An old Vice report titled “From Rehab to a Body Bag” that initially aired in 2014 has recently been making the rounds again via shares on social media. The story took a look at the rehab industry, taking time to examine and identify many of the expensive amenities often associated with addiction treatment by the general public. The report was often horrifying, disgusting and in many ways ridiculous. The worst part about it, however, was that much of it was accurate and truthful.
For many years the addiction treatment industry has been synonymous with what many in society view as an industry that instead of clinically treating addiction through evidence-based practices places sufferers of substance use disorders in a spa or luxury setting at the cost of tens of thousands of dollars a month, ultimately with poor outcomes. The horrific relapse rates that often associated with addiction treatment do little to change the perception that addiction treatment is a hoax or an expensive proposition that shows little in the way of effectively helping a patient recover from addiction and enter into a high quality of life. One of the major problems is that the addiction treatment industry as a whole has done little to change this perception.
Over the last several years, buzz words like “premier”, “luxury” and “executive” are being used by addiction treatment centers to market themselves to consumers. But what do those terms even mean? What is the substance behind those words, other than a marketing or branding tactic to attract patients and look good on web sites? And how does this long-standing approach of marketing amenities actually help the patient or in any way take away from the public perception that addiction treatment is an expensive proposition that in the end lacks results?
The truth is that high quality treatment is not necessarily an amenities-driven proposition. High quality treatment comes from the quality of the clinical services being performed at a treatment center. For years treatment centers have been promoting their facilities and amenities to the public as a way to justify the high cost of treatment. Spa-like atmospheres, pools, massages and saunas, beautiful rolling landscapes and the like, with the manufactured idea that those suffering from addiction need to be coddled in a safe, plush environment. It often is misrepresented as necessary for “healing.” While a safe, supportive and healing atmosphere is absolutely necessary for those entering treatment, it does not necessarily have to equate into a 5 Star resort-like atmosphere. In fact, in some cases, such an atmosphere can be damaging to patients.
There are a couple points to make in terms of clarity. First, there are some treatment facilities that do excellent clinical work that also have high-class amenities and beautiful facilities. However, as any professional that knows these places well will attest, the quality of those provider’s treatment programs does not come from the amenities alone but in the great clinical work done by a dedicated staff of well-trained professionals. There are also some programs that do amazing clinical work with executives-level clients and clients of affluence. Due to the nature of this executive-level patient population, such facilities and amenities are appropriate, as this is typically the quality of life that the specific patient population is used to and expects in their everyday life. Additionally, these executive-focused treatment centers employ a staff well-trained to handle this specific population and their clinical needs. However, it is important to note that executive-focused rehabs are small in size and ethically do not simply accept any patient that can afford them. They only accept appropriate clientele that are a clinical fit for their treatment programming, as it is geared towards the needs of that specific patient population.
However, what has happened in the treatment industry is that operators have now decided to market any expensive, amenities-driven facility as “luxury” or “executive.” As a way to get patients through the door, treatment facilities promote their amenities and the quality of their facility. “It will be easier to get people into treatment if they are being treated in a mansion with a cleaning staff, private chef and impressive scenery,” they think. Never mind that many rehabs are accepting patients who have never been exposed to such amenities. A client has good, private insurance? Well, let’s entice them with amenities, seems to be the thought process. Never mind that those suffering from addiction may in fact be harmed by going to such an amenities-driven facility, as doing so basically plays into the entitlement issues most substance use disorder suffers have naturally and sends a message of “sure, your behaviors have caused many around you pain and you have destroyed most things in your life, but let’s reward you with a spa getaway where you can attend some groups if you want to but will definitely get some time by the pool and a hot stone massage.”
This is not to say that treatment centers should not be offering high quality environments for patients. Just because someone suffers from addiction does not mean they should be confined to a rat-infested, dirty environment or a poorly kept facility. Addiction is a disease and we should be treating it like we treat any other disease, in a clean environment that promotes dignity, respect and compassion. However, what is important is that the vital piece of treatment is the clinical work taking place and not the flat screen TVs, 1200 thread count sheets, campus juice bar or state of the art gym. For far too long poor clinical services have been wrapped in a veil of high-quality amenities. Generic group therapy education is offered at ridiculous price points because of Olympic size swimming pools, ropes courses, masseuses and the ability to pet horses once a week (that is not to say equine-assisted therapy isn’t beneficial, but a behavior tech taking a patient to pet a horse IS NOT the same as equine-assisted therapy.)
For far too long many operators in the addiction treatment industry have been accepting money from people in crisis for subpar clinical services and high-end amenities. This is not only backwards but it should be embarrassing for the addiction treatment field as a whole. Instead, the the industry, shocked and appalled when society looks at rehab as a joke and a revolving door of relapse, wants to wonder why many in society think little of the work being done by the field. It is hard to argue when much of the public simply looks at the addiction treatment field as a bunch of charlatans and snake oil salesman only looking to make a quick buck of the suffering of others. Is that accurate? Of course not. Such a blanket statement is entirely inaccurate. There are many hard-working professionals who have dedicated their careers and their lives to helping those suffering from addiction. There are many ethical operators that provide high quality clinical services to those suffering. Many of these programs also have amazing facilities with impressive amenities. Some rehabs truly tailor their treatment programs to executive-level clients. However, on a large scale and for a long time, many treatment operators have been using their facilities and amenities in order to charge boatloads of money to clients while offering subpar clinical services or generic programming and often via a part-time clinical staff. It’s as if a treatment operator will spend tons of money on a facility and amenities but do everything it can to save money on its clinical staff. How backwards is this thinking? It is only right that many are outraged over such practices.
The number one point to remember is that addiction treatment and the value and quality of addiction treatment is driven by the clinical services offered by a treatment center or rehab. There is nothing wrong for charging a premium on high quality services- medical treatment can be expensive. However, unlike other medical treatment and procedures, people are not being asked to pay $30,000-$90,000 a month by a hospital because the amenities are nice. They pay for treatment and services. Unfortunately for many years, many in the rehab field have been providing beautiful facilities and expensive amenities at the cost of families pocketbooks without providing high quality clinical care, duping families that expansive and impressive décor and a spa-like atmosphere was necessary to provide comfort for those suffering in order to begin a journey of recovery. The impressiveness of the facility, the surroundings and the luxuries became the selling point and the impressiveness of the clinical treatment was forgotten or hidden from view. Or nonexistent. Parents and families were sold on the wrong focal point and it seems that it became easier to justify expensive programs if the facilities were expensive and impressive.
Clinical care, evidence-based approaches, clinical philosophies and highly trained, educated and competent staff are what make up the backbone of a quality addiction treatment program. Unfortunately for many programs this hasn’t been the focus. There have always been high quality clinical programs that have operated with an excellent staff and put patient and family care first. However, the quantity of those programs pale in numbers to the revenue-motivate, bottom-line driven facilities promoting themselves as high-end, premier, executive and luxury that in the end offer little in terms of innovative, comprehensive quality clinical care. Programs that promote their bells and whistles, however when whittled down provide nothing in terms of clinical insight and effectiveness. Many don’t even have clinical philosophies to speak of or haven’t updated their clinical offerings in decades.
The bottom line is that if the addiction treatment industry is going to be taken seriously, we need to provide the best possible clinical care and also need to ensure that patients, families and insurance companies are paying for clinical services, not amenities. Televisions, swimming pools, golf simulators and luxury SUV rides are wonderful…and none of them do a thing to treat addiction. Therefore, we need to stop asking people in crisis to shell out tons of money to pay for shiny things. If a high quality clinical program has nice amenities, all the better. But shame on us for asking for thousands of dollars because a facility looks nice and has a bunch of toys if we are offering limited or substandard clinical care. Addiction is a deadly disease and it needs to be treated as such. Therefore clinical services must be at the heart of what a rehab offers. If we are not offering comprehensive clinical care first and everything else second, is it any wonder we’re setting up patients for relapse or failure or poor overall outcomes? Rehab is not a “break” or a “vacation” or a time to “unwind and refresh.” It is not a spa or a “getaway.” We are losing almost 150 people nationwide a day to overdoses. People are dying. Families are being ruined. Communities are being impacted. Addiction IS a deadly disease and patients need to be armed not just with some “time away” or a little education about addiction, but they require the highest quality of long-term clinical care necessary in order to be given the best CHANCE at success. This means patients, families should be paying for clinical services, NOT cool and impressive amenities. A curved TV, personal chef and infinity pool just aren’t going to cut it. Individuals and families need to become educated consumers and make sure that for what they are being asked to spend on life-saving treatment that they are actually receiving, first and foremost, treatment.
There is nothing wrong with a beautiful facility with nice amenities. However, what is most important is that the amenities are not the focus nor the “selling point” for a treatment center. What needs to be at the heart of life-saving, life-enriching treatment are the clinical services offered that are the treatment. If a facility can have both, that is ideal. However, as a field and an industry, we need to get away from selling families in crisis on amenities and make sure that the clinical care being offered is of the highest quality and is not being sacrificed for the look and feel of the facility and its amenities. People are dying, families are being torn apart and it is about time that we as an industry truly offer the high quality of clinical care that patients and families need first rather than offering them pretty, shiny things that sound nice and will get them through the door. Families need to be educated about the clinical work that takes place in a treatment center that will help their loved one overcome addiction, not amenities.
If you or someone you know is in need of help because of drug and/or alcohol abuse or addiction, please give us a call. Maryland Addiction Recovery Center offers the most comprehensive dual diagnosis addiction treatment in the Mid-Atlantic area. If we aren’t the best fit for you or your loved one, we will take the necessary time to work with you to find a treatment center or provider that better fits your needs.