On Thursday September 14th, The New York Times released an article that both shocked and puzzled many advertisers and business owners. On that date, Google began silently disabling groups of advertisements related to “treatment centers” across the United States.

First off, let’s dispel a rumor that is flying around: Google did not “shut down” all addiction treatment related ads. Not yet anyway, and maybe not ever actually. They’ve imposed restrictions As of now, here is what has been restricted:

  • Some advertisers with a history of arbitrage and other violations were removed completely. Their accounts were banned and any new accounts will be squashed.
  • Some advertisers had only a % of their ads removed
  • Some keywords are completely blacklisted
  • Most new advertisers are being denied in general

I’d also like to say this: there is nothing inherently “wrong” with an actual treatment center advertising via PPC. Perfectly legal, and no ethical quandaries as long as you follow some basic rules. A lot of the most respected treatment centers use (or at some point have used) PPC / Adwords. In fact, I’ve spoken with many treatment centers that only got into the PPC game to combat lead brokers using arbitrage to funnel clients away from their treatment centers. Google recognized the fact that 50,000+ people per year or more are dying from overdoses, and decided to make a stand.

Today I’m not here to talk about shady treatment centers, phone rooms, “marketers”, patient brokering, human trafficking, or anything in between. I’m simply taking a peek into the aftermath of Google’s new regulations. This post will also act as a live journal of sorts, to showcase some of the keywords that have been restricted. We wanted to wait a month to see exactly what changes Google would make, and if any major news releases would come out. In the past Google has made public announcements when they’ve restricted ads, such as the payday loan update in 2016.

Google has made a public effort to help fight human trafficking, but their news release was more geared towards sex trafficking than treatment centers and “body brokers.”

If you’ve been following some of the more competitive keywords, you’ll see that Google is slowly rolling out these restrictions as the days turn into weeks. Let’s have a look see.

In Florida, New Jersey…and even Idaho, a lot of the popular addiction treatment related keywords are a no go.

3 days after Google’s restrictions we tested a control group of keywords. Probably about 100 keywords in total. We waited 3 weeks to test them again, and then another 2 weeks and are finding that Google is in fact still slowly rolling out these restrictions. We tested them from multiple US locations using multiple devices and IP addresses.

We started by checking our home city, Delray Beach for a popular keyword:

We checked out a few of these websites and of course, most of them weren’t even located in Delray Beach. Some were, most weren’t. Actually only 1 out of 4 ads on this page was located somewhere near Delray Beach (about 25 miles away.) One of these treatment centers wasn’t even a treatment center. It was a referral service. Basically the Drug and Alcohol Treatment Center equivalent to 1-800-411-PAIN but shadier, if thats even possible.

After the restrictions (the “organic” maps listings) all of the results actually display results for actual treatment centers located in Delray Beach.

Next, we moved to Boca, baby:

Same deal here. None of these treatment centers a(the ads) are actually located in Boca. After the ban Google now displays results for actual treatment centers located in Boca (from a quick look anyway.)

Out of our examples so far, one of the worst examples and perpetrators was for a group of ads displayed for the keyword “san diego detox.” 50% of the domains we investigated were not even detoxes or treatment centers of any kind. Straight up referral services.

Again, you can see Google straight up annihilated all ads related to this keyword and for good reason. While 2 of these ads seem to be legit treatment centers, 2 of them are clearly not. They are nothing more than a massive call center.

You could find any of these jobs throughout Palm Beach County and across the USA.

Two Weeks Later…

We tested the same 100 keywords along with 20 or so random keywords on October 19th. There are still…seemingly random keywords that Google Adwords is allowing. Just one example:

While “rehab near me” is completely “dead,” it seems “treatment center near me” is ok. We don’t get the logic behind this, but Google Adwords rules / terms have never really been logical on a small scale.

Brand Keywords Seemingly Invincible

Bidding on branded keywords have remained unscathed. I’m sure there are surely some accounts that have been restricted, but the keywords remain in Google search.

As you can see, if you search for a well known treatment center like “Caron” 4 ads appear, none of which are the actual rehab the searcher most likely intended to find.

Competitors bidding on branded keywords isn’t just an issue for treatment centers, almost any industry you’ll find the same thing with a lot of competitive top brands.

Will Google restrict these keywords or have we reached a plateau?

Google Targeting Lead Brokers?

Underneath the moldy crust of the treatment center marketing industry are the “lead brokers agencies.” Lead brokers exist in many different forms that generate leads through:

  • cold calling people out of the blue
  • mass email marketing (SPAM)
  • Google’s organic results
  • and Google Adwords

You might even hear an ad on the radio asking if you need help for addiction, some of those are legit treatment centers but the majority are lead brokers.

Google’s main beef is with the lead brokers, not with individual treatment centers (for the most part.) These folks take a budget of e.g. 1mm / month and put it into a Google (or Bing, lets not forget them) ad budget. They make ads that target any number of keywords like “Caron Foundation” or “rehab near me” and bid high enough so their ads are visible to desperate addicts or families seeking help.

On the other end of their business model, lead brokers sell these leads directly to treatment centers looking to fill their beds. They have “live call” leads, hot leads, cold leads, email leads, live chat leads, SMS text leads…I’m sure there are even some offering video chat leads.

In addition to Google putting restrictions on “treatment center” related keywords, in the past few weeks Google shut down ads for keywords like “buy rehab leads” although (as you can see) there are still plenty of organic results peddling the same services.

NYT mentioned Google setting limits on 2 other industries in the past, but Google has a long history of penalizing entire industries as well as penalizing individual domains including eBay, BMW, Overstock.com, Rap Genius, and many more. Google even penalized themselves at one point. Most of those were violations of their webmaster guideline

From Google:

In the interest of user protection, we have decided to take immediate measures while we further research the industry. As a first step, we’ll be restricting ads traffic for certain rehab-related user queries…We are however looking into more robust, nuanced, and scalable means to ensure user protection while allowing good service providers to promote their business.

Another Google spokesperson stated:

“We found a number of misleading experiences among rehabilitation treatment centers that led to our decision, in consultation with experts, to restrict ads in this category. As always, we constantly review our policies to protect our users and provide good experiences for consumers…”

From ARC (a well known treatment center):

We fully support the actions of Google to protect consumers from unscrupulous companies looking to take advantage of this highly vulnerable population. It is time consumers are provided with transparent and truthful information to appropriately identify high-quality addiction treatment providers. We are hopeful this signals the end of deceptive marketing in our industry…

How much money we talkin’ here?

According to SAMHSA  via Forbes magazine, in 2015 the treatment center industry was estimated to be $35,000,000,000 (zeros written out in full for effect). In simpler terms, when I first moved to South Florida 10+ years ago I could literally count the treatment centers in Palm Beach County on one hand. There are now hundreds of treatment centers of all levels within South Florida alone, at least.

Anyone can navigate over to Google’s Keyword Planner tool to find “suggested bids” and estimations for these keywords.

1 click for one of the top keywords is estimated to be worth $187. That includes accidental clicks, clicks from competitors, and everything in between.

Even some of the “longer tail” queries for keywords like “rehab near me” go for $50+…easy. SEMRush’s popular tool shows volume for even the small time keywords can cost tens of thousands of dollars per month.

Where do we go from here?

It does appear that Google’s restrictions are starting to wind down in terms of keywords they are restricting, but what’s next? I have a few personal theories, perhaps Google will require all ads to have:

  • accreditation on State / local level
  • national accreditation such as CARF
  • EV SSL – to help prove the domain is actually linked with an actual verified company
  • even more restrictions

These restrictions were a nice start, but the same problem still exists. This hasn’t scratched the surface. Restricting PPC ads is great, but treatment centers are dumping millions of dollars per year into SEO as well. Listings on Google search (and Bing / Yahoo) still appear for shady treatment centers. Google’s search algorithm does a decent job of detecting spam, but doesn’t really go after these types of problems. Not yet anyway.

We are definitely going to continue to watch this entire industry and advertising landscape.

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