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Aiden Martinez
Aiden Martinez

Alcohol Rehabilitation Facilities ((TOP))

The common length of stay in drug and alcohol rehab is 28 to 30 days, 60 days, or 90 days. While treatment for any period of time is helpful, the National Institute on Drug Abuse (NIDA) recommends people spend at least 90 days in treatment.

alcohol rehabilitation facilities

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

Washington, DC - United States Senator Elizabeth Warren(D-Mass.), a member of the Health, Education, Labor, and Pensions (HELP)Committee, and Senator Tammy Baldwin (D-Wis.), Ranking Member of theSubcommittee on Employment and Workplace Safety, sent a letter requesting thatthe Government Accountability Office (GAO) investigate mandatory vocationalrequirements at drug and alcohol rehabilitation facilities that receive federalfunding. Their request follows a recentinvestigation by the Center for Investigative Reporting which found thatindividuals at some drug and alcohol rehabilitation facilities are beingrequired to work, unpaid, as part of their treatment program, creating a"huge, unpaid shadow workforce."

Some rehabilitation facilities have mandatory work requirements, describedas vocational therapy, in which facilities send participants to work forcontractors of or directly at private companies, with these individualsreceiving little to no pay for their labor. This practice appears to be aviolation of federal labor law, but has escaped federal enforcement.

"Individuals struggling with substance use disorder who attendrehabilitation programs should never be subjected to predatory conditions thatthreaten their recovery and violate their rights under the law. Federal fundingdedicated to supporting individuals and communities navigating substance usedisorder must be used in service of evidence-based prevention, treatment, andrecovery," the senators wrote.

The senators asked the GAO to investigate (1) the extent to which federalfunding was provided to rehabilitation facilities with mandatory workrequirements; (2) whether the evidence shows that mandatory work requirementssupport addiction treatment and recovery; and (3) what oversight exists toensure individuals in rehabilitation programs are fairly compensated, and thatprograms follow relevant labor and employment law.

In addition to hundreds of state-certified and monitored treatment facilities across New York State, the Office of Addiction Services and Supports directly operates and staffs 12 Addiction Treatment Centers (ATCs) across New York State. These centers provide individualized care that is responsive to the needs of each client and supports long-term recovery. OASAS staff at each facility are trained at addressing co-occurring or underlying conditions, such as psychiatric disorders. They also assist in your aftercare planning. Specialized addiction treatment services vary between each facility but can include: medication-assisted treatment; problem gambling, gender-specific treatment for men or women, and more. All centers are tobacco free and offer naloxone training events open to the community.

Understanding the specialized substance abuse treatment system, however, can be achallenging task. No single definition of treatment exists, and no standard terminologydescribes different dimensions and elements of treatment. Describing a facility asproviding inpatient care or ambulatory services characterizes only one aspect (albeit animportant one): the setting. Moreover, the specialized substance abuse treatment systemdiffers around the country, with each State or city having its own peculiarities andspecialties. Minnesota, for example, is well known for its array of public and privatealcoholism facilities, mostly modeled on the fixed-length inpatient rehabilitationprograms initially established by the Hazelden Foundation and the Johnson Institute,which subscribe to a strong Alcoholics Anonymous (AA) orientation and have varyingintensities of aftercare services. California also offers a number of community-basedsocial model public sector programs that emphasize a 12-Step, self-help approach as afoundation for life-long recovery. In this chapter, the term treatmentwill be limited to describing the formal programs that serve patients with more seriousalcohol and other drug problems who do not respond to brief interventions or otheroffice-based management strategies. It is also assumed that an in-depth assessment hasbeen conducted to establish a diagnosis and to determine the most suitable resource forthe individual's particular needs (see Chapter4).

The first step in understanding local resources is to collect information about thespecialized drug and alcohol treatment currently available in the community. In mostcommunities, a public or private agency regularly compiles a directory of substanceabuse treatment facilities that provides useful information about program services(e.g., type, location, hours, and accessibility to public transportation),eligibility criteria, cost, and staff complement and qualifications, includinglanguage proficiency. This directory may be produced by the local health department,a council on alcoholism and drug abuse, a social services organization, or volunteersin recovery. Additionally, every State has a single State-level alcohol and otherdrug authority that usually has the licensing and program review authority for alltreatment programs in the State and often publishes a statewide directory of allalcohol and drug treatment programs licensed in the State. Another resource is theNational Council on Alcohol and Drug Dependence, which provides both assessment orreferral for a sliding scale fee and distributes free information on treatmentfacilities nationally. Also, the Substance Abuse and Mental Health ServicesAdministration distributes a National Directory of Drug Abuse and AlcoholismTreatment and Prevention Programs (1-800-729-6686).

Becoming alcohol- or drug-free, however, is only a beginning. Most patients insubstance abuse treatment have multiple and complex problems in many aspects ofliving, including medical and mental illnesses, disrupted relationships,underdeveloped or deteriorated social and vocational skills, impaired performance atwork or in school, and legal or financial troubles. These conditions may havecontributed to the initial development of a substance use problem or resulted fromthe disorder. Substantial efforts must be made by treatment programs to assistpatients in ameliorating these problems so that they can assume appropriate andresponsible roles in society. This entails maximizing physical health, treatingindependent psychiatric disorders, improving psychological functioning, addressingmarital or other family and relationship issues, resolving financial and legalproblems, and improving or developing necessary educational and vocational skills.Many programs also help participants explore spiritual issues and find appropriaterecreational activities.

While the effectiveness of treatment for specific individuals is not alwayspredictable, and different programs and approaches have variable rates of success,evaluations of substance abuse treatment efforts are encouraging. All the long-termstudies find that "treatment works" -- the majority of substance-dependent patientseventually stop compulsive use and have less frequent and severe relapse episodes(American Psychiatric Association, 1995;Landry, 1996). The most positive effectsgenerally happen while the patient is actively participating in treatment, butprolonged abstinence following treatment is a good predictor of continuing success.Almost 90 percent of those who remain abstinent for 2 years are also drug- andalcohol-free at 10 years (American PsychiatricAssociation, 1995). Patients who remain in treatment for longer periods oftime are also likely to achieve maximum benefits -- duration of the treatment episodefor 3 months or longer is often a predictor of a successful outcome (Gerstein and Harwood, 1990). Furthermore,individuals who have lower levels of premorbid psychopathology and other serioussocial, vocational, and legal problems are most likely to benefit from treatment.Continuing participation in aftercare or self-help groups following treatment alsoappears to be associated with success (AmericanPsychiatric Association, 1995).

An increasing number of randomized clinical trials and other outcome studies havebeen undertaken in recent years to examine the effectiveness of alcohol and variousforms of drug abuse treatment. It is beyond the scope of this chapter to report theconclusions in any depth. However, a few summary statements from an Institute ofMedicine report on alcohol studies are relevant:

The terminology describing the different elements of treatment care for people withsubstance use disorders has evolved as specialized systems have developed and astreatment has adapted to changes in the health care system and financingarrangements. Important differences in language persist between public and privatesector programs and, to a lesser extent, in treatment efforts originally developedand targeted to persons with alcohol- as opposed to illicit drug-related problems.Programs are increasingly trying to meet individual needs and to tailor the programto the patients rather than having a single standard format with a fixed length ofstay or sequence of specified services.

Historically, treatment programs were developed to reflect the philosophicalorientations of founders and their beliefs regarding the etiology of alcoholismand drug dependence. Although most programs now integrate the following threeapproaches, a brief review of earlier distinctions will help primary careclinicians understand what precursors may survive or dominate among programs. Thethree historical orientations that still underlie different treatment models are 041b061a72




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