Federal Standards for SUD Treatment Centers: Why It's Time for Accountability

Author of the Month

January 26, 2026

Belinda (Belle) Morey, Author

Tom O'Connor, Publisher

The substance recovery system is criticized by both former patients, their families, and substance use and mental health disorder professionals for instances where financial incentives lead to practices that exploit the vulnerability of those with addiction. The consequences of this exploitation are the high cost of treatment, predatory marketing, insurance manipulation, and low standards of care driven by a profit-first mentality. This can result in patients being cycled through treatment programs for profit, rather than receiving the comprehensive, long-term support needed for recovery.

Author Belinda Morey is a frequent contributor to our Vital Voyage Blog and a member of the Editorial Advisory Board.

According to Belinda Morey 

Alright, let's get this out of the way first: addiction treatment is serious business. People's lives are literally at stake. But if you think the world of substance use disorder (SUD) treatment is all serene meditation circles and kumbaya moments, welcome to reality. It's messy, complicated, and sometimes downright absurd. Yet, underneath the chaos, there's a glaring problem we can't keep ignoring—the shocking lack of federal standards and accountability for SUD treatment centers. This is not a problem we can afford to put off addressing. The time for action is now, and the urgency of this issue cannot be overstated.

Hospitals must follow strict rules: track outcomes and safety reports, and continually demonstrate that they're not harming patients by accident. SUD treatment centers? Many of them operate in a shadowy "Wild West" where what you hear is often marketing fluff rather than solid data. And guess what? That's a huge problem.

Why More Information Isn't Just About Accountability 

We all want accountability, sure. But beyond that, it's about understanding something deeply human: addiction and recovery don't look the same on everyone's face. It's intensely personal, individual, and yes, sometimes bizarre.

Here's the kicker: many treatment centers, especially those funded by state, county, or federal money, are stuck in the '90s with a one-size-fits-all 12-step model. This model, while effective for some, doesn't work for everyone. Some people need a different approach, whether that's trauma-informed therapy, medication-assisted treatment (MAT), cognitive behavioral therapy, or even art therapy or dog therapy if that's what works for them.

So how do we measure what works? How do we determine if people are truly improving, or merely cycling through a revolving door? It's complicated, but transparency and solid data are the only way. Research indicates that tracking treatment engagement, completion, and other outcome measures is crucial to understanding and enhancing recovery success rates. Without those metrics, we're flying blind, and people pay the ultimate price.

A System Built on Shame and Silence: Let's Get Loud About It

Here's the harsh truth: the addiction treatment system was built on shame and silence. This isn't ancient history—it's recent enough to sting still. Consider this: for decades, addiction was seen as merely a moral failing. If you had a drinking problem, you were considered a bad person. Struggling with drugs? You were labeled weak. Mental health issues? You were called "crazy" or "lazy." This narrative kept families silent, isolated people suffering in silence, and allowed treatment centers to hide behind stigma. When we remain silent, people die—plain and simple. People die from untreated withdrawal symptoms that can linger for weeks in residential treatment. Withdrawal symptoms—like nausea, anxiety, insomnia, and more—can be severe and dangerous if not managed properly. Yet, many centers fail to adequately address these symptoms, prolonging suffering and risking patient safety. NCBI Bookshelf. People also die from medication errors and neglect, often swept under the rug because no one reports these tragedies openly. This silence isn't just negligent; it's deadly.

What Would Federal Standards Really Look Like? And Are They Even Attainable?

Considering federal standards for SUD treatment centers may be a dream. But what would that actually entail?

• Outcome Tracking: Public, verified data on relapse rates, retention, overdose deaths, and treatment completion. No more misleading marketing.

• Patient Safety: Protocols to manage detox safely (because, yes, two weeks into treatment with untreated withdrawal symptoms can be a nightmare). Medication errors? Not on our watch, SAMHSA.

• Qualified Staff: Clear minimum certifications are required for everyone—counselors, medical providers, and peer support workers.

• Access to Evidence-Based Treatments: MAT, therapy options, holistic care—whatever 

• actually helps the person in front of you. 

• Regular, Independent Inspections: Surprise audits by agencies that genuinely care about patient safety, not just rubber-stamping licenses.

*You may also like Jason Shiers post.

Sounds great. But is it realistic? 

The industry has entrenched interests, and funding is limited. We may need to think outside the box. Could tech-enabled remote monitoring help? What about community-based recovery models? How do we strike a balance between strict standards and personalized care? These are questions worth asking. But the potential for change is real, and it's this potential that should inspire us to keep pushing for a better system. Change is possible, and it's up to us to make it happen.

Why It Matters Beyond the Numbers

Numbers are sexy—data, statistics, outcomes. But people are more than numbers. They're messy, complicated humans with stories that don't fit neat charts. It's these stories that remind us why we're fighting for change, and why we can't afford to ignore the numbers.

That said, ignoring the stats is a death sentence. Medication errors, untreated withdrawal, neglect—it all shows up in the data if we just look. When we fail to track and act on these numbers, we fail the people we serve. It's about saving lives, simply put.

Call to Action: For Professionals, Families, and Everyone In-Between

For Professionals:

• Speak up. Advocate for policies that require transparency and federal standards.

• Educate your clients and their families about what good treatment looks like.

• Push for integration of peer support and diverse treatment modalities.

• Demand accountability—not just from treatment centers, but from regulators and funders. As stakeholders in the fight against substance use disorder, it's our responsibility to ensure that everyone involved is held to the highest standards of care and transparency.

For Clients and Families:

• Ask the hard questions: What are your relapse rates? What treatments do you offer? How do you manage withdrawal symptoms?

• Don't accept vague answers or glossy brochures.

• Connect with peer support groups or advocates who can help you navigate options.

• Share your story to break the silence and stigma. Your voice matters, and by sharing your experiences, you can help others who may be going through similar struggles. Together, we can create a community of support and understanding.

The Road Ahead: What Does Treatment Look Like?

Imagine a future where addiction treatment centers are as transparent and accountable as hospitals, where every person gets a treatment plan tailored to their unique story, where shame and silence are replaced with honesty, empathy, and respect. This future is not just a dream; it is a real possibility if we all work together to bring about change.

This future won't come easy. It requires relentless advocacy, policy change, and a cultural shift in how we view addiction and recovery.

But it's possible. And it's necessary.

Because behind every statistic is a human life that matters.

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Belinda Morey earned a Bachelor's Degree in Substance Abuse/Addiction Counseling.

You can contact Belinda at: bellebick10@gmail.com 

Belinda's Blog Progressisprogress.substack.com 

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