Note: this article focuses specifically on ethical challenges in the addiction recovery, more so than other areas of mental health or life change. If not applicable, feel free to skip ahead.
It is important that families affected by addiction are aware of unethical and unhelpful practices that are present in parts of the addiction treatment industry because they can lead to experiences that hurt people. Most unethical practices stem from places where profit-seeking motivates unethical behavior. For some types of addiction and mental health resources, such as support groups and counselors and therapists, ethical challenges are more rare because of the absence of financial motivation.
Rapid changes in the industry have changed the landscape by creating opportunities for individuals to earn greater profit than ever before. Unfortunately, these changes have also unintentionally encouraged unethical or illegal behavior that hurts individuals and families. By no means does this apply to all, or even a majority of providers. However, it makes it very important for families and individuals to do their homework, to both understand and trust their provider, and what is important for increasing the chances of successful treatment.
Changes and Unethical Behavior in the Industry
Changes in requirements for private health insurers to cover addiction treatment several years ago began to attract more profit-driven individuals to the industry due to the high rates charged for care. These high rates are reimbursed by insurers, creating strong financial incentives for centers to bring patients into their programs. Sometimes these incentives can override what is actually best for the health of the individual needing care. In other cases, treatment centers are defrauding insurers directly.
Examples of less-than-ideal behavior can take many forms, ranging from unethical to illegal:
False, “white lie” marketing. Promising services or amenities that aren’t there. This typically happens in the context of getting help from call centers, whose respondents may not have even visited the location.
Manipulative in-person marketing. Targeting support groups or other recovery communities in order to identify individuals that they can convince to seek treatment at their program. There are cases where benefits or payments have been provided to convince patients.
Not supporting continuing care. Failing to help individuals transition well from their program to their next step. This can range from lacking a long-term treatment or transition plan, to forcibly kicking out patients and leaving them without a place to go once insurance runs out.
Fraudulent billing. Charging insurance companies for services that are never delivered, or patients that do not exist or have not continued treatment.
Paid placement marketing services. Some websites and call centers offering treatment advice redirect interested patients and families from their desired facility to those for whom they are paid sizable fees. At times, online resources may be owned by providers of care, creating potential conflict of interest. There are unethical conflicts of interest when someone, whether a doctor or a website, is paid to refer an individual to a specific place and information on that payment is not disclosed.
Misrepresenting level of clinical care. Not having doctors or other medically-trained staff on the premises as promised or advertised
Sadly, this is not the extent of unethical behavior. These types of practices threaten to overshadow the important and life-changing work done by many treatment centers that help people overcome addiction. It can be difficult to sift through the range of treatment opportunities, and there are no perfect, fail-safe options, as each happens to employ imperfect people. Many providers don’t keep reliable or scientific records of succcess rates. In fact, the greater the confidence that a provider has in their ability to guarantee success can actually indicate a lack of understanding of the unpredictability and difficulty posed by the challenge of addiction.
Tips to Navigating Treatment Centers
For thousands of people, treatment centers play an important role in recovery, and the discovery of greater hope, health, and life. Using the following keys can help individuals and families considering a treatment center navigate the process.
Find providers that you can speak with directly. Be cautious around third parties, and try to connect with an individual that actually works at the center, before committing to their services. If possible, connect or visit the facility in person. Ask about the type and level of care offered, and how the provider helps people transition at the ends of their stays.
Lean on trusted relationships. Once you find an individual or provide with whom connection and trust can be built, try to work through the provider’s existing relationships in the industry to navigate various steps.
Don’t be afraid to say “no” to treatment centers or helplines that offer help if they don’t seem trustworthy. While recovery can happen in many contexts, the environment created by a provider’s team does matter.
Remember that change and healing around addiction can come in a range of providers and places. Finding a more expensive or luxurious program may be a more comfortable experience, but it may not indicate a higher likelihood of successful treatment. While quality among providers of free or government-funded care can also vary, the costs of treatment programs, ranging from $5,000 to $50,000 per month (which can be covered by insurance) make researching and understanding a treatment decision very important. Training, clinical credentials, and experience matter, but that may not be guaranteed by a more expensive price tag.
Work with an EAP (Employee Assistance Program) or health insurer to understand coverage. Understanding insurance coverage can be complex; having a clear understanding of what will be covered and what will not be can be helpful in informing treatment decisions.
Training, clinical credentials, and experience matter. Take a look at our guide (link to OneStep FAQ page) to help understand who and what are involved in treatment services at providers. Terminology can vary by state, so using a guide can be helpful.
Many experts and practitioners in the industry recommend finding next steps through relationships and people you trust. If you don’t know of people that could provide a personal recommendation, building relationships with individuals you trust in support groups or with a counselor may also be helpful in the process.