Treatment Centers – 1 – A Growingly Profitable Industry in the United States

The purpose of this short video is to emphasize the point that you are vulnerable and need to be very selective and careful when choosing a treatment center for your loved one. Rehab centers are a business and a very profitable business at that.

This video emphasizes that treatment centers are “for profit” businesses that have exponentially grown in number, and are very expensive to attend.

Everyday in the U.S. over 6,300 people seek some form of addiction treatment.  In 1986, it was a $9 Billion industry that included 4,000 treatment centers nationwide.  By 2016, the industry was worth $34 Billion, yet in that 20 year period drug overdose death rates have tripled.  Today, the U.S. is home to over 14,000 treatment centers.

One man testifies he’s been to 12 treatment centers in 10 years. Another says he’s been offered to go to treatment 20 times and actually went 10. Others describe the characteristics of treatment centers, and go so far as to compare it to “being on vacation”.  While you’re in treatment your meals could be prepared by a private chef, maybe there’s a swimming pool, your family is likely happy you’re there, and the center itself has promised to “fix” you.

A woman shares that after 5 months of treatment she incurred $92,000 in out of pocket expenses, and a man discloses his final cost of treatment was $150,000.  A father talks about emptying out college funds and using credit cards to pay for treatment, because like many other parents would agree, you’re willing to do whatever it takes help your kids get the help they need when they struggle with addiction.  It is apparent that treatment centers profit from selling hope to these people.

Treatment Centers – 2 – The “12 Steps” Failure to Deliver Success

Curious as to the types of treatment available, the creators of this video embarked on a journey around the country stopping at numerous treatment centers along the way. They learned that most are founded by Alcoholics Anonymous (AA) driven information, and similarly ran groups and meetings. The governing principles of AA are the 12 steps, and in turn those principles are the basis of most treatment centers. Treatment can include other things like poetry, yoga, anger management, and so on, but most do also include outside 12-step meetings.

Approximately 90% of the treatment centers in the U.S. are structured around the 12-steps, which begs the question: Do the 12-Steps WORK?

Harvard Medical School graduate, Dr. Lance Dodes has a thorough background in addiction. As a distinguished doctor of psychology, author, and having treated over a couple thousand people struggling with addiction, he’s proven himself a qualified addiction expert. He contends that if almost all treatment centers are based on the 12-steps of AA then their effectiveness depends entirely on if the 12-steps work. Unfortunately the 12-steps only have about a 5-10% success rate.

Dr. Dodes concludes that if the vast majority of people in 12-step programs fail, those principles should not be the standard the treatment industry is based on.

Treatment Centers – 3 – Unconventional Therapies and Lengthy Stays

In this video Dr. William R. Miller says educational lectures (standing and talking in front of groups of people) has virtually no effect on treatment outcome.

There are an array of other therapies that inpatient facilities offer, including yoga, beach walks, kayaking, surfing, art therapy, music therapy, and so on. One former resident reflects on his experience staying at a treatment center, and cannot mask his distaste for “Equine assisted psychotherapy” (or horse therapy). He states specifically that petting a horse will “not keep a needle out of his arm”.

In search of what does “work” the journey continues to an educational conference for addiction counselors in Palm Springs, California. There we are shown a large exhibit hall where the various exhibitors all seemed to share a few commons ideologies: (1) addiction is a disease, (2) their company has a great success rate, and (3) the longer patients are in treatment, the better.

Treatment Centers – 4 – Over Promising the 12 Step “Gold Standard” of Care Part 1

In this video the executives of some of the largest rehab centers promote AA working as “the best” solution to sobriety. Treatment centers are promoted as the “Gold Standard” when it comes to “Care” despite the lack of evidence. Scott Sowle, Executive Director of the Newport Academy, admits, “There is no formal data to show that 12-step is proven but it definitely works.”

Emeritus Distinguished Professor William R. Miller, Ph.D. of the University of New Mexico states, “I don’t know of any evidence that the 12 step approach is superior to everything else, the data does not look that way.  If anyone is saying that it’s a statement of faith not a statement of science.”
Then why have the leading treatment centers in the U.S. incorporated the AA principles when delivering “Gold Standard” of Care? It may sound medical, fit into American themes, and touch on Americans approach to religion, but the 12-steps still are not an effective treatment for alcoholism.

The takeaway here is be careful when putting too much emphasis on 12 step program success claims many treatment centers make. They do work for an estimated 10% of people but it is not a solution that has hard data to support the claims.

Treatment Centers – 5 – Over Promising the 12 Step “Gold Standard” of Care Part 2

In this short video, John Schwarzlose, President and CEO of the famed Betty Ford Treatment Center in Rancho Mirage, California, says nothing has been more effective than the 12-steps.  When asked why this works Schwarzlose replies, “This is evidence based practice at its best.”

Dr. Marvin Seppala, Chief Medical officer of the Hazelden Foundation in Center City, Minnesota, quotes the “The Big Book” (the basic text for Alcoholics Anonymous), “Rarely have we seen a person fail that has thoroughly followed our path.”  He asserts that overtime that’s proven truth.

To follow-up on these strong statements condoning the 12-steps, the creators of this video went to the National Institute on Drug Abuse (NIDA) in Bethesda, Maryland.  Health Scientist Ruben Baler of NIDA says that 12 step programs are very popular, but they have no scientific basis to by which to measure its success.

The takeaway here is be careful when putting too much emphasis on 12 step program success claims many treatment centers make. They do work for an estimated 10% of people but it is not a solution that has hard data to support the claims.

In our experience the highest success rates are attained with a combination of aftercare support that includes regular psychotherapy, medically supervised treatment and active involvement in community support groups like AA (12 step program).

Treatment Centers – 6 – The High Risk Bet on 12-Steps

This video begins with a statement that AA based treatment is a gamble: You’re gambling that you are a part of the 5-10% of people that find success in AA style (12-step) treatment. Under this type of treatment if you’re not doing well it’s because you’re not going to enough meetings, or you should start going to more meetings. The 12-steps and their effectiveness is a statement of faith not a statement of science. AA is therefore not really a treatment, it’s a fellowship

New York cab driver Steven Sheley then shares his personal experience with the 12-step program, professing his love for AA and how it has kept him sober for 25 years. After numerous run-ins with the law and an overall destructive life, he finally found sobriety through his passion for AA. Over the years he has walked some 150 men through the 12-steps, but only 6 of those men have made it. Sheley states that only 1 out of 20 people (about 5%) of people find success in the program.

Addiction Expert Stanton Peele, Ph.D. goes on to share his opinion, “AA is the most successful public relations effort of the second half of the American history.” Dr. Peele explains that there is no evidence or clinical studies that say AA produces better outcomes than not putting people in AA.

Treatment Centers – 7 – Beware of Accreditation and Evidence Success Rate Claims Part 1

This video discusses an odd element to the to the addiction industry: the non-profit accreditation companies that look like “official” government oversight agencies.  To the consumer this looks very official, but it actually serves as a part of a facility’s sales pitch.

Rebecca Flood, President & CEO of New Directions for Women says “I would talk to anyone about choosing a licensed and accredited facility because you’re required through accreditation to use best practices”.  An accreditation company MAY look at building safety issues and documentation, but they do not address the effectiveness of the treatment being provided.

The National Association of Addiction Treatment Providers (NAATP) is a coalition of treatment centers that look like a government agency.  Despite the official sounding name, this is merely a member network that upholds no standard of industry success, yet allows their advertisers to vigorously promote their success rates.  Most treatment center CEOs or Directors state their program’s success rate is 80% while up to now they lack the data to back it up.  People in the public have no way to effectively shop for the right treatment program amongst the constantly delusive advertisements.

Treatment Centers – 8 – Beware of Accreditation and Evidence Success Rate Claims Part 2

This video discusses the low bar that has been set for evaluating success rates in the treatment industry.  More than ½ the states require “evidence based treatment models” in order to get paid.  “Evidence” and “Evidence-based” have now become buzzwords within the industry.

In essence, “Evidence” and “Evidence-based” treatment requires a body of scientific research literature.  The controversy then presents that there only needs to be one positive trial outcome (even if there are 19 negative outcomes) to be qualify as “Evidence-based”.

How do you then measure the success rate? The Directors of the treatment facilities admit that it is timely and expensive to follow up with every discharged or past patient, so they are largely relying on self-reports.  On the other hand, the doctors who advocate true science based data for measuring treatment success, say that self-reports are not reliable.  There is no way to know if the number of abstinent patients is correct or not, and what’s to stop someone from not disclosing they’ve been drinking?

The takeaway here is to ask your treatment center specifically how they track and measure success rates? Is it self-reporting or another method? And if the treatment center makes a “guarantee” than find out specifically what is guaranteed and be sure to get it in writing.

Treatment Centers – 9 – Sub-Par Standards for Addiction Counselors

The requirements for getting into the treatment-counseling field are not especially difficult to fulfill. Certificate training programs for prospective treatment center counselors have no high school or college as a prerequisite and can be completed in 6 months. The creators of this video even found open-for-hire counselor positions that require no education beyond experience with a 12-step program.

Having addicts be responsible for the health, safety, and care of other addicts raises a big issue in the credibility and integrity of the treatment industry. Counselor duties could include supervising medications, suicidal clients, and after-hours care, all while they themselves may be unstable in their own recovery. Medical personnel and other trained professionals should be in charge of these types responsibilities and treatments. After much adversity, the state of New Mexico now does require substance abuse counselors to hold a Bachelor’s degree.

Truth be told, there should have never been a controversy surrounding the qualifying education level of a person that’s helping another person with their “disease”. It’s described as an “accident of history”, when people in the U.S. with alcohol problems were simply ignored, and the only help they could get was from other people in recovery through AA and the 12-steps. Members of 12-step program can offer their “support as an adjunct” but that alone is not enough to be a working professional; that’s being an advocate.

Treatment Centers – 10 – Beware! Remember it’s a “For Profit” Business Part 1

Recovery treatment centers have a reputation for facilitating controversial financial transactions.  It can be quite easy to take advantage of families, and especially parents, when they think their child is going to die.  They may think that if the treatment costs $50k per month then it must really work, but in this “for profit” industry that’s usually not the case.

David Taborelli was incoherent when he was dropped off at a Palm Springs treatment center with over 4 times the legal limit of alcohol in his system.  He attests the staff went through his wallet to see which credit cards they could run $23k on.  The next day when he decided to leave the facility they only refunded half of his money.  He ultimately hired an attorney to recover the remainder of the funds for the one night stay.

The testimonies in this video propel the notion that substance abuse treatment centers are only concerned with profits.  David’s expensive evening is a shining example of someone not of sound mind being financially taken advantage of, but we cannot neglect the many instances where the family members of addicted person essentially “mortgage everything” to pay for their treatment.

Treatment Centers – 11 – Beware! Remember it’s a “For Profit” Business Part 2

This video suggests that despite the “propaganda” treatment centers serve in their sales pitch, there is no direct correlation between time in treatment and likelihood of sobriety.  Experts in the industry and patients, alike seem to share this sentiment.

Dr. William R. Miller says the argument that “longer is better” is not based on clinical trials.  It’s not the length of treatment that matters, it’s the effectiveness of the treatment.  Dr. Lance Dodes asserts that if the treatment itself is not addressing the psychological factors behind the addiction, than it defeats the purpose.  Addictionist Marty Brenner says rehab, sober living environments, and outpatient services are all services designed to keep the addicts there longer to make more money.

Referring to his experience as a resident of a rehab center in Malibu, California, Michael Elovitz described the experience as “money wasted”.  He describes an incident during “family weekend” whereat his father and sister were in attendance.  Michael told the therapist he can no longer afford these services and wasn’t sure he was getting anything out of it.  The therapist then resorted to using scare tactics in the presence of his family, stating that “if he didn’t stay he will die”.

David Taborelli (as featured in Video 10: “Treatment Centers – Mortgaging the Farm: The Cost of Recovery”) remarks that treatment centers will never ask if you’re “ready to quit drinking” as the make or break factor to get you in.  Instead their concerns are based on if the credit card works or if the insurance company gives it a thumbs up – then you’re ready.  Addictionologist Stuart Finkelstein, MD, says spending money on say a $40k treatment center in Palm Springs, California is no more effective than going to 90 Alcoholic’s Anonymous (AA) meetings in 90 days and reading “The Big Book of AA”.  The only difference is the exorbitant cost.

The takeaway here is to be cautious of the upselling that does occur with many treatment centers. You are at a very vulnerable point in life and unfortunately some treatment centers will take advantage of that fact.

Treatment Centers – 12 – Summing up a Hefty Bill

This video divulges alarming breakdown of what’s included in the price of one month of treatment at the famed Betty Ford Center versus residential care at The Regency Senior Care Home (both in Southern California).

Betty Ford residents receive:

  1. Private room
  2. Meals
  3. Utilities, Laundry, Housekeeping
  4. Professionally trained staff
  5. Access to medical professionals
  6. Meditational therapy
  7. Relapse prevention lecture therapy
  8. Process lecture with peers
  9. Small group lectures
  10. Specialty lecture groups
  11. Individual therapy
  12. Pet therapy
  13. Fitness facilities
  14. Nicotine support
  15. Transportation to outside AA meetings.

TOTAL: $53,000 for 30 days of Treatment at Betty Ford

The Regency Senior Care Home offers:

  1. Your own one bedroom apartment
  2. Meals served restaurant style off a menu
  3. Utilities, housekeeping, laundry
  4. Professionally trained staff
  5. Access to medical professionals
  6. Music therapy
  7. Art therapy
  8. Memory therapy
  9. Mind, body and spirit workshops
  10. Exercise therapy
  11. Spiritual presentations and lectures
  12. Hearing exams
  13. Adapting to walker and wheelchair workshops
  14. Specialized therapeutic exercise classes
  15. Fitness facilities
  16. Nutritional counseling
  17. Cooking classes
  18. Transportation Services to doctors’ appointments, movies, church services, meals, bowling, museums, and farmers’ markets.

TOTAL: $4,005 for 30 days of residency at The Regency Senior Care Home

Treatment Centers – 13 – Beware! Remember it’s a “For Profit” Business Part 3

This video emphasizes the conundrum of treatment centers that act as non-profit organizations.  Whether it be a treatment center, or any kind of business acting as a “non-profit”, that doesn’t mean surplus funds aren’t used for bonuses, kickbacks, and paying the heads of the organization exorbitant salaries.

The following list is composed of high-earning individuals who can attribute their hefty salaries to treatment centers located in the U.S. (as featured in this video segment series):

  • John Schwarzlose earns $558,945 annually as President & CEO (Betty Ford Center)
  • Marvin Seppala, M.D. earns $610,691 annually as Chief Medical Officer (Hazelden Foundation)
  • Valerie Slaymaker, Ph.D earns $293,468 annually as Chief Academic Officer (Hazelden Foundation)
  • Janina Kean earns $432,30 annually as President & CEO (High Watch Recovery Center)
  • Mark Mishek earns $842,991 annually as President & CEO (Hazelden Foundation)
  • Brian Boon earns $891,984 annually as President & CEO (Commission on Accreditation of Rehabilitation Facilities aka CARF)
  • Mark R. Chassin earns $991,914 annually as President & CEO (The Joint Commission on Accreditation of Healthcare Organizations)

When an industry makes money off people in crisis, it’s no surprise that the recovery business is flooded with kickbacks and exchanging referral fees.  Dr. Finkelstein was alarmed when he received checks in the mail from an unnamed treatment center with “YOUR NAME” printed on them.  Included also was a letting disclosing they offer a 10% commission if he sends patients to their facility.  His surprise was coupled with questioned the legality of the whole matter as it proves a conflict of interest.

In 1989 and 1993, legislation referred to as “Stark Law” was added to U.S. Federal Law prohibiting referral by a physician who accepts Medicare or Medicaid to another designated health service provider if that physician (or family member) has a financial relationship with that entity.  As it turns out, because most treatment centers do not received Federal funding, sending enticements such as the checks Dr. Finkelstein received is a completely legal business practice.

The recovery business is a relationship driven industry wherein referrals are bought and paid for every day.  This is greatly divergent to the medical industry which operates under a different code of ethics.  Health Scientist Ruben Baler agrees there is a big conflict of interest in the way treatment centers report their success rates while they are grossing so much money.  They fail to follow up and report on the possible negative outcomes of their past residents.

Meanwhile, vulnerable parents everywhere continue to spend their life savings on treatment for their children in hopes it will neb their addiction.  As treatment centers, outpatient facilities, and sober-living housing continue to expand, addiction is still going rampant.  If the recovery industry lacks self-policing practices in pursuit of financial gain, there’s a major belief from those with a different caliber of ethics for the government to police it.

Treatment Centers – 14 – Praying for Change

The final chapter of the Treatment Center series opens to a full screen excerpt from the referral incentive letter sent to Dr. Finkelstein (as featured in Video 13: Treatment Centers – Not-for-Profit Gravy Trains). It was sent to him by an unnamed treatment center disclosing the following: We will have an annual operating budget of about $180 million and a strong focus on expanding. It’s used to reinforce the ongoing demonstration of the great potential for financial gain in the recovery business, and the medical professionals and addicts who are praying for change within it.

Treatment center owner Christopher Bathum says that people (addicts and their families) don’t have an awareness of what they are doing they get taken advantage of constantly. They are essentially looking to the treatment centers as a solution to problem while a moment of extreme pain, but it doesn’t actually solve the problem, it is a painkiller for the moment. He goes on to say he knows families that have spent millions of dollars on treatment and yet have not succeeded.

In an industry that makes billions from families in crisis it’s clear that something needs to change. There is a call to be more accountable, scientific, more results oriented, and cost effective. Having more treatment center staff members on hand to address the psychological symptoms of alcohol and addiction would have a positive impact. In the long run, Lance Dodes MD of Harvard believes good psychotherapy to work out the issues is what really helps.

Furthermore, each patient entering treatment needs to be assessed individually: the program needs to fit the patient; the patient doesn’t need to fit the program. People are complex, and there is not a one size fits all solution, yet it’s too easy for the recovery industry to capitalize on the business of selling hope. Change needs to come soon because for some addicts and their families it’s already too late.

Copyright by Strength and Hope 2024. All rights reserved.

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