My Addicted Son is Caught in the Cycle of Patient Brokering

Alice's son, as a child, now a victim of patient brokering

My 22-year-old son is a drug addict who has been caught up in the vicious cycle of detox, treatment and relapsing — all perpetuated by a terrible scheme called “patient brokering.”

With the growing number of drug treatment facilities, many unscrupulous players in the treatment industry are participating in kickback schemes known as patient brokering or “body brokering.” In return for referring a patient to a drug treatment facility, the broker receives a generous compensation of $500 to $5000. Brokers will offer to share these kickbacks with patients or entice them with drugs to leave an existing facility and qualify for another because they have relapsed. These brokers troll AA meetings, coffee shops in popular rehab towns and, in my son’s case, detox and rehab facilities.

My son’s recruitment into this darker side of drug treatment occurred when he met a broker about his age at a Florida detox facility. He persuaded my son and a few others to fly to another detox in California, all expenses paid. After a week in California, they decided to go back to Florida where this broker was able to fly them back to another detox, all expenses paid. The night before leaving, he put everyone up at a hotel on Sunset Strip providing cash so they could party all night on whatever drugs they could find.

The sad truth is that once these kids were entwined in this scheme, they quickly become a highly sought-after commodity. It becomes very difficult for them to break away from this cycle, as it offers them a means of surviving without financial help or oversight from parents. These brokers are preying on people with brain diseases, building false hope and trust, only to set them up for failure. Patient brokering is illegal in many states, however, it is prevalent in Southern California and Florida. It enables the person with an addiction, as he or she believes there will always be another place to land. And it mocks the efforts of true recovery.

This corrupt practice by players with no credentials in drug treatment, other than being drug abusers themselves, has been perpetuated by a combination of events. This includes legislature that needs tighter boundaries, more oversight of treatment centers and stronger regulation of sober houses. The Affordable Care Act (ACA) requires insurers to pay for all substance abuse treatment including drug testing. This benefit has been highly leveraged by unethical treatment facilities opening a floodgate for opportunistic billing practices. My insurance once copied me on a $20,000 claim for a one-time drug test submitted to my insurance by a lab I had never seen before. My insurance information was likely passed on or sold just like bank account numbers for purposes of identity theft.

Well-meaning laws have financed a billion dollar industry over the past ten years and have created a trail of millionaires who have sold profitable treatment centers to larger healthcare companies. Being able to keep children on policies up to age 26 has also fed the industry the largest at-risk population to the doorsteps of these treatment facilities and sober houses with the guarantee they can be perpetually cycled through the system. The business model is not recovery. “The business model is relapse,” explains Alan Johnson, chief assistant state attorney for Palm Beach County, in the South Bend Tribune.

My son has been in dozens of residential and detox programs since he graduated high school over three years ago. Like most young people, his drug use was propelled by mental illness. His depression and anxiety started around middle school and grew worse toward the end of his father’s battle with cancer. After the death of my husband, my son’s drug use escalated from pot and alcohol to prescription drugs. He struggled socially even though he had a wonderful sense of humor, intelligence and a warm heart. He showed great promise and enthusiasm for history, music and writing. Adolescence can be a harsh place for those who feel and observe more in life. His increasing anxiety and chronic depression became so debilitating he had to eventually leave school his sophomore year, suffering another bout his senior year. It was a struggle for his teachers and me to get him through to graduation.

While in high school, his psychiatrist decided to try ADHD stimulant medications. My son began to assertively campaign to administer these meds himself or asking the psychiatrist for an increased dosage. It was a constant battle to keep him from trying to abuse them; I knew then that stimulants were his drug of choice. This was one of my earliest mistakes — that I didn’t take him to an addiction specialist. An otherwise competent psychiatrist, who attended a top medical school and trained in New York City, couldn’t recognize a budding addiction disorder. More emphasis on addiction and treatment needs to be taught in medical schools and other healthcare fields.

If he wasn’t depressed, his behavior became more egregious when he was home from boarding school. He had multiple incidents of rage and anger that was always drug- or alcohol-fueled. One such episode resulted in a 911 call that began the trail of legal issues that are still unresolved. He received psychiatric care at a well-known facility for 30 days and was discharged with a diagnosis of an addiction disorder. It was “highly” recommended that he go to a pricey long-term treatment facility for young adult men. They never explained to me or my son that this was at least a one-year commitment until he was enrolled.

He called me almost every day begging to come home. After eight months my son walked out and took a train to New York City. The next day he awoke at New York-Presbyterian Columbia University Medical Center with no recollection of how he got there after stealing and drinking five tall boys of beer at Penn Station.

I desperately wanted him back home but he struggled to stay sober. He did all right the first month going to meetings, enlisting in a local Intensive Outpatient Program (IOP) and holding a part time job. After noticing he was withdrawing more from his brother and me and not attending meetings, I became suspicious. Shortly thereafter, he tested positive for over-the-counter stimulants and was discharged from the IOP.

At that point, I couldn’t continue the financial bleed of paying for treatment and sent him to a 30-day rehab in Florida that would take my insurance. Although he did attend a few decent programs in Florida, he had difficulty making the transition into sober living. The longest he lasted at one facility was four months. After leaving the highly structured environment of a residential program, his anxiety and depression quickly kicked in and he relapsed.

He bounced back and forth between a sober house that tolerated drug use (one which was eventually shut down) in exchange for attending treatment at an affiliated IOP. Eventually I contacted the regional the National Alliance on Mental Illness (NAMI) office who was very helpful in suggesting a few reputable facilities. He agreed to enter one and I thought he was making real progress but he left before treatment ended for the allure of more drug use and another shady sober house. The pain of doing “the work” and confronting his feelings proved too painful. Tiring of these living conditions, he eventually asked to return home and agreed to try more local options.

After trying detox and a new treatment program, my son was unable to stay sober and eventually fled to California again with the help of his previous broker. He is still in the Los Angeles area, cycling through facilities.

Both my son and I have been victimized by this broken system. I have entrusted professionals with my son’s health and have rarely felt that he received effective care. It seems to be a business fraught with greed, false hope and ridiculous fees that play on parent’s worst fears and anxiety. I’ve also struggled with the guilt and shame over my son. There’s no shortage of people wanting to give me advice or pass judgment. When uninformed family members or friends feel that my son’s addiction could have been quelled by sending him to college, I am discouraged beyond measure for all I have done in hopes of helping him.

There are still many well-intentioned and excellent treatment programs out there. There are plenty that take insurance and the quality of care is no different than those that charge above and beyond insurance. This I’ve learned the hard way. My experience is partly due to my son’s inability to commit and stay the course. I lost a lot of influence over his decisions once he became a legal adult, which is why communication skills are so important. I was lucky to have a local support group led by a Parent Coach who educated us on the CRAFT approach. It hasn’t stopped him but it has helped me keep the lines of communication open even in the most contested moments. Parents need to try their best in due diligence in helping their sons and daughters select a program that gives them their best shot at change. There is always a sense of urgency in making this decision but doing research can help. The best resource out there are parent support groups. This is where you will get recommendations and honest feedback from others’ experiences.

It has taken me years before I could understand and accept this awful disease on its own terms. I’ve had internal turmoil over how much support to give my son without “enabling.” “Detaching with love” sometimes seems like a convenient excuse to check out and not deal with the chaos anymore, but at times seems like the only thing left to do for my own self-care. But to remove myself from helping him is counter-intuitive to being a parent. So, I feel the constant struggle of walking the thin line between helping and enabling.

But I won’t give up on my son.

What to Look For and What to Avoid When Looking for an Addiction Treatment Program

It can be very difficult to assess good addiction treatment vs. bad addiction treatment. Get tips on how to navigate the system so you can find the best treatment for your son or daughter.

What to Look for – and What to Avoid – when Searching for an Addiction Treatment Program

    User Picture

    Indiana mom

    March 25, 2019 at 3:36 AM

    I’m in Indiana my son is 33 years old now but looking back I see that he had some issues early on I thought was just drinking or smoking pot he became a marine married with a child into Afghanistan came back and we thought that was the problem and has spent the last two years spending time money and energy getting him to a hyperbaric chamber that worked like amazingly but now I know that he is an alcoholic and truly believe that the marijuana I thought was helping is creating psychosis because it is not the same marijuana that was from the 70s the THC levels are higher and he needs more to feel normal he has lost all of his friends and looking back we saw him still from our house and he basically has no one except an enabler and she is 10 years older than him and really a female version of him. It is sad and sickening to watch.
    I have had to remove myself from the situation because until now I have never seen such disrespect from him and I can allow that it was physically making me ill . I still seethe 5 yr old but he is dead
    I’ve never been so disappointed and deflated in my life and blamed myself for a while until I sought out help .
    I feel stupid ,I was the all in parent , going to DaRE in the whole junior high I was only 1 of 3 parents that showed up for drug awareness … my husband and I was the you can do it parents now I’m mad
    We could have got the same results sitting in a bar.
    It’s like anything we didn’t care for … smoking drinking and cussing partying scary movies screaming music
    He chose
    Now he chooses to be the victim
    Anything and everything he’s ever done in his life that we warned him about as proven we were right he was wrong and he self sabotages .

      User Picture

      Josie Feliz

      March 25, 2019 at 4:32 PM

      Thanks for sharing, Indiana mom. We’re so sorry you’re going through this with your son. If you ever feel like talking to someone about this, just know that our Parent Helpline is always here for you. Our Helpline is a good place to start if you’d like to talk to someone about what you’re going through. Feel free to connect with us in whichever manner you choose in the future: -Josie Feliz

    User Picture


    October 20, 2018 at 7:59 PM

    I’m lost and not sure how to help my son anymore. He’s 33 now and has moments of sobriety, but can’t syay sober longer than 9 mos. He let his insurance lapse and now we seem to be at a complete DEAD END. Every day I pray for strength to continue living this life.

      User Picture

      Josie Feliz

      October 22, 2018 at 11:40 AM

      Thanks for your message Hope. We have forwarded your message to one of our helpline specialists who can help better answer your question, and she will be reaching out to you shortly.

      Our Helpline is a good place to start if you’d like to talk to someone about what you’re going through. Feel free to connect with us in whichever manner you choose in the future:

    User Picture


    October 10, 2018 at 11:16 AM

    How is your son now? Im in the same situation. My son is in and out of facilities being their puppet. I thought of taking him off the insurance but would feel incredibly guilty if it backfired. He is well sought after since his insurance is top of the line. He always was eager to please but now its to any broker that gets a hold of him. Any suggestions since you published your article?

    User Picture

    Angela Hillen

    April 5, 2018 at 7:14 PM

    This is “my story” as well with my 21 yr old son caught up and being victimized by first being brokered to now referring patients. This is all new to me and I want to have a voice in all this. Prior to this happening just in the last two months, I had never even heard of such thing. As a parent there is a huge need for education. Parents NEED to be aware of this and the need to investigate anywhere their child is going for treatment. Thank you for sharing.

      User Picture


      May 24, 2018 at 6:02 PM

      I’m glad you found my article and know this is a becoming a larger issue. I am not surprised to hear your son is also “referring” as that is typically how they build their network. The broker will promise the patient money upon completion of a program but seldom pay. The “referrer” will renege and keep the money so you can see the benefit of becoming involved. Florida is cracking down and has made brokering a crime. The California has a bill (SB1268) in draft to make patient brokering a misdemeanor with a $2500 fine. Unfortunately that will not be enough to curtail this activity.

        User Picture


        April 27, 2019 at 9:25 AM


        Your story is heartbreaking. Thank you for sharing. I’m a filmmaker and recovering alcoholic from Chicago working on a documentary film about patient brokering. I’m actually in Florida know doing interviews. My producer and I feel strongly that more people need to be aware of this issue and hope to bring it to a larger audience. If you’d be interested in sharing your story with us, please reach out. We’d love to hear from you.

      User Picture


      April 27, 2019 at 9:42 AM

      Hi Angela

      Thank you for sharing you story. I’m sorry to know the pain this has caused you and am wondering how your son is now? I’m a filmmaker and recovering alcoholic from Chicago working on a documentary film about patient brokering. I’m actually in Florida now doing interviews. We feel this story needs to be brought to a larger audience. If you’d be willing to share your story with us, please reach out. We’d love to speak with you further.

Leave a Comment

Please leave a comment below to contribute to the discussion. If you have a specific question, please contact a Parent Specialist, who will provide you with one-on-one help.

Your email address will not be published. Required fields are marked *