Treatment

Treatment Pathways

Example 1: Driving Under the Influence (DUI)

After receiving a DUI a person might be court ordered to treatment for substance use in addition to other penalties. Often treatment will flow with

• The person will contact an outpatient behavioral health treatment facility to co-ordinate to have treatment
• The treatment facility will complete a Substance Use Assessment and determine what type of treatment is required given the assessment outcomes.
• Usually, the court and state laws will make some determinations. For example, 2 years of treatment, or intensive outpatient treatment for a period of time.

Example 2: Typical outpatient treatment

Outpatient treatment usually involves weekly group and/or individual treatment sessions that are led by a CDP. Depending on the substance use assessment, people often recommended to a few different tracks of treatment. For example:

• Level 2.1 Intensive-Outpatient Treatment: Typically involves 9 hours per week of group treatment divided up over 3 days.
• Level 1.0 Outpatient treatment: Typically involves 1.5 to 3 hours per week of group treatment.
• ADIS: A one weekend educational group
• Integrated Dual Disorder Treatment: This is for those that typically suffer with mental health concerns and/or a serious mental illness in addition to a substance use disorder. This usually completed with 4 hours of group weekly. Additional individual mental health therapy, case-management, and psychiatric services may also be included.

Example 3: Long time use with little success in past treatment

When a person has struggled with substance use and tried treatment several times, they may desire to add multiple supports (e.g., with peer groups like Alcoholics Anonymous), Medically Assisted Treatment, Outpatient treatment, and mental health treatment. Often times it is discovered that there are multiple core reasons for substance use problems.

Having multiple modalities of support can give people the chance to succeed.

• For example, some people will prefer to stand-in-line daily with friends in recovery to receive Methadone Medically Assisted Treatment. These people could self-administered a daily dose of Buprenorphine to similar biological results, but may at this time recognize they need the structure and social support of a daily regiment.
• For those who identify their substance use is connected to mental health issues like impulse control, distress tolerance, complex trauma, difficulties with relationship attachments may benefit more from an outpatient treatment that is specifically Integrated Dual Disorder Treatment.

Example 4: Caught at school using drugs

Some schools may have a zero tolerance for drug use that can result in suspension or expulsion from school. Many school Principals and School Districts in the Tri-Cities WA are compassionate and understand that substance use within the school aged population is a systemic problem and often related to Adverse Childhood Experiences (ACEs). While trying to protect the greater body of students, Principals often suspend students caught with drugs or being under the influence and refer them to a school Prevention/Intervention Specialist or outpatient substance use clinic. While treatment is voluntary, Principals’ have been known to reduce a suspension if the student completes a Substance Use Assessment and/or some treatment. Those students caught with drugs on them may involve law-enforcement.

Example 5: Inpatient: I need to go somewhere to reset

To begin the process of being admitted to an inpatient treatment facility for treatment, a person will usually be required to complete a Substance Use Assessment with an outpatient provider or at the inpatient center. Inpatient treatment is usually reserved for those whom meet a high level care need. There are inpatient facilities that also specialize to assist particular groups such as those that need withdrawal management, are pregnant women or have small children, need security (e.g., furlough from jail), those with intensive co-occurring mental illness and substance use. Inpatient is usually for 14 to 28 days and sometimes longer within specialized programs that transition to a more residential treatment. There are currently no inpatient facilities in the Tri-Cities for substance use. This means that transportation will be required. Outpatient clinics often provide bus passes or other means of transportation.

Example 6: Withdrawing with or without serious health risks

For those withdrawing there are options within the Tri-Cities. Some people will need medical clearance due to health risks associated withdrawal. Many people that do not want to withdrawal alone and want to begin treatment will attend a Detox center. These are 1 to 7 day stay facilities designed to assist in safe management of withdrawal and importantly to connect to services that can assist in recovery.

Example 7: What do I do when I am in jail?

When in jail in the Tri-Cities WA, there is usually no withdrawal management medicines provided once a person is medically cleared to be in jail. For those on state medical insurance, coverage usually ceases while in jail. This means that if you would like a Substance Use Assessment to develop a case or appeal for a treatment furlough, you will likely need to self-finance this service. Some jails also have internal peer support groups and case-managers that can assist in connecting people to treatment facilities and other resources upon release.

Example 8: Peer support groups AA/NA/Religious groups/Other groups

The Tri-Cities has numerous peer support groups. Some follow the traditional Alcoholics Anonymous model of peer support and involve peer sponsors (e.g., Narcotics Anonymous). In the Tri-Cities there are also faith based and cognitive-behavior model (e.g., SMART-Recovery) support groups. Additionally, there are similar peer support groups for family and friends of those with addiction (e.g., Al-Anon).