I had the good fortune of attending the world premiere of The Business of Recovery last night at the Newport Beach Film Festival. You can learn more about the film and view a trailer here. http://www.thebusinessofrecovery.com
I thought the film was crafted well. Interviews with professionals and lay people were interspersed with statistical data and anecdotal stories. There were dramatic reminders of how the industry was failing people. One of the themes was how the industry clings to the 12 step model of recovery with little evidence that it’s useful for the vast majority of addicts. One of the clauses of Obamacare is that insurance won’t pay for non evidence based medical care. Recovery homes skirt this by pulling up a study that shows some benefit to their model of treatment while 20 studies will show no benefit. They can point to the one study and say they are evidence based. Surfing around the internet looking for rehab centers will disclose that many tout that they are “evidence based”. Also success rates tend to be exaggerated. Often no follow up is done of people who are discharged from their facilities.
This leads me to what I believe is the biggest deficit of the film. That is the lack of leadership of the medical establishment. The American Society of Addiction Medicine wasn’t even mentioned in the movie. A big part of the problem is that ASAM is largely in bed with the treatment industry. The film featured some physicians that were critical of the industry but they don’t represent the consensus opinion of ASAM. It’s the job of physicians to decide which treatment options are the best. They are the ones who should be weighing the academic studies and clinical trials and deciding which is best. Would you want an oncologist treating your cancer based on a 75 year old book? Unfortunately many physicians, who are being enriched by the system as it is, also cling to 12 step models.
As hard as the film was on treatment centers it was even harder on sober living homes. Sober Living homes basically have no standards. Some interviewees described them an party homes. The mother of one of the people in the movie who overdosed in a sober living home was in the audience last night.
I think the take home message for the film is let the buyer beware. If you got the cash, treatment centers will prey on your fears for yourself or for your loved ones. They will exaggerate their success rates. They will have counselors with little more training other than them being sober themselves. One of the interviewees complained that part of his treatment was to pet horses. Ask a lot of questions up front because they want cash up front. If you don’t like the treatment you won’t get a refund.
Steve, Thanks for your insights, especially about ASAM. They will have to be on board to turn things around. I would also recommend Inside Rehab by Anne M Fletcher. It covers much the same ground quite well.