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Continuum of Care

What is it, and what can you expect from Oxford Treatment Center’s continuum of care?

No two people’s reasons for drinking or using drugs, timelines for seeking out treatment, or recovery journeys are quite the same.1 The experiences of a person who developed a severe opioid addiction after escalating their use of a prescription medication, for example, is likely to be vastly different from that of a teenager who is binge drinking several times per month.

For the best chance at success and continued sobriety after treatment, your course of treatment may be customized to you and your unique challenges and needs. Toward these efforts, facilities may operate several of their own varying levels of care, known as a continuum of care, or will make arrangements for you to maintain treatment continuity elsewhere.

Overview

In an attempt to optimize treatment outcomes, ideally a person’s treatment should be tailored to his or her specific needs. These needs can be based on a number of elements that include: 2

  • The severity of addiction.
  • How long the substance abuse has been going on.
  • Whether or not the person has a social network of support.
  • The person’s adherence and response to certain therapies.
  • Continued access to the substance in the person’s daily life.
  • Certain risk factors that could have some bearing on outcomes (age, gender, etc.).

A wide range of treatment options provides a higher chance of creating an addiction treatment plan that will work for you. Because your needs will change over time and throughout treatment, it’s important the program continually adapt as needed so it keeps pace with those developments.

What Is Continuum of Care?

rehabilitation sign against a sky backgroundContinuum of care refers to having different levels of treatment available, sometimes at different facilities, so the rehab program can be adjusted based on a person’s changing needs for more or less intense treatment over time.3 It also means making sure the right therapies are available for the person at each phase of treatment to provide the greatest chance of long-term recovery.

For example, let’s say you enter a relatively low-intensity treatment program based on your initial evaluation by a treatment professional. With good continuity of care, if at any point your treatment team determines that your recovery progress isn’t optimal, arrangements can be made to shift your level of care to a higher intensity. The treatment is adjusted to fit the person, rather than the person being expected to thrive in a one-size-fits-all setting.

A full-service continuum of care involves a number of treatment phases designed to work with the person at each step of recovery, including a range of elements from initial intervention to detox, therapy, and aftercare, along with all the potential steps in between.

The Full Continuum

Though individual recovery journeys may vary somewhat, a full continuum of care may start with inpatient detox and treatment and be followed up with outpatient care and various aftercare measures such as support group meetings and regularly scheduled counseling appointments.

One study of publicly funded substance abuse treatment programs found that a full continuum of care consisting of 3 weeks of inpatient treatment prior to outpatient treatment interventions resulted in improved outcomes relative to a partial continuum program as analyzed by measures of alcohol, drug, and psychiatric severity .4

Oxford Treatment Center offers a full continuum of care to be able to address many people’s substance use disorders in ways unique to the client.

Initial Evaluation

People with substance abuse issues often receive an initial evaluation by a treatment professional to better assess their addiction severity and treatment needs. It is around this point that you commit to entering treatment. This leads to seeking out a facility and working with its staff to develop an initial treatment program.

Detox

If the person is still under the influence of the substance and/or will require some level of withdrawal management, he or she undergoes detox before any other treatment elements can be introduced.

Detox protocols will vary depending on the substance of abuse and the degree of physiological dependence and withdrawal risks. The abrupt discontinuation of certain substances, such as alcohol and benzodiazepines (a group of prescription anti-anxiety medications), are associated with dangerous withdrawal symptoms during detox.

Other acute withdrawal syndromes, such as those associated with opioids, may include symptoms that, while not often immediately life-threatening, can be extremely uncomfortable and risky in terms of relapse likelihood.

Withdrawing in a medical detox program with people experienced in managing detox and withdrawal can make the process safer and more comfortable. With semi-private detox rooms and EarlySense technology—which allows the facility’s nurses and doctors to monitor your vitals during sleep for potentially life-threatening changes—Oxford Treatment Center can make sure you’re detoxing safely and in some privacy.

In many cases detox programs and longer-term treatment centers are connected, or at least have a relationship that facilitates patient transfers to encourage a continuum of care. However, even if this isn’t the case, a reputable treatment center can help you make a smooth transition from the detox facility into a treatment facility of your choice.

Residential Treatment

There are several different ways a facility can approach residential treatment. The various aspects of residential treatment can include:

  • Medical support of co-occurring medical and mental health issues, if necessary.
  • Various behavioral therapies to help the person better understand and manage triggers and cravings.
  • Family or couples counseling to strengthen support for abstinence outside the program.
  • Education and skills development for better relapse prevention and a smoother transition into post-rehabilitation life.

In residential care, the treatment team can provide round-the-clock supervision and support while focusing on the individual’s progress through treatment; treatment adjustments can be made based on that progress.

Residential treatment makes it possible to give the client access to the full range of therapies and treatments that can benefit that particular person, depending on the circumstances of the person’s specific substance abuse problems, other mental health issues, and family, work, school, or other issues in the person’s daily life that may have contributed to the addiction or abuse.

This is where Oxford Treatment Center’s continuum of care really thrives: The facility has offerings ranging from experiential and recreational therapies like equine therapy and access to 12-step groups to access to medical staff as well as family programming and access to lecture and education courses about addiction.

Research has shown that the length of time spent in treatment can influence recovery, with longer times spent in treatment resulting in more positive outcomes. For this reason, it could be beneficial for you to make a commitment to completing the residential treatment program for the period of time recommended by the treatment professionals.

Outpatient Treatment

Many people who complete a course of treatment in an inpatient or residential program step down into outpatient treatment for continued recovery efforts, though outpatient substance abuse treatment may also serve as the first point of entry into the treatment continuum.

With this kind of treatment, the person can go back to living at home and return to a mostly normal daily life, while regular contact is still maintained with the treatment facility.

The outpatient program at Oxford Treatment Center, like any continuum of care, is customized to your recovery path. The amount of time you spend with a counselor or therapist will be based on your needs. You may continue with therapy and skill-building programs, as well as taking part in self-help support groups, such as 12-step meetings.

Support for continued recovery is readily available, helping with the transition from living with 24-hour support to managing your addiction with less help. The aim is to help the person reach a point of managing the addiction with a minimum of support, leading to the next treatment level.

Intensive Outpatient Treatment

For some people, living at home and returning to daily life outside the treatment program may create a higher risk of relapse than it would for other people. You may have more daily exposure to the abused substance, social networks that encourage substance abuse, or co-occurring disorders that require management for longer periods of time after you complete residential treatment. That’s where intensive outpatient treatment (i.e., intensive outpatient program, or IOP) comes in.

Designed to provide a higher level of transition support for those who have these types of challenges, Oxford’s 10-week IOP focuses on education, therapy, and building accountability. Morning and evening sessions—lasting about 3 to 4 hours each—will help you gain and reinforce skills to help avoid relapse and recognize triggers.

Partial Hospitalization

In cases where a heavier hand may be needed, Oxford Treatment Center’s partial hospitalization program (PHP) might be the best call. This 3-week minimum treatment option requires 20 hours a week and provides you with access to medical staff, as well as focuses you on reinforcing skillsets and trying out real-world scenarios in a safe environment.

These outpatient treatment options are available at Resolutions Oxford, a sober living facility just 16 miles from the Oxford residential campus.

Aftercare or Post-Treatment Support

Once the treatment portion of the program is complete, you can return to a new daily life of recovery maintenance; however, this doesn’t mean that the continuum of care is complete. Even after treatment is over and you are able to manage the addiction alone, stress or other emotional or physical challenges might occasionally increase the risk of relapse.

Oxford Treatment Center’s discharge planners will work with you to create an aftercare plan that works for you. In the aftercare stage of your continuum of care, Oxford provides access to weekly meetings on campus, and to its expansive alumni network.

Programs that include aftercare are committed to the full continuum of care, demonstrating that they are also committed to giving you the best chance at recovery from your substance abuse or addiction issues. These programs prepare you for long-term maintenance of your substance abuse disorders.

 

References

  1. National Institute of Drug Abuse. (2018). Principles of Effective Treatment
  2. Murphy, S.A., Collins, L.M., & Rush, A.J. (2007). Customizing Treatment to the Patient: Adaptive Treatment Strategies. Drug and Alcohol Dependence, 88(Supp 2), S1-S3.
  3. Substance Abuse and Mental Health Services Administration. (2006). Substance Abuse: Clinical Issues in Intensive Outpatient Treatment
  4. McKay, J.R., Donovan, D.M., McLellan, T., Krupski, A., Hansten, M., Stark, K.D., Geary, K. & Cecere, J. (2009). Evaluation of full vs. partial continuum of care in the treatment of publicly funded substance abusers in Washington state. The American Journal of Drug and Alcohol Abuse, 28(2), 307-338.
  5. Moos, R.H. & Moos, B.S. (2006). Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction 101(2) 212-222.
About The Contributor
Scot Thomas, M.D.
Senior Medical Editor, American Addiction Centers
Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating... Read More