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What are the most effective patient-centered care models for treating substance abuse disorders?

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Substance abuse disorders (SUDs) are complex and chronic conditions that affect millions of people worldwide. They can impair physical, mental, and social well-being, and increase the risk of various health problems and complications. To treat SUDs effectively, it is essential to adopt patient-centered care models that address the individual needs, preferences, and goals of each person. In this article, you will learn about some of the most effective patient-centered care models for treating SUDs, and how they can improve outcomes and satisfaction for both patients and providers.

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Team-based approach:

Collaborative care involves a multidisciplinary team to address SUDs comprehensively. This model ensures personalized treatment through shared decision-making, ultimately improving patient outcomes and healthcare efficiency.### *Behavioral incentives:Contingency management uses rewards for achieving treatment goals like clean drug tests. This strategy boosts motivation and engagement, making it easier for patients to stick with their recovery plans.

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1 Collaborative Care

Collaborative care is a model that involves a team of health professionals, such as primary care providers, psychiatrists, nurses, social workers, and peer specialists, who work together to coordinate and integrate the care of patients with SUDs and other co-occurring conditions. The team uses a shared decision-making approach, evidence-based practices, and regular monitoring and feedback to deliver personalized and comprehensive care. Collaborative care has been shown to improve access, quality, and efficiency of care for patients with SUDs, as well as reduce costs and health disparities.

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Simon B.

PhD Student & Founder at Nexus Reform Ltd Driving Integrated Care Models in Mental Health and Substance Use
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I concur that an integrated approach to treating substance use issues is vital, and it's noteworthy that 60-70% of those affected also face mental health challenges. However, the term "abuse" in the article's title is problematic. It carries stigmatizing connotations that could influence public opinion and clinical care. The word suggests that substances have an "approved" use and anything beyond that is abuse, a notion that is often neither clinically nor ethically justified. For instance, labelling heroin use as "abuse" implies there's an acceptable level of use, a problematic stance. It's essential to use precise and empathetic language like "substance use" to facilitate a more nuanced, evidence-based discussion.

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The Harmony Workshops - Roger Mehta

B.A. (Hons) Counselling & Psychotherapy & B.A. Addiction Counselling. Founder - Giving A Voice To Dual Diagnosis
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I self medicated through substance misuse and then substance abuse to manage childhood trauma and C-PTSD for 16 years. We must start to treat SUDs from a dual diagnosis perspective. Though not everyone is trying to self medicate a mental disorder, there are a significant amount who are. That's also not taking into account the impact of racism, the marginalised and those living in poverty. SUDs can only be reduced through a multidisciplinary, holistic approach. Thank you.

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Philip Hannum

RRT Chaplain at BGEA Rapid Response Chaplain & First Responder Chaplain, Volunteer & Lay Leader at GMC
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The best model that I have personally observed is the approximate 20 year recovery provided to a close friend through a Betty Ford Clinic visit. The visit was successful and it has cascaded to the benefit of many others.

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Tilahun B Mossie

Mental Health, Community-Based Education
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Transdiagnostic treatment that comprises comprehensive intervention is a good approach. Transdiagnostic methods are those that pinpoint fundamental weaknesses and use universal concepts in therapeutic intervention. Clinicians are finding these kinds of interventions effective because treating substance use disorders (SUD) always has to take these vulnerabilities into account.

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2 Motivational Interviewing

Motivational interviewing is a technique that helps patients with SUDs explore and resolve their ambivalence about changing their substance use behavior. It is based on the principles of empathy, collaboration, autonomy, and evocation, and aims to elicit and strengthen the patient's intrinsic motivation for change. Motivational interviewing can be used as a standalone intervention or as part of a broader treatment plan. It has been proven to enhance engagement, retention, and adherence to treatment, as well as reduce substance use and related problems.

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Dr. Renee Parisi, CNP, DNP, CPC

Healthcare Management Expert Leading Collaborative Physician Partners
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In my experience, instead of confronting resistance with confrontation, therapists using MI should "roll with" or navigate around it. We can acknowledge resistance without escalating it, allowing the client to retain a sense of autonomy and control by acknowledging their autonomy and the fact that they have the right to make their own decisions. This sets a tone of respect for their choices. It is not my job to change their behavior; it is only my job to provide options for change.

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3 Recovery-Oriented Systems of Care

Recovery-oriented systems of care (ROSCs) are networks of services and supports that promote the recovery and wellness of people with SUDs and their families. ROSCs are guided by the values of person-centeredness, empowerment, resilience, hope, and diversity, and offer a range of options and pathways for recovery. ROSCs emphasize the importance of peer support, community involvement, cultural competence, and continuous improvement. ROSCs have been associated with improved recovery outcomes, quality of life, and social functioning for people with SUDs.

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4 Medication-Assisted Treatment

Medication-assisted treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies, to treat SUDs involving opioids, alcohol, or tobacco. MAT can help patients reduce or stop their substance use, prevent or reverse overdose, manage withdrawal symptoms, and address cravings and relapse. MAT can also improve physical and mental health, social and occupational functioning, and retention in treatment. MAT is considered a gold standard for treating opioid use disorder, and has been endorsed by various professional and governmental organizations.

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5 Contingency Management

Contingency management is a strategy that uses positive reinforcement, such as vouchers, prizes, or privileges, to reward patients for achieving specific behavioral goals related to their substance use treatment. For example, patients may receive incentives for attending appointments, providing drug-free urine samples, or completing homework assignments. Contingency management can help patients modify their substance use behavior, increase their motivation and self-efficacy, and enhance their treatment engagement and outcomes. Contingency management has been effective for treating various types of SUDs, especially stimulant use disorders.

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6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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What are the most effective patient-centered care models for treating substance abuse disorders?

1

2

3

4

5

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1 Collaborative Care

2 Motivational Interviewing

3 Recovery-Oriented Systems of Care

4 Medication-Assisted Treatment

5 Contingency Management

6 Here’s what else to consider

Healthcare

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What are the most effective patient-centered care models for treating substance abuse disorders?

1

2

3

4

5

6

1 Collaborative Care

2 Motivational Interviewing

3 Recovery-Oriented Systems of Care

4 Medication-Assisted Treatment

5 Contingency Management

6 Here’s what else to consider

Healthcare

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