Why is Addiction Care Management or Case Management Needed
Why Choose Addiction Care Managemen Outpatient Model
Fact: In 2002, 22 million Americans
had substance dependence or abuse
Fact: Approximately 3,500,000 of them
received some kind of treatment
Fact: At least 2,800 relapsed.
Most will keep relapsing !! (SAMHSA,
Fact: Of those admitted to addiction
treatment, 60% already have one or
more prior treatment admissions; 24%
have three or more prior admissions
Fact: The majority of people completing
addiction treatment will relapse in
the year following treatment (Wilbourne
& Miller, 2003), 80% of whom relapse
within 90 days of discharge (Hubbard,
Flynn, Craddock, & Fletcher,
Fact: Between 25% and 30% of clients
who complete addiction treatment will
be re-admitted to treatment within one
year, 50% within 2 – 5 years (Hubbard,
Marsden, Rachal, Harwood, Flynn,
Craddock, & Fletcher, 2001).
PROBLEM: Treatment is not enough
and a reliance solely on 12 Step
programs is not enough. All Treatment
Programs refer their patients only
to 12 Step Programs when completed.
The Disease of Addiction is a difficult
Chronic Illness to treat and requires
more over a long-term.
SOLUTION: Addiction Care Managements outpatient
Model of providing long-term Management of
Care. Outcomes and success are better, stronger
and more meaningful.
The Disease of Addiction is Chronic and just like Diabetes it never goes away. In 2003 SAMSHA – (The Substance Abuse and Mental Health Services Administration) published that 80% of Addicts who complete a Treatment Program go back to active Addiction within their first year. The majority relapse within the first 6 months. Alcoholics Anonymous has even worse numbers of only 5% staying in Recovery. Our current Model of Treatment Services focuses too much just on Treatment and is an Acute system instead of a Chronic system of care. Bryan Bowen has seen this up-close too many times and developed the missing key – Addiction Care Management’s Outpatient Model of Continuing Care – A system where newly Recovering Alcoholics or Addicts can be followed for a longer term, have access to more services than just AA or NA (though they remain important) and have an Addiction Care Management Specialist to work with them and remove the Family as “The Recovery Cops”. Addiction Care Management Outpatient’s Program also provides help and education for the Family and helps them step out of trying to control the Addiction and get better help with issues that arise with living with a newly sober person.
Why The Current Recovery Process Fails
How Addiction Care Management Works
Addiction Care Management Details:
Addiction Care Management Outpatient’s Program assesses the Patient’s Life Skills, Recovery, Family and Mental Health needs Pre and Post Treatment. First contact is made when Family or loved one calls 1st Step Interventions for an Assessment. An Addiction Care Specialist from 1st Step Interventions will follow the Patient from their Intervention, thru Treatment and for up to 1 year Post Treatment. During this time the Addictions Care Specialist will have intimate knowledge of the Addicts issues, pitfalls and areas where they are doing well. They will also work with you – The Family – providing needed Support, Education and Answers.
- While the Patient is in Treatment, follow up for the Client and “Family” for questions and support. One month is included in the Intervention Service.
- Weekly post-Intervention follow up Conference calls for the Family. Once the Patient is out of Treatment your Addiction Care Specialist will have regular interaction with the Patient thru conference calls, face-to-face meetings. Your Addiction Care Specialist will help assess where the Patient is at, their needs and help manage that they get met.
- Weekly consultations with the Patient Therapist/Case Manager/Counselor if Patient is in treatment during the time of Addiction Care Management. This includes but is not limited to, following Patient during treatment, recommendations for continuing residential treatment, outpatient treatment, continuing care and appropriate therapist/psychologist referrals. Advising the clinical team on the recommendations for Continuing Care Planning, once the Patient has completed the primary treatment program. This is dependent on IP sighing a Consent Form
- Signing off on and helping construct the Patient’s Continuing Care Plan. Providing resources as needed.
- Addiction Care Management Outpatient Program will put together the pieces of the Patient’s “Roadmap for Recovery” and the boundaries for each piece. Working with other Professionals in the Community where necessary to provide the best service
- Addiction Care Management Outpatient Program and the “Roadmap for Recovery”.
- Addiction Care Management Outpatient Program will manage all of the recovery activities. outlined for the Patient in the Continuing Care Plan.
- 1st Step removes the family from the role of policing the patient’s recovery. The chief codependent to the Addict within the Family will be identified and the relationship will be worked on.
- Addiction Care Management Outpatient Program will implement a “Stress identification and reduction Plan” for Patient’s stress and in each case a plan will be put into place with appropriate education and training were necessary. This may include Life Skills.
- Addiction Care Management Outpatient Program will manage Patient’s recovery in stages that build on each other and individual responsibility and provide an exit stage.
- Providing support for Client and Family and providing a concrete plan for Client and Families growth and recovery.
- Addiction Care Specialist led assessments of Patient’s progress and well-being. Patient must have a signed consent, if in Treatment, for communication to take place. Addiction Care Specialist will follow Addiction Care Management Outpatient Program’s assessment criteria for Addiction issues and provide Patient and family with qualified updates and any additional tools if needed.
- Managing random alcohol and drug screening of Patient after treatment if required. 92% of Pilots recover because they have to participate in a drug and alcohol testing program for 5 years post Treatment. This does work and the minimal cost is worth it. Addiction Care Management Outpatient Program can supply all necessary testing material and has a lab for additional testing.
- Managing and helping provide accountability on Patient’s adherence to Continuing Care plan.
- Providing a Relapse Plan. Should a Patient have a relapse your Addiction Care Specialist will manage that plan if event happens during the time of Addiction Care Management. Your Addiction Care Specialist will get everyone back on track with no drama or shame.
- Weekly Face-to-Face meeting with Patient if possible and TBD. Expenses are responsibility of Client.
Average amount of time per month Addiction Care Management outpatient Program provides up to 16 hours per month (unused hours cannot be used from one month to another.) This includes time spent with Family during weekly conference calls and helping the Family move into its own recovery, Working with The Family Workbook, Weekly Contacts with Patients either by phone or face to face, Addressing issues as they come up for Patients or Families, Managing referrals to other Doctors, Psychiatrist’s, Therapists etc. Being Accessible to Family or Patient at any time to help process issues or problem solve issues as they arise as. Making sure the Patient participates in a 12 step program and actually works the steps with a Sponsor. This also includes on going education for the Family and Patient and helping each move forward in their own Recovery. Addiction Care Management will also handle ALL issues as they do or will arise with the recovering patient, or a Family member. Should a case require more time than 16 hours per month than additional fees may apply, but will always be discussed first.
Dr. Jekyll and Mr. Hyde It’s a widely accepted belief that we alcoholics and addicts have two personas that may be extremely divergent or just slightly different. We may even have more than two that add to our deep experience of internal conflict. For example, we may recognize the loving husband and father who coaches Little League and enjoys his family when he’s not lying to them, getting drunk and beating his wife and kids. Subtler is the addicted doctor who practices quality medicine and plays by the rules until he decides to lie to his staff and family as he begins to self-administer narcotics or other controlled substances. You probably know the cliché phrase Dr. Jekyll and Mr. Hyde from the story by Robert Louis Stevenson. Dr. Jekyll is a fine individual who turns into the monster, Mr. Hyde, once he ingests the “poison.” This seems like alcoholism, except the alcoholic starts becoming Mr. Hyde before he ingests the alcohol or other drug. The transformation into Mr. Hyde, the using addict, precedes his actual use. You have heard it before - “Relapse happens before the usage”. In essence, people get ready to relapse. They begin to behave, think, and feel in ways they used to behave, think and feel when they were actively addicted. This has always been called a “dry drunk.”
Relapse is active use. Relapse behavior, thinking and feeling come first. But remember, a person doesn’t relapse until he or she takes the drink, the pill, the needle or the sniff. Addiction Care Management will teach you to intervene on yourself before you take the relapse action. We will focus on the Dr. Jekyll part of you becoming Mr. Hyde. One of our major goals is to heighten self-awareness without increasing self-obsession. When you are able to notice the earliest signs of your addict emerging and you take the appropriate steps to avoid using, you have averted a relapse. You are beginning to take the actions needed for “living sober.” We Professionals who are alcoholics and addicts know what it’s like to be at war with ourselves. We know what it’s like to be at war with others too, but the big war is an inside battle. Until we are solid in recovery, and even then, we maintain strong defenses against seeing ourselves clearly. We work to mute the opposing players within us. Dry…using. Dry…using. Back and forth we go, we undermined steady, forward growth in recovery by forces within. Is this experience unique to alcoholics and addicts? NO! It is part of being human. But does it cause trouble for addicts and alcoholics? Yes, and so we must look inside to see who’s there. What blocks us from maintaining a healthy recovery?
Trauma Why are you afraid? This is a big question, one you will tackle repeatedly in Treatment and Addiction Care Management. Sometimes you’ll be able to look back on your life and remember old behaviors, beliefs, feelings and relationships that were distressing to you. Now, you may be able to see that you felt afraid. You felt alone. You felt inadequate to take care of yourself. But you had nowhere to turn for help. Many addicts and alcoholics have grown up with trauma. Trauma means being in a state of utter helplessness and hopelessness. It may be the experience of living through an earthquake, flood or war when you thought you might die. It may be the experience of living with out-of-control, alcoholic parents. You couldn’t stop them and you couldn’t protect yourself. Another, a trusted family member, friend or a stranger, may have abused you. In these examples you have been the victim of trauma — a natural disaster or someone else’s out-of-control behavior. As you work through the exercises of uncovering the past, you will remember these traumas. You may see that your relapses have been directly connected to these past experiences and your fear of the power of these memories in recovery. Many people drink or use to try to control memories. We will help you remember and we will help you learn to cope with all of your past. This work is hard and painful, but it is often necessary to maintain sobriety. There is another kind of trauma that is also related to relapse. That’s the trauma you inflicted on yourself and others by being addicted. We will work with you to uncover how you lost control, how you were helpless, what you did to yourself and others and how hard it is to remember and to take responsibility for your behavior, beliefs, feelings, and patterns of relationship. You traumatized yourself. You became your own victim. You were out-of-control and helpless, though you may have believed it was just the opposite.