|• Alcohol Addiction
• Cocaine Addiction
• Crack Addiction
• Crystal Meth Addiction
• Ecstasy / Club Drug Addiction
• Food Addiction
• Gambling Addiction
• Heroin Addiction
• Inhalent Addiction
• Internet Addiction
• Ketamine Addiction
DID YOU HEAR THAT?!Someone dies of an accidental overdose every 19 Minutes, in this country! 80% of THE WORLDS RX's are taken by Americans & we are only 5% of the global population We prescribe in a year, enough pain meds forevery Man, Woman & Child 1 pill every 4 hours for 3 weeks.
• 40-60% of people relapse after drug and alcohol treatment. NIDA
• Anything less than 90 days of treatment increases the chance of relapse - NIDA
• An individuals treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
What do we know about the success rate of 30 days in treatment? How do treatment centers come up with their numbers? What's really their criteria? Are there any hardcore, evidence based statistics out there? There better be...Do you think they'll let convicted felons out with out being sure they're clean? ..or a pilot get his license back without knowing for sure?! ..or a Dr. work with a patient?
Drug Courts are proven to retain offenders in treatment considerably longer than most other correctional programs. 3 phases starting with a treatment plan. 90 days inpatient treatment. Continued random monitoring. Intensive case management. Over 2 year span http://www.nycourts.gov/courts/2jd/brooklyntreatment/handbook.pdf
The 5 year Plan The Airline Pilots HIMS (Human Intervention Motivation Study) is specific to commercialpilots and coordinates the identification, treatment and return to thecockpit of impaired aviators. It is an industry-wide effort in whichcompanies, pilot unions, and FAA work together to preserve careers andfurther air safety. http://www.himsprogram.com/Content/Aftercare
Physician Health Programs (PHPs) have a record of success• Blueprint Study* - 904 physicians from 16 state PHPs who'd been under PHP care for 5+ years - 79% no relapse - Most relapses not followed by another - No patient harm• Domino Study - 735 physicians in WA state - under monitoring from 5-11 years - 80% no relapse - no patient harm *Dr. Skipper
PHPs oversee evaluation and treatment Monitoring evaluation and treatment programs • 28 of 37 programs (76%) maintain list of authorized providers • 48% maintain criteria for authorizing them • All but one program (95%) require treatment programs to send regular progress reports during treatment of a physician.
Treatment alone often fails to attract and retain peoplesuffering from substance use disorders (SUDs). Evenwhen patients complete substance abuse treatment,relapse is so common it is frequently cited as a hallmarkof the disorder. Dr. Greg Skipper, MD TREATMENT IS ONLY THE BEGINNING OF RECOVERY!
The 5 year Plan Key Components of The 5 year plan are Case Management & Care Planning and they include...Intervention. Minimum 90 day treatment, Reevaluate. Sober Living - Reevaluate. IOP, Reevaluate. 12 - step, continuing. Monitoring, Reevaluate. Motivator /Leverage, Reevaluate
INTERVENTION: Intervention is a meeting of the entire family and or support system toaddress collectively the problems and or concerns of the family and orsupport system."Right there...at the very beginning of treating the addict...we are recognizingthat this is a MUCH BIGGER deal than just getting the IP off drugs or drink.This is the meeting that takes place before the IP ever even gets into theroom!
TREATMENT: At this point the IP may or may not even think they have aproblem at all. We all see it...The people around the IP allsee it, but the IP most likely thinks that their disease is stillmanageable. So then the solution becomes..."let's get ‘emto rehab.Yeah...That's a great next step. Most insurance will pay for atleast 28 days, but most professionals agree that 90 days isthe minimum amount for any meaningful and effectiverecovery to begin. The best adjunct for 28 days of residentialtreatment is 90 days in sober living combined with an IOP(Intensive Outpatient program).
SOBER LIVING: The best plan after treatment is if IP's are placed into sober living facilities directly from treatment. This will help maintain some of the structure they've become used to in treatment....The problem most sober living facilities is that the IP goes from the intense structure of treatment into a very unstructured sober living facility so they take advantage of the excessive freedom and that's when they get into trouble, therefore it's very important to find a Sober Living facility that has a good relationship with their treatment facility and can work with both the IP and treatment team to keep the momentum going...
INTENSIVE OUT PATIENT IOP is extremely valuable in terms of supporting the transition from "In Patient" recovery to the delicate task of reintegration into full life.
MONITORING The quantitative component of the plan.
STEPPING & Peer Support NOBODY Does this alone
Ongoing Case management can really take you from the pre-intervention phase through all 5 years of monitoring. It includescontingency contracts, intensive monitoring of Urine Testing,validating meeting slips, monthly or quarterly reports, intenselystructured phone support for family system, ongoing frequentcheck-ins with recovery team and, if warranted...check-ins withtherapists.
The benefits of Long term Case Management & Care planning arenumerous. Case Management is: A tool the therapist can use to help the patient with compliance. The ability to create plan to elevate to a higher level of care if they fall out of compliance. The Therapist and/or Family do not having to "police" behavior•Support to treatment plan established by therapist or facility.
Also part of the recovery plan...
For many, the idea of addiction is that it is still amoral issue. For others, they understand that itis a medical problem. What most non-addictsfail to understand is that it's NOT a curabledisease; but it is a treatable one.
If we were dealing with Cancer...When would bethe best time to start treatment?
Why is an outsider better than doing it yourself?Same reason that a company shouldn't monitoran employee
Full Disclosure..Addicts respond better whenthey know what's coming ahead of time & theyare a part of the process.Very important to plan & implement while still intreatment. Contracts, Contracts, Contracts!!!
"The "carrot" is the ability to practice medicine, andmake a living, without a public record. The "stick" isaction against the license if the physician does notcomply with the requirements in the contract. As youknow, consequences are GOOD!!! Our success is basedon behavior modification. Good behaviors are rewardedand unwanted behaviors result in prompt negativeconsequences." Dr. Scott Hambleton