DRUG ADDICTION INFORMATION
Please use the links below to learn more about the many types of addiction. This list compiles some of the more common addictions and is by no means complete. If you would like information about something you don’t see here, please contact us for additional support.
TYPES OF ADDICTION INTERVENTIONS
Addiction Recovery – 5 Year Plan By Ken Seeley
The 5 Year Plan For Addiction Recovery
In this country, someone dies of an accidental overdose every 19 minutes. 80% of the world’s prescriptions are taken by Americans. We’re only 5% of the global population. In one year, we prescribe enough pain medications for every man, woman, and child to take a pill every four hours for three weeks.
Is the 5 year plan applicable to my addiction?
According to NIDA, 40-60% of people relapse after drug and alcohol treatment, and anything less than 90 days of treatment increases the chance of relapse.
An individual’s treatment and plan of services must be assessed continually and modified as necessary to ensure that it meets their 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 their criteria, really? Are there any concrete, evidence-based statistics out there? How do they determine that convicted felons are clean to re-enter society, or that a pilot can regain his license after treatment?
Drug Courts & The 5 Year Plan
Drug courts are proven to retain offenders in treatment considerably longer than most other correctional programs. The process has three phases, starting with a treatment plan. Then there’s 90 days of inpatient treatment, continued random monitoring, and intensive case management over a two year span. http://www.nycourts.gov/courts/2jd/brooklyntreatment/handbook.pdf
The Airline Pilots HIMS (Human Intervention Motivation Study) is specific to commercial pilots and coordinates the identification, treatment and return to the cockpit of impaired aviators. It is an industry-wide effort in which companies, pilot unions, and FAA work together to preserve careers and further air safety. http://www.himsprogram.com/Content/Aftercare
Recovery And Transportation Industries
HIMS is the program that United and over 48 other airlines use (except for American, which has its own EAP program). If they fail a test, DOT offense protocol is to wait one year to start the process to re-apply for licensure. The FAA is looking to take their license if they are using, but offer this program. 92% long term recovery rate 2 years – less then 10% relapse. 8% decided to retire. Pilots need to have medical certification that they are able to fly as long as they are accountable. FAA requires quarterly reports from the airline from an AME (arial medical evaluator) who decides what should be required. The weakest component is the link to aftercare.
Physician Health Programs (PHPs) have a record of success.
– 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
– 735 physicians in WA state
– under monitoring from 5-11 years
– 80% no relapse
– no patient harm
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 people suffering from substance use disorders (SUDs). Even when patients complete substance abuse treatment, relapse is so common that it is frequently cited as a hallmark of the disorder. Dr. Greg Skipper, MD. Treatment is only the beginning of recovery!
Key Components of the 5 year plan are case management and care planning, which include
- 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 to address the problems and concerns of the family. There, we recognize that this is a much bigger deal than just getting them off of drugs or alcohol. This is the meeting that is planned and takes place before the person even comes into the room.
TREATMENT: At this point the dependent may not think they have a problem at all. Everyone around them sees it, but they likely think their disease is still manageable. The solution becomes rehabilitation and recovery. Most insurance will pay for 28 days, but professionals agree that 90 days is the minimum amount for meaningful, effective recovery to begin. The best adjunct for 28 days of residential treatment is 90 days in sober living, combined with an IOP (Intensive Outpatient program).
SOBER LIVING: The best plan is for those in recovery to be placed in sober living facilities directly after treatment. This will help maintain some of the structure they’ve become used to in treatment.
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
Ongoing case management can really take you from the pre-intervention phase through all 5 years of monitoring. It includes contingency contracts, intensive monitoring of urine testing, validating meeting slips, monthly or quarterly reports, intensely structured phone support for family system, ongoing check-ins with recovery team and, if warranted, check-ins with therapists.
The benefits of long term case management and care planning are numerous. 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…
Motivators Leverage Consequences
For many, the idea of addiction is that it is still a moral issue. For others, they understand that it is a medical problem. What most non-addicts fail to understand is that it’s NOT a curable disease, but it is a treatable one.
If we were dealing with cancer, when would be the best time to start treatment?
Full disclosure: addicts respond better when they know what’s coming ahead of time and they are a part of the process. It’s very important to plan and implement while still in treatment.
“The “carrot” is the ability to practice medicine, and make a living, without a public record. The “stick” is action against the license if the physician does not comply with the requirements in the contract. As you know, consequences are GOOD! Our success is based on behavior modification. Good behaviors are rewarded and unwanted behaviors result in prompt negative consequences.” Dr. Scott Hambleton
Why A Skilled Interventionist
A skilled interventionist:
- Will minimize the natural progression of negative consequences.
- Will know how to dissect the family system to create the bottom line to motivate the loved one.
- Will educate family on the importance of the 5 year plan.
- Will insure case manager remain objective about their recovery so the family can be emotional in the relationship.
Motivators leverage consequences.