09/10/2025
A worthwhile read. Challenging, especially if you are working in recovery
The Recovery Industry: How We All Became Part of the Repeat Business Model
There is a quote that cuts to the heart of advocacy: "If you really want to be an advocate, start by listening to the people you claim to be advocating for."
For too long, our community has been listening to the system. And the system has learned to say all the right things. It talks about being "evidence-based" and offering "opportunity." But a harder truth emerges when we stop listening to the institutions and start listening to the people caught in their gears.
The truth is that the addiction recovery system isn't broken; for many, it's working exactly as it was designed. It functions as a sophisticated penal system, one that has perfected the art of generating repeat business. This isn't just about a few bad actors. This problem is deeply embedded in the very fabric of our professionalized, clinically-run programs. They have, nearly without exception, ignored the new guidelines for compassionate, effective care because the old way is simply too profitable.
This is the clinical façade, a system hiding in plain sight. Here is how it operates:
1. It Uses the Language of Care to Practice Control
Visit the website of any modern treatment agency. You will find a glossary of reassuring buzzwords: "person-centered," "trauma-informed," "evidence-based." This language is a marketing shield. In practice, the model remains ruthlessly compliance-based. A "person-centered plan" becomes a contract of rules to be followed. "Trauma-informed care" is forgotten the moment a client breaks a rule out of a trauma response. It’s a bait-and-switch, promising collaboration while delivering control.
2. It's Designed for "Billable Moments," Not Breakthroughs
The modern clinical agency often operates on a fee-for-service model. Every group session, every check-in, every drug screen is a billable event. A person who achieves stable, long-term recovery and no longer needs intensive services is, from a business perspective, a lost revenue stream.
The system is therefore not financially incentivized to produce wellness. It is incentivized to manage illness. A client who cycles in and out of a program—discharged for a rule violation, only to return after a relapse—is the perfect client. Each return means a new intake, a new series of billable services, and another turn of the financial crank. This isn't a healthcare system; it's a subscription model with a human being as the recurring charge.
3. "Clinical" Justification Is the Perfect Cover
This is where the clinical model is most insidious. When a person is kicked out of a program, it's documented in professional jargon: "Patient discharged due to non-compliance with treatment protocol." "Client left against medical advice."
The system uses its clinical authority to officially blame the victim. The program's failure to connect with and help the individual is expertly reframed as the individual's failure to comply. The program's statistics remain clean, its funding secure. The person is left with an official record of their "failure," adding another layer of shame that makes it harder to seek help again.
This is the penal system, simply rebranded. It has traded the overt punishment of a halfway house for the quiet, bureaucratic punishment of a discharge summary. The outcome is identical: the person is abandoned at their moment of greatest need.
If we can't trust the courts, the houses, or the clinics, where does our community turn?
The answer is to stop trying to fix the existing system and start building a new one alongside it.
Empower Peer-Led Movements: The future of recovery support lies with organizations run by and for people with lived experience. These are the only groups immune to the perverse financial incentives of the clinical-industrial complex. We must demand that public funds be diverted to these grassroots efforts that offer genuine, judgment-free support.
Demand Radical Transparency: We must force these clinical agencies to publish the data that matters. Not their cherry-picked success stories, but their discharge rates for non-compliance. We need to know what percentage of their clients are kicked out. This single statistic will expose their business model.
Advocate for the Guidelines, Not the Agencies: We must stop directing people to "trusted" programs and start educating our community on the principles of real, modern care: genuine harm reduction, patient-led goal setting, and unconditional support. We must teach people to interview programs as skeptical consumers, not to approach them as desperate supplicants.
This is a difficult truth to confront. It means accepting that the entire industry—from the court-mandated sober home to the credentialed clinical agency—may be built on a foundation of repeat business. And that business requires a steady supply of people who are set up to fail. Real advocacy means turning our backs on that industry and investing our time, money, and faith in the people it has discarded.
