[Alice] Are the results that people are getting
from drug testing in Johnson County accurate?
Some are accurate, but not all are accurate.
[Alice] Like many private contractors
for the criminal justice system,
Averhealth is backed by private equity.
It's just so lucrative and pervasive.
[Marie] Averhealth is determining my future.
If I went to prison, I don't know
if I'd be able to come back from that.
dramatic music
[gunshots popping]
[Melissa] How ready is Taiwan's military
in the event of an invasion?
[speaking Chinese]
[Melissa] People say Taiwan is a part of China
or Taiwan is not a country.
[person speaking Chinese]
[Enoch] As long as Xi Jinping is in power,
we need to be prepared for the worst.
dramatic music
[screaming]
tense music
-[Marie] All right, you ready? -[child] Yeah!
Let's head out.
It's always the hardest day of the month.
It could be the last time that I see my daughter
and drop her off at school.
It usually shouldn't be a problem,
but with the way that the drug testing system is,
I never know what to expect.
[Alice] Marie is on felony probation
for fentanyl possession.
She has monthly check-ins with her probation officer,
and she must stay completely sober.
At her last meeting,
she was sent to jail for 72 hours
after testing positive for alcohol,
a substance she says she never consumes.
-So had you been drinking? -No.
Like, I haven't drank in probably six-plus years,
something like that.
-What did that feel like? -Oh, man.
It really just-- it honestly made me mad.
Like, I had a lot of anger when I heard
that there was something going on with my test.
I'm a recovering drug addict,
and once you've done all those bad things for so long,
nobody will believe you.
Nobody trusts you.
[Alice] Marie's probation requires drug testing
through the private company Averhealth.
[narrator] At Averhealth, we believe
the road to recovery goes way beyond
a positive or negative test result.
[Alice] Averhealth was born
in the midst of the opioid epidemic.
They've built a niche privatizing testing
in the U.S. criminal justice system.
But across the country, people being tested
accuse the company of inaccurate results.
And it's not just suspected drug users
alleging Averhealth's tests are wrong.
So does one of its own top scientists.
Vice News uncovered court documents
from a case in Michigan revealing that Averhealth's
former lab director claimed that up to 30%
of the tests being reported were wrong,
either false positive or false negative.
Averhealth said in a statement that it was compliant
with all standards
and that its former lab director's allegations
were baseless.
It also noted that an independent investigation
commissioned by the state of Michigan
found no issues with the testing process.
But Michigan temporarily suspended
its contract in March.
The state declined to comment as to the reasons.
But agencies in more than 20 other states
are still working with the company,
running up to 8,000 tests a day.
Drug testing has a massive impact on people's lives,
but the science behind the tests is very mysterious.
So we're headed to a lab to understand
how these tests actually work.
light music
Alex Krotulski is a forensic toxicologist
at a nonprofit lab outside of Philadelphia.
He demonstrated how a supposedly perfect test
can still go wrong.
So in here we're gonna grab some of our things
that we need for our test.
So in this refrigerator, we have these green boxes,
and in these green boxes are tiny glass vials
of all known drug standards.
So this is again what we use
to prepare our quality controls.
This is a library of drugs.
[Alex] Yeah.
The drug we're going to look for
is benzoylecgonine, the metabolite of cocaine.
I'm going to show you in a moment
how we prepare samples
to run them on a mass spectrometer.
[Alice] Mass spectrometry
is the gold standard of drug testing.
It compares the molecules in a sample to known drugs.
These instruments have strict quality control processes
to ensure accuracy.
[Alex] As a forensic toxicology lab,
there's always a number of controls that you put in place
to make sure that not only your experiments are working
and that your instrument's working,
but that you get the right result in the end.
[Alice] The quality control process
sounds like it takes a lot of time and effort
to get right, is that correct?
[Alex] It takes time to not only prepare
those additional samples.
It takes time to analyze the data
for those additional samples.
[Alice] If quality controls fail,
can the results be trusted?
Generally, no.
Generally, that's a huge red flag
for a forensic toxicologist.
They should say, "No, these tests are not accurate.
"Send the sample back to the lab.
"Go through the process again.
Make sure everything passes the next time."
[Alice] What Krotulski is describing
is at the heart of the whistleblower's claims
against Averhealth.
She said that the company was delivering results
even when quality controls failed.
And she said when she brought the improper lab practices
to management, Averhealth's executives
dismissed quality controls
as being too time-consuming.
Averhealth markets its rapid turnaround time,
and for the company, time equals money.
The drug testing industry is a $4 billion market,
nearly half of which is in the United States.
[Jason] We are absolutely saving lives.
We can point to thousands of case stories
where people have completely turned around their lives.
[Alice] Averhealth CEO Jason Herzog
worked at an investment bank
prior to acquiring the company.
Averhealth is funded by private equity
and received a $47 million investment
in 2021.
Herzog and Averhealth declined
our request for an on-camera interview.
But in the past, Herzog has said
he sees Averhealth as a disruptor.
[Jason] Before, the clinicians could only rely
on what the patient told them, and we've taken it
to an objective level so that there's no question
what's going on in that individual's life.
[Alice] Objective testing depends on
near-constant surveillance.
People need to be available for testing at Averhealth
365 days a year
and can be tested two to three times a week.
Averhealth says testing frequently
helps people stay sober,
but the company also profits from tests,
and people like Marie pay out of pocket.
I've spent over a thousand dollars,
if not thousands of dollars on these tests.
There's so many people that go there every single day,
multiple times a week.
They're getting millions of dollars
from all of us.
What was the impact of going to jail because of...
-Oh, boy. -...some of these tests?
You know, it caused a lot of problems with my family.
And if that happens again,
I have 18 months in prison this time.
With that being said, I would for sure lose my child.
[Alice] If Marie goes to prison,
the state could place her daughter into foster care.
Defense attorney Jay Norton
has contested Averhealth results in Kansas,
and he says Averhealth's profit incentives
are at odds with its supposed mission
of rehabilitating people.
[Jay] Averhealth is a for-profit company
that exists for the purpose of making money, right?
They're not a government agency.
They're getting contracts from the government
to provide these services.
And they want to keep that gig, 'cause they're making
millions and millions of dollars off of it.
Who is being required to test with Averhealth?
Virtually everybody, even people
who are not accused or convicted
of alcohol- or drug-related crimes.
Almost anybody who's on probation for anything
will be required to do
the daily urine testing call-ins.
Averhealth benefits 'cause they make money.
What is your perspective on the role
that Averhealth plays in the justice system?
Averhealth is performing a function
that used to be performed by people
that worked within the court system.
It's now been outsourced to a private company.
The courts have placed all of their faith in Averhealth
and are relying on Averhealth
to give them accurate results.
And nobody's checking up on whether they are or not.
There's no oversight over Averhealth.
[Alice] Courts are testing so often
because it costs them little or nothing to run.
And Averhealth makes the messy business
of monitoring someone's compliance
seem simple and easy,
but blanket drug testing has a social cost.
Failed tests are one of the most common reasons
someone on supervised release ends up behind bars.
Over-reliance on drug tests is a problem
that's even bigger than Averhealth,
according to Melissa Moore, a researcher
with the Drug Policy Alliance.
What do you make of the fact that a lot of people
are drug tested in the criminal justice system
whose original offense actually was not drug-related?
[Melissa] I think this shows in so many ways
the tentacles of the drug war that have seeped into
so many different aspects of people's lives.
The profit motive in and of itself
has led to a lot of people referring to
especially urinalysis drug testing as liquid gold,
because it's just so lucrative and so pervasive
across so many different sectors.
What do you make of the argument that drug tests
actually keep people out of prison?
That they're an alternative to incarceration?
Straight out, not the case.
I mean, we see so many people
end up being remanded into custody
because of just a positive toxicology.
Not because they've re-offended,
not because they've actually committed
any other crime,
but simply because they tested positive.
It doesn't necessarily lead
to them actually getting care or treatment.
Drug tests are really this instrument
that's often weaponized against people.
It adds an additional hurdle that often people stumble over
or can't clear,
and it's because the system around the testing itself
is super problematic.
[Alice] Averhealth said in a statement
that accuracy is paramount.
That it is regulated and that it recently passed inspections
by the clinical laboratory improvement amendments
in the College of American Pathologists.
It also said its testing frequency
is backed by addiction medicine
and varies based on the individual,
ranging from once a year to twice a week.
Marie's most recent test came back negative,
but she's just one of more than 500,000 people
currently testing with Averhealth
in the United States,
and if the allegations are true,
this means there could be hundreds of thousands
of people who are at risk for unjustly going to jail
or losing their children.
[Marie] Is it hard for me to stay sober?
Of course it is.
The old me, 10 years ago,
if this happened to me
and they said I was testing positive,
I would've said, "Screw this.
"I'm gonna go out, and I'm gonna use fentanyl,
"since you're saying I'm doing it anyways.
I might as well."
Okay. I won't hold on.
I'll just catch you if you fall, okay?
I know deep down in my heart,
I know my truth,
which is there's nothing in my system--
not even a cigarette.
Nothing at all.
Averhealth really is determining
my future and my entire life,
and I feel like they know that.
So it's really sad to think
that there are companies out there
that are profiting off of my addiction,
and that is disgusting.
tense music
[speaking Chinese]
[both speaking Chinese]
[Melissa] Home to 23 million people,
Taiwan is under constant threat
of invasion by China's formidable military.
And at its closest point
here on Taiwan's Kinmen Islands,
that danger is just over one mile away.
To those who live here, these islands
are part of a country, an independent democracy,
complete with its own executive, legislative,
and judicial branches of government.
But Beijing has long viewed Taiwan
as part of its own territory and has vowed to take it back
one way or another by 2049.
Here, however, a quiet invasion
is already happening.
Cing-Jhang Hong is a local surveyor
who helps the Taiwanese coast guard
track the movement of Chinese ships
that enter Taiwan's waters illegally.
Only these aren't warships.
They are dredgers gathering tons of sand
for construction projects.
At times, hundreds of these unmarked ships
test and exhaust the resources of Taiwan's coast guard.
It's called gray zone warfare.
tense music
[Melissa] While this may look like
slow motion territorial loss,
Beijing's crackdown
on pro-democracy protests in Hong Kong
and Putin's invasion of Ukraine
have fueled concerns that Russia's closest ally
will make good on a longstanding threat
to overtake the island.
[speaking Chinese]
[Melissa] Yet, even here on Kinmen,
one of the lines of defense against China,
the majority of Taiwanese remain divided
on whether an attack is possible.
[gate squeaking]
[speaking Chinese]
[indistinct chatter]
dramatic music
[Melissa] Tension between China and Taiwan
is partly rooted in the outcome
of the Chinese Civil War.
In 1949, the ruling Kuomintang Party
was defeated by the Chinese Communist Party
and withdrew to Taiwan,
where they relocated their government,
The Republic of China.
It's considered an illegitimate state
by Beijing, which maintains that Taiwan
is part of the Communist People's Republic of China.
Xi Jinping has promised
to over 1 billion Chinese citizens
that Taiwan will be theirs.
But like Ukraine,
Taiwan has a strong democratic leader,
President Tsai Ing-wen,
who refuses to be bullied by her more powerful neighbor.
tense music
[Melissa] President Tsai's bold declaration
falls on mostly deaf ears here.
Many of the men in this room
are about to or have just completed
their mandatory military service.
It lasts only four months, however,
meaning that despite Taiwanese defiance,
the island remains unprepared for a Chinese invasion.
[speaking Chinese]
[air horn blaring]
[rapping in Chinese]
[Melissa] Taiwan's conscription
remains deeply unpopular.
Any talk of lengthening the commitment
is met with opposition.
Hsu Chiao-hsin is seen as one of the rising stars
of the Kuomintang Party and a rare voice
advocating for extending the draft to one year
and requiring women to serve as well as men.
How ready is Taiwan's military
in the event of an invasion?
Mm. [speaking Chinese]
[Melissa] Many Taiwanese conscripts
end up with little training on how to shoot,
leaving those concerned with the island's defense
reliant on target practice with airsoft guns.
[beep]
[gunshots popping]
[Melissa] Oh...
[instructor speaking Chinese]
[beep]
[gunshots popping]
[Melissa] That was better.
What do you think of Taiwan's military?
[speaking Chinese]
[Melissa] Max Chiang is the owner of Polar Light,
a company that until recently
worked with local law enforcement,
but is increasingly training the general public.
[Melissa] More than half of the participants here
showed up in part because of what they saw
happen to Ukraine.
[speaking Chinese]
[beep]
[gunshots popping]
[Melissa] The tough reality is that
even if every Taiwanese fought,
they would stand little chance against China.
In the absence of a ready military,
Taiwan is reliant upon its relationship
with the United States to serve as both
a deterrent to China
and a supplier of high-tech weaponry.
Taipei only has official diplomatic relations
with 14 states and no seat at the UN.
In that sense, it is very much isolated,
making the U.S. relationship all the more important,
but it's a complicated one.
Even the U.S. does not recognize Taiwan
as a sovereign state.
However, the two have a long history together.
Taiwan's transition to democracy in the 1980s
was encouraged by Washington.
And in recent years, the U.S.
sees it as a front line in
the global ideological battle
between democracy
and authoritarianism.
In May, President Biden set off alarms in Beijing
when he appeared to stray from U.S. policy on China.
[reporter] Are you willing to get involved militarily
to defend Taiwan if it comes to that?
Yes.
[reporter] You are?
That's the commitment we made.
[Melissa] The White House later walked that statement back,
but on August 2nd, House Speaker Nancy Pelosi
visited Taiwan in a show of support.
[Nancy] Today, the world faces a choice
between democracy and autocracy.
America's determination to preserve democracy
here in Taiwan and around the world
remains ironclad.
[Melissa] Speaker Pelosi was the highest ranking
American representative to visit the island
in 25 years.
Beijing condemned her visit, and Chinese state media
lobbied for her plane to be shot out of the sky.
That didn't happen,
but China responded dramatically
and held its largest military drills ever,
exacerbating tensions
by encircling Taiwan's border and airspace.
[speaking Chinese]
[Melissa] Those who feel more urgency about an attack
have decided to rally their fellow citizens.
-How are you? Nice to see you. -Hey, Melissa.
Good to see you.
[Melissa] Enoch Wu is a former soldier
in the special forces
and a democratic progressive party candidate.
Now he leads a nonprofit that trains Taiwanese citizens
in civil defense.
We met him during the first day
of Taiwan's annual military exercises.
[Enoch] We're about to see a air raid drill.
What's gonna happen is siren's gonna go off,
and for the next 30 minutes, the general public's
expected to take cover, stay indoors.
Cars are expected to pull over.
We're talking about 20 million people
going through this drill.
Do you think these exercises are effective?
I think it serves as a good reminder
that this is something we need to be prepared for.
And I think folks start getting it,
especially seeing what's going on in Ukraine
for the last couple months.
[alarm blaring]
tense music
[Melissa] Taipei has almost 27,000 shelters,
yet many do not have supplies like food, water, or medicine.
Enoch thinks more preparation needs to happen,
and not just with shelters.
His organization, Forward Alliance,
has held more than 40 civil defense workshops
since a spike in interest following the Ukraine war.
[man speaking Chinese]
[Melissa] Yeah. It's pretty serious.
I mean, they're imagining
bullet wounds and stuff like that.
So this is really wartime thinking.
Usually you don't get a lot of shootings in Taiwan.
Given the scale of China's military might,
it's not surprising that many Taiwanese choose
to get on with their lives and not participate
in doomsday scenarios.
But China will make its move one day to take back
what it believes is already its own.
How do you respond when people say Taiwan is a part of China
or Taiwan is not a country?
[Enoch] We're a functioning democratic government.
We moved the country forward and became
one of the most liberal countries in Asia.
So for me, the fact
that citizens decide where we go
is proof enough that we are our own.
[Melissa] Are we in a more dangerous period for Taiwan?
[Enoch] We know we have a very aggressive neighbor
in the Beijing government
that's intent on addressing our differences with force.
As long as this regime stays in power,
I think it's the responsibility
of every single Taiwanese
and really the international community
to make sure that war does not break out across the straits.
But we can't control what an authoritarian regime does.
As long Xi Jinping is in power,
we need to be prepared for the worst.
dramatic music