Acute care (AC) models of addiction treatment encompass service interventions that intervene at a late stage of problem development via services focused on brief biopsychosocial stabilization that lack sustained support across the stages of long-term personal and family recovery.
Recovery management (RM) is a philosophical framework for organizing addiction treatment services to provide pre-recovery identification and engagement, recovery initiation and stabilization, long-term recovery maintenance, and quality-of-life enhancement for individuals and families affected by severe substance use disorders.
William L. White, The White Papers
As a treatment community, we must begin to embrace what science tells us about addiction, and acknowledge addiction as a chronic brain disease. Only then can we begin to embrace the recovery-oriented system of care as the standard for treatment. Sanford Addiction Treatment Centers believes that this shift to recovery-oriented systems will decrease recidivism, and reduce overall medical, treatment, and employer costs. This will also reduce the load on the ancillary public systems (e.g., the Department of Health and Human Services (DHHS) and law-enforcement). And will improve the overall health and functioning of individuals, families and communities.
Acute Care vs. Recovery Management – Addiction Treatment
In a recent article by William L. White, he presents material that defines and distinguishes two different models of addiction treatment. An acute-care (AC) model that focuses on brief biopsychosocial stabilization. And a recovery management (RM) model that emphasizes sustained recovery support.
Recovery-oriented systems of care (ROSC)
Recovery-oriented systems of care (ROSC) are networks of formal and informal services to sustain long-term recovery. ROSC include: clinical treatment, 12-step involvement, early-education programs, community groups, family education, employer understanding, exercise and quality of life connection, etc.
The system in ROSC is not a local, state, or federal treatment agency but a macro-level organization of a community, a state, or a nation. ROSC initiatives provide the physical, psychological, cultural, and social space within local communities in which personal and family recovery can flourish.
William L. White, The White Papers
The goals of communities, payors, and providers should all align. That is to prevent addiction and/or effect full-recovery with as little disruption to daily life functioning as possible. If this isn’t the goal, we are violating our ethical duties and bringing unnecessary negative consequences to individuals, employers, communities and payors.
The consequences might come in the form of:
- Negative financial impact to individuals, employers, and communities due to job loss, workforce impact, and recidivism that cost payors exponentially more money.
- Impact on the public, as they are often the ones financially carrying the weight of the public programs put in place to manage the human impact of these consequences.
- Impact on families and children as the symptoms of addiction don’t just lead to financial stress, but also relational stress, divorce, domestic violence, changes in personality, medical complications, etc. The symptoms of addiction reach beyond the individual inflicted with the disease.
Recovery Oriented System of Care
We know much more about the disease of addiction and the best practices for assessment and treatment than we did a decade ago. In that regard, it is our responsibility to respond, adjust, and evolve based on this new information. A recovery- oriented system of care is not at odds with an acute-care model. As William White writes, the acute care model has an important place within the treatment system and/continuum of care. “Continuum of care” being the key phrase.
In medicine, the term “continuum of care” means the delivery of care over a period of time. And in patients with disease, continuum of care covers diagnosis to end of life. We now know that operating a treatment program with a full continuum of care is best practice. This means connecting individuals to the various parts of the continuum, based on the assessed needs, at any given point in the recovery process. This means interfacing with the community to enhance prevention on one end of the continuum, connecting individuals to the appropriate level of care when treatment is needed, and providing or connecting individuals/family with recovery management skills and follow-up services on the other end of the continuum.
At Sanford, we are motivated to improve, raise the standard, and help people heal as quickly and as fully as possible. It’s the reason we stay innovative, and are regularly looking for more efficient ways to promote healing. This is a win for everybody – individuals, families, payors, providers, and communities – locally, nationally, and globally.
Read William White’s article below:
August 20, 2020 Selected Papers William L. White