We Need To Talk About The 40 Billion Dollar ReasonWhy Addiction Treatment Keeps Failing!

January 19, 2025

Jason Shiers, Author & Psychotherapist, Speaker, and Book Author 

Tom O'Connor, Publisher

The title "We Need To Talk About The 40 Billion Dollar Reason Why Addiction Treatment Keeps Failing!" is not just a rhetorical headline, but a call to action. It draws attention to the urgent and significant systemic problems within the US addiction treatment industry. Despite its estimated worth of tens of billions of dollars, the sector is plagued by high relapse rates and a lack of effective, evidence-based treatment. 

The core "reason" for the failure is not a single issue but a complex set of problems driven by a profit-first model that prioritizes revenue over recovery. 

Jason Shiers, a renowned psychotherapist and author, recently published an excellent book: Infinite Recovery Project: The Intelligence of Addiction - A Trauma-Informed Spiritual Approach to Recovery, Healing, and Lasting Change. The Infinite Recovery Project is a comprehensive program that combines trauma-informed therapy with spiritual practices to provide a holistic approach to addiction recovery.

According to Jason Shiers:

Most addiction treatment does not work, not because people do not try, but because the system is built on flawed models. We are confusing compliance with healing.

Here is the root cause of that failure: the revolving door is financially profitable.

The value of the addiction treatment sector is significant. High relapse rates, ranging from 50-70% within a year after many programs (Kelly et al., 2020), which may appear to be a failure on paper, are often an inherent feature of the business model.

Re-Admissions Sustain this Industry

This is not a conspiracy; it is the natural, yet ugly, consequence of a profit-driven system built around symptom management, rather than root-cause resolution.

Think about what drives a system that prioritizes short-term, 30-day stays and abstinence-only metrics.

The need for quick fixes - deep, trauma-informed, nervous system work is slow, nuanced, and intensive. It does not fit neatly into an insurance or funding billing cycle or a rapid detox timeline. Instead, we get models that address the addiction as a primary behavior, completely bypassing the trauma history that is present in over 70% of clients (SAMHSA, 2022)

Avoiding True Healing

Acknowledging the role of systemic trauma and nervous system dysregulation means completely redesigning the model, something most large institutions will not do if the current model is solvent.

The emphasis on 'powerlessness' in many models can actually re-traumatize people by mimicking the disempowerment of earlier life events (Pagano et al., 2018)

When the industry's success is defined by filling beds and processing clients, its mission — lasting healing — is compromised.

The Solution 

Empowerment through Value Shift

Stop defining recovery by a negative, what the person is not doing (using substances)...and start defining it by a positive: what the person is building (safety, connection, self-regulation).

We have to shift the value proposition from brief, intensive crisis management to long-term, integrated, relational healing.

We must reward outcomes that reflect lasting safety, not just clean drug tests.

This means prioritizing safety and agency.

Integrate the body (Somatic Work): Without somatic integration, we are missing the mechanism by which safety is recorded (van der Kolk, 2021).

Success must be measured by overall quality of life, relationship health, and nervous system resilience, moving beyond abstinence as the sole metric. This understanding is crucial to addressing the current shortcomings in addiction treatment.

Until we change the way success is measured and funded, we will continue to punish people with a system that has a vested interest in their return.

The opposite of addiction is not sobriety, but safety. We cannot create safety in an unsafe or compromised economic environment, which is why we need to shift the focus of addiction treatment to creating safe spaces for recovery.

Question For Our Readers

If you could force one policy change today to shift the incentives from 'repeat business' to 'lasting healing' in this sector, what would it be? 

Let's Envision a Brighter Future for Addiction Treatment.

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Jason Shiers can be reached at jason4656@gmail.com. If you want to learn more about the Infinite Recovery Project (IRP), please visit  http://www.infiniterecoveryproject.com/

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