Let’s Not Throw the Baby Out With the Bathwater!
by Thomas G. Beley, PhD, LCSW
There has been an enormous amount of negative publicity regarding substance use treatment facilities and so called “sober homes” in the south Florida area. So much so that the integrity of the entire treatment industry has been under scrutiny. And perhaps so it should be. Given the accounts of fraudulent billing, “patient brokering,” and human trafficking occurring, it is disheartening to know that we continue to live in a society where vulnerable groups of people are preyed upon for monetary gain. There is a definite need to take a closer look at what is actually going on. However, let’s not let the emotional sensationalism of these news stories cloud the facts and issues of what is really going on.
Our nation is currently under siege by a problem that has been a long standing health issue that seemingly continues to be the “step child” of our healthcare system despite the fact that it is one of the leading contributing causes of death in our country. Addiction has become a menace to our society. Illegal drug use, legalized drug use, prescription medications, and alcohol have infiltrated all segments of our population. While pharmaceutical companies have well intentionally figured out ways to introduce an assortment of new medications to combat the side effects of prescribed opioid medications, deaths from opioid overdoses have become the number one cause of accidental deaths in the United States outnumbering car accidents.
The problem of addiction is not going away and, unfortunately, it is only going to get worse. The fact is that we need treatment centers and we need “sober” homes. They have been a main stay for people suffering from the scourge of alcohol and drug addiction for decades. What we do not want to do is to scare people away from getting the help they need. Let’s not forget that there are many established quality treatment centers and “sober” homes throughout the nation.
One of the problems that legitimate treatment centers have encountered is the limitation that insurance companies have placed on them in providing effective treatment. Treatment is often cut short by insurers, often citing “there is no medical necessity” in favor of a less intensive program meaning they are often discharged from the facility without really getting the full care that is needed. As a result, there has been a proliferation of these “less intensive” treatment programs which is where the insurance loophole begins to expand. Many of these “less intensive” programs are ineffective at best because of a lack of credentialed professionals running them, or they have been established with the sole purpose of milking the insurance companies of benefits.
A problem is occurring that many of these well-established treatment facilities and “sober homes,” historically known as halfway and three-quarter houses, are being overshadowed by these bogus; make shift facilities that have taken advantage of the insurance loophole. Make no mistake, some of these places have little interest in providing the necessary help needed to address those suffering from an addictive disorder. The primary goal is to make money. Their sole purpose is to prey on a vulnerable population, many of the victims are young adults in their early twenties with little or no life skills who are still on their parents’ insurance. Many of these individuals have been in the throes of their addiction for years and have little choice. Either they and the family do not know any better or they simply feel resigned to play along within a deficient system.
Many of these victims are offered easy money to recruit other patients to live in a so-called “sober home” who will often have connections with a so-called “treatment” facility. In many instances, there is an established unethical relationship of “brokering” whereby there is an exchange of money for patients between the “sober” home and the “treatment” facility. Each supplying the other with a steady stream of “insured” bodies. Patients are actually encouraged to go out and recruit other patients from other “sober” homes and treatment facilities in exchange for money, free room and board, or both. In some instances, the owner of the “sober” home also owns the “treatment” facility.
Many people leaving a bona fide treatment facility will need a halfway or three-quarter house for support and a transition back into sober living. However, a legitimate half-way or three-quarter house, now often referred to as a “sober home,” will be just that, a place where people can live and receive the necessary support and structure to transition back to a normal life. The halfway and three-quarter house has been an integral part of recovery since addiction was recognized as a medical condition decades ago. The concept of the halfway and three-quarter house is basic. The person pays rent for a safe, structured place to live with other recovering people. The concept being a person can engage in life responsibilities such as work or school and return to a supportive setting until such time the person can live independently.
However, for some, the concept of the halfway and three-quarter house has morphed into the so-called “sober home” where clients are more or less forced to participate in a “less intense” treatment program in exchange for free room and board. While in theory this sounds like a very reasonable proposition, the reality is we have vulnerable people being “brokered” into, at best, untenable and ineffective facilities. Many of these individuals do not need “less intense” treatment, what they need is guidance and direction in developing life skills and purpose, which is often a part of more intensive treatment
Families are also enticed by these facilities with the promise of not needing to pay rent for their loved one to live in such a “sober home.” The catch is their son or daughter will have to participate in a highly ineffective “less intense treatment program” which is usually compromised of other patients who have no desire to recover or are simply just trying to get by; to survive playing what now amounts to a very deadly game of so-called “recovery.” Life for some of these individuals has become not trying to recover as much as trying to negotiate a better “treatment” deal. They bounce from one treatment program to another, from one “sober home” to another, with no real direction of getting back on track with their life.
Legitimate treatment centers often encounter prospective patients and families negotiating treatment terms because they have been offered free plane fairs, waived co-payments and deductibles, free room and board post treatment, and other enticements by these questionable treatment facilities. Somewhere along the line, treatment for a deadly disease has become more like purchasing a car. People, unfortunately, have been seduced into looking for the better deal rather than effective treatment that is going to save a life.
The Politics of Addiction
How is it that the treatment industry for substance use disorders has become increasingly more suspect of unethical practices over the years? The answer is a very simple one, neglect. Neglect at all levels of our society except one and that is the criminal element.
Regardless of how much research that has been conducted over the years, and there has been a plethora of research in better understanding addiction, it seems to be still falling on deaf ears. People continue to turn a blind eye to the fact that substance use disorders and addiction is one of leading health hazards and causes of death in our country.
Despite the fact that it has long been recognized as a medical condition requiring medical and professional interventions, there continues to be the stigma of the ‘addicted’ person suffering from a lack of will power, fortitude, and discipline. Research has clearly demonstrated that this is not the case. There are neurobiological and behavioral underpinnings to this disease that have impacted key areas of the brain including a person’s genetic make-up. What is even more important regarding this research, which has been around for decades, is that there are effective interventions and treatment approaches that can be utilized. The old adage of relapse being a part of recovery is simply not true anymore. Unfortunately, this research seems to be slow in reaching our treatment industry forcing many people suffering from addiction to be treated with antiquated and ineffective approaches.
What compounds this malaise even further is the fact that the insurance industry and the pharmaceutical industry seem to have little incentive for change making it difficult for legitimate treatment facilities to do their job effectively. These facilities are often limited in the amount of treatment they can provide and are often in a battle with the insurance companies to prove medical necessity for further treatment. Even when medical necessity is proven, insurance companies are reluctant to authorize further treatment, in part because of the abuses that tend to occur across the board in our healthcare-insurance paradigm, but also because they are tired of paying for treatments that are seemingly ineffective.
Insurance companies are fighting back. Why should they pay for another intensive treatment when that person has been through a similar “treatment” four or five times previously? As a result, the insurance industry has relied on the premise that treatment needs to be provided on a shorter-term basis and in a less restrictive setting. As a result, there has been a proliferation of these less intensive programs that have focused on relapse containment, which is not necessarily a negative goal, but they are extremely limited when it comes to addressing the coping and life skills necessary to live a more productive and meaningful life.
The insurance industry has also relied on the pharmaceutical industry’s propensity to develop better maintenance medications. These medications, creating a multi-billion dollar windfall of their own, are geared more toward reducing symptoms and maintaining the person so they do not decompensate any further, not necessarily getting the person back on track with their life. The goal of stabilization and maintenance is not enough. People with addiction issues need a treatment program that will address the neurobiological, psychological, and behavioral aspects of this illness.
All of this creates a vacuum of need for the person suffering from an addictive disorder. As such, they are left vulnerable with little or no options to choose. They are preyed upon by the opportunists whose only intent is financial gain subjugating these individuals to less than supportive living conditions and participation in ineffective programs that will only lead to relapse, hospitalization, or worse, death.
Yes, the reality is there does need to be a crackdown on these unethical and fraudulent “sober homes” and ineffective “treatment” facilities. However, what is going to happen after that? Let’s not throw the baby out with the bathwater. The problem is not with the fact that there are unscrupulous people out there ready to take advantage of a faulty system. This happens in any organization or industry where there is a faulty system in place. The real problem is that there is not enough attention being paid to the real issue, the disease of addiction and the need for more effective treatment.
The problem of addiction needs to be the focus of our attention. Last year alone there were over 52,000 deadly opiate overdoses in the United States outnumbering that of car fatalities. Add in another 88,000 alcohol related deaths and the number of deaths from addictive substances becomes staggering. This is close to the equivalent of a passenger 747 jumbo jet airliner crashing every day for a year. This does not even include the deaths of other addictive legal and illegal substances. It is estimated that the use of addictive substances costs our nation $740 billion dollars annually. Let us not lose focus on the true issue.
Let’s also not lose sight of the fact that there are a number of well-established and effective treatment centers and “sober homes” throughout the country that have been in operation for years. These are facilities that are committed to working with a population that have long been neglected and now preyed upon. These are the facilities that need to be recognized and supported.
Established treatment programs will be staffed with credentialed licensed professionals. The facility is also usually certified or is in the process of getting certified by an external credentialing organization such as the Joint Commission or the Commission on the Accreditation of Rehabilitation Facilities (CARF). The facilities will have established levels of care with clear clinical guidelines as to treatment philosophy and outcome. Involvement with the person’s family and support system will also be an integral part of the program. Transparency and openness for others to see the work they are doing is tantamount to their efficacy and success.
The credible sober home will also have the same transparency and openness. The facility will usually have structured ground rules and 24-hour supervision. The main goal being a time limited supportive living environment geared toward assisting the recovering person getting back into the mainstream of life and personal direction. Most important, it will not have any affiliations with insurance or with a treatment facility. A credible sober home may be endorsed by a number of treatment facilities but they will operate independently and separately of those treatment facilities.
The bottom line is that there is effective and meaningful treatment out there. It is just a matter of finding those places. It is going to take a concerted effort of accountability at multiple levels to address all the problems at hand with addiction. There is no one entity to blame. Lawmakers, healthcare professionals, treatment programs, the insurance industry, and families are all going to need to take a closer look at what they can do to address the problem of addiction.
– Thomas G. Beley, PhD, LCSW
Palm Healthcare Company
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In the past few weeks, there has been an influx of negative coverage from some very prominent voices in media, including the New York Times and most recently Megyn Kelly in an NBC News Investigation piece, about the issues that have been plaguing the South Florida recovery community. Bad news travels fast, and these days every bit of it goes viral. There is a lot to say about the topic. A lot has already been said, but this conversation means something very significant to a lot of people.
This is nothing new; stories from various sources have been published over the last few years. From local news outlets like the Sun Sentinel or Palm Beach Post, to more nationally (or internationally) known outlets like BuzzFeed, cautionary tales have been reaching out to warn people about the dangers of illegitimate and unregulated drug treatment and sober homes.
Reports have highlighted the devastation of the opioid overdose crisis, and rightfully so.
They have exposed some of the most apprehensible and illicit activities of patient brokers and fraudulent facilities.
The media has engaged in a full-on assault against the corruption and criminality of the South Florida drug treatment industry, and we have a few words for them…
THANK YOU… FINALLY!
With great gratitude, we thank the media for all the coverage of everything wrong with the treatment industry, because it is about time we all addressed these problems.
Finally, we have more people paying attention to the serious and life-threatening faults of shady and illegitimate drug rehab and sober home companies. Any number of the recent reports will show that for years unscrupulous con-artists have profited millions of dollars off of the suffering of some of the most vulnerable people in the country, under the pretense of providing some semblance of health care and therapeutic value.
For too long there have been grossly unethical practices involved in those abusing the treatment industry. Human trafficking in the form of patient brokering and providing drugs to relapsed addicts in order to defraud insurers are only part of this complex issue.
Thankfully, there are finally more proactive steps being taken to prevent these issues from continuing or escalating to even more extremes. The state attorney, along with the efforts of law enforcement and task forces, are taking more action against those who exploit the system. As far as the limits and loop holes, new legislation is being advanced. Arrests and raids are putting an end to many of these illegal enterprises.
“But there is hope”, as Cynthia McFadden on the NBC news video put it. As per the interview on Megyn Kelly’s program, Palm Beach County State Attorney Dave Aronberg states that they have made 29 arrests in Palm Beach County since last July, being patient brokers, treatment center owners, and corrupt doctors and with many more to come.
Thank you… but we need more action!
Respectfully, and with humility, we think we would all fare better without making statements that paint the entire treatment industry and the recovery community with a broad stroke of prejudice. Especially when it comes to distinguishing addiction treatment facilities from sober living facilities, because they are not the same thing. A lot of stories forget to mention that the issues with sober living may often have nothing to do with the treatment industry, and that almost no one ever send their loved ones to South Florida for sober living homes.To learn more about the difference between these two, subscribe to our blog and check out our FREE e-book:
5 Critical Mistakes To Avoid When Picking A Sober Home
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Still, we should lay out all the facts.
Some reports will claim Florida has the worst overdose death rates in the nation. The only problem… it’s not even close to true.
For example: Florida actually had less overdose deaths per 100,000 people than 23 other states! These numbers include the top 5:
- West Virginia- 41.5 per 100,000 people
- New Hampshire- 34.3 per 100,000 people
- Kentucky- 29.9 per 100,000 people
- Ohio- 29.9 per 100,000 people
- Rhode Island- 28.2 per 100,000 people
Meanwhile, Florida is 24th on that list. Florida has experienced increasing rates of drug overdoses over the last few years, although still not in the top 3 states as of the most recent figures. Yet, people forget to note that overdose rates don’t necessarily mean overdose deaths. The distinction may seem small, but ask any addict and they will tell you there is a big difference.
Of course we should not ignore the bad, and we all know the opioid epidemic is bad and Florida has suffered greatly. But it is an equal injustice to ignore the facts plaguing the rest of the country. It is also unjust to condemn the treatment providers who still believe in doing the right thing. It is true that there are more unethical and illegal facilities than previous years. But to assume every facility qualifies for this kind of categorization is unfair, to say the least.
Let us not forget, South Florida is home to some of the best high-quality holistic drug and alcohol treatment in the country. There are numerous addiction treatment providers who have been serving South Florida and the recovery community for decades; helping countless people in pain while making consistent contributions to the sustained improvement of their clients and their communities.
But again, we thank those who are out there challenging the current system and demanding better care. This call to action means those of us willing to suit up and show up have all the more reason to keep doing what we believe in. It means anyone looking for treatment will know what to look for and what questions they need to ask, because this is vital to keeping their loved ones safe. Asking the right questions can lead you to the right kind of help.
All this means the South Florida treatment providers who are committed to helping people will step up and show that what we do makes a difference.
For a more detailed look into the difference between addiction treatment programs and sober living facilities, download our FREE e-book:
5 Critical Mistakes When Picking a Treatment Center and How to Avoid Them
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The impacts of the indecent and deceitful practices that have touched the treatment industry are heartbreaking. We all see the dire tragedy of it, including those of us in the treatment industry who still believe in helping people who suffer.
Accredited and legitimate treatment providers are also impacted by these problems. Patient brokers will sometimes infiltrate high quality and honest facilities disguised as patients themselves in order to recruit patients to other illegally operated facilities. Brokers sell their victims false hope, with promises like:
- Material gifts
- Cash payments
- Free rent
Brokers can end up pulling patients out of treatment, against medical advice, in order to exploit their insurance benefits without equipping the individual with any level of care or even basic security. This terrible strategy is one of the obstacles that authentic treatment providers must frequently try to overcome; the outside influence of people trying to take advantage of the entire industry.
So again, THANK YOU. The more light we shine on the shady parts of what has happened, the more people will see where the greater danger exists. Addiction treatment in South Florida is NOT the problem; people who exploit addicts fighting a life and death battle and call it treatment… THAT is the problem. Not to mention the environment in the nation that is breeding this opioid crisis in the first place.
Our hope is, as we strive with all we can to improve how we care for and address substance use disorder and its related issues, that we can inspire others to see that real recovery is possible. We hope our dedication to creating lasting change in the lives of all the people who come to us for help will prove that people can recover, and that treatment does work.
Perhaps most importantly, we thank the media for raising awareness and igniting a conversation. Since the first few reports started to gain popularity, more people are talking about it. The momentum has created a greater platform, and we need to make it count. More people are connecting to the discussion, which means there is more hope than ever of finding a solution.
I will say what I said in an article last week, in case anyone missed it… we are in this together.
This unites all of us in a common objective- to end the extortion of the men and women, sons and daughters, fathers and mothers who need our compassion, now more than ever. With compassion, we can meet in the middle and have a real conversation. It means dropping the stigma of substance use disorder and having an open dialog about how we can all help each other make this country, not just South Florida but all of America, a better place for the addict who still needs help.
We still believe in the value of quality care. We still believe in the recovery community of South Florida, and because of it we are grateful that something is being done. While we still think there is plenty more to do, we are hopeful. If no one talks about it, no one will be willing to help fix it. Hopefully we will be able to move this conversation toward how we can best take care of each other, especially those who have already lost so much. Our mission is to take this topic from what is wrong with those who hurt people and turn it to what is right and what has been accomplished for the people who needed it most.
It is time we really work together to make a difference. Politicians, law enforcement, health care advocates, trustworthy and accredited treatment providers and members of the recovery community have to pull together and speak out about this if we ever want it to get better.
While some people may disagree with this piece and the delivery, the media has at least accomplished something- they have reminded us of an important part of the conversation. Surely, South Florida has an amazing recovery community, but if we pretend it is perfect it will never get better. Awareness might help us change everyone’s perspective.
So to the New York Times, Megyn Kelly, NBC News and all other news outlets, with gratitude and humility, hope and compassion… we thank you.
P.S. For more on this subject, like us on Facebook or subscribe to our blog. We look forward to keeping up the conversation.
For more information on how to find a safe, ethical and effective addiction treatment program make sure to explore more of our Palm Healthcare Company website. If you or someone you love is struggling, please call toll-free now. We want to help.
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Recently I came across an article with a title essentially warning people not to send their family members to Florida for drug and alcohol treatment. The interviews argue that high rates of overdose should justify officials urging people in other states not to send their kids to treatment in the area. However, the article also acknowledges that “South Florida has long been a destination for world-class addiction treatment” and includes a quote from Palm Beach County League of Cities member Andy Amoroso stating:
“Stop sending your children and your loved ones to South Florida,”
I think there is a real problem with this kind of statement though…
It ignores the fact that most people looking for recovery come from states with much worse issues of overdose crisis than South Florida.
To be clear, Florida has seen a spike in drug related issues, but guess what… so has basically everywhere in America! We are in the midst of a drug overdose epidemic all across this nation.
For example, let’s talk about where I came from. In 2014 I wrote about how my home state of Ohio led the nation in opioid overdose deaths. Ohio now also has the highest rates of heroin related deaths.
1 out of every 9 heroin deaths… happens in Ohio!
Dayton, Ohio is number 1 in the country by many reports for drug overdoses. Today, Dayton is quickly becoming known as the heroin capitol of America.
I have lived in Florida for around 4 years after coming to Delray Beach to get sober. I am an active member of a vast recovery community in the Palm Beach County area, and I would never have gotten the chance to do all the amazing and life changing work I am privileged to do if no one had sent me to South Florida to get help. In all likelihood, I would be dead.
Crunching the Country’s Overdose Numbers
There is no denying that Florida is typically in the top 5 rankings when it comes to total overdose numbers. However, there should also be some context to really show the difference between how other states are being affected. To get a little perspective, I want to run down some numbers.
The Henry J. Kaiser Family Foundation compiled data from every state in order to show some details on the opioid overdose crisis. In those numbers they discovered the top 3 states in opioid overdose deaths for 2014 were:
Ohio- 2,106 opioid overdoses- which was 7.4% of nationwide deaths
California- 2,024 deaths
New York- 1,739 deaths
Out of 10,584 nationwide heroin related deaths in 2014, 1,208 were in Ohio. That is 11.4% of the countries heroin deaths in a state with a population a fraction of the size of California’s, New York’s and Florida’s.
In 2015 the top 3 states for overall overdoses were:
In 2015 Ohio’s overdose death rates jumped again to 3,310. In 2016 those numbers are again expected to have skyrocketed to well over 4,000.
While we should acknowledge that the entire state of Florida had around 3,228 overall overdose deaths in 2015, Florida actually had less deaths per 100,000 people compared to 23 other states! These numbers include the top 5:
West Virginia- 41.5 per 100,000 people
New Hampshire- 34.3 per 100,000 people
Kentucky- 29.9 per 100,000 people
Ohio- 29.9 per 100,000 people
Rhode Island- 28.2 per 100,000 people
As well as:
So while Florida may be experiencing high rates of overdose, we need to see that dozens of states are seeing a much higher percent of their population be killed by drugs. Some states have less than half the population Florida does, but are still suffering with tragically high percentages of their population dying from overdose. Those people who want help deserve access to that same “world-class addiction treatment” that South Florida has to offer. For several years, countless families across the U.S. have suffered while the resources and the community in South Florida has helped to save thousands of men and women who needed a little hope and a second chance.
Prescription Drug Problem
In the Midwest, the problem with prescription drug abuse is an extremely distressing element of the opioid crisis. In 12 states, the number of opioid painkiller prescriptions actually exceeds the number of residents living in those states! This includes:
Out of the 1.3 million people living in this state, there were 13 million doses of opioids dispensed in a 3 month period!
Just in case you haven’t seen the news in the past few years, prescription drugs have been one of the largest contributing factors to the current opioid epidemic and the rise in heroin addiction.
The reality is professional and effective treatment programs in South Florida save the lives of countless people from all over the United States. The positive impact on the world is immeasurable. The reason so many people travel here for treatment is not just the fact that there are beaches and sun in Florida (Although they are amazing). They travel because so many of the states being hit the hardest by the opioid epidemic are states that have limited resources when it comes to comprehensive drug addiction treatment.
We aren’t traveling here to bring drugs Florida had never heard of before. We’re trying to escape the familiar and fatal atmosphere we were stuck in for so long. We take this drastic step in a desperate time because we want to believe the help is out there.
Some would still argue that a large number of treatment centers creates a problem with corruption within the industry itself. One can’t argue with some of the stories we read, but if that’s the case maybe instead of turning people away we should be educating people on the most important things to look for in a legitimate treatment program. We should encourage families to seek out qualified and established addiction specialists. Instead of insisting they shouldn’t trust the industry; we should be telling them to look for the accredited addiction specialists who have earned a respected reputation through their record in service and their certifications. Let’s celebrate the treatment providers who do make a difference instead of signing on for whole-sale condemnation.
At the very least, lets teach them to make sure a treatment facility in South Florida is approved by:
The Joint Commission is a United States-based nonprofit organization that accredits more than 21,000 health care organizations and programs in the U.S.
Florida Department of Children and Families (DCF)
The DCF is a state agency providing social services to children, adults, refugees, domestic violence victims and a number of other groups.
To learn more about how to find an accredited and effective treatment program, download our FREE e-book
“5 Critical Mistakes When Picking a Treatment Center and How to Avoid Them”
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No matter where we live we should never turn people away from our community for help. We should provide a platform for awareness. It is critical that addicts and their families know what makes effective treatment programs important. Florida should always be proud of the strength of its recovery community.
We are in this together
Accurate and detailed data for overdose death rates 2016 is not yet available. Yet it is estimated that almost 60,000 Americans died last year from drug overdose. Some experts say over 2 million Americans are suspected to be opioid dependent currently, and that overdose death rates in 2017 are only going to get worse.
Of course, it is understandable that people are concerned about the strain that addiction and overdose puts on their communities, but there is something we cannot, as Americans, forget… we are in this together. In the article I mentioned previously, one of the individuals quoted spoke of people struggling with addiction like we are all inconvenient intruders who have no place in their neighborhood. Thankfully, this is not the experience many of us live with.
I have to say it again… We are in this together.
We are all citizens of the same free country fighting the same fight. Even more important, we are all human beings. Every one of us is free to seek something that can save us. I often believe I would have never had this chance if I had not come to South Florida. I didn’t know what was possible… and thankfully nobody told me not to come looking for it. Nobody told me I wasn’t welcome.
This isn’t just about South Florida; any community with addiction treatment programs and a recovery community should know, we get it. We understand how it can seem a little scary when you think your neighborhood is changing. It’s easier to say “as long as it’s happening over there” until “over there” becomes everywhere.
At the height of the opioid epidemic in America, it is certainly not the time to hide the welcome mat and use fear to scare people away. It is time to make our voices louder and unify the recovery community to show more people that recovery is possible. Until more treatment opportunities are advocated for across the country, we will use every resources we have to preserve and protect the lives of those who are suffering. South Florida is still a great place for addiction treatment. If no one has told you yet, you are welcome here!
Palm Healthcare Company has been serving the South Florida community for 20 years, now with multiple specialized facilities and innovative holistic treatment programs designed to help create lasting change. If you or someone you love is struggling with substance abuse or addiction, please call now. We want to help. You are not alone.
CALL NOW 1-888-922-5398