Low-threshold addiction treatment programs seek to provide care strategies to minimize the risk of self-harm. These are typically programs such as medication-assisted treatment or other modalities that do not require the patient receive inpatient counseling or treatment.
This article explores the concept of low-threshold care. What is it? How is this approach being used to help addicted patients gain access to needed care? What are the pros and cons of this approach?
An article in The International Journal of Drug Policy sought to define the scope of care for low-threshold addiction treatment. The strategy has been to use low-threshold forms of treatment to engage the most recalcitrant and marginalized patients in addiction treatment.
Low-threshold care provides treatments that ease the potential for self-harm while eliminating stigma and other barriers. The goal of these services is to provide some sort of addiction treatment for even those that are the toughest to reach. The article suggested that there are three criteria for services defined as low-threshold:
Consider some of the benefits and drawbacks of this treatment.
These treatment modalities have both pros and cons for the patient and the provider. In some instances, the pros can also be cons, depending on the perspective. For example, a pro for the severely addicted could be that they can receive treatment without addressing some of the root behavioral issues that led to their addiction. So, they can maintain without getting completely clean.
From a provider perspective this could be frustrating; while the patient is maintaining and not overdosing, he or she is not quite ready to get well.
Treatments such as buprenorphine, a medication-assisted therapy, can often be considered a low-threshold treatment, particularly when the patient is provided a prescription and instructed to self-administer the drug. A drawback to this approach is that it does require subsequent appointments to gradually taper off the medication. If the patient lacks the motivation to return or does not seek additional counseling, this treatment designed to reduce self-harm could be less effective.
In “Comparative Treatments of Substance Abuse,” the authors spell out features that are both the pros and cons of the nature of the treatment:
From this perspective, it is not necessary for a client who is ambivalent about abstinence to completely stop using in order to obtain help changing substance use behavior. Rather, services are designed to meet the client where he or she is at with respect to possible treatment goals and stage of change.
If the goal of addiction treatment is to offer care to patients at all stages in the spectrum of substance abuse, low-threshold treatments offer alternatives to full inpatient behavioral, psychological, and pharmacological treatment.
If you are a clinician with patients who need more intensive addiction treatment than low-threshold treatments provide, we can help. Contact us to find out more about referring patients to our facilities.