Alcohol/Drug group treatment guidelines and sessions
Therapeutic Health Services is committed to patient success in treatment. We recognize the importance of group therapy, individual counseling, and/or Medication Assisted Treatment (Methadone and Suboxone). The goal is for each patient to have a healthy and sustaining recovery through our program.
One of the benefits of treatment is group therapy. This is where patients meet to share their own personal experiences. Together they can process the challenges of recovery, substance use, and have peer support within a therapeutic setting. Therefore, THS uses motivational interviewing and Cognitive Behavioral Therapy as an evidence-based approach.
Motivational interviewing helps people move past insecurities and mixed feelings to find the motivation to change their behavior. Cognitive Behavioral Therapy is a common type of talk therapy done with a mental health counselor in a structured way. Together these approaches assist each patient in their specific treatment goals.
Each of our branches offers day and evening treatment groups for Intensive Outpatient, Weekly Outpatient, and Relapse Prevention for our alcohol/drug outpatient program
In order to assist our patients’ success, we have established the following treatment guidelines for group sessions:
- Each patient is requested to attend every group session. If an individual misses a session and is able to document a reason for absence, they may be excused.
- Each patient is requested to be present and on time for the start of the group session. After 15 minutes, (if it is a 3-hour Intensive Outpatient Group) we ask that each individual wait until the group breaks and they are allowed into the session for the remaining group session. For our weekly outpatient group, the individual will be asked to attend the next session and it will count as a missed group.
- Within the group session, homework assignments may be assigned. Each participant is requested to complete assignments on time and turn them in when the facilitator requests. If there are comprehension or reading issues, please discuss these with the facilitator so accommodations can be made.
- Part of the treatment program and participation is to maintain an abstinence-based recovery. If you present as being under the influence, you will be asked to provide a urine sample. You will not be allowed to attend the session for that day.
- Communication is important, as well as personal boundaries. Group therapy sessions help enable understanding and setting of appropriate and healthy boundaries. We ask that all patients participating in group sessions utilize “I” Statements. We also ask they provide appropriate feedback during group processing and discussion.
Why do we have these guidelines?
Following these treatment guidelines helps facilitate the recovery process. Another key to a successful recovery process is consistently attending group sessions. It is important to tell the group facilitator and your assigned primary counselor about your progress made in treatment and recovery. Remember, it’s important to follow the established treatment guidelines.
If you are interested in attending any of our group therapy sessions, or need information on group times and locations, ask your counselor about the benefits of attending different groups.
To learn more about this program, please check out the Drug and Alcohol FAQ Post.
In 2012, Washington State voters approved an initiative (I-502) that legalized the use of Marijuana. Since this occurred, individuals have asked: Why are asking about my use of marijuana? This question may be elicited from the substance use history on the assessment. While Therapeutic Health Services recognizes the implementation of I-502, there are still issues that arise from continued cannabis use. This is specific to treatment for substance use and the question for those who carry a medical marijuana card.
Understanding the law and the effects of using marijuana
The Washington State Liquor and Cannabis Board provides a fact sheet online regarding the implementation and law of I-502. It also provides information about the nature of and effects from using Marijuana. Three of the more important facts of this are:
- Only adults, age 21 and older, are able to purchase and possess marijuana
- Marijuana is illegal to consume in public places, or in view of the public
- It is illegal to operate a motor vehicle while under the influence. If an individual tests positive for 5 nanograms or more of active THC, they may have significant legal issues.
Another important factor is the scientific research that shows marijuana is addictive. Based on this research, about nine percent of users become addicted to marijuana. This number increases among those who start young (to 17 percent) among people who use marijuana daily (to 25-50 percent).
Research also shows that while the short term effect of the “euphoria” one feels, there is also an impact where an individual may experience:
• Slower reaction
• Problematic with thinking, learning, and memory
• Confusion, anxiety, panic, and/or paranoia
• Increase in heart rate, blood pressure, and appetite (hunger)
• Decrease interest in activities
• And, on rare occasions, psychosis (specifically among adolescents who are heavy and/or chronic users)
We also recognize that marijuana use by women who are pregnant and/or breastfeeding may pose a risk to their pregnancy and/or infant. One of the main factors impacting the health and well-being of the unborn child is how carbon-monoxide is passed from the mother to child. This disrupts the oxygen supply and may result in growth issues, premature birth, miscarriage, or stillbirth. Other research has shown that children may be born with low birth weight, certain birth defects and symptoms. These are similar to children with Fetal Alcohol Syndrome.
There are additional information on the nature of marijuana and its effects. The National Institute on Drug Abuse published both articles. The first is titled – How Does Marijuana Produce its Effects? The second article is titled – What are Marijuana Effects?
Common myths and misconceptions regarding marijuana and treatment for substance use
Recently, the newly elected Mayor Jenny Durkan and the Seattle City Attorney Pete Holmes (as reported by Seattle Times staff reporters Daniel Beekman and Christine Clarridge) vacated misdemeanor marijuana possession convictions. Despite this recent move toward further implementation of legalization of marijuana use; there are still some misconceptions and myth’s individuals have. I will address the two most common misconceptions and myths regarding marijuana and treatment for substance use here.
Why do I need to disclose my marijuana use?
One of the most common issues this writer, and other clinicians within THS, faces are those individuals who come in for an assessment. As part of the assessment process, the clinician is attempting to establish a history of substance use to determine pattern of frequency, amount, and whether or not any specific substance an individual is consuming has caused any maladaptive issues in their lives. Mainly, increase in tolerance to achieve same effect, withdrawal symptoms, cravings, and others related to potential identification of problematic use and dependence.
One of the ways I work with these patients is educating them that this is an assessment to determine whether or not there is a problem with any given substance, whether it is alcohol, marijuana, cigarettes/nicotine, opiates, etc. While we do not require the patient to respond to the assessment questions; the issue is that the assessment may not be accurate and/or complete.
Marijuana is legal and non-addictive
Another common misconception and myth is that now that marijuana is legal, we shouldn’t consider it problematic. Contrary to this, evidence shows that marijuana is not only highly addictive, it is also the most commonly abused drugs (especially among adolescents). In addition, like all other substances, marijuana follows the trajectory of potential development of substance use disorder (like alcohol and other drugs).
Therapeutic Health Services and Treatment for Substance use Disorder
Where this leaves us is understanding that while there is still evidenced based research to be done (relating to the approval and medicinal factors of marijuana use), most individuals may need to engage in an abstinence based recovery program while participating in any treatment for substance use with this agency. There are some probation divisions that have stepped back when it comes to the marijuana use. However, there are other probation departments that continue to hold an abstinence model of all mind-mood altering substances.
Yet, when it comes to someone having a DUI due to suspicion of marijuana use, this agency follows the same protocol in obtaining police report of the incident, blood work requested to determine levels of marijuana use, and completes the biopsychosocial assessment to determine whether or not there is a significant problem. This is based on the DSM-V Criteria for Cannabis Use Disorder. The clinician may determine whether or not there is a significant problem. Then they determine whether an individual has a mild, moderate, or severe substance use disorder for cannabis.
Learn more about drug and alcohol treatment on our FAQ Post.
When it comes to the outpatient drug and alcohol treatment program, one of the requirements is attending a minimum of 2 sober support meetings each week. This is usually required for those individuals who are recommended to attend a Deferred Prosecution, Intensive outpatient, and relapse prevention. Those with an outpatient recommendation for treatment may be advised to explore attending sober support meetings. If probation is involved, it might be recommended as part of one’s treatment program at the time of the assessment.
Does this mean I have to attend an Alcoholics Anonymous?
The most common sober support meetings a person may attend are local Alcoholic Anonymous meetings. However, there are a variety of other sober support meetings in the Greater Seattle/King County and Snohomish County areas an individual may attend. The following is a list (with appropriate hyperlinks to their websites) of common support groups a person may be referred to.
The best way to connect with and find meetings is to go to the Seattle Intragroup website. These meetings are located throughout the Greater Seattle/King County Area.
Along with the Seattle Intragroup website, Seattle also has one of the largest AA Meeting groups. They are One Step At a Time (OSAT). One of the reasons this is the largest sober support meetings is that they meld outdoor activities (climbing, hiking, and biking) with recovery.
Present research shows that substance use disorder does not affect the individual alone. There are family members who may suffer because of the nature of substance use disorder has on the family unit. Most people, when they enter treatment, also carry particular traits from their own family of origin. While not as prevalent within the Seattle area, Adult Children of Alcoholics and Family Dysfunction is a 12-step based program that works with those individuals who grew up in a home with prevalent substance use and/or family dysfunction. This is a 12 step based program with their own “red book” and workbooks.
Buddhist Recovery Support Groups
There are two different support groups that utilize Buddhist philosophy as part of their recovery process. The first one is the Northwest Buddhist Recovery Group. This group utilizes a 12-step based recovery approach with the integration of mindfulness and meditation. There are limited groups within the Seattle/King County areas. One does not have to be a Buddhist to participate.
The second Buddhist recovery support group is Refuge Recovery. This support group does not follow a traditional 12-step program. However, does incorporate more Buddhist teaching, philosophy, and practice as part of recovery. They also have their own recovery oriented book.
For those in the faith based community, one of the more recent and fastest growing support groups is Celebrate Recovery. Originally started under Rick Warren, this has grown to assist individuals with substance use, co-dependency, sexual integrity, and other related issues. They follow the 12-steps and the 8 principles of recovery (based on the Beatitudes).
One of the challenges is that when most people engage in outpatient drug and alcohol treatment, a majority of them are familiar with AA or NA meetings and may have apprehension about joining them. Smart Recovery does not utilize the traditional 12-step program. While it is an abstinence based program, they focus on working with people in motivating toward change. You can view more about this program at their About Smart Recovery page.
Other Recovery groups within the Seattle, King, and Snohomish County Areas
In addition to those groups mentioned above, other recovery groups are open for specific substance use related issues.
Do I have to work with a sponsor and complete the 12-steps as part of my outpatient drug and alcohol treatment?
No, we do not require an individual to seek out a sponsor and work on completing the 12-step program as part of outpatient drug and alcohol treatment. There are two recommendations that I personally make for my patients. First, I advise that sober support meetings are generally designed to work in building a healthy sober support network. This is important as some patients that come to Therapeutic Health Services may have a network of friends or associates that may continue to drink and use. Attending and working with individuals who are in a healthy recovery program themselves, increases the ability for an individual to have a successful recovery.
The second recommendation is something that I learned in my own youth. Best advice I ever received. Each of us do well to have three important people in our lives. Someone significantly older (10 years or more) that is a mentor. The second person is someone within our own age range (2-5 years) as they are our peer support. And, the third, someone significantly younger (by about 10 years) that we are able to mentor ourselves. This is the benefit sober support meetings have to offer. An individual may work with a variety of people with several years of stable and healthy sobriety, while also working with those peers who are in the young stage of their own recovery and treatment program. As a clinician, we recommend attending sober support meetings, connecting with people, and working with individuals. However, it is not required.
What about when peers that I attend group with meet up – does that count?
Yes, and I highly encourage those individuals engaged in outpatient drug and alcohol treatment with Therapeutic Health Services continue to work on recovery outside of their treatment attendance with this agency. If three or more individuals connect over coffee and discuss recovery related topics, checking in with one another, holding one another accountable, this does count as a recovery based sober support meeting. Whether you are utilizing a 12 step approach or not.
The main point is that each person should attend recovery based sober support meetings (dependent upon their level of care). Whether it is AA, NA, or any of the different recovery support groups. The take away is to build up a healthy sober support network while engaged in outpatient drug and alcohol treatment for greater success at stabilizing an maintaining an established sober lifestyle.
For more information on the THS Drug and Alcohol Program, check out our FAQ Post
Addressing substance use disorder through drug and alcohol treatment and recovery
The Substance Abuse and Mental Health Services Administration (SAMHSA), through Center for Substance Abuse Treatment (CSAT) held a National Summit on recovery in 2005. The focus of this summit concerned the movement toward a recovery-oriented system of care. Those who participated in the summit developed a working definition of drug and alcohol treatment and recovery:
“Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life.”
Based on this definition, guiding principles emerged to help facilitate movement toward a more integrated evidence-based practice. This practice aims to assist each individual in addressing substance use disorder.
New perspective on recovery
New research shows that recovery is a process of change. We challenge individuals to shift the way they understand, interpret, and define new ways of thinking and behaving. Therapeutic Health Services incorporates a cognitive behavior therapy (CBT) approach in working with each individual patient. This therapeutic model assists the clinician to meet the patient where they are. This helps them understand and process specific stimuli in addressing underlying reasons for substance use. Coupled with CBT is allowing the patient to guide the conversation and addressing specific challenges the individual is facing.
Whether in group or individual counseling sessions, the process is to move beyond the understanding of quitting substance use. Abstinence is an integral part of the recovery process. However, the movement toward significant change begins with the next stage by assisting patients in achieving emotional sobriety.
Physical sobriety and emotional sobriety
In the early stage of recovery, the first challenge is to manage and cope with any withdrawal symptoms. The next step is the recognition of cravings and alternate ways of coping with intense cravings. Finally, individuals must identify those specific stimuli (people, places, things, and events) that lead to cravings. The duration of this early stage is determined by the extent of one’s substance use. In general, this early stage (Abstinence) may last between 3-9 months. For those with mild substance use disorder, it may last 1-3 months. For those with a moderate substance use disorder, may last 2-4 months. And for those with a severe substance use disorder, approximately 6-9 months.
First, individuals achieve physical sobriety (no withdrawal affects, adequate coping skills, and ability to recognize specific stimuli). Then the actual recovery process can begin. In my individual and group sessions the process is typically associated with the idea of self-discovery and mastery. It is the stage where an individual begins to redefine who they are. They come to discover their own unique and specific purpose. Then they can develop ways to begin to be of service toward others.
Here, the individual is assisted in addressing ways to actively listen to their own self-talk. They also develop and incorporate insight into becoming more mindful and coming to terms with their past. They do this while embracing new ways of thinking and living. It is essentially a process of changing the way one thinks. This is done by developing their own values and beliefs in a way that leads toward a healthy lifestyle. This typically takes up to approximately 2 years. The hope is to develop a manageable means of regulating emotional well-being, while achieving relational, physical and nutritional, financial, and spiritual well-being.
Maintenance and enhancement of a sober lifestyle
The final stage that I introduce to my patients (in a group and individual setting) is that sobriety is a process. A process of maintaining the changed lifestyle a person has achieved through the stages of drug and alcohol treatment and recovery. This extends beyond initial abstinence and recovery. Once an individual achieves a meaningful, healthy, and vibrant lifestyle through recovery and treatment, we challenge them to continue to maintain their overall health and wellness. From a treatment perspective, this is accomplished through a conversation of developing an after care plan. This includes a relapse prevention plan.
In all aspects, achieving overall healthy living includes maintaining this healthy lifestyle. Being vigilant of those things that may bring an individual back toward the lifestyle of active use. Therefore, the main point is the developed awareness that drug and alcohol treatment and recovery is more than quitting the substance use itself. It is to assist each individual in addressing how to restore balance in their life and achieve peace of mind.
For more information on drug and alcohol treatment and recovery, please visit our Alcohol & Other Drugs FAQ post.
Intensive Outpatient Treatment or Deferred Prosecution? What type of drug and alcohol treatment is right for you?
A very common situation when attending a scheduled assessment is the possibility of petitioning the court for a deferred prosecution. Working with these individuals, the attorney typically requests a 2 year deferred treatment program. In some cases, an individual takes a deferred prosecution on a first time DUI offense. Here is what you may want to know regarding the 2 year Deferred Prosecution treatment program compared to another type of drug and alcohol treatment program.
Assessment to determine criteria for ASAM Level of Care 2.1 – Intensive Outpatient Treatment
First, any CDP (or CDPT) is qualified to assess whether an individual meets the criteria for the Deferred Prosecution. We may assess an individual at the Intensive Outpatient Treatment level.
The assessment THS provides is a state certified 6-dimension Biopsychosocial assessment. The American Society for Addiction Medicine (ASAM) developed the assessment. While a person may request a Deferred Prosecution, the assessment will need to reflect whether (as stated previously) that a person is assessed at the higher level of care for an intensive outpatient treatment.
In addition, if someone doesn’t meet the 2.1 ASAM level of care, they’ll be referred to a lower level of care. This could be ASAM 1.0 Outpatient/After care services and/or ADIS/Victims Panel depending on the outcomes of the assessment.
Furthermore, if a person does meet the criteria, the assessor will explain the 2-year deferred prosecution program. Typically, this program is beneficial for individuals who have had recent multiple DUI or Substance Use related legal charges.
The difference between an Intensive Outpatient and Deferred Prosecution
With an Intensive Outpatient treatment program, an individual may expect to be in treatment between 4-8 months (depending on the recommendations for what type of drug and alcohol treatment would be best). Therapeutic Health Services does not have a “cookie cutter” approach to standard treatment programs. Rather, our approach is based on continuum of assessment utilizing the ASAM Criteria. Individuals will have a treatment plan review within the 30, 60, and 90 day milestone of their admission date.
However, with the Deferred Prosecution, this is a Washington State Law legislation (See, RCW Chapter 10.05) where a person is committed to a 2 year treatment recovery based program. This program has three phases.
- I is 3x per week for 3 hours and is 8 weeks for 24 sessions
- II is once per week for 1.5 hours and is 26 weeks
- III is once per month for CD monthly monitoring for 16 months
With all treatment programs for our outpatient services (Intensive, Weekly, Relapse Prevention, and Intervention) we recommend individuals provide random observed urine samples on a monthly basis (or, as directed by primary counselor and agency request). For our intensive and relapse prevention treatment programs, we require individuals attend at least two sober support meetings per week.
Commitment to provide treatment for Deferred Prosecution
THS will provide a letter to the court that shows our commitment to provide treatment for all deferred prosecutions. We attach the letter to the Assessment summary letter. This includes the cost for the full treatment program. Apple Health or State Insurance cover the program costs.
Finally, if you might benefit from a deferred prosecution treatment program and are working with an attorney, contact us. Contact any THS Branches to schedule an assessment to determine if you meet the criteria for the program.
For more information, please call 206-323-0930 or visit the Alcohol & Drug FAQ post.
Therapeutic Health Services Pregnant & Parenting Women’s Program
Offers a parenting group called Nurturing Parenting. Nurturing Parenting uses an evidence-based curriculum. The program admits clients who are parenting and/or pregnant and are engaged in treatment for substance abuse. Treatment for pregnant women can be challenging but is a huge step in rehabilitation and reunification of the family. Nurturing Parenting works on building and establishing trusting relationships between parent and child. It also explores the hardships and successes of parenting during treatment and recovery.
THS Offers Nurturing Parenting at Summit/Seneca, Shoreline and Eastside Branches
This group is open to any clients who are parenting and/or pregnant.
• Shoreline: Tuesdays at 11:15am-12:15pm
• Summit/Seneca: Wednesdays at 10:15am-11:15am
• Eastside: Fridays 11am-12pm
If you are interesting in learning more about the Pregnant and Parenting Program at THS, please call 206-323-0930 or visit the P&P Program page.
In my office, I have a picture
One that I had found at a local thrift store. It is a simple picture of a Bicycle and a caption that reads: “Life is like riding a bicycle. To keep your balance you must keep moving.” Patients comment on this picture. Drug and alcohol treatment and recovery are the same way. To keep our balance, we want to keep moving forward in order to maintain a steady and vibrant pace. Moving backwards means we are merely spinning our wheels and going nowhere. Slowing down the momentum, or coming to a stop, we begin to lose our balance.
Within our drug and alcohol treatment program, the focus is on how to assist our patients in moving forward
Like riding a bicycle, there is some awkwardness. However, with time and patience, an individual begins to discover certain freedoms. Freedoms that come with learning and growing as we stabilize and find new ways to enjoy life. Therapeutic Health Services focuses on helping our patients improve overall quality of life. This is accomplished through fostering an atmosphere of healing while engaging in the recovery process. THS accomplishes this through cultural humility, integrity, professionalism, quality, respect, and providing a safe environment for all.
Our approach to recovery is a person-centered approach
We strive to meet where our patients are at in the present moment. Developing a therapeutic alliance with them as they navigate treatment and recovery. Regardless of what brought a person into treatment (i.e., DUI, CPS, or other Legal, Medical, Family, or Work related issues); our main focus is on the individual and how we are able to work with them in forging a new path. Whether it is to assist them in maintaining compliance to resolve presenting legal issues; or working with them in identifying ways to continue to build upon the improved quality of life they desire. THS strongly believes that each individual is unique. We offer different perspectives, insights, and work with them in a collaborative environment. As a result, we can help them find their own balance to move forward.
To learn more, visit our Drug and Alcohol Treatment Program page
Therapeutic Health Services locations at Summit/Seneca, Shoreline, Eastside and Everett provide specific treatment for pregnant and parenting women who suffer from substance use disorder and opiate addiction. Our counselors have considerable knowledge and experience working with:
- CPS and Family Court assessments and evaluations
- Parenting groups and classes
- Public health nurses
- Inpatient services
- Pregnancy and methadone
What are the steps to have an assessment?
The first step is to contact and schedule assessments at the front desk. Let the front desk know that you are either pregnant and/or parenting a child under the age of 17. Our goal is to get you an assessment within 48 hours. You can reach the front desks of the branches that offer Pregnant & Parenting services at the numbers below.
Summit/Seneca – 206-323-0930
Shoreline – 206-546-9766
Eastside – 425-747-7892
Everett – 425-347-5121
Hours of operation and directions can be found on our Locations Page.
What type of outpatient treatment does THS offer?
In addition to having individual services with your CD counselor, THS offers weekly parenting classes and groups, mental health counseling, family therapy, and support that can help in aiding your recovery and rehabilitation.
We strive to treat the whole family and provide childcare for children while their caregivers attend their treatment services.
Please visit our Pregnant & Parenting Program page to learn more.
What are the steps to enrolling in drug and alcohol treatment?
The first step is to contact and schedule a drug and alcohol treatment assessment. You can do this through the front desk of any of our branches. Just call the number listed on the THS Locations page. You can also complete our Drug & Alcohol Get Help Form. A clinician will then contact you within 24 hours. We schedule all assessments for 120 minutes.
In addition, if your assessment is required by law enforcement, please have your probation or referral source provide a copy of the police report for charges from substance use. They must also provide criminal history and a 5 year driving abstract. You can either bring these documents in at the time of your scheduled assessment or you can fax them to the office. For more on this, see the question below.
Finally, you must attend your scheduled appointment by arriving 30-45 minutes early to complete the intake paperwork and packet. At that time, you will provide an observed urine sample that we send to the lab. This is required for all alcohol/drug assessments.
Upon completion of your evaluation, the intake coordinator will provide your referral source an assessment summary letter within the next 7 days. If there is a treatment recommendation, you will be informed of the recommendation (pending verification of the urine analysis) and provided necessary group start times.
Therapeutic Health Services provides drug and alcohol treatment and assessments in King and Snohomish Counties for the following:
- DUI/Reckless Driving infractions
- DOC Intakes/Evaluations
- Family Court – Custody Evaluations
- Employee Assistant Program referrals
- CPS and Family Court assessments and evaluations
We are committed to providing a thorough and timely assessment. To assist patients, we have a collaborative relationship with various probation, attorneys, and courts within the King County and Snohomish County areas.
What if I disagree with your assessment or I am unable to participate in the treatment with THS?
Therapeutic Health Services is committed to meeting each individual where they are. They recognize that each person is a consumer. If you disagree with the assessment, or your attorney disagrees with the assessment, you are welcome to seek a second opinion.
If you are unable to attend the recommended group sessions, we will provide at least three referrals to other local area agencies. They may be able to accommodate your schedule.
Why do I need to provide a copy of my police report, driving abstract, and criminal history?
For any pending adjudication of DUI or other court-related issues which are due to recent use of alcohol and/or drugs, state law requires us to:
- Obtain and review the recent police report of the incident
- Document review of the BAC/BAL level (if obtained and recorded)
- Document review of the criminal history and driving abstract
Without these, the assessment may be incomplete – pending verification of the documentation.
What type of outpatient drug and alcohol treatment does THS offer?
THS offers various groups for outpatient treatment services. These include: Intensive outpatient treatment groups that meet for three hours, three times per week; Weekly outpatient treatment groups that meet weekly for an hour and a half; and a variety of other groups that meet weekly for an hour.
Locations for Drug & Alcohol Services
Each of our branches has different group schedules and times. The group days and times will be provided at the time of your assessment.
Please check the THS Locations page to find the branch closest to you and the phone number to call during business hours. We offer Drug and Alcohol services at our Summit/Seneca (First Hill Seattle), Shoreline, Eastside (Bellevue), Kent, and Everett branches.
You can visit the Greater Seattle Intragroup Alcoholics Anonymous page for more resources.
THS is proud to announce our 2017 Mental Health and Substance Use Program Outcomes
For both youth and adult clients, we track progress every 90 days on a number of general measures of improvement towards treatment goals. For the Substance Use program, we track measures of improvement such as basic medical care received, alleviation of chronic symptoms and reduction in use of alcohol and drugs. For Mental Health, we track the development of self-management skills, improvements in mood and behavior, and client ability to engage positively with family.
Like other opioids – heroin, Vicodin®, OxyContin®, Vicodin® or fentanyl – too much methadone can be harmful. Unlike these drugs, methadone effects start slow and take time to reach full effect. Methadone stays in the body much longer than other opioids. MAT clinical staff will start a patient on a low dose of methadone and will gradually increase the dose over time. This increases the total amount accumulated in the body.
In order to set a starting dose, staff take your body into account. Your physical health and other prescribed medications, supplements, and any herbal remedies you may be taking are considered. Staff also consider your use of opioids (amount, frequency, method of administration), and use of other drugs or alcohol.
It is very important that you provide staff with honest, true, accurate information. If you don’t, the dose of methadone you are administered may not take into account your lifestyle and needs. A patient’s dose is considered by a provider using guidelines provided by the federal government.
Staff will slowly increase your dose as you start in treatment. This allows for the methadone level to gradually build up. You may still experience withdrawal symptoms after starting on methadone. However, your providers will evaluate your symptoms to help you get to a stable dose.
An ideal methadone dose should accomplish the following: relieve symptoms of withdrawal, should not make you feel drugged or “high”, and remove your craving for opioid drugs.
These effects might not be achieved right away. It may take time for MAT staff to find the optimal dose for you. Each person’s body and metabolism is different, so each person’s dose has to be set to their unique needs.
There is a great risk of harm if you take too much methadone. Symptoms of over-medication include feeling “high”, drugged, or unsteady, drowsiness or “nodding off”, slow or difficult breathing, mental confusion, extremely contracted pupils, blue lips or fingernails, a slow heartbeat or feeling very calm or itchy.
An unusual boost in energy and/or the ability to stay awake for a long time may also indicate overmedication.
If you experience any of these symptoms at any time, DO NOT IGNORE THEM. If you or someone you know experience any of these symptoms, THS clinical staff or emergency services should be contacted. All patients are encouraged to have Narcan/Naloxone at all times. It can be life-saving in the case of methadone toxicity. Ask your methadone provider or your medical provider for a prescription and more information regarding the use of Narcan.
Mixing other drugs or alcohol with methadone can be very dangerous, resulting in mixed-drug toxicity (i.e. benzodiazepines, alcohol, other sedatives). This toxicity can lead to hospitalization or even death.
Many people do not understand what addiction and addiction treatment looks like and how it works for patients. Many people falsely believe that using methadone is the same as using heroin. They may think that you are trading one addiction for another. This, however, is absolutely not true. It is important to remember the points below when speaking to your family and friends about treatment:
Opioid addiction is a chronic illness and methadone is an opioid prescription medicine used to treat it. Methadone has been used in this way for more than 54 years. Through Medication-Assisted Treatment (MAT), millions of people have recovered from opioid addiction.
Methadone does not make you “high”. People who are treated with methadone will function perfectly well while taking it.
Just like diabetes, heart, and blood pressure medications, methadone must often be taken on a daily basis for up to a lifetime. Many people need a long-term daily dose to ensure their well-being.
In certain jobs, drug testing is required. Honesty is a good approach in this case. Not telling an employer about your prescription could mean you are found to test positive for opioids. However, your treatment cannot be used against you. Laws like the Americans with Disabilities Act protect persons in treatment for addiction from job discrimination. Certain “reasonable accommodations” must be made. This can include a work schedule that allows for clinic attendance.
Take-home medication, sometimes known as “carries”, require patients to fulfill specific criteria outlined by both the federal government and the individual clinic. If you are interested in learning more about these criteria, your counselor can provide a handout. Once you have met the criteria, your counselor helps you fill out an application for take-home doses. This application is then reviewed for approval by the medical director and care team.
“Methadone & You”, Brochure by Addiction Treatment Forum. 2000.Clinco Communications.
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The first thing you need to know about addiction recovery
Is that it doesn’t happen overnight. Recovery can take many years and even after a long period of sobriety, relapse is always a possibility. Betty is a patient at Therapeutic Health Service’s Summit Branch. Her story of recovery highlights the time it can take to reach recovery and what it takes to get there.
Betty became a patient of THS in 1981
She was 30 and pregnant with her daughter. Betty had been addicted to heroin for several years. She was in need of real help. At that time methadone was just starting to be used in the long-term treatment of opiate addiction. Previously Betty had tried a 21-day detox program that used methadone, a new treatment at the time. “It was a three-week program, so there was no time for counseling and other issues in your life. It was very hard to get the benefit of methadone in such a short time” Betty recalled. “A lot of treatment goes along with methadone. It’s your mind, body, and soul, all those have to be addressed and that takes time.”
Betty’s addiction was a traumatic experience
When asked what she remembers of that time, Betty said “Before I got on methadone I was totally lost. I had a habit and I didn’t know what to do about it, I just know I didn’t want it. Every moment is spent trying to figure out what you’re going to do for your next fix.” For Betty, methadone provided the stabilization she needed to move past her addiction.
The relief was just…Even the first day the relief was just…amazing. Just knowing I didn’t have to do things I didn’t want to do. I probably would not go to prison for the rest of my life. I could start rebuilding a life. Methadone was a real miracle for me.– Betty Hopper, THS Patient
Now 68 and retired
Betty is living the kind of life she always wanted to. She exercises regularly, lives in a beautiful, no-fuss apartment and is heavily involved with her church. Betty helps her church community in a number of different ways, including helping at their regular homeless feed. Knowing she can help others, provide treats, and study her faith means the world to Betty. Her recovery through time has made these things possible.
Betty wants others to know that methadone isn’t a way to get high, it’s a way to get well
I’d love for methadone treatment to be destigmatized. It’s really important to me because it’s affected my life so much. The perception is so opposite what’s really happening at these clinics. If people realized what we really do here, they would have a whole different view of methadone clinics. We have real treatment. We have groups, we have counselling, we have doctors, we have all kinds of outreach programs available through the clinic that you wouldn’t get anywhere else.
– Betty Hopper, THS Patient
Betty receives daily methadone treatment
Through a low-level maintenance dose. This helps her have peace of mind as she goes about her day. She’s seen the benefits of treatment through time. Having been sober for 20 years, Betty looks forward to growing old with grace knowing she has the support she needs.
Thanks to methadone and regular counseling
Therapeutic Health Services has been helping people like Betty recover from addiction to opiates for nearly 50 years. Recovery through time has improved and through their efforts, thousands of people have recovered from addiction. Each day the care staff at Therapeutic Health Services is helping people to create the lives they want to live.
We hope that you will join us
In supporting the recovery of hundreds of people like Betty. With your support, people in need can take their next step in moving past addiction and into a brand new life. Please show your support and donate, you’ll be part of creating a new tomorrow, today.
THS is hosting Alcohol/Drug Information School (A/DIS) at two of our branches, Summit and Eastside, once monthly through to December 2019. These courses help individuals make more informed decisions about substance use. What is Alcohol/Drug Information School? The Alcohol/Drug Information School classes offered through Therapeutic Health Services meet the requirements set forth in the Washington State Administrative Code (WAC) in conjunction with Washington State Courts, Probation, and the Washington State Dept. of Licensing. Participants will have the opportunity to learn more..
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Your Information. Your Rights. Our Responsibilities. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Effective Date: Jan 1, 2018 LAYERED SUMMARY TEXT – Your Rights You have the right to: • Get a copy of your paper or electronic medical record • Correct your paper or electronic medical record • Request confidential communication • Ask us to limit the information we share more..
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Therapeutic Health Services offers medically assisted treatment with Suboxone prescription. As part of our mission, we believe that those who are opioid dependent (prescription or illicit) may benefit from either a MAT-Methadone or MAT-Suboxone treatment program. We combine this with counseling and psychosocial support. We conduct treatment under the direction of a qualified physician (according to the Drug Addiction Treatment Act). What’s the difference between Suboxone and Methadone? Methadone is typically provided through our dispensary and is generally for those more..