Addict brokers profit as desperate patients are ‘treated like paychecks’ – By DAVID ARMSTRONG and EVAN ALLEN — BOSTON GLOBE – MAY 28, 2017
Days after he relapsed on heroin last summer, Patrick Graney received an offer that was too good to turn down.
How would he like to get treatment in a beach town with a hipster vibe in South Florida — with all expenses paid, including airfare from his Massachusetts home?
Graney didn’t have to think long. He was on a flight south the next day. Two months later he was dead.
The arrangement — according to interviews with Graney’s mother and girlfriend and saved Facebook messages he sent — was brokered by Daniel Cleggett, a flamboyant figure, and some would say a pillar, in the Boston-area drug recovery community.
A former addict who has spent nearly a quarter of his life in jail, Cleggett has turned entrepreneur in the burgeoning treatment industry for people addicted to opioids such as heroin and prescription painkillers.
He presides over an expanding empire of treatment facilities in Massachusetts, but he has also helped recruit addicted young people from Massachusetts for drug rehab centers in South Florida, according to the patients’ families and others who know Cleggett and are familiar with the arrangements.
Two of these young men, including Graney, died from overdoses in hotel rooms in the oceanside resort communities where they were sent for treatment.
The 31-year-old Cleggett refers to himself on Facebook as a former “lunatic, outlaw addict” — but one who has been sober for five years and is now committed to helping others follow his path.
In a brief telephone interview, Cleggett said he had no role in Graney going to Florida for treatment — despite the messages to the contrary Graney sent. He declined to answer any questions about brokering in general or his role in helping other people travel to Florida for treatment.
“I help people all day, every day. That is what I do,” he said. “I had nothing to do with whatever place he went to.”
Cleggett is just one player, albeit a prominent one, in a murky network of middlemen, often referred to as marketers or brokers, who recruit and arrange transportation and insurance coverage for desperate young men and women from the Northeast and Midwest.
Patient brokers can earn up to tens of thousands of dollars a year by wooing vulnerable addicts for treatment centers that often provide few services and sometimes are run by disreputable operators with no training or expertise in drug treatment, according to Florida law enforcement officials and two individuals who worked as brokers in Massachusetts.
Cleggett refused to say whether he was paid to find customers for Florida treatment centers.
The facilities are tapping into a flood of dollars made available to combat the opioid epidemic and exploiting a shortage of treatment beds in many states. As center owners and brokers profit, many patients get substandard treatment and relapse.
While drug warriors are hunting down pain patients legitimately using opioids to control their pain, they offer zero affordable alternatives to treat either pain or addiction.
They are stuck in an endless cycle of trying to “punish our way out” of the overdose crisis.
If people with addiction were able to make well-reasoned decisions to enter and follow treatment, they would not be addicted in the first place.
If pain patients didn’t find opioids more effective and affordable for treating pain than anything else, they wouldn’t be taking opioids.
While guidelines against opioids are proliferating, NO ONE is formulating guidelines for addiction treatment centers. There are no legal requirements or professional standards for “recovery clinics” at all, so it’s a wild west race for the dollars being showered upon these disreputable agents.
The role of patient brokers in steering addicts to out-of-state treatment centers is now coming under scrutiny from law enforcement, including Massachusetts Attorney General Maura Healey, according to a spokeswoman for her office.
“These recruitment operations take advantage of the desperation of people struggling with addiction to refer them to treatment centers not based on their best interest, but in order to get a commission,” Healey said in a statement. “Patients need to access safe and effective recovery options instead of being treated like paychecks.”
Two people engaged in the business of recruiting addicts for Florida facilities said there are scores of people recruiting patients in Massachusetts and neighboring New England states where rates of opioid abuse are high. They spoke on the condition they not be identified for fear of prosecution.
Brokers are primarily paid in two ways, they said. One is a per-head fee — ranging from $500 to $5,000 — for each patient who successfully checks into a treatment center. In other cases, brokers get a monthly fee from a particular facility but must meet a quota of patients to collect payments as high as tens of thousands of dollars.
In addition to sometimes paying for patients’ flights, brokers often help them obtain private insurance, and then pay the premiums on their behalf until treatment benefits are exhausted after 60 to 90 days. The Florida centers frequently bill the private insurers at higher, out-of-network rates that can easily total $10,000 or more a week.
The relocation to Florida did little for Graney. He was bounced out of a treatment facility, and two months after arriving, he was homeless and trying to find help on his own. He fatally overdosed in a Delray Beach hotel room with a stranger he met hours earlier at a detox center that turned him away.
He told the group that he was jailed for the first time when he was 14 and spent seven of the next 12 years locked up. He was homeless. He abused alcohol and drugs.
In his mid-20s, Cleggett went to a retreat modeled on the 12-step Alcoholics Anonymous program. The treatment clicked. He was soon managing a sober house in Maine where addicts in recovery lived together. Those experiences prompted him to open similar treatment facilities in Massachusetts, he told the group in Holbrook. He now operates five facilities with 100 total beds, he said.
“The way it was explained to both of us is that it is a fresh start in a new state,” she said of Cleggett’s pitch. She said Cleggett sent photographs of a facility that looked like “a five-star resort.” There were daily yoga sessions, she said he told them, and clients were given money to go the movies.
Cleggett told them everything would be paid for, Jones said. They would be in a private insurance plan — not Medicaid, the government insurance program the two had used in the past and that pays far less for treatment than commercial insurers. If anyone questioned them about their insurance, Cleggett told them to say they were unsure about the details or they were covered by their parents’ plans, she said.
After a few weeks in Florida, Graney relapsed.
Graney’s insurance was terminated
The center does not allow people to be kicked out for lapsed insurance and Graney stayed from Aug. 24 to Sept. 7, with the understanding he would pay for his treatment later, Goodman said.
Graney was ultimately discharged after it was reported that he brought heroin into the facility and gave it to another patient, who overdosed, Goodman said.
On the evening of Sept. 9, Graney went to a Delray Beach detox center seeking help. He was turned away because no beds were available, according to a police investigation of his death. He then checked into the hotel room, bringing along a man and a woman he met at the detox center. At 2:12 the next morning, the man called 911 to report Graney was unconscious on a couch with a brown liquid coming from his mouth.
The stranger attempted CPR until paramedics arrived. It was too late. Graney was dead from what the medical examiner later determined was acute cocaine intoxication. He was 30 years old.
At the Dunkin’ Donuts on Atlantic Avenue in Delray Beach, white vans carrying patients to treatment facilities pull in and out of the parking lot throughout the morning. People spill out of the vans, grabbing a quick cigarette break or a cup of coffee. They reload and head off to rehab centers in bland office parks, far from the white sand beaches and trendy restaurants and galleries.
Officials estimate that Delray Beach alone — a city of 16 square miles with 67,000 residents — has more than 800 treatment facilities. And within five miles of the city, according to one rehab operation, there are hundreds of Alcoholics Anonymous meetings every week.
Cities such as Delray Beach are a draw for out-of-state residents seeking recovery because they are walkable, the weather is warm, and the people are friendly. It’s a perfect place to come get sober — or get rich off those trying to do so.
“It’s where the money is,” said Aronberg, the state attorney. “This is a hotbed of corruption.”