Everyday Erinyes #166

Experts in autocracies have pointed out that it is, unfortunately, easy to slip into normalizing the tyrant, hence it is important to hang on to outrage. These incidents which seem to call for the efforts of the Greek Furies (Erinyes) to come and deal with them will, I hope, help with that. As a reminder, though no one really knows how many there were supposed to be, the three names we have are Alecto, Megaera, and Tisiphone. These roughly translate as “unceasing,” “grudging,” and “vengeful destruction.”

In all of the United States, there is one chain of addiction treatment centers which is publicly traded. (Hazelden, for instance, is pretty large, including as it does publishing, which reaches all over the world, and it has the issues institutions have when they get big. But it is and always has been non-profit. Publicly traded is different.)

This publicly traded chain is called American Addiction Centers. It is headquartered in Brentood, TN. If you go to its main website (it has over a hundred, in order to maximize appearance in search results), you will have to know just where to look to find out that it is publicly traded. (Incidentally, is a publicly traded company really allowed to use dot org for its site?) If you click on “About Us” in the banner and read all the fine print, you will find a sub-category called “Investor Relations.” You won’t see anything about that on the home page, nor, probably, under any of the other categories listed across the banner.

The article in Mother Jones which drew my attention to this chain was entitled “America’s Only Publicly Traded Addiction Treatment Chain Makes Millions Off Patients. What Could Go Wrong?” The subtitle indicates that “Mother Jones spent five months investigating deaths at American Addiction Centers.”

The company has roughly 1500 beds in California,Nevada, Florida, Colorado, Texas, Virginia, Mississippi, Utah, Louisiana, New Jersey. The facilities in the Las Vegas area comprise about 300 of those. It was in one of them, “Solutions,” that Cody Arbuckle died at the age of 23, of an overdose of Imodium (loperamide HCl), which apparently, if you take enough of it, can get you high. He was newly admitted and was supposed to be tightly supervised while going through withdrawal, but was left unattended for several hours instead.

Mother Jones finds irony in the fact that his death occurred just about two months after the chain’s CEO gave an investor presentation in New York City:

On a spring morning in 2017, in a Grand Hyatt ballroom in midtown Manhattan, Michael Cartwright took the stage and talked about growth. “There’s no great brand out there—Nike, whatever you consider a great brand out there today—that doesn’t have a great sales and marketing platform,” he told the audience of health care investors and executives attending a UBS-sponsored confab. That’s why, Cartwright said, his company—American Addiction Centers, the nation’s only publicly traded addiction treatment chain—had built a thriving marketing machine.

And it was vast. Some 65 sales reps marketed AAC’s services to therapists, DUI

Michael Cartwright, CEO of AAC

attorneys, and doctors. The company operated more than 100 websites, ensuring AAC showed up frequently in search results. “If you type in ‘heroin addiction’ or ‘methamphetamine addiction,’” Cartwright, AAC’s CEO, told his audience, “you’re probably going to come across one of our websites.” Each month, roughly 30,000 calls came in to AAC’s call center in Nashville, where, he said, “we have 100 sales reps answering the phone every day.” AAC had dozens of facilities across eight states, including high-end residential centers, outpatient programs, and sober-living housing. According to Cartwright’s slides, the average residential client brought in more than $22,000 in revenue. 

The Las Vegas facilities have seen multiple deaths besides Cody. There was Connor Jackson, 25, a suicide. Joseph N., 25, unknown causes (in his sleep.) April Leeming, 33, also unknown causes (but she was known to have a seizure disorder, and was unmonitored for nine hours.)

Yet another death, this one in California, was mentioned in Mother Jones, but described in more detail by ABC news in Florida – AAC runs a facility in Tampa Bay, and that facility has issues of its own, which made the death and lawsuit in California local news to ABC Tampa Bay.

The deceased, Shaun Reyna, was admitted delusional and hallucinating. He was assigned a room to himself. There were razor blades in the room. Twenty hours after admission Shaun Reyna was dead. He had cut himself multiple times with his razor, and he bled out.

The attorney for the Reyna family, Jude Basile, who obtained for them a $7 million dollar judgment, is of course appalled at the lack of supervision, but seems equally appalled by the chain’s marketing practices:

They were negligent in how they marketed and brought people in… These people took calls from their mass marketing program and were paid a commission and had sales quotas…. American Addiction Centers pressured sales people to sell by any means possible and fired them if they failed to meet sales quotas. 

That is indeed how call centers operate. In most cases, however, it is a matter of life or death only to the employees who can’t meet the quotas. That isn’t so in this industry, which IMO makes the call center marketing model more than usually abhorrent. Attorney Basile added:

“Unfortunately, I think government regulation and oversight is lagging in this industry that has developed over night.”

Amen, Mr. Basile. Amen.

Oh, and the stock prices? After peaking in 2015, when the company had been publicly traded for about a year, at $46.60, it has now dropped to under $2.00. In spite of closing facilities (I’m not sure which ones, or even if they followed through on that announced intention, frankly.)

Alecto, Megaera, and Tisiphone, I’m afraid we will get no Federal regulation with the current regime in the White House. But you can start to help build public opinion on the subject. So please do.

The Furies and I will be back.

Cross posted to Care2 HERE.