educated son of two therapists, until a friend offered him some. Four years later, he blew through a US$20,000 inheritance in a month to get heroin.
On this day, he knows he will draw the wrath of Dr Samuels: Subverting the rules, he recently got his seventh tattoo. "Don't you owe me an apology?" Dr Samuels said to him, almost shouting.
Mr Jordan answered quietly: "Yeah, I guess I owe you and some people an apology."
"I'm glad you're apologising to me. That's good, but what's bad is, it came so naturally," Dr Samuels said. "All of us have some real impulse control problems. That's why we're drug addicts."