Although drug overdoses have always been of concern, the CDC states that since 1999 the number of overdoses has more than quadrupled. Additionally, more than six out of ten overdoses involve some form of an opioid. According to the American Society of Addiction Medicine, the United States is in the middle of an overdose epidemic that is being led by opiates. With 144 Americans dying because of a drug overdose each day, unconventional methods are being used to support those who are in recovery.
The Importance of Creating Community Partnerships
The disease of addiction begins as a sense of feeling separate from, beneath or different than others. Unsurprisingly, the disease is fueled by isolation, depression and social anxiety. For these reasons, community is vital for individuals in recovery.
The Definition of Community as It Pertains to Addiction
Community in relation to addiction means more than simply a neighborhood, it refers to human connections that were created during treatment, 12-step programs, recovery houses and scheduled activities. Individuals suffering from addiction will be reluctant to reach out to others. However, long-term recovery is unlikely until they decide to participate in the community-driven activities: The ultimate goal is to encourage individuals in recovery to connect with others.
Banding Together to Remove Barriers
It is imperative that family, friends and treatment professionals work together to learn how to discontinue enabling behaviors and set healthy boundaries. This helps to eliminate the safety nets and break down the barriers that individuals suffering from addiction create to avoid engaging with the community. Individuals who are not suffering from addiction crave interaction with others; however, this is not true for those who are afflicted with addiction. Their brains tell them the opposite. Consequently, it is vital that an environment is created that requires the person in recovery to engage (and re-engage) with the community. That individual's recovery is contingent upon it.
The National Institute on Drug Abuse (NIDA): Types of Recovery Programs
The NIDA provides information related to the types of programs available to those in recovery.
Recovery Support Services (RSS)
A collection of community services designed to provide the individual with emotional and practical support to promote continued sobriety. These components include recovery housing, mutual aid groups (e.g., Alcoholics Anonymous (AA), Narcotics Anonymous (NA), etc.), recovery community centers, recovery coaching, recovery-based education (could be high school or college programs) as well as provide recovery management through telephone calls and checkups.
Recovery-Oriented Systems of Care (ROSC)
These recovery programs assist individuals with severe substance use disorders. Services offered typically include long-term, outpatient care, recovery coaching, recovery housing and case management through checkups.
Social and Recreational Recovery Infrastructures, and Social Media
These programs are designed to help individuals who are in recovery enjoy socializing with others and enjoying activities that do not include the use of alcohol, and/or drugs. Activities may include creative arts programs, recovery-specific cafés, bowling leagues and clubhouses, etc.
Adolescent Community Reinforcement Approach (A-CRA)/Assertive Continuing Care (ACC) (A-CRA/ACC)
This program stresses the importance of the implementation of continuing care services directly following discharge from a residential treatment facility, or following a period of outpatient treatment. Through the ACC program, clinicians visit the homes of those in recovery to offer A-CRA procedures that correspond with the individual’s strengths, reinforcers and needs. In addition, clinicians provide information related to home/community therapy sessions, community services that are available, as well as midweek phone calls between the adolescent and the therapist.
Community Conversations About Mental Health
This program concentrates on providing information related to creating a community dialogue around mental health issues: Its goal is to build awareness and support. Community Conversations About Mental Health offers a toolkit that provides tips and outlines to successfully promote mental health as well as to support an individual’s access to treatment and recovery services within the community.
Community Conversations Toolkit:
- A Discussion Guide for Community Conversations About Mental Health
- A Planning Guide for Community Conversations About Health
- An Information Brief for Community Conversations About Mental Health
- Mental Health in My Community
Gloucester, Massachusetts, has implemented a program that consists of medical professionals and police department personnel working together to provide individuals in recovery with a variety of services, programs, and support systems designed to assist them with maintaining their sobriety.
Police Department Based Addiction Outreach Programs: A Step in the Right Direction
First responders have been witnessing the devastation of the U.S. drug-overdose epidemic for some time, which has led to the creation of police department-based addiction outreach programs.
Police Assisted Addiction and Recovery Initiative (PAARI)
PAARI is a nonprofit organization that assists overdose victims once they return home. The organization’s mission is to provide support for the police addiction initiatives in Gloucester, Massachusetts, to assist other police departments that are interested in implementing a similar program, and to illuminate the unique opportunity that police departments have to directly impact drug addiction within their own communities.
Rebecca Wolfe, M.Ed., is the clinical responder for the police department in Arlington, Massachusetts. She provides an outline demonstrating how they embedded programs in their police departments to help those suffering from addiction.
How to Create an Addiction Based Outreach Program
Educate the Public and Expand Community Access to Naloxone
Using various mediums, the community was invited to an event featuring three key speakers:
- A certified interventionist — to talk about his or her own addiction experiences.
- A court clinician — to discuss the steps necessary to attain court-ordered substance abuse treatment for a loved one.
- Staff members from a needle exchange program — to discuss the signs of drug overdose and to demonstrate how the life-saving drug Naloxone is administered. According to Wolfe, attendees received a free double-dose Naloxone kit, compliments of the needle exchange program.
Remove Excess Prescription Opiates Within the Community
Host drug take-back days to remove leftover prescription medications that have the potential of leading to addiction. Consider installing permanent kiosks in the lobby of the police stations to allow access to the medication drop-off point 24/7. To eliminate the need for transportation, the Arlington Police Department organized drug take-back events at its public housing locations.
Directly Target Individuals Who Are at the Most Risk
The likelihood of those who are actively using drugs attending an outreach program meeting is slim. The more chronic the drug use, the less likely the individual is willing to have contact with the police. Furthermore, in most communities, Naloxone is available for purchase at most local pharmacies and offered for free at numerous community treatment centers. However, due to the stigma associated with addiction, many individuals choose not to ask for the medication.
Build a Bridge Between Police and Individuals Suffering from Drug Addiction
In order to reduce the number of deaths related to drug overdose, these individuals need to know that help is available. Wolfe realized that having police officers personally deliver Naloxone to those who needed it the most may positively impact the relationship between them. By providing the medication, police were making it clear that they wanted to help individuals suffering from addiction, not just arrest them.
Reaching Those in Need
As the clinical responder for the police department, Wolfe could access police reports. She began to reach out to individuals who recently overdosed. Furthermore, police officers informed her of their concerns related to individuals residing in the neighborhoods they patrolled. After gathering the information, she needed to contact the individuals who had recently overdosed. To do so, Wolfe would call these individuals (as well as anyone else who was listed on the police report) to offer them Naloxone and discuss various treatment options.
If Wolfe could not reach them by phone, she would visit their homes. Even when individuals refused to see her, she made it clear that they could contact her if they decided they wanted help.
Access to Treatment
Due to high demand and limited openings, finding a treatment facility or detox bed can be a challenge. Individuals who have made the decision to seek treatment may become discouraged and start to feel overwhelmed as they call numerous facilities and are turned away due to bed shortages. However, if interventionists and volunteers assist people who are seeking treatment by finding them a place to receive treatment, this heartbreaking dilemma can be avoided.
Reduce the Likelihood of Relapse with a Coming Home Day Program
While in a treatment facility, individuals have a very restrictive environment. However, following treatment, individuals head home and are frequently on their own without much structure or support. This may hinder an individual’s ability to remain sober. Therefore, a solution to the problem was necessary. To solve this problem, a Coming Home Day program was implemented. Individuals who had completed their treatment and were scheduled to be discharged were encouraged to contact the Arlington Addiction Community Training and Support (ACTS). A community volunteer meets with the individual on the day he or she leaves the treatment center. The volunteer may bring the individual to an NA or an AA meeting, or provide information about other services available. Coming Home Day is a relapse prevention technique designed to bridge the gap between inpatient care and community living.
The Government Acknowledges Drug Addiction
The Drug-Free School and Communities Act (DFSCA)
The DFSCA requires that all higher learning institutions that receive federal funding develop programs that:
- Describe the health risks that are associated with drug and/or alcohol use.
- Detail the penalties for breaking the law (state, federal and local).
- Provide students with a list of local treatment options.
- Describe conduct standards as they relate to substance use.
- Evaluate the effectiveness of their programs every two years.
Drug Court as Both Legal and Medical Authority: A Research Note
Drug courts were created in 1989. Since that time, these courts have been combining rehabilitation strategies with punitive measures in an attempt to reduce rates of drug offender recidivism through recovery.
Saving Lives Requires Setting Stigma Aside
Wolfe states that the program they have created is comprehensive and effective. Instead of dedicating full-time staff to address this problem, a team approach allows them to strategically and tactically assist those who need it the most. This approach has allowed them to provide those in need with a quick, compassionate and effective response.
To learn more about community-based programs and what you can do to help, visit the links below:
- The Addiction Recovery Guide
- Addictions and Recovery.org
- Hazelden Betty Ford Foundation
- The New Recovery Advocacy Movement (NRAM)
- National Registry of Evidence-based Programs and Practices (NREPP)
- Recovery to Practice (RTP)
- Faith-based and Community Initiatives (FBCI)
- Partners for Recovery (PFR) Fact Sheet
- Drugs & the Brain Wallet Card
- The Science of Drug Use - Discussion Points
- Drug courts: Background, effectiveness, and policy issues for Congress