“I think that the Addiction Treatment Industry has made significant strides towards positive change, however we continue to face some concerning practices that must be addressed." -Dr. Stephen Odom, PhD
Thanks to television shows, podcasts, social media and celebrities in rehabs you’d have to live under a rock not know about the epidemic of addiction in 2017. This is actually a good thing. I always say awareness is key. But there’s a high price to pay for addiction: it costs addicts their jobs, families, freedom and too frequently, their lives.
Sadly, if they even make it to treatment centers, addicts end up arriving more than just spiritually and emotionally bankrupt—they are likely to be financially in dire straits as well. Turns out, that even though addiction is costly, recovery may be even more so.
An opportunity to make big bucks tends to leave a lot of wiggle room for unethical behavior. The business of addiction treatment has become quite a lucrative enterprise for a lot of people, with the unsavory few who incorporate shady and unethical practices into rehabs, treatments centers and sober living ruining it for the ones who don’t.
This means addicts, who are an extremely vulnerable demographic and need to be treated with optimal care, may be at risk. When it comes to getting proper substance abuse treatment, getting the right rehabilitation can mean the difference between life and death.
For a look at where we stand today and how we got here, I recently spoke with Dr. Stephen Odom for an eye-opening view into practices in addiction treatment in 2017.
Dr. Stephen Odom On Addiction Treatment In 2017
Dr. Stephen Odom, PhD. is President, CEO and Chief Clinical Officer of New Vista Behavioral Health, the parent company of Simple Recovery, Infinity Treatment Centers, and Avalon by the Sea, Malibu.
He has worked in the mental health and substance abuse industry for nearly 30 years and has the insight of a professional from the inside of a vastly changing juggernaut of controversy.
Dr. Odom, what are some of the biggest changes you’ve seen in the addiction treatment industry and is there anything that concerns you? Back in 2010, the Mental Health Parity and Addiction Equity Act (MHPAEA) was finally pushed through congress and mandated chemical dependency to be treated as any other illness. The result of that and The Affordable Care Act was that suddenly treatment was open to everyone with health insurance… the world opened up…at the same time, big-business realized there was money to be made and they got involved.
There were also very small operators who were usually people who recently became sober and decided “Hey, there's a lot of money to be made in treatment centers and I can help people like I was helped” and the next thing you know there were a lot of people running healthcare operations who had no experience in healthcare, and so they used methods and practices that came from other industries.
Sales tactics, call centers—things that increased admissions significantly evolved in the addiction treatment field, along with other tactics that were detrimental: paying for patients, brokering...that really flipped what was a good thing into what we call out here “The California Gold Rush.” Managed care initially didn't know how to handle these manipulations and they paid many treatment services and urine drug testing claims at “retail rates,” but after a few years they'd had enough, and began auditing claims, reducing claims payments, and becoming more strict in their requirements to be a covered provider.
How did that behavior and those activities affect the industry and can it be fixed?
People have been squeezed out of the industry for potentially fraudulent claims and unethical patient acquisition practices. Fortunately, there is a decision-making process managed care uses to determine eligible providers – both in-network and out-of-network - that uses criteria like national accreditation, quality standards and other standards to vet who they will pay for treatment services. The good news is that the institutions who are still standing have usually gone through thorough inspection. This consolidation is a good thing and was necessary.
I think all the signs are there for us to really attack addiction and get into the treatment of it so we can help people get better. I think we must be concerned about how to make sure it's still accessible to everyone. I think there's a lot of fear it's all going to be dismantled. We're going to find a way to do this. We are in a consolidation period, and in many ways treatment is going to get better because of it. The ones who are doing it right will survive and thrive and the ones who aren't doing it right will have to find something else to do...which is OK by me.
I think there are a lot of unethical people out there who work in this industry and I feel strongly about ethical practices in treatment centers and doing no harm trying to get people to where they need to go based on all the right circumstances…and keeping them there to recover in a safe environment. What do you think about standards and ethical behavior in addiction treatment?
What has been shamefully forgotten is that caregivers in the addiction treatment world are dealing with vulnerable people. As behavioral health providers we need to do what's best for them, and not just our bottom lines. We have so much influence in a time of crisis; it is a huge responsibility that must be taken seriously.
I don't believe people plan on being unethical, I think people bring what they know, and when you bring a mentality that was a way to sell mortgages or sell cars into addiction treatment and behavioral health what I described above can be the result. It's not pre-planning. Because managed care is only paying for very brief inpatient and residential stays, and pushes patients into outpatient care prematurely… people often still need a safe, sober place to live. Sober living homes are necessary; we just need to find a way to regulate it. We need to come up with a set of standards so there is licensing or certification for sober living. With no standards and no qualifications, you have can have a bunch of people living together who may still be active in their disease living in a place with few rules or boundaries. To find a place that feels more like home while you must go through something difficult like detox seems to make sense for a lot of people. As soon as we get sober living licensed I'm going to be a really happy guy.
Awareness Is Key: Addiction Treatment In 2017
It was so amazing to be enlightened by Dr. Odom and it really got me excited about the future of addiction treatment.
As an owner of Widespread Recovery and Laguna Detox, I feel strongly there are so many things the public needs to know. It’s important to be aware of the most common unethical business practices in the addiction treatment industry:
· Improper credentials and licensing.
· Billing: overcharging or double-billing clients or insurance.
· Patient brokering.
· Active use of substances.
· Sexual or violent misconduct.
The discussion with Dr. Odom made me feel hopeful about the future of addiction treatment because things are changing and progressing. The stereotyping and stigma of addiction is slowly going away. Addiction is being acknowledged as a disease and not just a choice for weak people.
Not only that, but many attendees in 12-step meetings are younger people and no longer the image of the old man on the street with a bottle of booze in a brown paper bag.
Addiction awareness is everywhere, we’re talking about it and it has become a part of our national agenda. Practices in addiction treatment have completely flipped 180°, and that’s a really good thing.