The Ethical and Financial Concerns Regarding The Addiction Treatment Process

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To understand the benefits and shortcomings of addiction treatment sometimes requires both perspectives. An outside and one from the inside of the industry itself. A few years ago an individual in long-term recovery teamed up with a filmmaker who previously had no understanding of the practices of addiction treatment centers nor the industry itself. They produced a documentary that will air in a few days that paints quite a different picture of the addiction treatment industry that may surprise many people who may have previously hailed the addiction recovery process as something that exists purely to help those in need, no questions asked. Obviously treatment centers have benefited thousands of their patients lives and can boast numerous success stories that may not have been possible without their program and expert staff, but this documentary prods the issue of “The Business of Recovery” and asks the opinions of treatment center executives, research experts and addicts as well as their families who, in some cases, have a very different story to tell. The main complaint about the treatment practices at most centers was brought home in this documentary from a specific woman named Susan Colasurdo whose young adult son Michael died of a heroin overdose shortly after being interviewed in the documentary. She herself said while being interviewed that “Not one of them has done anything different from the others” in reference to the numerous programs and treatment approaches that tried to treat her now dead son, not to mention, she says, the “Being left in the dark” feeling regarding the expenses she paid for at any given one of the centers she tried with her son.

The documentary aims most of it’s criticism at 12-step programs which it claims makes up for about 90% of treatment programs across the United States. They also claim only about 5-10% of those exposed to and treated by a 12-step program succeed in attaining lasting sobriety. The people behind this documentary did not set out to present a strategy to overhaul the way things are done, but they did offer some interesting suggestions that could benefit the thousands of patients trying to end their addictions:

  • More of a strict science-based approach to treatment. Miller says in the movie that some addiction field leaders will call a treatment “evidence-based” if just one study shows a basis for it—even if dozens of other studies call the approach into question. Greg Horvath says too much of what happens in addiction treatment is based on “passion and belief,” adding, “We don’t treat cancer that way.”
  • A commitment by government to regulate the industry more closely if it will not police itself better. The film offers sharp criticism of sober home operators in this regard, with Michael Colasurdo saying “They’re not so sober” and acknowledging that one home where he stayed conducted no drug testing and routinely allowed residents to leave the premises on evenings and weekends.
  • Stronger education and credentialing requirements for clinicians. Dee-Dee Stout, a consultant and counseling professional, admits in the film that the fact that she herself started working with addicted patients after she had just nine months of sobriety and no educational background in the field amounts to a “scary thought.”
  • Clinical services that are less heavy on educational lectures and coercion and look more at the factors that motivate individual patients.
  • A more systematic approach to measuring the success of treatment, moving away from efforts that rely solely on patient self-report. “I don’t understand how an industry that has never defined what success means can be allowed to cite success rates,” says Greg Horvath.


Perhaps the most important thing to take away from these suggestions is the fact that motivation and caring are the most important parts of the treatment process and they belong at the top of the list instead of standardized care and profit margins.



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Sobriety Foundation

The Ethical and Financial Concerns Regarding The Addiction Treatment Process

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