The Other Side of the Coin

Dr. Alison Tarlow

The Other Side of the Coin

The reputation of South Florida drug treatment has now spread across the globe. Whereas before, the recovery mecca known as Delray Beach was a little known fact to, well, many residents of Delray Beach. The epidemic-like proportions of opioid-abuse, as well as overdose and death, and the abundance of treatment centers and “sober homes” have catapulted our once serene oasis for sobriety into a den of iniquity. The media are feverishly covering stories of insurance fraud, scam-artists, and everyone from doctors to barely-qualified “recovery coaches,” who are being blamed for taking advantage of families and their loved ones when they are in their most vulnerable state. As if families were not paralyzed enough by the fear of opioid addiction gripping onto their beloved kin; now they have to question every relapse, every new treatment center, and every new halfway house, over and over again. And I say this because the relapse rates for opiate addiction are both astounding, and incredibly demoralizing. The bad news is that the chances of a “one and done” treatment experience with opioid addiction are low.

The good news is that research has determined that treatment can and does have a cumulative effect, meaning that being in treatment any number of times does not negatively correlate with the chance of long-term recovery. In fact, statistics tell us that the opposite is true: more treatments, and longer treatment stays, are both positively correlated with the ability to sustain long-term sobriety.

So what is the other side of the coin? The other side is the one that touts hundreds upon thousands of people whose lives have been saved because of the treatment and concomitant recovery support that they found in South Florida. Not only are there some of the best national and international treatment programs located here, but there are also leading doctors, pharmacologists, and evidence-based interventions. From CBT to DBT to MAT (we treatment providers love our 3-letter acronyms); we also work tirelessly to develop industry standards that are soon followed by other states. We have task forces and state laws in action, and we are a trailblazing state for addiction treatment laws around the country. We are a hub for state-of-the-art conferences, and people from around the nation and the world come to Florida to attend our educational programs to receive the most up to- date information in the field of substance abuse and treatment.

If we take a look back, we can see why Florida has become so infamous for substance abuse, treatment, and recovery. In 2010, Florida was considered the pill mill capital of the country. In 2012-2014, the pill mills and pain management clinics were regulated and closed down by the DEA. Addicts were no longer able to buy pills like Oxycontin so readily and cheaply. Supply and demand drove up the costs of the highly-abused narcotics, and so heroin became the cheaper and more accessible way for the addict to get their fix. And gone were the days of the “street junkie.”, now, opiate addicts were coming from all walks of life; suburban kids, housewives and business men. Between 2012 and 2017, heroin made a massive comeback but now the drug is frequently being mixed with Fentanyl, a synthetic opioid used for surgical anesthesia.

This mix has produced a much greater risk for overdose and death, and the drug combination is the number one killer of young people across the United States. In reaction to this, South Florida recovery facilities began to rise. What began as the few and the reputable programs in South Florida soon became as common as Starbucks… practically one program or recovery house on every corner. There was, by all accounts, a treatment boom. It was not so different from the mortgage crisis, in which an economic boom brought out the crooks looking to scam and make a fast buck. It seemed that there was money to be made off the people seeking treatment, and so just like every other industry boom that has unfolded in the history of our country, the bad guys started to emerge among the good guys, to see how they could economically, and perhaps even literally, rape those most vulnerable, who were seeking treatment to save their lives. And so the dirty side of treatment began to rise to the surface, and the Megan Kelly’s of the media decided to cover the issue from its most ugly angle. Let’s face it: the world loves a story, and the seedier, more “under-belly” version, all the better.

Permit me please to share a short anecdote: In the early 2000s, I worked for a renowned women’s eating disorder facility as a lead psychologist. We were approached by an award winning photographer who was looking to shoot a documentary film on Eating Disorder treatment and recovery. The director spent many months shooting at the facility, and many more months editing and producing the film. The film was met with critical acclaim, and went to the Sundance film Festival in 2006. My first awareness regarding the approach to this film came to me when the producers were looking for several main characters to follow in treatment. These personalities, we were told, needed to be raw, gritty, and heart-wrenching. The protagonists of the film had to be suffering and struggling, and the more unmanageable their symptoms and behaviors, the better. Although I realized it was a documentary, rather than a fictional tale, it was clear that the filmmaker was not seeking out a happy ending. Of course, it was not supposed to be a fairy-tale. The most compelling individuals – the lost souls – were sought out for the film. By the time the editing was complete, most of the scenes that remained demonstrated the harshest aspects of treatment, and the most demoralizing of outcomes.

Was this an accurate representation of what we did each and every day to help these women who are struggling with a life-threatening illness? Was this an accurate representation of professionals working in treatment, individuals seeking recovery, and treatment outcomes? No. What would have been a more accurate representation would not have made the Sundance film Festival, nor would it have made for a massive HBO documentary following. In fact, two years after the film was made, one of the characters died. The producers went back and added a line to the end of the film, informing viewers of this tragic, final outcome. Heart-breaking-yes. Compelling- absolutely. What you don’t get to read is the follow up on the two other main characters, both of whom went on to develop full lives, including a family, professional success, and overall health and happiness- despite any struggles they had to overcome.

And so, back to the other side of the coin; what about the success stories that have sprung from the hub of recovery in South Florida? Well, truth is, there are simply too many to discuss. There are thousands of people filling up the meeting rooms of NA/AA/ and various other “A’s” around Dade, Broward, and the Palm Beaches. Many of these people gain years of clean time and then get jobs helping others in recovery. These are people who go back to school and complete their degrees. These are people who are allowed back into their family homes, lives, and hearts. These are the people holding out their hands in sponsorship or support to addicts who are new to recovery. These are bosses giving jobs and 2nd, 3rd, and even 4th chances to young people who are desperately trying to turn their lives around. These are people who extend their hands and their hearts to those family members who were not so fortunate on their journey to recovery, and say with humility, “There but by the grace of God, go I.” The good news is that, with focus on the South Florida treatment industry by the Federal Government for the past few years, many illegitimate operations have been found out and shut down.

Furthermore, the pop-up programs and sober homes looking to make a fast buck, with minimally-trained and experienced staff, have folded. Key scammers have been arrested, tried, and sentenced, leaving room for the legitimate, professionally-run, morally and ethically-guided programs to remain. South Florida has been under the spotlight, and therefore, if you fi nd the right people, and ask the right questions, you can and will fi nd wonderful treatment facilities and sober homes that have every intention of helping your loved one. These programs offer empirically-based treatments, and with highly-trained professional staff. These facilities have master’s level clinicians, doctoral level clinical directors, and psychiatrists who specialize in addiction medicine and medication-assisted treatments. These are programs that are accredited by both state and private agencies, in order to maintain the best possible standards of care and treatment. These are professionals most concerned with saving lives, who will do what it takes to help those who demonstrate that they truly want the help. Years of training and experience in this field allow these professionals to know and understand the difference between those who are just treatment surfing, and those who are really there to save their lives. We know that chances can’t just happen once or twice, but that sometimes to really “get” recovery, you might have to go a few times around in treatment, or more. We know that it can be hard to put your finger on what makes that difference; that “a-ha” moment when the light-bulb goes on, or the spiritual awakening occurs, or the God Moment happens. It could come from a process-oriented group, a psycho-educational tool, a talk with a behavioral health tech who has 3 years clean and understands exactly the struggle it takes to remain in treatment and complete the program. It could be from opening the Big Book and reading a paragraph that resonates. And maybe it is from hitting the bottom and feeling sick and tired of being sick and tired.

Whatever it is, it happens, and it happens in South Florida – at our treatment centers, at our sober homes, and at our 12 step meetings. There are passionate, ethical professionals in South Florida, and we are willing to guide you as to what is in the best interest of your loved one. We will be at the task force meetings to be sure we understand the laws, and speak up about what changes we believe are necessary for the betterment of the community. We are on the front lines, working 24 hours a day, 7 days a week, to prevent another overdose and death from happening. We rejoice when we learn that a client who came to South Florida for treatment two years ago, just picked up their 2-year medallion back in Colorado, and another picked up 7 years after coming to South Florida for treatment from Charlotte, North Carolina, and never went home again, but instead remained here to get educated and give back to the recovery community. We cry when we learn that we have lost a battle and feel devastated, and then have to get back up again, and go back into the fi ght; for it is a war on addiction, and we are the soldiers. And for every media horror story, there are countless success stories. And every day, there is hope. And that, my dear readers, is the other side of the coin.

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the states
of Florida and Pennsylvania. She is also a Certifi ed Addictions
Professional, and Florida Supreme Court Certifi ed Family Mediator.
She is Clinical Director of Holistix Treatment Centers, including
Holistix Margate, and The Detox Center, West Palm Beach.