Reducing Relapse Rates Among Opiate Users

On Oct. 3, 2014, the CDC released a new data survey. This data revealed that the national statistics for deaths due to opiate overdoses quadrupled (1999-2010) while deaths due to heroin doubled (2010-2012). The data came from 28 states revealing: The number of persons using OPR nonmedically on a frequent basis also has grown (6). From 2002–2004 to 2008–2010, past year heroin use increased among persons reporting frequent nonmedical use of OPR, from 62.0 to 94.7 per 1,000. Moreover, the only increases in past year heroin use were observed among persons who reported past year nonmedical use of OPR… Some in the government’s health agencies believe the increase in heroin use and overdoses can be attributed to the cost and diminished accessibility of opiates on the street. Data indicates that non-prescription pain medication users are at greatest risk for using heroin. The greatest increase of heroin use was found between two demographics: the 26 to 34 years and 50 years and older age groups. Males in both demographics were found to be at greatest risk. (JAMA, Sept. 2012, Vol. 172, No. 16) In 2007, Florida led the nation with doctors who prescribed opiates: 98 of the nation’s top 100 prescribing doctors. Because of the national outcry, Florida enacting stricter regulatory laws controlling pain clinics and the dispensation of painkillers. Between 2003 and 2012 Florida has seen heroin use rise and fall but since 2012, Florida’s statistics indicates that heroin use is on the rise again. Addiction Treatment is Only Part of the Answer A study published in The Irish Medical Journal, (Smyth, B.P. et. al., June 2010) found that...
Aftercare Fights Stigmatization and Relapse

Aftercare Fights Stigmatization and Relapse

The Johns Hopkins Bloomberg School of Public Health released the results of a new study examining Americans’ attitude toward those suffering from substance use disorders opposed to those suffering from mental illness. Americans have a harsher, unsympathetic view of people who suffer from addiction and are less willing to support positive public policies to deal with SUD. Published in the October issue of the Journal of Psychiatric Services, the study suggest that Americans view SUD as a weakness of character and a personal failing rather than a treatable medical condition like diabetes or heart disease. 64 percent of those responding believe employers should be able to deny employment to people with a drug addiction compared to 25 percent who believe employers have a right to deny employment to those suffering from mental illness. How do we as an industry respond to the misunderstandings and bias held by so many Americans? And what role does aftercare programs play in combating stigmatization? Addiction Recovery and Management The authors of another study sited in Addiction Recovery Management found that the acute care model, along with the commercialization of addiction treatment have moved addiction treatment into the brief, and discrete care models. The researchers believe a sustained recovery management model would produce far more positive results that would include post-treatment monitoring and support. (Addiction Recovery Management, 2011, pp 67-87) A new report from the University of Pretoria found “there was a lack of manual or guidelines on how aftercare and reintegration service should be rendered…” Furthermore, clinicians were relatively uninformed adding to “the lack of support, boredom and experience of stigma” felt by...
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...
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