Documentaries often suit investigative journalism better than long-form articles because they can get close to the persons involved, condense events through editing, and illustrate a point visually as well as verbally. Such is the case with “Shuffle,” an engaging and enraging doc focused on corruption, inefficiency, and laxity within the largely unregulated American addiction treatment industry. 

Having garnered some press attention in the past 10 years, the issue nevertheless remains an obscure one despite the opioid crisis and increase in treatment facilities. As director Benjamin Flaherty mentions near the documentary’s end, the growth of rehab centers and services has not corresponded with a projected rise in long-term recovery rates. This disconnect is also a personal one because Mr. Flaherty is himself a recovering alcoholic who credits the program he went through for being transformative. Hearing how some centers treat addicts as commodities, he set forth to examine fraud, profiteering, and malpractice utilizing his filmmaking experience. 

Shot over three years, the feature begins in South Florida, otherwise known as the rehab capital of the country due to its multitude of treatment centers and sober homes. The irony that an area famous for its party atmosphere is home to so many recovery facilities is not lost on Cory, a young man lured to treatment in the Sunshine State years earlier and still unable to get clean. There’s also Cory’s friend, Nicole, who’s been to 36 facilities and reads a long list of names of those she’s known who have died. Along with Daniel, a young Kentuckian who went to California for an outpatient rehab program, the documentary creates compelling portraits of the real-life consequences of the industry’s “shuffling.”

Briefly chronicling the evolution of rehabilitation from religious charities to for-profit “destination rehabs,” the film identifies the current period of growth and corruption as a direct result of the Affordable Care Act and its provision for addiction treatment coverage without a lifetime limit or healthful outcome conditions. Soon after the legislation’s passage, 800 numbers and Facebook ads proliferated while a broker system was established in which finder’s fees took a piece of the insurance money. Further get-rich-quick schemes led to testing scams, a cash-grab diversification of services, and a reliance on medically approved controlled substances at some centers.

Mr. Flaherty addresses how untreated opioid addiction costs the healthcare industry billions of dollars, and even acknowledges how the law helped him when he was in need of help. Yet he also interviews a former addict-turned-outreach coordinator and an insurance analyst, neither of whom shows their face, to discuss the fraud taking place. It’s noted that a patient can accumulate claims over a year in excess of 1 million dollars, some of which can shockingly get into his or her own pockets via a kickback for cycling through recovery and relapse, as demonstrated by Cory. 

Despite this swindle, the young addict is not portrayed as a criminal so much as a social outcast with a chronic disease who got wise to the corruption around him — who realized how it pays to be in treatment. Elsewhere, Mr. Flaherty makes reference to accusations of conflict of interest pertaining to the former deputy director of the Office of National Drug Control Policy under President Obama, A. Thomas McLellan. Mr. McLellan, the film relates, did not respond to Mr. Flaherty’s requests for comment.

Besides conflicts of interest, Mr. Flaherty briefly explores the influence of private equity investing on the industry, how investment capital’s impetus is to generate wealth — not health — and how sobriety becomes a loss of profit. Ultimately, though, it is the individuals he follows who prove his points, particularly those who get better in more regulated programs, such as those offered in Massachusetts. Tragedy strikes as well, though the subtle direction depicts it quietly and reflectively instead of emotionally.

Although no drug use is shown, an uneasiness troubles the viewer a couple of times, particularly when one senses that an interviewee may be high. The director himself questions whether filming the vicious circle of rehabilitation and relapse provides a platform for indulgence by the addicts. Yet his low-key voiceover narration, empathetic personal story, and investigative analysis neutralize his concerns, casting him as an overly cautious, conscientious filmmaker wishing to avoid exploiting his subjects as many centers have done. He needn’t have worried: his aim was true and his documentary is an eloquent eye-opener of struggling souls and the often uncaring system preying on them.