Sunday, March 8, 2009

Bridging the gaps

Mounting evidence suggests that teens and young adults are at the highest risk for developing drug or alcohol problems. In an economic climate in which mental health resources are dwindling, finding appropriate drug-addiction treatment for this age group can be an especially overwhelming process.

That is where Mass General can help.

ARMS – Addiction Recovery Management Service – gives teenagers and young adults between the ages of 15 and 25, and their families, an individualized approach to treating their substance-related problems, guiding them each step of the way. The goal is to bridge the gaps on the road to recovery by connecting these young patients to a full array of services that will meet their needs.

Downward spiral

"My late teens and early 20s were a blur," says Ben Brown, a 24-year old patient in the ARMS program. "It wasn't until my mother read about ARMS that I truly got my life on track."

Brown had grown up in a middle-class household in the suburbs of Boston, performing well in high school and starting in the honors program at a local university. But experimentation with alcohol and drugs spiraled. Although the school made several attempts to help him with his addiction problems, an overdose was the straw that broke the camel's back and he was expelled. He started living out of his car or sleeping on friends' sofas, regularly using cocaine, heroin, prescription drugs, and supporting his habits through shoplifting.

Brown made several attempts to get sober through detox programs. He would succeed for weeks or months at a time. "The detox counselors would always tell me to follow-up with a 12-step program," says Brown. "But it just didn’t work for me, and I didn’t know where else I could turn." After a concerted attempt to get sober, he would start using again and fall into the same patterns, shoplifting and living out of his car.

"I reached a turning point when I was cited for my second DUI," says Brown. His car – his home – was impounded and he returned to his mother’s house. "She was determined to make a change, and that’s when she made an appointment for me with Jason."

Coaching the recovery

Jason Boyle, LICSW, is a recovery coach for the ARMS program. As a caregiver within the Psychiatry Department at Mass General, his patients have access to the clinical, medical and addiction resources available at a world-class institution. Treatment for patients like Brown starts with an evaluation of all aspects of a patient’s history, current symptoms and available resources, in order to devise the recovery plan that is most likely to succeed. This includes diagnosing any related behavioral or psychiatric conditions that may be contributing to the problem and helping a patient establish goals related to their overall health and well-being and their transition to adulthood.

Recovery coaches like Boyle continue to guide patients through traditional inpatient, residential and/or outpatient services, providing rapid access to information and support combined with addiction counseling, outreach and care management.

Family members are incorporated into treatment plans and support systems, even when patients might be resistant to treatment, as is often case with this age group. ARMS is unique in providing research-based, innovative approaches to help parents cope. Several evening groups are held specifically for this purpose. Parents are taught skills that will help tailor their interaction with their children at home, through communication and contingency plans, to increase the likelihood of their child entering treatment.

Consultations available

ARMS also can provide a one-time consultation for anyone who does not wish to enroll in the program just yet. "Even patients who are not quite ready to commit to sobriety, or their families, can contact us with questions about how to make this next step," says Boyle. "It is a big step to embrace treatment and we’re available to people at any stage of that process."

Until ARMS, there was no available resource that could offer the decisive combination of support, understanding and professional addiction expertise and information. ARMS is a tangible asset in critical moments of need, helping families and young people to manage current crises and to facilitate entry to suitable quality services.

To understand how the program can assist a young person struggling with addiction, consider this analogy: Imagine paramedics at the scene of a car accident asking a traumatized, injured teenager with a crushed pelvis what Emergency Department (ED) he or she wants to be treated at. And that's just the beginning. Once the ED physicians stabilize the hip, imagine them sending the patient away, with their family or on their own, with the suggestion to find a surgeon at a completely separate institution. In the unlikely chance that they get themselves to a hip specialist, that doctor can then send the patient out to find an inpatient unit for recovery, then a separate place for physical therapy and so on.

Right now, studies show there is a 90 percent unmet treatment need in the United States for youth with a substance disorder. Finding continuous and comprehensive care for addiction treatment in this environment is incredibly complicated. There are silos of services out there - acute residential treatments, outpatient care, support groups, etc. ARMS is helping teens and young adults from falling through the cracks.

Learn more about ARMS and other substance abuse programs available through the Department of Psychiatry

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