The Business Model of Addiction
Addiction is not just a disease. It’s often a comorbidity with other mood disorders (bipolar, schizophrenia, etc). If you don’t treat the root cause the comorbidity will run its own course and become an independent pathology. It’s a significant factor in the compiled morbidity statistics for affected cohorts that can shave off more than 20 years of lifespan in the form of organ failure and suicide.
There is no group therapy, no 12-step program that can address a compulsive tendency to self-medicate if the underlying pathology is not addressed. It’s a maladaptive response to a physiological or psychological crisis that is prone to a continuous escalation of tolerance until physical dependence is established.
At that point there is no sense of euphoria or intoxication to the user, only temporary mitigation against the absolute, immediate suffering of withdraw.
Clinicians and “addiction specialists” who are not sufficiently educated or equipped to identify and treat the root cause of addictive pathologies are a major contributor to our national mental health crises. They conflate morbidity associated with alcoholism and opioid addiction by failing to treat the underlying mechanisms of causal mood disorders in deference to naive idioms of patient care that only serve their interests.
Forced or sedated detoxification & prescribed group therapy are often the only tools employed by practitioners who are woefully uneducated or whose only qualification is being a recovering addict.
They work for for-profit institutions like Lakeside Milam or Fairfax Behavioral Health, administering bowls of jello & Just Say No videos from the 80’s under the pretext of care for $35,000 a month billed to your insurance.
If you inquire about recidivism, efficacy or individual therapies they will scold you as being an enabler contributing to the addict’s behavior & failed recovery.
The reason they are so defensive, reactionary & secretive about their treatment outcomes is that it is in their financial interest for addicts to fail. Returning customers are the pedal stone of any business model & these sham recovery centers are no exception. They are not interested or qualified to address the root causes of addictive pathologies and have everything to gain if a patient relapses. They’ll blame the patient or their loved ones & charge their insurance.
Often patients come out worse than they were at admission. They learn skills and behaviors from hardcore addicts caught in the cycle of addiction & recovery while their underlying pathologies go untreated.
I recently met a patient that had been admitted to Cascadia Behavioral Healthcare in Tukwila more than thirty times. Cleary suffering from an undiagnosed mood disorder that was the root cause of his addictive pathology, neglected, untreated and suffering.
Do the math, that’s nearly a million dollars worth of jello & coloring books. They know prior to admission that their treatment won’t work. But it’s a successful business model that is antithetical to both addiction treatment and mental health care, callously indifferent to suffering & directly contributing to morbidity statistics.
In the aggregate, we as a society have the knowledge, tools and capability to successfully treat both mood disorders and their corresponding comorbidities. But we do not have the will.
As long as recovery is a function of unbridled capitalism people you know and love will continue to suffer & die needlessly. It’s too late for millions of people but we have the capacity to change going forward. It’s long past time for healthcare reform, and mental health should be at the forefront of our thinking at every step. Anything less is just a business model.