On the last day of his life, Gary Benefield expressed hope for the future. He was finally about to “get right,” he said.

A Harley-riding tough guy and retired utility worker, Mr. Benefield had let addiction get the better of him. He was downing a dozen Budweisers a day and smoking nonstop, despite needing an oxygen tank to breathe. But that July day in 2010, he was headed to A Better Tomorrow, a California treatment center promising 24-hour care while he got sober.

Mr. Benefield was about to join the millions of Americans who have placed their fate in the hands of the nation’s sprawling, haphazardly regulated addiction-treatment industry. It is a wildly profitable business, thanks in large part to addicts like Gary.

He kissed his wife, Kelly, goodbye at the tiny airport in Show Low, Ariz., a town named for the lucky turn of a playing card more than a century earlier. “He told me he loved me,” she said later. That evening, he checked in at the treatment center.

In This Series

The next morning, as dawn broke over A Better Tomorrow’s postage-stamp lawn and stucco walls, two new voice mail messages awaited an employee there.

One came from Kelly Benefield, asking: Could someone help her bring Gary a cake that day? It was his 53rd birthday.

The other came from a manager: Gary Benefield was dead.

A Land of Opioids and Opportunity

America is convulsed by an addiction crisis — painkillers, heroin, alcoholism, meth — and its victims die with tragic regularity. But Mr. Benefield’s case is extraordinary.

His death in July 2010 kicked off a six-year battle that very nearly brought down one of the biggest addiction-treatment companies in the country, an epic clash between an addiction-treatment multimillionaire and a college kid and budding financial wizard.

On one side was Michael Cartwright, a former addict pursuing his dream of building a nationwide empire of trustworthy drug-treatment clinics — a kind of Mayo Clinic for addiction. His Nashville, Tenn., company owned the clinic where Mr. Benefield had died.

On the other was Chris Drose, who, uninspired by his class work at Furman University, became fascinated with short selling — a risky investment strategy of trying to make money by betting that a company’s stock will fall.

In Mr. Cartwright’s company, the college junior saw a very big “short.” And he attacked.

Addiction treatment is one of the most lucrative health care industries to emerge in a generation, a massive business fed by a national addiction crisis that, by most measures, is out of control. Drug overdoses kill more Americans than car accidents, but only a fraction of the country’s 23 million addicts go into rehab, creating an untapped market — and an enormous business opportunity.

Yet the industry focused on curing addiction has its shortcomings. One of the most significant: There is little consensus on the most effective ways to treat patients.

Should patients travel far from home, as Mr. Benefield did, to isolate them from temptation? Or should they stay close to their support networks of family and friends? Should they be treated with medications that reduce the appetite for opioids? Or should they be coached to conquer their illness through willpower?

The field is also covered by a patchwork of regulations that haven’t kept pace with its growth. That has created room for opportunistic small operators to spring up, some with questionable track records.

The industry started taking off when President George W. Bush in 2008 signed a law requiring insurers to pay for rehab. The 2010 Affordable Care Act expanded coverage further. Suddenly just about anyone with insurance could get help.

Today, private insurance covers treatment for millions of working and middle-class Americans. Annual spending by private insurers on opiate addiction alone rose more than 1,000 percent in the five-year period ending in 2015, to roughly $721 million, according to Fair Health, an independent nonprofit that keeps a database of private insurance claims.

Mr. Cartwright’s company, American Addiction Centers, operates treatment centers in eight states around the country. That was how Mr. Benefield ended up in a treatment facility in California: Eager to get sober, he and his wife searched online from their home in Arizona for a clinic, found A Better Tomorrow — which eventually became part of Mr. Cartwright’s business — and then called up to book a spot.

This account of Mr. Benefield’s final days, and the battle over American Addiction Centers, draws on interviews with executives, front-line employees, addicts, police and investors, as well as thousands of court documents.

A Wall Street Payday Worth Millions

On October 3, 2014 — four years after Mr. Benefield’s death — Michael Cartwright and his business partner, Jerrod Menz, rang the opening bell on the New York Stock Exchange to announce the first of day trading in their company’s shares. Mr. Cartwright, standing next to his teenage daughter, clapped. Mr. Menz gave the thumbs up.

At the close of trading that day, shares in American Addiction Centers held by the two men — the two largest shareholders — were worth a combined $202 million.

It was a crowning achievement for both men, but particularly for Mr. Cartwright, who had started his career running a rehab center for mentally ill addicts in inner city Nashville.

In 2012, Mr. Cartwright started buying up smaller providers, including one that had been started by Mr. Menz, his longtime friend, in Southern California, and assembling them into a national chain.

Mr. Cartwright himself had abused drugs as a younger man, “anything I could get my hands on,” he said in an interview. Mr. Cartwright also spent time in a psychiatric hospital after a breakdown, an experience that helped to shape his belief that anyone can overcome addiction as long as they have the right mind-set.

He credited his grandmother’s tough love with helping him turn his life around. “She wasn’t about to let me wallow in my own poop,” he wrote in his book, “Believable Hope.”

Addiction should be overcome by willpower and hard work in therapy, Mr. Cartwright said. Other treatment providers put more emphasis on medicines to help addicts — particularly opiate addicts — function in the long term.

The treatment world is split by methodology and motivation — inpatient and outpatient, religious and secular, nonprofit and moneymaking. Such a Balkanized industry seemed ripe for consolidation by a businessman like Mr. Cartwright.

With aggressive internet marketing and a central call center, Mr. Cartwright pulled in patients from around the country. Patients stay for weeks at a time in a treatment house, undergoing therapy paid for by private insurance.

“If you can create a great brand, which I think Michael can,” said Lucius Burch III, an early investor in American Addiction Centers and a former chairman of a Nashville company that runs private prisons, “you have an opportunity to build a huge company.”

An Easter Egg Hunt for Something Bad

But there were people who believed they saw big vulnerabilities in that emerging brand, including a college student in South Carolina.

With bushy eyebrows and a boyish face, Mr. Drose comes from a family of skeptics and crusaders. His grandfather helped plot the assassination of Rafael Trujillo, a dictator in his native Dominican Republic, in the 1960s.

He remembered the day, in late 2014, that he discovered the investment idea that would launch his career. He was 19, sitting on a purple armchair in his dorm room at Furman, where he liked to spend his spare time scanning financial filings in search of stocks to “short,” or bet against.

“It’s like a big Easter egg hunt,” Mr. Drose said recently. “Except, for something bad.”

That day, one company stood out to him — American Addiction Centers. In just a few months in existence as a publicly traded stock, its shares had risen a blistering 60 percent.

Any time a stock rises that quickly, short sellers like Mr. Drose sense an opportunity. But there was something else that piqued his interest.

A business that profited from people’s desperation seemed like “an industry that might have something weird going on,” Mr. Drose said.

But weird wouldn’t begin to describe the world he was about to enter.

Culling through American Addiction Centers’ public filings, he noticed that a health insurer had sued one of the company’s subsidiaries, claiming that it had conducted unnecessary drug tests on patients’ urine. Posing as a prospective patient, Mr. Drose called the company and asked how often it conducted drug tests, and came to believe that American Addiction Centers was testing much more frequently than other providers.

He wrote an article about his findings on a website called Seeking Alpha, which short sellers frequent for investment tips. The company’s stock promptly dropped 10 percent.

That was a big win for anyone short-selling the stock. Short sellers borrow shares in a company, then sell them hoping that the price falls. Their goal is to buy back the shares later, at a cheaper price, and return them to the lender. The price decline is their profit.

In Nashville, Mr. Cartwright watched his stock fall, and was stunned. “We found no substantiation for any one of his claims,” he said in an interview, referring to Mr. Drose’s article.

Battle lines were being drawn and Mr. Drose’s work was attracting attention elsewhere. Kingsford Capital, a hedge fund based outside of San Francisco, hired him as a consultant and told him to keep digging into the treatment business.

And another interested party had noticed Mr. Drose’s work, too: a man named Charles Hill, who ran a treatment center in Temecula, Calif., the town where Mr. Benefield had died.

Mr. Hill told Mr. Drose that he knew a great deal about American Addiction Centers. He congratulated him on his article about the urine testing, and suggested he start searching for lawsuits brought by families of patients who had died in California. “You’ve been looking in the wrong place,” he told Mr. Drose.

Following Mr. Hill’s advice, Mr. Drose flew to California in the spring of 2015. He may have been working for a major hedge fund, but he was so young — still only 20 — that he had to pay extra to rent a car.

The two men met at Mr. Hill’s rehab center in Temecula, a maze of cul-de-sacs and shopping plazas book-ended by the velvet green Santa Rosa mountains and the snowcapped peaks of the San Bernardino range.

Mr. Hill thought the college kid was an investigative reporter. So he was thrilled to have someone to listen to his concerns about the treatment business.

“I didn’t even know what short selling was,” Mr. Hill recalled.

Competing Methods and Deep Differences

Standing five feet seven inches in scuffed leather boots and faded jeans, Mr. Hill is a former painkiller addict and a natural storyteller. The story that perhaps best defines his life involved a football injury back in the 1990s. It shaped his personal philosophy of drug treatment, one that puts its trust in modern medications — and is at odds with people like Mr. Cartwright, who want patients to ultimately lead a truly drug-free life.

Mr. Hill was injured at the age of 42, too old to be playing tackle football. But eager to relive his high school glory days, Mr. Hill — his nickname is Rocky — had joined some friends to start a full-contact football league, The Over the Hill Pigskin Shootout. They used old pads donated by the Los Angeles Rams.

One fateful tackle, though, ended the fun. He tore the rotator cuff in each of his shoulders. His doctor prescribed a powerful painkiller, Norco.

And Mr. Hill — who was already in the addiction treatment business — became an opiate addict himself.

When he tried to stop taking the Norco, his life unraveled. He couldn’t sleep. He subsisted on Ensure, the nutrition drink, because eating made him vomit. He considered suicide.

A doctor specializing in pain management told Mr. Hill that the opiates had permanently altered his brain. Therapy and group meetings couldn’t fix that.

The doctor prescribed Mr. Hill a different drug, buprenorphine, which satisfies the craving for opiates but does not result in a high. Minutes after the first dose dissolved under Mr. Hill’s tongue, the world righted itself.

“Before, it felt like someone had put a vacuum in me and sucked out all the joy,” Mr. Hill said. “And then, it was like someone had suddenly reversed it.”

Mr. Hill’s successful treatment with buprenorphine was for him a revelation. Today, he sends the opiate addicts he treats to a local doctor for a prescription for the same drug he still takes every morning.

For many addicts, that prescription is all they need to get on with their lives, Mr. Hill said. Mr. Cartwright, by contrast, believes that ultimately “abstinence has to be the goal,” he said in an interview.

That is only the start of their differences.

Mr. Cartwright’s company specializes in enrolling addicts in intensive inpatient programs, often far from their families — where they stay full-time in a sober living center with other recovering addicts.

Mr. Hill prefers an outpatient approach that is close to the patient’s support network. During the day, addicts come to Mr. Hill’s two-story building, where they meet with therapists. At night, they go home.

Mr. Hill believes the inpatient model is motivated more by greed than doing good. Inpatient providers can bill insurers up to $10,000 for 28 days of services; Mr. Hill charges $1,400 a month for his outpatient treatments.

Stumbling Across ‘a Gold Mine’

There is great debate about which treatment approaches work best, and even how to measure their efficacy.

“A lot of organizations say they have the cure, but they have no incentive to try to prove it through the data,” said Robert Poznanovich, executive director of Business Development at Hazelden Betty Ford Foundation, one of the best-known addiction-treatment providers in the United States.

Hazelden offers a mix of outpatient and inpatient treatment. Modern addiction treatment grew directly from Hazelden and its secluded farm in Minnesota. In 1949, a group of businessmen and a Catholic priest pioneered the idea of bringing alcoholics to a rural location, where the men (they were all men back then) could focus on the 12-step principles without the distractions and temptations of everyday life.

The approach became known as the Minnesota Model and was copied by other nonprofits for decades. Then, the new insurance laws in 2008 and 2010 transformed what had largely been a government-funded and charitable-minded field into an enticing for-profit business. In just a few years, that gave rise to a $35 billion industry of inpatient programs such as the one offered by American Addiction Centers.

Mr. Hill’s concerns about American Addiction Centers were not just about the debate between inpatient vs. outpatient philosophies of treatment. He told Mr. Drose about patients who had died in rehab homes around Temecula and nearby Murrieta that Mr. Cartwright later acquired.

The deaths, Mr. Hill contended, showed how the company was unequipped to deal with medically fragile addicts. Yet, Mr. Hill claimed that for years the company kept taking those patients, assuring them that they would receive adequate care.

As far back as 2008, Mr. Hill had told the California agency that oversees drug-treatment programs that he believed some patients at Mr. Menz’s facilities (ones that later became part of American Addiction Centers) were in danger. When some of the dead patients’ families later filed lawsuits against those companies, he followed every twist and turn of the cases.

He had also spent a good part of 2011 and 2012 working with Hardy Gold, a prosecutor in the state attorney general’s office who was interested in Mr. Benefield’s death. The two began trading emails discussing aspects of the investigation — emails that would later cause headaches for the prosecutor. At one point, Mr. Gold visited Mr. Hill’s office to get a tutorial on the addiction-treatment industry.

During that time, American Addiction Centers sued Mr. Hill for defamation, saying he had made false statements about its patient care. A judge dismissed the suit.

Mr. Hill kept up his attacks on American Addiction Centers. And in Mr. Drose, he believed that he had found a new way to take on the company.

Mr. Drose spent hours talking to Mr. Hill that day in Temecula. When he returned home, his backpack was stuffed with lawsuits, depositions and autopsy reports. “Damn,” Mr. Drose said he thought at the time. “I left there thinking I had stumbled across a gold mine.”

Open Beds and ‘Closing a Sale’

Mr. Drose returned to Kingsford’s offices in Atlanta, took over a glass-enclosed conference room, and made piles of documents related to each death.

None of the deaths had been disclosed to investors when the stock of American Addiction Centers began trading publicly.

The dead included Shaun Reyna, an alcoholic, who killed himself with a shaving razor in one of the company’s treatment houses. Mr. Reyna’s widow said in a 2014 lawsuit that the staff had ignored signs that her husband was suffering withdrawal symptoms that required urgent medical care. The case is expected to go to trial early in 2018.

There was also Gregory Thomas, who hanged himself from a bridge one block from the company’s main office in Temecula in November 2010. He had been brought to the office by a company employee, but never went through with the treatment.

Mr. Thomas’s body hung from a bridge for several days before anyone noticed. A judge ruled that the company wasn’t liable because Mr. Thomas had not been admitted.

But the circumstances of Mr. Benefield’s death, as detailed in a lawsuit his wife brought in 2011, stood out.

The treatment house that he ended up traveling to, A Better Tomorrow, was founded by Mr. Menz, Mr. Cartwright’s partner in American Addiction Centers. It would become a core part of the publicly traded company.

When Mr. Benefield called A Better Tomorrow in late July 2010, he was about to help the company solve a problem: a patient shortage.

There were too many empty beds, Mr. Menz had told his staff members at a monthly meeting, and they needed to fill them. The employees — who referred to signing up new patients as “closing a sale” — understood the risk of failure.

“If you’re not closing,” Jody Brueske, the former sales representative who enrolled Mr. Benefield would later testify in a separate case involving his death, “you’re going to be the next one walking out the door.”

From their kitchen in Springersville, Ariz., the Benefields did not know any of that. All they knew was that A Better Tomorrow had come up in an internet search. A former snowboarder, Mr. Benefield was so excited he even packed his gym clothes, thrilled at the prospect of getting healthy again, according to court records. Ms. Benefield declined to be interviewed; her statements primarily come from court documents.

Hope’s Sudden Turn to Horror

From his first phone call to his death, Mr. Benefield’s relationship with A Better Tomorrow lasted a mere two days. Compressed into those 48 hours is a case study in how financial pressures and business motivations can collide with the needs and expectations of the fragile patients who represent the industry’s bread and butter.

Just days after the staff meeting led by Mr. Menz, Ms. Brueske took the call from Mr. Benefield and his wife, Kelly. His case was pretty typical — an out-of-control drinking problem that was hurting someone’s marriage. But one thing set it apart: Mr. Benefield had chronic lung disease that forced him to use an oxygen tank.

Ms. Brueske had never dealt with a patient who used oxygen. But she felt that she couldn’t turn anyone away, because much of her pay came from commissions, she later testified.

According to a court transcript, a lawyer grilled Ms. Brueske on that point, asking her: “Did you feel personally pressured to get more clients in because of that sales meeting?”

Ms. Brueske responded, “Yes.”

Ultimately, Ms. Brueske assured the Benefields that A Better Tomorrow could provide the oxygen he needed.

In an interview, Mr. Cartwright disputed the sales rep’s testimony. He said that her perception of the pressures to fill beds “did not match reality.” He said the company would never promise to provide oxygen to a patient, because it would require a prescription. “If she promised that, she was out there on an island,” he said.

But from the moment Mr. Benefield stepped off the plane in California, there were signs the company wasn’t equipped to handle his care.

A Better Tomorrow sent a driver to pick him up at the San Diego airport. When that driver, a recovering meth addict with no medical training, got to the airport, he found that Mr. Benefield was having trouble breathing. His oxygen tank was empty.

The driver’s supervisor instructed him to give Mr. Benefield a sedative called Serax, even though Mr. Benefield had not been prescribed that drug. According to a transcript of court testimony, the Serax pills were leftovers from previous patients that were simply kept in the car in case the driver needed to administer a sedative on the spot.

Mr. Menz, in an interview, said it had never been company policy to dispense drugs without a prescription, nor did the company keep leftover medicine.

The driver and other employees also testified that staff members were discouraged from taking patients to a hospital emergency room — even when they appeared to be in distress — because A Better Tomorrow might risk losing a paying customer. The feeling was, “they are taking our clients,” the driver said of the hospital.

The treatment house where Mr. Benefield was taken was not a medical facility but a five-bedroom home with a two-car garage and a hot tub in the back. And the employees there did not know what to make of Mr. Benefield’s behavior — they were familiar with addiction symptoms, not respiratory ailments.

The afternoon of Mr. Benefield’s arrival, as he grew more distressed, the house’s employees called their managers at home for guidance. One supervisor they phoned — a licensed massage therapist and marriage counselor, not a doctor — told them to administer more sedatives.

Mr. Benefield’s oxygen tank remained unfilled.

That night, the employees found that Mr. Benefield had slid out of bed and was sitting on the floor. They hoisted him back into bed. When they went to check on him again in the morning, he was dead.

As part of the testimony by Ms. Brueske, the sales rep who worked with the Benefields, she described her boss’s advice after she learned of the death of her client. “You need to get thicker skin,” she recalled her saying. “People die in rehab all of the time.”

Mr. Drose said that he wasn’t sure what to think after he reviewed the testimony and other documents. “I’ve seen companies screw over shareholders,” Mr. Drose said. “This company seemed like it was hurting people.”

An ‘Abandoned or Malignant Heart’

But despite piles of documents detailing tragic deaths, it wasn’t clear to him that he had enough useful material to move the stock price down, which remained his ultimate goal. After all, addiction patients die with tragic regularity.

Mr. Drose’s boss at Kingsford Capital, the hedge fund where he was working, also wasn’t sure what all the material added up to.

“This seems like a lot of stuff,” Mr. Drose said his boss had told him as he stood among his piles of documents in the summer of 2015. “But what is really in here?”

A spokesman for Kingsford said the “firm does not comment on its investments.”

Bit by bit, Mr. Drose struggled to piece together the meaning of the deaths at American Addiction Centers.

He determined — after filtering through the reams of legal filings and other documents he had collected — that the prosecutor, Mr. Gold, had taken an interest in Mr. Benefield’s case. After speaking with a former police detective about what the possible charges against the company could be, he came up with a startling theory: The company could face a murder charge.

It was a wild idea. No other public company in California history had been charged with murder.

In California, second-degree murder involves someone acting with “implied” malice that reflects an “abandoned or malignant heart.” While that might sound like a legal concept straight out of Edgar Allan Poe, the theory was that the employees who gave Mr. Benefield sedatives, instead of taking him to the hospital, may have acted with implied malice.

Mr. Drose liked the sound of that. “Second-degree murder is what will destroy this company,” Mr. Drose wrote in an email to Mr. Hill. “I am sure of it.”

A Financial Killing From Others’ Misfortune

On and off in the years since Mr. Benefield’s death, a cast of characters — the empire builder Mr. Cartwright, the budding short-seller Mr. Drose, the crosstown rival Mr. Hill — had made A Better Tomorrow and American Addiction Centers a focus of their lives. Some hoped to build it up. Others dreamed of tearing it down.

Mr. Cartwright and Mr. Drose, in particular, saw fortunes to be made.

But in Mr. Benefield’s death, would a company — and by extension, an industry — be held to account? Would future patients benefit from the lessons learned from his death?

On July 21, 2015, a prosecutor charged a subsidiary of American Addiction Centers and four employees with second-degree murder in the Benefield case.

The company’s stock price fell 53 percent, erasing more than half its value in just one day.

Mr. Cartwright, vacationing in Italy, didn’t know what hit him. He called his board of directors to ask for help figuring out what to do.

One board member, the Nashville investor Mr. Burch, recently recalled his advice to Mr. Cartwright. “You can’t run away from it,” Mr. Burch told him. “There is not much you can do if someone calls you a son of a bitch, other than deny it and prove you are not. You get all the bullets you can, and fire at the enemy as quickly as you can.”

That’s exactly what Mr. Cartwright did.

First his company lawyers argued, among other things, that the official coroner’s report said Mr. Benefield had died of natural causes, but the prosecutor had relied on paid testimony from a different coroner to make a case for homicide. The lawyers got the murder charge reduced to abuse.

That was a big win. But Mr. Cartwright was just getting started.

“How do you bring a murder charge on a five-year-old, natural-cause death?” Mr. Cartwright said recently. “It makes no sense.”

Looking for answers, two private investigators were sent to interview Mr. Drose in Atlanta. Only then did Mr. Cartwright discover how all his enemies fit together.

Mr. Drose said that he had guessed that a murder charge might be coming — well before the actual charge was made public.

This gave Mr. Cartwright powerful new ammunition in his court battle: He didn’t believe Mr. Drose had merely guessed. He suspected someone had leaked confidential grand jury information to an investor in a position to make a financial killing.

“I think the charge was brought to make money,” Mr. Cartwright said in the interview earlier this year. “Can I prove it? No.”

Presented with that argument, the judge said that Mr. Gold, the prosecutor, appeared to have a conflict because of his relationship with Mr. Hill, but that it was not enough to unfairly influence the case. But by then, it was June 2016, almost six years since Mr. Benefield’s death. Two key witnesses had died and the case was running out of steam. Ultimately, American Addiction Centers agreed to pay a $200,000 fine and allow a monitor to oversee its operations in California.

In a statement, a spokeswoman for the California attorney general’s office emphasized that “the judge concluded that any connection between Mr. Gold and Mr. Hill did not create a likelihood of unfairness to the defendants in the case.”

The unprecedented murder case against a company, which would have sent a message to American Addiction Centers — and, by extension a desperately needed but poorly understood industry — had fizzled out.

‘One Man’s Trash Is Our Treasure’

Today, Mr. Cartwright is still angry that his company had to fight off what he considers an unfair attack. The stock price is hovering around a quarter of its peak value, diminishing his personal wealth.

But American Addiction Centers is growing again. In September, it bought a treatment company with a 114-bed hospital in Massachusetts. As part of the deal, it also acquired several toll-free numbers to generate referrals, including 1-800-ALCOHOL.

And he points out that while the care at American Addiction Centers has evolved since Mr. Benefield’s death, the resulting court fight did not prompt him to alter his treatment practices. “Why would I change policies and procedure because of someone dying of a heart attack at 3 o’clock in the morning?” he said.

His persistent critic, Mr. Hill, worries about what he considers the industry’s sorry state and the quality of addiction treatment. “It is going to take turning the field upside down,” he said. But he has also moved on, buying a place in Mexico where he enjoys swimming with dolphins. One day he hopes to retire there.

Christopher Drose’s work earned him a spot on Forbes magazine’s “30 Under 30” list of up-and-coming young investors. Today he works for a new hedge fund in New York doing what he loves: digging up dirt on companies, and betting against them.

“Some part of me likes to see people who are not telling the truth come face to face with it,” Mr. Drose said. “I’ve found a way to express that with stocks.”

American Addiction Centers has estimated that short sellers walked away with $250 million because of Mr. Benefield’s death and the murder charge against the company. Mr. Drose called that number overstated but declined to say how much money he made.

In 2015, Kingsford Capital sent out a holiday letter detailing its investment successes, which mentioned the murder charge involving American Addiction Centers. In the letter, the firm summed up its strategy that year as finding “gifts from garbage.”

“One man’s trash,” Kingsford Capital wrote, “is our treasure.”

Today in America, overdoses claim more lives than guns. Yet as the addiction crisis deepens, patients and their families are still struggling to sort out the most effective forms of treatment offered by the sprawling industry.

Mr. Benefield, a bear of a man with a big drinking problem, had pursued his hope of getting well. His wife, Kelly, was left to settle a civil wrongful-death lawsuit against the company that they had hoped would help him.

On Facebook, years after he died, Ms. Benefield wrote, “I miss him so much.”