Finding Your Next Step

Understanding Ethical Challenges in the Treatment Industry

It is crucial that individuals and families do their homework around recovery resources — particularly treatment centers. While it’s easier to switch from a counselor or support group that doesn’t fit to a new one, decisions around treatment centers often have greater consequences. Unfortunately, there are documented cases of unethical and illegal behavior at treatment centers where profits have taken priority over the people they are serving. It is challenging to understand the quality of services delivered, particularly due to a lack of data and the nature of addiction. Be wary of anyone who guarantees an outcome as the journey is unpredictable, and seek to speak to individuals that are actually onsite at the treatment center and not just a third-party connection service. Learn more about vetting possible providers in our articles.


Note: This article focuses specifically on ethical challenges in the addiction recovery landscape, more so than other areas of mental health or life change. If not applicable, feel free to feel free to skip ahead.

Becoming Aware of Unethical Practices

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 recovery 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 in order, to both understand and trust their provider, and to get a grasp on what is most 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.

These types of practices highlight how difficult it is to sift through the range of treatment opportunities and threaten to overshadow the important and life-changing work done by many treatment centers that help people overcome addiction.

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 where respondents may or may not have visited the treatment center.

Manipulative in-person marketing. Targeting support groups or other recovery communities in order to identify individuals they can convince to seek treatment at their program. There are cases where benefits or payments have been provided to convince patients to participate.  

Not supporting continuing care. Failing to help individuals successfully transition out of their program. This can range from lacking a long-term treatment or transition plan, to forcibly kicking out patients and leaving them with nowhere to go once insurance runs out.

Fraudulent billing. Charging insurance companies for services that are never delivered, for patients that do not exist, or for patients that are no longer in treatment.

Paid placement marketing services. Some websites and call centers offering treatment advice redirect interested patients and families to those for whom they are paid sizable fees. At times, online resources may be owned by providers of care, creating a 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 the 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. Many providers don’t keep reliable or scientific records of success rates. In fact, the greater the confidence a provider seems to have in their ability to guarantee success may indicate a lack of understanding of the unpredictability and difficulty posed by the challenge of addiction.

5 Keys for Navigating Treatment Centers

For thousands of people, treatment centers play an important role in recovery, and the discovery of greater hope, health, and life. The following 5 keys help individuals and families considering a treatment center navigate the process of choosing one wisely.

  1. 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 end of their stay
  2. Lean on trusted relationships. Once you find an individual or provider with whom connection and trust can be built, try to work through the provider’s existing relationships in the industry to navigate various steps.
  3. 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.
  4. Remember that change and healing around addiction can come in a range of providers and places. An expensive or luxurious program may be a more comfortable experience, but it does  not indicate a higher likelihood of successful treatment.Training, clinical credentials, and experience matter, but that may not be guaranteed by a more expensive price tag.
  5. 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 and will not be covered can help  inform treatment decisions.

Take a look at our guide (link to OneStep FAQ page) to help understand who and what are involved in treatment services. Terminology can vary by state, so using a guide can be helpful.

Many experts and practitioners in the industry recommend choosing your next steps through relationships with people you trust. If you don’t know people that can provide a personal recommendation, building new trustworthy relationships in support groups or with a counselor will be helpful in the process.



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