Everyone is aware of the opioid epidemic combined with fentanyl and xylazine. The combination of these drugs is lethal. Several innovative approaches are being used to intervene in overdose deaths. One approach is the pop-up clinic, where drug users can use under supervision, obtain immediate help if they overdose, and can be connected to substance abuse services. According to the CDC, over 90,000 overdose deaths occurred in the US in 2020. These clinics’ OPCs (overdose prevention centers), used for decades in Europe, are known as a harm reduction strategy. Some of the European sites offer food, showers, clothing, counseling, prevention materials, and links to drug treatment services. Some sites, especially in Europe, provide fentanyl strips to see if the drugs brought into the facility have fentanyl in them.
In the US, several cities have functioning OPCs. “While the effects of OPCs on hospitalization rates are not yet clear. 50 best pieces of evidence from cohort and modeling studies suggest that OPCs are associated not only with lower overdose mortality (approximately 88 fewer overdose deaths per 100,000 person-years, according to the most optimistic estimates) but also 67 percent fewer ambulance calls for treating overdoses and a decrease in HIV infections.”
Insite data indicates an increase in users seeking medical help through these sites. As of August 2022, 147 OPC are providing services in 91 communities in 16 countries. While OPCs are still considered illegal under federal law, the number of OPCs recently operating in the US has been successful. There is a need to remove the national barriers to OPCs in the US to save lives, reduce crime, and limit infection among those sharing needles. Additionally, OPCs have chill-out rooms that allow clients to inhale instead of shoot drugs into their veins. These rooms allow users to leave the site less impaired and thus safer on the streets.
In the US, there are few functioning OPCs. There are 2 in NYC, an underground OPC in Seattle, and in 2021, Rhode Island signed legislation that legalized privately funded OPCs.
Using Motivational Incentive
For any SUD program to be successful, it requires buy-in from the client. That means that the client participates and commits to the program and stays the necessary amount of time to receive the maximum benefits of the treatment. Often people go through the motions of participating only to leave treatment early and immediately use again. While motivational incentives are not new, they work. They help to give the client a sense of recognition and achievement when life feels challenging and confusing. It is a way of measuring small but necessary steps in the foundation of recovery.
Incentives help clients modify behavior and lead clients toward living clean and sober. Studies by the National Institute on Druse Abuse, Clinical Trails Network, demonstrated that incentives aided in positive client outcomes. In community-based outpatient programs, clients achieved a more extended duration of abstinence, remained in the study longer, and submitted more stimulant-negative urine samples.
People respond to positive feedback and rewards better than pain and punishment. “Positive reinforcement strategies are designed to increase the occurrence of a specific, desired behavior by breaking a larger goal down into smaller steps and reinforcing each of the steps.” This approach has been beneficial, especially for those suffering from stimulant abuse.
Integrated Therapies for Substance Use Disorders
The major obstacle for clients going through recovery is the pull of old habits and people with who one used to. There are many opportunities in recovery to pick up again. Still, if one takes to heart what is learned during treatment and aftercare, combined with a strong support group and new habits, the likelihood of staying clean and sober increases.
Many treatment facilities now offer a range of therapies, from traditional cognitive behavioral sessions to holistic modalities such as acupuncture, meditation, and yoga, to name a few. No one treatment approach is suitable for everyone. And treatment and aftercare plans must offer clients tools to keep them from returning to drugs when they feel overwhelmed, angry, and stressed. These tools must work at home when dealing with unhealthy family dynamics, work, and leisure time.
The range of treatment modalities, including drug education, medication management, group therapy, individual therapy, family therapy, work evaluation, life skills, relapse prevention, and holistic treatments, provide the client with a solid foundation to live in the moment and resist cravings. Having options like running or calling a friend in recovery can help a client through tough times.
Sometimes, drug and alcohol use worsen an underlying mental health disorder: anxiety, paranoia, COD, or other complex mental health issues. “Drug abuse changes the function of the brain, and many things can “trigger” drug cravings within the brain. It’s critical for those in treatment, especially those treated at an inpatient facility or prison, to learn how to recognize, avoid, and cope with triggers they are likely exposed to after treatment.”
The type of treatment one requires depends on the health of the client, the mental state of the client, the length of time taking drugs and alcohol, the type of drugs used, social issues (such as trouble with the law), family issues, and work issues. Medical staff and clinicians must consider everything about a client to determine the best treatment approach.
Qualified medical and clinical staff need to be able to re-evaluate the client’s progress regularly. These addiction professionals should have training in the therapeutic approaches being used. As the substance abuse treatment field grows more complex, more researchers look at the dynamics of the brain and behavior.
To date, the following are the types of therapies used in treating SUD:
- Contingency Management
- Motivational Interviewing
- Relapse Prevention
- Social Support
- Cognitive-Behavioral
- Coping Skills
- Harm Reduction
- Cognitive Therapy
- Drug Counseling
- Recovery Training (exercise)
- Standard Group Therapy
- Family Therapy
- Intensive Group Therapy
- 12-step Facilitation Group Therapy
- Psychoeducational Therapy Group
- Behavioral Skills
- Aftercare Plans
As one can see, a variety of therapies are needed to address a client’s needs. No single approach can manage all the aspects of a person’s life that led to a SUD. Appropriate diagnosis and treatment plans will give the client the most substantial chance of maintaining sobriety and learning to live again without substances.
If you are tired of chasing a fleeting high, if you want to rebuild relationships with family and friends, if you want to be a better version of yourself, we can help. Call now and speak with a representative who can answer all your questions and ease your mind. Recovery is possible; take the first step and call now.
References:
- https://www.nbcnews.com/health/nations-first-overdose-prevention-centers-opens-opioid-death-spike-rcna7058
- https://nida.nih.gov/sites/default/files/NIH-RTC-Overdose-Prevention-Centers.pdf
- https://www.cato.org/sites/cato.org/files/2023-02/briefing-paper-149.pdf
- https://adai.uw.edu/retentiontoolkit/incentives.htm#:~:text=Use%20of%20motivational%20incentives%2C%20also,%2Fgroup%2C%20etc.).
- https://attcnetwork.org/centers/attc-network-coordinating-office/contingency-management-part-1-evidenced-based-approach
- https://nida.nih.gov/sites/default/files/drugfacts-treatmentapproaches.pdf
- https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-021-00371-0