https://www.vox.com/policy-and-poli...ddiction-treatment-sean-blake-opioid-epidemic Vox is looking into an under-explored aspect of the problem: Rehab is not only less effective than it should be, and it is often pretty close toa scam. 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. We’re crowdsourcing the experiences of patients and families, with an emphasis on cost and quality of care. . . . ... Addiction treatment is difficult work, but it can succeed, and 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. American rehab is dominated by a 12-step approach, modeled after Alcoholics Anonymous, that only works for some patients and doesn’t have strong evidence of effectiveness outside of alcohol addiction treatment. hat’s often coupled with approaches that have even less evidence behind them. There’s wilderness therapy, focused largely on outdoor activities. There’s equine therapy, in which people are supposed to connect with horses. There’s a confrontational approach, which is built around punishments and “tough love.” The research for all these is weak at best, and with the confrontational approach, the evidence suggests it can even make things worse. “It is a scam,” Carol Beyer, founder of Families for Sensible Drug Policy and a mom in New Jersey, told me. She estimates she spent well over $100,000 on treatment — including 12-step and “tough love” programs — and still lost her two sons to drug overdoses.