The Business of Recovery

It’s time that the addiction/substance use disorder treatment system enter the 21st century and put patients, not profit, first.

 

The Business of Recovery

by Lloyd I Sederer, MD – Chair, Get Help Board of Advisors

Results guaranteed! 92 percent recover!
Pool, personal chef, and equine therapy included!

A promotion for snake oil? For a destination resort? Not exactly. That’s what families often read when they go online, frightened and desperate that a loved one with an addiction may die unless they are treated. That’s what those in the throes of an addiction read as well, and the seduction can be alluring.

People with addiction and their families often are (over)promised the moon, so to speak, and as we read in the accompanying story. But – they are required to pay rates from hundreds (to tens of thousands of dollars), every month for treatment. Some families mortgage their homes or spent their savings or money meant for the education of all their children.

The addiction treatment “industry” is principally for-profit. Many private, not-for-profits are in the business as well, with their CEOs and medical directors making high six-figure incomes. Annually, industry revenues are in the tens of billions of dollars. Addiction is ubiquitous in our society: Greater than one in 10 American workers have a substance use disorder, not counting tobacco (the greatest killer of all). The numbers of people affected is far greater when we consider the impact on family and other loved ones. 

This troubling substance use treatment system has largely escaped notice. That leaves patients and their families all the more subject to its false claims, inadequate treatments, and financial exploitation. That’s why we created Get Help.

A new study* (out of Harvard Medical School) importantly affirms the value of 12-Step Programs (like AA, NA). And we also know (see my recent book, The Addiction Solution: Treating Our Dependence on Opioids and Other Drugs (Scribner, 2018, now in paperback) how recovery interventions are additive: the best programs combine 12-Step with motivational techniques, cognitive-behavioral therapies, family education and support, and MAT (medication assisted treatment, like buprenorphine, methadone and Vivitrol {naltrexone}, which  can reduce cravings and help prevent relapse). 

Furthermore, what few addiction programs actually do (though many claim they do) is to assess the patient for the presence of a co-existing psychiatric condition, like depression, bipolar disorder, PTSD, and anxiety disorders. Unless a co-existing mental disorder is properly diagnosed and effectively treated the likelihood of attaining and sustaining recovery is markedly diminished because their mental health condition impairs their capacities to engage in the hard work of recovery.

What those affected by addiction, and their families, need is trustworthy information, which can keep hope alive. It’s time that the addiction/substance use disorder treatment system enter the 21st century and put patients, not profit, first.

*Kelly_JF, Humphreys_K, Ferri_M., Alcoholics Anonymous and other 12-step programs for alcohol use disorder.

Cochrane Database of Systematic Reviews 2020, Issue 3. Art. No.: CD012880. DOI: 10.1002/14651858.CD012880.pub2.

The views expressed here are entirely my own. I take no support from any pharmaceutical or device company.


From Vox

She wanted addiction treatment. She ended up in the relapse capital of America.

Brianna Jaynes asked for help for her drug addiction. Then Florida’s rehab industry exploited her for profit.

Brianna Jaynes wanted help for her addiction to painkillers and heroin. She ended up trapped in a cycle that focused on running up big insurance bills and landing profitable kickbacks — not addressing her drug problem.

In 2015, when Jaynes was 20, she started her rehab search by calling a number she found through Google. The person on the other end of the line promised to get her help: She’d be fine, and she’d get into one of the best addiction treatment facilities in the country. Jaynes had little experience with addiction treatment, and, in a moment of crisis, it was exactly what she wanted to hear.

But what Jaynes didn’t know is that she was speaking to a broker who, despite his claims, wasn’t working with the best treatment facilities. Instead, she later found out, he worked with facilities that had promised him a kickback for sending them patients. The facilities, in turn, would bill the patients’ insurance for thousands, if not tens of thousands, of dollars. READ MORE

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