In the early 1990s, Rimrock Foundation was visited by producers and camera crews from the popular CBS news program 48 Hours. It was a time when legalized wagering was beginning to experience explosive growth, due to largely to tribal expansions into the casino business, and 48 Hours had come to Rimrock’s facility in Billings, Montana, to examine some of the fallout from gambling’s rapid spread. "They spent about a week here, and they were fascinated by what they found out," says Rimrock CEO David Cunningham, adding that it was clear to the 48 Hours journalists when they left that there was indeed a very dark underbelly to wagering’s blistering pace of expansion throughout America.

Not too long ago, Chaz Cabela came across a case, a female desperately in need of help, where he could not refuse admission, even though the woman did not have the means to pay for care. A wealthy scion of a catalogue and retailing family, Cabela has sharply boosted the charity care offered at South Florida-based Advanced Recovery Center, ARC, since he bought the cen- ter two years ago. “If there was ever a case of desperate need, this was it,” says Cabela, who is of that unique and ubiquitous type of treatment industry entrepreneur, the type who goes to treatment, gets clean, and then decides to buy or start a treatment center...

Not too long ago, a client arrived at Clear Haven Center that presented the center with a unique set of challenges.

Back in the 1970s, Don Mullaney was leading a colorful double existence, by day working for Rensselaer County in upstate New York teaching prevention in the schools, while partying very hardy at night. Fast forward a few decades, and Mullaney is one of the very top players in the booming South Florida market for private addiction treatment services. As the founder of Behavioral Health of the Palm Beaches, Mullaney was a pioneer of the Florida Model of care, a cross between outpatient and residential developed in the 1990s that helped lead the treatment industry out of the darkest days of the managed care cutbacks. 

About 20 years ago, Chris Crosby, now CEO of thriving South Florida-based Watershed Treatment Programs, was working at Boca Ratonbased Anon Anew as an interventionist. Crosby was one of many such interventionists throughout the nation who then mostly worked as quasi in-house marketing agents at treatment centers around the country.

In 2002, Barry Karlin was approached with a deal to buy a group of methadone clinics. Since then he’s been on an opiate clinic acquisition tear, with CRC Health Corporation emerging as our nation’s biggest methadone dispenser, and Karlin as...

Almost forty years ago, doctors in tiny Norton, KS - a mostly agricultural enclave in the Northwestern part of the state - began to notice that an alarmingly large number of admissions to the local emergency room seemed to have a common substance abuse thread.

Several years ago, Caron Foundation’s information technology director Bob Wagner found himself at a fork in the road, needing a new IT system. For years, Caron - which in the 1990s effectuated a remarkable turnaround under CEO Doug Tieman’s new leadership - had used Substance Abuse Treatment Information System, SATIS, Betty Ford’s in-house system that the renowned treatment center had decided to commercialize in the 1990s.

When you talk to Chris Crosby about managed care, it quickly becomes apparent that you're talking to a man on a mission: "The whole way managed care approaches addiction treatment is a travesty," says Crosby, who, as CEO of South Florida-based Watershed Treatment Programs, runs one of the nation's largest and fastest growing treatment operations. "The payors wouldn't dream of denying coverage to someone with diabetes who has, yet again, ignored the advice of doctors about diet and exercise and wound up, yet again, in the hospital. But if an alcoholic seeks help repeatedly, that's somehow less worthy? The situation our industry finds itself in with respect to the payors is absurd and wrong, and it needs to change."

In 2002, The World Health Organization identified alcoholism as the third leading risk to health in the developed world, and the leading risk in low mortality developing countries like Russia. When WHO data on tobacco and illicit drugs are thrown into the mix, substance abuse emerges as probably the leading cause of death and disability worldwide, substantially beating out other single causes like high cholesterol, unsafe sex, obesity and diet deficiencies.

In the late 1990s, the family that owned diversified medical and behavioral health services provider College Health Enterprises made a fateful move, resolving that they would sell the youth division of the company. Hindsight is golden, but maybe they would have decided differently had they known that the unit, now known as Aspen Education Group, would become one of nation’s largest and fastest growing private providers of therapeutic services to the country’s growing ranks of troubled teens.

Several decades ago, Mary Jane Hanley was living in St. Louis as the wife of an ambitious corporate executive who had moved to the city to become CEO of chemicals and agricultural giant Monsanto. It was a different time, one in which young women were expected to support their husbands careers, a role that more often than not required extensive participation at company and executive social events. Mary Jane willingly participated, but it was not easy for her. “There was a lot of entertaining when Jack was moving up the ladder,” she said. “I was shy and I found out that a few drinks helped me get through it.”

It was many years ago that Dr. Morteza Khaleghi had his epiphany about addiction, related as it was to problems his wife’s side of the family had with the disease. “Yes, I saw the problems,” said Dr. Khaleghi, whose psychiatric education is rooted in the intensive self-analysis required for training in the psychoanalytic modalities. “But I also saw that recovery was possible, and that had a very profound effect on me.” In 1989, Dr. Khaleghi started a psychiatric facility in Northridge, CA, that opened his eyes to the extent that psychiatric ills were accompanied by addiction.

Dr. David J. Brailer is an excellent speaker, and his depth of knowledge in medical economics and information technology were certainly evident to all who heard him deliver the lead speech last fall at the National Summit on Defining a Strategy for Behavioral Health Information Management in Washington, DC. Hand-picked by President Bush to lead the charge on health care information technology issues as the National Coordinator for Health Information Technology, Dr. Brailer spoke eloquently on the urgent need to develop a nationwide electronic health record (EHR) technology, painting a picture of big economic benefits for insurance companies and governments flowing from greater efficiency, as well as major improvements in quality and convenience for consumers.