Treatment Options

Drug treatment is intended to help addicted individuals stop compulsive drug seeking and use. Treatment can occur in a variety of settings, take many different forms, and last for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a long-term process that involves multiple interventions and regular monitoring.

There are a variety of evidence-based approaches to treating addiction. Drug treatment can include behavioral therapy (such as cognitive-behavioral therapy or contingency management), medications, or their combination. The specific type of treatment or combination of treatments will vary depending on the patient’s individual needs and, often, on the types of drugs they use.

Treatment medications, such as methadone, buprenorphine, and naltrexone (including a new long-acting formulation), are available for individuals addicted to opioids, while nicotine preparations (patches, gum, lozenges, and nasal spray) and the medications varenicline and bupropion are available for individuals addicted to tobacco. Disulfiram, acamprosate, and naltrexone are medications available for treating alcohol dependence,1 which commonly co-occurs with other drug addictions, including addiction to prescription medications.

Treatments for prescription drug abuse tend to be similar to those for illicit drugs that affect the same brain systems. For example, buprenorphine, used to treat heroin addiction, can also be used to treat addiction to opioid pain medications. Addiction to prescription stimulants, which affect the same brain systems as illicit stimulants like cocaine, can be treated with behavioral therapies, as there are not yet medications for treating addiction to these types of drugs.

Behavioral therapies can help motivate people to participate in drug treatment, offer strategies for coping with drug cravings, teach ways to avoid drugs and prevent relapse, and help individuals deal with relapse if it occurs. Behavioral therapies can also help people improve communication, relationship, and parenting skills, as well as family dynamics.

Many treatment programs employ both individual and group therapies. Group therapy can provide social reinforcement and help enforce behavioral contingencies that promote abstinence and a non-drug-using lifestyle. Some of the more established behavioral treatments, such as contingency management and cognitive-behavioral therapy, are also being adapted for group settings to improve efficiency and cost-effectiveness. However, particularly in adolescents, there can also be a danger of unintended harmful (or iatrogenic) effects of group treatment—sometimes group members (especially groups of highly delinquent youth) can reinforce drug use and thereby derail the purpose of the therapy. Thus, trained counselors should be aware of and monitor for such effects.

Because they work on different aspects of addiction, combinations of behavioral therapies and medications (when available) generally appear to be more effective than either approach used alone.

Finally, people who are addicted to drugs often suffer from other health (e.g., depression, HIV), occupational, legal, familial, and social problems that should be addressed concurrently. The best programs provide a combination of therapies and other services to meet an individual patient’s needs. Psychoactive medications, such as antidepressants, anti-anxiety agents, mood stabilizers, and antipsychotic medications, may be critical for treatment success when patients have co-occurring mental disorders such as depression, anxiety disorders (including post-traumatic stress disorder), bipolar disorder, or schizophrenia. In addition, most people with severe addiction abuse multiple drugs and require treatment for all substances abused.

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DELRAY

Feds: Delray rehab owner arrested, billed $58 million for urine tests
LOCAL

By Christine Stapleton and Lawrence Mower – Palm Beach Post Staff Writer

Eric Snyder, owner and operator of a Delray Beach drug treatment center and sober home raided by the FBI in December 2014, has been arrested and charged with fraudulently billing insurance companies for $58.2 million over nearly five years, according to court records.
Snyder, 30, and Christopher Fuller, 32, described in a 26-page federal complaint as a “junkie hunter” hired by Snyder, were charged with conspiracy to commit health care fraud. The document described how Snyder bribed patients with airline tickets, cash, rent and visits to strip clubs. Fuller trolled AA meetings and “crack” motels to find patients, the complaint said.
Snyder was arrested on Tuesday and released on $250,000 bond. Bond was set at $200,000 for Fuller, represented by the federal public defender. Snyder’s next appearance in court is set for Aug. 1.
Snyder’s attorney Bruce Zimet said, “There’s no question he was involved in an industry that was involved in insurance fraud and corruption.” However, Snyder did not “intentionally” participate in fraud, he added.
“Eric has personally been involved in saving many, many lives and making a difference in many other lives of those suffering from addiction,” Zimet said.
Snyder is one of the many drug treatment operators exposed in a 2-1/2 year-long Palm Beach Post investigation that revealed the profits to be made from urine-screening in the county’s thriving but corrupt sober home industry.
Snyder’s treatment center, Real Life Recovery, and sober home, Halfway There, raked in more than $18 million from the $58.2 million in fraudulent claims to insurance companies, including Blue Cross/Blue Shield, United Healthcare, Aetna, Cigna and Humana for urine drug tests and “bogus” treatment, according to court documents.
“Urine analysis was fraudulently used as a profit-machine … including double billing for the same patients and splitting samples to maximize revenue,” the complaint said.
The profits have attracted the attention of the Internal Revenue Service. In March, the IRS filed a lien, saying Snyder owed $2 million in back income taxes.
Musclebound millionaire: The Palm Beach Post’s story on Eric Snyder
Snyder, a drug addict, came to Florida from New Jersey in August 2009 for treatment. In September 2010 — with about a year clean and sober — he started his first sober home business. His posts to his Facebook page changed from inspirational 12-Step affirmations and his devotion to sobriety to photos of himself with fistfuls of cash, pricey jewelry, fast cars and new tattoos.
Complaints of widespread insurance fraud in the industry prompted state and federal law enforcement agencies to launch a task force. On Sept. 11, 2014, agents from the FBI and the state’s division of insurance fraud raided a West Palm Beach sober living complex and treatment center called Good Decisions Sober Living.
Two weeks later, FBI agents in Miami received an email from the then-director of operations for Snyder’s treatment center with the subject line, “South Florida drug rehab insurance frauds.”
FBI agents met several times with the director before he or she left Snyder’s company, according to the complaint against Snyder. The person, who isn’t named in the complaint, told agents that Real Life Recovery was billing patients for services they never received.
If a patient was discharged on the first of the month, for example, Real Life Recovery continued billing the patients through the end of the month, according to the complaint.
In one case, Real Life Recovery billed a patient’s insurance company more than $3,200 for two days in 2013. But the patient told investigators he did not attend treatment on those days because he was in jail.
Agents interviewed other Real Life Recovery employees, who alleged a variety of fraud.
An employee who handled billing for Real Life Recovery told agents that Snyder fired him or her after the employee complained that signatures on treatment session sign-in sheets were being forged.
A therapist said Snyder fraudulently created patient charts and backdated them before being audited.
The facility’s clinical director said they were asked to sign notes for patient therapy sessions that never happened.
Other allegations in the complaint are commonplace in South Florida’s widely corrupt drug treatment industry, as described in Post stories in August 2015.Snyder offered discounts on rent for patients who attended intensive outpatient therapy sessions. Rent was normally $200 per week at his sober homes, but if patients went to therapy three times per week, it was $100. If patients went five times per week, rent was free.
But billing insurance companies for treatment and drug testing brought in millions of dollars. One former employee told FBI agents that Snyder said he would rather “eat (pay) $200 in order to make $5,000.”
Snyder paid his patients $200 for every new patient they referred to Real Life Recovery. Snyder paid Fuller to find patients by visiting “crack” motels and Alcoholics Anonymous meetings, the complaint stated.
Once he found them, Fuller bribed them with alcohol or drugs to get them to go to Snyder’s facilities, confidential witnesses told FBI agents. Fuller also bribed motel owners and receptionists to call him whenever they suspected an addict was checking into their motel. The motels named in the complaint were the Homing Inn in Boynton Beach and the Budget Inn on Federal Highway in Delray Beach as well as Southgate in Delray.
Kirit Shah, manager of the Homing Inn, denied accepting payments for referrals: “We never had a penny given from anybody.” Operators of the Budget Inn and Southgate did not return calls for comment.
Snyder kept Fuller off the books as an “independent contractor.” Agents found that Real Life Recovery’s Wells Fargo account had paid Fuller or his company, Surrender and Survive Inc., more than $17,000.
According to his Facebook page, Fuller is a group facilitator and behavioral health technician at Royal Life Centers, a Delray Beach-based treatment center. Calls and a message to the facility were not returned.
This is not Fuller’s first run-in with the law.
Jail records show he’s been arrested 19 times since 2003, mostly on charges of disorderly conduct, resisting arrest and domestic violence.
In 2012, Boynton Beach police arrested him on charges of prostituting women. He told police he would drive them as far south as Miami to meet men, according to his arrest report.
He was sentenced to 90 days in jail.
In 2013, he was arrested again by Boynton Beach police on domestic battery charges after punching his sister in the head. He was again sentenced to 90 days in jail.
In the federal complaint filed against Fuller this week, the mother of one patient said Fuller demanded he send her $1,400 before he would send her child into treatment. Real Life Recovery staff later dropped the patient off at the Homing Inn, where the patient overdosed and died.
In a separate case, Myra Cronin, whose 20-year-old daughter, Nicole, died in a shabby motel room where staff at Halfway There allegedly dropped her off in the middle of the night, cried when she learned of Snyder’s arrest on Wednesday.
“This is a small justice for Nicole,” said Cronin, who has filed a lawsuit against Snyder and his companies. “Shame on him and thank God they have taken some action.”

449 Recovery Says Hands Off To Junkie Hunters

NO Junkie Hunters
September 7,2016 449 recovery Blog
Patient brokering, also known as “body brokering”, is the practice of off-trading a client referral for money, and it’s becoming more common in today’s drug rehab and substance abuse treatment industry, and threatens to undermine the overall success rate for treating patients. Cases of patient brokering, insurance fraud and other unethical practices have led the FBI to investigate several drug rehab facilities and prompted drastic actions by health insurers, yet recent reports suggest such illicit activities are still taking place. Typically, “body brokering” works like this: a patient/body broker contacts a treatment center with a specific person who is in need of treatment. In return for this referral he/she expects a payment. This transaction could potentially come from another treatment center, a counselor or coach, a freelance treatment placement specialist, an interventionist, call centers who ask for a marketing agreement and most clearly, the street level marketer.
449 Recovery Goes on the Offensive
Recently, in an effort to outline and address the growing concern over “body brokering”, Andrew Maloof, Business Development Representative at 449 Recovery, was a featured speaker at an area round table and discussion in San Juan Capistrano. In general, the cost of patient acquisition involving the practice of paid referrals, or “body brokering” is between $10,000 to $15,000 per patient. In addition, many of those who are ‘sold’ to a clinic don’t receive the appropriate care that addresses their specific addiction situation. “To some, this practice may seem harmless,” explains Andrew, “but it’s clearly not. First of all, a good treatment center should not need to pay someone to send them clients. Their clinical work should speak for itself. Secondly, many clients you pay for may end up being inappropriate for your program.” Maloof and the staff at 449 Recovery have adopted an aggressive “hands-off” policy concerning the practice of paid referrals, and are actively seeking to influence other addiction treatments centers to do the same. Says Maloof, “The sale or purchase of a client/patient referral in our industry is nothing less than poaching. Not only is it unethical, it’s illegal, and it is a disservice to our patient/clients. We need to create a spirit of cooperation among all addiction treatment centers and do a better job of self-regulation so our industry can see improvements in our patient treatment success rates.”
Part Two Tomorrow