Musings on Last Week Tonight with John Oliver
Addiction Centers San Diego

Musings on Last Week Tonight with John Oliver

As an avid watcher of Last Week Tonight with John Oliver (I’ve been a fan since his segments on The Daily Show), it was an interesting experience to have him do one of his epic takedowns on MY industry. I’ve cheered as he skillfully deconstructed racist institutions, highlighted problems with student and payday loans, and exposed the predatory practices of many other rackets. I never expected him to come for the very problematic field of addiction treatment, but I’m so glad he did. The sad part is, most of what he said is true. We (ethical treatment centers) have lamented about the issues in our trade for a long time, but to have it exposed on a national platform was another story.

Of course, I wish he spent more time acknowledging the sizable minority of treatment centers doing excellent and ethical work, but when there are so many problems, I agree that as an industry we haven’t really earned it. It’s more important for people to be informed and cautious than to pat those on the back who are doing it right.

Honestly, sometimes it is hard being an ethical, evidence-based treatment center in a cesspool of deception.

You refuse to cheat to get ahead, you lose potential new clients to treatment centers that illegally offer to waive insurance deductibles and co-pays, and your statistics are honest and have data to back them up. You need to put a lot of time and money not only into the curriculum but also into hiring skilled professionals. I would never be able to sleep at night working for one of those companies, but I see how people in the trenches who genuinely want to help could get sucked in or remain ignorant. If you’re surrounded by stink, it can be easy to get used to the odor. However, people’s lives are at stake. People depend on us in their most vulnerable times to be ethical and honest. It’s despicable to take such a great responsibility and use it as an opportunity to take advantage.

The following discusses John Oliver’s very valid points and highlights who we are and what makes us stand apart.

AToN Center is a residential treatment center that addresses addictive behaviors and mental health issues. It was, is, and always will be run by psychologists and addiction specialists. It would be cheaper to use the free labor of interns or have less skilled staff working here, but treatment would suffer and that’s a risk we’re not willing to take. (Psychologists also have a very strict code of ethics, so with them at the helm, the facility is held to very high ethical standards.)

It would also be cheaper not to have Registered Nurses and Licensed Vocational Nurses on duty 24 hours a day, and to not have our Medical Director be as readily available to clients. But again, that’s not acceptable because being responsive to patient needs and safety is a priority. It’s why we exist.

Road to Addiction Recovery I loved that Oliver recognized the important perceptual shift taking place in this country regarding addiction. Thankfully, most people now know addiction is NOT a moral failing. We are able to view people with substance use disorders with compassion, nuance, and competence. We agree it is important not to stigmatize, overly label, shame, or marginalize people who are struggling.

We believe people should have options and choose the path of recovery that works for them. We offer many different roads to recovery because we believe recovery is as unique as the individual living it. We as a nation now know that it is our family, friends, community members, and ourselves who are facing the devastation that can accompany problematic substance use.

Oliver acknowledged that getting off of substances and completely changing one’s life IS NOT EASY. You do not come to treatment to be miraculously cured – you come to lay the foundation for healthy habits you will practice and nurture for the rest of your life. It’s a process.

Research is clear – discharge planning is one of the most important aspects of treatment, which is why we focus on it from the first day of a patient’s arrival. To say you leave treatment “cured” and requiring no ongoing support or structure is wildly irresponsible advice.

Another way AToN Center is different is our reliance on statistics and evidence-based care. I once heard it referred to as a “buzzword” at a conference – it is NOT a “buzzword” to sound good, it is the foundation of a solid program.

Our curriculum is truly evidence-based, founded on hard data and constantly evolving over time to keep up with the research. We are innovating the way treatment centers develop curriculum, making it personalized and consistent at the same time. We don’t just randomly pick things that seem interesting and throw them into our groups.

Everything serves a purpose, and any of us clinicians on staff can tell you why we’re doing what we’re doing. (Side note: We do offer equine therapy and clients don’t just go and pet horses. It is facilitated by yet another licensed psychologist and is offered as an auxiliary holistic activity and not a core part of our curriculum. We offer a menu of these type of activities such as acupuncture, yoga, personal training, hypnosis, and massage. We can explain the rationale behind offering holistic activities in addition to our core curriculum if you’d like to know more.)

We also have outcome research data, which we publish on our website. It is painstakingly collected and analyzed by our Clinical Director, a Ph.D. with an unusually large passion for statistics. We are not afraid to disclose limitations in our research and how we account for those. Ask us anytime about our data if you want more information or go to AToN Center’s Research Outcomes. 

Some other topics highlighted by Oliver:

  • “Liquid gold.” This is the disgusting commodification of urine for drug testing. Ethical treatment centers never overcharge or over-test. Urine drug screenings serve the purpose of monitoring and making sure everyone is safe. It should never be a money maker.
  • “Body brokering.” This abhorrent practice refers to the shady deals that go on to get people into treatment in order to profit off of their misery. It includes call centers who lack transparency, recruiting patients so one can capitalize off of their desperation and insurance plan, and paying for referrals. Good treatment centers should not engage in any of these practices. Your choice to enter treatment should be made with informed consent. You should know who benefits and how. You should have all of your questions answered and be given referrals if a treatment center cannot meet your needs. We do not do any of these things and are working to stop others from doing them. I have been sickened by the subpar and harmful treatment some people have received before making their way to AToN.
  • Conflicts of interest. Oliver highlights how the main websites providing the bulk of reviews on treatment centers (which appear legitimate and have become an online communal space for people to talk about addiction) are owned by treatment centers. Not shockingly, the rehabs which own these websites are the highest rated.

All relationships should be clearly identified and you should not have to guess who is aligned with who, or who profits off of what.

  • Bad management. A quality for-profit treatment center cannot lose sight of its purpose. It must always put the treatment of the clients before profit. You should be able to get an itemized invoice accounting for every dollar billed. Treatment in a luxurious setting can be expensive, but nobody should get defensive over the cost. It should happily be explained to you and never a surprise. If you cannot afford a treatment center, lower-cost referrals should be provided to you long before you make any big decisions.
  • Medication Assisted Treatment or MAT medications. Certain MAT medications are a core part of our treatment. If we do not provide the MAT medication you’re looking for, we always make appropriate referrals and make sure you get your needs met. Naltrexone, Vivitrol, Antabuse, and medications to assist in detox such as Buprenorphine are the standard of care and all options should be discussed to determine what is right for you.

It was heartbreaking to learn that the personable gentleman featured in the clip had passed away from addiction. To those of us working in the field, however, this is a grim reality.

Addiction can be LIFE OR DEATH, and the businesses associated with it should be as serious as the condition itself.

AToN is a nautical acronym that stands for Aid To Navigation. We take that role very seriously – we want to remain a guiding light to anyone struggling with addiction.

Sarah Zucker, Psy.D.
AToN Center 888-535-1516