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Editor’s Note: This article is based on interviews with several addiction treatment professionals who also act as consultants,providing their addiction treatment expertise to treatment programs in several countries through C4 Recovery Solutions.
It is a known fact that of the many individuals in the United States who suffer from substance use disorders and addiction are not receiving treatment for their addictions.
There are those who believe that this is the result of a flawed health care system, in which health insurance in unavailable to a large number of individuals. Some believe that the stigma addiction carries is keeping many individuals from seeking and receiving treatment for their addictions. Still, others believe that too much energy is expended debating whether addiction is indeed a disease—worthy of the same level of care and attention to treatment that is given to other chronic diseases, such as cancer or diabetes—and not enough resources are directed toward ensuring that addiction is better understood, by providing training to physicians and other clinicians.
According to the many treatment professionals, like Dr. Bob Lynn, all of these are barriers that prevent the United States from providing effective treatment to every addicted person. While this may sound like an impossible task, Dr. Lynn explains that this is already being done in other countries. Lynn is part of a group of consultants from around the world who work with C4 Recovery Solutions, a non-profit corporation that is dedicated to improving the effectiveness of substance use disorder prevention and recovery services worldwide. According to Rick Ohrstrom, the chairman and a founding member of C4 Recovery Solutions, the group remains committed to creating an international credentialing system that sets global professional standards for the addiction treatment workforce in an effort to improve upon the quality of addiction treatment worldwide.
Like many in his field, Ohrstrom is concerned that with the generational shift occurring in the addiction treatment field, there is reluctance on the part of both the retiring addiction professionals and the newcomers to the field, and as a result, vital information is not being passed on appropriately.
“In addition to bringing together people from different cultures that are doing the same types of treatment, C4 is convening people from both generations to enhance what’s good about both generations,” Ohrstrom said. “There is real value in that.”
Dr. Lynn, who brings more than 38 years of experience with addiction treatment, employee assistance programs and state government, has played a significant role in developing new assessment methods and coordinated treatment centers in the United States, Europe and the Middle East. Like his colleagues, who are working with C4 Recovery Solutions in more than 20 countries, Dr. Lynn takes an approach to addiction treatment that is based on a client’s individual needs. From there, treatment is provided through a continuum of care that allows treatment professionals to determine what is working or not working, in order to provide treatment that is based on positive outcomes.
Since the United States operates under a very bureaucratic system, many treatment centers are not invested in this type of outcomes-based treatment, Dr. Lynn said. For example, he explains that with the exception of a few sporadic programs, there is very limited outreach to drug and alcohol addicts in the United States. In other countries, such as Denmark, Amsterdam, the United Kingdom and Canada, addiction professionals are working to engage people in treatment at an earlier stage by going out on the streets and into prisons to identify individuals who are in need of addiction treatment services. According to Lynn, in many overseas programs, there are more groups that are willing to provide treatment to everyone, whereas in the United States, many people are literally being “screened out” of addiction treatment, most often because of their inability to pay for treatment.
The Middle East Project
There is much to be learned from the way addiction treatment is being provided in other countries, Dr. Lynn said. For instance, one would not expect that in the West Bank and Jerusalem, themain inpatient program would have a full continuum of care better than anything ever seen in the United States, despite deplorable political circumstances and living conditions, Lynn said.
According to Lynn, the staff in the Middle East program not only demonstrated a passion for their work, but also, were more credentialed and educated than staff in many other programs around the world. They had higher levels of training and held advanced degrees, Lynn said. The staff went to drug-infested areas and recruited people off the street to come to treatment. Each person was given care based upon his or her needs, for as long as necessary. The aftercare program included helping these people get jobs, and in some cases, even setting them up with their own businesses.
Majed Alloush is the General Director of the Al-Sadiq Al-Taieb Association, a charitable, non-profit organization that has been working in Palestine since 1986 to provide assistance and treatment for addicts and their families. The inpatient treatment and rehabilitation center, built in 1991, today is a 40-bed facility that offers a holistically-based program with wellness, prevention, intervention, treatment and rehabilitation services.
According to Mr. Alloush, the more than 36-year occupation of Palestine has resulted in residual feelings of oppression, despair and depression among many of the Palestinian people. About 65 percent of the population lives below the poverty line, and about 37 percent are jobless, creating a hopeless feeling among many, who turn to violence and drug use, Alloush said. In the past five years, alcohol has become a bigger problem in Palestine, and heroin, cannabis and prescription drug abuse also is on the rise, as is suicide.
This is pretty significant, according to Alloush, since the use of alcohol and suicide goes against the norms and way of life for the Palestinian people. There also is a significant amount of shame associated with these addictions and their consequences, Alloush explained, noting that the program run by Al-Sadiq Al-Taieb is designed to treat the entire family, not just the addict. The people in this region are a very tight-knit group, and everyone in the community knows one another, Alloush said.
Realizing that the youth in Palestine are at risk of drug use and violence, Alloush explained that the program also has a large prevention component. The program encourages children to play on the playgrounds that have been built, and strives to get youth involved in volunteer work around the community, Alloush said.
The RISE Project
An example of another project that focuses heavily on prevention efforts, particularly for its youth population, as well as assisting with education and skills development, is the Reaching Individuals Through Skills and Education (RISE) project. The program, which is part of C4 Recovery Solutions, has provided education, life and social skills training parenting training, youth leadership, adult literacy courses and peer drug prevention training to several communities in Kingston, Jamaica for more than 15 years.
According to RISE Executive Director Sonita Abrahams, many of the youth who have been involved in the program during childhood and/or adolescence, have gone on to get their education and return to work with RISE. The program, which recognizes addiction as a “family disease,” provides counseling services to the entire family.
Much of the program focuses on services that meet the needs of young people, particularly those living in the inner-city communities. Many of the youth programs under RISE have helped to unify members of the community and discourage gang violence, which is a major problem in parts of Jamaica. In addition to educational training and counseling, some of these programs engage adolescents by encouraging them to participate in activities such as dance, music and drama.
In addition to its work designing, implementing and monitoring projects to improve outcomes-based prevention, treatment and recovery services for substance use disorders worldwide, C4 Recovery Solutions also hosts annual conferences in the United States and Europe—the Cape Cod Symposium on Addictive Disorders (CCSAD) and the UK/European Symposium on Addictive Disorders (UKESAD). Also, to further the implementation of utcomes-based treatment systems, C4 Recovery Solution.
C4 Recovery Solutions operates on a variety of funding streams. The two main sources of revenue are the Ohrstrom Foundation and the time and work that is so generously donated by C4 board members. In addition, C4 makes a slight surplus by operating the Cape Cod Symposium on Addiction Disorders, which is applied to other projects.
C4 Recovery Solutions currently has other exciting projects in the works C4 also attempts to generate revenue from ongoing projects and applications. This year, C4 is launching a new innovative outcome management software, which aims to provide useful real-time analytics to the field, as well as a modest cash flow for other less financially-sustainable projects, like its Middle Eastern efforts.
C4 is always looking for partners to fund innovative new initiatives and welcomes any approaches from interested parties. To find out more about C4 Recovery Solutions, visit their website at www.c4recoverysolutions.org.
This article is published in Counselor, The Magazine for Addiction Professionals, February 2010, v.11, n.1, pp.10-13.
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As a person that has gone through "confrontational methods" I am very