Later On

A blog written for those whose interests more or less match mine.

How rehab recruiters are luring recovering opioid addicts into a deadly cycle.

leave a comment »

Julia Lurie writes in Mother Jones:

The offer was too good to resist: Go to rehab for a week, get $1,000 in cash. It was early 2017, and Brianne, a 20-year-old from a woody Atlanta suburb, had come to South Florida to leave her heroin addiction behind. At a residential facility called Recovery Villas of the Treasure Coast, she was approached by a charismatic guy I’ll call Daniel, a Pennsylvania native six years her elder. He could relate to her troubles—he’d struggled with addiction himself—and he could get her into another rehab after Recovery Villas. He would even pay her: $1,000 for the first week of her stay and $500 each week thereafter. That money could buy Brianne a whole lot of heroin.

Brianne, whose full name has been withheld to protect her privacy, could be a poster child for the opioid crisis: a blond, green-eyed former softball star who experimented with pills from the medicine cabinet with her high school boyfriend and within a few years was plunging needles into her veins. In 2016, she broke down and admitted to her mom, a software executive named Jen, that she needed help. They made a plan: Brianne would go to treatment for a few months, sober up, and then return home to study at Chattahoochee Technical College.

That never happened. Brianne took Daniel up on his offer and, over the next 18 months, did more than a dozen stints at Florida rehab centers from Palm Beach to Miami. She mainly flitted between Recovery Villas—which in addition to group therapy and 12-step meetings offered apartment housing and a pool—and Compass Detox, which felt like somewhere between a hospital and a hotel.

Sometimes, between stays, Daniel rented a room for Brianne and a few other “clients” at a Super 8 or Comfort Inn and supplied them with heroin and the overdose reversal medication Narcan, just in case. When the drugs ran out, Brianne would head into a detox program with dirty urine, an admission requirement for some facilities. Other times, she coordinated directly with rehab staffers who called her “honey” and “sweetie” and arranged free transportation—Ubers, flights if need be—to their centers. Daniel encouraged Brianne to try her hand at recruiting: For every patient she steered his way, he would pay her $400. After she started dating a recovering user who lacked health insurance, Daniel found rehabs that would take her boyfriend for free as long as Brianne attended with her Aetna insurance card, a practice known as “piggybacking.”

The addiction community has a name for what happened to Brianne. It’s called the “Florida shuffle,” a cycle wherein recovering users are wooed aggressively by rehabs and freelance “patient brokers” in an effort to fill beds and collect insurance money. The brokers, often current or former drug users, troll for customers on social media, at Narcotics Anonymous meetings, and on the streets of treatment hubs such as the Florida coast and Southern California’s “Rehab Riviera.” The rehabs themselves exist in a quasi-medical realm where evidence-based care is rare, licensed medical staffers are optional, conflicts of interest are rampant, and regulation is stunningly lax.

While experts say the practices described in this story are widespread, it is important to note that there are plenty of responsible treatment providers, and not all the facilities named engage in all the practices described. Recovery Villas, which was raided by Florida authorities last summer on suspicion of insurance fraud and is now under investigation by the state, did not respond to my questions. A Compass Detox spokesman said that paying clients for treatment and giving them drugs between rehab stints “is illegal and we don’t do that.” Compass obeys all relevant laws and regulations, he emphasized.

Drug addiction rates have skyrocketed over the past decade: If every American addicted to opioids lived in one city, it would be nearly the size of Houston(pop. 2.3 million). The demand for treatment, the increasingly white face of addiction, and recent laws requiring insurers to cover substance use services have all resulted in a surge in rehab spending and private investment. But as the Braff Group, which tracks health care trends, warned investors in a 2014 brief, “It’s not all kittens and rainbows. As we have seen countless times in other frenzied health care sectors, when the money flows in, so do the ne’er-do-wells, which can bring the sector the kind of attention it doesn’t want.”

It’s a given in the world of addiction treatment that relapses are likelyobstacles on the road to recovery. But for rehab owners and brokers who make money each time a patient is admitted, relapses can be a profit center. Dozens of drug users and parents I spoke with had tales like Brianne’s, and “there are probably thousands” of others, according to Karen Hardy, a Maine addiction counselor whose own son shuffled among dozens of rehabs. “Some end in death. Some don’t,” she says. “It’s Russian roulette.”

For Jen, Brianne’s recovery saga has been a nightmarish roller-coaster ride. At work one morning in June 2017, she received a text from an unrecognized number that made her blood run cold: “I OVERDOSED CALL ME NOW.” Over the phone, Brianne frantically explained she was at a hospital near Palm Beach after overdosing for the first time—in a motel room, with heroin provided by Daniel. There were more panicked calls that summer: Brianne at a gas station, without shoes, money, or transportation. Brianne bawling after yet another friend overdosed. (She lost 15 friends in a single year, Jen says.) The sounds of sickening shrieks and thumps as her boyfriend flew into a violent rage. Brianne overdosing again. Back home, her 13-year-old sister filled an Ugg shoebox with prayers jotted on slips of paper, begging God not to let Brianne die.

The amounts billed to Jen’s insurance company seemed outlandish: $3,000 for a routine drug test and, in one case, $22,000 in rehab charges in a single day. (Residential rehabs often charge private insurers $50,000 to $100,000 per month of treatment.) . . .

Continue reading. There’s much more.

The US seems increasingly dysfunctional.

Written by Leisureguy

1 March 2019 at 9:29 am

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: