27th January 2021

The Addiction Treatment Industry: A Closer Look

The addiction treatment industry is full of committed professionals doing their best to help addicts escape from the nightmare of addiction. We would like to preface this post expressing our gratitude, love, and support for all of those remarkable individuals devoting their lives to the struggle against addiction. But as in any industry, there are a number of problematic trends, profit-motivated businesses, and self-serving individuals and institutions that are preying on the afflicted, and lining their pockets as their clients suffer. Today we’ll be taking a look at the major problems we see in the drug rehab industry.

The Costs

This problem is particularly pronounced in America, but it exists around the world. This recent Vox study explored the astronomical costs of treatment, telling the stories of families taken to the brink of financial ruin by their attempts to save a loved one. The National Survey on Drug Use and Health conducted in the US in 2018 concluded that approximately 314,000 Americans wanted and needed treatment in 2018, but were unable to afford it because they weren’t covered by insurance. Another study found that drug treatment services were over 10x more likely to be excluded from insurance plans than other medical services and that the disparity was growing larger.

Insurance companies have also done a poor job of selecting treatment providers within the rehab industry, often pushing clients to cheaper centers in Florida rather than more expensive facilities closer to home. An influential article published by the New Yorker last fall details the “Florida Shuffle”, a phenomenon where addicts are funneled into sober homes who profit from insurance payouts while offering minimal services beyond 12 Step meetings and urine tests. In fact, many of the treatment centers and sober homes in America were charging insurance companies up to $20,000 per month for the urinalysis of a single patient, while offering sub-standard care. 

The New Yorker article tells of one such center, Good Decisions, operated by Kenneth Bailynson, who bought the Green Terrace Condominium complex and opened a urinalysis lab. As the New Yorker writes: 

The Palm Beach Post reported that Bailynson turned Green Terrace into “an armed camp, where guards with guns made sure addicts did not leave.” At his detention hearing, Jim Hayes, the Assistant U.S. Attorney for the Southern District of Florida, described Good Decisions as a “piss farm,” in business “only to harvest residents’ urine.”  

Facilities like these often attempted to lure patients in with smartphones, gift cards, and free rent. Many of the sober homes and treatment centers in the existing rehab industry have condoned drug use on their premises, and confined patients against their will. As John Lehman of the Recovery Outcomes Institute noted, South Florida became “the relapse, rather than the recovery, capital of the world.

Enduring Questions

Because relapse is so common, facilities are subject to so little regulation, and the fact that we still have an incomplete understanding of the neurological processes that underlie addiction, it’s difficult to pinpoint exactly what treatments, or elements of treatment programs, work. As one analyst told Vox, There are 4,000 quality control measures for Medicare and Medicaid services in America. “There are none for addiction - zero.”

Shatterproof, an American organization dedicated to establishing national standards of care for addiction treatment is looking to change this reality. They’ve teamed up with many large insurers to try to “identify, reward, and promote” treatment providers who scrupulously follow the scientific evidence and provide a high standard of care. While cynics might speculate that this is the result of insurance companies losing lawsuits against the families of those victimized by the Florida Shuffle and insurance coverage that discriminates against the addicted (the case Wit vs. United Behavioral Health found the company guilty of wrongly rejecting 50,000 claims, and other lawsuits abound), the move toward national and even international standards is largely positive. 

But the fact remains that studies of treatment outcomes are largely conducted by the facilities themselves. They generally rely on self-reporting from past clients, with no verification of claims of sobriety. And the treatment centers are incentivized to select data points, or even falsify data, in order to appear more attractive to potential clients. While Shatterproof aims to become similar to Yelp! and allow potential clients access to data from patients, insurance companies, and providers in order to accurately assess facilities, we’re a long way from having the information we need.

The Influence of Stigma

Because of the dangerous stigma which surrounds addiction, many promising treatments, and public health policies are neglected. Opioid replacement therapies, needle exchanges, safe injection sites, and promising alternative therapies like ayahuasca and ibogaine remain illegal in a host of jurisdictions. As the opioid crisis rages on, and more lives are lost to overdose every day, the stigma of addiction often prevents lawmakers from utilizing approaches that have been proven to save lives and experimenting with treatments that have the potential to win the war with addiction.

While the scientific evidence that addiction is a medical problem occurring in the brain has become overwhelming, people and governments in many countries around the world are stubbornly clinging to misguided moral notions that force us to battle addiction with one hand tied behind our backs. Can you imagine if potentially lifesaving cancer treatments were neglected, hospitals’ mortality rates went unrecorded, or those with hypertension were told that their inability to lower their blood pressure was a personal failing? Most of the problems we are experiencing in the rehab industry could be overcome if the public demanded that addiction be dealt with as a common health problem.

At Iboga Tree Healing House we are deeply committed to the safety and well-being of our patients. We will continue to advocate against the stigma of addiction, and for the strictest possible standards in patient safety and quality of treatment. If you feel that you need a treatment center that is devoted to the health and well-being of its clients, get in touch with us today!