Ethical Treatment? Never Heard of It.


Something isn’t quite right when your lab ‘fires’ you for bringing in too few urine tests. 

Watching a loved one struggle with substance dependency is an emotionally devastating experience; those of us who have experienced active addiction firsthand know that there is little we wouldn’t do to help end their suffering. Because we are so raw and so vulnerable when we are in a state of crisis, we are liable to believe anyone who assures us that they can help. Sadly, this blind and desperate trust has lead to a multibillion dollar industry that feeds off of human suffering, and continues to bleed despairing families dry on a regular basis. Initially, recovery centers were developed to meet the needs of men and women struggling from severe, life-threatening addictions and co-occurring disorders. They were generally opened and operated by therapists, addiction specialists, and other like-minded individuals whose personal experiences lead to a deep-seated passion for recovery. Since the treatment industry first began booming, however, many unethical and unqualified ‘businessmen’ have tried their hands in the game. Now, the majority of big-time rehabs throughout the country are run by self-interested, money-grubbing tycoons – men and women who have no personal investment in the livelihood of their potential clients. Their motive is profit, not long-term recovery.

In fact, the shorter-term the better. The more times one individual goes in and out of a specific program, the more opportunities the facility has to take advantage of his or her insurance policy.

Testing, Testing… 1-2-3

An inevitable part of addiction treatment is drug testing. If a patient is still getting high, the intensive, therapeutic work will be entirely ineffective. He or she may drag other patients down too (misery loves company, after all). Rationally speaking, drug tests should only be administered when drug use is suspected. Patients are also drug tested upon arrival, just to ensure that they are ‘sober enough’ to successfully begin treatment. This makes sense. Doesn’t it?

Nowadays, treatment centers are jumping at every opportunity to drug test their patients – they are even fabricating reasons to administer tests, or administering tests with no valid explanation whatsoever. Some centers will test on-site, and send urine samples out to labs for further investigation (despite the fact that initial results were negative, and the concerned patient has shown no blatant signs of intoxication). Some centers will test for a number of chemical substances – substances that a given patient has never used or shown any interest in. For example, an alcoholic may be tested for methamphetamine; a heroin addict may be tested for crack cocaine. Finally, it has become common practice to administer multiple drug tests per week. In some instances, multiple tests will be administered to a patient who has remained consistently sober for an extended period of time. Why? Well, to keep patients accountable, of course.

Accountability, Done Right

There are several glaring problems with this mentality. First of all, if patients become dependent upon near-daily drug tests to keep them accountable, they will struggle immensely once they are on their own and self-reliant. If inpatient treatment is structured adequately, even weekly testing will be unnecessary. This way, newly sober individuals learn to keep one another accountable, and consistently do the right thing regardless of potential consequences. Secondly, labs will charge insurance companies somewhere around $3,000 per urine test. Even two tests a week will add up to $24,000 every month. Three month programs will typically transfer those who have graduated from inpatient treatment into their ‘sober living houses’, where drug testing will continue in conjunction with an Intensive Outpatient Program (IOP). So, say aftercare is roughly 6 months long. In total, drug testing alone will cost around $216,000. That’s on top of the monthly cost of treatment, which, in some cases, can exceed $50,000.

Ethical Drug Testing

Most effective and reputable inpatient treatment centers are for-profit – and of course they are. They must pay a qualified and passionate staff of professional therapists and clinicians, and provide patients with an incomparable quality of therapeutic care. The goal of treatment is to help men and women who are suffering with addiction (and co-occurring mental disorders). Help them to achieve long-term, fulfilled recovery. Help them to develop and utilize skills tools that will prevent relapse, thereby preventing them from ever entering treatment again. Help end the familial crisis once and for all, and restore family functioning so that it is harmonious, healthy, and gratifying for all members. This is the goal.

In 2015, there were over 30 local labs throughout Palm Beach County. The majority of these labs (well over half), were directly linked to an existing treatment center or sober home. Last week, the lab that we have been using to confirm positive drug tests fired us. Why? Because we were not providing them with enough urine analysis tests. Yes, they fired us. We at Next Chapter only administer tests upon initial arrival and when we have ample reason to believe that a current patient is actively using. We very, very rarely administer random drug tests, because we understand that the cost of long-term, residential treatment can be taxing enough. And we will only send tests off to the lab when they come back positive, for confirmation. Our goal is to help restore the family to a functional state of being, not drag the family into a place of unresolvable debt. Fortunately, recent crackdowns on treatment-related malpractice have lead to the closure of many unethical facilities. More and more addiction professionals are banding together to bring morals, principles, and a strong code of ethics to light.

While there is still much work to be done, the future of addiction treatment looks bright. While we continuously strive to uphold an unwavering code of ethics, we will support our friends in the industry who strive to do the same. No ifs, ands, or cups about it.