The Florida Shuffle: Liquid Gold, Equine Therapy, And The Dark Side Of A $35 Billion Rehab Industry

“[…] The word 'rehab' is so broadly defined [it’s] 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's 'building'? Where did you find this building? What's happening inside it? Is it a hospital or a Hooter's? Or both – is it a Hootspital? What's the proof that it works, and what's the doctor-to-horse ratio like in there?”

The most recent episode of “Last Week Tonight With John Oliver” uncovers the gross lack of regulation in the U.S. rehabilitation system.

“Rehab should never be seen as a quick fix,” said Oliver, “it's often just the first step in a lifetime of recovery."

But there is little evidence that these rehab facilities – of which there are over 14,500 in the U.S. – aid in the recovery process.

Controversial treatments practiced at rehab centers aren’t scientifically backed (or regulated), and there’s no empirical evidence to prove the efficacy of treatments, like “equine therapy,” the host quips. Meanwhile, patients are forking out tens of thousands of dollars per month to attend such “buildings.”

The lack of regularity systems means there’s little stopping these facilities from opening and operating. This results in unaccountable care, and a recurring cycle of patient relapse.

Ultimately, these systems – such as those found in Florida – milk their patients’ insurance.

One way rehab centers do this, reports Oliver, is through repeated urine testing – which “The New York Times” dubs “liquid gold.” The payout from insurance companies for urine tests is high, and a major source of money for rehab facilities.

Experts suggest consulting doctors who are board-certified in addiction medicine, which only recently became an official specialty. There aren’t enough of these physicians, but a list of them can be found here.