Changes in alcohol and drug abuse treatment

TAP and TARP have noticed significant changes in the needs of our alcohol and drug abuse clients in recent months. A number of factors seem to have led to changes in how and why patients seek our services, their presenting problems, the treatments and follow-up services that best serve their needs.

The increase in opioid use, legalization of marijuana, insurance for 18-25 year old dependents, workplace drug testing, DUI laws, and the lowest unemployment rates in recent history –providing jobs to many who previously were unable to find work–have changed the number and nature of those seeking assistance through TAP and TARP.

Historically, TAP & TARP clients were limited to two lifetime episodes of treatment with strict dollar limitations on payment for each episode. That changed with the Mental Health and Addiction Parity Act of 2008, Obamacare’s Patient Protection Act. Those laws removed limits on the number of treatment episodes and extended insurance to children 18-25 years old.

Today, clients no longer lack resources when they are at their most vulnerable in their recovery, as they leave primary treatment.

Leaving the supportive and safe living environment of residential treatment is extremely challenging as one tries to establish a sober lifestyle.

It’s all about aftercare

Most people who go into a residential rehab treatment manage to detox and stay that way during their weeks- or months-long stay. But problems begin when they leave. Many patients walk out the door and fall off a cliff. The stresses of normal life return at the very moment our clients need it most and they can be essentially on their own.

Historically, those leaving treatment have been advised to go to “90 meetings in 90 days” and a once-a-week facility sponsored “aftercare” group. In many cases this is simply insufficient.

A survey of studies on relapse showed an average of 46 percent of people who attended residential drug treatment stay in recovery; and, about 40 percent did not achieve complete abstinence. That means less than 33% did not relapse.

Recently, the opioid epidemic has created what looks like a detox-rehab revolving door, especially among younger clients ages 18-26 years old, many of whom are recovering from opioid addiction and for whom the threat of overdose is greatest after a period of abstinence.

Perhaps because 90 percent of new heroin users have been white, people in power are finally noticing that drug abuse requires more help. The field has really accepted that problems are often chronic and many addicts and alcoholics need long term support.

The National Institute of Drug abuse stated that in many cases, “successful transition of patients from inpatient to outpatient and continuing care is abysmal.”

Even Medicaid is starting to cover continuing care, as are many private insurers, and Massachusetts now requires insurance companies to cover necessary outpatient care.

TAP and TARP have long known that continuing care groups, facility run aftercare groups and outpatient treatment following residential treatment all increase sobriety rates.  That is why many TAP and TARP clients who leave residential treatment are referred to intensive outpatient programs as a way to avoid relapse. Additionally, TAP and TARP sponsor continuing care meetings throughout Northern California; and, our counselors make monthly follow-up phone calls to clients for two years to check in with them.

If you or a family member is considering seeking assistance for a drug or alcohol problem, do not hesitate to call TAP at 800-253-8326 or TARP  at 800-522-8277.