variety of additional support programs including
family and peer support and auxiliary services,
provide educational materials on relapse
prevention and promptly intervene in the case of
relapse.^348 Monitoring the course of a patient’s
treatment and connecting patients with services
when they are needed are common public health
approaches to addressing chronic illnesses.^349
Case management is associated with an
increased chance that people with addiction will
access treatment for relapse, remain in treatment
for a longer period of time^350 (which is
associated with better treatment outcomes),
utilize support services^351 and demonstrate
improved social outcomes.* 352 A meta-analysis
of case management for patients in treatment for
addiction involving alcohol or drugs other than
nicotine found that case management can
improve patients’ family and social
relationships, living situations and health.^353Support Services ..............................................................................................................
Comprehensive care for patients with addiction
requires not only proper assessment,
stabilization, acute care and chronic disease
management, but support services as well.
These may include: Mutual support programs to bolster disease
management efforts and avoid the
recurrence of disease symptoms; and Auxiliary support services to address legal,
educational, employment, housing,
parenting and child-care issues that may
impede disease management.^356Health care providers are optimally situated to
facilitate links to these support and auxiliary
services.^357Mutual Support Services ............................................................................................
Mutual support programs, sometimes referred to
as self-help groups, can be a significant part of a
comprehensive approach to caring for a patient
with addiction. In fact, for many people with
addiction, these programs have been the main
help available to them and have been both
lifesaving and critical to helping them manage
their disease.^358 These programs allow
individuals with addiction to seek and provide
social, emotional and informational support
within a group of their peers. Participation in
these programs can increase the chances of
achieving and maintaining abstinence as well as* In one study, veterans with addiction involving
illicit drugs who were assisted by case managers
experienced a larger increase in the number of days
they spent gainfully employed than their peers who
went unassisted which, in turn, was associated with
lower rates of substance use, incarceration and arrests
resulting in convictions.An Example of an Effective Case
Management Program for WomenCASASARDSM is a welfare demonstration
program for mothers in Essex and Atlantic
counties in New Jersey who have addiction. The
program is designed to get women engaged in
treatment and employment services, help them
become sober and move successfully to stable
employment. CASASARDSM uses an intensive
case management approach to provide services
for these women.CASA Columbia’s research has found that
women with addiction involving alcohol or other
drugs (excluding nicotine) who receive income
assistance through CASASARDSM were more
likely to initiate treatment (66.5 percent vs. 50.3
percent) and complete their programs (43.5
percent vs. 22.7 percent) if they were provided
with case management services rather than
standard care. Looking at abstinence as one
outcome measure, over a 12-month post-referral
period, women participating in the
CASASARDSM program had a 64 percent higher
monthly abstinence rate than their peers in the
standard care program, and were likelier to have
remained completely abstinent by the end of the
12-month period (41 percent vs. 25 percent).^354
After another 12 months, the abstinence rate
among CASASARDSM participants had
increased to 47 percent while the abstinence rate
among non-participants remained relatively
unchanged (24 percent).^355