After the closures of 16 addiction treatment centers in the wake of government healthcare fraud investigations, mental health industry watchdog, Citizens Commission on Human Rights (CCHR) International calls for more oversight with stronger penalties for fraud and for endangering patients. The addiction treatment industry is rife with what CCHR calls “psych drug rehab fraud.” The market increased from about $35 billion in 2015 to $42 billion in 2020 and the fraud schemes abusing this have increased exponentially–federal legislation has had the effect of flooding the addiction treatment industry with more patients and more money.
Fraud schemes have involved billing for services not delivered for the time specified–for example, a 45-minute counseling session sometimes only lasted five or ten minutes, according to a report from the U.S. Department of Justice.
A shuttered Milwaukee addiction center allegedly ordered refills of naltrexone, a psychiatric drug used to treat addiction, in the names of former–not current–patients, while also selling to patients for $1,000.
The Food and Drug Administration (FDA) advises that patients taking naltrexone, “be warned of the risk of hepatic [liver] injury.” Other potential side effects include depression and suicidal ideation or attempts, anxiety, panic attack, nervousness, fatigue, frequent headaches, and so-called “posttraumatic stress disorder” and “obsessive compulsive disorder.” In other words, the drug can cause “psychiatric conditions,” requiring additional treatment.
Addiction psychiatrists claim they can help prevent overdose deaths by expanding their practices to assess for and treat substance use disorder. In 2020, the National Drug Control Budget sought $34.6 billion for drug control, including prevention, and treatment. In 2022, some $10.7 billion was given to the federal Department of Health and Human Services that included funding to expand access to substance use prevention, treatment, harm reduction, and recovery support services.
CCHR says Americans should expect a good return for taxpayer dollars spent on this–at least a reduction in drug abuse. However, this has not been forthcoming.
— According to the Substance Abuse and Mental Health Services Administration, more than 18 million people ages 12 and older have used prescription drugs for nonmedical reasons in the previous year. That’s more than 6% of the U.S. population.
— Some 614,000 teens aged 12-17 admit to using a stimulant prescribed to treat Attention Deficit Hyperactivity Disorder for nonmedical reasons. Abuse of the drug leads to almost 1,500 emergency room visits every year, and serious side effects include stroke.
— The Centers for Disease Control and Prevention reports more than 106,000 persons died from drug-involved overdose in 2021. Of these, 32,537 involved stimulants, including cocaine or psychostimulants with abuse potential–up 5,848% from 547 in 1999.
Former Congressman Ronnie Shows wrote about “eliminating wasteful spending” and Medicare fraud, stating: “Sadly, when it comes to healthcare fraud, mental health and drug treatment programs are some of the worst actors.”
Add to this a New York Attorney General’s comment when sentencing a psychiatrist to 71/2 years in jail for indiscriminately dispensing psychiatric drugs: “There are few things more pathetic than a crooked doctor, particularly one who uses his office like a drug dealership.”
CCHR maintains a psychcrime database of such cases.
As for their expertise in treating addiction, psychiatrists are among the top three healthcare professionals that have higher rates of drug misuse.
Psychiatrists’ role in the opioid epidemic is also telling. According to a study published in the Journal of the American Board of Family Medicine, adults diagnosed with a “mental illness” receive more than 50% of the 115 million opioid prescriptions in the U.S. annually. Nearly 19% of Americans labeled with a mental health disorder use prescription opioids compared to only 5% of those without a mental health condition.
Much of the fraud occurs because of the Diagnostic and Statistical Manual for Mental Disorders (DSM), known as psychiatry’s “billing bible.” DSM lists more than 50 billing codes for substance abuse disorders alone. According to a study in PLoS Medicine, 70% of the psychiatrists involved in determining mental disorders to be included in DSM-5 were financially affiliated with drug companies.
Dr. Tana Dineen, Ph.D., with over 30 years of experience as a psychologist, states: “It seems that, whatever the results, addiction treatment,” in the mental health industry’s hands, “is identifiably a business that ignores its failures. In fact, its failures lead to more business. Its technology, based on continued recovering, presumes relapses. Recidivism is used as an argument for further funding….”
CCHR encourages people to report fraud and abuse in the mental health industry.
 Hayley DeSilva, “15 addiction treatment centers close following CEO fraud charges,” Becker’s Behavioral Health, 3 Mar. 2023, www.beckersbehavioralhealth.com/behavioral-health-addiction-treatment/15-addiction-treatment-centers-close-following-ceo-fraud-charges.html
 Dan Munro, “Inside The $35 Billion Addiction Treatment Industry,” Forbes, 15 Apr. 2015, www.forbes.com/sites/danmunro/2015/04/27/inside-the-35-billion-addiction-treatment-industry/?sh=6c948dc617dc; John LaRosa, “$42 Billion U.S. Addiction Rehab Industry Poised for Growth, and Challenges,” Market Research.com, 5 Feb. 2020blog.marketresearch.com/42-billion-u.s.-addiction-rehab-industry-poised-for-growth-and-challenges; Zachary Rothenberg, “Trends in Combating Fraud and Abuse in Substance Use Disorder Treatment,” Journal of Health Care Compliance, Sept.-Oct. 2018, www.nelsonhardiman.com/wp-content/uploads/2018/09/HCCJ_0910_18_Rothenberg.pdf
 www.cchrint.org/2017/01/31/risky-pills-for-a-weighty-problem/, citing: Hubert, Susannah K., MPH. “NDA 021897, Vivitrol(R) (naltrexone for Extended-release Injectable Suspension).” Letter to Nancie A. Zecco, Senior Regulatory Associate. 04 Nov 2010
 “Naltrexone Side Effects,” Drug.com, www.drugs.com/sfx/naltrexone-side-effects.html; www.psychiatryadvisor.com/home/conference-highlights/apa-2019/naltrexone-xr-may-be-associated-with-dysphoria-suicide-ideation/
 www.webmd.com/mental-health/addiction/abuse-of-prescription-drugs; www.samhsa.gov/data/report/2017-nsduh-detailed-tables
 www.cchrint.org/2017/10/03/largest-psychiatric-hospital-chain-patient-sexual-assault-abuse-violence/; Ronnie Shows, “Dear GOP: Eliminate Waste And Fraud To Help Pay For Healthcare Bill,” The Daily Caller, 29 June 2017, dailycaller.com/2017/06/29/dear-gop-eliminate-waste-and-fraud-to-help-pay-for-healthcare-bill/
 www.cchrint.org/2019/07/29/psychiatric-industry-and-behavioral-centers-profit-from-opioid-crisis/; khn.org/news/patients-with-mental-disorders-get-half-of-all-opioid-prescriptions/
 Katie Moisse, “DSM-5 Criticized for Financial Conflicts of Interest,” ABC News, 13 Mar. 2012, abcnews.go.com/Health/MindMoodNews/dsm-fire-financial-conflicts/story?id=15909673
Citizens Commission on Human Rights International
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