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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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Open bookThere are thousands of self-help books promising to teach readers the secret to leading a better life, including many dealing with addiction recovery. Although you can’t cure drug or alcohol addiction simply by reading a book, self-help books can increase your understanding of addiction and help you figure out ways to handle cravings, codependent family relationships, and the challenges of mental health disorders like anxiety and depression.

6 Addiction and Recovery Self-Help Books to Add to Your Reading List

If you’re in the early stages of recovery, the following titles can help you stay motivated and on the right path to building a successful sober lifestyle.

1. Unbroken Brain: A Revolutionary New Way of Understanding Addiction by Maia Szalavitz

Published in 2017, Unbroken Brain is a New York Times bestseller by one of the premier American journalists covering addiction in America. Szalavitz has written for TIME.com, New York Magazine, VICE, Scientific American, Psychology Today, and The Guardian among others. She is also in recovery herself, giving her a personal perspective on this complex issue.

Unbroken Brain reviews recent scientific research to make the argument that addictive behaviors fall on a spectrum, much like autistic behaviors. The author states that instead of suffering from a “broken brain” or being afflicted with an addictive personality, someone abusing drugs or alcohol has a learning disorder that can be addressed with targeted treatment.

2. Sober For Good.: New Solutions for Drinking Problems — Advice from Those Who Have Succeeded by Anne M. Fletcher

Featuring advice from recovering alcoholics of many different backgrounds, Sober for Good shows that recovery is possible for everyone. Sober for Good is often recommended by people who don’t feel that the 12-step approach of AA is the right fit for their needs but aren’t sure what alternatives are available.

Fletcher has been featured on The View, Good Morning America, CNN, and other national media programs. She is an award-winning health and medical writer, speaker, and consultant on the topics of addiction and lifestyle change.

3. Living with Co-Occurring Addiction And Mental Health Disorders: A Handbook for Recovery by Mark McGovern

Co-occurring disorders such as PTSD, depression, and anxiety are common among people seeking treatment for drug and alcohol addiction. Although a dual diagnosis can present challenges for recovery, having a co-occurring disorder doesn’t mean that sobriety isn’t a realistic goal.

McGovern explains how co-occurring disorders can affect the recovery process while stressing the importance of working with your treatment team to set achievable goals, create a support network, and make positive changes that support your recovery. A Professor of Psychiatry and of Community and Family Medicine at the Geisel School of Medicine at Dartmouth, his professional career is devoted to research into the needs of persons with co-occurring disorders.

4. Willpower’s Not Enough: Understanding and Overcoming Addiction and Compulsion by Arnold M. Washton

Washton seeks to dispel the oldest and most persistent myth in addiction recovery: No matter how badly someone wants to change, willpower along can’t cure a drug or alcohol addiction. Addiction represents a desire for a change in mood, which means recovery must involve addressing the underlying issues that contributed to unhappiness with one’s current lifestyle.

Willpower Is Not Enough was first published in 1990, but each printing has involved updating the information to reflect contemporary views. The title is regularly recommended by members of 12-step groups as well as people who struggle with process addictions such as gambling addiction and sex addiction.

5. Beyond Addiction: How Science and Kindness Help People Change by Jeffrey Foote, Carrie Wilkens, Nicole Kosanke, and Stephanie Higgs

Attempting to shame or punish people with a substance use disorder is a popular approach, but it’s one that never works. Beyond Addiction explains why positive reinforcement and kindness are more effective than “tough love” in promoting a lasting recovery. The book draws on the authors’ 40 collective years of research and clinical experience to promote progressive treatment approaches that make lasting change possible regardless of past struggles.

In addition to offering valuable insight for individuals in recovery by stressing the value of positive affirmations, Beyond Addiction provides a guide for friends and family of recovering substance abusers who wish to learn more about how they can best support their loved one’s sobriety.

6. Recovery: Freedom from Our Addictions by Russell Brand

If traditional self-help books are too dry for your tastes, Russell Brand’s humorous and entertaining approach may be just what you need. Part memoir and part self-help guide, Recovery advocates the 12-step approach to sobriety by explaining in great detail how the steps can apply to your life.

An English comedian, actor, and radio host, Brand has been an outspoken recovery advocate due to his own struggles with heroin, alcohol, sex, and food addictions. As part of his activism in the recovery community, he opened a nonprofit coffee house in London operated by people in abstinence-based drug abuse recovery programs.

Understanding the Limits of Self-Help Books for Addiction Treatment

Although self-help books do offer some important benefits in recovery, they should not be used as a replacement for traditional forms of addiction treatment. Detox, counseling, and holistic treatments provide the best foundation for sobriety.

Self-help is only effective when a person can:

  • Clearly identify the problem
  • Approach treatment logically
  • Dedicate the necessary time and energy to achieving the desired results

Someone who is actively abusing drugs or alcohol is suffering from impaired impulse control, critical thinking, and problem-solving skills. He or she is likely in deep denial about the extent of the addiction and will continue patterns of substance abuse despite any negative consequences that occur.

If you wish to use self-help books as part of your addiction recovery, they are best incorporated into your aftercare plan for maintaining sobriety following residential treatment.

By Dana Hinders

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

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