Resource | Playbook

SAFE Community Treatment and Recovery Guide

Our nation simply does not have enough treatment capacity, and what treatment options there are often are not affordable or available to many people. This line of effort explores how treatment can be an effective component of a community’s effort, as well as ways to better connect those who need treatment to a place where they can find the treatment best tailored for their needs.

This section will also contain recovery resources so that people can access support before, during, after, and in lieu of treatment should that be appropriate. Recovery is a lifelong journey, unlike the “event” of a treatment episode. This tool was developed to help individuals, families, and communities succeed as the journey toward wellness begins or continues.

Support and Grow Recovery Housing in Communities

Evidence shows that recovery residences are instrumental in demonstrating recovery outcomes and breaking the cycle of relapse, treatment, and incarceration. Despite this, recovery homes are often under-resourced and excluded from public sector policies and resources. The National Council for Behavioral Health and National Alliance for Recovery Residences released the first policy guide encouraging states to adopt recovery housing standards, certification processes, and promotion of nationally recognized standards to ensure patient safety and public health are placed at the forefront. Drawing from legislative language from Florida, Indiana, Ohio, Pennsylvania, and Massachusetts, the National Council compiled sample legislation to create the first “model” law on recovery housing.

Educate State Lawmakers on Recovery Housing

Research indicates that recovery housing provides individuals with substance use disorders a greater chance of achieving long-term recovery than those who do not live in recovery- oriented environments. Despite this evidence, misconceptions regarding recovery housing and the benefits to communities persist. The National Council for Behavioral Health drafted a recovery housing issue brief to educate state legislators on the facts about recovery housing. Communities with recovery housing options offer support to those with substance use disorder, which improves outcomes related to addiction. These positive outcomes are sometimes difficult to communicate to legislators due to the stigma around addiction and recovery housing. This issue brief provides the evidence necessary to begin productive conversations about recovery housing with those in government.

Find Recovery Housing in the Community

Recovery housing offers sober, safe, and healthy living environments that at minimum provide peer-to-peer recovery support, with some providing professionally delivered clinical services aimed at promoting abstinence-based, long-term recovery. Recovery housing is an evidence- based practice that can improve outcomes for those with substance use disorder. Communities with recovery housing options offer support to those with substance use disorder, which improves outcomes related to addiction. However, it can be challenging to find a housing environment supportive of the needs of someone in early recovery. The National Alliance for Recovery Residences provides helpful links to locate quality recovery residences.

Employment Resources for Individuals in Recovery

Many individuals in recovery acquire a criminal record, making it difficult to find employment and provide for themselves. The National H.I.R.E. Network can assist with resources. The agencies and organizations listed in the clearinghouse can be of assistance in providing job- related and legal services, answering questions that arise for those with criminal records, or offering referrals to other useful organizations. The National H.I.R.E. Network (Helping Individuals with criminal records Re-enter through Employment) serves as an information clearinghouse and provides leadership on public policy to promote the employment of people with criminal records. Its clearinghouse offers resources, information, and assistance to aid people with criminal records, practitioners, researchers, and policymakers. Listings are by state, government agencies, and community-based organizations that assist people with criminal records.

Build a Peer Recovery Program to Provide Integrated Care

Peer support programs use the lived experience of those in recovery and professional learning to help others with comparable experiences learn how to manage stress, promote their own resilience, identify prevention strategies to reduce and address life situations that cause difficulties, and live successful lives in the community. These programs leverage lived experience of recovery from addiction, plus skills learned in formal training, to deliver services either in peer support settings or behavioral health settings to promote holistic recovery and resiliency. The Integrated Behavioral Health Services for Peer Recovery Programs in Maryland toolkit from On Our Own of Maryland is a mechanism for thinking about and implementing integrated services in peer support programs. Its ideas and information are intended to serve as ways to begin (or further) the conversation, to incorporate respect in all discussions, and to provide practical suggestions on ways to get started or move forward. This resource reviews the integration of behavioral health services and peer recovery programs in Maryland. It focuses on creating a foundation of shared values and principles to build a strong peer recovery program. Even though the guide was created for Maryland, the practices apply across communities.

Focus on Treatment for Co-occurring Mental Health and Substance Use Disorders

Over the past 15 years, there has been an increased awareness of people with co-occurring mental health disorders in routine addiction treatment settings. Research results suggest that sequential treatment (treating one disorder first, then the other) and purely parallel treatment (treatment for both disorders provided by separate clinicians or teams who do not coordinate services) are not as effective as integrated treatment. National and state initiatives related to co-occurring disorders have been significant, stimulating considerable interest in providing better services for people with these challenges. Although clearly interested in improving existing services, addiction treatment providers have lacked pragmatic guidance on how to change. The Dual Diagnosis Capability in Addiction Treatment Toolkit from the Center for Evidence-Based Practices at Case Western Reserve University is a response to numerous requests by community treatment providers for more specific guidance on how to enhance services based on their current status and guides program and system authorities in assessing and developing the dual diagnosis capacity of addiction treatment services. For a community that has identified a lack of treatment options for co-occurring mental health and substance use disorders, this toolkit offers practical tools and useable materials that will rapidly improve services for programs with patients who have co-occurring disorders entrusted to their care.

This resource outlines the capabilities needed to treat dual diagnoses. The motivation among addiction treatment providers to improve the quality of care offered to their patients is impressive, if not inspirational. This toolkit was developed in direct response to addiction treatment programs at the “action” stage of readiness.

Locate 12-Step Meetings in Your Community

For people in recovery, one option for support is to utilize the 12-step tradition, including Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), for support. These tools help those looking for assistance in finding AA or NA groups to support their sobriety. If there is no AA or NA meeting nearby, individuals can participate through online meetings.

Most Americans with health insurance face greater barriers in accessing services for mental illness and addiction than they face for accessing care for other medical conditions. The majority of health plans impose higher out-of-pocket spending requirements and more restrictive treatment limitations on addiction and mental health benefits. The Mental Health Parity and Addiction Equity Act (MHPAEA) was passed in 2008 to correct healthcare practices that discriminate against those with a mental illness and/or addiction. It aims to curb the financial and non-financial, or “non-quantitative,” ways that plans limit access to addiction and mental health care. The Parity Toolkit for Addiction and Mental Health Consumers, Providers, and Advocatesprovides a blueprint for consumers looking to assert the MHPAEA, including model appeals and helpful consumer tips for patients and families. This guide helps individuals and families who believe their insurers’ practices are violating the parity law. It addresses strategies for navigating the enforcement of parity law with health insurance providers to assist with cost coverage for substance use disorder treatment.

Teach Community How to Find Quality Addiction Treatment

Finding treatment for a drug or alcohol problem is not a quick or easy process and can be overwhelming. This comprehensive, step-by-step guide will help your community members identify effective addiction treatment options and answers to the questions you may have along this journey. This guide helps assess the need for treatment and considerations for finding a quality treatment provider. The steps and guidance outlined in this guide are applicable to a range of communities, and they help demystify the process of finding treatment options.

Warm Handoff from Overdose into Medication-Assisted Treatment

Naloxone immediately expels opioid molecules from the receptors in our brains, causing a near immediate reversal of the primary cause of an overdose, namely suppressed breathing. However, there is no miracle drug that clears the body of the urges, the underlying substance use disorder, that typically led the patient to take a dangerous dose of opioids — administration of naloxone puts a patient into active withdrawal. But there is a treatment that works very well and should be the next step after administering naloxone — Medication-Assisted Treatment (MAT). Typically, after receiving a lifesaving dose of naloxone, patients are released with only information and numbers to call if they’re ready to start their recovery. Sometimes they are even introduced to a peer support specialist, a former user who encourages the patient to seek long- term treatment. Too infrequently, physicians also prescribe one of a handful of medications known as MAT. This is commonly referred to as a “warm handoff,” directly transferring overdose survivors from the hospital emergency department to MAT. There is growing evidence that these drugs can immediately reduce some of the symptoms of opioid withdrawal and the urges that usually lead active users to immediately search out more opioids to combat withdrawal.