Researchers uncover several risk factors associated with postpartum opioid overdose which include a history of overdose during pregnancy, a diagnosis of opioid use disorder (OUD), neonatal opioid withdrawal, and greater than average use of emergency care in year before the birth.
Addiction Recovery Management Service
We see patients in two locations on Mass General's main campus. The location will depend on your clinician.
Division of Child and Adolescent Psychiatry
Yawkey Center for Outpatient Care, Suite 6A
32 Fruit Street
Boston, MA 02114
Adult Outpatient Psychiatry Services
Wang Ambulatory Care Center, Suite 815
55 Fruit Street
Boston, MA 02114
Explore This Treatment Program
The Addiction Recovery Management Service (ARMS) is an outpatient, dual diagnosis clinic made up of a multidisciplinary team of clinical psychiatrists, psychologists and masters-level social workers who are trained to work with youth and their parents to provide an individualized plan for recovery.
As part of Massachusetts General Hospital with links to the medical, clinical and addiction research resources within the Center for Addiction Medicine, ARMS offers a unique level of expertise. We evaluate each patient’s history and current symptoms in order to devise the treatment plan that is the most likely to succeed. We understand that substance use and mental health issues are closely connected. Our team is trained to assess and treat comorbid mental health problems such as depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), bipolar disorder as well as other mental health issues.
All are welcome at ARMS, and we meet each patient where they are. We can be a valuable resource for those who are unsure they even have a problem, those still thinking about making changes, those taking the first steps towards treatment, or those enrolling in ARMS to fully pursue their recovery and overall wellness. Patients are not required to be abstinent to engage in our program.
We are an outpatient program providing comprehensive outpatient individual therapy, group therapy, and outpatient psychiatry consultation and follow-up. Our services include assistance in the following areas:
- Assessing the varied dimensions of potential substance use and mental health issues
- Determining necessary treatment for related behavioral or psychiatric conditions
- Connecting patients and families with the treatment services they need at ARMS or, if necessary, making a referral and helping families navigate the treatment system
- Monitoring existing patients’ progress through their addiction treatment
- Assisting with relapse when it occurs
Our Approach to Treatment
ARMS helps young people with substance-related problems to lead healthier, more empowered lives by crafting an individualized treatment plan for them. The good news is that treatment does work when addiction is approached like any other chronic disease, which requires time, flexibility and a commitment to overcome the relapses that are likely to be a part of any behavioral modification. By targeting harm reduction approaches and avoiding the guilt and shame often associated with addiction, we help patients to achieve happy, independent lives without substances.
We help our patients choose positive behaviors instead of the destructive behaviors they have favored in the past and use the latest research evidence to inform our treatment.
Zero Tolerance Doesn't Work
As chronic disease of the brain, addiction is much like diabetes. Behavior modification is at the core of treatment, and it’s a difficult process. Patients often don’t want to change, even after admitting they have a problem, and most patients undergo an average of five to seven relapses before they are able to maintain a stable recovery. Even then, lifelong vigilance is required.
Adolescents who enter treatment are more likely to achieve long-term sobriety than those who enter as adults, and the earlier they enter, the more effective treatment will be. However, adolescents need specialized treatment that is tailored to their development level.
Sobriety should not be seen as the central aim for everyone. Rather, treatment is successful when it helps young people achieve greater stability and better functioning.
Positive goals for those with substance-related problems include:
- Abstinence from substances associated with poor functioning
- Reduced use or intensity of use
- Improved functioning in school and better relationships
- Improved physical health
- Improved mental health
Getting Started at ARMS
Every enrollment begins with an evaluation that is completed by an experienced clinician with expertise in substance-related problems and conditions.
This appointment usually takes two to three hours, with the majority of that time spent with a licensed social worker or psychologist. The evaluation is used to determine each patient’s level of substance use and any other contributing factors that may be present, including mood and anxiety issues, ADHD or other comorbid mental health issues. We also review any pertinent records, in order to learn childhood history and current presenting symptoms.
During the initial assessment, we provide recommendations and feedback on an appropriate treatment plan dependent on each patient’s particular circumstances and needs. These recommendations will include:
- Level of care determination (detox, inpatient, residential, partial, intensive outpatient programs, standard outpatient, etc.)
- Diagnoses of substance use and/or mental health issues
- Feedback on measures completed
- Recommendations for other services including referral for psychopharmacology, neuropsychological assessment, vocational support, and/or school-based recommendations
At the conclusion of this appointment, the patient will be asked to visit the laboratory at the main hospital to complete a toxicology drug screen. This toxicology screen may include a urine sample, an oral fluid swap or a blood draw and is required of all new patients. The results of the toxicology screening will not in any way impede a patient from receiving services at ARMS; it is simply a tool we utilize for all patients, new and returning.
We offer a variety of treatment options through ARMS for both teens struggling with substance use disorders and their family members. Our team of clinicians evaluates each patient’s individual history and current symptoms to create a treatment plan that is the most likely to succeed. Contact us to learn more about the treatment options below or read our Frequently Asked Questions.
Treatment Options for Young People
We have several different outpatient treatment options at ARMS:
- Individual psychotherapy (Please be aware that there may be a wait time depending on our availability)
- Group therapy - we have several different age-specific group therapy offerings appropriate to each patient’s readiness for sobriety, which is determined at the evaluation and on an ongoing basis
- One-time consultations - trained addiction psychiatrists who can be seen for consultations or on an ongoing basis to provide medication support both for mental health issues and substance use
- Medication support - trained addiction psychiatrists who can provide medication support both for mental health issues and substance use, including naltrexone/vivitrol and suboxone programs
If a patient signs up for ongoing services at ARMS, we do require random drug testing throughout treatment. You will not be terminated from treatment based on your toxicology screen results.
Group Therapy Options
We have several different outpatient groups at ARMS. Patients may be recommended to attend multiple groups per week, or a specific combination tailored to their needs. This will be determined at your evaluation.
- Dialectical behavior therapy (DBT) skills group – 13-week group program, meets once weekly incorporating DBT techniques for patients 18-26 years old to help teach emotion regulation skills for depression, anxiety and anger
- Skills and support – 8-week group program, meets once weekly for patients 18-26 years who are not sure if they are ready to change their substance use behavior
- Dual diagnosis – 8-week group program, meets once weekly for patients 18-26 years struggling with mental health and substance use issues
- Long-term after-care group – a weekly group for patients who have completed a group program and are looking for ongoing support to meet their substance use and life goals
- Drop-in therapy group – a flexible weekly group for established patients who may not be ready to commit to regular therapy or for those who need additional support
- Drop-in psychiatry group – a flexible weekly group for established patients who need to see a psychiatrist for support, discuss medications, or be seen before a formal psychiatry appointment if there is a wait for that appointment
At present we do not offer any groups for 14-18-year-olds, but we are actively working to build a group therapy program for these patients.
Services for Parents
We also provide evidence-based coaching, support, and services to parents of young people with substance-related problems who are not yet willing to seek treatment themselves.
ARMS works with the parent-child unit to address issues that coexist with addiction, such as how to improve communication and problem-solving skills, how to set appropriate boundaries around behaviors, and also help families address issues that may be present around the stigma, shame, worry, and anger that they may feel. Although we do not provide family therapy specifically or provide treatment options for siblings, we do facilitate referrals as needed in this regard.
We are dedicated to helping our patients and their parents face challenges and struggles as they arise and ease the process of achieving long-term recovery.
We offer a variety of different services for parents of young people with substance abuse problems:
- Parent orientation group – 30-minute free group to orient parents to resources for parents at ARMS
- Parent education and support group – weekly free group for parents, 8-week clinician led curriculum providing education and skills to parents of youth with substance use problems
- Individual parent coaching – 1:1 parent guidance and support with a clinician trained to support parents and address your unique needs, which can be billed to insurance. This treatment option is for those in a parenting role, not other family members.
- Parent long-term support group – free weekly after-care group for parents who have completed the parent education and support group
We understand that children are not always motivated to continue treatment, so we welcome you continue using our parent services even if your child is refusing care.
ARMS is committed to improving our understanding of effective treatments for youth with substance use disorders, decreasing risky behaviors associated with substance use and identifying factors that support recovery.
See the list below to learn more about the research being conducted at ARMS. Contact us at 617-643-4699 if you have any questions about research at ARMS.
- Substance Use Disorder and Bipolar Disorder Treatment Study, Amy Yule, PhD
- Mind and Body Recovery Study, David Eddie, PhD
- Unified Protocol Group Treatment Study, Kate Bentley, PhD
- Long-Term Recovery Study, John Kelly, PhD
- Neuropsychological Predictors of Treatment Drop-out in Patients within an Intensive Outpatient Program, James McKowen, PhD
- Overdose in Treatment-Seeking Youth with Substance Use Disorders, Amy Yule, MD
- Development and Testing of Adolescent Twelve-step Facilitation, John Kelly, PhD
- Staff Psychologist
- Professor of Psychiatry in Addiction Medicine at Harvard Medical School
- Clinical Director, West End Clinic Addiction Services
- Chief, Division of Child and Adolescent Psychiatry
- Co-Director, Center for Addiction Medicine
- Director, Substance Abuse Services in Pediatric Psychopharmacology
- Department of Psychiatry
- Medical Director, Addiction Recovery Management Service
- Instructor at Harvard Medical School
Patient & Family Education
- Information for Young Adults – You may not think that your substance use is a big deal, especially if your friends drink or use drugs. However, if you do use substances, you should be aware of how they are impacting you and what the possible consequences may be.
- Information for Parents – When young people develop substance-related problems, their whole family is impacted. At ARMS, we strive to support parents. Learn more about how we can support you as the parent of a young person with possible substance use disorder.
- About the ARMS Program – Video series featuring clinical director James McKowen, PhD discussing the program, staff and treatment options.
- Teen & Young Adult Substance Use: Tips for Families - Adolescents are more vulnerable to developing substance use disorders because of how the brain develops, so it’s important for parents pay attention and to intervene as soon as a possible substance use problem is identified. These tips can help families struggling with youth substance use.
- Understanding Addiction – In order to understand addiction, it is necessary to move past the many emotional responses that both those in recovery and their loved ones have to the word itself, and it is important to understand addiction for the medical condition that it is.
- Prescription Drugs: The New Epidemic – Over-the-counter remedies, including cough syrup and cold medicine, along with prescription drugs are being used recreationally by an increasing number of young people, who may think of these drugs as a harmless way for them to relieve anxiety or get high.
- Understanding Recovery – Addiction is a chronic illness influenced by genetics, environment, life events, and behavior. Overcoming addiction takes a lot of effort, and while stable recovery can take time to achieve, it is the most likely outcome for people suffering from addiction. Many find the journey of recovery to be a powerful and transformative one, where they not only give up substances but also experience new personal growth and an increased sense of meaning and purpose.
- The Developing Brain - Substance use can have a great effect on the developing brains of young people.
Supporting Young People with Substance Use Disorders - Interview with Amy Yule, MD, on the American Psychiatric Association's The Medical Mind Podcast
- Caffeine: What You Need to Know (PDF) - Learn about how caffeine affects your body
- Sugar: What You Need to Know (PDF) - Learn about different kinds of sugars and how to add better sugars to your diet
- Tips to Add More Fiber to Your Diet (PDF) - Learn more about adding more fiber to your diet
The sites below provide helpful Resources for addiction and recovery information and support.
- Substance Use and Mental Health Services Administration (SAMHSA)
Building resilience, facilitating recovery, building a life in the community for everyone
- Massachusetts Substance Abuse Information and Education Helpline
The helpline provides free and confidential information and referrals for alcohol and other drugs
- Mass General West End Clinic
Mass General's West End Clinic is an outpatient facility for those with alcohol and drug addictions, co-occurring mental health disorders and other types of addictive behaviors
- Learn to Cope
A peer-led support network for families dealing with addiction and recovery
- Recovery Research Institute (RRI)
The Recovery Research Institute offers resources to individuals in recovery and those seeking help with addiction, along with resources for family, friends and clinicians looking for ways to help a loved one
- Addiction Center
Providing addiction information and treatment center reviews
- Alcoholics Anonymous and Narcotics Anonymous in Boston
Includes searchable meeting list, service activities and literature list curated by the AA Central Service Committee of Eastern Massachusetts
- Narcotics Anonymous
Find an NA meeting near you
- Helping Others Live Sober
Resources to help people in recovery stay clean and support one another
- Relapse Triggers
What triggers relapse? This page lists 12 things that may serve as triggers
- Street Drugs
A listing of drugs, their effects and withdrawal symptoms
- Factors of Teen Drug Use
A helpful article delving into the factors that contribute to teen drug use and their perception of risk
- ATTC Topic Library
Topics currently available in this online library explore issues such as prescription drug abuse, recovery oriented systems of care, alcoholism, trauma, women and addiction, co-occurring disorders and motivational issues
- The Fix
An independent, daily website delivering news, articles and opinion pieces on addiction and recovery
- Partnership for Drug-Free Kids
Partnership for Drug-Free Kids' mission is to reduce teen substance abuse and support families impacted by addiction
- National Association for Children of Alcoholics
NACA's mission is to eliminate the adverse impact of alcohol and drug use on children and families
- Boston 311
Within the city of Boston, residents can call 311 to get information about substance use treatment and services
ARMS strives to build bridges with community business and organizations that are supportive to youth in recovery. We know that youth get well in their community and that sports, work and other activities are critical to a meaningful and rewarding recovery. We have fostered connections with the following programs and organizations, which are invested in building healthy, rewarding, and meaningful lives for those affected by addiction.
- THE WAY LLC - fitness training & boxing gym
- Brooklyn Boulders - rock climbing community
- Phoenix Sober - active sober community
ARMS is a non-profit organization and does not hold any conflicts of interest or financial partnerships with these organizations.
Support Our Work
The ARMS clinic relies on philanthropic contributions to fund its groundbreaking work in dual diagnosis substance use disorder treatment, research, education, and training. When you give to ARMS, you will create a very real impact on our ability to expand knowledge about substance use disorder, treatment, and prevention.
There are many different ways to support the work of ARMS. Use our online form to make a donation—under “I’d like to designate this gift to a specific program or area at MGH” enter “ARMS”.
- Sep | 25 | 2019
Episode #2 of the Charged podcast.
- Patient Education
- May | 16 | 2019
Not everyone who uses alcohol or drugs is, or will become, an addict. This article will help you be more aware of drug and alcohol use might be impacting you and what the possible consequences may be.
Pioneering Psychiatry Research
The integration of patient care and clinical research has been a hallmark of the Department of Psychiatry for more than 30 years. Today, the department has the largest clinical research program in the hospital, with studies at the forefront of neuroscience, molecular biology and genetics.