Exclusive: CIA Torture Doctors Toured Federal Supermax Prison in 2003, Learned How to Respond to Hunger Strikes

USP Florence ADMAX — Photo: Bureau of Prisons

The super-maximum security or administrative maximum (ADX) federal prison in Florence, Colorado is widely considered the most remote, the harshest, the most punishing prison in America. Its prisoners include Ted Kaczynski (the “Unibomber”), purported 9/11 would-be terrorist Zacarias Moussaoui, “shoe-bomber” Richard Reid, and many other political and convicted terrorist prisoners.

According to former ADX prisoner Eli Hager, “It’s just the harshest place you’ve ever seen. Nothing living, not so much as a blade of grass anywhere.”

“My cell was all concrete. Every single thing, made out of concrete. The walls, floor, the desk, the sink, even the bed — a slab of concrete.”

In July 2003, three doctors from the CIA’s Office of Medical Services, and two senior officers from the CIA’s Rendition and Detention Group (RDG) were invited by Bureau of Prison (BOP) officials to visit ADX Florence. CIA officials were looking for help as their super-secret detention program was growing by leaps and bounds.

For full document, see end of article for embedded copy, or click here

According to a newly declassified document obtained by the ACLU, written by the chief of CIA’s Office of Medical Services (OMS) in 2007, by 2003 “the number of post-interrogation detainees” had grown, and “with no apparent prospect of transfer elsewhere, OMS had turned to the Federal prison system for insight into long-term prison care.”

Only a month earlier, in June 2003, Bureau of Prisons personnel were “invited to [CIA] Headquarters to discuss problems of long-term confinement.” This exchange of visits between CIA and BOP adds to what already had been revealed about collaboration between the nation’s top spy agency and the federal bureaucracy in charge of the nation’s prison system.

A June 2016 story at Vice by Jason Leopold explored the nature of BOP’s assistance to the CIA in late 2002. According to Leopold’s research, BOP “provided training to interrogators and guards on specific interrogation techniques,” including the use of short-shackling (or short-chaining).

Only a few weeks after BOP left the Salt Pit CIA black site, a CIA prisoner, Gul Rahman died of hypothermia, chained by BOP-taught short shackling in his cell.

But getting all this information was not easy. In November 2016, the ACLU settled a Freedom of Information Act lawsuit with the Bureau of Prisons over documents relating to a November 2002 visit by BOP officials to the CIA’s notorious Salt Pit black site prison. That visit was first mentioned when the Senate Select Committee on Intelligence (SSCI) released a redacted executive summary of their full 6,000 page report on the CIA’s torture, rendition and secret prison program.

The SSCI executive summary was released in December 2014, yet details about the CIA’s black site torture program are still slowly oozing out. The main issue here is the secrecy under which the CIA operates. In the case of the torture program, such secrecy allowed collaboration with torture to spread out far beyond the CIA program itself.

When the National Commission on Correctional Health Care inaugurated their annual summer conferences on mental health care in 2004, psychologists from the CIA’s Office of Medical Services, otherwise involved in torture at black sites, were there to participate. The lessons learned at the NCCHC conference were incorporated later that year into OMS Guidelines on interrogations and detention at CIA black sites.

“Top Secret”

When the ACLU won its appeal over BOP denial of any records relating to the 2002 visit to a CIA prison, they discovered that the only documentation of the visit consisted of a few emails. The reason there were no records of the BOP visit was because the CIA told BOP officials not to keep any records!

According to the released emails, the training BOP gave CIA and Guantanamo personnel was supposed to be “top secret.” They weren’t allowed to talk about it with anyone, not even their supervisor.

But neither the 2014 FOIA release to ACLU, nor the SSCI executive summary, revealed the presence of yet further BOP training to the CIA. Until now, the CIA visit to the Supermax prison in Florence, Colorado was unknown.

The situation is strangely similar to another visit to the CIA’s Salt Pit prison, which was undertaken by SSCI staff personnel themselves! A SSCI aide speaking on background told me that the visit in late 2003 — revealed in a little-quoted CIA counter-narrative to the SSCI investigation report — left no paper trail, because at the request of the CIA, the committee retained no records of the visit.

The OMS official described the July 2003 training at ADX Florence:

“The ADX staff provided a comprehensive tour and briefing that gave a good feel for the circumstances of detention, the medical care provided, and their experience with terrorist prisoners. OMS learned their protocols for dealing with hunger strikes, medical complaints and routine evaluations; and how they minimized the risk that personal effects as spectacles and toothbrushes would be made into weapons.”

Forced Feeding and Isolation

It is telling that the CIA/OMS protocols for dealing with hunger strikers was drawn up in consultation with BOP. The U.S. government has been widely condemned for following a policy of involuntary forced feeding of hunger strikers.

According to the OMS Chief’s narrative, such involuntary forced feeding was taking place at ADX Florence. At the time of the CIA’s visit, there were 22 “terrorist” prisoners kept in high-security detention. “About a third had made suicidal gestures,” he wrote, while “12 had initiated hunger strikes (5 were fed involuntarily by N-G tube).”

According to the OMS chief, “Fewer than five detainees ever refused food,” while in the CIA’s secret black sites. CIA policy on hunger strikers “was based on that of the Bureau of Prisons — allow[ing] a hunger strike to continue unless there was some apparent impact on the detainee’s health, or his weight fell to less than 90% of average for height. If one of these thresholds was reached, the health risks were explained. If a detainee still continued to refuse food, he was fed through an NG tube.”

The top CIA medical official claimed in his narrative that nasogastric tube feeding of hunger strikers “would have been accomplished involuntarily if necessary, but the few who required it were compliant and often assisted with the procedure.”

Whether that is true or not may never be known. But the OMS chief stated that hunger strikes “ended soon after these feedings began.”

Not mentioned by the CIA medical officer was the use of so-called “rectal rehydration and feeding” used on prisoners who refused liquids or food. Reports state that the CIA engaged in this torture practice on at least five prisoners.

At the same time as their visit to Colorado, OMS personnel were supervising the medical aspects of the CIA’s “enhanced interrogation” torture (EIT) program, which included use of waterboarding, “standing sleep deprivation (lasting from one to four days), punctuated by sessions which routinely included attention slaps, walling and water dousing,” as well as confinement in a closed box.

The “enhanced” version of sleep deprivation could last up to 264 hours, “with an 8 hr sleep break at 180 hrs,” and was considered the “mainstay” of the EIT program.

Other techniques weren’t discussed, like the use of “rectal rehydration”, mentioned above, and of solitary confinement or “isolation.” The latter was relegated to a list of so-called “standard” interrogation techniques (as against “enhanced” techniques). Other CIA “standard” techniques included diapering, hooding, water dousing, and continuous light or darkness, and use of sleep deprivation for less than 72 hours, among other forms of abusive treatment.

The OMS chief’s narrative, at one point, describes the especially debilitating effects of “isolation”:

“The impact of sustained isolation was the primary problem and proved more psychologically challenging than had the interrogations. By design, no contact with other detainees was allowed in Agency detention facilities and continuous white noise prevented them from hearing one another.”

Isolation, or solitary confinement, is also a key element at Supermax prisons in America, and cause tremendous psychological damage, according to most authorities. Today, U.S. Army interrogation policy, which also covers the CIA, uses isolation as a primary interrogation technique, despite its known damage to prisoners’ psyches and well-being.

Commenting on the CIA’s reliance on the BOP for assistance with their black site administration, Deputy Director, ACLU National Prison Project, Amy Fettig said in an email, “The fact that the CIA took lessons from our own prisons to learn how to torture people really tells you all you need to know about the use of solitary confinement in America.”

The CIA’s emphasis on use of “isolation” was never mentioned in the famous Office of Legal Council memos offering legal justification to the CIA’s torture program. Most likely, this is because the long-term damage secondary to such use of solitary confinement was well-known and could have been used as predicate evidence of intent to harm the detainees. Such evidence of foreknowledge of harm could open CIA personnel to prosecution under the torture statute.

In a November 16 press release from Physicians for Human Rights regarding the release of the CIA/OMS document, PHR stated, “The 90-page document provides a chilling account of how CIA health professionals willingly participated in torture. The ‘Summary and Reflections’ of an unnamed chief of CIA Medical Services narrates the decision-making process that led to health professionals signing off on, and participating in, interrogation and detention practices that clearly constituted torture. The document provides a cascade of self-justification and minimization of the risks and harm to detainees.”

The PHR statement quotes Dr. Scott Allen as saying “much of the information in this document was already known.” But Dr. Allen is wrong on this point. The revelations about the level of cooperation between the CIA and other federal civilian offices, such as the Bureau of Prisons, is still not totally known.

There are other important revelations that will come out of this CIA/OMS document, and I’ll be writing about them in the days to come.

Full text of CIA’s Chief, Office of Medical Services narrative, in PDF format: