IOP Group Reflection

As previously discussed, the program the author would choose to evaluate is MAT treatment programs. This population consists of individuals that have been diagnosed with opiate use disorder, and receive opiate-substitution medications, such as Methadone or Suboxone. These program evaluations would be consumer-centered, performed in the clinics they receive services. Interested stakeholders would include the treatment center where the participants receive services, as well as other MAT service providers. Additionally, the funding sources for these individuals and program centers, such as county, state, and federal agencies, along with medical insurers, would also gain value from the program evaluation research.

There are a variety of treatment modalities, both conservative and emerging, that clinicians, therapists, and doctors use to treat heroin and opioid dependence. Cognitive behavioral therapy (CBT), motivational interviewing (MI), 12 step programs, and acceptance and commitment therapy (ACT) are just a few that have been used in the past, and even today, in the treatment of substance dependence. Medication-assisted treatment (MAT) is yet another form of therapy; particularly for opioid and heroin dependence, that has been around for decades. However, it has recently begun to spark interest and controversy in light of the growing epidemic.

The participant is a 49 year old African American male who began using substances at the age of 13. He was diagnosed with severe alcohol, cocaine, and opioid use. The participant has been incarcerated over the past 32 years. He was recently paroled after completing eight years of a sixteen year sentence in the Illinois Department of Corrections for burglary and theft. The participant is on medications to treat HIV/AIDS and has been diagnosed with Major Depressive Disorder. He was referred to Healthcare Alternative Systems residential program through TASC as a condition of his probation.

In October of 2002, the Food and Drug Administration (FDA) approved the use of Suboxone for the treatment in the United States of opiate addiction (Mintzer, 2007). It is a medication-assisted treatment; however it “does not require participation in a highly-regulated federal program such as a methadone clinic” (Stuckert, 2013). It does not cause the high or euphoria feeling associated with opiate dependency. In fact many patients that have taken the treatment have said that they have felt little more than having more energy and no real high at all (Thompson-Gargano, 2004).

The counselor met with the patient for her scheduled Addiction Severity Index assessment. The patient is a 54 year old black male. The patient states he is single with no children. He report currently lives with sister in law of his decease brother. The patient reports having a 14 years of education however no degree. The patient report receiving disability for mental health disorder. The patient reports he is currently not on probation. The patient reports he last use Cannabis 7/17/15 and started using at the age of 13 and smokes 3 to 4 times a week at least 2 joints. He also report using Alcohol 7/20/15 a 40oz beer and usually drank a couple a day. The patient denies any issues with HI/SI. Patient also reports he is taking his medication as prescribed. The patient appear to be in the pre-contemplation stage of change. The patient next scheduled individual session with the counselor is on Monday, July 27, 2015 at 02:30p

The client met with his counselor on 05/06/2017 for his one on one session to discuss his treatment plan goals. the client has been on track with his goals and is working on his second step. the client discuss one of the things that his currently working on and that is acceptance. the client explained that he is having a hard time acceptance certain situations and things that happen in his life, and most of the time it result in him resulting to using drugs. the client as well talked about being disappointed in himself for relapsing after two years of being sober. the client reported that he didn't use the tools that were given to him from his last his was in the program, getting a sponsor and learning coping skills. the client reported that

THESIS STATEMENT: To investigate Methadone maintenance is found to be more effective in treating heroin addiction than 180 day detoxification. The objective is how methadone maintenance, a widely used but controversial method of weaning heroin addicts off the drug—with counseling has psychosocially enriched 180 day methadone assisted detoxification.

“In 1949, Isbell and Vogel, working at the U.S. Public Health Hospital in Lexington, Kentucky, showed methadone to be the most effective medication for withdrawing addicts from heroin (Joseph, Stancliff, & Landgord, 2000, p. 347). Further studies revealed that administering methadone to an addict for seven to ten days had a relapse rate of more than 90% when treatment ceased. “By 1998, the number of methadone patients in the United States had increased from the original six research patients in 1964 to about 44,000 patients in New York Stated and 179,000 patients worldwide” (Joseph, Stancliff, & Landgord, 2000, p. 347). The number of individuals enrolled in MMT continues to increase as the methadone clinics and the overall effectiveness of MMT gains

Xavier then reported, the applicant recovery is up and down and the reason the patient was transferred and admitted to the Norwich location was due to an altercation as the Hartford Dispensary has zero tolerance for physical violence. Since May of of this year, the applicant's UDS results are negative. Last positive result was in April for cocaine, according to the counselor. Please note, during the applicant intake, he was asked about other illicit drugs and only confirmed for use of heroin and THC, not the cocaine. The applicant's current dose at the Hartford Dispensary is 105mgs as he is being detoxed daily. His highest dose was at 145 mgs before his detoxification. The physical altercation was the applicant's first behavioral incident at the clinic. He was also on a 90 Probation for his illicit use and it would have expired in August, but due to the recent incident, he was removed from the clinic, not discharged, but transferred as mentioned before. Counselor Xavier only concern of the applicant is maintaining his

2. The patient was provided with weekly sessions, random UDS testing, group sessions if needed, and any other case management the patient needed. The patient came to the clinic in need of treatment for his opioid dependence and was compliant with his treatment.

As I began thinking about what topic covers a multitude of citizens and is a significant issue and problem that affects the justice system here in the United States, almost automatically I was drawn to my deep passion for recovery based solutions to drug and alcohol addictions. I have found my experiences in recovery, to repeatedly be surrounded with the pain of those whom have suffered and are still suffering from effects of their addiction(s). Many addictions have grown out of the same medications that when used properly, provided the relief sought to provide pain maintenance and therefore relief of such pain. I firmly believe that without some form of spiritual

¨ More than a quarter of a million Americans are enrolled in methadone clinics, where they participate in “methadone replacement” or “methadone maintenance” to treat narcotic addictions to heroin or morphine, or prescription painkillers like oxycodone, hydrocodone, OxyContin or Vicodin.¨ (Novus Detox, 2016) Clinics that treat opioid addiction use several combinations other than methadone to be effective. In addition to daily methadone treatments, there are also random drug test to make sure the individual is complying with the program. There is also individual and group counseling that provides education and support with each being customized with goals set forth by the patient. Some addiction require patients struggling to seek professional help with a psychiatrist and/or speciality

A psychiatrist in a methadone clinic in Northeast Washington, D.C. works with patients who are addicted to drugs. Some of her patients suffering from addiction

will schedule an appointment to discuss and create a budget plan. Patient is currently free from all illicit drugs, which has helped her Adderall medication to be more beneficial. Primary Counselor will encourage Pt. to follow through with all mental health appointments. Counselor will prompt Pt. to develop a positive self-image. Pt. has denied having any auditory or visual hallucinations during the last quarter as evidenced by group and individual session notes. Pt. has had some setback in achieving her goals of decreasing her family conflicts and resolving intimate relationship issues. Counselor will encourage Pt. to attend the AMS parenting group and share her expectations regarding having a more functional family unit. During the next quarter therapy sessions, Counselor will utilize role-playing, role reversal, modeling, and behavioral rehearsal to assist Pt. in order to develop positive ways to resolve conflict with ex-husband. Pt.’s current treatment plan goals focus on opiate use disorder, financial, mental health services and parent-child relational problems. During the upcoming quarter, current goals will continue to be

The patient only has two group sessions remaining for the Methadone Stabilization. The next group session is scheduled on 9/5/2017. The patient reported that the group was going well and the attendance eventually started to decrease to the point that people aren't coming.