All across the country, the opioid epidemic burns like a wildfire. From the pill mills of south Florida to the high-class and high volume L.A. drug scene, Americans everywhere are engaged in a battle against the insidious disease of addiction. In response to this struggle, sober living and rehabilitation centers have sprung up everywhere in the hope of offering help to those desperate to break the cycle and get clean.
However, in some parts of the country, those with less than noble intentions have found a way to take advantage of the heartbreaking reality that is addiction. In an exclusive interview, CELEB talks with Parham Nematollah, a licensed advanced alcohol and drug counselor with a master’s degree in marriage and family therapy. Nematollah is also the COO of Buckeye Recovery Network in Huntington Beach, California. He spoke with CELEB about the disturbing implication of some of these pill-mill-to-rehab-and-back-again schemes, and the suffering they bring.
The Opioid Crisis in the U.S.
Right now, overdose deaths in the U.S. are at all-time highs. Despite efforts in recent years by the FDA to crack down on narcotic prescriptions, economic stress and uncertainty often spur spikes in cases of those suffering from addiction. The CDC reported that the first quarter of 2020 was the worst yet—data is still being collected about the latter half of the year.
Per the CDC, “While overdose deaths were already increasing in the months preceding the 2019 novel coronavirus disease (COVID-19) pandemic, the latest numbers suggest an acceleration of overdose deaths during the pandemic.
“The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard,” says CDC Director Robert Redfield, M.D. “As we continue the fight to end this pandemic, it’s important to not lose sight of different groups being affected in other ways. We need to take care of people suffering from unintended consequences.”
“Synthetic opioids (primarily illicitly manufactured fentanyl) appear to be the primary driver of the increases in overdose deaths, increasing 38.4 percent from the 12-month period leading up to June 2019 compared with the 12-month period leading up to May 2020.”
Nematollah says the scope of the epidemic is hard to comprehend. “In 2018, there were about 67,000 overdoses from drugs. And I don’t know if you remember but at the end of 2018, there was a 737 Boeing jet crash. And then, a few months later, in March 2019, there was another 737 Boeing jet that crashed. And the following week, they said, ‘737 jets can no longer fly until we figure out what happened.’ And they actually stopped flying them for like a year and six months or something like that. But when you take the 67,000 people that died of opioid overdose, and you divide by 365 days in a year; every single day a 737 jet full of passengers is dying of drug overdose. Every single day. And nobody’s doing anything about it.”
When we talk about the opioid crisis in America, we’re really talking about much more than substance abuse. The opioid epidemic has highlighted the stark reality of a healthcare system that works in favor of those with money and often leaves those without bereft of options. Addiction is a common trauma coping response, and it’s not uncommon for trauma like extreme poverty or deprivation to trigger addiction. As a result, poor communities are often the hardest hit by addiction issues, and they also struggle the most to access resources for sobriety and healing.
But what about those with means, is it easier to get and stay sober? The answer is surprisingly complicated. While those with means have access to a wider variety of treatment options, they are also the target of a system which aims to exploit their need to take their money.
Some Addiction Centers Have Become Body Brokering Centers with a High Return Rate
Nematollah filled us in on the dark underbelly of the sober living community. A system where those suffering from addiction are seen as a renewable resource; at least, unless they die from the dangerous game being played. Nematollah explained gravely, “Here’s what the whole cycle looks like, in a nutshell. People get recruited—people that are usually sober individuals who got sober through a treatment center. Their job is to go head hunt, and to go find other people that may have an interest of getting sober. They’ll just say ‘hey, do you want to come out to California to get sober?’ They might be in Tennessee and Nebraska and Arkansas. And these people help the individual get an insurance policy. They will pay for the flight from wherever they are to the treatment center over here. The person looking for help will get free treatment, free trip to California. And the person that recruited them will get a kickback, somewhere between $1,500 to $3,000, or so, per person recruited.”
In 2018, to address this system of exploitation, Congress passed a law known as the Eliminating Kickbacks in Recovery ACT (EKRA). National Law Review explains, “The Eliminating Kickbacks in Recovery Act (‘EKRA’) was enacted by Congress on October 24, 2018 and was a part of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (‘SUPPORT Act’). EKRA prohibits patient brokers from accepting or paying kickbacks for patient referrals from laboratories, clinics, recovery centers and other clinical treatment facilities.
Its purpose was to address to the growing opioid crisis in the United States by prohibiting patient referrals, kickbacks or other renumeration for drug recovery centers.”
However, it’s clear that these centers have found ways around the law. At times they even seem to ignore the laws at will. By using non-licensed professionals to recruit patients, the centers avoid running afoul of the law by some interpretations.
What Goes on Behind the Scenes
Nematollah continues to explain the system and how it ensnares people in an often vicious and unending cycle. “The person comes here from Tennessee or wherever, and they get sober for a little while. Then they get shipped off to the next level of care.
So treatment has a bunch of levels of care. The first is the acute detox, when you help them get off the drugs just to stabilize. Then, it’s on to residential care. Residential is like a 30-day program. After that they get shipped to aftercare, which is a program that is outpatient. At this stage, they’re living in their own environment.
And oftentimes, it’s a sober-living program associated with the treatment center. These predatory places say, ‘hey, as long as you stay in the sober living, and you come to our treatment, you can stay there for free.’ Which is illegal. Insurance can’t pay for sober living rent or anything like that.”
From there, Nematollah says, things sometimes take a dark and horrifying turn. “Here’s where the sad part happens. We have some of these bad providers in Orange County. Some people hit a brick wall on their own. But some providers will target those in sober living, take them to a hotel room, and get them loaded on drugs. They pay for their drugs, they basically shove them off the cliff into relapse.
And once they are in need of help again, or once they use their drugs for three or four days, it puts them right back in the beginning of that cycle again, so they have to start the detox process again. They go back to detox, residential care, outpatient care, and relapse, and the insurance company will cover all of that. And the individual that’s helping them get back into treatment with the referral gets paid under the table.”
Rosen’s High Body Count
If it sounds too horrifying to believe, you have to look no further than the case of Dr. Randy Rosen. He was arrested on suspicion of one of the biggest cases of related fraud and possible manslaughter after taking millions of dollars from insurance and causing the deaths of several patients in this detox-sober-relapse cycle.
The Orange County Register reports, ” … the lifestyle enjoyed by Dr. Randy Rosen, girlfriend Liza Vismanos and their two children was built on the backs of often-desperate drug users eager to make a buck however they could—even if it meant enduring unnecessary surgeries, getting unnecessary lab tests and receiving unnecessary injections for inflated prices, according to Orange County prosecutors.
Rosen ran Wellness Wave, a surgical center in Beverly Hills, and Vismanos owned Lotus Laboratories, a toxicology lab in Los Alamitos. Over the course of just a few years, they billed health insurance companies $676 million for medical procedures and tests and collected $52 million in reimbursements, according to court documents that paint a picture of unrepentant greed and callous disregard for human suffering.
A slice of the money they brought was used to pay so-called ‘body brokers,’ also known in the rehab industry as ‘junkie hunters’—usually recovering users who recruited other addicts for unneeded medical procedures. Those recruiters got kickbacks of some $12 million for their troubles, according to prosecutors.
And a smaller slice of the money went to the users themselves, as recompense for the use of their insurance cards and their bodies. Some got just a few hundred dollars, often withdrawn from ATMs after the procedures were complete. Others got $2,500 or more.
‘The procedure takes me less than 5 minutes. So on an hourly that would be about 120k. Lol,’ Rosen wrote a text message to one of his body brokers, according to court records.”
The Orange County DA’s office released this information about Rosen; “A Beverly Hills surgeon charged with stealing nearly $29 million in an elaborate insurance fraud scheme that involved hiring body brokers to pay patients at Southern California sober living homes to undergo medically unnecessary surgeries, medical testing, and other medical procedures has been ordered to be released from the Orange County Jail after he tested positive for COVID-19. Four others have been charged in connection with the illegal operation.
Dr. Randy Rosen pleaded not guilty on July 2, 2020 to 88 felony counts in two separate cases in connection with recruiting and hiring numerous body brokers to find and pay patients to have medically unnecessary Naltrexone implant surgeries and cortisone shots.”
Four others were charged in connection with Rosen’s arrest.
How to Tell if a Center is Legitimate
Nematollah explains that California has become a hot spot for these unethical “treatment” centers because they can sell the idea of, “come enjoy the sun and sand and get sober.” For those desperate to escape the grips of addiction, doing so in paradise holds a lot of appeal. Florida has become infamous for it’s pill mills, and Interstate 75 which runs right up the east coast has been known as a drug superhighway for years. Those strewn along its path are prime targets for the California centers.
If you’re struggling with addiction and looking for help—or trying to help a family member—how can you be sure that you’re headed somewhere legitimate? It would be unimaginably sad for someone to enter a treatment program in good faith, only to be sent right into the helicopter blades of this bodies-for-profit system.
Nematollah has advice for those looking to weed out the unsavory clinics from the legitimate ones. “Start with looking for a website. A lot of these shady places don’t have one. And contact them. Ask to speak to someone not on the admissions team. Ask for clinicians, the clinical director, the program director. You want to ask for a therapist, and you want to find out what these individuals do. What do they do when you’re in their care? What type of family involvement is included in the treatment process?
What are the expectations in regards to the treatment process. Have them map out what a day in treatment, what a week in treatment looks like.
The good places will make you feel confident. The bad places don’t have answers, they’re vague. Even if you’re not exposed regularly to healthcare, your Spidey senses will be tingling on the phone with these places. Google reviews aren’t the best places to turn, but they can give you some first-hand information on people’s experiences. Do the vetting process just like you would anything else.
Another good thing to check would be how long they’ve been in business. A lot of these new places, they are all just one, two, three years old. They’ll change their name, they’re brand new. Ask how long have they been there? How long has the staff? If they’ve been there for over 6 to 7 years, or 10 years, their reputation is going to proceed itself.”
Nematollah says that even in their program at Buckeye, they often have people trying to recruit their patients out from under them, which is a sad outcome. At Buckeye’s, they’re licensed and keep the family in the loop on the patient’s treatment. But they have had people who leave to attend the body brokering programs. Nematollah explains, “A client will come to us and all of a sudden they say, ‘hey we’re leaving you guys.’ We ask why they’re leaving since we’re the best facility for them to be at if they’re doing well. Well, we find out so and so facility down in San Juan Capistrano, they’re paying program attendees $200 a week just to show up to their facilities. When someone tells Mary and Joe who are detoxing and getting off of heroin that they can get up to $800 per week by just going sitting in a group three times a week, what do you think they’re going to do? That’s how ruthless they’re getting with it.”
It’s not all bad though. Nematollah adds, “we acknowledge that this problem is not the majority in our industry, or even Orange County as a whole. There are many great, ethical, operators and treatment centers in California and all over the country and we’re committed to standing by them and working together to change this narrative.”
For those patients at Buckeye Recovery Network, they’ll receive evidence-based and compassionate care. With licensed professionals and a determination for excellence, Nematollah and his center are everything the body brokers are not: honest, caring, and skilled.
Nematollah explains that there are non-medical facilities open that function as these body-brokering “treatment centers” to avoid running afoul of the law. And in an attempt to mitigate the millions of dollars of fraud being committed, insurance companies are now cracking down on what and how much they’ll cover, which harms the people who are desperately seeking help from legitimate facilities.
Buckeye’s COO has been sober for 13 years himself, and adds, “I believe in the possibility of human transformation, I believe that all people can transform who they are, how they are, how they live at any given moment, if they are exposed to the proper environment and with the proper guidance.”