Addiction treatment is a story in search of a villain

There is a difference between something that is interesting and worthy of comment vs. a journalistic attempt to concoct controversy and intrigue that people can buy. There isn’t much of the first, but there is a lot of the second. People in recovery falling victim to horrible, greedy people is an interesting story. Unfortunately, it’s out of place and really not useful to anyone.

There are three pretty safe assumptions that almost everyone can agree on: First, there are many people who want to live life without an active addiction. Second, many of them think they need help to create a better life. Third, some providers of help to people in recovery make a lot of money providing that service.

There is probably nothing new in any of this. What’s new? Maybe this: we live in a time when the concept of privacy is changing rapidly. The lines between what is said and what is not said, between what is good on television at 6 pm, have changed. And public discussion of all sorts of things once considered private, including addiction, is front and center. That kind of “cap” change invites public discussion about addiction, gender identification, and all kinds of things. Our culture has changed.

It also seems that the more “transparent” we become as a culture, the greater the tolerance and need to be entertained. Reality television becomes more and more shocking, interesting. And our need for a good story is a product of a voracious human appetite for stimulation. And that leads us to confuse evidence with entertainment.

There are many entertaining things written about the addiction treatment industry, but not all of it is honest or even helpful. Look, the fact that addiction is now part of the public conversation is probably a good thing. Maybe talking about it is a good step in the direction of tackling it like any other health-related issue. No one is shocked, embarrassed, or judged by dealing with arthritis, allergies, or cancer, but addiction invites all that nastiness.

So what is reality versus entertainment? What is wheat vs. the straw? The “story,” the one that is being instilled into the public consciousness about people in recovery, is that they are powerless as powerless victims of the wealthy who want to rob insurance companies. And I cannot ignore that the story emerges in our culture at a time when the belief that only the bad have more money than they need to live, that there are “good” people and “bad” people, and that the differentiating factor is money. Good people = don’t have a lot of money. Bad people = have a lot of money. And bad people can become good by giving money to good people.

Let’s go back to the recent newspaper article: the guy they say was a “bad” man has never been charged with anything. He had a picture of the guy’s face. Is it so that people can say that he seems to have done something wrong? I don’t understand the value there. Maybe that’s entertaining, but of no value.

The lawsuit described in the article (which has not been answered by the other party) says all kinds of things that anyone can say in a lawsuit. It may surprise some to learn that what lawyers say in court doesn’t have to be true. I did not see in the article the fact that the defendant company is owed millions by the insurance company or that the parties have been trying to reach an agreement to resolve an unrelated business issue for months. It seems relevant, but only if you want to discuss the facts. Otherwise, it’s just… entertainment.

And the part about insurance companies paying a lot for toxicology lab services… No one tells an insurance company what to pay. They decide what to pay. Where is the story? Where is the villain, the victim? History needs one, right? To be entertaining, there has to be a victim and a villain. That’s what makes it fun, right? It makes it fun. And that’s different from reporting facts about a topic.

In the drug and alcohol treatment space, there are serious elements of the truth that are missing because they don’t sell, such as:

1. The treatment industry is undergoing a major change as it has expanded from providing psychotherapeutic services to providing medical services;

2. The challenges facing insurers and enforcement activity is a huge wake-up call for an industry that needs to be compliance conscious and view healthcare the same way traditional, driven healthcare providers see them. for a scientifically validated and documented medical need. Physicians have played within these boundaries for many years, but treatment providers are new to what it takes to deliver medical services;

3. Providers who make a lot of money treating people in recovery do so almost entirely because they do a good job and know how to manage their expenses. Our community still doesn’t believe that health care providers should work solely for non-profit organizations and be part of a “health care clergy” (“If you really cared, you’d do it for free”);

4. Insurance companies have been masterful in handling public relations related to the treatment industry. In an era of record profits from insurance companies, they often have no policies or procedures on how much or how much people in recovery should receive, but then refuse to pay and point fingers at the providers. And ironically, many treatment providers beg payers for such guidelines and have approached them to hire (at lower rates than insurers pay!);

5. Insurance companies decide how much to pay for services, not providers; and

6. Neither treatment center owners nor those in recovery speak with one voice and have no effective political/legislative power. Insurance companies, however, have enormous political and legislative power.

Despite many conversations that may seem very open when it comes to addiction, I’m not convinced that we actually have an open mind. They fly items that oversimplify things and sell stories designed to entertain. There is a large gap in the insurance benefits available to people recovering from addiction. The current pressure (payment denials, delays, and reductions) placed on treatment providers by insurers, for example, is not found in any other aspect of health care.

In fact, the challenges from payers to providers in this space reflect an insurer view of addiction treatment as episodic, not chronic. Taxpayers don’t question the treatment of diabetes like they question the treatment of addiction. Legislation is passed (the recent sober home regulation act) reflecting the fact that the state of Florida will not protect people in recovery residing in sober homes (they turned the problem over to an unregulated “non-profit” entity and no name). At the end of the day, there really are no consequences for this kind of bragging, as both the treatment industry and people in recovery are easy to manipulate. They remain marginalized and lack a serious political presence.

If there is ever going to be meaningful treatment for addiction, then the full story must be told and all players must work together to agree on meaningful solutions. The problem with the treatment industry is not that there are a bunch of big shots who take advantage of addicts. The problem is that our culture is more interested in pointing fingers and putting its head in the sand on this issue (imagine how the actual treatment could affect the prison conglomerate!) than we are in creating solutions. At this time, there is no urgency on the issue of treatment (because there is no pressure). Instead, we’re just entertaining ourselves.