Archive for June, 2018

Two men talking“Continuum of care” is a phrase that’s commonly used in addiction treatment, but many people seeking help for a substance use disorder find themselves wondering exactly what this means.

Essentially, continuum of care refers to having a detailed plan for what services a person needs to help him or her stay sober after seeking residential treatment. This is a system where clients are guided and monitored over time as they progress through all levels and intensities of care. In some cases, this approach may be referred to as a “Recovery-Oriented System of Care” (ROSC).

There’s No Quick Fix

The most common misconception about addiction treatment is that detox and a quick inpatient stay are all that is needed to ensure lasting sobriety. Unfortunately, treating addiction is much more complex.

Addiction is widely recognized as an illness, but it’s not like getting strep throat and having your doctor write a prescription for an antibiotic. It’s more like being diagnosed with diabetes and having your doctor recommend diet changes, exercise, and blood sugar monitoring in addition to your medication.

You can live a full and productive life after being diagnosed with a substance use disorder, but you need to stay on top of your recovery. If you become complacent, you put your sobriety at risk.

Personalized Care Is Essential

No two people with a substance use disorder are exactly alike. Someone who has been abusing drugs or alcohol for many years has very different needs than someone who has only recently developed an addiction. Exposure to trauma, the availability of family support systems, and the presence of a co-occurring mental health disorder are also examples of factors that can widely influence what services are necessary after residential treatment.

Depending upon the client’s specific needs, some services that may be recommended as part of the continuum of care include:

  • Ongoing outpatient counseling
  • Intensive outpatient treatment that offers a more intensive counseling experience but still allows the client to return home each night
  • Sober living homes that serve as an interim step between residential treatment and living independently
  • Participating in 12-Step groups
  • Participating in alumni events sponsored by the residential treatment center
  • Online recovery education programs

Steps in the Continuum of Care

Every case is a little different, but the general steps in the continuum of care are as follows:

  1. Assessment: Determine the nature and extent of the substance use disorder, as well as any chronic illnesses or co-occurring mental health conditions that would complicate care.
  2. Treatment Plan: Develop an evidence-based plan for addiction treatment.
  3. Treatment: Use detox, counseling, and holistic treatment to build the skills necessary for long-term sobriety.
  4. Evaluation: Determine how successful treatment has been in helping to break old behavior patterns.
  5. Case Management: Develop a plan for ongoing care, such as intensive outpatient treatment or sober living.
  6. Extended Care: Provide the services necessary to ease the transition into independent living while addressing physiological, psychological, and spiritual concerns.
  7. Monitoring: Periodically check in with the individual to make sure there are no areas of concern.


Notice that the level of support gradually decreases as the client becomes more adept at practicing the skills necessary to manage the chronic nature of a substance use disorder.

Easing the Transition to Independent Living

Although the specifics are different for each individual, the goal of continuum care planning is to ease your transition from the structured environment of residential treatment to an independent sober life.

Your care team will help you determine what support you need to practice applying the skills you’ve learned to everyday situations. This includes:

Your continuum of care plan can help address specific goals you may have for yourself as you embrace the possibilities of a life without drugs or alcohol. For example:

Providing a Roadmap to Recovery

It may be helpful for you to think of the continuum of care in addiction treatment as a roadmap to recovery. You still need to do the work of building the skills necessary for sober living, but this approach provides you with a detailed plan and actionable steps to guide the process.

However, this does not mean that your continuum of care plan is set in stone. If you suffer an unexpected setback, the plan can be adjusted as needed. There’s no criticism or judgement, only a sincere desire to help you find the best way to move forward with your recovery journey.

By Dana Hinders

 

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Poverty and addictionThe relationship between addiction and poverty is complicated. Lower income people are slightly more likely to struggle with drug or alcohol abuse, but this doesn’t necessarily mean that poverty causes addiction. In some cases, financial troubles are the result of a substance use disorder.

Poverty Increases Addiction Risk Factors

There are several ways in which financial struggles increase the risk of a person developing a substance use disorder:

  • Poverty increases stress. Stress is well recognized as a risk factor for substance abuse and relapse after treatment. Worrying about how to afford shelter, food, and other basic needs causes a tremendous amount of stress. When you’re struggling to make ends meet, there is a great temptation to turn to drugs or alcohol to temporarily escape from your problems.
  • Poverty increases feelings of hopeless. When meeting daily expenses is difficult, dreams of attending college, buying a home, opening a business, or traveling the world seem impossible. Feeling as though you are powerless over your own future creates a vulnerability to substance abuse.
  • Poverty decreases self-esteem. In a culture that values material possessions and financial success, being poor can feel like a moral failing. This can lead to feelings of guilt, shame, and diminished self-worth. According to Psychology Today, people struggling with low self-esteem have an increased vulnerability to developing substance use disorders.
  • Poverty decreases social support. Having the emotional support of friends and family helps people cope with difficult situations in their lives. However, lower income adults are less likely to have strong social support networks simply because they are expending all of their energy on trying to survive from day to day. For example, a UCLA survey found that lower income adults are less likely to be married even though they value marriage just as much as their higher income peers.
  • Poverty decreases access to healthcare. Although the number of uninsured adults has decreased in recent years, the Henry J. Kaiser Foundation found that 45 percent of uninsured adults lacked coverage simply because the cost was too high. Despite the fact that most of these individuals had at least one working adult in the family, 1 in 5 admitted to foregoing recommended medical treatment due to cost. Access to preventative health care is also severely limited for members of this group. Untreated mental health conditions or chronic illnesses that are poorly controlled can lead to the use of drugs or alcohol to self-medicate symptoms.

One frequently cited example of how poverty affects addiction risk is the Appalachian opioid epidemic. Stretching from the Southern Tier of New York to northern Alabama, Mississippi, and Georgia, the Appalachian region of the United States has struggled with widespread poverty since the early 1900s. The majority of the available jobs are physically demanding, carrying a high risk of injuries despite their relatively low wages. Residents who begin taking opioids to cope with chronic pain from their employment-related injuries often find themselves spiraling into addiction. The effects of substance abuse make it nearly impossible to keep working, thus perpetuating financial struggles.

Addiction Can Cause People to Slip into Poverty

It’s important to remember that people with substance use disorders don’t necessarily develop an addiction simply because they are poor. Someone who is solidly middle class can easily slip into poverty as the result of an untreated drug or alcohol addiction.

As an addiction develops, it becomes increasingly likely that a person will have problems performing at work. This might include arriving late, missing shifts, failing to meet project deadlines, or getting into arguments with colleagues. Eventually, this can lead to job loss.

Being terminated for performance issues will make it harder to find another job. This increases the overall stress in the person’s life and provides an incentive to engage in criminal activity to fund continued substance abuse.

Middle class individuals can also slip into addiction-related poverty by selling assets or dipping into retirement savings to buy drugs or alcohol. Untreated addiction impairs judgement and critical thinking skills, which can lead someone who is normally very financially responsible to burn through decades of accumulated wealth in just a short time.

Promoting Recovery by Treating the Root Causes of Addiction

No two people with substance use disorders are exactly alike. To promote a lasting recovery, it’s vital that treatment plans address the underlying issues contributing to addiction. This could include providing job skills training, affordable housing resources, or access to community-based assistance programs for low-income individuals in addiction to detox and substance abuse counseling.

By working to heal the mind, body, and spirit, St. Joseph Institute helps clients move towards a future free from the burden of addiction. With personalized care, you can regain control of your life.

 

By Dana Hinders

To learn more about our programs, please visit our website.

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dentist officeDuring your next dental appointment, you may be asked about more than your brushing and flossing habits. A recent survey found that 77 percent of dentists now perform substance abuse screenings as part of routine exams.

Why Are Dentists Are Worried About the Addiction Epidemic?

Dentists may not be considered primary care providers, but dental health plays a key role in your overall physical health. This puts dentists in a unique position to fight substance abuse.

Dentists often see patients who have tooth decay due to substance abuse issues. For example, methamphetamines are a leading cause of tooth decay and tooth loss. Alcohol abuse is a primary risk factor for oral cancer. Tobacco use leads to gingivitis and tooth loss.

Addressing the risk of substance abuse is also important because dentists are the second leading prescriber of prescription opioids. This puts them at risk of inadvertently starting someone on the path towards addiction or feeding the habit of someone who already has a full blown opioid use disorder. Drug interactions could be another potential concern, since prescription opioids given for pain relief after a dental procedure could have dangerous interactions when combined with alcohol or illegal street drugs.

What Do Substance Abuse Screenings Look For?

Substance abuse prevention efforts often start the moment a patient walks into the office. Staff members may be looking for signs of potential problems such as:

  • Poor personal appearance, including bloodshot eyes
  • Slurred words, unsteady movements, or other signs of current intoxication
  • A history of broken appointments
  • Repeated requests for unusual prescriptions based on a self-diagnosis
  • Dramatic complaints of severe pain not in line with the issue the patient is being seen for
  • Someone who arrives near closing time seeking opioid prescriptions with the promise to return for an appointment the following day

In addition to a more informal evaluation, the dental hygienist may ask the following questions:

  • How often do you consume alcoholic beverages in a typical week?
  • Have you used tobacco products such as cigarettes or smokeless tobacco in the past three months? If yes, how much and how often?
  • Have you used marijuana more than five times in your life? If yes, when was the last time you used marijuana?
  • Have you felt you should cut down or otherwise control your drinking or drug use?
  • Do you get angry, upset, or annoyed when people ask you about your alcohol or drug use?
  • Do you feel guilty about your drinking or drug use?
  • Have you ever needed a drink or used drugs immediately in the morning to calm your nerves or get rid of a hangover?

Female dentists are more likely to believe addiction screenings are part of their professional responsible than their male counterparts, with 61 percent of women and 52 percent of men conducting screenings.

Age is another factor in how dentists perceive the importance of addiction screening, with 62 percent of dentists over the age of 53 and 47 percent of dentists under the age of 53 conducting screenings.

What Happens Next?

Although the rise of addiction screenings at the dental office should be encouraged, screening people at risk of substance use disorders is only a small part of the battle.

A 2013 study in the Journal of the American Dental Association reports that most dentists who screen patients for substance abuse do not provide referrals to counseling or follow up with patients who exhibit warning signs of addiction. Despite their concern for the well-being of their patients, they feel unqualified or not prepared to offer more extensive drug use prevention services.

Providing continuing education opportunities and additional training to help dentists refer at-risk patients to the appropriate resources would be a cost-effective way to tackle the public health concerns associated with substance use disorders. Until then, however, it’s up to each individual to look out for the signs of addiction and urge friends, family, neighbors, colleges, and others in need to the appropriate evidence-based treatment programs.

Based in Port Matilda, Pennsylvania, St. Joseph Institute for Addiction provides detox and counseling to address the issues contributing to substance use disorders. Our faith-based approach views addiction as physical disease in need of treatment for the mind, body, and spirit. This allows for a solid foundation of sobriety, setting the stage for a future free from the burden of addiction.

By Dana Hinders

To learn more about our programs, please visit our website.

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