New Study Reinforces the Need for Comprehensive Aftercare

New Study Reinforces the Need for Comprehensive Aftercare

The September, 2014, issue of the Journal of the American Medical Association published the results of a new study which found that those who overcame one addiction had a lower risk of developing a new addiction. The study, which involved 34,653 individuals suffering from substance use disorder were interviewed twice three years apart during 2001 and 2004. The data taken from the National Epidemiologic Survey on Alcohol and Related Conditions found the long-held belief that addicts would substitute one addiction for another to be erroneous. Indeed, only 13% of former addicts replaced the first substance with a new one. Those who stopped using their original drug of choice had significantly lower risk, less than half, of developing a new addiction. Young unmarried men with psychiatric problems were most likely to fall victim to additional addictions. The study further revealed that the substitution hypothesis, which has guided many treatment protocols, evolved out of therapists’ assumptions. These new findings raise many new issues. However, lifestyle changes, as well as strong coping strategies still play a crucial role in establishing a stable recovery. Therefore, the availability of strong aftercare programs remains a critical component to sobriety. Technology Supports Continuing Care for Substance Abuse Disorders In January, 2012, the Journal of Substance Abuse Treatment published a study examining benefits of computerized continuing support for those suffering from SUD. The study spanned 18 months and included several disease management programs, as well as components such as recovery coaches. While participation fell after the first year, those that accessed a variety of program components maintained a higher rate of abstinence and consumed less alcohol or...
Technology, Behavioral Health and Positive Addiction Treatment Outcomes

Technology, Behavioral Health and Positive Addiction Treatment Outcomes

“Technology offers the opportunity to target numerous issues concurrently and…tailoring…the profile of needs of a given individual. Indeed, a technology-based system could…conduct a comprehensive assessment of an individual’s health behavior and then offer access to system components grounded in science-based approaches to promote health behavior…Such a tool could offer a comprehensive and coordinated approach to the constellation of issues a given individual may be experiencing.” (NIHPA Author Manuscripts. 2012; 31(3)313) In just a short period, these concepts are now a reality that treatment providers can successfully utilize in their inpatient, outpatient, and aftercare programs. The ramifications of these tools are profound. Indeed, Recovery Passport Solutions’ 365 comprehensive approach helps shifts outcome results away from the abysmal state of treatment failure. This past summer, SAMHSA-HRSA’s Center for Integrated Health Solutions held a webinar reviewing the topic of technology and behavioral health. The works cited included Bickel, Marsch et. al., 2008, and Marsch, 2013, funded by NIDA. These significant studies revealed results that were impressive: Technologically based programs were useful and acceptable to diverse populations They had a large impact on behavior and health outcomes They increased quality of care, reach, and the ability to personalize are They were cost-effective Furthermore, the studies found that these technologies allowed clinicians to spend more time with patients requiring intensive care by replacing hours spent in typical client-clinician interactions. Other patients continued to have contact with clinicians through the programs making contact more efficient. Technology-based programs offered therapeutic tools known as TES that: Provided clients who had lower cognitive functioning, anxiety, heavy alcohol use at time of admission, and ambivalence about treatment with better...
Are You Ready to Meet the Criteria for Pay-for-Performance?

Are You Ready to Meet the Criteria for Pay-for-Performance?

Everyone knows the business of Addiction Treatment needs to change for the good of the clients, the community at large and the nation. The latest trend for insurers is the pay-for-performance model. Are you ready to meet this challenge? We know that: Recidivism rates are too high Treatment facilities need to have quality trained and licensed staff Implementation of Best Practices is uniformly needed Aftercare programs must be designed using best practices Clients need access to aftercare for an extended period Collection, analysis, and changes based upon real time data can improve outcomes Licensed sober living homes utilizing best practices in aftercare are needed to stabilize early recovery. The last few decades have demonstrated that the acute care model is not applicable in treating addiction. In a 2011 study, published by the Journal of Substance Abuse Treatment (Sept:41 (2):193-200) the researchers found that the pay-for-performance including bonuses altered counselor behavior, and increased client retention. Indeed the retention ratio went from 40% to 53% in a 90-day period. The issues raised in pay-for-performance are indeed complex. A special meeting of the Washington Circle, (supported by NIDA and SAMHSA-ascpjournal.org/content/7/1/18) comprised of a multidisciplinary group of experts convened to examine research gaps in performance measures for substance use disorders. Reforms in health care have heightened the need for accountability in performance measures regarding patients suffering from mental health and substance use disorders. While many best practices already exist that address biology, behavior and social issues related to substance use disorders, many facilities do not incorporate these effective treatment protocols. Members of the review panel questioned organizational readiness, resources and leadership as obstacles...
Ethics, Addiction Treatment and Technology

Ethics, Addiction Treatment and Technology

Ethics, morality, legalities, best practices are words one might logically associate with any medical treatment for a disease or a condition. Sadly, when it comes to addiction private treatment providers, rules of decency and concern may be left behind. Addiction treatment is BIG business, as is its close relative Sober Living Environments. Devious practices are everywhere, and though they may be close to the letter of the law and legal in the strictest sense, they are far from ethical. The addiction treatment industry is rife with not so professional practices. • Dubious marketing practices • False statistics • Questionable insurance billing practices • Paying for referrals • Feeder websites • Questionable treatment practices • Billing patients for procedures that have not be proven to be successful • Paying gifts to interventionists • Sharing patient information • Taking in clients that cannot be treated • Taking in patients whose insurance will not cover the treatment The November 17th article in Addiction Magazine by Bob Ferguson dealt with this issue. In this article, Ferguson discusses the move by panelists in NCAD’s last Augusts’ conference. Panelists raised the bar on the issue of ethics by posting a draft of what they considered ethical precepts for addiction treatment providers. The challenge was picked up by Bob Ferguson of Jaywalker Lodge whose administration posted its own attempt at transparency and ethics. Below is a brief summary of some of the Jaywalker Code of Ethics. (The list below includes only a few of many of the items listed in the article) • Jaywalker does not engage in …misleading or deceptive practices • We do not...
FDA Approves Potent New Opiate Pill: Users Beware!

FDA Approves Potent New Opiate Pill: Users Beware!

The FDA has approved another tool in the arsenal of drugs that are highly addictive. This drug, marketed as tamper resistant seriously adds to the underlying issue of opioid abuse–addiction. This new drug marketed as tamper resistant to being crushed and injected does nothing to avoid overdoses due to pill ingestion. The reduction in overdoses due to injecting and crushing the drug is positive. But this tamper resistance does not reduce the number of people who quickly grow addicted to this powerful new opiate. The sad realty is that most people who overdose from opiate medication do so in pill form. To date, more people die of accidental overdoses due to ingesting opiates than from an automobile accident and other motor vehicle accidents. The potency of this pill and the one approved last spring creates grave concern. This pill (Targiniq ER) now ranks as one of the most powerful opiates available. Targinq ER combines a long-acting opioid analgesic oxycodone with naloxone. The naloxone is used to counteract euphoric effects of the oxycodone. The President of Physicians for Responsible Opioid Prescribing, Dr. Andrew Kolodny, said in a number of interviews that the best way to gain control of the current epidemic is to stop creating NEW ADDICTIONS. Therefore, responsibility rests heavily upon the shoulders of prescribing doctors and dentists. Treatment providers need to be cognoscente of the dilemmas attending to use of these drugs and their long-term risks. This latest drug approval comes only months after the FDA approved the use of Zohydro, another long-acting form of hydrocodone. Despite alarms sounded by doctors’ groups and even some governors and state legislatures, the FDA...
Addiction Treatment, Trauma, and the Role of Technology

Addiction Treatment, Trauma, and the Role of Technology

For the last few decades, the role of trauma has been ignored in shaping addiction treatment. It fell out of favor with the development of managed care. However, more recently, a resurgence of interest in focusing on trauma in addiction treatment has occurred. Many believe, and logic would support such beliefs, that trauma often underlies the cause of an addiction. In an attempt to analyze and explain the unrelenting pattern of treatment and relapse, one can look to unacknowledged and untreated trauma. We all know that addiction treatment is more than “just say NO,” without supportive therapies. Study after study has demonstrated that after a traumatic event people resort to a variety of coping mechanisms—alcohol or drug use are two of them. Studies of children who suffered abuse (physical, sexual, emotional) often go on as adults to be involved in other abusive relationships. New brain studies are examining the changes in animal brains associated with trauma and behavior. Untreated, trauma mounts on top of trauma and emotional, intellectual, mental, physical, and spiritual health deteriorates. The National Institute of Mental Health has a list of incidents that are associated with PTSD: Rape Torture Kidnapping Natural Disasters Muggings/Physical threats Accidents Abuse (emotional, mental, physical) Witnessing a violent event In the study, Design Strengths and Issues of SAMHSA’s Women…. (Psychiatr Serv. 2005 Oct;56(10):1233-6) researchers examined the design, cost, and outcomes of trauma-informed programs for women with a history of violence, substance abuse and mental health disorders. After 12 months the women in the intervention group maintained and continued to improve in all three areas related to drug use, mental health and trauma...
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