Recovery and the rehab dollar

The race is on for the rehab dollar. The addiction treatment industry has flourished in recent years, as more operators see it as a means to an easy profit. The absence of a universally accepted method of treating addiction means that anyone can set up a rehab and make all sorts of outrageous and difficult to disprove claims about their treatment programme. This deception is aided and abetted by a very unsupervised internet. Although there is an attempt to limit misleading addiction treatment advertising  on the internet, wily operators and their SEO counterparts easily circumvent these restrictions. The target audience, namely desperate addicts and their families, are easy to exploit by dodgy operators who prey on their vulnerabilities.

The addiction treatment industry has changed

Thirty years ago, when I first became interested in the field as a doctor, it was a bunch of people, mostly addicts themselves, who wanted to help “the still suffering addict”. The customer was the addict. Now the customer is the health insurance. They are the party the industry needs to please. The patient and his or her wellbeing have become almost incidental to the process. 

People with little sympathy for the plight of the addict now own most treatment programs and prioritise returning maximal profit to themselves and their investors, driving the change in priority. Concern for the company’s bottom line is more important that the addict’s rock bottom. In this sense, the addiction treatment industry is now no different from any other medical services industry.

Does addiction treatment have a claim to exceptionality?

Is the service provided any different from hip replacements or cardiac surgery? Is it a straightforward commercial transaction?

The answer lies in the nature of the problem. Hips and hearts have physical defects that require mechanical solutions. Psychological problems have an emotional component that requires focussed and empathetic counselling and sometimes medication. But addiction is strange beast. How does one motivate the addict to refrain from deliberate self destruction through their uncontrolled use of drugs and alcohol. Having achieved this, how to introduce a lifestyle that will support the change.

Sustainable recovery for the addict always requires moving from a self-centered, self-serving way of being to a lifestyle with some humility, some gratitude, more honesty and less manipulation and some faith in the process. Recovery from addiction is about a cultural change, some would say a spiritual journey. Herein, for me, lies the problem. If treatment service providers are now just businesses that are run according to the very same principles that sustain addiction. Then recovery from addiction will become a commodity purchased by the desperate, sold by the dishonest and likely to lose its precious value.

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