Every day at dawn, tens of thousands of people begin lining up at Acadia Healthcare’s addiction clinics to get a cup of methadone. The daily dose staves off opioid withdrawal and keeps many from turning to dangerous street drugs like fentanyl.
The for-profit chain of 165 methadone clinics — the country’s largest — has generated more than $1.3 billion in revenue since 2022. It is “a business that we continue to feel great about,” Acadia’s chief executive told investors this year.
That business has been built in part on deception, a New York Times investigation found.
Methadone is a narcotic, and the clinics are heavily regulated by federal and state governments. In addition to handing out methadone, the clinics are required to provide counseling and other services, like drug testing.
But Acadia often fails to provide that counseling, according to five dozen current and former employees in 22 of the 33 states where the company has clinics. Instead, employees at times falsify the medical records that Acadia uses to bill insurers, according to the employees and internal emails.
Sometimes a counseling session recorded in a patient’s medical chart is simply a chance encounter. For example, medical records for a patient in Iowa show she had a 40-minute counseling session in December 2023, but the patient said in an interview that it was actually a hallway chat that lasted less than five minutes.
Acadia’s business is built on volume. Its counselors carry caseloads that are sometimes more than double the limit set by state regulators, according to employees and inspection records. With so many patients, the clinics can become assembly lines, offering little more than a cup of methadone.