Improve Access to Quality Treatment Programs

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Table of Contents

[[#Current_Status|Current Status]]

[[#Cost_of_Rehab|Cost of Rehab]]

[[#Cost_of_Rehab-Overview|Overview]]

[[#Cost_of_Rehab-Insurance|Insurance]]

[[#Promising_Programs|Promising Programs]]

[[#Promising_Programs-Mobile_App_reSET-O|Mobile App reSET-O]]

[[#Promising_Programs-My_Life_Recovery_Program|My Life Recovery Program]]

[[#Promising_Programs-myStrength|myStrength]]

[[#Promising_Programs-Baltimore.2C_MD|Baltimore, MD]]

[[#Promising_Programs-Boston_Medical_Center|Boston Medical Center]]

[[#Promising_Programs-Telepsychiatry|Telepsychiatry]]

[[#Promising_Programs-Using_County_Jails_as_Treatment_Centers|Using County Jails as Treatment Centers]]

[[#Tools_.26_Resources|Tools & Resources]]

[[#Scorecard_Building|Scorecard Building]]

[[#Resources_to_Investigate|Resources to Investigate]]

[[#Sources|Sources]]

Current Status

With so many people needing treatment, it is important to find ways for more of them to get access to quality and affordable treatment. This could involve a variety of innovations, such as expanded use of on-line tools, Virtual Reality, and more.

  Most recovery support services fall under the Recover-Oriented Systems of Care (ROSC) umbrella which follow the recovery-related values and beliefs. These include concepts such as people who suffer from addiction have essential worth and dignity; the stigma related to addiction is something that prevents many people who are addicted from seeking help and this must be combated; there are many paths to recovery; access to treatment is a human right, even though recovery might mean something more; people who are in recovery as well as their families have valuable experiences and support to offer to those who are still struggling with substance abuse. Recovery-Oriented Systems of Care are based on the idea that severe substance use disorders are treated most effectively through a chronic care management model which involves outpatient care, recovery housing, recovery coaching, and management checkups.They are meant to be culturally sensitive and easy to navigate.<sup class="reference">[1]</sup>

  Current treatment programs are largely based on the 12-Steps of Alcoholics Anonymous (AA), but there is little to no scientific evidence showing that this process is effective. Dr. Lance Dodes stated in the documentary ''The Business of Recovery'' that 12-Step programs are typically only helpful for 5-10% of people who partake in them, meaning that they are largely ineffective for the vast majority of people. Treatment programs that are based off of AA's 12-Step program therefore are not necessarily providing effective treatment, but are still charging exorbitant prices, especially considering that AA is a fellowship that is free to participants outside of treatment programs. <sup class="reference">[2]</sup>

  Studies conducted on patients with Alcohol Use Disorders (AUD) have found that pharmaceutical interventions, when used with psychosocial co-interventions, resulted in better alcohol consumption outcomes. This demonstrates that looking into adding in medication to treatment programs could be advantageous for opioid users.<sup class="reference">[3]</sup>

  Other treatment programs include recovery coaching, recovery housing, recovery management, peer-led recovery community centers, and recovery-based eduaction.

 '''Medication-assisted treatment''' (MAT) is available in accredited and certified private and public clinics across the United States. The [https://www.samhsa.gov/medication-assisted-treatment/about Division of Pharmacologic Therapies (DPT)] of the [https://www.samhsa.gov/ Substance Abuse and Mental Health Administration ]is responsible for overseeing the certification of opioid treatment programs (OTPs). Medication-assisted OTPs include using buprenorphine, methadone, and naltrexone.<sup class="reference">[4]</sup> A combination of medication, counseling and behavioral therapy is regarded as the most effective in treating opioid dependency. According to an article in the New England Journal of Medicine MATs are both cost-effective and safe, and result in the reduction of the risk to overdose.<sup class="reference">[5]</sup>

  [How to get people in rural communities to actually get the treatment that they need, info on this many people who cant get treatment, transportation (what the barriers to access?) payment, how are they supported in current standard of care? talk more about online programs]

 <span style="color: #e81f1f">'''[Insert NEJMl table]'''</span>


Cost of Rehab

Overview

See [https://www.drugrehab.com/treatment/how-much-does-rehab-cost/ drugrehab.com] for overview of cost and it's contributing factors.


Insurance

[http://Drugrehab.com Drugrehab.com] has site that [https://www.drugrehab.com/insurance-check/ checks if your insurance provider covers addiction care].

Promising Programs

Mobile App reSET-O

[https://peartherapeutics.com/ Pear Therapeutics] has developed an eFORMULATIONS treatment tool for opiate dependence called reSET-O. reSET-O is a mobile medical application that is used in conjunction with pharmaceutical therapies to treat opioid dependence. Clinical trials have shown reSET-O to be a promising solution to opiate dependence, showing that reSET-O plus pharmacotherapy achieved enhanced abstinence from opioids, reduced drop-outs in treatment, and reduced required clinical intervention when compared to traditional face-to-face therapy.<sup class="reference">[6]</sup>

My Life Recovery Program

'''[http://myliferecoverycenters.com/ My Life Recovery Program]''' - This online program that has some good recognition. This might be an option for rural areas and/or during incarceration. The program is designed to last 3 to 6 months and consists of bi-weekly online video/audio workshops and practical tools, along with homework exercising, grounding techniques, and supportive emails. <sup class="reference">[7]</sup>

myStrength

[http://www.mystrength.com myStrength] is an on-line and smartphone platform that can enhance the capacity of mental health service providers by enabling them to serve more people more effectively. It can also provide valuable tools to support the people during the times between professional consultations. There is solid and growing research on the value and effectiveness of this innovative platform.<sup class="reference">[8]</sup> Learn more about [[MyStrength|myStrength]].

Baltimore, MD

• The County Health Department has created a dedicated phone line staffed with clinical social workers with specialized training in helping people with substance abuse issues move toward recovery for themselves or loved ones.<sup class="reference">[9]</sup>

• This resource, education and advocacy help line will operate during normal County business hours, from 8:30 a.m. to 4:30 p.m.<sup class="reference">[10]</sup>

• The County will advertise and extensively promote the new help line in order to connect families and substance users with the resources they need for recovery.<sup class="reference">[11]</sup>

• In addition to connecting with County support by phone, individuals may go directly to the [http://baltimorecountymd.gov/41088REACH County website] for information.

Boston Medical Center

Boston Medical Center opened its [https://www.bmc.org/programs/faster-paths-to-treatment Faster Paths to Treatment Opioid Urgent Care Center] in August 2016. This center, which is specifically for treating patients addicted to prescription painkillers, is located next to the hospital emergency room, giving patients immediate access to comprehensive care including counseling, case management, home visits and transportation to detox.
 :


Telepsychiatry

Innovative use of technology and new business models can bring access to quality mental health care to people for whom it has been frequently out of reach or not affordable.


Using County Jails as Treatment Centers

In Kenton County in northern Kentucky, the prison has become an important treatment facility. Instead of focusing on punishing or just locking up people with substance abuse issues, the Kenton County Detention Center focuses on turning a time of incarceration into a time for much-needed treatment. Leaders in Kenton County believe that jail be the best place to initiate addict recovery. They often end up in jail for minor crimes, long before they commit more serious crimes that warrant a prison sentence. Kenton County is one of over 20 Kentucky county jails that have started full-time “therapeutic communities” that focus on rehabilitation within their walls, providing inmates the type of services that private treatment centers offer on the outside.<sup class="reference">[12]</sup>



Tools & Resources

[[TR_-_Improve_Access_to_Quality_Treatment_Programs|TR - Improve Access to Quality Treatment Programs]]

Scorecard Building

[[PO_-_Improve_Access_to_Quality_Treatment_Programs|Potential Objective Details]]
[[PM_-_Improve_Access_to_Quality_Treatment_Programs|Potential Measures and Data Sources]]
[[PA_-_Improve_Access_to_Quality_Treatment_Programs|Potential Actions and Partners]]

Resources to Investigate

[[More_RTI_on_Treatment_Programs|More RTI on Treatment Programs]]

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Sources

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1. Facing Addiction in America - The Surgeon General's Report on Alcohol, Drugs, and Health. Chapter 5. Recovery: The Many Paths to Wellness. '''insert file here'''

1. [http://www.forbes.com/sites/danmunro/2015/04/27/inside-the-35-billion-addiction-treatment-industry/#38d34d2a67fd [1]]

1. [http://jama.jamanetwork.com/article.aspx?articleid=1869208 [2]]

1. The Substance Abuse and Mental Health Administration (SAMHSA). Medication-Assisted Treatment.

[https://www.samhsa.gov/medication-assisted-treatment [3]]

1. Medication-Assisted Therapies -- Tackling the Opioid-Overdose Epidemic.

[http://www.nejm.org/doi/full/10.1056/NEJMp1402780#t=article [4]]

1. [https://peartherapeutics.com/reset-o/ [5]]

1. [https://www.liferecoveryprogram.org/ [6]]

1. [https://www.mystrength.com/outcomes [7]]

1. 100 Million Healthier Lives City, Town-Wide, and Regional Efforts.[https://www.baltimorecountymd.gov/news/baltimorecountynow/Kamenetz_Announces_Significant_County_Substance_Abuse_Initiatives_ [8]]

1. 100 Million Healthier Lives City, Town-Wide, and Regional Efforts. [https://www.baltimorecountymd.gov/news/baltimorecountynow/Kamenetz_Announces_Significant_County_Substance_Abuse_Initiatives_ [9]]

1. 100 Million Healthier Lives City, Town-Wide, and Regional Efforts.[https://www.baltimorecountymd.gov/news/baltimorecountynow/Kamenetz_Announces_Significant_County_Substance_Abuse_Initiatives_ [10]]

1. [https://www.nytimes.com/2017/06/16/opinion/sunday/opioid-epidemic-kentucky-jails.html [11]]