Principles of Drug Addiction Treatment (Section 5 continued…) UCLA Integrated Substance Abuse Programs Continuum of Care 1.

Principles of Drug Principles of Drug Addiction Treatment Addiction Treatment

(Section 5 continued…)(Section 5 continued…)

UCLA Integrated Substance Abuse ProgramsUCLA Integrated Substance Abuse Programs

Continuum of CareContinuum of Care

11

A Nice Simple Treatment ModelA Nice Simple Treatment Model

TreatmentTreatment

Addicted Patient

Non- Addicted Patient22

A Chronic Care ModelA Chronic Care Model

Detox

Continuing CareRecovering Patient

RehabDurationDetermined byPerformanceCriteria

DurationDetermined byPerformanceCriteria

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Stages of TreatmentStages of Treatment

1. Treatment EngagementDetoxification/Stabilization

Purposes: Safe/Adequate reduction of withdrawal symptomsPhysical/Emotional stabilization

Promote problem recognition Engage patient into rehabilitation

44

Stages of TreatmentStages of Treatment

2. Rehabilitation

Purposes: Sustain stable abstinence

Teach self-management skills

Identify & reduce threats to progress

Medications (maintenance and relapse prevention)

Engage patient in continuing care

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Stages of TreatmentStages of Treatment

3. Continuing Care

Purposes:Monitor & Support AbstinenceEncourage Self-MonitoringIntervene Upon Threats to Relapse Promote Participation in Long Term

Support Activities

66

Treatment ServicesTreatment Services

Continuing Care/Aftercare Programs

Intensive Outpatient/Psychosoci

al Behavioral Treatment

Sober Living Residence

Long-term Residential Treatment

Short-term

Residential

Treatment

Detox/Inpatient

Detox/Outpatient

Medication Assisted Treatment

77

Medical Detoxification Treatment Medical Detoxification Treatment ProgramsPrograms

Medical Detoxification is a treatment service used to Medical Detoxification is a treatment service used to systematically withdraw individuals from a substance in systematically withdraw individuals from a substance in an inpatient or outpatient setting. an inpatient or outpatient setting.

Treatment is provided under the care of a medical doctor.Treatment is provided under the care of a medical doctor.

Detoxification is a short treatment and does not address Detoxification is a short treatment and does not address the psychosocial and behavioral issues linked to the psychosocial and behavioral issues linked to addiction. addiction.

Detoxification is most valuable when it encompasses Detoxification is most valuable when it encompasses formal processes of assessment and results with a formal processes of assessment and results with a referral to successive substance abuse treatment. referral to successive substance abuse treatment.

Detox/Inpatient

Detox/Outpatient

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Inpatient Residential TreatmentInpatient Residential Treatment

Short-term Residential Treatment Short-term Residential Treatment (commonly referred to as the Minnesota (commonly referred to as the Minnesota Model) focuses on the introduction to the Model) focuses on the introduction to the 12 Step Program and long term 12 Step Program and long term participation in 12 Step programs for participation in 12 Step programs for recovery support.recovery support.

Long-term Residential Treatment (often Long-term Residential Treatment (often referred to as the modified Therapeutic referred to as the modified Therapeutic Community approach) involves an Community approach) involves an extended period (3-12 months) of living extended period (3-12 months) of living within a highly structured recovery within a highly structured recovery community. “Treatment” is delivered via community. “Treatment” is delivered via peer interactions within the community. peer interactions within the community.

Sober Living Residence is a living Sober Living Residence is a living environment that has supervision and a environment that has supervision and a recovery environment. It should be used recovery environment. It should be used in conjunction with outpatient treatment in conjunction with outpatient treatment and is not considered “treatment” on its and is not considered “treatment” on its ownown

Sober Living Residence

Long-term Residential Treatment

Short-term Residential Treatment

99

Intensive Outpatient TreatmentIntensive Outpatient Treatment

Outpatient Treatment varies in length of stay, Outpatient Treatment varies in length of stay, but typically lasts at least 90 days and is but typically lasts at least 90 days and is followed by outpatient continuing care. followed by outpatient continuing care.

Patients generally receive 6 to 30 contact Patients generally receive 6 to 30 contact hours per week. hours per week. Core services include: group, individual and family Core services include: group, individual and family

counseling, psychoeducation, relapse prevention counseling, psychoeducation, relapse prevention training, positive reinforcement techniques; family training, positive reinforcement techniques; family involvement; urine and breath alcohol testing; 12 involvement; urine and breath alcohol testing; 12 Step (or alternative) participation; case Step (or alternative) participation; case management; medication, vocational and management; medication, vocational and educational services. educational services.

Intensive Outpatient/Psychosocial

Behavioral Treatment

1010

Medication Assisted TreatmentMedication Assisted Treatment

Medication (e.g. Methadone, Buprenorphine) Medication (e.g. Methadone, Buprenorphine) provided in phases by a certified, licensed Opioid provided in phases by a certified, licensed Opioid Treatment Program (OTP) or a through a trained Treatment Program (OTP) or a through a trained medical doctor.medical doctor.

Medication Assisted treatment provides Medication Assisted treatment provides maintenance pharmacotherapy using an opioid maintenance pharmacotherapy using an opioid agonist, a partial agonist, or an antagonist agonist, a partial agonist, or an antagonist medication. medication.

The medication may be combined with other The medication may be combined with other treatment services, including medical and treatment services, including medical and psychosocial services. psychosocial services.

Medication Assisted Treatment

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Continuum of CareContinuum of Care

Continuing Care/Aftercare Programs

Detox/Inpatient Long-term

Residential Treatment

Intensive Outpatient/Psychosoci

al Behavioral Treatment

Sober Living Residence

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