Opioid abuse is not like other problems. With very little use, pain meds and heroin can quickly become an addiction. This addiction has unusual drug dealers. Some are intentional (Big Pharma like Purdue Pharma, Cephalon, Janssen Pharmaceuticals, Endo Health Solutions and Actavis) that exploit our pain and desperation. Other’s are likely well-meaning like primary care doctors most of whom are manipulated by the pharmaceutical companies to write prescriptions.
If you or a loved one is prescribed pain meds, take this seriously. Use as little as possible and work closely with your doctor. If you can’t stop, get help immediately. The longer someone abuses opioids, the harder it is to get back on track.
It was a mystery for the last few years – why were so many people going to Missouri to get their prescriptions (…mostly opioids like Vicodin/Lortab or Oxycodone)? Mystery solved. As of 2012, Missouri was the only state in the United States that did not participate in a national registry for prescription drugs.
Let’s dive a bit deeper…
What’s The prescription drug monitoring program?
Better known as PDMP, it’s an online database that collects data on controlled substance prescriptions dispensed within each participating state. It can act as an early warning system for prescribers to avoid dangerous drug interactions and to ensure quality patient care.
PDMP is also a tool that also can be used to intervene in the early stages of prescription drug abuse, as well as to assist providers in preventing prescription drug abuse and enable providers of pain medications to know if they are treating someone who has been “doctor shopping” (going from doctor to doctor for multiple prescriptions).
PDMP does not impact the legal prescribing of drugs by a provider – it simply makes it possible to spot a potential problems or trends.
Why Missouri Doesn’t want PDMP?
Well, Missouri kind-of does want PDMP. In 2012 the state came oh so close to enacting PDMP. But while proponents say most Missouri citizens and legislators support participation in PDMP, it has been blocked by lawmakers like State Senator Rob Schaaf, a family doctor who argues (…inaccurately in my humble opinion) that allowing the government to keep prescription records violates a patient’s personal privacy. He’s probably referring to HIPAA and/or HITECH which are privacy laws that protect a patient’s health records. After successfully combating the 2012 version of the Missouri legislative bill, Dr. Schaaf said of drug abusers, “If they overdose and kill themselves, it just removes them from the gene pool.” Dr. Schaaf is seemingly more focused on individuals liberty (…for prescription drugs) than on life. Fortunately, he appears to be in the minority within Missouri.
How to access the PDMP information
It’s not so easy. You’ve got to be a doctor, part of the legal system or law enforcement to get access. The PDMP data is stored by specified statewide regulatory, administrative or law enforcement agency as designated by state law. The agency distributes data from the database to individuals who are authorized under state law to receive the information. Information is shared across state lines when needed.
Odyssey Behavioral Healthcare, a partnership between Nautic Partners, LLC and CEO Scott Kardenetz, announced it completed the acquisition of residential/outpatient mental health and addictions treatment providers Pasadena Villa (TN, FL) and Lifeskills South Florida (FL).
Odyssey, headquartered in Brentwood, TN, was formed to build a diverse platform of behavioral healthcare facilities across the treatment spectrum in psychiatric and addiction care. Scott Kardenetz is a 25-year veteran with former leadership positions at Ardent Health Services, Psychiatric Solutions and Universal Health Services. Nautic and Odyssey plan to invest $50 million of equity capital to support its strategy of growth.
Behavioral Health mergers and acquisitions experts expect this trend to continue, with a growing emphasis on the development of a full continuum of services and settings which promises to be an even bigger market than the strictly luxury-leaning residential programs that historically been the focus of consolidation.
About Odyssey Behavioral Healthcare
Odyssey Behavioral Healthcare was formed in 2015 as a partnership between Nautic Partners and Scott Kardenetz. Odyssey’s treatment centers include Pasadena Villa and Lifeskills, which provide adult residential treatment care in three primary facilities and outpatient care in Tennessee and Florida. Odyssey will seek to expand the platform through new development and acquisition. In developing its platform, Odyssey seeks to acquire and develop treatment facility leaders in their therapeutic niche and that can benefit from senior management leadership and support.
Scott Sowle, the founder and executive director of Muir Wood Adolescent & Family Services (Sonoma County, CA) teamed up with private investors to acquire the residential and outpatient addiction and co-occurring disorders treatment organization from Constellation Behavioral Health. Constellation Behavioral Health operates Alta Mira Recovery Programs in California.
Muir Wood will operate as a stand-alone program focused on youth treatment, run by founder and executive director Scott Sowle. They will be expanding their residential treatment capacity by adding a residential campus for adolescent girls program. Constellation Behavioral Health operates Alta Mira Recovery Programs in California. Muir Wood will expand its residential treatment capacity for young males from its present 6 beds to 10. The adolescent male program, housed on a six-acre campus, includes weekly family programming, experiential therapies, and an accredited academic program.
For years I have listened to parents’ tales of wasted time and money as they shifted from one therapist to another, one residential treatment program to another without experiencing the progress they anticipated. What parents don’t know costs them big time. Tens of thousands of dollars in expensive, non-evidence based treatments along with countless hours searching generic databases that don’t really help someone understand the differences in care and how to tell good interventions from bad.
Yes, this happens to be one of the services Fonthill Counseling provides but even if you do not use us, take these suggestions to heart. We offer a free consultation and will help you determine if higher level of care like residential treatment is even a good fit for your struggling teen or young adult child.
1. Professional Advisement
Chances are, if you’ve ever bought a house or had surgery, you consulted with a professional within the respective industry. So what do parents think when they start their online searching for treatment options? Do they honestly think they know how to determine the quality, effectiveness and safety of a program from reading through a website or spending 10 min on the phone with an ‘admissions counselor?’ There is WAY more to choosing any sort of therapeutic intervention than the list your insurance provides or what you find on Psychology Today.
A high quality professional advisor (aka Educational Consultant or Therapeutic Placement Consultant) will know if insurance will cover expenses AND (…and this is the important part) how to actually GET insurance to pay. They know when a kid is appropriate to remain at home and start/continue with outpatient therapy and when they are no longer appropriate for home and need a higher level of care. They will also know the positives and negatives of programs that are clinically, financially and logistically the best fit for your loved one. One program we worked with for years had lots of staff turnover which resulted in 2 suicides in close succession. We no longer refer to them. Guess what? That program does not advertise about the suicides.
Even if you are just doing preliminary search to see what might be available for your acting out son or daughter, whether you’re thinking about therapeutic boarding school, residential treatment for substance abuse or an eating disorder, or you’re looking for a treatment program for depression or anxiety, find a professional.
WARNING! Stay away from any ‘professional’ that is offering advice for residential treatment, therapeutic boarding school or a therapeutic wilderness program but does not have any clinical credentials. Look for professionals that have at least a master’s degree in counseling, psychology, social work or marriage and family therapy. Also, and this is REALLY important, make sure they are licensed in some clinical field (Licensed Professional Counselor, Licensed Clinical Social Worker, Licensed Marriage and Family Therapist, etc.). Many, many professionals are providing advice without really having a formal, clinical background.
Every parent asking us for help starts out by saying their highest priority is ‘quality’ or ‘effectiveness.’ But once we start drilling down into details, reality mandates compromise. One of the biggest realities is cost. Cost matters… and it should. It’s not healthy, and certainly not necessary, for parents to think it’s appropriate to spend any amount to fix a problem. Residential treatment can cost between $400 per day up to $80,000 per month. Insane. What many parents don’t realize is the ‘retail price’ quoted by a treatment program admission counselor (…price is almost never posted on their website) is often not set in stone.
Let me explain. If a parent calls Fonthill Counseling and needs to find an eating disorder program in the mid-West for their college-aged daughter, it’s likely we’ll contact Timberline Knolls (pretty good program located in Illinois). If the parent calls Timberline directly, they’ll get a daily or monthly rate quoted to them with a minimum length of stay. Now, if Fonthill Counseling calls, we can negotiate a lower rate along with other accommodations (ie. single vs double room, admission date, etc.). Most programs also have ‘scholarships’ or supportive funding they can tap when their numbers are low. They’d rather have full client roster but less income per person rather than few clients and even less income since their overhead costs do not change much based on census.
But now we have to back up a bit and talk about insurance. Bottomline – insurance does NOT want to pay for residential treatment. Ever. It’s vital that if you think your son or daughter needs a higher level of care, you have your professional get a) a psychological evaluation conducted and b) preauthorization. Here is a link to more details on getting insurance to pay for treatment. If you do not submit that to insurance or if the residential treatment program fails to submit it (and they are in-network) your chances of having insurance cover treatment is very, very, very low. If your insurance covers medical inpatient and residential treatment, they are required by law to pay for mental health residential treatment. Insurance companies will argue with you on this but its the law.
Unless the client is very motivated to participate in treatment, we recommend having your professional find a transport service to transition from home to treatment. These are not thugs in black shirts that throw a bag over your kid’s head and drag them to a running van. These are often well-trained professionals using counseling skills that create enough rapport and trust to get your kid to voluntarily get into the car. Like any service, there are sketchy people trying to make a quick dime and true professionals with exceptional interpersonal skills (we’ve used Right Direction Crisis Intervention many times with great success). Insurance will never cover this but definitely worth the cost.
Why not have parents escort their own kid? Unless you have great rapport and the issues leading them to treatment have nothing to do with trust issues, running away, drugs or medically complicated issues, parents do not have the clinical skills in supporting kids during a powerless experience like transitioning from home to residential treatment.
4. Quality Control
At Fonthill, we call this ‘oversight.’ Hiring a team like Fonthill ensures through regular email, phone and treatment team meetings their is unbiased, third party oversight over the treatment plan, therapy and communication at the residential treatment program. Most of the time, we are talking with the therapist and interpreting their clinical impressions back to the parents. Since parents are not clinicians, the terms and progress may not make sense but to us, we can sift through and quickly understand how things are going. Residential programs also treat clients with greater attention to detail than those without the same oversight.
How do you know when your child is ready to leave? When can you trust the treatment program is being honest about progress? What should be set up at home, in the community or back at college to ensure your money was not wasted when they transition back to real life? In our humble opinion, the first day of intake should be the first day of discharge planning. We ensure the residential treatment program has a measurable treatment plan with clearly identifiable goals.
As we get close to discharge, as the professionals circle up and agree that he or she is ready to return home or back to campus, Fonthill Counseling will often link with a therapist, psychiatrist and case manager and make sure all appointments and documentation is set up way before. This is sometimes called aftercare, community-based living, or step-down. The final discharge meeting should just be a big hug-fest since all the prep work has already been done.
We like to have the first therapy session take place within 24 hrs of discharge. First medication management appointment should be within the first 72 hrs. Case management continues to provide that oversight and continuity, making sure the treatment plan from residential treatment is modified and extended into real life. Typically, we are providing parenting support, on-call support if something goes wrong, and linking with school personnel to help the kid get back on track.
Finding residential treatment is much larger a task than what folks realize but with a little support from a professional, you can avoid wasting resources that would be better spent on your family.
If you are a parent who wants to learn more about residential treatment for your teen or young adult child, our Parent Support Group is for you. This group is specially designed for Parents of Teens and Young Adult Children either in residential treatment or in need of residential treatment. Whether you have an acting out teen obsessed with gaming or a daughter exhibiting what seems like an eating disorder, residential treatment may be an option. But how do you choose? How do you know the good ones from the bad? We will walk you through the basics of the therapeutic program world through a discussion format.
Topics will range from residential and treatment options, how to creatively pay for programs and use insurance, myths vs reality of treatment, parenting advice and skill building, and finally, sharing and venting. This is also an open forum to address any other problems related to acting out teens/adults – you’re not alone.
Mondays 7:00pm Starting September 8
Fonthill Counseling Conference Room – 141 Providence Rd Suite 160 Chapel Hill NC 27514
Licensed therapist with expertise in residential treatment, counseling and parenting education will lead didactic, interactive and experiential sessions.
Due to limited seating, preregistration is required. Please email us at help@fonthillcounseling for sign-up instructions.
Kolmac Clinic has six locations in Washington DC area. Unfortunately the program does not offer services in Virginia, but has locations in downtown DC and Maryland. Each site boosts group treatment tailored to the population in need. For example, the Towson, MD site has a larger population of young adults and targets programming to this population. The K St location specializes in corporate executive’s substance concerns.
During the visit to he K St location, the office appeared dated and office presentation seemed less important (e.g., stain on rug, old furniture). Staff appeared friendly, but often passed through the waiting room (in the middle of the office) without acknowledging guests waiting for appointments.
Fees + Insurance + Financing
The daily charges are $400 for detoxification, $193 for rehabilitation, $120 for the initial clinical evaluation and $100 for continuing care. Most insurance plans cover part or all of the costs at Kolmac. The exact out-of-pocket expense for the patient varies accordingly. Patients interested in treatment with us should call with insurance information and our staff will explain costs. Once the patient has scheduled an appointment our staff will verify the insurance coverage. Payment plans are available if needed.
The clinic accepts all insurances except Tricare and state funded plans (e.g., medicare and medicaid).
There is quite the mixed bag of reviews found online. With an agency the size of Kolmac, this is to be expected. There generally are either really terrible reviews or really great reviews without much in between. This is one of those clinics we HIGHLY recommend visiting first before you make a decision about starting treatment with them.
Best way to reach them is through their online contact form found here or their general number at 301.589.0255.
I posted the article below to highlight a typical evolution within family wealth. It’s part cautionary tale and part voyeuristic experience for those of us that will never be billionaires. It’s a tale of rise and greed and fall. The important lesson here is that the tale of this once prominent family doesn’t end just because the money did. Lives are changed and rebuilt.
AS WITH MANY OF AMERICA’S GREAT FORTUNES, the Stroh family’s story starts with an immigrant: Bernhard Stroh, who arrived in Detroit from Germany in 1850 with $150 and a coveted family recipe for beer. He sold his brews door-to-door in a wheelbarrow. By 1890 his sons, Julius and Bernhard Jr., were shipping beer around the Great Lakes. Julius got the family through Prohibition by switching the brewery to ice cream and malt syrup production. And in the 1980s Stroh’s surged, emerging as one of America’s fastest-growing companies and the country’s third-largest brewing empire, behind only public behemoths Anheuser-Busch and Miller. The Stroh family owned it all, a fortune that FORBES then calculated was worth at least $700 million. Just by matching the S&P 500, the family would currently be worth about $9 billion.
Yet today the Strohs, as a family business or even a collective financial entity, have ceased to exist. The company has been sold for parts. The trust funds have doled out their last pennies to shareholders. While there was enough cash flowing for enough years that the fifth generation Strohs still seem pretty comfortable, the family looks destined to go shirtsleeves-to-shirtsleeves in six.
“We made the decision to go national without having the budget,” sighs Greg Stroh, a fifth generation family member and former Stroh Brewery employee. “It was like going to a gunfight with a knife. We didn’t have a chance.” His analysis comes tinged with inevitability. It wasn’t. A handful of family-owned regional brewers such as Yuengling and Schell’s continue to thrive, while others, like Olympia and Hamm’s, sold out. And the Strohs’ largest rivals during the 1980s and 1990s, the Coors, who also aspired to turn their no-frills, regional suds into a national powerhouse, remain in the top 100 on the FORBES America’s Richest Families list.
The Strohs chose a different path, a saga that serves as a powerful reminder: Hard as it is to build a family business designed to last in perpetuity, it’s shockingly easy for any successor to tank it.
FOR ITS FIRST CENTURY the Stroh beer business, based in Detroit, grew by following the basics: respect your customers; respect your employees. The former meant catering to Midwest working-class tastes at working-class prices (the family watered down Bernhard Stroh’s precious recipe, after hops and wheat shortages in World War II left Americans accustomed to weaker brews). The latter by treating every employee like an honorary member of the clan. John Stroh, who oversaw a dramatic sales surge in the Eisenhower years, “was known for walking the brewery and knew everyone’s first name,” his grandnephew Greg remembers. “Employees would run through walls for the family.” As if to connect the customers and the business, the Stroh signature was emblazoned on every bottle, topped by a family crest with a lion. Sales surged in lockstep with postwar Detroit, from 500,000 barrels in 1950 to 2.7 million barrels in 1956.
The mammoth changes came in the early 1980s. John Stroh had moved into the chairman’s role in 1967 and handed control of the brewery to his nephew, Peter, who became CEO in 1980. Like John, he had a plan to grow, but not incrementally: He would do it by acquisition. In 1981 Stroh bought New York-based brewer F&M Schaefer, which, like Stroh, was founded by a German immigrant in the mid-1800s and also offered low-priced suds to its regional fans (famous marketing line: “The one beer to have when you’re having more than one”). The next year, in what family members describe as “the minnow swallowing the whale,” Peter Stroh bet the family business, borrowing $500 million (the book value of the Stroh business was $100 million at the time) to buy Joseph Schlitz Brewing of Milwaukee.
Suddenly Stroh was the third-largest brewer in the U.S., with seven plants and a national footprint. On paper there was synergy. FORBES valued the company at $700 million in 1988, listing the Strohs with one of the largest family fortunes in the U.S. at the time, shared by 30 relatives.
But Peter Stroh’s grand vision of a thriving U.S.-wide brewer failed to materialize. It largely missed the boat on the biggest industry trend in a generation: light beer. And Stroh’s core product–cheap, watery, full-calorie beer–was a commodity. But saddled with debt, Stroh couldn’t afford to match the ad spending of its bigger rivals, Anheuser-Busch and Miller. Unable to spur demand through marketing, Stroh turned to price, introducing a 15-pack for the price of 12 cans and a 30-pack for the price of a case of 24. While the latter had legs, it wasn’t enough to outrun the shrinking margins.
Meanwhile, an ambitious family from Colorado began moving into the Stroh markets. “It became a competition between Stroh and Coors,” says Scott Rozek, a former director-level employee who spent 12 years at Stroh. “At that time there were four big breweries in a three-brewery industry–there was really only room for three.” By the end of the 1980s Coors overtook Stroh as the country’s third-largest brewer.
In August 1989 the Stroh Brewery Co. was in retreat. The company that had treated employees like family laid off 300 people, one-fifth of its white-collar workforce. “I had to let go four of the five people in the marketing research department. It was heartbreaking,” remembers Ed Benfield, former director of market research at Stroh.
The next month Peter Stroh, who died in 2002, agreed to sell the family business to Coors for $425 million. But Coors got cold feet and pulled out of the deal a few months later. “It had something to do with due diligence, and Bill Coors,” says Benjamin Steinman, longtime editor of newsletter Beer Marketer’s Insights. “There were lots of stories.”
Desperate, Peter Stroh brought in renowned adman Hal Riney to give the Stroh’s brand a more upscale look and position. The cherished Stroh signature gave way to block print, prices were raised, and the 15- and 30-packs were nixed. It could not have been a worse decision. But since the product hadn’t changed, customers could do the math: Sales of Stroh’s-brand beer fell more than 40% in one year, “the biggest drop in sales in the history of beer,” says Benfield.
Market share for Stroh’s, as well as for its acquired brands like Schaefer, Schlitz and Old Milwaukee, fell from 13% in 1983 to 7.6% in 1991. Even CEO Peter Stroh admitted the troubles. “We’ve been through a very difficult period,” he told FORBES in 1992. “We tried to do too much.”
And yet it tried to do more. In 1996 Stroh repeated his mistake, borrowing yet more money for the $300 million acquisition of struggling brewer G. Heileman. The purchase fell flat. Heileman had breweries in cities like Seattle and Portland, where Stroh didn’t, but it lacked a big stable of strong brands. One industry analyst remembers the deal described as “two sick chickens–they were both declining.”
It got worse. Peter Stroh had tried to diversify the business, with investments in biotech and Detroit real estate. Both were far from the family’s core competencies and lost them millions more. By 1998 cousin John Stroh III had taken charge at Stroh Cos., the brewery parent. And while the company had turned to contract brewing for others, including Sam Adams, as a way to make up for plummeting sales, Stroh took a mortal hit in 1998 when it lost a contract with Pabst.
By 1999 there was internal concern about whether they could even make their interest payments on the debt incurred, says one former executive. And so Bernhard Stroh’s legacy was sold for scraps: Miller Brewing, owned at the time by Philip Morris, bought Stroh’s Henry Weinhard’s and Mickeys brands, while Pabst bought the rest of the brands owned by Stroh’s as well as its brewery near Allentown, Pa., for a price several sources peg at around $350 million–about $250 million of which was used to pay down debt incurred with the Heileman purchase. Some of the remaining $100 million or so was transferred to a fund to pay employee pension liabilities, which Stroh had retained in the sale. The rest went into a fund for the family that dribbled out checks until 2008, when it was completely tapped.
FOR GENERATIONS, GROWING UP STROH meant a life of comfort. “My life with my father felt like being inside a gilded bubble,” says Frances Stroh, whose father, Eric, quit the company after a fight with his brother Peter in 1985. An artist at heart, Eric spent millions buying hundreds of antiques–guns, cameras, guitars–to fill the big house that Frances grew up in. Saving, Frances says, was not a priority.
And why would it have been when the checks rolled in? In the 1980s the seven members of the fourth generation got $800,000 a year. (There were another 20 or so shareholders from the third and fifth generations as well, who received differing amounts.) That enabled several Stroh families to live in stately homes on gated Provencal Road in the tony Detroit suburb of Grosse Point Farms, with maids, cooks, country club memberships, boarding school tuition and no need for 9-to-5 jobs. “A lot of people were living off the family business,” says Greg Stroh, who’s now 47.
As with too many families with more money than direction, drugs and alcohol followed. Frances Stroh was kicked out of boarding school at Taft after she was caught drinking. Her three brothers also got kicked out of different prep schools. In an excerpt from a memoir about the family that Frances is writing, she describes one incident during her college years when she was snorting cocaine with her brothers while the rest of the family was downstairs having Christmas dinner at their Grosse Point Farms home.
One of her brothers, Charlie, narrowly avoided going to prison for dealing cocaine in college in the early 1980s. His parents forced him to join the Marines, and good behavior in the service was the key to evading a prison sentence. Yet the demon of addiction reappeared two decades later, in 2003, when he fell to his death from a tenth-floor hotel balcony in Texas, as the sheets he tied together to form a rope failed to hold. He was 43. One report quoted police saying he called the front desk at the hotel “to report a bank robbery and other nonsensical things.”
There have been other tragedies throughout the years. Nick Stroh, a fourth-generation member of the family and a freelance journalist in Africa, was bludgeoned to death by Ugandan troops in 1971 after he investigated reports of an army massacre. Peter’s brother Gari Stroh Jr., who ran the Stroh Ice Cream division, became a quadriplegic after a fall from a horse on his farm in 1982. And so on.
All of which served to make 1989–the year of the failed sale to Coors–something of a shock to the family. For the first time the company couldn’t come up with dividend payments. “My generation probably grew up with the illusion that things were going to be pretty good,” says Greg Stroh. “We had to make adjustments.”
Eric Stroh was hit particularly hard. His first wife had to briefly loan him money to help him make ends meet. In 2009, a few months after the checks stopped for good, the overweight and diabetic Eric collapsed, alone, after letting a leg wound go untreated–most of his estate went into trusts to pay liabilities to his two former wives (the second one had gone to high school with Frances).
Frances and her two surviving brothers each inherited $400,000 from a trust. She also inherited her dad’s collections of antique cameras, guns and guitars–some of which turned out to be fakes, and others, fittingly, worth pennies on the dollar of what her father had paid for them.
To learn more about how to insulate your family from the unintended consequences of wealth, contact Fonthill Counseling for a fee consultation.