The shocking truth about the addiction treatment industry
What families need to know about referrals and kickbacks
While I was in London last week, I chatted with a friend who places children into top British boarding schools for a fee. Nothing wrong with that! But it made me think about my training as an addiction recovery specialist and interventionist, where we were warned that "selling souls" was highly unethical and illegal in most states. Both involve placing people in residential facilities, but with vastly different ethical standards.
The $100,000 question
Imagine this: a luxury treatment center offers you a check for $100,000 just for bringing them a patient. This isn't made up - my therapist knows of a mental health professional who was offered exactly that amount by a Swiss luxury facility. What would you do? The right answer is to say no! This practice is illegal in most states, though some places like Maine have different legal situations.
Speaking of Maine, I know someone who sent their son to a luxury rehab there. They've been wondering if the place pays referral fees - a valid concern! Maine is the only state without laws against healthcare kickbacks. While federal laws protect Medicare and Medicaid patients (and since 2018, those with private insurance), Maine's state law doesn't stop treatment centers from paying referral fees for cash-paying patients…if they are doing so.
I've seen the industry's tactics firsthand. When I attended addiction conferences and people found out I was from Gstaad, luxury treatment centers suddenly tried to cozy up to me. Why? Because Gstaad means wealthy potential clients. They weren't interested in my expertise—just connections to wealthy clients. I felt like prey!
The ugly truth
Like most things involving large sums of money, the addiction treatment world has a dark side. Unscrupulous people prey on vulnerable and desperate families needing help. Treatment centers sometimes pay "body brokers" who find wealthy people or those with good insurance to fill their beds.
The problem goes beyond uncomfortable networking at conferences.
The consequences can be deadly. Take the case of 22-year-old Alex, who transferred from a Florida facility to one in California. The body broker actually texted him: "you know you have to fail your urine test in order for them to justify getting you into treatment." This was a lie made up by the broker to manipulate Alex who died in a motel near the treatment center.
Red flags everywhere
Some treatment centers have rules that make no sense - like only treating certain addictions while turning away others. The industry has plenty of unethical and even criminal behavior.
In Rhode Island and Massachusetts, Recovery Connections Centers of America (RCCA) got caught billing Medicare, Medicaid, and other funders for services they never provided. A US judge sentenced the owner to 98 months in prison followed by three years of supervised release. He was also ordered to pay $3.5 million in restitution and forfeit luxury assets including a beachfront property in Panama.
Protecting yourself
So how do you protect yourself and your family in this minefield?
Work with recovery professionals who charge transparent fees for their services and don't work on contingency or receive referral bonuses. It's better to pay directly for expertise rather than work with someone who may be incentivized to place clients at specific facilities.
Look for professionals who demonstrate commitment to long-term recovery outcomes, not just placement. Ask about their follow-up protocols and how they measure success. One example is the ARISE (A Relational Intervention Sequence for Engagement) intervention model.
The ARISE approach has shown an 83% success rate at getting people into treatment, according to the American Journal of Drug and Alcohol Abuse. What makes this model different is its transparent, family-centered approach. There are "no secrets" in the ARISE process - the person struggling with addiction is aware of all planned meetings and invited to participate from the beginning.
Ask direct questions about their referral process: "How do you get paid? Have you been offered money by treatment centers?"
Verify that recommended facilities have no lawsuits against them and have all the proper certifications.
Trust your gut - if something feels off, it probably is.
In the end, someone who turns down a $100,000 kickback is someone who values ethics over money. They are working for you, not the treatment center. That's who you want helping you or your loved ones find treatment. When lives are at stake, ethics must come first.
Facts