Nikki Soda was 22 when she realized her drinking and drug use had gotten out of hand. After spending an entire paycheck on a spur-of-the-moment trip to Key West with a friend, she called her mom for help, and her mom refused. So Nikki did something few people do on their own: she walked into her boss's office and admitted she thought she had a problem. He told her she was fine, since she drank and used "just like he did." That was the real red flag—a 22-year-old young woman keeping pace with a grown man wasn't a sign she was fine. It was a sign she needed help.

Since then, Nikki has spent more than a decade working on the other side of treatment. She earned a master's in addiction policy from Georgetown and most recently served as Director of Membership and State Advocacy for the National Association of Addiction Treatment Providers, a role that took her to treatment centers across the country. Today, she runs her own consulting firm alongside her husband.

That inside view has given her strong opinions about what's working in treatment and what isn't. "Meet them where they're at" is a common approach that lets a person's own goals guide their care, but Nikki questions how far it should go in the early stages. Someone in active addiction is making decisions with an impaired brain, she explains, and if her care in detox had followed what she wanted at the time, she would have chosen to keep using.

She also wonders whether money is shaping too much of the industry, pointing to the people on the front lines, and she shares her concern about the shift back toward criminal penalties for substance use, including funding being pulled from treatment programs in jails.

It's a candid look at what people in treatment really need, and what's at stake when recovery becomes a business.

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This episode is sponsored by Guardian Recovery. If you or someone you love is struggling with addiction or mental health challenges, Guardian can help. Visit https://www.guardianrecovery.com or call 888-721-3790 for confidential support and guidance.