When Laurie Couch joined Affected by Addiction Support Group for the first time, a closed Facebook group with 70,000 members, she felt a sense of belonging. Here were people who understood their struggle to care for a child addicted to drugs, and were there to support her, at any time of the day or night. She began to respond regularly to people who were grappling with cravings and comforting parents devastated by their children's addictions.
Private addiction support groups abound on Facebook, and Affected by addiction is one of the most prominent. Last June, group owner Matt Mendoza spoke at the Facebook Community Summit, where Mark Zuckerberg unveiled his plan for a total of one billion people in "significant groups." In July, Zuckerberg posted a glowing review of the support group on his Facebook page. The group was profiled by Good Morning America in February, sparking an avalanche of new members. In the segment, Mendoza told the hosts that "there have been hundreds, if not thousands, of people who have received treatment as a result of this community." It did not expand the process.
In March, Couch's son almost overdoses. They live together in rural Kansas, where they do not have access to much personal support, which is part of what made addicted to addiction attractive to begin with. As a result of his overdose, he approached the group in search of comfort and encouragement while being scared and discovering what to do.
Soon after, a stranger named Garrett Hall sent Couch a Facebook message.
"Hi, Lauri [sic] I saw your name in the Affected By Addiction support group, and I had this strange / strong urge to simply reach out," Hall a Couch wrote. "[A] Are you doing well?"
Although there is no indication of this on his Facebook page, and he never mentioned it to Couch, Hall had a professional connection with Affected by Addiction. Between 2015 and 2016, she worked for the Mendoza blog company, Addiction Unscripted, owner of Affected by Addiction.
Hall never revealed to Couch that he had professional ties with Addiction Addicts. He simply offered to put her in touch with "someone I have come to love in the last 12 months."
"She is the woman who helped me recover sobriety and my life returned to normal and has helped so many people and families," he continued. "I honestly believe that she is a miracle worker, she is my hero."
Couch soon received a call from Meghan Calvert, a saleswoman at a treatment center called Pillars Recovery. It is owned by Darren Orloff, who is part of the volunteer leadership team of Affected by Addiction. Couch, who has sales experience, knew a sales pitch when he heard it. She told Calvert to take advantage of the desperate people.
"I contacted Laurie to see how he could help," Calvert answered when I approached her. "I have a large list of free resources and I offer assistance to anyone looking for free or private options … Garrett has never asked me for anything in return."
After the call, Couch was surprised to discover that he could not log in again for Affected by Addiction. In fact, she realized, it had been banned. The experience left her feeling paranoid, as if she could not trust anyone. He warned his son to be careful with support groups.
The combination of the opiate crisis and Obamacare, which facilitated obtaining insurance covering addiction treatment, has fueled a boom in the rehabilitation market. Centers that manage to attract clients with the right insurance policies can make huge profits, and some spend millions of dollars in marketing to do so, often attracting addicts from across the country to rehabilitation centers in Florida and southern California.
It is not uncommon for rehabilitation centers to use deceptive advertising or offer incentives such as airline tickets to people with lucrative policies. Sellers often contract with treatment centers that pay them to attract customers, either per person or through a monthly contract. Individual patients are so valuable that the system has spawned a market for "patient intermediation," where centers, sometimes illegally, buy and sell the right to treat a particular person.
It is difficult to put together a consistent set of ethical standards in the marketing of treatment centers. Each of the dozens of owners and operators of treatment centers I spoke to in the course of this report was quick to condemn the intermediation of patients, but they also complained that it is difficult for them to stay open without buying clients like everyone else. the rest. Some people say it's okay to pay sellers monthly contracts but no bonuses; Others say that it is OK to pay performance bonuses as long as they are not strictly linked to the number of patients. But there are two general rules that emerge every time: 1) do not be misleading about who you are, and 2) do not blatantly pay for patients.
"Outside of paying per head, it becomes a really gray and ambiguous area where people are walking," said David Skonezny, industry consultant and founder It's Time for Ethics in Addiction Treatment, a Facebook group where industry professionals discuss both general principles and specific treatment centers. He says that people can be involved in brokerage while they think they are doing the right thing: help people get sober and receive a payment to boot. But he urges addicts to be extremely cautious, especially online.
A few months ago, Skonezny posted a warning in his group, encouraging members to spread it on Facebook: "CAUTION: Many times people in social media groups are solicited or respond to publications that appear to be an offer of help when these posters really represent unscrupulous centers and receive compensation … for referring you or your loved one to a treatment center or sober life ".
Rehabilitation specialists have adopted the internet, where technology companies have increasingly made it easier for them to choose the most desperate goals of the crowd. Last year, after reporting deceptive rehab ads on Google, the company temporarily banned ads from treatment centers. Google has announced that it will allow them to do so again, provided that the centers and their operators pass a background check and verification of the license. Few interested parties with whom I have spoken have faith in that solution.
On Facebook, rehabilitation marketers are even harder to pin down. Some advertise publicly as representatives of a given center and offer their help to people who are struggling. Others run community support groups without revealing their financial interests, creating a group of people seeking help to find potential clients or spending time in groups that already exist, waiting for potential clients.
Brandon Bergman, Research Scientist and Associate Director of Recovery The Massachusetts General Hospital Research Institute studies addiction and recovery in young adults, and is particularly interested in the role that online communities could have in the results. He cautioned that there is no empirical evidence that online communities have benefits for people in recovery, but he says it is reasonable to assume that they have some of the same benefits as in-person support groups, and some of the same risks.
"There is a long history of people going to [12-step] meetings and that the drug traffickers take advantage of them, for example," he told me. Early recovery is a very vulnerable time and people are desperate for help. It's easy to use that for profit, even convincing someone to go to a specific treatment center. "I'm not surprised that this is happening online because there is nothing special about online space."
In November, I wrote about Affected by Addiction, the Facebook Group where Couch was launched by a marketer, and its links to rehab marketing companies . At that time, Mendoza, the founder of the group, worked as a marketer in a California treatment center called Windward Way, and Affected by Addiction was part of the marketing arm of rehabilitation, although that was not disclosed in the group.
When I contacted Facebook for that story, a spokesperson sent a strange response, saying they knew about the undisclosed conflict of interest, but they thought it was a good thing.
"We know that the management of communities as Affected" The Addiction Support Group can require a great commitment of time … We believe in sustainable business models to create a positive impact in the world ", wrote the spokesperson of Facebook, linking to other community groups, such as a rock collection fan page led by a store selling rocks.
Selling rehab is not exactly like selling rocks and cups. Consumers are desperate for help in the darkest hour. "Laurie Couch, for example, described herself as isolated and in panic when Garrett Hall approached her." I wanted to hear a miracle at that moment, "he said.
Hall did not return requests for comment.
Facebook continues to be a big fan of addicted people, Mendoza is part of its community leadership program, Zuckerberg. loved Affected by addiction on its own page and several Facebook employees published the story Good Morning America on its walls, including Deepti Doshi, director of community associations.
"Few people I've met in recent months have inspired me as much as Matt Mendoza," Doshi wrote. "I'm so excited that leadership and bravery are presented here."
The connection between Windward Way and Affected by Addiction would not have been obvious to the people in the group, but the links were also not particularly hidden. Mendoza managed Addiction Unscripted, the company that manages the Facebook group, outside the Windward office. There was an 800 number on top of the Facebook group that appeared to be a general helpline, but rang directly to the rehabilitation admissions department. The first time Mendoza went to Facebook HQ, he brought his boss, the owner of Windward.
Vendors at the treatment center had to approve all of the group's publications, which gave them the first opportunity to send good candidates for their rehabilitation and try them to convince them to go to Windward in California. They needed that advantage, Mendoza explained to me a few weeks ago, because they knew that such a large Facebook group would be full of other marketing specialists, waiting to enter as soon as a juicy message was made public.
Initially, after my article appeared in November, Mendoza presented a warning about the relationship with Windward Way. Then they broke the ties completely. At the end of March of this year, Affected by Addiction added a set of rules, which include:
"One of the most common marketing scams used by unethical treatment centers is PM people within support groups such as these in an attempt to obtain a client to their treatment center, without any care for clinical evaluation, for that reason … Recommendations of treatment centers, treatment programs or other treatment options, whether public or privately among the members of the group If someone offering a place of treatment contacts you privately, you should immediately contact at least two moderators or administrators. "
"I explained the whole scam to people, that people will leave and that" I will do what I did, "Mendoza told me when I asked if marketing specialists still used the group to search for patients." Obviously, I have committed mistakes. You wrote about my mistakes. I recognize those mistakes. "
He said he had completely retired from the treatment marketing industry, and that he made no money with Affected by Addiction or Addiction Unscripted in 2017. He repeatedly said that he had no idea how to control the treatment centers, so he does not want to be part of the rehabilitation industry, instead, he wants to be part of the recovery community.
He said that three things pushed him to change the way he is affected by the addiction: First, my article made him realize that disclosure was important Second, he had conversations with industry leaders that changed their understanding of the ramifications But the most significant catalyst came at the end of December: his father, who had been fighting addiction, was once again ready to receive help, a decision that Mend In one of the last texts that his father sent to Mendoza, he told his son that the treatment center he had arrived was more important to him than the patient's care. Shortly before the new year, his father committed suicide.
"All these things led to that, but it was my father the big change," he told me. "I think the treatment industry is so polluted that I do not want to be recognized as part of the treatment industry."
Earlier this month, Mendoza announced that he is moving away from his role as leader in the group. In a recent Facebook Live post, Mendoza said he needs to take time for himself, and has given power to a team of volunteers that includes moderators inherited, people Mendoza found when publishing a survey in the group, and the partner who logged on after leaving Windward Way: the owner of the treatment center, Darren Orloff.
Orloff owns Pillars Recovery, where Meghan Calvert, who approached Laurie Couch, works as a marketer.
Mendoza denied knowing that Hall had been sending messages to people in the group. Calvert admitted calling Couch, but said there was no money involved when he got his number. Orloff refused to use the group to recruit patients for Pillars.
"I know Darren very well, and I know that Darren would have no intention of taking us out of course, he has been fundamental in what we have been doing as a leadership group," Mendoza said.
On his face, the relationship between Mendoza and Orloff seems similar to the one he had with Windward Way. As he did with the owner of Windward Way, Mendoza took Orloff to Facebook HQ when he was invited in March, shortly after Couch spoke with Calvert and Hall. Mendoza made Orloff the administrator of Affected by Addiction and published an Instagram video that refers to Orloff as his "non-profit partner". Both share an office on the Newport Beach pier.
Mendoza and Orloff argue that the relationship is very different, and Orloff volunteers his time without financial gain. When I told Mendoza for the first time what happened to Couch, he seemed horrified. "I do not know anything about this, these are new news for me, and this would be against any of our rules, established values," he said. "I have no interest in trying to monetize this anymore, so I would like to get to the bottom of that."
After I started asking questions about Couch, I was invited to the secret Facebook Leadership Group where the two dozen volunteers discuss how to manage the community of 70,000 people.
Because Facebook depends on users to mark bad behavior, instead of actively monitoring groups such as Affected by addiction, it is up to the group owners to put together their own moderation teams and train them to recognize and solve problems. In large groups, these moderators have a huge workload and enormous responsibility, and they take care of everything from suicide members to predatory vendors. It's a lot to ask of any volunteer, especially those who have no training or experience in handling these life or death issues.
That's not acceptable, according to Jesse Heffernan, a consultant who helps advocacy groups develop programs and services, brand development and outreach efforts. The group of moderators affected by the addiction invited him as an advisor while developing his rules and leadership structure. He is no longer actively involved with the group.
"People are looking for help on these digital platforms, which makes them so vulnerable and so easy to tackle if they have unwanted purposes," he told me. "If you [going to] claim to be a support group of 70,000 people, you need to have more than 20 volunteer moderators … It's a full-time job that someone with paraprofessional experience needs to navigate."  Since Mendoza is taking a step back, Orloff is one of the few recovery professionals in a leadership team charged with keeping patient runners out of the group. Orloff admits to having worked with patient brokers in the past, although he says he does not do it anymore.
Until the end of 2017, according to Orloff, Pillars often paid outside marketers to fill their beds, including a company called Sober Services, which is owned by Marketer Shane. Win. Win originally presented Mendoza and Orloff. According to Mendoza, Sober Services also sent patients to Windward Way, Mendoza's initial partner in Affected by Addiction.
Earn has stated in public records that, during the time that Orloff obtained patients from him, Earn's business practices included business clients for chief's fees and getting bribes from insurance claims. Last fall, he filed a lawsuit alleging he had been molested by a different rehabilitation owner, who owed him $ 7,000 for each patient Earn had brought, plus a portion of the money a drug testing lab was paying to the center. referral treatment In total, according to the claim, Earn was owed more than $ 700,000 in commissions and bribes for about a year and a half of referrals to that rehabilitation and its related businesses.
"Two years ago, people did not look at the intermediation client in a bad light," Orloff told me when I asked him about his dealings with Sober Services. "Now I see it wrong, but at that moment everyone thought I was fine and that there was nothing wrong with it." Earn's claim was filed in September 2017. Orloff told me he stopped receiving Sober Services patients in "End of 2017," but said he could not specify an exact date.
The connections between Sober Services and Pillars went beyond patient referrals during 2016 and 2017. Orloff ran Pillars out from Earn's office in Irvine, California, between August and December 2017, at which point he says they separated. In mid-2016, Orloff and Earn registered a corporation called Sober Services LLC, which Orloff says he never did business, but that he intended to take advantage of the merchant's good reputation while providing other treatment-related services.
For much of 2017, Sober Services phone number is listed on the Pillars website. In October 2017, the Sober Services Facebook page published, "Sober Services presents Pillar Recovery: powerful and affordable addiction treatment," with a link to the site and an 800 number for Sober Services.
This period of overlap came to an end, says Orloff, when he discovered that Earn was diverting potential Pillars clients to send them to other rehabilitation centers using the Pillars website. Once Orloff realized what was happening, he cut ties with Earn and moved into his own office.
The Verge tried to contact Earn for comments on several occasions, but never responded.
Meghan Calvert, the marketer who called Laurie Couch, had worked for Sober Services and Pillars in 2016 and 2017, according to Orloff and her LinkedIn. When Orloff left the Sober Services office, she went with him, Orloff said. Calvert confirmed that she started a full-time job at Pillars in November 2017. When I asked for Sober Services, she cited a confidentiality agreement.
When I asked Calvert if he had ever received money or sent patients to the former Mendoza couple, Windward Way, she replied: "Since I worked full time in Pillars, no, I did not." When I asked her if she was involved in patient mediation, she told me in the work she had before Pillars, that "I had only received a check from my employer"
Despite the breakup, Gane still seemed to be enmeshed in Pillars' digital presence until I started asking questions about the relationship at the end of April. At that point, there were two Facebook pages for Pillars. One of them listed Shane Earn at Sober Services as the contact. There was nothing on the page of any of the Pillars that suggested that the two pages be directed by separate people. After asking Orloff specifically about the two Facebook pages, the one that was connected to Earn was eliminated.
The other Pillars page, managed by Orloff, is an administrator in the Facebook community's community, the 600,000 member health care provider meeting place called Show Me Your Stethoscope, which Facebook used as an example of " Leaders Inspiring Change "in an October press release. In an effort to achieve a transparent scope, as advised by Mendoza, Pillars now publicly has a direct reference line for the treatment group.
Facebook has spent a year acting as a cheerleader for community support groups, especially those that focus on recovery from addiction. But scratching the surface of these organizations reveals the need for an arbitrator, instead. Without that, there is nothing that protects the most vulnerable people from the platform of this impenetrable entanglement of altruism and electronic commerce.
Not only is he affected by addiction. There are a large number of groups and Facebook pages targeting addicts and their families, and it seems that everyone, large or small, is a potential hunting ground for marketers, whether the administrators intend to be so. as if not
Last month, a woman posted in another closed group, the Addiction Recovery Support Group, complaining that a member had given her phone number to a vendor.
" When I told them that I was not interested in going so far, they got very rude to me, kept asking about my insurance information and even told me how wrong it was for me to keep hurting my family by not going to the rehabilitation center [their]"he wrote.