News of the growing opioid epidemic regularly makes its way into homes across the U.S.; it’s in our newspapers, social media posts, and television and radio programming.
However, for approximately 2 million people, the opioid epidemic is far more than a news story. Every day, over 115 people in the U.S. die of an opioid overdose. Sadly, while the public narrative around the epidemic may be wrongly rooted in notions of poor choices and careless abusers, that’s far from reality.
The truth is that opioid addiction knows no demographic boundaries, and for many, the first stop on the downward spiral of addiction starts with prescription opioids.
How big is the problem? If statistics aren’t enough to convince the nation that it’s of dire consequence that we quickly remedy the situation, perhaps the fact that in September 2018, both the House and the Senate passed H.R.6, The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT)for Patients & Communities Act with the nearly full support of both Republicans and Democrats.
Passing this bill with such an overwhelming bipartisan vote, particularly during this time of political polarization, speaks volumes to the urgency and widespread reality of opioid use and abuse in the United States.
Many hope that this and futures bills will work to provide much-needed assistance to Americans – family, friends, and society as a whole — who grapple each day with the direct and indirect effects of opioid addiction.
But is the government doing enough to protect Americans from the significant, long-term physical and mental trauma that is indelibly linked to opioid abuse?
To answer that, we first must understand that opioid addiction is first and foremost a mental health crisis, and then we must factor in that notion into any feedback we have on the efforts put forth by the government and through the SUPPORT for Patients & Communities Act.
Eight Takeaways from H.R.6 – The SUPPORT for Patients & Communities Act
Includes a comprehensive Opioid Recovery Centers grant program that allows for the establishment and operation of “comprehensive opioid recover centers that serve as a resource for the community” as well as numerous other community-based efforts to control the use and abuse of drugs like heroin and fentanyl. (Section 7121, 7181)
Lifts some of the restriction on medications primarily used for opioid addiction by allowing more types of health care providers to prescribe the life savings drugs “allowing for more flexibility with respect to medication-assistance treatment for opioid use disorders”. (Section 3201)
Expands existing grant program that supports opioid overdose: first response training as additional training safety to allow first responders, like firefighters and police, to carry naloxone, making it easier for those overdosing to receive immediate medical attention. (Section 2002)
Allows for an effort to increase in “cutting edge” research projects related to not only to opioids but specifically to “find new, non-addictive drugs for pain management. “Expands the ability of federal agencies to pursue research projects designed to address issues regarding pain and addiction. (Section 7041)
Makes changes to Medicaid and Medicare that expands access to addiction treatment
New educational and awareness initiatives to spread the word about proper pain treatment from health care providers. (Section 2005)
Increases cooperation between FDA and U.S. Customers and Borders Protection (CBP) to limit the number of illicit drugs, like fentanyl, that crosses the borders by allowing for improves tools and resources for detection and testing. (Section 3014, 3022)
Increases penalties meant to control over-prescription of opioids by drug manufacturers and distributors. (Section 3271).
In addition to the points above, the bill takes a deep dive into the financial, medicinal, and legal factors that contribute to the opioid epidemic. There is no doubt that the United States needs to continue to consider bills likes this if we want to make significant strides against this raging epidemic, but what many fail to realize, and perhaps where the SUPPORT for Patients & Communities Act falls short, is that the opioid epidemic is, as mentioned above, far more than a drug problem or a crime problem; instead, the opioid epidemic is a mental health crisis.
To really make an impact on the opioid epidemic, the government and medical community must first acknowledge and act upon the root of the problem. In doing so, additional grant monies can be provided, which is necessary if we want to bridge the significant difference between the 8 to 10 billion currently being used to fund opioid addiction and the tens of billions experts feel are required.
H.R.6 continues to lay a solid foundation for future efforts to fight the opioid epidemic, but it is by no means an ending point. If we, as a nation, want to save the men, women, and children tragically impacted by opioid abuse, then we must continue to create programs, grants, and strategies that take into account the mental health crisis that is driving it.
Today, mental health issues are prevalent in the United States – one in five adults experience some occurrence within a given year. And while many people manage to cope with their condition, for 9.8 million people, that mental illness becomes a serious affliction that limits or interferes with their everyday life.
Unfortunately, those suffering from mental health problems – like PTSD, personality disorders, anxiety, and depression – are frequently vulnerable to addiction and the devastating toll it can take on their personal and professional lives.
This problem is even further compounded when someone already struggling under the heavy burden of mental illness also struggles with addiction or substance abuse.
Potential Signs of Co-Occurring Addiction & Mental Health Conditions
There are multiple signs and symptoms that can suggest co-occurring conditions, and to truly find out if you or a loved one are struggling under the weight of both, it’s important that you seek the help of a qualified care provider. However, the following signs can typically act as indicators.
A history of mental illness
Prior mental illness is often the strongest indicator of an existing or potential mental health condition. Though substance abuse may not have been present in the past, if you or a loved one has suffered from a diagnosed medical condition in the past, it’s likely that it can continue to have an effect and lead to or thrive under substance abuse.
A history of mental illness within your family can also indicate an increased risk of dual conditions. This is not necessarily limited to mental illness passed down from parent to child. Instead, it can also be any childhood exposure to mental illness, which can imprint unhealthy copying skills or other mental health issues without a hereditary link.
Using substances to escape problems
Recent life changes, particularly negative ones, like death, divorce, job loss, etc., can leave some searching for a way to cope with the emotional distress. If you or your loved one are turning to drugs and alcohol to cope with prevailing emotional distress, a mental illness, like depression, may be further contributing to substance abuse tendencies.
An attempt to quit leads to hostility, violence, or suicidal thoughts.
Quitting a substance can be difficult for anyone, but those that struggle with a mental condition may find it to be significantly more difficult. In some cases, it can lead to self-harm, unprovoked hostility, and suicidal thoughts. If those feelings or actions are present during an attempt to quit, then it can be indicative of an underlying mental condition.
Seeking Treatment for Co-Occurring Conditions
Co-occurring addiction and mental health issues add a layer of complexity to substance abuse care, combining the trials and tribulations of mental health issues with further impaired cognitive dependence and reasoning.
To further complicate the issue, many addicts aren’t aware of their mental health issues or have not received a formal diagnosis. For those reasons, treatments of these co-occurring diseases can be difficult and frequently requires a highly personalized continuum of care.
What does this end-to-end treatment solution look like? In this case, as with many others within the addiction and rehabilitation community, the solution is one that is highly dependent on the patient’s unique situation.
This includes the severity of mental health issues and/or substance dependency and patient’s personal and professional obligations, which may dictate what type of treatment program they can feasibly enroll in.
There are two primary rehabilitation programs to which a patient can enter: short-term and long-term. For patients struggling with co-occurring substance abuse and mental health issues, either treatment methods typically begin with an intense intake process that includes an initial assessment and ends with a customized program that is used to determine the long-term roadmap to recovery.
Because of the dueling struggles that often face those with mental and addiction problems, our Florida facility-based programs are typically strongly based in psychotherapy and include a one-on-one counseling component, as well as the potential to incorporate group and family therapy, life skills training, and other staple sessions proven to be effective in both mental health and addiction recovery.
Short-term treatment typically last anywhere from four to six weeks and is often compatible with the needs of patients who, due to professional or personal obligations, simply can’t engage in a treatment program that last several months.
Despite a shorter stay, the Evolutions Treatment Center short-term co-occurring treatment program offer intensive care and supervisions, with sessions lasting six or more hours. During these sessions, patients have access to comprehensive therapeutic services as well as a continuum of care to help them return to a new, sober life.
Long-term co-occurring substance abuse treatment programs are designed to last three or more month. Though many patients experience success with short-term treatment, patients that have long-standing or reoccurring abuse, or those that are suffering with severe addiction may find that a long-term treatment program is more beneficial.
Patients enrolled in the long-term program will participate in continuous treatment while in our care (several hours a day, seven days a week). Throughout the program, patients are evaluated and upon reaching specific mile stones, graduate to the next level, allowing for steady and supportive care throughout the duration of their stay.
Co-occurring addiction and mental health conditions can make it increasingly difficult for a person to seek help and, once provided with it, to maintain a sober life post-treatment.
As such, one of the most important things anyone can do when seeking treatment for co-occurring condition is to work with facilities trained to manage both substance abuse and mental illness. This will provide a solid foundation on which to build recovery and return to a stable, drug-free, and safe life beyond in-patient treatment.
Outpatient Treatment vs Inpatient Treatment: Mental Health & Addiction
Over 43 million American’s suffer from a mental health condition, making the subject a significant issue within the United States. Mental health programs and substance abuse rehabilitation centers offer those individuals a source of hope – providing the tools, resources, and support necessary to help them adapt and return to their families, lives, jobs, and community.
However, treatment is not a one-sized fit all solution and selecting the correct course of treatment is important for both short- and long-term success. Those seeking treatment for themselves or their loved ones must be able to evaluate the options available and choose the best fit for their unique needs and diagnosis. As part of our Full Continuum of clinical services, we have provided our thoughts on the differences between “Outpatient” and “Residential” (inpatient) treatment below.
Outpatient vs. Inpatient
From a housing perspective, there are two primary treatment options: inpatient and outpatient. Though some patients may not be able to make the decision on their own, it’s important to understand the primary differences.
Inpatient or residential treatment is the most intensive care program and what many think of when “rehabilitation” becomes part of the conversation. In this case, patients check in to a facility and remain there for the duration of treatment – essentially putting their outside life on hold while they work towards recovery.
Inpatient programs are often recommended to those that suffer from severe addiction or substance abuse problems, as they allow for around-the clock care and support during detox and withdrawal.
Our Primary Care Program is available to those who choose or are otherwise advised to engage in an intensive, full-time rehabilitation program. Those enrolled commit to a 30 to 90 day stay in our residences, though additional time can be provided if needed.
Outpatient treatment enables the patient to maintain somewhat of a home life, whether is be returning to their home to sleep and enjoy weekend some independence in the evening and on weekends or maintaining their place in the workplace.
Although this type of program does allow patients some flexibility, one should not assume that it does not allow for intensive treatment.
At Evolution, we provide patients with a variety of licensed mental health programs – ranging from 30 days to six months – including the following:
Outpatient Programs (OP): One to nine hours per week, with group sessions lasting about one to two hours each.
Patients can use these programs in conjunction, stepping down from one to the next as their recovery allows or they can choose to enter at any point based on their need.
Determining Treatment Based on Need
What determines which program is best for a patient? Typically, the following factors are considered when advising a patient to seek inpatient or outpatient treatment.
Medical and psychiatric needs (e.g., monitoring detox/withdrawal, co-occurring disorders)
Patient history/stage of addiction (e.g., past experiences with treatment)
Risk of relapse
Patient’s current home environment
Insurance and affordability, when necessary
Personal and professional limitations (e.g., inability to take an extended leave from a job, family needs, etc.)
Keep in mind that each situation is unique and therefore you should work closely with licensed medical staff before deciding.
Choosing a Care Facility
When choosing a facility for either inpatient or outpatient treatment, it’s important to thoroughly evaluate the facility’s staff, programs, and methodologies. Treatment centers that offer both inpatient and outpatient programs can offer an added benefit, as those that complete inpatient treatments can step down to outpatient programs if/as necessary.
At Evolutions, we offer both inpatient and outpatient programs and are dually licensed to treat substance abuse and mental health disorders. Once engaged in our programs, clients have access to a comprehensive, multi-disciplinary team of skilled professionals that can offer support to both patients and their families.
Both inpatient and outpatient programs offer those struggling with a mental disorder and/or addiction the opportunity to receive the help they desperately need. The decision to pursue either program often depends on a variety of factors, and so it’s important to work close with medical professionals as well as your loved ones as you determine the best option.
The Relationship between Outcomes and Success (Treatment & Recovery)
For many, the decision to seek treatment is a starting place, with the days, weeks, months, and years that follow representing the real race. And, just like an athlete trains for success, those seeking treatment must approach rehabilitation as an essential healing and conditioning step that will train their bodies and minds for long-term success.
With that in mind, the question becomes “how do I find the best facility for myself or my loved one?” How do you determine which rehabilitation center can help create a solid foundation for the challenges that lie ahead?
Assessing Outcomes & Determining Success
There are many ways to answer that question, but for those beginning their search, one of the best factors to consider is outcomes. On paper, outcomes may simply represent the numerical equivalent to success, but those numerical representation have real life implications as they speak to the tools, resources, and strength that patients have both inside and outside a treatment program.
Today, many treatment centers fail to follow-up with their patients, equating successful outcomes to the completion of the in-house treatment period. However, one of the biggest challenges patients must face is the return to “normal life,” where stressors lurk alongside temptation.
With that in mind, individuals and families that are reviewing their treatment option should always consider the outcomes as presented by a treatment center, identifying those that account for long-term success in their definition of “outcomes.”
At Evolutions Treatment Center, we recognize success at various milestones. The decision to enter a program and the ability to complete that program represent individual examples of success, but to us, the success of the program must be determined by the patient’s ability to sustain a long-lasting recovery that allows them to return to their family and community.
For that reason, we are invested in providing aftercare support and reaching out to patients at 1-week, 1-month, 3-month, 6-month, and one-year post-treatment intervals. In doing so, we work with patients to strengthen our effectiveness, basing success on their ability to maintain abstinence, increase their quality of life, and stay committed to utilizing resources and tools such as continual therapy, treatment, and/or support.
Today, we’re happy to report that nearly 90% of responding clients maintained abstinence, over 80% continue to report an increase in their quality of life, and a full 77% continue to recognize the importance of aftercare by engaging in ongoing utilization of the tools and resources around them (i.e. therapy, etc.)
Factors that lead to Positive Outcomes
Outcomes are important factors to consider when reviewing treatment facilities, but it’s also important to understand some of the leading contributors to a successful outcome. At Evolutions Treatment Center, we recognize that our program is only as successful as the staff, methodologies, and overall environment allow. With this sentiment in mind, we encourage those seeking a treatment facility to inquire about the following, all of which play a significant role in the outcome.
It’s true that addiction recovery efforts can, in theory, take place anywhere as long as the individual is willing and has a solid support system, but in our experience, clients that feel relaxed, secure, and comfortable while in treatment can better focus on their recovery.
This doesn’t mean that patients must deplete their finances to gain access to this environment. We offer upscale accommodations at an affordable price and accept most types of commercial health insurance, allowing patients to maintain dignity and comfort regardless of their circumstance.
There is no single successful approach to recovery, and each client comes to us as part of their own unique journey. For that reason, we limit the number of clients we serve at any given time, enabling us to provide each one the personal time and attention they need and deserve.
Our care programs are designed to meet the specific needs and challenges our patients, with commitment stays ranging from 30 to 90 days (though other flexible arrangements can be made), and treatment programs that combine psychotherapeutic, evidence-based and holistic practices. There practices range from Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) to Art Therapy and Pet Assisted Therapy (for a full list of therapy practices, visit our About Page).
We also recognize the importance that alternative therapy plays in recovery, both inside and outside our facility. Therefore, we offer access to and encourage clients to participate in physical fitness, yoga, meditation, etc., each of which can assist clients once they transition back to every day life.
As any member of the recovery community knowns, the journey is not complete once an in-house program comes to an end. And, much like most medical procedures require follow-up appointments, we believe that a successful outcome requires follow-up care.
Extended care should be a focal point of any comprehensive treatment program as it helps with the difficult transition from the security of primary, on-site treatment to everyday life, a time when patients can be vulnerable.
In addition, clients also have the option of engaging in day or evening IOP with housing as well as a 2-month transitional program in our Joint Commission Accredited housing, providing housing, supervision, support, etc.
Recover is an ongoing journey, and successful outcomes depend on strong foundational support and care. In this sense, “outcomes” represent both short- and long-term success for you and/or your loved ones.
Therefore, all treatment centers should strive to determine outcomes through interactions that exceed the 30-, 60-, or 90-day treatment phase, and individuals and families that are seeking help on the road to recovery should consider a center’s commitment to long-term outcomes in addition to short-term treatment.