Drug & Alcohol Treatment Continuum of Care

If you or a loved one has ever been to a drug or alcohol  treatment center you have probably run into the situation where the staff is telling you that you need more treatment afterwards. Many times with little or no explanation as to why. They often don’t understand why the doctor or clinician is asking the patient to stay longer and the family to spend more money.

Other times you get no discharge recommendations at all and wonder what they should do next.

There is logic and evidence behind following the drug & alcohol treatment “continuum of care” and after reading this article you will at least be informed on how the treatment process should work. The purpose of this article is to clear up some of the confusion surrounding the drug & alcohol treatment process and show how to navigate the continuum of care.

First, a little history:

Before AA there was little or no hope for an alcoholic. A drunk was basically treated like a mental patient and locked in a hospital to be observed and studied. Then they were released with essentially no “treatment”. Then, in 1935 Alcoholics Anonymous was born and was originally introduced into hospitals. This allowed a seemingly proven method of curing alcoholism.

In the early days of alcohol treatment (1950’s and 1960’s) the 30 day treatment model (“Hazelden Model” or “Minnesota Model“) was developed and at the time was a revolutionary way of treating alcoholism. Throughout the years this model has changed and expanded but the old way of doing things is still widely accepted by insurance companies as “treatment” or the way people are treated for alcohol and drug addiction. But, after billions of dollars spent treating addiction, the healthcare industry and  government agencies have learned that addiction is not fully addressed with the old 28-30 day treatment stay. You don’t just go off to a 30 day treatment center and come out cured! They have since developed a step-down system through different levels of intensity called the Continuum of Care.

The refined way of doing things:
The Substance Abuse and Mental Health Services Administration definitions “Continuum of Care” as the following: A concept involving a system that guides and tracks patients over time through a comprehensive array of health services spanning all levels and intensity of care. The continuum of care covers the delivery of healthcare over a period of time. Another term for continuum of care in the addiction treatment or behavioral health space is what is called a “Recovery-Oriented System of Care” (ROSC). The definition of a ROSC is “a coordinated network of community-based services and supports that is person-centered and builds on the strengths and resilience of individuals, families and communities to achieve abstinence and improved health, wellness and quality of life for those with or at a risk of alcohol and drug problems” (SAMHSA).

In plain english, a continuum of care is a series of mental health care levels that step you down from most intense to least intense “treatment” experience. A process (or continuum) that removes you from the drug/alcohol saturated environment and gives you tools and opportunity to apply or use said tools. This process has shown greater success for recovering addicts & alcoholics at a lesser cost. It should be noted that you can enter the continuum of care at any level but you should follow the continuum thereafter.