Drug rehabilitation centers are widely believed to be the best option for addicts. They provide specialized treatment and an environment that gives the individual everything they need to beat their addiction. Success rates vary, but while there is never a guarantee of success, there are few, if any, better alternatives.
Unfortunately, over the past couple of decades, the rehab industry has had a very rocky record. For context, it is a $35 billion industry. Now, there is nothing wrong with for profit healthcare. We live in a capitalist society, and one of the principles that we all live by to some extent is little good comes for free.
However, far too many rehab centers are focused only on the profit. And to make money, they just need patients, not results. As long as they can continue getting patients, it doesn’t matter whether what they’re doing works.
Of course, this is true of all for profit healthcare. If people believe they’re benefitting from your service, you can get away with cutting corners and even downright scamming people. But there are some unavoidable factors that make this far easier when it comes to addiction rehab centers.
What is success?
If you go to a doctor to treat a virus, after following his or her directions you know if the treatment has been effective. You’re either still ill or are on your way to getting better. Even if you have a terminal illness, there are very specific markers that show whether treatment is helping you in a tangible way.
With addiction this is simply not the case. There are no tests you can do to prove whether someone has recovered. At the end of a course of treatment, if a patient is substance-free, all this means is that the center managed to police them well enough through the program.
We can check in with the patient a month later, or a year later, and find that they’re substance-free, and yet we still cannot be 100% sure they won’t relapse. Are they substance-free due to circumstances or because the treatment worked?
Now, this is a very reductive view. There are ways to measure success. Good rehab centers have accurate data on their patients during and after the program. But my point is that success is much more difficult to define, let alone measure, than other illnesses.
And because it is difficult to measure, it is very easy for providers to fudge the data. Many rehabs rely solely on self-reports to prove their success rates. People who have relapsed and are in the midst of addiction again are often unlikely to admit it. Especially if they want to avoid returning for treatment.
Many rehabs claim to have impressively high success rates, while in reality they have no actual clue.
Again, this is not a problem per se with for-profit treatment centers. However, the difficulty in defining success makes it easy for opportunists to make a lot of money without actually helping people.
In addition to the difficulty of defining and measuring success, there is another reality in the US that makes it easy for rehabs to get away with scamming patients.
Major lack of regulation
Healthcare is generally regulated by governmental bodies and this is crucially important. Doctors, clinics, hospitals, and pharmaceutical companies cannot make claims that are not scientifically backed. They are fined, stripped of their credentials, and even jailed if they grossly mishandle a patient’s treatment. If this was not the case, we’d see a lot more people dying of treatable illnesses because they were duped by a so-called professional.
The rehab industry unfortunately is subject to very little oversight. John Oliver recently went into this on Last Week Tonight. He brought to light just how little regulation there is for rehabs. They are basically free to make any claims they like without contradiction. Patients who relapse because of gross misconduct don’t have much legal recourse.
On the one hand, this is par for the course when it comes to addiction. As we’ve seen, success is much more difficult to define. And if someone relapses, it’s going to be very difficult to blame the rehab center.
On the other hand, there are evidence-based treatments. Results may be more difficult to prove, but certain treatments have far better evidence of success than others. In addition, treatments based on proven scientific principles are more likely to work than those based on conjecture or anecdote.
Better regulatory oversight can and should be put in place to prevent rehabs taking advantage of some of the most vulnerable people in our society. Success can be proven to an extent, and those centers that have no reasonable evidence should not be allowed to continue functioning unchecked.
What can you do?
Calling for more oversight is all well and good, but most of us do not have the influence to make a major impact. So what can you do in the meantime if you or a loved one are in need of urgent treatment?
Remember that success can be quantified to an extent, and look for rehabs that have some level of proof of their success. Do a basic check on the qualifications of the practitioners they employ. Determine whether they have an aftercare program – one sign that they do care what happens to clients after they leave.
While there are certainly too many rehab centers that make dubious claims and do not have their clients’ best interests at heart, there are many others that use evidence-based treatments and can offer evidence of their success. Do not choose a rehab without doing the requisite research first. The right choice can mean the difference between recovery and a continued downward spiral.
Author Bio: Dr. Nancy Irwin is co-author of “Breaking Through, Stories of Hope and Recovery” and a Primary Therapist at Seasons in Malibu World Class Addiction and Mental Health Treatment Center.