- Rehab is now seen as a place to address addiction to drugs or alcohol, but there are no set definitions or federal standards for what it should consist of.
- Many rehab facilities make impressive claims about their success rates, but often have no data to back up these claims.
- Self-reported statistics and phone calls with former clients are often used to determine success rates, but these can be unreliable.
- Different rehabs offer different approaches to treatment, with some offering equine therapy despite no evidence of its effectiveness.
- Some high-end rehabs charge exorbitant prices, but cannot account for every moment of treatment.
- Oversight problems exist throughout the rehab industry, with low barriers to opening a rehab facility in some states.

- In California, anyone can start an outpatient rehab center as long as they have private pay clients.
- In Florida, there are no laws to prevent anyone, even someone like O.J. Simpson, from opening a sober home.
- The influx of insurance money into treatment centers in Florida has led to unethical practices, such as exploiting insurance coverage for urine testing.
- Some operators engage in patient brokering or junkie hunting to attract patients with good insurance.
- The cycle of admission, relapse, readmission, and relapse again is known as the Florida Shuffle.
- It is difficult to find unbiased information about treatment options and many referral businesses prioritize profit over individual circumstances.
- Websites that review treatment centers may be owned by the centers themselves, casting doubt on the authenticity of the reviews.
- Obtaining information about complaints and investigations against treatment centers can be a lengthy process.
- The addiction treatment industry lacks oversight and expertise, making it difficult for individuals to navigate and find effective help.
- Seeking guidance from a doctor certified in addiction medicine is recommended.
- The term "rehab" is broadly defined and lacks a clear definition, making it difficult to assess the quality and effectiveness of treatment centers.
- Accessing evidence-based and trustworthy help for addiction should be easier than it currently is.

The addiction treatment industry is dangerously unregulated. John Oliver explains why many rehab programs should incorporate more evidence-based care and carefully reconsider their doctor-to-horse ratio.

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-♪ ♪ -♪ ♪ Rehab, the most common place to go after hitting rock bottom, other than Dave & Buster's.

Every 1 of those men is at the lowest point in their lives in that photo.

Now, rehab is a place where people can address addiction to drugs or alcohol.

Something that, until relatively recently, was seen as a moral failing that could be overcome with sheer willpower.

Perhaps best epitomized by this amazing PSA from the 80s, starring singer Belinda Carlyle.

And 1 morning I woke up, I looked in the mirror and I said, you look frightening.

Now, incidentally, Belinda Carlyle has since admitted that after that PSA was shot, she used cocaine for another 20 years, to a point where, And I'm quoting her directly here, I'm surprised I still have a nose.

Which is the kind of statement you only normally hear from toddlers who just spent the afternoon with their uncle.

He told me he got it in his fingers, and I fucking flipped, man!

I was crying, screaming, the whole thing.

-...- Now, thankfully, thankfully, there is now a broader understanding that addiction is complex, and that nothing about getting off alcohol or drugs is easy.

Experts now view addiction as a medical problem, often likened to a disease or a chronic condition.

And a common way of treating it is through stints in rehab.

It is a $35 billion industry, with over 14,000 rehab facilities across the United States.

Some of which have fancy names, like Promises, or Passages, or Milestones.

You know, names that sound like perfumes worn exclusively by widows.

And some rehabs can even afford to run TV commercials like this.

Cliffside Malibu has been helping people just like you for over 12 years.

Our experienced, compassionate staff will help you get your life back.

Call the number or go to the site below now.

Don't wait, because your tomorrow may never come.

That's like Frosted Flakes ending a commercial with Tony the Tiger getting shot by poachers.

Now, in recent years, it has gotten easier to get insurance to pay for rehab.

That's largely thanks to the fact that George W.

Bush passed and Barack Obama expanded laws requiring health insurers to increase coverage for it.

But while we use rehab as a shorthand, it is worth knowing that there is no set definition for what it should consist of.

In fact, there are no federal standards for counseling practices or rehab programs.

And while many rehabs are staffed by people doing their best to help, a report a few years ago found that the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.

And for a sense of just how bad things can be, look at Florida, a state whose rehab industry has seen an epidemic of overdose deaths and fraud, to the point where 1 local official issued a chilling warning.

The clear message would be, stop sending your loved ones to South Florida because we're sending them back in body bags.

That is the worst and yet possibly most honest tourism slogan for Florida I've ever heard.

Come to South Florida, we'll send you home in a body bag.

So tonight, let's look at what rehab is and why the industry's so troubled.

And let's begin with the fact that rehab should never be seen as a quick fix.

It's often just the first step in a lifetime of recovery.

Yet many operators make huge claims about their success rate.

The father and son who run it make some pretty big promises about what they can do for you.

When you send patients home, what do you say to them?

You will never use drugs and alcohol again.

For a start, there is no way when patients leave, this arsehole doesn't say, -"Ciao." There is no fucking way...

-$$TRANSMISSION that sound doesn't come out of his lips.

Lots of rehabs feel free to make suspiciously impressive claims, as 1 researcher found out.

We called inpatient programs and asked them what their success rate was.

And the lowest rate we got quoted was 80 percent.

You know, I do know that about 80 percent of the clients who have come in here are now sober, long-term.

We've had about an 80 percent success rate here at 180.

And then we would ask, and on what data do you base that?

They had no hard data to back up their claims.

And at that point, why even stop at 80 percent?

Why not say you have a 140 percent success rate?

For every 10 people that come into our facility, 14 emerge completely sober.

Where did those extra 4 people come from?

Rehab success rates are often based on self-reported statistics involving them simply calling former clients.

And those results can be problematic, as a man who's participated in 1 of those studies can tell you.

I mean, I just said, you know, I'm fine, you know, but yeah, I was drinking.

You know, like, I mean, it's crazy, you know, but I was embarrassed to say, you know, I didn't stay sober.

And you can kind of understand that for every reason.

It can be hard to admit that you've relapsed, plus it's a phone call, so you'll say whatever it takes to make it end.

Because getting sober may be hard, but nothing is harder than an eight-minute phone call with another human being.

And look, for all those claims of success, it is very hard to know exactly what you're getting at any given rehab.

You might get the traditional 12-step based approach, which undoubtedly works for some, although most experts argue that there should also be consistent access to other newer treatments like certain behavioral therapies or medications like these.

But rehabs are not required to offer those.

And because a rehab can essentially be whatever its proprietor says it is, that means they can frame almost anything as treatment.

For instance, many high-end rehabs offer something called equine therapy.

And again, if people respond to that, that's great.

But there is no empirical evidence that as a treatment for addiction, it works.

Which means some people who paid a high price for it can end up having this experience.

So, first of all, I absolutely love that guy.

Oh, sure, you could ride 1 somewhere, or you could just drive a car, which is like a horse, except it can play music and it doesn't constantly shit everywhere.

Now, 1 of the places, 1 of the places that offers equine therapy is Cliffside, the place from the ad that you saw earlier.

Now, a month of treatment there costs tens of thousands of dollars.

And its founder, Richard Tate, gets a little defensive when asked if it's worth that price.

Listen, $73,000 sounds like a lot of money, but if you go to the 4 Seasons for 30 days, okay, that's gonna be 40 grand.

Was there any life-changing thing going on there?

Everything that we've done here is mindful.

It only seems like horse shit to people that don't know better.

But you don't have to know better, bro, because your life didn't depend on it.

♪ Besides, you're being a little unfair to the 4 Seasons.

Plenty of life-changing things happened there.

Just last year, Jaden Smith claimed that the 1 in Toronto spiked his pancakes with cheese after kicking him out of his room.

And if a handful of Canadians tricking an evicted child millionaire with undisclosed ricotta isn't a life-changing thing, I guess I don't know what is anymore.

And $73,000 for 30 days does sound like a lot of money, because it is a lot of money.

And you would hope that at Cliffside, they could account for every moment of treatment at that price, but that does not seem to be the case.

They probably went to, whatever they did, there's a therapeutic, meaning behind it.

♪ -'Cause you were in trouble for a minute there, but the therapeutic meaning line was absolutely inspired.

Because the truth is, anything can have a therapeutic meaning.

Even the act of them being lost could be therapeutic.

It's called inadvertent wilderness therapy, and it's 140% successful.

And look, so far, we've just talked about the fancy high-end residential facilities, But there are oversight problems throughout this system because in many states, the barriers to opening a rehab can be dangerously low.

For example, in Idaho, as long as you are not operating a residential program for adolescents, you don't need a license at all.

In California, as long as you take private pay clients, anyone can start an outpatient rehab center.

And in Florida, if you want to open a sober home, a group home where people stay, often while they receive outpatient treatment, there is nothing in state law to stop you.

Simpson could open 1 right now, which would obviously be called the Juice Cleanse, and there would be nothing standing in his way.

And Florida actually provides a window into how the flood of insurance money into treatment centers has caused massive problems, Because the industry boomed there, and unscrupulous operators have found it way too easy to game the system.

Insurance covers drug tests, and some places have exploited that, arranging for kickbacks from testing facilities, basically meaning the more urine they take, the more money they make, and it adds up fast.

For a single $30 store-bought urine test, you could get up to $1,500 in payouts from insurance companies.

If you run 5 tests a week on a single addict, that's $7,500.

Urine is so valuable that in the recovery industry, it is known as liquid gold.

And peeing liquid gold sounds like the symptom of an STD.

You can only contract from fucking C-3PO.

No, C, I don't think all women born after 1990 have it anyway.

Unless you're sleeping with all women born after 1990, see?

And with money like that to be made just from urine, it is hardly surprising that some operators have gone to extreme lengths to attract patients with insurance, even engaging in something called patient brokering or junkie hunting.

Mercedes Smith, a recovering addict herself, told us sober home operators compete for addicts with good insurance, enticing them with promises of free rent, free food, free cigarettes.

We would have to drive around Delray and anybody with, like, suitcases, we would have to ask them, do you have insurance?

Okay, so in terms of questions to ask people from the window of a moving vehicle, do you have insurance is barely less sinister than would you like some candy or what size of flesh are you?

-♪ ♪ -♪ And it gets even grimmer because the truth is there can be more money in a patient relapsing than in them recovering.

So at its worst, this system encourages a cycle of admission, relapse, readmission, and relapse again.

This cycle even has its own special term.

And if you are not extremely lucky, this is how it ends.

In the Florida Shuffle, you go in and out of recovery, in and out of rehab centers, in

and out of sober homes, milking the individual for their insurance until that person dies.

Yeah, the Florida Shuffle turns out to be horrific and not, as I'd assumed, a party where everyone throws their keys in a bowl and gets to go home and fuck their neighbor's alligator.

And if at this point you're thinking, well, I guess I just need to be extra careful when I'm looking for treatment, Well, that is the final big problem here, because it can be nearly impossible to find good, unbiased information.

Let's say you're sitting at home, and you see this ad, which plays a lot.

have a problem with drugs or alcohol, you need to call the number on your screen now.

Addiction is a disease, and you can't go it alone.

The call is free, and so is the consultation.

That is a hostile tone that you would not tolerate elsewhere.

--AUDIENCE LAUGHS-- But the important thing to understand is that the addiction network is not a rehab.

It is a referrals business, meaning they make money by routing your call to centers all over the country, which reportedly pay them 40 to 50 dollars for your call.

So in a moment of crisis, your individual circumstances are not being taken into account.

They're simply placing your fate in the hands of whoever has $50, which is a terrible system.

I have $50, but I have no idea how to treat someone with an addiction.

I'd probably just give them a copy of my handmade anti-drug pamphlet titled, Napping with the Devil, Please Stop Doing Heroin.

-♪ Napping with the Devil ♪ -♪ Napping with the Devil And if you're thinking now, well, hold on, I wouldn't fall for a sketchy-looking TV ad, I'd do my own research, that is great.

But let's say that you saw that Cliffside ad and you thought, well, that looks good, but I do want to check it myself first.

Well, a Google search will quickly land you on rehabreviews.com, which says that Cliffside is the choice for those that have to have the finest of everything.

Or you might land on the thefix.com, whose review of Cliffside raves that it is a great choice for anyone who has the means to recover there.

What you probably won't see on either of these websites, at least, not unless you know exactly where to look, is that both of them are actually owned by Richard Tate, the founder of Cliffside Malibu.

You remember, the guy who looks like Matt Lauer fucked a pair of Oakley sunglasses.

That fact of ownership certainly casts some doubt on the fact that the fix awarded Cliffside a rating of 5 out of 5 stars.

Presumably 1 star for every 10 patients whose location he's completely unaware of.

-♪ ♪ -♪ And let's say someone you love was truly in crisis and you wanted information on Cliffside from an outside source, like what complaints had been lodged with the state and what the state found when they investigated.

Well, in order to get that information, you would need to file a public records request with California's Department of Healthcare Services and then wait for months for them to send you what could be a huge pile of documents to sort through.

And that is too long to wait for urgent information.

It's akin to a pregnancy test that takes you 8 and a half months to get the results.

That is practically useless, and a huge waste of perfectly good urine, which as I now understand it, is liquid gold.

Everything about this industry is incredibly difficult to navigate, which is dangerous, Because even 1 of its own trade groups, its own trade groups, has warned that some sectors of it are out of control.

And for a sense of just how helpless you can be in the face of all this, just listen to Tom McClellan.

You would think that if anyone knows this world, it would be him.

I had, become an expert in the addiction field.

All that training, all that knowledge about addiction did not prepare me for the most fundamental question of all.

Where do you send your kid for treatment?

Even the nation's deputy drug czar couldn't confidently navigate this system.

And remember the funny guy who hated horses?

And if you're wondering what experts would advise you to do in seeking treatment, many that we spoke to suggested beginning not with a rehab, which may try and sell you on its own services, but with a doctor who is board certified in addiction medicine.

Now, it's only recently become an official specialty, so there just aren't many of them around, but you can find those that do exist at this website here.

They may be able to guide you toward a treatment that best suits your needs, which might well not be a fancy center where you have to pay $73,000 to have this guy lose you.

Look, look, this system clearly badly needs more expertise and oversight.

And until then, it may be really important for all of us to understand that at present, the word rehab is so broadly defined as to be close to meaningless.

It is honestly barely better defined than the word building.

And if someone were to tell you, I have a drug problem, but don't worry, I'm going to building in Florida, you would naturally say, hold on, what building?

What's the proof that it works and what's the doctor to horse ratio like in there?

And sadly, right now, it can be way too difficult to get answers to those questions, which is crazy, because so much about battling addiction is really hard.

But getting good, evidence-based, trustworthy help should be the fucking easy part.

And right now, it is way too easy to literally wind up pissing money up a fucking wall.


Speaker 0: -♪ ♪ -♪ ♪ Rehab, the most common place to go after hitting rock bottom, other than Dave & Buster's. Don't let their smiles fool you. Every 1 of those men is at the lowest point in their lives in that photo. Now, rehab is a place where people can address addiction to drugs or alcohol. Something that, until relatively recently, was seen as a moral failing that could be overcome with sheer willpower.

Perhaps best epitomized by this amazing PSA from the 80s, starring singer Belinda Carlyle.

Speaker 1: I used to do drugs. And 1 morning I woke up, I looked in the mirror and I said, you look frightening. I got sick of it, so I quit. And now, life's a bitch.

Speaker 0: Rad. Now, incidentally, Belinda Carlyle has since admitted that after that PSA was shot, she used cocaine for another 20 years, to a point where, And I'm quoting her directly here, I'm surprised I still have a nose. Which is the kind of statement you only normally hear from toddlers who just spent the afternoon with their uncle. He told me he got it in his fingers, and I fucking flipped, man! I was crying, screaming, the whole thing.

I'm surprised I still have a nose! Is it still there? The guy's fucking crazy! -...- Now, thankfully, thankfully, there is now a broader understanding that addiction is complex, and that nothing about getting off alcohol or drugs is easy. Experts now view addiction as a medical problem, often likened to a disease or a chronic condition.

And a common way of treating it is through stints in rehab. It is a $35 billion industry, with over 14,000 rehab facilities across the United States. Some of which have fancy names, like Promises, or Passages, or Milestones. You know, names that sound like perfumes worn exclusively by widows. And...

And some rehabs can even afford to run TV commercials like this.

Speaker 2: Cliffside Malibu has been helping people just like you for over 12 years. We accept most insurance. Our experienced, compassionate staff will help you get your life back. Call the number or go to the site below now. Don't wait, because your tomorrow may never come.

Speaker 0: Wow! That is a hard turn there. That's like Frosted Flakes ending a commercial with Tony the Tiger getting shot by poachers. Now, in recent years, it has gotten easier to get insurance to pay for rehab. That's largely thanks to the fact that George W.

Bush passed and Barack Obama expanded laws requiring health insurers to increase coverage for it. But while we use rehab as a shorthand, it is worth knowing that there is no set definition for what it should consist of. In fact, there are no federal standards for counseling practices or rehab programs. And while many rehabs are staffed by people doing their best to help, a report a few years ago found that the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care. And for a sense of just how bad things can be, look at Florida, a state whose rehab industry has seen an epidemic of overdose deaths and fraud, to the point where 1 local official issued a chilling warning.

Speaker 3: The clear message would be, stop sending your loved ones to South Florida because we're sending them back in body bags.

Speaker 0: Holy shit! That is the worst and yet possibly most honest tourism slogan for Florida I've ever heard. Come to South Florida, we'll send you home in a body bag. So tonight, let's look at what rehab is and why the industry's so troubled. And let's begin with the fact that rehab should never be seen as a quick fix.

It's often just the first step in a lifetime of recovery. Yet many operators make huge claims about their success rate. Take Passages in Malibu. The father and son who run it make some pretty big promises about what they can do for you.

Speaker 4: When you send patients home, what do you say to them?

Speaker 5: You're cured. Totally cured. Hundred percent. You will never use drugs and alcohol again. Your dependency has been cured.

Have a wonderful life.

Speaker 0: Bullshit! For a start, there is no way when patients leave, this arsehole doesn't say, -"Ciao." There is no fucking way... -$$TRANSMISSION that sound doesn't come out of his lips. But it's not just passages. Lots of rehabs feel free to make suspiciously impressive claims, as 1 researcher found out.

Speaker 6: We called inpatient programs and asked them what their success rate was. And the lowest rate we got quoted was 80 percent.

Speaker 7: You know, I do know that about 80 percent of the clients who have come in here are now sober, long-term.

Speaker 1: We've had about an 80 percent success rate here at 180.

Speaker 6: And then we would ask, and on what data do you base that? And no 1 had any data.

Speaker 0: They had no hard data to back up their claims. And at that point, why even stop at 80 percent? Why not say you have a 140 percent success rate? For every 10 people that come into our facility, 14 emerge completely sober. Where did those extra 4 people come from?

We have no idea. That's how good we are. And that's the thing. Rehab success rates are often based on self-reported statistics involving them simply calling former clients. And those results can be problematic, as a man who's participated in 1 of those studies can tell you.

Speaker 8: They call you up... And they ask how you're doing. And... You just lie. I mean, I just said, you know, I'm fine, you know, but yeah, I was drinking.

You know, like, I mean, it's crazy, you know, but I was embarrassed to say, you know, I didn't stay sober.

Speaker 0: And you can kind of understand that for every reason. It can be hard to admit that you've relapsed, plus it's a phone call, so you'll say whatever it takes to make it end. Because getting sober may be hard, but nothing is harder than an eight-minute phone call with another human being. Nothing. Nothing at all.

And look, for all those claims of success, it is very hard to know exactly what you're getting at any given rehab. You might get the traditional 12-step based approach, which undoubtedly works for some, although most experts argue that there should also be consistent access to other newer treatments like certain behavioral therapies or medications like these. But rehabs are not required to offer those. And because a rehab can essentially be whatever its proprietor says it is, that means they can frame almost anything as treatment. For instance, many high-end rehabs offer something called equine therapy.

And again, if people respond to that, that's great. But there is no empirical evidence that as a treatment for addiction, it works. Which means some people who paid a high price for it can end up having this experience.

Speaker 9: They had, like, the whole equine thing. I mean, you go and fucking pet horses. What is petting horses gonna do for me? It didn't do a goddamn thing. I don't even fucking like horses.

Speaker 0: -♪ ♪ -() Okay. So, first of all, I absolutely love that guy. Second of all, he's completely right. Horses can go straight to hell. Why do we even need them anymore?

Oh, sure, you could ride 1 somewhere, or you could just drive a car, which is like a horse, except it can play music and it doesn't constantly shit everywhere. You're an idiot, Patches, an idiot. Now, 1 of the places, 1 of the places that offers equine therapy is Cliffside, the place from the ad that you saw earlier. Now, a month of treatment there costs tens of thousands of dollars. And its founder, Richard Tate, gets a little defensive when asked if it's worth that price.

Speaker 3: Listen, $73,000 sounds like a lot of money, but if you go to the 4 Seasons for 30 days, okay, that's gonna be 40 grand.

Speaker 8: Right.

Speaker 3: Okay, what did you get? Was there any life-changing thing going on there? Everything that we've done here is mindful. It only seems like horse shit to people that don't know better. But you don't have to know better, bro, because your life didn't depend on it.

You didn't go through it.

Speaker 0: Okay, calm down, bro. -♪ You know what I mean? ♪ -♪ You know what I mean? ♪ Besides, you're being a little unfair to the 4 Seasons. Plenty of life-changing things happened there.

Just last year, Jaden Smith claimed that the 1 in Toronto spiked his pancakes with cheese after kicking him out of his room. And if a handful of Canadians tricking an evicted child millionaire with undisclosed ricotta isn't a life-changing thing, I guess I don't know what is anymore. And $73,000 for 30 days does sound like a lot of money, because it is a lot of money. And you would hope that at Cliffside, they could account for every moment of treatment at that price, but that does not seem to be the case.

Speaker 3: Where are

Speaker 1: your, Where

Speaker 8: are your patients at today? I don't know. Where are they? Where'd they go? No, you're not.

Rob's not here. I have no idea. I have no idea.

Speaker 10: Okay. Do they...

Speaker 3: I have no idea. They probably went to, whatever they did, there's a therapeutic, meaning behind it.

Speaker 0: Good save, bro. -♪ I'm a bad boy... ♪ -'Cause you were in trouble for a minute there, but the therapeutic meaning line was absolutely inspired. Because the truth is, anything can have a therapeutic meaning. His patients are stroking horses?

That could be therapeutic. They're biting owls? That could be therapeutic. Even the act of them being lost could be therapeutic. It's called inadvertent wilderness therapy, and it's 140% successful.

--AUDIENCE LAUGHS- --I... And look, so far, we've just talked about the fancy high-end residential facilities, But there are oversight problems throughout this system because in many states, the barriers to opening a rehab can be dangerously low. For example, in Idaho, as long as you are not operating a residential program for adolescents, you don't need a license at all. In California, as long as you take private pay clients, anyone can start an outpatient rehab center. And in Florida, if you want to open a sober home, a group home where people stay, often while they receive outpatient treatment, there is nothing in state law to stop you.

Technically, O.J. Simpson could open 1 right now, which would obviously be called the Juice Cleanse, and there would be nothing standing in his way. And Florida actually provides a window into how the flood of insurance money into treatment centers has caused massive problems, Because the industry boomed there, and unscrupulous operators have found it way too easy to game the system. Take urine testing. Insurance covers drug tests, and some places have exploited that, arranging for kickbacks from testing facilities, basically meaning the more urine they take, the more money they make, and it adds up fast.

Speaker 1: For a single $30 store-bought urine test, you could get up to $1,500 in payouts from insurance companies. So let's do the math. If you run 5 tests a week on a single addict, that's $7,500. 6 addicts at 5 tests a week, $45,000. That's over 2.3 million a year.

Speaker 0: Exactly. Urine is so valuable that in the recovery industry, it is known as liquid gold. And peeing liquid gold sounds like the symptom of an STD. You can only contract from fucking C-3PO. No, C, I don't think all women born after 1990 have it anyway.

Unless you're sleeping with all women born after 1990, see? Are you? Are you doing that, see? You're a dog, see? You're a metal dog.

-$1,000,000. And with money like that to be made just from urine, it is hardly surprising that some operators have gone to extreme lengths to attract patients with insurance, even engaging in something called patient brokering or junkie hunting. Here is how that works.

Speaker 11: Mercedes Smith, a recovering addict herself, told us sober home operators compete for addicts with good insurance, enticing them with promises of free rent, free food, free cigarettes.

Speaker 4: We would have to drive around Delray and anybody with, like, suitcases, we would have to ask them, do you have insurance? Do you have a place you can go?

Speaker 0: Okay, so in terms of questions to ask people from the window of a moving vehicle, do you have insurance is barely less sinister than would you like some candy or what size of flesh are you? -♪ ♪ -♪ And it gets even grimmer because the truth is there can be more money in a patient relapsing than in them recovering. So at its worst, this system encourages a cycle of admission, relapse, readmission, and relapse again. This cycle even has its own special term. It's called the Florida Shuffle.

And if you are not extremely lucky, this is how it ends.

Speaker 12: In the Florida Shuffle, you go in and out of recovery, in and out of rehab centers, in

Speaker 8: and out of sober homes, milking the individual for their insurance until that person dies.

Speaker 0: Yeah, the Florida Shuffle turns out to be horrific and not, as I'd assumed, a party where everyone throws their keys in a bowl and gets to go home and fuck their neighbor's alligator. And if at this point you're thinking, well, I guess I just need to be extra careful when I'm looking for treatment, Well, that is the final big problem here, because it can be nearly impossible to find good, unbiased information. Let's say you're sitting at home, and you see this ad, which plays a lot.

Speaker 10: We are the Addiction Network. And if you

Speaker 13: have a problem with drugs or alcohol, you need to call the number on your screen now. Addiction is a disease, and you can't go it alone. The call is free, and so is the consultation. So why haven't you called?

Speaker 0: Why haven't you called? That is a hostile tone that you would not tolerate elsewhere. Tampax tampons. Why isn't 1 in you right now? Seriously, explain yourself.

--AUDIENCE LAUGHS-- But the important thing to understand is that the addiction network is not a rehab. It is a referrals business, meaning they make money by routing your call to centers all over the country, which reportedly pay them 40 to 50 dollars for your call. So in a moment of crisis, your individual circumstances are not being taken into account. They're simply placing your fate in the hands of whoever has $50, which is a terrible system. I have $50, but I have no idea how to treat someone with an addiction.

I'd probably just give them a copy of my handmade anti-drug pamphlet titled, Napping with the Devil, Please Stop Doing Heroin. -♪ Napping with the Devil ♪ -♪ Napping with the Devil And if you're thinking now, well, hold on, I wouldn't fall for a sketchy-looking TV ad, I'd do my own research, that is great. But let's say that you saw that Cliffside ad and you thought, well, that looks good, but I do want to check it myself first. Well, a Google search will quickly land you on rehabreviews.com, which says that Cliffside is the choice for those that have to have the finest of everything. Or you might land on the thefix.com, whose review of Cliffside raves that it is a great choice for anyone who has the means to recover there.

What you probably won't see on either of these websites, at least, not unless you know exactly where to look, is that both of them are actually owned by Richard Tate, the founder of Cliffside Malibu. You remember, the guy who looks like Matt Lauer fucked a pair of Oakley sunglasses. And that fact... That fact... That fact of ownership certainly casts some doubt on the fact that the fix awarded Cliffside a rating of 5 out of 5 stars.

Presumably 1 star for every 10 patients whose location he's completely unaware of. -♪ ♪ -♪ And let's say someone you love was truly in crisis and you wanted information on Cliffside from an outside source, like what complaints had been lodged with the state and what the state found when they investigated. Well, in order to get that information, you would need to file a public records request with California's Department of Healthcare Services and then wait for months for them to send you what could be a huge pile of documents to sort through. And that is too long to wait for urgent information. It's akin to a pregnancy test that takes you 8 and a half months to get the results.

That is practically useless, and a huge waste of perfectly good urine, which as I now understand it, is liquid gold. -$1,000,000. -$1,000,000. Everything about this industry is incredibly difficult to navigate, which is dangerous, Because even 1 of its own trade groups, its own trade groups, has warned that some sectors of it are out of control. And for a sense of just how helpless you can be in the face of all this, just listen to Tom McClellan.

He was Obama's deputy drug czar. You would think that if anyone knows this world, it would be him. Well, guess what?

Speaker 14: I had, become an expert in the addiction field. And then my son became addicted. And, I had no idea what to do. All that training, all that knowledge about addiction did not prepare me for the most fundamental question of all. Where do you send your kid for treatment?

Speaker 0: It's true. Even the nation's deputy drug czar couldn't confidently navigate this system. And the tragedy is, his son died. And remember the funny guy who hated horses? He died, too.

So this is a matter of life and death. And if you're wondering what experts would advise you to do in seeking treatment, many that we spoke to suggested beginning not with a rehab, which may try and sell you on its own services, but with a doctor who is board certified in addiction medicine. Now, it's only recently become an official specialty, so there just aren't many of them around, but you can find those that do exist at this website here. They may be able to guide you toward a treatment that best suits your needs, which might well not be a fancy center where you have to pay $73,000 to have this guy lose you. -...

-... Look, look, this system clearly badly needs more expertise and oversight. And until then, it may be really important for all of us to understand that at present, the word rehab is so broadly defined as to be close to meaningless. It is honestly barely better defined than the word building. And if someone were to tell you, I have a drug problem, but don't worry, I'm going to building in Florida, you would naturally say, hold on, what building?

Where did you find this building? What's happening inside it? Is it a hospital or a Hooters? Or both? Is it a Hootspital?

What's... What's... What's the proof that it works and what's the doctor to horse ratio like in there? And sadly, right now, it can be way too difficult to get answers to those questions, which is crazy, because so much about battling addiction is really hard. Getting clean is hard.

Staying clean is hard. But getting good, evidence-based, trustworthy help should be the fucking easy part. And right now, it is way too easy to literally wind up pissing money up a fucking wall.

Speaker 1: You

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Rehab: Last Week Tonight with John Oliver (HBO)