Have you heard what’s going on with drug addiction in this country? No, not the 47,055 Americans who are dying from it every year, or the tripling of heroin overdose deaths. Not the 23.5 million Americans who currently have an illicit drug or alcohol abuse issue, or the $700 billion in annual costs related to crime, lost work productivity and health care. These are important, startling statistics that certainly deserve attention and resources. But what I am referring to are the unscrupulous people trying to make a profit off of our nation’s current drug epidemic with unethical and shocking practices like patient brokering, identity theft, kickbacks and insurance fraud. It’s not widespread abuse – fortunately, there are still many high-quality, ethical treatment programs in this country – but it is happening often enough for us all to be concerned.
Somehow, even with all of our laws pertaining to drug possession and use, we still find ourselves in a largely unregulated addiction treatment field. And even worse, the biggest driving force seems to be well-meaning legislation like the Affordable Care and Parity Acts which made treatment more accessible for more people, opening the doors to predators and frauds to get in on the action.
A Behavioral Healthcare survey on ethical concerns within the addiction treatment industry identified patient brokering tactics in the form of money and gifts that some treatment centers are using to entice patients. Need treatment but don’t have insurance? Some programs will sign you up for a policy and pay for your first month if you go to their center. Need sober living but can’t afford it? Some programs will offer free rent and other amenities, then bill your insurance excessively for unnecessary drug testing and other services to make up the cost.
Sadly, many unregulated sober living homes have become unsafe and overcrowded “flophouses” where crimes like theft, human trafficking, prostitution, and illegal drug use are commonplace.
In fact, BuzzFeed News ran a story last year titled “Addicts for Sale” and described how people struggling with addiction are bought, sold and stolen for their insurance policies with many women forced into prostitution to keep a roof over their head and pad the pockets of rehab con-artists.
We’re also seeing patients-turned-recruiters, people just out of treatment with very little time in recovery who can suddenly start making big money selling people they know to rehab centers, checking themselves into competitor programs to lure clients away, and collecting “finder’s fees” of $500-$1,000 per patient or more. And if that doesn’t work, people are getting paid to relapse so that treatment centers can collect more insurance money. Shockingly, some of these practices are not technically illegal. And even if they are, states do not have the resources to regulate.
A Palm Beach Post investigation of the county’s $1 billion drug treatment industry found that testing the urine of recovering addicts is so lucrative that treatment centers are paying sober homes for patients. Urine drug screening costs maybe $6 once a week, but centers test every 48 hours and bill insurance $1,200 each time.
Florida has seen the brunt of the headlines (including the arrest of treatment center owner Kenneth Chatman), and actually has passed a Florida Patient Brokering Act which states that paying a marketer a per-head fee for patients, or offering any kind of financial incentive directly to an individual to entice them to pick your service, is a third-degree felony. But treatment programs around the country are slowly becoming aware of the lack of ethics creeping into this field.
One reason is that a program’s unethical actions can now have far-reaching affects to other centers clear across the country. Termed “black hat marketing”, some corrupt providers are overstating their treatment capabilities and using better established treatment program names to market and attract patients (a form of identity theft). They’re also using misleading websites or call centers to lure out-of-state patients who were actually looking for treatment nearby.
It’s an exploitation of some of our nation’s most vulnerable individuals and it needs to stop.
Excuses and rationalizations abound, including those about just wanting to help people who are struggling with addiction no matter what it takes. It should never take a bribe. Or fraud. These actions cannot be justified.
The biggest issue I have with these unethical practices is that, when it comes down to it, the patients are likely to lose the most by not getting the right treatment when they've just been sold to the highest bidder. We say we care about outcomes and evidence. We need to do better.
And we can.
If you work in this industry, report ethical violations to associations, accreditors, licensing bodies and state departments of health.
Last year, the National Alliance for Recovery Residences (NARR) officially approved a code of ethics. Familiarize yourself with these and urge other associations to follow suit. As Marvin Ventrell, executive director of the National Association of Addiction Treatment Providers (NAATP) said, “The industry is not corrupt. There are unethical players but to paint the entire addiction treatment industry with that brush is unfair. And we have to be absolutely clear to the public about that.”
Even if you don’t work in this industry, someone selling another person to the top bidding treatment provider should concern you. Statistics show this disease is rampant and does not discriminate. The next victim could be your wife, husband, brother, sister or child.
Unethical should equal illegal when it comes to the business of providing care for those suffering with substance use disorders.
Need help with substance abuse or mental health issues? In the U.S., call 1-800-RECOVERY or 800-662-HELP (4357) for the SAMHSA National Helpline.