Designated Case Managers as Facilitators of Medical and Psychosocial Service Delivery in Addiction Treatment Programs

Abstract Background The COVID-19 pandemic has created a crisis in access to addiction treatment. Programs with residential components have been particularly impacted as they try to keep infection from spreading in facilities and contributing to further community spread of the virus. This crisis highlights the ongoing daily trade-offs that organizations must weigh as they balance the risks and benefits of individual patients with those of the group of patients, staff and the community they serve. Main body The COVID-19 pandemic has forced provider organizations to make individual facility level decisions about how to manage patients who are COVID-19 positive while protecting other patients, staff and the community. While guidance documents from federal, state, and trade groups aimed to support such decision making, they often lagged pandemic dynamics, and provided too little detail to translate into front line decision making. In the context of incomplete knowledge to make informed decisions, we present a way to integrate guidelines and local data into the decision process and discuss the ethical dilemmas faced by provider organizations in preventing infections and responding to COVID positive patients or staff. Conclusion and commentary Provider organizations need decision support on managing the risk of COVID-19 positive patients in their milieu. While useful, guidance documents may not be capable of providing support with the nuance that local data and simulation modeling may be able to provide.

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Three Dynamic Healing Modalities for the Treatment of Substance Use and Co-Occurring Disorders: Aromatherapy, Equine Therapy, and Creative Arts Therapies

10.1093/med/9780190275334.003.0022 ◽

2018 ◽

Author(s):

E. Hitchcock Scott

Keyword(s):

Large Scale ◽

Addiction Treatment ◽

Treatment Modalities ◽

Treatment Programs ◽

Creative Arts ◽

Traditional Treatment ◽

Equine Therapy ◽

Creative Arts Therapies ◽

The Right ◽

Healing Modalities

This chapter comprises three subchapters, and each subchapter offers a brief introduction to 1 of 3 healing modalities: (1) aromatherapy, (2) equine therapy, and (3) creative arts therapies. All 3 healing processes are considered to be well regarded in the field of addiction treatment. Yet the credibility of each one could benefit from more well-designed, large-scale, randomized controlled trials. Even so, there is significant research supporting the efficacy of each of the 3 treatment modalities. Safety is especially important with impulsive patient populations, such as those with dual diagnoses, addiction and trauma. All three modalities are able to be powerful, and at times transformative, when practiced by qualified health practitioners. For patients who struggle with substance abuse, co-occurring disorders and adverse childhood experiences, especially those who have felt as if they were failed by traditional treatment programs, a non-traditional treatment modality may provide just the right intervention.

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Case Management

Encyclopedia of Social Work ◽

10.1093/acrefore/9780199975839.013.42 ◽

2013 ◽

Author(s):

Maria Roberts-DeGennaro

Keyword(s):

Decision Making ◽

Service Delivery ◽

Case Management ◽

Delivery System ◽

Case Managers ◽

Evidence Based ◽

Care Providers ◽

Service Delivery System ◽

Generic Set ◽

Management Functions

A generic set of case management functions are performed in most practice settings. To improve outcomes within a complex service delivery system, case managers need to collaboratively work with clients and care providers. By incorporating the paradigm of evidence-based practice, case managers can improve decision making through integrating their practice expertise with the best available evidence, and by considering the characteristics, circumstances, values, preferences, and expectations of clients, as well as their involvement in the decision making.

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Relationship between severity of tobacco dependence and personality traits, insomnia and impulsivity in male and female individuals entering alcohol treatment

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1107 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S322-S323

Author(s):

A. Wnorowska ◽

P. Serafin ◽

A. Topolewska-Wochowska ◽

A. Klimkiewicz ◽

A. Jakubczyk ◽

...

Keyword(s):

Personality Traits ◽

Addiction Treatment ◽

Tobacco Dependence ◽

Treatment Programs ◽

Negative Consequences ◽

Male And Female ◽

High Severity ◽

Neo Five Factor Inventory ◽

Competing Interest ◽

Alcohol Dependent

IntroductionTobacco dependence (TD) often coexists with alcohol dependence. Previous research documented that both biological and environmental factors influence simultaneous development of the two disorders. However, it has not been determined whether the same psychological and psychopathological factors affect TD in alcohol-dependent males and females.AimThe objective of the study was to assess risk factors for high severity of TD in alcohol-dependent individuals considering gender differences.MethodsThe study entailed two groups: male (n = 284) and female (n = 102) subjects entering alcohol addiction treatment programs in Warsaw, Poland. Standardized instruments were used to assess: severity of TD – Fagerstrom Test for Nicotine Dependence, personality traits – NEO-Five Factor Inventory to assess, consequences of drinking – Short Inventory of Problems, impulsivity – Barratt Impulsivity Scale, and Sleep Disorder Questionnaire-7 as a measure of insomnia.ResultsIn the studied sample, current smokers comprised 79.1% (n = 225) of male and 79.4% (n = 81) of female participants. Multivariate regression model showed that high negative consequences of drinking (P = 0.001) and low NEO Openness score (P = 0.009) were associated with high risk of TD in female alcoholics (corr. R2 = 0.223; P < 0.0005). Bivariate analyses showed that TD was associated with impulsivity, openness, agreeableness and neuroticism in male alcohol-dependent subjects. Insomnia was the only significant predictor for high severity of TD in the males (corr. R2 = 0.068; P = 0.002).ConclusionsDifferent factors contribute to severity of tobacco dependence in male and female alcohol-dependent individuals entering addiction treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Screening for homelessness among individuals initiating medication-assisted treatment for opioid use disorder in the Veterans Health Administration

Journal of Opioid Management ◽

10.5055/jom.2015.0298 ◽

2015 ◽

Vol 11 (6) ◽

pp. 459 ◽

Cited By ~ 5

Author(s):

Marcus A. Bachhuber, MD, MSHP ◽

Christopher B. Roberts, MPH ◽

Stephen Metraux, PhD ◽

Ann Elizabeth Montgomery, PhD

Keyword(s):

At Risk ◽

Addiction Treatment ◽

Women Veterans ◽

Opioid Use Disorder ◽

Treatment Programs ◽

Veterans Health ◽

Health Administration ◽

Opioid Use ◽

Medication Assisted Treatment ◽

Male Veterans

Objective: To determine the prevalence of homelessness and risk for homelessness among veterans with opioid use disorder initiating treatment. Setting: Addiction treatment programs operated by the US Department of Veterans Affairs (VA).Participants: All veterans initiating treatment with methadone or buprenorphine for opioid use disorder between October 1, 2013 and September 30, 2014 (n = 2,699) who were administered the VA’s national homelessness screener. Main outcome measures: Self-reported homelessness or imminent risk of homelessness.Results: The prevalence of homelessness was 10.2 percent and 5.3 percent were at risk for homelessness. Compared to male veterans, women veterans were less likely to report homelessness (8.9 percent vs 10.3 percent) but more likely to be at risk (11.8 percent vs 4.9 percent). By age group, veterans aged 18-34 and 45-54 years most frequently reported homelessness (12.0 and 11.7 percent, respectively) and veterans aged 45-54 and 55-64 years most frequently reported risk for homelessness (6.5 and 6.8 percent, respectively).Conclusions: The prevalence of homelessness in this population is approximately 10 times that of the general veteran population accessing care at VA. Screening identified a substantial number of veterans who could benefit from VA housing assistance and had not received it recently. Programs to address veteran homelessness should engage with veterans seeking addiction treatment. Integration of homelessness services into addiction treatment settings may, in turn, improve outcomes.

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