Why medical tourism is rare in the addiction market

When consumers in the United States think of medical tourism, what usually comes to mind is cosmetic surgery and knee and hip replacements that can be delivered at medical centers abroad for a fraction of the cost. Rarely do they think of addiction treatment.

This is partly because there are numerous treatment centers with relaxing atmospheres and quality care within the United States and the cost of travel abroad wouldn’t be justified. Plus, U.S. treatment programs no doubt bristle at the notion that care can be called “tourism.” 

“I’ve known people who have gone to South America to have plastic surgery, it’s so much cheaper there,” says Phoenix Adams, LCSW, managing director of Caron Renaissance Ocean Drive in Florida. “But that’s not part of the conversation here at Renaissance, where we focus on our core competencies.”

Medical tourism, as a concept, just doesn’t apply to what Caron does—and it doesn’t apply to the industry in general, Adams says. “I’ve heard of hospitals and clinics setting themselves up as go-to destinations to attract people from all over,” he says. “But I don’t think of us as an industry like that, and I don’t think that’s a very healthy perspective in terms of what we’re trying to do, which is to put the patients’ needs first.”

Caron, which operates two treatment centers in Florida in addition to its main location in Wernersville, Pa., is particularly uncomfortable with the profit factor. 

“When I hear ‘medical tourism,’ I hear a connotation that promotes a financial aspect,” says Adams. “Caron is non-profit, and we’re not concerned with putting money into the pockets of shareholders.”

Crossroads Centre in Antigua might be the sole example of a program that has capitalized on a limited niche of far-flung destinations for addiction treatment. Positioned where the Atlantic and Caribbean meet, Antigua is known for beautiful beaches and ocean views.

“Tourism means to leave where you live,” says Crossroads CEO Nicholas Peraticos. In fact, many Americans have gone to treatment at Crossroads, but many “just do a cost analysis, and this costs a lot less,” he says.

Because of the funding provided by its founder, musician Eric Clapton, a 30-day stay for treatment at Crossroads is $28,500.

“Some just want something peaceful and quiet,” says Peraticos. “If you were coming to Antigua on a holiday for a month and living at that location, that alone would be your cost,” he says. Because of the backing from Clapton’s foundation, patients can take advantage of the location, food and the treatment itself. Crossroads has been treating patients for 19 years.

Peraticos agrees with Adams: Treatment, however idyllic the setting, is still treatment. And he believes addiction-realted medical tourism in another country would be a hard sell to investors.

“You would have to convince people that what you do is good, and that the environment is beautiful and peaceful,” he says. “We happen to have a track record. But if I were an investor in the medical field and I was looking at Barbados, for example, I don’t know that building up or buying a program would be a good investment.”

It’s true, however, that medical tourism sometimes promotes the idea of wellness through treatment, similar to a spa retreat, says Adams.

“I want to emphasize that when we offer things like massage and acupuncture at Caron, it’s because these are the services that patients come to Renaissance or Ocean Drive for. Those are the amenities that make treatment more bearable,” he says.

Still, while such amenities do enhance the treatment experience—Caron also offers patients the opportunity to jog on the beach, take bike rides and swim—Adams maintains it’s not tourism—it’s treatment.

“I don’t feel that we are competing at all with the luxury part of the business,” Peraticos says. “We are a very beautiful, scenic place, and if it were a hotel, you would say it was a high-end hotel, but we don’t do the thread count and the butler service.”

Already traveling

Most people who access residential treatment in the United States already are traveling to the locations, says Renee-Mari Stephano, JD, president and founder of the Medical Tourism Association, based in Palm Beach Gardens, Fla.

“You’re already taking someone out of their environment, out of the way of temptations, and you have the ability to choose a place that’s based on cost, quality, acceptability, availability and privacy,” she says. “So, in essence, addiction treatment has always been a medical tourism product.”

But in fact, addiction treatment is not active in the medical tourism industry, she says.

“The largest number of people who travel for treatment are going for surgery—especially dental and [cosmetic],” says Stephano. “We see very few providers in the addiction rehab space, and I think that’s a shame. There’s a great opportunity there, particularly as we are evolving in terms of what we consider to be wellness and wellbeing. Employers are providing great access, with expanding health benefits to help insurance cover some of these treatments.”

The one component of Crossroads that could qualify as tourism is its Renewal Retreat program, which is open to anyone (not just Crossroads alumni) who has been in long-term recovery but would like to take a week to refresh their recovery in the Antigua environment, says Peraticos. The program has five cottages with individual apartments and is separated from the main treatment campus.

Destination as treatment

Stephano of the Medical Tourism Association says it’s important for stakeholders in the local area of the destination to offer some support for the treatment program. In fact, many people come to the Untied States for addiction services from the Middle East and Asia, she says, because “culturally, the services aren’t available there or they’re looking for privacy. If you’re a high net-worth individual, the world is your oyster.”

The perception of the destination is a part of that, she says. “Why are so many treatment centers located in Florida? If you’re a cash-paying patient, and you can choose where to go, you’re not going to go to Minnesota in the middle of the winter.”

Experts also note that aftercare is an important aspect of recovery, and local resources are imperative for patients. Destinations abroad are unlikely to offer the same support that nearby facilities can provide. Technology tools will gradually improve the ongoing aftercare connection, but most agree that treatment doesn’t end after a residential stay.

Alison Knopf is a freelance writer based in New York.

Long-term support

One problem that Stephano sees for the addiction treatment industry is the lack of a long-term support system. Patients who travel for plastic surgery do not necessarily need long-term support—it’s an acute procedure. “There are not many recovery centers that have a care continuum,” she says. “We developed a certification program launched in 2009 that was designed around the patient care continuum. This would be very appropriate for the addiction rehabilitation industry because it’s looking at the business practices, and what services are available to the traveling patient before, during, and after treatment.”

Stephano adds that technology can help provide this aftercare.

“If you have cancer, you go to online forums, chat rooms, support groups, all kinds of things,” she says. “A cancer [treatment] provider could actually consolidate all of those things for you and give you one app, with support groups, articles customized for my situation. When people leave rehab, they’re still piecing it together. If people could do this on their own, they wouldn’t need to check themselves into a residential program. If you’re charging someone $100,000 for rehab, I think you could put together an app for them to get what they need.”