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Used and Abused

What's it like to work at the state's largest detox? These counselors were scared straight.

On November 10, 1996, Denise Marshall was the graveyard supervisor at Arapahoe House's drug and alcohol detoxification facility in Wheat Ridge. When she'd arrived at 10 p.m. the night before, the facility already housed eighteen clients in various stages of intoxication. By the time Marshall's shift ended, at 7:30 the next morning, four others had appeared, drunk or stoned, needing to dry out. It was a light load for Detox West and a staff--four counselors, including Marshall--that could absorb up to twenty new admissions in a matter of hours.

Marshall recognized one of the new clients. "He was what we call a 'frequent flier,'" she recalls, a habitual drunk who was a regular visitor to the detox. As she sat at her desk and began filling out his paperwork for admission, the man became hostile, throwing about his belongings in a growing rage and then, suddenly, lunging at her. His punch had a tremendous impact--he'd gripped a roll of quarters in his hand to amplify the force--and a second later she found herself spitting out a broken tooth. The police were called, and the man was whisked off to jail.

Working in a detox is risky--drunks are unpredictable--and Marshall knew when she signed on five years ago that there might be hazards. But this was far from the first time that she'd been injured, and the incident infuriated her. "This facility is not a safe place to work," she scribbled in that night's shift report.

"Of course, Arapahoe House will find a way to blame this on the supervisor, I'm sure," she added.

And, she says, the following day she was reprimanded by her superior, who reminded her that she was not to send any more clients to jail. The reason, as Marshall well knew by that time, was money. Jefferson County pays Arapahoe House's west-side detox to take in all of the drunks picked up by the county's law-enforcement agencies. The operative word is "all": If the detox refuses to accept one--even if it is because he is violent or threatening--Arapahoe House is penalized at a rate of $150 per refusal.

"We expect them to handle these people--that's their business," explains Tom Giacinti, director of Jeffco's Department of Community Corrections, which administers the contract with Arapahoe House. "I mean, if they're drunk, they aren't going to be real violent."

Less than a week later, Denise Marshall was on the graveyard shift when the man who'd assaulted her showed up again.

Her choices were slim. She could admit the man and hope he wouldn't be violent on this particular night. Or she could send him back to jail, risking the wrath of her bosses. "And I had been getting increasing pressure from my supervisor not to send people to jail," she recalls.

So instead, she got creative. She ordered the man sent to another Arapahoe House detox, this one in Englewood, where the facility didn't have a penalizing contract with the local police. She warned the staff there that the man would be arriving. They alerted the police, who quickly carted him off to the Arapahoe County jail when he showed up.

Marshall, who quit her job at Arapahoe House late last month, estimates that during particularly bad stretches, she would resort to that maneuver three to four times a week. "I had a thing worked out with some of the supervisors at the other [Arapahoe House] detoxes," she says. "It was an unwritten agreement. It was the way we got around getting injured."

At other times when she felt pressure to admit drunks that she thought were too out-of-control or threatening for Detox West, Marshall improvised a less complicated solution. "When they told me I had to keep a violent person, I'd call the police and say, 'I'm opening the door now and letting him walk out,'" she says.

"When you're put under pressure to do something that threatens your safety or your job, you problem-solve," she explains. "I did it to keep myself, my staff and my clients safe."

It didn't always work. During her five years at Arapahoe House, Marshall says that violent clients broke her hands twice, gave her several black eyes and yanked out hunks of her hair.

Marshall isn't alone in her concerns over the safety and well-being of Arapahoe House workers and clients alike. A number of former and current counselors and supervisors say the contract with Jefferson County has forced them into making snap choices between their personal security and their job security. They have their own stories of violence and danger at the Detox West facility. The stories, many of which can be verified through written staff reports and other documents, range from instances of benign neglect (harried counselors dispensing medications without prescriptions, not monitoring clients' vital signs as they dry out) to actual sexual assault and battery.

These workers have expressed their frustrations at being given few, if any, tools to handle their responsibilities toward the intoxicated people in their care. For instance, they point out that there is no medical staff on site to watch over clients who can show up with complex medical problems and who can suffer sudden seizures during withdrawal.

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