Screenshots that show the unethical and often illegal practice of body brokering, in which rehabs pay third-party agents to fill detox and treatment spots (those agents, in turn, often "break off" some of the money that they receive for the addicts themselves after they spend the agreed-upon amount of time in whatever facility they are placed in).
I'll start with a Department of Justice notice about two brothers who ran the South Florida treatment facility mentioned in the first set of screenshots below (Compass), who were convicted of multiple counts of fraud and other crimes (link here).
Here's a long quote from this article, which shows just how flagrant these operators were:
"According to court documents and evidence presented at trial, Jonathan Markovich, 37, and his brother, Daniel Markovich, 33, both of Bal Harbour, conspired to and did unlawfully bill for approximately $112 million of addiction treatment services that were never rendered and/or were medically unnecessary, and that were procured through illegal kickbacks, at two addiction treatment facilities that they operated, Second Chance Detox LLC, dba Compass Detox (Compass Detox), an inpatient detox and residential facility, and WAR Network LLC (WAR), a related outpatient treatment program. Jonathan Markovich, who owned both facilities, was also convicted of bank fraud in connection with PPP loan applications in which he falsely stated that Compass Detox and WAR were not engaged in illegal conduct.
The evidence showed that defendants obtained patients through patient recruiters who offered illegal kickbacks to patients (such as free airline tickets, illegal drugs, and cash payments). The defendants then shuffled a core group of patients between Compass Detox and WAR to fraudulently bill for as much as possible. Patient recruiters gave patients illegal drugs prior to admission to Compass Detox to ensure admittance for detox, which was the most expensive kind of treatment offered by the defendants’ facilities, therapy sessions were billed for but not regularly provided or attended, and excessive, medically unnecessary urinalysis drug tests were ordered.
Compass Detox patients were given a so-called “Comfort Drink” to sedate them, and to keep them coming back. Patients were also given large and potentially harmful amounts of controlled substances, in addition to the “Comfort Drink,” to keep them compliant and docile, and to ensure they stayed at the facility. Certain patients were also routinely re-admitted and repeatedly cycled through Compass Detox and WAR to maximize revenue."
***
You love an addict. You see their life endangered by their use, perhaps even lose contact with them for a while when they're on the street or on a bender.
One day, at last, you learn that they're entering treatment. The relief is ineffable.
Now they have a chance, you think.
And most of the time, this is true.
***
As I wrote about in "9 Factors to Consider When Choosing an Inpatient Rehab," selecting a facility that fits your needs plays an important role in treatment success.
Unfortunately, there are some facilities that are just plain rotten.
In New York State, we are protected to some (limited) extent by the Office of Addiction Services and Supports (OASAS), which is fairly active as state addiction treatment regulators go; they have a helpline for people in treatment who feel that they are being abused, and they tend to take action (eventually) when enough complaints build up.
In other areas of the US, however, and even in some circumstances in NYS, addiction treatment facilities essentially have carte blanche to abuse their clients.
During my time in treatment, I've heard people told that, because their counselor could call their probation / parole officer and send them to jail or prison, they had essentially no rights in the treatment process.
I've witnessed both male and female patients being sexually exploited.
I've seen multiple patients getting treatment outside of their home state told that, if they chose to leave the facility they were being treated at, they would be left on the side of the road - even though the facility promised transportation to and from bus hubs, airports, etc.
***
I wrote about my treatment at Palm Partners' facility in South Florida a couple of weeks ago (article here).
In terms of the quality of treatment provided, at least during the time that I was treated there, this was actually one of the better facilities in the Delray Beach area (which, during the for-profit rehab boom of the early- to mid-2010s earned the tagline "the recovery mecca of the US and the relapse mecca of the universe").
During my stay at Palm Partners, I was drug tested every single day for every drug under the sun. The drug tests included weird sh*t like kratom, Darvon, Demerol, quaaludes (are we stuck in the '70s?).
Given that I was in inpatient treatment, which involves being closed off from the world and monitored 24/7, this was highly irregular, as was the fact that they were billing my insurance for GCMS - highly specific, confirmatory testing that is expensive and ordinarily only used after cheap screening tools like immunoglobulin drug tests first indicate a positive.
As patients, we knew what this was about (cough: insurance fraud).
Because every single urine or saliva sample is worth hundreds to thousands of dollars, these facilities either create in-house labs or develop kickback relationships with external testing facilities.
And the racket, which is worth millions of dollars per year in drug testing profits alone, begins.
A couple of years after I finished treatment at Palm Partners, I received notice that my treatment records were being subpoenaed in redacted form as part of a regulatory investigation of the facility.
It eventually shut down, then rebranded as a weight-loss treatment center (probably because it had been forbidden from billing insurance after fraud was uncovered).
***
Unfortunately, that kind of billing fraud is about the mildest sort of unethical behavior that shady treatment facilities engage in.
During the boom of for-profit addiction treatment centers in South Florida and California during the 2010s, vast fortunes were made.
I'm talking Tudor mansion, Rolls Royce with driver included money.
(Or, because this was Florida, gaudy, postmodern McMansion on a smelly canal with a former cheerleader / escort who is now your trophy wife money).
The big-name treatment facilities branded the entire recovery process - from detox to drug testing to inpatient to sober living.
They developed cult-like followings who swore that they owed their lives not to recovery, but to that specific program and the people who led it, who were treated as celebrity personalities.
These facilities spent millions of dollars on marketing per year - stop and think about that; addiction treatment facilities spending literal millions of dollars recruiting clients - but the competition became so fierce that they had to resort to other methods.
This is where body brokering entered the picture.
Body brokers are third-party agents who receive fees for each addict that they place into detox and inpatient treatment.
If you're thinking about this arrangement as someone who hasn't been on the inside of it, you might be wondering why the facilities don't just use their own marketers to recruit patients. It's a reasonable question that someone thinking ethically would consider.
Unfortunately, many of these for-profit facilities are thinking exclusively about the bottom line.
They need brokers out on the street mingling with the active addict population and trying to entice them into entering treatment.
They need people who aren't bound by ethical or legal constraints, who can find addicts who don't necessarily want to get clean but are willing to pretend that they are for the right amount of money.
These brokers, in turn, get a flat fee from the facility for every addict who spends a certain amount of time in whatever treatment center they are placed in.
As you'll see in the subsequent screenshot, this often translates into frank exchanges boiling down to: "If you spend X days in Y treatment facility, I'll give you Z amount of cash for it."
Because detox and inpatient are worth tens of thousands of dollars in (creatively billed) insurance payments for each short treatment episode, the addicts often decide that it's worth it to spend a few days in a comfortable detox facility if they get - in this example - a thousand dollars ("I'll give you a stack each once they walk in").
Addicts are sometimes offered cash and drugs to use before they enter detox, as well.
In the following screenshots, you'll also see that Frankie, the body broker in question, has four addicts in a hotel room waiting to be shipped out to the promised treatment center.
However, something has gone wrong (either he hasn't given the addicts the promised fee, he's changed the arrangement from what was agreed upon, etc.), and the addicts are trying to get out of it.
The situation ignites into an argument about who promised who - and who owes whom - what.
If you've been in the South Florida treatment world, then there's a good chance that you know who this Frankie (Francisco) scumbag is.
He applied his craft with all of the subtly of a mob boss, and he's been exposed for illegal practices.
Unfortunately, Frankie was just one of the more egregious examples of an exceedingly common phenomenon.
Again, these body brokers are rogue agents. They aren't licensed, accredited, or supervised.
There are few limits on what they can do or promise to do, and their actions are in some instances legally separate from the facilities that they funnel people into.
Moreover, because they're individual agents, taking civil legal action against them is more complicated and less likely to result in a fruitful judgment than simply suing a facility.
Now, you could argue that these facilities have an ethical responsibility to make sure that they're dealing with "recruiters" trained in addiction counseling, intervention specialists, etc., and to investigate claims of mistreatment by the brokers that they work with.
That's because you're a good person.
Most of these facilities don't give a sh*t about that.
***
In any situation with such a skewed power dynamic, the weaker party stands a significant chance of getting taken advantage of.
In the screenshots below, which involve another body broker in the South Florida area, the broker asks the addict who is helping him recruit other addicts whether she has a boyfriend (there are literally pages and pages of screenshots of flirty messages and requests for dates that went unanswered or were brushed off; the addict in question told the broker that "she had a man," and he kept on pressing the issue).
So now this body brokering arrangement has devolved into a situation in which addicts are doing the work of the brokers by recruiting other addicts for treatment - and there is potentially sexual exploitation involved, as well.
***
These screenshots were taken from a blog called B for Vendetta (https://bforvendetta2.wordpress.com/), run by a friend of mine who was an addiction counselor in South Florida along with three compatriots.
It was dedicated to exposing widespread abuse in the Florida for-profit treatment mill, and it created quite a stir when it was active in the late 2010s.
It's written in an engaging, menacing style that is half V for Vendetta, half Jigsaw from Saw.
The writers - who pretend to be a single personality - give exposed individuals / facilities a chance to confess to their crimes publicly or in court.
I'm not claiming that every instance of abuse discussed in the blog unfolded exactly how the blog says that it did because these investigations are not my own, but I can vouch for the people who created the blog, who knew the South Florida treatment landscape from the inside, and I am confident that they were writing it for the right reasons.
The blog also discusses unethical practices involved in the facilities' marketing, including paying public figures like recovered professional athletes as spokespeople despite the fact that they have no training in addiction treatment.
It provides insight / opinions on drug testing policies, billing practices, professionalism of treatment staff, marijuana use policies, and other topics, too.
One of my goals is to help elevate small, independent blogs written by active addicts or people in recovery.
Unfortunately, writers like us are at a huge SEO disadvantage because the keywords that would help people find us are dominated by treatment facilities, news outlets, and insipid "recovery is amazing; buy my counseling classes or merch" accounts.
Being on methadone, albeit on a taper, helps me in a sense because my toes are still in the waters of treatment.
If you are reading this and are aware of widespread abuse on the part of a treatment facility, then get in touch using the Contact form here, on Instagram (concreteconfessional), or by emailing concreteconfessionalblg@gmail.com.
***
In actionable terms, if you are reading this as a loved one of an addict or an addict him/herself, make sure that you don't ever deal with someone who is not directly attached to whatever treatment facility they are promising to help you get into.
Beware of people who claim affiliation with multiple, separate treatment providers; they are almost certainly brokers.
Ask detailed questions about their license / certification and their legal relationships with facilities.
Be exceedingly careful of anyone who offers plane tickets if you agree to come to a certain facility; this is likely illegal and gives them incredible leverage once you show up for treatment because they know that you probably can't get back home on your own.
Independent "body brokers" are never to be trusted. Every force that shapes their shady industry incentivizes unethical and often illegal practices.
If you are aware of body brokers operating in your area, obtain screenshots and send them to your state's addiction treatment regulator (OASAS in New York State, for example).
If they don't take action, your state's Attorney General's office is also a resource.
If you aren't sure who to contact, gather your evidence and send it to me.
Even if you don't believe that what you experienced at a treatment facility rises to the level of unethical or illegal abuse, leave a detailed, negative review online anywhere you can possibly put it. Include staff names, dates, specific incidents, and other useful information, and write it as succinctly and objectively as possible.
***
There is a reckoning taking place throughout the U.S. right now as family and friends of addicts, as well as addicts themselves, are realizing that not all treatment is good treatment.
We are being preyed upon by people who know that we are desperate to stay alive.
I wouldn't want to be one of those people - even outside of my conscience's complaints - no matter how much money I was making.
You are dealing with people at the end of their tethers, who are close to death anyway. Many have years in prison and inescapable, untenable debt hanging over their heads.
At some point, someone is going to decide to make you pay regardless of the consequences.
Love you all. Stay safe out there,
B.
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