Support & Advance Effective Treatment
Return to Opioid Top-Level Strategy Map or Zoom Map (Improve Treatment & Enable Recovery for People with SUDs)
Table of Contents
Background
- Substance Use Disorders (SUDs): occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home.[1]
- A diagnosis of substance use disorder is based on evidence of impaired control, social impairment, risky use, and pharmacological criteria.[2]
- Drug classes for which an individual could be diagnosed with a SUD include: alcohol, cannabis, nicotine, opioids, inhalants, hallucinogens, amphetamine, caffeine, cocaine, and sedatives.[3]
- Opioid dependence is a brain disease with both psychological and physical effects. Medication-assisted treatment combines therapy and medication in recovery to address them.
- Counseling treats the psychological aspects of addiction and helps teach people effective recovery skills to prevent relapse.
- Medication targets the physical aspects. Physical effects of the disease occur in the limbic region of the brain and have to do with the way the brain reacts and adjusts to the constant presence of opioids.
- Treatment has a high return on investment--even with success rates lower than ideal.
- The average cost for 1 full year of methadone maintenance treatment is approximately $4,700 per patient, whereas 1 full year of imprisonment costs approximately $24,000 per person.[1]
- According to several conservative estimates, every dollar invested in addiction treatment programs yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft. When savings related to healthcare are included, total savings can exceed costs by a ratio of 12 to 1.[2]
Current Status
One aspect of improving treatment is reducing treatment dropout rates. Psychiatrist Sally Satel puts the dropout rate during the first few months of addiction treatment at 40-60%.[4] [any empirical studies to support this idea?]
Promising Programs
Triggr Health
Triggr Health has developed a data-driven, personalized system that helps recovering addicts in part by predicting when they are most likely to suffer a relapse. The company uses a combination of digital tools -- including a mobile app -- and human interaction to help its patients overcome addiction. Trigger Health's tools encourage patients to set and meet goals for curtailing their drug use.
Treatment Options
The following list goes reads from lower intensity interventions to higher intensity interventions[5]
- Early Intervention: Assessment and Education
- Acupuncture-based approaches: Detoxification using Acupuncture
- Outpatient Services: Supportive recovery environment. Therapy.
- Intensive Outpatient/Partial Hospitalization Services: Structured supportive environment. Increased therapy sessions. Possible hospitalization for withdrawal or other issues.
- Residential Inpatient Services: 24-hour care, structured setting. May include medical, nursing, or clinical care or monitoring. Increased therapy sessions.
- Medically Managed Intensive Inpatient Services: 24-hour nursing care, daily physician care. Highly structured environment. Therapeutic counseling services available.
Counseling Options
Group Counseling: In group counseling, a person can learn from the experiences of others going through recovery. A counselor, psychiatrist or psychologist guides the group, providing opportunities to discuss issues that led to opioid dependence and ways to stay drug-free. For many people, talking to others with similar problems helps in their recovery and allows them to develop a support network.[6]
Individual Counseling: One-on-one therapy with a counselor, psychiatrist or psychologist could be helpful for someone who prefers a more private setting over a group environment. It provides the opportunity to examine the issues that led to opioid dependence and strategies for change.
Peer Support Group Programs: Like Narcotics Anonymous and Alcoholics Anonymous, 12-step programs help people in recovery by helping support drug-free lifestyles. Meetings are usually led by people who have been through the program and are living successful lives in recovery. See Strengthen Peer Recovery Support Services & Programs for more information
Link to National Acupuncture Detoxification Association Page
Referrals
Referral Protocol
For people who walk into law enforcement or mental health services that are struggling with addiction or know others who are. This tool helps analyze financial or other barriers that may exist. Referrals to other groups as well. [7]
Contact: Stonington Human Services at (860) 535-5015, Stonington Prevention Council [contacted source for resource]
Tools & Resources
TR - Improve Treatment & Enable Recovery for People with SUDs
Scorecard Building
Potential Objective Details
Potential Measures and Data Sources
Potential Actions and Partners
Resources to Investigate
RTI - Improve Treatment & Enable Recovery for People with SUDs
Sources
- https://www.samhsa.gov/disorders/substance-use
- https://www.samhsa.gov/disorders/substance-use
- https://www.samhsa.gov/disorders/substance-use
- http://www.wsj.com/articles/how-to-treat-an-opioid-epidemic-1484323662
- http://www.endopioiddependence.org/opioid-treatment-options
- http://www.endopioiddependence.org/opioid-treatment-options
- http://www.theday.com/policefirecourts/20170114/the-problem-is-everywhere-stonington-fights-opioid-crisis
- ^ https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/drug-addiction-treatment-worth-its-cost
- ^ NIDA. (2018, January 17). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition on 2019, January 15
