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The administrative resistance to calling 911 was so pronounced that when one overmedicated, mentally disturbed patient fled the facility in hysterics one summer day in 2008, she was left to lie on the road outside the gate, screaming for help before collapsing into convulsions. One camp executive told staff on duty at the time, “Leave her alone. We don’t want to make a scene,” according to Bottoroff and other former staffers. It was left to neighbors to call 911. Nevertheless, the camp still makes more emergency calls than any comparable facility in the Santa Cruz area, according to addiction and ER doctors who reviewed 911 log data we obtained — perhaps a measure of just how ill many of the patients are at this nonmedical facility. That log showed 158 calls between January 2008 and August 2011. “That’s a lot of calls,” a local government official says. “It ought to be investigated.” Logged 911 calls represent only a small portion of total ER visits, the official observes, because it doesn’t account for people who arrive by other means.

Camp Recovery’s drive for secrecy was especially pronounced when it came to potential instances of sexual misconduct, violence or drug use among the adolescents in treatment, former staffers say. “There were several situations in which we were told by the director of the adolescent unit, per [current executive director] James Bailey, not to call 911,” says Bottoroff. Former staffers speak of wild nighttime teen assaults on weaker youth or even staff, and recount hushed-up incidents of underage girls having sex with adult male patients at their cabins. “They were trading favors for cigarettes and alcohol,” Bottoroff says of one such incident she encountered. In almost all such cases of on-site crime, according to an employee complaint to state regulators, the orders handed down from Stearns, the former executive director, in 2009 were clear: “We don’t contact the police.”

State investigators were rarely able confirm the most serious employee allegations on the few occasions when they bothered to investigate, a review of state reports shows. But this could be due to efforts by managers to cover their tracks. Trevor Bottoroff, a former Camp Recovery counselor and Shawn’s husband, says that sometimes managers would rewrite log sheets to make them seem more benign. At other times, supervisors would simply remove them. Murphy, the camp’s former adolescent director, came to see CRC as “the slumlords of treatment.” Other evasions are commonplace at Camp Recovery. The camp openly advertises that it offers prescription-based medical detox, though it is not licensed as a medical facility to do so.

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In California, regulation of drug treatment facilities appears especially ineffective. California’s Department of Alcohol and Drug Programs, for example, has never investigated the deaths of nearly 200 patients over five years at CRC’s 12 outpatient methadone clinics. Mostly likely, addiction experts say, the clients’ rampant substance abuse is the culprit, not sloppy practices at CRC, but that supposition has not been rigorously tested. In fact, Pennsylvania regulators cited two of CRC’s methadone clinics for failing to properly screen patients for drugs or narcotic use, a potentially deadly oversight. Weiner, the CRC spokesperson, said that CRC itself would doubtless look into any client deaths: “At least somebody’s going to wonder why they didn’t come in for their treatment the next day.”

“The programs have experienced the reality that there are no consequences if anyone dies,” says a knowledgeable ex-government official about California’s drug programs, including CRC’s methadone clinics, which have become the chain’s cash cow. With nearly 27,000 daily clients nationwide at 54 outpatient clinics, CRC founder Barry Karlin was dubbed by Treatment magazine “America’s Methadone King.”

Loose oversight seems to have been critical in enabling CRC to flourish. It’s hard to imagine, in particular, that without the scandalously weak monitoring of the teen treatment industry CRC’s Aspen division would be able to continue its harshly regimented, unproven behavior-modification methods and dicey emergency protocols. “Without regulations and enforcement, this profitable industry will continue to have actors that present unacceptable risks to the children they serve,” U.S. Rep. George Miller, D-Calif., said last year when introducing a federal oversight bill.

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