From misleading sales tactics, deceptive advertising and unethical marketing practices to healthcare insurance fraud and patient brokering, the largely unregulated field of drug rehab is rife with deceptive and unscrupulous—even illegal—business activities. Industry reforms, professional standards and consumer protections can and must be put into place.
Far too many vulnerable people and families suffering from substance use disorder are being harmed by the unethical marketing and business practices of some addiction treatment providers and a lack of universal standards to ensure quality throughout the field.
As a result, it is more imperative than ever for the field to hold itself to the highest ethical, legal and quality standards in the health care industry, commensurate with the lifesaving work of helping people overcome the disease of addiction. It's also time to consider a regulatory framework to ensure minimum standards are upheld and that those who desperately need quality care can get it.
The stakes—patient safety and public confidence in addiction treatment—are high.
People needing drug addiction treatment and their families are often desperate for help and don't know where to turn or what to do, and are therefore vulnerable to those who seek to take advantage of them.
Growing market demand for addiction treatment, driven by the opioid crisis and expanded insurance coverage, has attracted unprecedented private investment and a rapid influx of new providers motivated by profit over people.
The specialized addiction treatment industry is now a $35 billion industry. By way of comparison, in 2003 it was only $21 billion, and it is expected to top $42 billion by 2020. As it continues to grow, any regulatory framework should be determined by this core value: treating all who have addiction with dignity and respect.
As a leading member of the National Association of Addiction Treatment Providers, the Hazelden Betty Ford Foundation is committed to a robust code of ethics, and our Recovery Advocacy team is focused on addressing the following unethical and dangerous emerging business trends in the industry:
One factor contributing to unethical and illegal practices, and also the overall quality of addiction treatment in the United States, is the fact that some states have limited requirements for addiction treatment facilities, sober homes or the people who operate them. In this environment of under-regulation and dramatically expanding market demand, the market has seen an upswing in for-profit centers that offer exclusive, spa-like environments that "guarantee" success, but offer little in the way of evidence-based treatment, effective behavioral therapy or demonstrated outcomes.
To ensure quality, efforts must be undertaken to improve the nation's regulatory framework for addiction treatment. Reforms ought to bolster state licensure requirements; accreditation standards; clinician education qualifications; and access to comprehensive, evidence-based care and support that is coordinated and integrated with the rest of the health care system. The Hazelden Betty Ford Foundation has identified quality standards in collaboration with another nonprofit provider, Caron Treatment Centers, that can serve as a guide for such reforms.
Risky substance use and addiction—and related hospital costs, crime and lost productivity—cost society $500 billion a year, according to the National Center on Addiction and Substance Abuse. This public health issue is too important to individuals, families and communities to allow the status quo to continue.
It is time to restore faith and accountability in the addiction treatment field. It is time to establish quality standards and an enforceable regulatory framework to guide all treatment organizations.
It is time to ensure ethical, quality care for all people who seek help for addiction.
Therefore, we advocate for federal legislation:
We also support an assortment of legislation to improve addiction treatment quality by:
Listen to a related podcast episode featuring Hazelden Betty Ford Foundation's former president and chief executive officer Mark Mishek discussing Consumer Beware: Not All Addiction Treatment Is the Same.