Attaining sobriety is not the only goal of addiction treatment. Maintaining that sobriety during long-term recovery requires continuing care.
This article, the sixth and final part of a series of articles about ASAM standards of care, examines how addiction medicine physicians and addiction specialists can ensure continuity of care as patients transition from active treatment into recovery maintenance.
Continuing Care and Addiction Treatment
ASAM's Standards of Care for addiction treatment include their recommendations for maintaining recovery long-term. The treatment of most substance abuse is ongoing because these diseases are chronic, characterized by relapse and sometimes a lifetime struggle with these disorders.
That is why SAMHSA (Substance Abuse and Mental Health Services Administration) is shifting their treatment modalities to embrace acute care as a chronic undertaking, in order to combat what they call the “revolving door of multiple acute treatment episodes.”
This actually fits within ASAM’s standards for continuing care management. The standards imply that continuing care is a process that starts after the patient has achieved sobriety and met all general treatment goals. ASAM suggests that this leads patients to a secondary period whose length is unspecified, but focused on “sustainable recovery-focused self-care.”
ASAM standards suggest continuing treatment throughout the recovery process.
The goal with this long-term treatment modality is to continue addiction treatment, potentially throughout the recovering patient’s lifetime to reinforce and sustain his or her sobriety. The ASAM standards suggest that the addiction treatment specialist should monitor and review the patient’s progress over time. This could include the following treatment modalities:
- Patient interviews
- Physical and psychological examinations
- Analyzing progress based on clinical rating scales
- Reviewing medications
- Laboratory studies
- Engaging the patient in recovery activities
SAMHSA acknowledges that ongoing treatment is individualized; so creating more specific ASAM guidelines is, in fact, problematic. SAMHSA suggests that instead of one-off treatments of detox and recovery, treatment for substance users “must infuse the language, culture, and spirit of recovery throughout their systems of care.”
In fact, we understand from years of successful addiction treatment that recovery should exist within a continuum of care, instead of just during a crisis. SAMHSA suggests this treatment should be gender and age-specific, culturally aware, and available within the client community as a reoccurring resource designed to maintain recovery.
The National Academies of Sciences Engineering Medicine Health and Medicine Division in their report titled America’s Health in Transition: Protecting and Improving Quality suggests that addiction treatment should be patient-centered and ongoing, depending upon patient needs. They suggest that self-management is ongoing and should be monitored periodically by an addiction treatment counselor as part of peer support and recovery.
Addiction Treatment – An Ongoing Journey
It is important to recognize the validity of the recommendation that addiction is not an episodic disease, but, like cancer, should be continually monitored for reoccurrence in the form of relapse. SAMSHA suggests that there are even long-term cost savings associated with focusing on a chronic, not an acute, care model.
Advanced Recovery Systems believes in the necessity of chronic care management for substance use. Our services are designed to support the recovery process long-term. Contact us to find out more about referring patients to our facilities.
