Patient Brokering: Human Trafficking in Substance Use Treatment & Recovery

Terry Cluse-Tolar, PhD, LISW-S; Michel Coconis, PhD, LSW & Glenn Abraham, PhD, LISW-S | September 20 | 2:45-3:45 PM

Topic: Research, Healthcare | Knowledge Level: Beginner, Intermediate | Location: TBD

Patient brokering is the practice of referring or selling people with addictions to drug treatment facilities for payment. Some facilities will provide payment immediately to the broker once the patient is admitted. Others provide payment once the patient has remained in treatment for a certain length of time, usually timed by payment of the client’s insurance. Patient brokering is human trafficking that keeps patients in a cycle of recovery. The presenters report on their qualitative study of brokers and what they do. Patient brokering is illegal in many states (Leonard, 2015; Marbin, 1993). In 2018, the President signed into law the Eliminating Kickbacks in Recovery Act, making patient brokering a federal crime with penalties of up to 10 years in prison and $200,000 in fines (Editorial Board, 2018). Patient brokers can make $500-$3000 per patient who enters treatment (Wallsten, 1996) and as much as $5,000 to $30,000 per month, selling the patient to the highest bidder. Brokers find patients in several ways. Some have websites; some through word of mouth, at NA/AA meetings; or some approach people on the street they assume are homeless as a result of addiction. Conditions are right for patient brokering practices to grow. With more treatment beds available than needed plus young adults having continued coverage on their parents’ health insurance until age 26, this creates more competition and money to be had in the recovery field (Stapleton & Beall, 2015). This, plus the heroin epidemic, is a perfect storm for patient brokering.

Presentation Objectives:

·  Define patient brokering and its relationship to human trafficking

·  Describe a qualitative research study of brokers

·  Explain how brokers are recruited and the reasons brokers engage in brokering

·  Discuss why knowledge of brokering is important for social workers as they work with clients struggling with addiction

·  Discuss the changes needed in substance use disorder treatment to reduce the likelihood of those with addictions becoming brokers

About the Presenters