Outpatient Drug Treatment
Outpatient drug treatment and understanding the process of addiction is imperative in having a successful rehab experience. Alcohol and addiction programs range from inpatient for detox, at the highest level of acuity, to outpatient which is the lowest level of acuity. No matter where someone is in their addiction, there is a level of treatment that can help. Most centers that treat substance abuse can offer different levels of care. Matrix Institute has developed The Matrix Model of addiction treatment and provides intensive outpatient, outpatient, and medication-assisted treatment at their own centers in the greater Los Angeles area.
- The Current State of Addiction
- Intensive Outpatient Drug Treatment
- Benefits of Intensive Outpatient Drug Treatment
- Matrix IOP Centers
- Addressing the Treatment Gap
The Current State of Addiction
Addiction and the way it is treated, seem to be in a constant state of flux. There are changes in the types of addiction and, importantly, changes on how addiction is perceived and how it is treated. Nevertheless, while there have been significant advances, addiction will continue to be one of this country’s most challenging issues, affecting all levels of society. While traditional addictions, focusing on alcohol and illegal substances (cocaine, methamphetamine, heroin, and so on), continue to be present, there are now also significant concerns about problems with prescription medication (Xanax, OxyContin, and so on), inhalants, and designer drugs (spice, K2, bath salts). Furthermore, the number of people who have a process addiction, or behavioral addiction, has also risen. This includes people who are addicted to gambling or to sex, for instance. There is a significant need for clarification about what substance abuse treatment is, from inpatient rehab, to outpatient programs.
A further concern is that it is now known that people who suffer from an addiction, also commonly suffer from a mental health issue, known as a co-occurring disorder, or comorbidity, as reported by the National Institute on Drug Abuse (NIDA). This is often the question of whether the substance use is the “chicken” or the “egg;” that is, did the mental disorder precede the substance use, or did the substance use cause the mental disorder? According to NIDA:
“Many people who are addicted to drugs are also diagnosed with other mental disorders and vice versa. For example, compared with the general population, people addicted to drugs are roughly twice as likely to suffer from mood and anxiety disorders, with the reverse also true.”
So the reality is that people with mental disorders are more likely to abuse substances and people with substance use problems are more likely to develop mental disorders. So there really is no distinct “chicken” or “egg” per se. It more like a chicken omelet.
Addiction is Indiscriminate
Drug addiction affects all elements of society, touching the lives of individuals and their families, and also the criminal justice system, the education system, and the health care system.
Furthermore, addiction is indiscriminate of geographical area. NIDA has also reported on different geographical areas, painting a picture of the particular drug problems affecting them. At a recent police commissioner meeting in Los Angeles, it was discussed that methamphetamine arrests continue to rise. Indicators for prescription opioids and heroin have remained stable, but they have risen for designer drugs. Meanwhile, MDMA indicators have dropped, and there is a mixed picture for cannabis and cocaine.
The Necessity of Treatment
Those who have developed an addiction must receive treatment. Treatment can be offered in a variety of different ways, one of which is intensive outpatient treatment. NIDA has also reported on treatment admission statistics for outpatient drug treatment in Los Angeles showing that the number of treatment admissions has remained stable. The main substances reported at admission are:
- Cannabis (27%). This represents a slight increase since the last data was collected, up from 25%. Over 50% of admissions in this category were in people under the age of 18.
- Alcohol (23%)
- Heroin (20%)
- Methamphetamine (17%)
- Cocaine (7%). This represents a significant reduction since the last data was collected, down from 13%.
- Other narcotics and opioids (3%)
- Sedatives, tranquilizers, and benzodiazepines (0.3%). This represents a slight drop since the last data was collected, down from 0.5%.
- Other prescription drugs (Ritalin, Adderall) (less than 0.1%).
- MDMA (0.2%). This represents a decrease since the last data was collected, down from 0.6%.
The Substance Abuse and Mental Health Services Administration (SAMHSA) has created a number of resources for providers to ensure they are able to provide appropriate intensive outpatient treatment, specifically the TIP 47: Substance Abuse: Clinical Issues in Intensive Outpatient Treatment.
“Helps clinicians design and implement intensive outpatient treatment programs for people with substance abuse problems. Discusses cultural competence and approaches, using 12-step programs, cognitive behavioral therapy, and therapeutic communities.”
Intensive Outpatient Drug Treatment
Intensive outpatient drug treatment, or IOP, may be recommended for people suffering from a dependency or addiction, following a full medical and clinical assessment. For those who do not require medically-supervised detox, then IOP may be a suitable form of treatment for them. It has also been shown to be beneficial in those who have undergone detox and require therapy to continue their recovery. Lastly, IOP is suitable for those who need to be able to accommodate their family and work life together with their treatment.
Through intensive outpatient drug treatment, Los Angeles residents with an addiction are empowered to rebuild their personal life, focusing immediately on rebuilding family ties, as they continue to live at home. The goal is to achieve long term recovery, and also to build a supportive community around the individual. This is one of the ways in which it sets itself apart from inpatient treatment, where a supportive community is only specified after someone leaves the residential facility.
Therapy Provided in Outpatient Drug Treatment
During intensive outpatient drug treatment, patients will take part in regular group therapy. At the same time, they will work with an individual therapist, with whom they meet at least once per week. Groups in group therapy should not exceed 10 people, as this better enables people to feel safe and comfortable. During group therapy, and IOP in general, a range of topics and areas are covered. These include the role of the family, co-occurring disorders, the stages of change, spirituality, how addiction progresses as a disease, what happens to the chemistry of the brain in an addicted individual, how cravings and urges can be managed, relapse prevention skills, and post-acute withdrawal syndrome (PAWS).
For intensive outpatient treated to be effective it is recommended to follow the Matrix Model, which has been proven to be effective in a range of studies.
“The current study examined the effectiveness of Matrix outpatient stimulant treatment. […] Results indicated that the pretreatment subject characteristics of ethnicity and drug of choice significantly associated with treatment outcome using Matrix model treatment. Findings also demonstrated a treatment dose/abstinence response such that those who received longer Matrix treatment episodes demonstrated better abstinence outcomes. Further, in-treatment abstinence status and treatment length significantly associated with drug use status at follow-up.”
The Matrix Model has been recommended by the National Institute on Drug Abuse as a scientifically based approach in “Principles of Drug Addiction Treatment, a Research-based Guide,” (NIDA, 2012). The Matrix Model has also been recommended as an effective treatment modality in the 2016 U.S. Surgeon General’s Report, Facing Addiction in America; The Surgeon General’s Report on Alcohol, Drugs, and Health (HHS, 2016).
Benefits of Intensive Outpatient Drug Treatment
Instead of staying in residential rehab, many patients benefit from doing outpatient drug treatment. Intensive Outpatient Programs (IOP) are less involved than traditional rehab (despite the name “intensive”), which tends to be a good level of treatment for “functional addicts.” There are a number of key benefits to individuals who undergo IOP. These are:
- That the costs are much lower than residential treatment centers, as patients do not have to pay for room and board, nor for 24/7 support staff.
- That the patient is able to continue to live at home, which offers a significant degree of comfort and stability. This can be a very strong motivator, as patients feel that they continue to be part of the community. Furthermore, it enables them to continue to take on their role in the family as well.
- That they can continue to learn or work while they take part in IOP. Again, this is a strong motivator to stick with the program, as those who do not recover will inevitably lose their job or school placement. If they enter residential rehab, there is also an increased chance of them losing this.
- That they access a strong support structure at home and in the community. This also includes spiritual support for those who have a religious belief. Essentially, by enrolling in an IOP, people can remain in contact with support, love, friendship, and encouragement. All of this plays a vital role in recovery.
Matrix IOP Centers
Los Angeles is a very large city, and one that is home to a huge variety of outpatient drug treatment programs. Key with IOP programs is that they have to be in convenient locations for the patients who use them, as they must be able to commute between the center and their home, work, and/or school. This is different from residential rehab, where someone could potentially go to a center at the other side of the country. For some people, this is beneficial, as it means they remove themselves fully from the environment in which their addiction was enabled. But with IOP programs, the emphasis is on rebuilding community and family relationships, which means it has to be within an individual’s personal geographical locations.
Some of the options for Matrix IOP’s in Los Angeles include:
All of Matrix Institute facilities offer intensive outpatient drug treatment. We understand that at times finances are a significant barrier to receiving treatment for many, not in the least because it is quite common for those suffering from addiction or dependency to have lost their jobs. That said, Matrix Institute IOP centers are in network with most insurance plans and have flexible payment plans available, so that people can focus on their recovery above all else.
Understanding that help is available for addiction and mental health is the beginning of moving towards recovery. The Matrix Model is a trusted model by doctors and clinics and continues to be a leader in research for alcoholism and addiction. The Matrix Institute Intensive Outpatient programs throughout Los Angeles help families recover from the devastating effects of addiction. We believe that our approach is so successful because we meet each person where there are at in their addiction so they can move to recovery.
Addressing the Treatment Gap
While there is a mixed picture in the number of people who abuse substances in Los Angeles, it continues to be a significant issue there. Los Angeles is quite reflective of the entire population of this country, where 9.2% of the population admits to having used some form of addictive substance in the past 30 days, as reported by NIDA.
Unfortunately, it has been observed that there is a significant ‘treatment gap’ for people who have fallen into the trap of abuse, dependency, or addiction. NIDA has reported that around 8.9% of people in the country require treatment, yet only 1% of people receive it. Significant efforts are being made to reduce this gap, and one of those efforts is to increase awareness of treatment options that are out there. People must be informed about how they can get help with their problems, and which facilities are available to them. It is crucial that this important work continues, due to the devastating impact of substance abuse on lives. Those with an addiction are more likely to lose their job, to become separated from their loved ones, to become homeless, and to end up in jail. Furthermore, substance abuse affects everyone else in the community as well.
A secondary issue of importance, as reported by the SAMHSA, is the risk of military veterans developing an addiction.
“The demanding environments of military life and experiences of combat, during which many veterans experience psychological distress, can be further complicated by substance use and related disorders. Many service members face such critical issues as trauma, suicide, homelessness, and/or involvement with the criminal justice system. Approximately 18.5% of service members returning from Iraq or Afghanistan have post-traumatic stress disorder (PTSD) or depression, and 19.5% report experiencing a traumatic brain injury (TBI) during deployment. […] Between 2004 and 2006, 7.1% of U.S. veterans met the criteria for a substance use disorder.”
A constant threat, as well, is that someone may overdose on drugs. This can result in significant injuries, or even death. In fact, the Centers for Disease Control and Prevention (CDC) has reported on a sharp rise in overdoses over recent years.
“The United States is experiencing an epidemic of drug overdose (poisoning) deaths. Since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin). CDC analyzed recent multiple cause-of-death mortality data to examine current trends and characteristics of drug overdose deaths, including the types of opioids associated with drug overdose deaths.”
The CDC has also reported on the impact of overdoses in emergency room and the health care sector. Furthermore, there are particular concerns about the statistics on women, where there has been the sharpest rise in emergency room admissions as a result of opioid abuse. Furthermore, SAMHSA has reported that people who abuse substances are also more likely to self-harm, and more likely to be suicidal.
These are some truly sobering statistics and they demonstrate just how widespread and how dangerous substance abuse is. In the main, it highlights how important it is that people seek out the help that they need, and that entire communities are aware of the availability of treatment in their areas. In fact, families, friends, neighbors, and coworkers are all recommended to look into the help that is out there, so they can support someone who they believe may need it. To find out more, call Matrix at (310) 478-8305.