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Monday, March 20, 2017

NEWS RELEASE: Upcoming Alcohol Awareness Month about more than alcoholism, drunk driving

Orignal post on PRBuzz.com

April 2017's thirty-first observance of Alcohol Awareness Month is the first since the U.S. Surgeon General signaled a shift in alcohol policy. The Surgeon General's Report on Alcohol, Drugs, and Health marks the first time the office took on the health impact of alcohol use in a manner similar to the way the same office took on tobacco smoke in 1964. Award-winning alcohol and health writer, Scott Stevens, says, “All alcohol use impacts health, healthcare costs, and the economy. It's not just about impaired driving or the disease of alcoholism anymore. The dialogue on this drug is changing from what it does for the drinker, to what it does to the drinker.”
Stevens released I can't see the forest with all these damn trees in the way: The health consequences of alcohol December 2, immediately after the Surgeon General's “unprecedented” report. “Alcohol use is a cost driver for the health system because more long-term health consequences from moderate drinking are coming to light… while more ‘benefits’ of 'responsible' drinking are being debunked,” Stevens says. “I’ve championed this theme since my first book in 2010 and in each of the two books that followed.”
Among the scientific findings on alcohol use:
The carcinogen alcohol causes eight types of cancer. It is the only dietary link to increased breast cancer risk and the second-leading cause of oral cancers.
...Stroke risk doubles immediately on a single drink and remains elevated two hours later.
...Heart disease is not prevented by alcohol: It is caused by and worsened by alcohol use.
...Plus 60 more pages on the evidence-based health fallout from so-called moderate use.
Twenty-to-forty percent of hospital resources go to treating alcohol-related complications according to the National Council on Alcohol and Drug Dependence, Inc. (NCADD). The economy takes a $250 billion annual hit from alcohol costs, mostly lost productivity, according to the Centers for Disease Control and Prevention (CDC). Stevens adds, “It's easy to see what causes the problems, is the problem. Alcohol's consequences aren't just for hard drinkers and certainly aren't limited to alcoholism or drinking and driving.This is a drug, a toxin, and a carcinogen in any amount. People routinely complain about healthcare costs and sagging productivity… over a beer or a shot. They’re not seeing the forest. Just the trees.”
The book is available at Amazon, other online and bricks-and-mortar booksellers, and the author's website www.alcohologist.com. It is the second release by the author in the past year, preceded by an educational DVD series, The A-Files: Alcohol A-Z.
Each of Stevens's three books includes a chapter on the health fallout of drinking alcohol. “It's not about discouraging drinking, except for the alcoholic. It's about making informed decisions about using alcohol based on evidence-based science. Informed decisions don't come from observational studies and wishful thinking.”
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About the Author
The noted journalist on alcoholism is a founding influencer of the world's largest medical portal, HealthTap.com. His books on the disease include 2010's What the Early Worm Gets, 2012's Every Silver Lining Has a Cloud, which earned finalist honors in the Indie Book Awards and USA Best Books Awards in 2013, and Adding Fire to the Fuel, a 2015 USA Best Books Awards Finalist and 2016 Book Excellence Award winner. He also created the Alcohology mobile app.

Saturday, March 18, 2017

An addiction is anything you have to hide


(Originally posted on AddictedMinds.com)

A many-faceted challenge for families, interventionists, and other addiction pros alike is defining an addiction. We have textbook definitions. We have tests. But when it comes down to addressing the addiction with an addict in denial that he or she has one, we are consistently challenged with breaking down denial.
Signaling the problem, we turn to the Diagnostic and Statistical Manual (DSM). The latest version is October 2016’s DSM-5. Its 11-part impersonal analysis for any substance use disorder:
  1. Taking the substance in larger amounts or for longer than the you meant to
  2. Wanting to cut down or stop using the substance but not managing to
  3. Spending a lot of time getting, using, or recovering from use of the substance
  4. Cravings and urges to use the substance
  5. Not managing to do what you should at work, home or school, because of substance use
  6. Continuing to use, even when it causes problems in relationships
  7. Giving up important social, occupational or recreational activities because of substance use
  8. Using substances again and again, even when it puts the you in danger
  9. Continuing use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance
  10. Needing more of the substance to get the effect you want (tolerance)
  11. Development of withdrawal symptoms, which can be relieved by taking more of the substance.

Signs, signs, everywhere signs

The DSM 5 allows clinicians to specify how severe the addiction is, depending on how many of the 11 signs are present. Two or three symptoms indicate a mild substance use disorder, four or five symptoms indicate a moderate substance use disorder, and six or more symptoms indicate a severe substance use disorder.
BOOM! That was easy.
Now tell the addict he or she is one and needs help. The 947 pages of the American Psychiatric Association’s ‘bible’ do little for that discussion. Assume very few people under the influence of a mind-altering drug have the capacity to use that same mind to analyze (honestly) the symptoms.
A simple pair of personal questions gets at the a-ha moment the impersonal DSM can’t get at eyeball-to-eyeball:
Are you hiding your use? Why?
The answers are C-R-I-T-I-C-A-L to making change. You can get at any of those 11 DSM criteria with those two questions. We hide use because we don’t want anyone to see. Or judge. Or evaluate us on a DSM scale. We don’t want them to see because we don’t want to hear that it’s “wrong” or “shameful” or fill-in-the-blank. Yet, family sees. Counselors see. The addict needs that vision and it comes from that introspection. And very few – if any – are ever asked directly what they are hiding, and why are they hiding it.
Addicted Minds’ Editor-in-Chief, Scott Stevens, is the author of four alcohol books including the December 2016 release, I Can’t See The Forest With All These Damn Trees In The Way: The Health Consequences of Alcohol. Buy the new BookLocker title now on Amazon (viewbook.at/prehab), alcohologist.com, and everywhere books are sold. Stevens also heads up BlogTender LLC, a content marketing firm headquartered in Lake Geneva, Wis.
Photo by Vasilisa Karpova, used with permission.

Saturday, January 14, 2017

American Beverage Institute declares war on common sense



Sarah Longwell is rolling a clown car full of falsehoods through every Main Street news outlet that will run it. The term 'red herring' comes to mind when reading this opinion in the Modesto Bee, Rockford Star, and the Journal Standard (Jan. 13) and the Tribune/Democrat (Feb. 11) because the supplier of this viewpoint is the American Beverage Institute: The largest liquor lobby in the country. (click on any of the links to read the Institute's ad) 


Why not give it inches of column space to roll out the same alarmist language ('prohibition') and tired, discredited OBSERVATIONAL studies in favor of drinking a toxin and known carcinogen? This is not an op-ed piece. It is an advertisement. Follow the money: Who pays Sarah? Alcohol. She KNOWS what she is writing is a retread of alcohol's parade of junk science without medical or scientific basis. 


The Surgeon General's report, while falling short on all the alcohol harms beyond the disease of addiction, does signal a shift in American alcohol policy. One that would leave Sarah dramatically underemployed. Don't fall for special interests declaring a self-serving war on facts: There are NO evidence-based health benefits to drinking alcohol. The 'overwhelming scientific evidence' mentioned at the end of her editorial points to a $250 billion national health pandemic and a proven health problem causing 89,000 deaths a year.

_______
Addicted Minds' Editor-in-Chief, Scott Stevens, is the author of four alcohol books including the December 2016 release, I Can't See The Forest With All These Damn Trees In The Way: The Health Consequences of Alcohol. The new BookLocker title is available now on Amazon (viewbook.at/prehab), alcohologist.com, and everywhere books are sold. 

Monday, January 2, 2017

Seven clues that 2017 will be the Year of the Pandemic


Much of the decade leading up to 2017 has been characterized by an Opioid Epidemic, according to author Scott Stevens. For the final 1,000 or so days of the decade, America will continue to gain ground against painkiller and heroin deaths. However, according to Stevens, 2017 will “mark a switch in the dialogue from illicit drugs developed in pharmaceutical labs or grown in faraway lands to a homegrown pandemic that claims 90,000 American lives.” Here are the award-winning author's seven reasons why the U.S. will finally talk about the drug we love – alcohol – instead of the drugs we loathe.
1) Pro-marijuana factions are forcing the attention away from the problems created by their drug to the one that's already legal. Recreational pot — legalized and/or decriminalized in eight states now — is 'less dangerous' than both alcohol and tobacco. Granted, one side of the Titanic may, in fact, have been safer than the other, the 'safety' of marijuana versus booze is not a new claim. Well-bankrolled pro-marijuana interests are making hay with what they claim is, for the first time, research measuring the potential harm of these drugs in a more quantitative way. Their findings showed the dangers of marijuana "may have been overestimated in the past, while the risk of alcohol has been commonly underestimated.” They are at a minimum half correct no matter where you fall on the legalization/decriminalization argument. As the pro-pot teams swarm the media, America can't help but hear that it's wishful thinking that their favorite drug-of-choice is safe because it is legal.

2) Our new president is a teetotaler.
 Donald J. Trump doesn't drink. Like so many Americans he has a family history including the disease of alcoholism. He gets that it is a disease related to the use of a socially and physically toxic drug. But beyond alcoholic drinking, Trump doesn't buy that the moderate drinking (use of a drug) is acceptable.

3) Our new president is a business owner.
 He's not shy about talking about increasing efficiency in Making America Great Again. Among the measures a business owner uses is productivity. Even moderate use creates absenteeism (a productivity drain), and increased risk of accidents/injuries (another productivity drain). Tardiness/sleeping on the job. Hangovers and withdrawal affecting job performance. Poor decision making while under the influence of a central nervous system depressant. All clobber productivity.

Seventy percent of the $250 billion alcohol costs the U.S. economy every year comes from losses in productivity resulting from premature death, impaired productivity, institutionalized populations, incarceration, crime careers, and victims of alcohol-related crime. Other effects on society included crime, social welfare administration, motor vehicle crashes, and fire destruction and cost more than $40 billion. Government, private insurance, and victims bore most of the economic burden of alcohol and drug problems. That's a not-so-great anymore America he wants to make great again.

4) The Fourth Estate continues to become less dependent on the Big-Alcohol teat. 
History lesson… When much of the Glass/Steagall Act was repealed in 1999, financial services advertising rocketed to the top five of advertisers, and negative stories about the industry fell to the back page or out of the newscast. Would Enron, the Tech Collapse and the Mortgage Crisis have happened if news operations had been less beholden to the financial services industry? Yep. But would those calamities happened as swiftly and destructively? Doubtful.

Conversely, alcohol advertising has today tumbled out of the top-ten. Alcohol ads typically tie brands with cool, sexy, stylish, on-Fleek people and fun times. Ultimately, these concepts come together to suggest: if I use this product, I too can be cool, sexy, on-Fleek and successful like the people in the ad, having fun like they seem to be. Ads so influence young people that media is under pressure from groups like AlcoholJustice and The Center on Alcohol Marketing and Youth (CAMY) to keep the ads off air, out of public view in neighborhoods, off social media, and out of print. News outlets beholden to their advertisers – or at least not airing stories that will cost an advertiser business – are seeing less advertising from brewers and distillers. The result: More of the negatives from alcohol use can make it onto your laptop or into your living room.
5) American losses are too staggering to ignore any longer. More Americans die each year from alcohol than the number of Americans killed in the entire Korean and Vietnam conflicts combined. More than twice as many people die an alcohol-related death in the U.S. than die an opioid-related death (90,000 vs. 33,000). When opiates killed 10,000 in a single year it was an 'epidemic.' When the flu killed 30,000 in a year, vaccination levels ballooned. People did something. Three times as many die each year from moderate to heavy use of alcohol. People are starting to take note of what alcohol does to them rather than what they think it does for them.

This number of alcohol-related deaths is rising, too, not falling.
6) Healthcare reform reform will add the prevention element on which it has missed the mark. Twenty to 40 percent of general use hospital beds in the U.S. – those not used for specialties like maternity and birth – are used to treat alcohol-related complications. Two hospital admissions each minute are alcohol-related. Alcohol is a substantial driver of healthcare utilization.
And it is a substantial driver of illness. Alcohol is listed as a known (not a suspected) carcinogen by the Department of Health and Human Services. Eight cancers are directly tied to alcohol use: The higher the use, the greater the risk. It's the only dietary link to an increased risk of breast cancer. More than 60 diseases are linked to alcohol use. More than 200 prescription and over-the-counter remedies react adversely with this toxin. We've had a history lesson above in #4. Here's a math problem: More sickness + hospitalization = higher medical costs = higher insurance premiums. What causes problems, is one.

7) The status quo is unsustainable.
Addicted Minds' Editor-in-Chief, Scott Stevens, is the author of four alcohol books including the December 2016 release, I Can't See The Forest With All These Damn Trees In The Way: The Health Consequences of Alcohol. The new BookLocker title is available now on Amazon (viewbook.at/prehab), alcohologist.com, and everywhere books are sold. See this release on PRLog.

Friday, July 8, 2016

How others' alcohol use became your business: The Toxin-omics


Drinking is 'The American Way,' 'How We Roll,' 'Harmless Fun,' or just 'None of Your Damn Business.' Just ask a drinker. He or she doesn't even need to have the disease of alcoholism: You attempt to get between a person and the beverage of choice and you'll hear defense. The defense is offensive when you know the economics of the toxin and drug alcohol.
The economic impact of drinking – casual drinking and alcoholic use – tallies an eye-popping $250 billion every single year in the U.S. By way of comparison, smoking costs the economy $173 billion… all other drugs combined cost the economy $130 billion. A 2011 study in the Journal of the National Cancer Institute determined the cost of all cancer care in the U.S. totaled $124.5 billion in 2010 … half as large as the alcohol toll. How big is the we-don't-have-a-problem alcohol problem, by the numbers?
  • That's enough to buy a 48 inch HDTV for every man, woman and child in the U.S. And an X-Box. Every year.
  • Two-hundred-fifty billion dollars is the same as the annual expenditure on fashion and apparel in the entire U.S.
  • The Treasury in 2008 bailed out the banks with a $250 billion “investment” that created critical echoing still heard in the 2016 Presidential campaign and brought hundreds of 99 Percenters camping in Wall Street. That was just a one year expense.
  • For the ubersmart Keynesian economists out there, $250 billion is a NEGATIVE GDP (gross domestic product) value of $74 billion. (For those of us less-smart: Alcohol shrinks the economy the way it shrinks libido.)
  • For the 216 world economies tracked in the CIA World Factbook, $250 billion is bigger than the 40th largest economy on the planet, and bigger than the output of the bottom one-third of countries COMBINED. 
The costs are in healthcare, lost productivity, legal and corrections costs. Alcoholism is part of the total, but $250 billion is driven by all drinking, even social or moderate use. The CDC readily admits the $250 billion is on the low side, too. The researchers believe that the study still underestimates the cost of excessive drinking because information on alcohol is often underreported or unavailable, and the study did not include other costs, such as pain and suffering due to alcohol-related injuries and diseases.

Alcohol revenue does not cover alcohol economic damage
The monetary consequences are something everyone shares: Drinkers and non-drinkers alike. The numbers get complicated, because the drug Americans enjoy and defend so vigorously, also costs the most in health and hard dollars. Each drink consumed has a median cost of $2.05 in economic harm (lost productivity, health care costs, property damage and criminal justice system expenses). That's according to the Centers for Disease Control and Prevention (CDC). So the drinker pays for that in alcohol tax, right? No. The median paid in tax per drink is less than a nickel a drink. The Tax Policy Center estimates that state and local taxes on alcoholic beverages bring in about $6 billion in revenue nationwide. The overall economic benefit from the manufacture and distribution is less than a quarter per drink.
Industry watchdog, Alcohol Justice, suggests closing the gap between tax revenue and the economic damage, which may also reduce use. According to Alcohol Justice's Charge for Harm Campaign, "Big Alcohol produces, sells, and promotes products that cause harm and incur costs - to both government and its citizens. Appropriately taxing alcohol at state and federal levels will help reduce related harm and provide needed funds. We support state and federal increases in alcohol taxes and fees."
Even if drinkers bore the full $2.05, everyone else still pays in lost productivity. Show up late, never, hungover or just without your A-game and someone has to step in or step up. It doesn't always happen that way. Which costs the company. So the company charges more for its goods or services. Lost productivity, according to the National Institutes of Health (NIH) is more than 70 percent of the $250 billion annual cost of alcohol use in the United States. Every shopper pays… no matter if we shop Walmart or Macy's.
This is the part of the revenue formula pro-alcohol forces leave out of the dialogue when pushing for more beverage licenses, longer hours of service, and absurd ideas like selling alcohol at college sports venues. With greater access to alcohol, the revenue does go up in a bar, store, or restaurant. But so does the economic damage. And never the twain shall meet.
Need a hospital bed? Wait. And pay more.
Here's another way to look at the economic harm. There is an alcohol-related hospital admission every 30 seconds and, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 20-40 percent of general use (non-specialty) hospital beds are used to tend to alcohol-related complications. Heroin addicts aren't breaking the healthcare system. Aging Baby Boomers aren't pushing it past capacity. Alcohol use is drowning it.
Health care costs related to alcohol use are not limited to the drinker. There are unintended – and sober – victims in traffic crashes you've no doubt heard about from the impaired driving activists, Mothers Against Drunk Driving (MADD). However, children of alcoholics who are admitted to the hospital average 62 percent more hospital days and 29 percent longer stays according to the Children of Alcoholics Foundation.
Nested inside of every major cause of death in the U.S. is the fact that alcohol use is a contributing factor to each of those causes of death or hospitalization. Alcohol is a carcinogen, for example. It is the second-leading cause of oral cancers and is the only dietary connection ever made to an increased risk of breast cancer. The Agency for Healthcare Research and Quality (AHRQ) estimated the price of cancer care for one year of life increased to $207,000 in 2013.
Heart disease, not cirrhosis, is the leading killer related to drinking. Annually, about one in every six U.S. healthcare dollars is spent on cardiovascular disease. By 2030, annual direct medical costs associated with cardiovascular diseases are projected to rise to more than $818 billion, while lost productivity costs could exceed $275 billion. What is the preventative measure hiding in plain sight? Stopping drinking. About 1 in 3 adults—or approximately 86 million people—have at least one type of cardiovascular disease, which means many more Americans could die from what is often preventable through lifestyle changes or managing medical conditions. There are 1.5 million heart attacks and strokes in the U.S. annually. One in five strokes is alcohol-related. One dollar spent on alcohol education (e.g. abstinence) saves $4 in healthcare costs down the road. (Plus $7 in criminal justice system costs for good measure.)
Bottom line: We ALL pay
The healtcare cost equation under mandated insurance means part of every insurance policy premium is gobbled up to care for alcohol-related problems. An insured person doesn't have an account from which he or she dips. Insurance premiums are pooled. You can be a non-drinker… your own premium will be lower because of your relationship with alcohol… but your premium will still reflect the experience of the insurance pool. With insurance mandatory, and 67 to 70 percent of adults using alcohol in the past year, there is a majority of your insurance dollar used to mitigate the expense of drinking.
Binge drinking alone – four or more drinks per occasion for a woman and five or more drinks for a man – accounts for more than 75 percent of costs related to excessive alcohol use in all states, just under $171 billion. Binge drinking is reported by about 18 percent of adults in America. (Wager that the self-reported binge drinking number is MUCH higher, people aren't typically honest about their answer to the non-of-your-damn-business question.) According to the CDC. binge drinkers and their families paid less than half of the costs associated with high alcohol use (41.5 percent) while federal, state and local governments paid about 42 percent, or more than $94 billion, of the costs.
The government doesn't have a separate checkbook funded by drinkers or beverage companies to pay for this: It uses your checkbook.
Visit www.alcohologist.com for more on the health and economic costs of drinking a toxin and known carcinogen. And order The A-Files: Alcohol A-Z for what alcohol does TO you, not FOR you. I Can't See The Forest With All These Damn Trees In The Way is now available in paperback.

Tuesday, July 5, 2016

Yahoo! I heard another internet alcohol & health lie!



A ridiculous, and dangerous, piece of fiction emerges from cherry-picking observational studies. In that pursuit, anyone can find support for smoking, alcohol use, or use of any other drug. However, the evidence-based science demonstrates ZERO health benefit to even moderate use of a toxin and known carcinogen. (READ THE DELICIOUS PIECE OF FACT-MANUFACTURING YAHOO! UK IS PEDDLING)

Aside from the fact that daily drinking is one of several indicators of the disease of alcoholism, there is no health benefit to drinking any amount, at any age, for either gender. Spend 52 min. with The A-Filesif you want to find out what this drug does TO you, instead of this fiction of what it does FOR you.

For example, Women... this is the ONLY dietary factor shown to increase risk of breast cancer. Each drink daily (10g of alcohol) increases risk by 11 percent. More than four a day brings the same risk as smoking a pack of cigs a day. It's the #2 cause of oral cancers. Was cancer intentionally left from this article? Probably... because alcohol causes eight types of cancer. “The relationship between alcohol and cancer is not widely appreciated by the public and remains underemphasized even by physicians. When it comes to cancer, there is no safe level of alcohol consumption.” American Journal of Public Health Feb. 2014

The heart health myth was discredited more than a decade ago. It causes pre-diabetes, a precursor to type 2… it doesn’t reduce the risk as observational studies claim. Additionally, one in five strokes is alcohol-related. The risk of stroke is both long-term and short-term. In fact, stroke risk increases instantly and remains elevated for two hours after consuming alcohol. There are also consequences for liver, brain, pancreas. More than 60 diseases are caused by even "moderate" use of alcohol and it is the third-leading cause of preventable death and illness in the U.S. and U.K.. This dandy dietary tip just could kill someone.

The immune system is sacked by even moderate use: That's basic bioscience, not the junk science in this pro-alcohol piece. Sex problems linger even a year after complete abstinence (http://www.examiner.com/article/sex-problems-last-a-year-after-heavy-drinking-stops-according-to-new-study) and an older 2007 study -- evidence-based -- notes a falloff in sex drive with regular moderate use. And life expectancy? Jeez. The CDC notes a reduction of life expectancy 18 months (moderate use) to 20 years (heavy use).

Get evidence-based facts before succombing to Yahoo!'s dangerous and irresponsible article.

The entire 26 episode HD The A-Files: Alcohol A-Z series is available on disc, along with fact sheets, for helping professions. Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com 

Saturday, July 2, 2016

Selling care: Patient brokering in addiction treatment

health, healthcare, treatment, drug addiction

Ambulance-chasing. Society generally looks on with disgust at the attorney who markets directly to the accident victim in the hours after the ink on the police blotter dries. The practice isn't illegal, but it brings up the subject of ethics. A similar practice has smoldered silently in the addiction care business for the last decade and will be leading to more scrutiny – and crackdown – over the second half of 2016.
Treatment centers provide a service (detox, intensive outpatient, inpatient, partial hospitalization, or some combination of elements) for a fee, which is charged to the client or the client's insurer. It's America. Lawyers charge a fee in a time of need. Mutual fund companies charge a fee to manage the retirement money upon which you'll develop a need. Lawyers are regulated. Fund companies and their sales reps are regulated and supervised. The practice is largely unregulated in the treatment industry.
The ambulance chaser in the addiction care business solicits business in 12-step meetings and detox facilities and even emergency rooms. There are reputable recovery coaches and other addiction paraprofessionals in the service of those struggling with substance abuse who also attend to those venues and offer suggestions. When they are paid by a treatment entity to deliver those struggling heads to the facility's beds is the point in which the practice becomes predatory.
Take for example, Alcoholic Joe. Joe turns up in the emergency department, unconscious due to acute intoxication. (e.g., he's beyond drunk) A responsive ER staff will inquire about what he's had, how much, and how frequently. Maybe even a social worker or staff associate will address the possibility that Joe has a substance use disorder and suggest courses of action beyond the hospital's capability. Other resources may be given to Joe, if he inquires. He takes it to heart (or his wife does) and Joe goes to a 12-step meeting.
So far, so good. When Joe bumps into a counselor, a self-styled recovery guru or a fellow at the meeting, the conversation sometimes turns to treatment. If the person steering the conversation toward a facility is getting paid $1,000 or $5,000 a head to steer Joe toward that facility – and never discloses he or she is on the dole – is where the industry is getting its latest black eye.
It's not unfamiliar territory for the healthcare biz. Rewind the tape back to the early 90's when physicians were accepting elaborate junkets from pharmaceutical companies and medical device makers. The public bristled when the kickback exposed that the patient might not be getting the best medication or device for his condition, just possibly the medication or device offered by the company with the sweetest “conference” destination. In the early 2000's a similar practice in the mutual fund business was discontinued when fund companies were found to have influence over brokers who might not be offering the most suitable investment for the client, just the funds that landed on the “preferred list” because of the extras offered the broker or brokerage firm.
As the opioid epidemic continues to grow within the shadow of the alcohol pandemic, more treatment centers are opening. Which can only be considered a good thing if they are treating the patient and not the one who provided the patient. As start-up facilities – and some established ones – struggle to keep cashflow manageable, a pay-per-client (heads-in-beds) can be an attractive alternative to shelling out for a marketer's salary and benefits. A captive marketer is going to work for one facility or group of facilities. He or she may not have a component of their compensation based on the census of the facility (e.g. percentage of beds filled at a given time). But they are, in theory, still driven by getting the right fit between the client and the facility. Many even network with other centers' marketing staff and refer business to the right fit based on the cost, insurance and most importantly the client's needs. When a consultant makes a referral without accountability to the facility or for the outcome of the treatment for that client, but for what it appears to be the financial gain of a $5,000 payday over a $1,000 payday, the treatment industry's self-policing has a weakness.
There is no inference that every per-client marketer or treatment facility that employs the tactic is sketchy. As with any enterprise, there are scrupulous and unscrupulous sales people. This industry is no exception even though it is commonly referred to as a helping profession which comes in contact with families and clients during a real and human and emotionally charged crisis.
In the early part of this decade, healthcare officials as well as federal agencies have had the practice show up on their radars. In some cases, the fit between the client and facility or program was so poor, litigation ensued. In extreme cases, people have relapsed and/or died while in the care of a program. Not that the relapse is uncommon with the disease of addiction to alcohol or other drugs… it's not a welcome outcome in or shortly after treatment.
For now, the status quo is under greatest scrutiny in California and Florida, two treatment industry hotbeds. However the status quo remains as a practice that is not illegal – like ambulance chasing – just potentially unethical until greater oversight and guidance is provided. For the time being, it pays to ask a question if and how a person is being compensated for making a recommendation of one facility over another.
The entire 26 episode HD The A-Files: Alcohol A-Z series is available on disc, along with fact sheets, for helping professions. Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com