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Their insurance provider made additional payments, as well. Through it all, the Blakes drained their savings for retirement, along with college funds for both Sean and his younger brother. But none of the treatments stuck. In AugustSean died of a drug overdose involving alcohol and fentanyla synthetic opioid.
He was 27 years old. Sean was one of the hundreds of thousands of victims of an opioid epidemic that began in the s. His death was part of a grim milestone: the deadliest year on record in America for drug overdoses, with more than 70, people dying to drug overdoses in alone. Families are desperate to avoid this fate. Each of them has spent tens of thousands, if not hundreds of thousands, on addiction treatment. In story after story, the same experience was repeated over and over: of patients and families getting sucked into an American rehab industry that is largely unregulated, shockingly ineffective, and ruinously expensive.
Vox is launching an investigation into the notoriously opaque addiction rehab industry, called The Rehab Racket. Addiction treatment is difficult work, but it can succeedand evidence-based care does exist. For opioid addiction in particular, studies show medications like methadone and buprenorphine cut the death rate among patients by half or more. But the parents I spoke to have learned — as thousands of Americans discover each year — that much of the US rehab industry does not provide evidence-based, effective care.
His underlying bipolar disorder went undiagnosed and untreated until late in his life. After Sean got out of residential treatment, there was frequently no or little adequate follow-up. I contacted all of the facilities that his family said he attended.
Their suburban house — two stories and with a modest lawn — needs a new coat of paint, and some parts have languished in disrepair, Tim said. But the Blakes assured me that it would have all been worth it if Sean was still alive. Photos of him alongside his brother and parents, with his wavy blond hair and wide smile, adorned the walls.
Relics and artifacts from when he was alive — drawings, paintings, poems, essays — were scattered around the house. But Sean had no trouble. Sean began to have problems with alcohol and marijuana in high school, and his parents sent him to outpatient addiction treatment twice. They hoped the two treatments would take care of the addiction problems for good. In the fall ofafter he graduated high school, Sean decided to the Navy and become a cook. But he did so well on an admissions review that the Navy said he should instead be a submarine electrician, a higher-skilled position.
Sean did well in the Navy for a few months. But once he advanced in the training program, and got more freedom and cash, he again began using drugs, including alcohol, marijuana, cocaine, and opioids. The problem came to the forefront as Sean visited from the Navy on Easter weekendabout five months after he enlisted. The family sat down for brunch — and Sean took off on his bike to buy drugs. Three months after that, Sean, by then 20 years old, was discharged from the Navy. He had by then started using heroin.
So they gave him an ultimatum: get into treatment, or move out. He moved out for a bit — but ultimately came back to agree to treatment in October That could have been the turning point. The Blakes wanted to get Sean in a residential program. But in in Vermont, and most of the US todayaddiction treatment was hard to access. The Blakes said insurance coverage was spotty.
Over the next decade, the Blakes sent Sean to more than a dozen rounds of rehab, spending tens of thousands of dollars, in hopes something might finally cure him. Through it all, Sean was well aware of what he was going through. As time goes on, I may want God to help me forgive myself, give me the courage to do the right thing, and shape me into a better man. Right now, I need God to bring me out of the chaos. The problems with addiction treatment create what experts describe as a vicious cycle: Desperate for some sort of cure, people get into the first addiction treatment they can, paying whatever is necessary.
So the patients or their family members seek another treatment, and the process begins anew. For some families, this can repeat a dozen or more times, and in the end, the person struggling with addiction still may die or continue to suffer. Insurers do a bad job communicating which programs work.
Accreditors, industry groups, and other regulators do very little to verify the quality of care. After five weeks at the Hazelden Betty Ford program, Sean got into a fight over something minor, and got kicked out in November In New Found Life, Sean seemed to Blonde girl at ups Brattleboro Vermont better at first. But within a few months, Sean would be homeless and using drugs in Los Angeles — and within six years, he would die of a drug overdose.
In a few cases, Sean returned to these facilities multiple times. Each of the treatments could range between the hundreds to tens of thousands of dollars, according to bills that the family provided. There were also sober houses, with their own extra costs, sprinkled in between.
Some of the places Sean went to are still respected and, according to experts in the field, do use evidence-based models of care. Even in the best facilities, addiction can be very difficult to treat, with many ups and downs, and success not always guaranteed. Sean himself presented problems, Kim said, because he was in denial about his opioid addiction for much of his life in large part, she suggested, because opioid addiction was especially stigmatized in the step programs he repeatedly attended.
But many of the treatment facilities Sean went to were deeply flawed. John Kelly, an addiction treatment expert at Harvard, told me treatment can take several times over several years to stick. But there were also problems, she argued, with how the rehab system treated Sean. For one, the majority of treatment centers Sean went to were based around the 12 stepspopularized by Alcoholics Anonymous and Narcotics Anonymous.
Blonde girl at ups Brattleboro Vermont many of these programs purport to treat addiction as a medical condition, they often take a moralizing view toward addiction — one that feeds into stigma. While Sean did struggle with other drugs, opioids were at the center of his drug use for much of his life.
Brooklyn said that stigma against medications, perpetuated by treatment programs and step meetings, likely made it harder for Sean to accept treatments that could have helped.
Kim also speculates that Sean had PTSD by the end of his life, based on some of his erratic behaviors. His mental health issues likely worsened his addiction: If Sean was using drugs to self-medicate and calm his mind, not treating underlying disorders and only going after his addiction with step treatment was somewhat like trying to heal a gunshot wound with a Band-Aid.
Inafter struggling in rehab after rehab, Sean went to New York. Sean spent this time stealing to get money for drugs, sometimes even at the expense of food.
The crimes eventually landed him in the Rikers Island jail, where he contacted his parents. But it was in Rikers that Sean was first told that he likely had bipolar disorder and began receiving treatment for it. And it was there where he was started on methadone for his opioid addiction.
Rikers is an exception; in later stints in Vermont jails, Sean was cut off from psychiatric medications.
Before he got out of Rikers, Sean would be weaned off methadone, a potentially lifesaving medication, because back home in Vermont, the local methadone clinics at the time were inaccessible — with waiting periods extending months or even years. Soon after his release, Sean would again relapse, going back to the cycles of rehabs and jail. For the Blakes, each of these failures represented not just more heartbreak, but also more financial costs. We are both working longer than expected. The Blakes at least had the savings to shoulder the costs, with their incomes as a doctor and teacher.
But they wonder what they would have done without those savings. But the Blakes had to shoulder the cost of inadequate rehab after rehab — until Sean died. Addiction treatment can succeed. Some of this work is now happening in Vermont. Charlie C. I believe that, percent. Perhaps it could have helped Sean, too. The same methadone clinic that had a years-long waiting period when Sean got out of Rikers in can now see new patients within, at most, days.
But those access improvements only came to fruition in and on. The reality, though, is in most of the US outside Vermont, addiction patients still often face the problems that Sean did. According to the surgeon generaljust one in 10 people with a drug addiction gets specialty treatment. But addiction is a chronic, relapsing condition. To solve these problems, experts say that a large investment is needed into addiction treatment across the US — focused not just on scaling up access, but making sure that treatments are centered around evidence-based care, meet higher quality standards, and rigorously track outcomes for patients.
Kim works at one such place, prescribing buprenorphine, the opioid addiction medication, for patients at a needle exchangeknown as the Safe Recovery Program. Kim guided me to her office, where patients can get started on addiction treatment the day they show up — at little to no cost, depending on insurance coverage.
email: [email protected] - phone:(463) 492-1600 x 7091
She spent more than $, on drug rehab. Her son still died.