At 24, Boyd was living in Chicago when he decided to get help. He had been drinking alcohol since a young age, but more recently he’d been drinking far more often – and dangerously.

He found a rehabilitation center online and reached out to the facility in Orange County, an affluent coastal area of Southern California, for treatment.

Boyd, a pseudonym used at his mother’s request, checked in at the facility, where he completed his initial detox and participated in therapy sessions. He was later readmitted to the same rehab program twice after his initial intake, his mother told the coroner’s office of the Orange County Sheriff’s Department.

Eventually he was moved to another nearby location operated by the same treatment program. However, despite the stated policy of sobriety on the treatment program’s website, Boyd began to use fentanyl.

In June 2024, two weeks after his final readmission, Boyd was found unresponsive in the bathroom at that facility, according to the coroner’s report.

He arrived at the emergency room in cardiac arrest; his heartbeat was restored, but he had minimal brain function, the coroner’s report later found. He remained on life support and died six days later.

The coroner’s office ruled his death an accidental fentanyl overdose.

Boyd’s story is not an isolated one. It points to a larger problem in the treatment industry. We are psychologists who research societal factors that contribute to overdoses. Our recent study found that out-of-state residents overdose in excessive numbers in Orange County, a hub for addiction treatment centers, compared with the rest of the state.

This finding runs counter to previous research that consistently shows that areas with more treatment facilities tend to have fewer overdoses.

Exploiting addiction and insurance fraud

In response to the opioid crisis in the United States, federal laws now require most private health insurance plans to cover addiction treatment. These laws have been mostly beneficial, providing millions of Americans access to treatment they otherwise could not afford.

However, the large amounts of insurance money flowing into the treatment industry have also attracted dishonest operators looking to score easy profits, especially in areas with weak regulatory oversight of treatment facilities.

A common scheme is to recruit patients with generous insurance plans to enroll at treatment centers, then bill their insurance companies for unnecessary or poor-quality services at inflated prices. These reimbursement payments can allow owners to pocket enormous sums of money, from a few hundred to........

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