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HYANNIS, Mass. — The more than 1,000 people attending a national conference for the addiction treatment industry last weekend wore bright blue lanyards around their necks promoting Sovereign Health, a chain of treatment centers that was one of the event’s financial supporters — and was recently raided by federal agents.

Sovereign’s prominent and untimely sponsorship of the Cape Cod Symposium on Addictive Disorders, one of the largest and most influential addiction treatment events of the year, created an awkward juxtaposition for an industry eager to improve its reputation.

Many in the sprawling, $35 billion addiction treatment business are dismayed by revelations of unethical marketing, patient brokering, and shoddy care — all coming as the demand for quality treatment has never been higher amid a national opioid epidemic. Providers say they welcome a crackdown on shady operators, but fear people in need will think they’ll be preyed on wherever they go.


“There’s been a long-running stigma with addiction treatment,” said Maria Ulmer, chief operating officer at Summit Behavioral Health. “Now, we have a different stigma attached to it — that we’re not doing right by the patients.”

The Cape Cod conference attendees are largely counselors, physicians, nurses, and other professionals who take in seminars on everything from the latest medications used in addiction treatment to legal and ethical issues in clinical practice. Many receive educational credits they need to maintain their licenses — and conference organizers monitor attendance with scanners.


“It’s a great opportunity to learn about what is happening in other areas of the country,” said Dr. Yngvild Olsen, medical director for the Institutes for Behavior Resources Inc. in Baltimore and secretary of the American Society of Addiction Medicine’s board of directors, who presented on advocacy at the symposium. Addiction treatment as a health care field — and not a criminal justice problem — is relatively new, she said, and discussions between care providers with different approaches can move the industry forward. “They’re conversations we need to have.”

The symposium, now in its 30th year, is put on by the nonprofit C4 Recovery Foundation, which holds other educational conferences and works to provide treatment access to low income populations around the world, including in Turkey and Palestine. When it began, the symposium was regional and largely focused on alcoholism, said its chief operating officer, Jack O’Donnell; now the emphasis has shifted to opioids, and the event draws providers from across the country.

“For a large percentage of people, they come here to get true education,” O’Donnell said.

The financial engine of the four-day event, however, is the more than 100 exhibitors and sponsors, which include treatment centers from across the country and vendors, such as marketing and drug testing outfits, looking for related business. For the sponsors, the conference is a chance to make connections, win business, and gain referrals.

“The booths support what goes on upstairs,” said Patrice Muchowski, a vice president of clinical services for treatment provider AdCare, referring to educational events. She said conference organizers have worked to bring more sophisticated training and seminars to the event in recent years. Most speakers are not paid, said O’Donnell.

The expansive exhibit hall is a bazaar of flashy offers to get the attention, and business, of the hundreds of attendees who treat people with addiction disorders. Some of the methods used are discouraged by other medical groups and organizations.

There were several money giveaways — from $300 to $1,000 — for attendees who put their business cards in bowls located at the exhibit booths of sponsors. Some companies gave away electronic devices like an Apple Watch, Amazon Echo, and Fitbit; others handed out Visa and Amazon gift cards of up to $250. One treatment center gave away a giant, yellow mum.

There was promotional swag galore. The free items, all branded with the name of the sponsors, included lip balm, stress balls, water bottles, coffee mugs, pens, fidget spinners, notebooks, sling bags, flashlights, wristbands, screen cleaners, cellphone accessories, and hats. One treatment center sponsored free chair massages.

Several other medical societies and health care trade groups have moved to limit the kinds of giveaways prominent at the addiction treatment conference.

The ethics code of the Pharmaceutical Research and Manufacturers of America, known as PhRMA, advises its members to not offer items like pens, notepads, mugs and similar items to health care professionals and their staff, saying they may foster a perception that company interactions with them are based on something other than medical and scientific issues. It also says items such as gift certificates should not be offered, to avoid any potential appearance of impropriety. AdvaMed, a trade group representing medical technology and diagnostics companies, has similar voluntary restrictions.

O’Donnell said that the giveaways at the symposium were different.

“We’re not dependent on each other,” he said. “We’re independent providers out there. And giving away pens and notepads and stuff like that isn’t significant in anybody’s world, and is certainly not going to be a decision-maker on any treatment decisions.”

The money giveaways were for fun, he said.

“I don’t think people look at it as, ‘Oh, because I won a drawing or anything, that’s inappropriate.’ It’s more entertainment,” he said.

Several attendees privately expressed embarrassment at the prominent branding of Sovereign Health at the conference. The company, on its website, highlighted “the honor of being a silver lanyard sponsor” of the symposium.

In June, more than 100 federal agents raided several Sovereign facilities in California, searching for evidence of health care fraud, illegal patient referral payments, and money laundering, according to court documents filed by the company.

Sovereign has repeatedly denied any wrongdoing while accusing federal authorities of conducting a “Mickey Mouse” operation based on false and misleading information.

O’Donnell said conference organizers took the approach that the company was innocent until proven guilty.

“We think we have a relationship with somebody that we trust. And they say, things are gonna be fine, so to speak,” he said. “We give people, sometimes, the benefit of the doubt.”

  • I worked in addictions and mental health until 1996 for 20 yrs. This symposium ..the largest…and other conferences gave new education on various topics to possibly give better patient care. The thought that a group such as one being raided by FBI and then hosting this symposium would not have happened 20 yrs ago. The field has mushroomed into producing unethical providers whose goal is profit …bogus expensive treatment centers..patient brokering…in my state a huge organization has several methadone clinics who are run so poorly it is a sin. I got out because after HMOs came inin 1990 1991
    .the quality of care went to pot my opinion. I live in a state that has oneof the highest overdose rates and after almost 5 yrs since the first community meeting around this crisis see very little done to open more treatment beds and provide necessary continuity of care. I checked out the group hosting thr Symposium….they present as there isnt ANYTHING they can treat….cater to private insured.. No medicare medicaid free care beds here..and are entirely too slick for me. The lack of movement to really fight this crisis is unbelievable.

    • The conference is put on by a non-profit that educates addiction professionals. They are not a treatment center. In order to provide this education (some 50+faculty, 60+workshops), they have to have an exhibit hall and sponsors. There is nothing unethical or wrong with this. Same as for any professional organization or association that has a conference.

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