Key Points

  • Meta agreed to pay up to $17 billion and add mandatory safety controls for teen users on Instagram and Facebook, settling claims from state attorneys general across 51 jurisdictions.
  • New platform rules require a default two-hour daily limit for users under 18, overnight blocks from midnight to 6 a.m., disabled like counts on posts, and deactivated cosmetic surgery filters.
  • Ten California addiction treatment providers allege Cigna paid roughly 16 cents on the dollar for covered care, resulting in a gap of about $12.8 million; no court has ruled on these claims.
  • Before entering an out-of-network program, ask your insurer for the specific reimbursement rate for your level of care in writing, and ask the facility whether it will bill you for any unpaid balance.
  • The DEA placed three synthetic kratom-related compounds on Schedule I after linking them to at least 73 overdose cases, the majority fatal; traditional botanical kratom leaf is not covered by this order.
  • People who have developed physical dependence on products marketed as kratom may have opioid use disorder and should be assessed and treated accordingly, regardless of what the packaging stated.

Addiction News Weekly Episode 1.15

In This Episode

Episode Transcript

Welcome to Addiction News Weekly by Rehab.com, where we break down the biggest stories in addiction, recovery, and public health. This week, three institutions got pushed.

Meta’s $17 Billion Settlement and What It Means for Teen Mental Health

Meta and a coalition of state attorneys general filed a proposed settlement last week, ending a landmark federal trial in Oakland before Instagram head Adam Mosseri finished the company’s defense and before Mark Zuckerberg took the stand. Court filings reported by multiple outlets put the payment to the 29 states that sued in 2023 at up to $16.68 billion, with California’s attorney general’s office describing the total as roughly $17 billion paid out over 10 years, resolving the claims of 51 attorneys general.1 Meta denied wrongdoing and called the agreement an important step.

The operational requirements may carry more immediate weight for families than the payment itself, because they take effect in months rather than years. Accounts for users under 18 get a default two-hour daily limit and an overnight block between midnight and 6 a.m., and only a parent can lift either restriction. Notifications shut off overnight and during school hours. Like counts disappear from posts made by minors, cosmetic surgery filters are disabled, and young users can choose a feed that is not algorithmically targeted at them. An independent auditor will have access to company information and a direct line to the attorneys general.1

Here is the honest treatment picture. Compulsive social media use in adolescents is not a standalone diagnosis, and residential programs do not treat it the way they treat alcohol or opioid dependence. What programs do treat is the cluster it commonly travels with: anxiety, depression, disrupted sleep, and, in adolescence, a documented overlap with substance use. This is why adolescent programs are usually built around the dual diagnosis model, which addresses mental health conditions and substance use at the same time.

Nothing in this settlement pays for anyone’s care or expands insurance coverage. What it gives parents is language and legitimacy when they raise the concern of a child’s platform use with a pediatrician. If screen use appears alongside sleep loss, withdrawal from friends, or a drop in functioning at school, that is reason to seek an assessment now rather than wait for the platform changes to arrive.

Cigna Paid Addiction Providers 16 Cents on the Dollar, Lawsuit Alleges

A lawsuit filed August 19 in the U.S. District Court for the Central District of California alleges that a gap between what insurance says it covers and what a provider actually receives ran to roughly 84 cents on the dollar.2 Ten out-of-network substance use disorder treatment centers and clinical laboratories say Cigna paid them approximately 16% of their covered charges across 83 patients treated between March 2022 and March 2026. As a group, they say they received about $2.5 million against covered charges of roughly $15.3 million and are seeking the balance of about $12.8 million.2,3 No defendant has filed a public response, and no court has ruled on any of these claims.

The fee structure described in the complaint is the section with the widest implications. On self-funded employer plans, the complaint alleges Cigna collected a per-member fee plus a cost-containment fee calculated as roughly 27 to 29% of the difference between what a provider billed and what Cigna paid, with a third-party repricer taking another 9 to 12% of that same difference.2 The plaintiffs argue those fees tracked the size of the reduction rather than the accuracy of the price, and allege Cigna’s fee for reducing the bills was nearly double what it paid the providers for delivering treatment. Those are the plaintiffs’ characterizations, not findings of fact.

The complaint separately alleges the approach violated the federal mental health parity law, which is supposed to stop addiction treatment from being covered on worse terms than physical health care. The Mental Health Parity and Addiction Equity Act, and how the Affordable Care Act extended it, requires that insurers apply the same criteria to addiction benefits that they apply to comparable medical or surgical benefits.

What Out-of-Network Patients Need to Know About Insurance Payments

If you are considering an out-of-network program, the reimbursement rate your plan actually applies matters more than the fact that it covers addiction treatment at all, because a low payment to the facility can turn into a balance bill that reaches you directly.

Ask two questions before admission. First: what specific rate will my plan pay for this level of care at an out-of-network facility? Second: will you bill me for any difference between what the plan pays and what you charge? Get both answers in writing, from the plan and from the program, before any services begin.

DEA Places Three Synthetic Kratom Compounds on Schedule I

The Drug Enforcement Administration issued a temporary order on August 25, 2026, placing three compounds into Schedule I of the Controlled Substances Act: mitragynine pseudoindoxyl, MGM-15, and MGM-16.4 The order states that the placement is necessary to avoid an imminent hazard to public safety. Between February 2025 and May 2026, mitragynine pseudoindoxyl was linked to at least 56 overdose cases, 48 of them fatal. MGM-15 was tied to 17 cases in three months this spring, 16 of them fatal.4

The action applies to deliberately manufactured and concentrated compounds, not to traditional botanical kratom leaf. The Justice Department made that distinction explicit in its announcement.5 The distinction matters clinically because the DEA found that products containing these compounds were marketed as kratom and sold as flavored chewable tablets and liquid shots under brand names at gas stations and vape shops, often without any age restriction.4 The label on the packaging is not a reliable guide to what is inside.

Dr. Sylvie Stacy on Kratom Dependence and Opioid Treatment

Dr. Sylvie Stacy, Rehab.com’s Medical Officer, explains what the scheduling action means in clinical practice.

“A really important thing to point out here is that this action from the DEA covers deliberately manufactured concentrated compounds. It doesn’t cover traditional botanical kratom leaf, and the Justice Department really made that clear. But here’s the problem for anyone assessing use of these products. The DEA found these products were marketed as kratom and were sold as flavored chewable tablets and liquid shots under brand names at gas stations and vape shops, often without any age restriction. So the label on the package is not really a reliable guide as to what’s inside.

“Someone who bought what they believed was an herbal supplement may be physically dependent on really a potent opioid. I’ve treated patients who started with powdered substances or the standard tablets and then progressed to the more concentrated analogs, and they were taking multiple doses per day. When they try to cut back, they often hit a wall. I’ve seen patients who have high blood pressure, racing heart, severe body aches, GI distress, and chills, and they need supportive medical management, often for several days. It really is true opioid withdrawal, and it responds to opioid-focused care. It’s definitely not the effects that someone should get from simply discontinuing a legitimate product that can be purchased readily over the counter.

“I think a good rule of thumb is that if someone who has been using these products regularly gets withdrawal when they stop, that is opioid dependence, and it should be assessed and treated as opioid dependence, no matter what the packaging said. The medications that I use when I do diagnose someone with opioid use disorder are the same ones that we use for any opioid use disorder. Suboxone is what I prefer for most patients in this situation. Naltrexone is a great option for someone if they’re able to go through the withdrawal process first. A small percentage of my patients have actually been great candidates for methadone as well.

“The final thing I want to point out here is that these products don’t show up on standard drug test panels, so they can easily be missed if we don’t take a careful history. We really need to be specific with our intake processes to gather information about brand names and doses, and also to remind our patients that we’re there to treat them. We’re not there to report them or to get them in trouble, so really encouraging them to be forthcoming about what it is that they’ve been taking.”

Conclusion

This week, three institutions faced three different kinds of pressure. A platform agreed to pay billions and rebuild how teenagers use its apps. An insurer is being accused in court of paying a fraction of what addiction treatment costs. And a regulator pulled three products from store shelves after 64 people died.

The pressure that changes systems comes from people who ask questions, keep records, and refuse to accept the first answer. That works at the individual level as well. If you or someone you love is looking for treatment, Rehab.com lists thousands of verified centers across the country. Free, confidential support is available anytime through the SAMHSA National Helpline at 1-800-662-4357. If you are in immediate crisis, you can call or text 988 at any time.

For more, visit Rehab.com. We will be back next week. I’m Kay, and thank you for listening.

Sources in This Episode

  1. Bray C, Alspach R, Lau T. Meta agrees to settle social media addiction case for up to $16.8B. FOX 35 Orlando. August 27, 2026. https://www.fox35orlando.com/news/meta-agrees-settle-social-media-addiction-case-up-16b.amp. Accessed September 8, 2026.
  2. Romero T. Providers sue Cigna over alleged $12.8 million addiction claims shortfall. Insurance Business Mag. August 2026. https://www.insurancebusinessmag.com/us/news/risk-compliance-legal/providers-sue-cigna-over-alleged-12-8-million-addiction-claims-shortfall-586905.aspx. Accessed September 8, 2026.
  3. Bender E. Cigna faces $12.8M lawsuit over addiction-treatment claims. Healthcare Finance News. August 2026. https://www.healthcarefinancenews.com/news/cigna-faces-128m-lawsuit-over-addiction-treatment-claims. Accessed September 8, 2026.
  4. Drug Enforcement Administration. Schedules of Controlled Substances: Temporary Placement of Mitragynine Pseudoindoxyl, MGM-15, and MGM-16 in Schedule I. Federal Register. August 26, 2026. https://www.federalregister.gov/documents/2026/08/26/2026-17429/schedules-of-control. Accessed September 8, 2026.
  5. Spencer Fane LLP. DEA Temporarily Schedules Synthetic Kratom-Related Products Mitragynine Pseudoindoxyl, MGM-15, and MGM-16 in Schedule I. August 28, 2026. https://www.spencerfane.com/insight/dea-temporarily-schedules-synthetic-kratom-related-products-mitragynine-pseudoindoxyl-mgm-15-and-mgm-16-in-schedule-i-is-7-oh-next/. Accessed September 8, 2026.
  6. U.S. Department of Justice. Justice Department Schedules Synthetic Kratom-Related Opioids as Schedule I Controlled Substances. Accessed September 8, 2026. [DOJ press release, date August 2026 — confirm exact URL from DOJ.gov for publish.]

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Dr. Sylvie Stacy Written By: Dr. Sylvie Stacy MD, MPH Chief Medical Officer
Sylvie Stacy, MD, MPH, Medical Officer at Rehab.com, is a board-certified addiction medicine specialist with over a decade of experience treating individuals with addictions in diverse clinical settings including residential treatment programs, detox centers, outpatient clinics, and correctional facilities.