Home-based treatment may offer promise for addicts
Matt Eacott of Madison had tried and failed 15 times to break free of his addiction to opioid drugs when his counselor suggested a new approach.
Instead of leaving home as before for a month-long residential treatment program, only to find himself unable to adjust and back on drugs shortly after returning, the new model would in essence bring the treatment to him. He would stay at home while receiving intensive therapy and attention for an entire year. Last week, he said he hopes his success offers a promising alternative for others struggling with addiction.
“I’m 34 years old, and I’m now celebrating three years of sobriety,” said Eacott, who now works in construction, is a certified recovery advisor and is engaged to be married in September. “This lets you establish a normal life, not away somewhere, with a multi-disciplinary team that comes right to your home environment.”
The approach, developed at the Yale University School of Medicine, is described in an article in this fall’s edition of Connecticut Medicine, the journal of the Connecticut State Medical Society. It is based on the premise that addiction should be treated as a chronic condition, rather than as an acute illness that can be cured in a month-long program. Patients enroll in the program for one year, meeting with visiting nurses, a certified recovery advisor, family and individual therapists and other caregivers at home and in office appointments. A GPS tracking system on the patient’s phone monitors their attendance at 12-Step or other recovery group meetings, and regular urine tests verify abstinence from drugs or alcohol. Along with the one-on-one and group therapy, Eacott took Suboxone, a prescription drug that helps break opioid addiction, but has since weaned himself off of all medications.
The nurse, counselor and therapists, he said, were key to helping him get back on track after a relapse.
“It felt more like support, more like friends, not just people telling you what to do,” he said. "I had tried everything, and I was someone who didn't believe recovery was possible."
Dr. Ellen Edens, assistant professor of psychiatry at the Yale School of Medicine, said she became excited about the initial success of the program when she heard about it from the colleague who had been implementing it, Dr. Charles Riordan, clinical professor of psychiatry at Yale. Edens co-authored the article on the program, in which the experiences of five patients are described. Seven months after completing the year-long program, four of the five patients had stayed off drugs or alcohol.
“This is a novel program that stopped me in my tracks,” she said. “I’ve been a cheerleader for it.”
More pilot studies are needed to further verify the program’s effectiveness and enlist insurers to provide coverage, she said. The cost for the year-long program is $37,000. That compares to $25,000 to $45,000 for a month-long stay at a private residential treatment facility, she said, where the relapse rate is as high as 80 percent.
“When people get out of residential treatment, they’re totally overwhelmed,” she said. “There are environmental and physical cues that lead to cravings and relapse, and you need support at those moments.”
Andrew Buccaro is executive director at Project Courage in Old Saybrook, which has collaborated with Aware Recovery Care in Madison in offering the new program with several patients. One of its most important features, he said, is that it stays with patients for an entire year – considered the essential length of time for maintaining recovery.
“The assumption has always been that you get better out of your environment. That’s driven treatment for decades,” he said.
But with the “revolving door” of residential treatment programs, he said, a new approach is clearly needed.
“I’d love to see this become a permanent fixture in the continuum of care,” he said.