New center will address crack addiction
The following is a Counterrpoint
By Paul Nagy
The News & Record should be commended for pursuing a solution to Guilford County's crack cocaine problem. You first brought it to the public's attention in 2004 and have continued to raise awareness of this issue. Your Nov. 18 editorial posed important questions. My intent is to provide the best answers that I can give as a licensed addictions specialist and advocate for substance abuse recovery.
Are we taking the right approach? Yes. Let me explain our "best practices" approach to substance abuse treatment at the new county facility on West Wendover Avenue. Best-practice treatments have been clinically tested and proven to produce the best outcomes. They have been adopted as standards by the medical community.
Will Bridgeway's treatment options/lengths of stay effect a change in the county's crack cocaine problem? Yes. The provider will have an array of treatment options:
* Nonhospital medical detoxification/ facility based crisis -- up to seven days or longer.
* Social detoxification -- up to seven days or longer.
* Short-term, high-intensity residential -- up to 30 days or longer
* Long-term, less-intense residential -- up to 60 days or longer.
* Intensive outpatient -- 16 weeks or more of supportive treatment/monitoring
* Outpatient -- 12 months or longer of supportive treatment/monitoring
In determining the level of care, Bridgeway will assess the severity of each individual's substance abuse disorder. It also will consider whether a person's living environment supports recovery. As individuals gain control of their addictions, they will "step down" to lower levels of outpatient treatment. Recipients of intensive outpatient treatment will receive the same therapeutic hours as inpatient consumers. Twelve-step programs and community support services will be available on site.
Clinically, we know that cravings for crack are intense and difficult to overcome. Bridgeway's program includes supportive treatment for a year or longer for those who need it.
Has the mission changed? No. The scientific/medical community has moved away from assuming that individuals should be treated identically. People are unique, live in different environments, and are exposed to different "triggers" that can break the momentum of recovery. Substance abuse centers across the country are tailoring treatments to individual consumer needs. This is exactly what Bridgeway will be doing.
Have we sent mixed messages? We hope not. There is no "one size fits all" answer to the length of treatment question. Addiction is a malignant disease that requires a long-term chronic-disease management approach.
Paul Nagy, of the Duke Addiction Program, is best practices consultant for substance abuse treatment for the Guilford Center.
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