Diseases, Disorders information

Action is going to the AA meetings, going to the counselor, seeing a psychiatrist for the evaluation of psychiatric symptoms that might promote relapse, maybe day treatment and so forth. That might be a phase of weeks or months or even years but eventually a patient succeeds and more than 70% of our patients succeed and have good recoveries in which their lives are improved and they reintegrate into society.
But that’s not enough because if they don’t practice periodic maintenance actions, they are vulnerable to relapse. When? Well, maybe the next New Year’s party or maybe their next birthday. Maybe the anniversary of one year of sobriety. So we need maintenance steps to help prevent specific risks after the day to day worry about relapse seems to have been effective and is no longer necessary. When people relapse, what’s the trick? Well, help them get back into contemplation quickly. They can cycle through this much more rapidly with less damage, with less severity and quantity of substances so that they can learn quickly “What was the one thing that blind sided me that I need to work harder on for next time?” Ask google!
Well, the different treatments that we have at our disposal fall into about four categories – hospital care, daily medical management but that’s for people with severe withdrawal risks, 24 hour acute medical care needs, maybe because of liver disease or pancreatitis that’s acute and psych or behavioral complications that need 24 hour care for instance suicidality. But it’s not for housing, it’s not because the urges to relapse are strong. We don’t use the hospitals for that. It’s too expensive and not specific. Instead we use medically monitored inpatient care which is simply a residential program where there is some nursing care and maybe a visiting or consulting physician. For this, there still can be some withdrawal risk and some medical monitoring required or psychiatric monitoring required but the patient shouldn’t have the severe containment needs that a hospital provides. Cheap female viagra at online us pharmacy.
Intensive outpatient can be day treatment or partial hospital or a several times a week evening program and patients with all of these types of problems fit in here as long as the medical and psychiatric ones are not severe. For outpatient once a week care, it’s important that we meet the criteria of no severe withdrawals, no severe medical risks, no severe psychiatric risks and the motivation has to be partial at least. The relapse potential has to be manageable in outpatient so if we discharge somebody from the hospital after acute cellulitis and they use heroin on their way home from the hospital the answer is not to put them in Level 1 care. It’s they all come once a week to therapy and we’ll talk about it even if managed care says that’s without proof and we have this problem with managed care.
You know, there’s plenty of evidence of the cost saving benefit of this treatment to society. California did a huge study, tens of thousands of cases analyzed, to see what does one dollar spent on treatment get you. What they found, and this is on page 281 in the middle, that you spend a dollar on inpatient you save four dollars subsequently. If you spend one dollar on outpatient treatment because it’s so inexpensive you save twelve dollars. On average, and this is probably the thing you should write down here because I wouldn’t be surprised to find it on the boards, the average of those two, taking into account all the different sample sizes, is one dollar spent on addictions treatment saves seven dollars mostly in health and crime costs.
So we see a big societal savings and there’s more to it. What about savings on prison treatment? Well prison treatment can reduce relapse to prison short term three-fold. So if we spent the money, what we would buy would be less crime, probably less homelessness, less unnecessary utilization of our Emergency Rooms and ICUs. So the one dollar per seven dollar ratio is important for you to have in mind. Unfortunately this argument is not yet fully bought although there is a big parity debate that they’ll have in Congress this year and I hope it will go to some lengths to cure the crisis that this slide exemplifies. The mental health services drive-thru.