Sad student with laptop and notebook complaining lying on the floor in the night at home

In 2018, Google instituted a certification process for online advertisers of addiction treatment providers powered by LegitScript, a third-party online verification and monitoring organization, in an attempt to curtail fraudulent advertising and patient brokering schemes. Soon, Bing and Facebook followed suit and implemented the certification requirement. The companies claim LegitScript certification protects consumers by cutting down on suspicious advertisers and removing them from online search results.

While perhaps well-intended, the lengthy and expensive process required by these private companies actually hinders people from finding help nearby when they need it most. Certification requirements also extend to support groups and crisis hotlines, meaning these services cannot advertise to help ensure people can find them in times of need. For most providers, particularly those treating patients with public or safety-net insurance, the hefty price tag beginning at $995 per location in application fees plus $1,975 per facility in annual fees is not sustainable. As a result, patients searching for treatment options online never see the full array of options available to them.

In addition to punishing providers who can’t pay for certification, there is little proof the requirement is working to cut down on the online reach of fraudulent treatment centers. An investigation found many illegitimate providers still appear high up in search results despite the LegitScript requirement for paid advertisements. Buyers and sellers of opioids continue to find new ways to operate on Facebook despite the platform’s adoption of LegitScript certification for treatment centers. It seems the certification process, while a roadblock for legitimate treatment providers looking to advertise, is doing little to keep fraudsters from appearing in search results and potentially leading patients in need astray.

Tech giants should not be the arbiters of quality in addiction treatment. Outpatient addiction treatment programs are already highly regulated by the federal government, just like methadone clinics, and states are increasingly regulating all levels of addiction treatment. Moreover, addiction treatment programs intent on providing the highest level of care can voluntarily pursue accreditation by national accrediting bodies like The Joint Commission and the Commission on Accreditation of Rehabilitation Facilities (CARF), in addition to complying with federal and state oversight policies and licensures. In an already highly regulated industry, do LegitScript’s added layers actually add value? Participants in LegitScript have noted continued challenges despite being certified and wonder whether the process of weeding out scam providers is actually working.

Patients seeking high-quality addiction treatment should be guided by principles of care published by leading expert organizations in the field of addiction treatment, not ill-informed social media platforms.

For example, the federal Substance Abuse and Mental Health Administration issued the Five Signs of Quality Treatment, and nationally-recognized patient advocacy and policy group Shatterproof published its National Principles of Care, both establishing markers of quality care a patient should seek in a provider. These guiding principles include the provision of evidence-based treatment by licensed health care professionals, accreditation by national accreditors, acceptance of third-party payment (and case managers that can help patients find third-party payment options), and provision of other health and social services, either directly or by community partnerships. While LegitScript worked with the National Association of Addiction Treatment Providers to develop its standards, one has to wonder why tech giants chose to partner with a for-profit third party rather than existing and highly respected licensing and certification organizations.

CleanSlate complies with all state and federal regulations and is certified by CARF in all 10 states where we operate. We adhere to strict internal quality measures, including those required by SAMHSA, to be deemed a qualified practice setting to provide proven outpatient opioid treatment with buprenorphine-based medications. Yet, despite our commitment to exceptional quality and to our patients’ success in treatment and recovery, we would have to pay hundreds of thousands of dollars to a self-appointed third party to reach many of the people who might really need our help. This is unacceptable.

When someone needs help with opioid or alcohol use disorder, they should be able to find it easily. The red tape that tech giants currently require of legitimate providers makes it difficult to reach these people without paying them dollars better spent to enhance operations, expand treatment options and ultimately provide better care for patients.

Greg Marotta

Greg Marotta is the President and CEO of CleanSlate, a leading national medical group that provides office-based outpatient medication treatment for the chronic disease of addiction, primarily alcohol and opioid use disorders.