Predicting Substance Recovery Service Trends: Best Practices, Reimbursement, and Employment – Part 2

This is the second in a 2-part series containing predictions of trends you may see in the delivery of substance recovery services. In the first blog, we covered Outpatient Counseling. In this post, we discuss Inpatient Detoxification Centers and Driver Alcohol Education Programs.

I believe there will be an explosion in jobs specifically for CADAC professionals, and within the substance recovery field as a whole.

Detoxification Centers

Detoxification centers serve are comprehensive inpatient units that support and care for the patient with withdrawal symptoms as they overcome their dependence. The multidisciplinary support includes medical, psychiatric, nursing, clinical and peer support. Treatment teams are comprised of medical doctors, psychiatrists, registered and licensed nurses, masters-level therapists, case managers,  and administration.

The cost billed by inpatient detox centers to insurance companies is the highest within the realm of substance recovery services. A five-day inpatient stay is easily in the tens of thousands of dollars. These facilities also assume the greatest. Alcohol withdrawal alone has resulted in many deaths; it is never recommended to attempt without supervision and outside of the care of professionals

For the above reasons, I expect to see the emergence of a “home detox” model. It won’t be for everybody, and it may sound crazy to those in recovery or having spent years working in the field. There will be obvious barriers for many patients, including the large number of clients who are homeless or those whose home environment was a part of the problem, not a part of the solution. This model will not replace the inpatient center, but seeks to identify and serve the 60-80% of clients who do not require that highest level of service at an outside facility. The home detox model allows clients to remain at home, with the support of family and friends, while receiving professional care and a continuum of support after withdrawal symptoms subside.

The in-home treatment team is comprised of a visiting nurse, home health-aide, and substance-recovery social worker who coordinate treatment, transition, and aftercare. A medical doctor and psychiatrist review and oversee the individualized treatment plan. The emergence of pharmacological supports (Suboxone, Vivitrol) also support this approach.

I believe that the home detox model will support the client’s behavioral health needs through Structured Outpatient Addiction Programs (SOAP) or Intensive Outpatient Programs (IOP) in the community. This empowers the client to connect with their naturalized community and promotes pro-social and pro-sober peer support. SOAP & IOP Programs are five days per week from 9am-3pm.

SOAP Program participants engage in group therapy (two 60-minute groups, and two 30-minute groups each day), individual counseling, and case management services. Most programs also offer on-site drug screening and medication management.

Perhaps the greatest strength is the ability of clients to continue to manage their lives with minimal disruption (What would you tell your Boss if you had to “go away” for two weeks? Who would take care of your dog? etc.). The customization of the treatment plan and the reduction in stigma are additional benefits resulting from the home detox model, but the driving forces for its implementation will be the lower cost and improved risk management.

New graduates of addiction recovery counseling programs can be proactive in developing non-clinical skills to compliment traditional substance recovery supports. I believe that Substance Recovery Social Workers will provide clinical service navigation and case management services. In mental health services, this position would be titled a Clinical Case Manager. The Assumption College Certificate Program in Alcohol and Substance Abuse Counseling emphasizes a comprehensive approach to recovery and individualized supports, rooted in strength-based individualized treatment planning. The skills learned within this carefully conceived progression of courses will place the graduate in an advantageous position as the field continues to blossom.

Driver Alcohol Education Programs

Driver Alcohol Education contracts are awarded to agencies to work with court-referred mandated offenders who have been convicted of a DUI/DWI. It is a self-pay program that provides 16 weeks of psycho-education to first-time offenders in a classroom environment at a cost of approximately $600.

As a former program director of a Driver Alcohol Education Program and Second Offender Aftercare Program licensed by the Department of Public Health in Massachusetts, I expect there to be a significant increase in arrests and related DAE (Driver Alcohol Education) program enrollments in the coming years. The cause won’t be drinking and driving, it will be an increase in drugged driving, and the inevitable development of a roadside test for substances such as cannabis and opiates that proves to be admissible in court. We currently do not have these tools.

New substance recovery professionals hoping to provide this service should understand that it’s a structured psycho-educational 16-week curriculum offered by the state (Bureau of Substance Abuse Services). It’s an excellent fee-for-service opportunity to complement full-time employment, often paying $35.00 per hour (without benefits). You are also reimbursed for record work, but documentation is minimal.


FOR REFERENCE: the O*Net Resource Center is the premier source of employment skills and trends, offered under the sponsorship of the US Department of Labor/Employment and Training Administration (USDOL/ETA).

O*Net Summary: Substance Abuse and Behavioral Disorder Counselors
O*Net Summary: Mental Health Counselors
O*Net Summary: Mental Health and Substance Abuse Counselors
O*Net Summary: Substance Abuse and Behavioral Disorder Counselors

Download Free Guide to a Career in Substance Abuse

Related Post

Receiving Your Certificate in Alcohol and Substanc... Are you considering a career in substance abuse counseling? Substance abuse counselors work with people who have addictions in order to guide them...
Why Earn A Substance Abuse Counselor Certification... Are you looking for a job where you can help people with their problems? Do you want to make a difference in the lives of people affected by the o...
How You Can Help People Affected by The Opioid Cri... More and more, there are stories in the news, from family members, and on social media that speak to the opioid epidemic that's affecting our nati...