Last September, West Chester addiction psychologist Drew Alikakos made a jarring discovery: His patients were disappearing.
People weren't showing up for appointments, and he was unable to reach them. Even stranger, a patient told Alikakos that he'd been trying to call the doctor for days but kept getting connected to somebody in Florida.
Alikakos, 59, an affable man with a soft spot for heroin addicts, was stumped. In a surreal moment, he dialed the number Google listed for his office and wound up screaming at the guy who answered — a fellow sitting at a phone in the Sunshine State.
After a heated exchange, Alikakos was able to figure out the mystery.
"People in Florida were shanghaiing my phone number off Google," Alikakos said. When patients called Alikakos, they spoke instead with disarmingly persistent marketers offering free airline tickets, housing, and spots in treatment centers as soon as the next day. Convinced that they needed therapy amid palm trees and warm breezes, several of Alikakos' patients quit West Chester for Palm Beach County.
"This," Alikakos concluded, "is the biggest scam going."
Targeting vulnerable drug addicts and their families, deceptive marketers have been "hijacking" the phone numbers of drug treatment centers in the Philadelphia area and elsewhere, then rerouting them to Florida treatment centers. The ploy takes advantage of a Google feature that allows people to edit a business' phone number on the search engine.
Marketers in far-flung states also cull clients from opioid-plagued places such as Philadelphia by using misleading strategies — such as gaming searches so a person typing the words treatment center near me would see large directories of purportedly local centers with toll-free numbers that direct callers elsewhere.
The prize is a piece of the estimated $45 billion drug-treatment industry fed by an exploding heroin epidemic. Treatment centers pay marketers as much as $1,000 a referral, according to Florida law enforcement.
"Just Google Philadelphia rehab and dial a few numbers you find and see where it leads you," said Al Johnson, Florida's chief assistant state attorney and head of a task force looking into the scheme. "You're at the risk of being hijacked. And Florida is ground zero for people in the Northeast being steered by hijacked Google searches."
Johnson offered a warning for Philadelphia-area treatment centers, as well: "If you don't check on a daily basis, your Google [presence] will be hijacked. Greed has corrupted the system of drug treatment."
It's unknown how many people have been affected by hijacking.
But Alikakos is aware of a few.
"A mother of a client who went to Florida is suicidal," he said. "These people trust you, and all of a sudden they're off on some referral and find themselves in some hole in Florida. How dare you treat humans like meat, shipping them off?"
Local officials and law enforcement agencies said they hadn't heard of the addiction-phone hijacking scheme. The Philadelphia office of the FBI would offer no comment. Sprint, AT&T, and Verizon did not return phone calls.
Like Alikakos, however, drug-treatment practitioners in the area have become well-acquainted with Florida interlopers over the last year.
"It has become a significant problem," said Rick Pine, CEO of Livengrin Foundation, a treatment center headquartered in Bensalem. "It's not unusual for me to search [online for] Livengrin in Bensalem and end up with Florida call centers."
Kevin King, director of community relations at Malvern Institute, based in Plymouth Meeting, said unprincipled marketers "attack constantly."
The owner of a treatment center in Florida, King said he knows some marketers whom he describes as "felons" who hole up in bunkerlike backrooms making phone calls that prey on the weak.
Typically, insurance reimbursements for out-of-network treatment of patients who travel to Florida is three times the amount paid for the same in-network services, according to the "Report on the Proliferation of Fraud and Abuse in Florida's Addiction Treatment Industry," presented by a Palm Beach County grand jury at the end of last year. It's no coincidence, Johnson said, that 75 percent of people in Florida addiction treatment facilities are from out of state.
But many individuals who travel to Florida facilities may not be aware that much of what they pay out of pocket may not be reimbursable, according to a statement from Richard Snyder, chief medical officer for Independence Blue Cross.
After Gaudenzia treatment center in Philadelphia was victimized by hijacking last year, IT director Rick Forwood said he discovered that Florida marketers had taken advantage of a common Google feature.
When people search on Google, it brings up an information box that offers an address and phone number. The box also includes a line that reads, "Suggest an edit." Clicking on that line has allowed a person to change the phone number and replace it with another, Forwood said. If the owner of the page doesn't respond, he said, the change is made.
"It's pretty straightforward," Forwood said. "I could have changed the number of a Fortune 500 company if I wanted."
To complete the deception, a marketer could easily purchase a phone number with a Philadelphia regional area code to replace Gaudenzia's number, making it seem authentic, said Shannon Detwiler, a telecommunications engineer and expert in phone security with Evolve IP, a cloud services company in Wayne.
Forwood said he complained to Google, saying, " 'You do understand it's ridiculous this could happen, right?' "
Google promised to fix the problem, Forwood said.
A spokeswoman for Google who declined to be interviewed said in an emailed statement, "We have no plans to remove 'suggest an edit' and we are continuing to work on ways to fight these issues and keep our information up to date."
Peter Thomas, membership manager of the National Association of Addiction Treatment Providers, based in Denver, said that the misuse of the "suggest an edit" feature is "scary" because, although there are many good treatment centers, "people who mislead patients and act like they're someone else are not focusing on good care. There's potential to cause harm to patients."
Richard Frankel, a law professor at Drexel University and a consumer-protection expert, suggested that perpetrators of phone hijacking may be breaking various civil and criminal laws related to fraud, deception, and theft of service.
In Palm Beach County, the grand jury's report has led to the creation of a statute taking effect July 1. The law doesn't address "suggest an edit" abuses specifically, but it will allow Florida to "muscle up" in the battle to end exploitation of patients as well as misrepresentation of services in connection with phone hijacking scams, said a spokesman for the state attorney.
Even without the fraud, looking for help on Google can be daunting for the desperate parent of a heroin-addicted child.
A person typing the words treatment center near me into Google would encounter so-called organic listings under the ads that include large directories with prominently displayed toll-free numbers that direct consumers to places other than local facilities.
"A family in crisis needs clear information," said Melissa Gettler, vice president of marketing at Caron Treatment Centers in Reading. "This aggregator model is unethical."
In many cases, digital consultants say, maps on Google showing treatment centers fraudulently display nonexistent names or numbers. And phone numbers in organic listings often ring in call centers far from the caller's location.
One Google listing for drug rehab in Philadelphia includes a number with a local 267 area code that is answered by a "hotline" in Miami. A treatment center identified as being on Market Street in Philadelphia features a toll-free number with a man on the other end who said, "I couldn't tell you why my phone is ringing in Manchester, N.H. Do you need addiction help?"
This brave new world of searching for assistance for substance abuse is too much for Charles Scott, 51, an alcoholic from Northeast Philadelphia who installs security systems.
Scott said he once called an 800 number that he thought would reach a Philadelphia rehab center, but he wound up speaking to a person in Florida who offered to pay his bus fare to Palm Beach County.
"The guy buttered it up, making the place sound all sweet and chocolaty," Scott said. "But I knew it was a bait-and-switch thing and I didn't go.
"I called rehab places in Philadelphia for help before. But it's always Florida that answers."