Note: This is the fourth and final installment in a series of articles about Miami’s long history with drugs and drug treatment.
By David Greenberg, South Miami Recovery Social Media and Blog Writer | South Florida
History: Knowing Our Past Prepares Us for Our Future
We started this journey through Miami’s drug history with pirates and buccaneers. Flashing forward to the 1900s, we discussed everything from Al Capone to the Cocaine Cowboys. We examined how various institutions and individuals – medical, religious, legal and more – began the effort to treat drug abuse and the disease of addiction in the second half of the 20th century.
In the 1970s and early 80s, the primary treatment model focused on 28-day, inpatient hospital programs that were often followed by extended treatment in a second facility. In many areas, including Miami, treatment was reinforced through a strong connection with the 12-step meetings in the community – especially Alcoholics Anonymous and Narcotics Anonymous. During the 80s and 90s,12 Step programs rapidly expanded, especially NA, which rose from three meetings in Dade County to over 50. You might say recovery was “in.” Many addicts came into treatment because of a dependence on cocaine (the emergence of freebase and crack), heroin, marijuana and something called Quaaludes or methaqualone.
Insurance, Mergers and Change
The transition began in the late 1980s as treatment moved away from hospital-based settings like South Miami Hospital, Mount Sinai, Glenbeigh, and North Miami General – to name a few – to more private facilities.
Why was there a need to change something that wasn’t broken?
The simple answer was business. As hospitals merged and became big corporations, there was more focus on the bottom line. South Miami Hospital was no exception as it became part of Baptist Health Systems of South Florida. The initial replacement for inpatient treatment was residential and partial hospitalization; by 2010, the most common treatment modalities became the outpatient and intensive outpatient levels of care.
Insurance was a driving force in these changes. More and more, insurance companies were eliminating coverage for the 28-day system and changing to a managed-care approach. The result? Fewer patients were able to receive the acute care they needed.
There was some hope in promises of parity under Obamacare, which said that the treatment of substance abuse was going to be on an equal level with all medical care. But those promises faded quickly, and substance abuse treatment continues to struggle medically and financially.
The question remains whether those changes constituted a good medical decision. We know it was a good financial decision for the insurance companies and the hospitals.
Private Recovery Treatment Programs
As these changes were starting in the 1980s and early 90s, one of the results was a proliferation of private recovery programs with non-credentialed therapists and counselors. It wasn’t until the mid-90s that the industry became professionalized with higher levels of education, licensure and certifications.
Despite the growing trend to monitor private treatment, much of the industry has been under a dark cloud due to corruption in what was essentially an unmonitored medical industry.
Some of the worst of that corruption took place not very far from us in Palm Beach County. That’s where a flood of so-called sober living homes proliferated. While some of these did good things, many were there simply for the owners to turn a profit.
Why was this such a lucrative business? Because there’s a market. While the drugs of the 1980s are still out there, the drug crisis entered a new phase with the addition of opioids.
An Opioid Epidemic
The escalation of America’s opioid crisis truly began in 2013. The jury is still out regarding how much responsibility for this lies with pharmaceutical companies themselves. Clearly, the call for a more supportive pain management, along with ease of access, opened the doors for the initial abuse of opiates. What started with the middle class – in part because managed care policies did not want to touch either detox or long-term treatment – soon exploded into what we know as the full-blown opiate crises. Without access to acute opiate monitoring, no real detoxification or treatment, most were left to fend for themselves. Those lucky few that had money ($10,000 – $50,000) could afford private treatment centers.
The sober living homes came in to fill this void, or at least make a profit off it. For almost a decade they profited unchecked. In the last few years, that has started to change, and that’s when we learned about what was going in in places like Delray Beach.
In the latter part of the 2010s, officials in Palm Beach County began cracking down. In a 10-month period alone, 30 operators of addiction treatment center and sober homes were charged with body brokering. Body brokering is when middlemen find and refer addicts with good insurance coverage to recovery programs willing to pay the highest finder’s fee. In the worst cases, a treatment center would even pay a client to relapse so they could continue billing the insurance company. One owner of a Delray Beach rehab center was charged with billing insurance companies more than $58 million in bogus treatment.
Public Perception of Addiction Treatment
Many areas are still struggling with reputation issues when it comes to the ethics and practices of substance abuse treatment centers. That makes for a distrustful public, as well as some mental health and medical professionals uneasy about treating substance abuse. Additionally, the negative issues have reached the 12-step groups because of resistance to the treatment industry and negative public opinion.
Given that addiction is not going away, and the opioid epidemic has made things even worse, it’s not a promising outlook. What’s the answer?
Proven Addiction Treatment in Miami, Florida
Part of the answer lies with the treatment centers that are out there really trying to help people.
What you need to do:
Do your research! (Not just Google)
Ask others for referrals and recommendations, especially trusted professionals.
Check for the highest credentialing like Joint Commission and CARF.
Don’t rely entirely on insurance (they generally don’t like to pay more than they have to).
Family and significant others need to participate; look for treatment programs emphasizing family therapy.
Listen to the truth, not just what you want to hear. There’s no quick fix. Time heals.
It’s our belief that South Miami Recovery is one of those.
We are group of people, some recovering from our own addictions and all with a passion and understanding of how to help someone get clean and sober. We were affiliated with the best former South Miami Hospital Addiction Treatment Program and saw the writing on the wall. So, in 2012, we started South Miami Recovery.
Our goal is about much more than living life without drugs and alcohol. We want you to come away from South Miami Recovery feeling comfortable in your own skin, living with hope and having a fresh new outlook on your life. Without that, you’re miserable, and relapse is waiting for you.
It’s our mission to help addicts and alcoholics find true freedom from active substance dependency. That’s the starting point of your own journey of recovery. And remember, you are not alone.
So, as we close this last installment in our series of articles about Miami’s history with drugs and drug treatments, we leave you with this message. If you are someone struggling with addiction right now, we’re here to help. Please take the first step – reach out to us. We’re here for you.
In our next series we will explore the Miami night life scene. Stay tuned for Miami: Sex, Drugs & Rock ‘n’ Roll.
South Miami Recovery is a drug and alcohol addiction treatment center located in Miami, Florida. To learn more about our unique approach to recovery, call 305-661-0055 today.
David Greenberg is a recovering addict celebrating 35 years of recovery. He got his start in recovery at Mount Sinai Hospital and Concept House and remains active following a 12-step lifestyle.