As drug addiction soars in the United States, a booming business of rehab centers has sprung up to treat the problem. And when drug addicts and their families search for help, they often turn to Google.
But prosecutors and health advocates have warned that many online searches are leading addicts to click on ads for rehab centers that are unfit to help them or, in some cases, endangering their lives.
This week, Google acknowledged the problem — and started restricting ads that come up when someone searches for addiction treatment on its site. “We found a number of misleading experiences among rehabilitation treatment centers that led to our decision,” Google spokeswoman Elisa Greene said in a statement on Thursday.
Google has taken similar steps to restrict advertisements only a few times before. Last year it limited ads for payday lenders, and in the past, it created a verification system for locksmiths to prevent fraud.
In this case, the restrictions will limit a popular marketing tool in the $35 billion addiction treatment business, affecting thousands of small-time operators.
“This is a bold move by one of the world’s biggest companies, saying people’s lives are more important than profit,” said Greg Williams, co-founder of Facing Addiction, a nonprofit group that is an advocate for people struggling with addiction.
Many rehab centers, a large number of which are clustered in warm climates like Florida, Arizona and California, rely on Google searches to attract patients from across the country. Their strategy often included buying an ad that would come up when someone searched for phrases like “drug rehab” or “alcohol treatment centers.”
As of this week, Google has stopped selling ads related to those searches, although it may lift the restriction if it can find a way to weed out misleading advertisements.
Search ads for addiction treatment are lucrative. Treatment providers, in some cases, have been willing to pay $70 per ad click, according to an analysis that Mr. Williams’ group conducted and presented to Google executives.
But the payoff for those clicks can be significant. Addicts who sign up for 30 days of residential treatment can bring in tens of thousands of dollars from private insurance.
The crucial, if the unwitting, role that Google has played in the treatment industry exposes the deep flaws in how drug addicts are cared for in America. Despite the rapid growth in the number of addiction cases — and the Trump Administration’s declaration that the opioid crisis is a national emergency — the treatment industry remains a hodgepodge of upstart businesses, with only a few well-known providers.
What constitutes treatment is also all over the map, from yoga and equine therapy to daily doses of medication. And unlike other serious illnesses, like cancer or heart disease, where a physician typically refers the patient for treatment, many addicts and their families look for help on the internet.
That has made Google one of the largest referral sources for treating a disease that affects millions of Americans. And the companies willing to pay the most for ads are the ones that addicts are most likely to see on their search.
But ad-driven searches, according to advocates and law enforcement officials, have not always led patients to the best care. In some cases, they have found that patients are being duped, a phenomenon Google on Thursday acknowledged.
Last December, a Florida grand jury released a report detailing abuses in the state’s addiction treatment industry, which is centered around Palm Beach County. Among the findings, the grand jury zeroed on the problems with how some of the shoddy programs were being marketed online.
One witness, according to the grand jury report, described how “online marketers use Google search terms to essentially hijack the good name and reputation of notable treatment providers only to route the caller to the highest bidder.”
Another common trap: Addicts search Google for a rehab program close to their home, but they will click on an ad for a referral service pitching treatment in another state. The referral service then collects a fee, if they signed up.
Google’s restrictions were cheered by health officials, who have called for more medically-based treatment. “People don’t always know what good treatment is,” said Dr. Vivek Murthy, who was surgeon general in the Obama Administration and published an oft-cited report last year that warned of the nation’s addiction crisis. “I am glad Google took steps to prevent the spread of these false ads.”
In targeting the ads for addiction treatment, Google consulted with experts including Mr. Williams, who himself has been in recovery for many years. He said he began discussions with Google executives around the time that Dr. Murthy released his report.
Mr. Williams said that he had explained to Google that his own experience trying to buy ads from the company had illustrated how the process of finding information about addiction treatment online was providing people with unreliable information. Mr. Williams said he discovered this when his group received a grant from Google that would help him buy ads promoting a website providing information about community-based treatment — and found he couldn’t compete.
Buying ads on Google involves bidding to place your ad at the top of the search results when a user types in words relevant to your product or service. But Mr. Williams found that the bid prices for words related to treatment had gotten so expensive that his group couldn’t pay as much as the for-profit treatment providers. Some of those treatment providers, Mr. Williams told Google, were not only misleading, they had been charged with crimes.
In a series of phone calls and a meeting in Washington, D.C., Mr. Williams presented the company his research. He highlighted that some of the biggest buyers of ad words related to treatment had been accused of misdeeds related to insurance fraud and sexual assault.
“We stumbled upon this issue organically,” said Mr. Williams. “And they heard us out.”