CHI Recovery Offers Evidence-Based Alternative to Traditional Rehab

By The Fix staff 01/10/18

In CHI's Hub and Spoke model, each client works with a collaborative clinical team consisting of medical doctors, alternative health practitioners, nutritionist, psychotherapists and case managers.

A man and woman embrace, happy people in background.

According to statistics from the American Society of Addiction Medicine (ASAM), drug overdoses are the leading cause of accidental death in the United States. As recently as 2015, there were 52,404 drug overdoses resulting in deaths; a number which exceeded all deaths that occurred from the Vietnam War—a war which lasted 20 years! In 2017, this number rose again, this time above 59,000 deaths. Similarly sobering is that between 1999 to 2008, the overdose rate has nearly quadrupled. As many of us have heard from major media outlets and reported by the CDC, America is currently experiencing an opioid “epidemic.”

Along with the expansion of addiction and substance abuse has come a nascent recovery industry to meet the demand for addiction recovery services. As of today, there are more than 14,500 drug and alcohol treatment facilities across the United States. Though there are more options than ever before for those seeking treatment, many questions remain about how addiction works and how to treat it. More specifically, there are serious concerns that many standard rehab programs may not work very well at all, when you consider the results from research.

In order to understand the problem, it helps to have a basic sense of what a “standard rehab” is. Generally speaking, standard rehabs are typically 30-day programs which or may not include medical detox. Many of these programs are strictly 12-step based, use a relatively narrow addiction-only approach to what is addressed, offer little in the way of follow-up care, and typically offer no medical care whatsoever for this complex physiological brain disorder. While these features are not necessarily bad in and of themselves, they differ from the multi-faceted and wide-ranging approach taken by CHI Recovery in Northern California.

To understand how unique and different CHI Recovery’s holistic healthcare program is, it’s important first to understand the problems associated with the traditional rehab approach. To begin, many 30-day residential programs inadvertently create an isolated recovery environment, one that may not benefit clients once they are out in the elements. This phenomenon could be called “facility-centered treatment,” wherein residents do well while they are sequestered from their triggers and supervised around the clock, but have difficulty translating to “real life” change once the program ends.

Secondly, while 12-step recovery has proven helpful to many people struggling with addiction, the science behind its efficacy is shaky at best. Alcoholics Anonymous or AA was founded in 1935, a time when the neuroscience of addiction was not well understood. Although addiction had been medically labeled as a disease, it was still popularly treated as a spiritual affliction. While there’s no doubt that spiritual approaches to recovery can help some people with addiction and alcoholism, advances in addiction medicine suggest that other approaches are necessary as well to help the majority of clients make a full recovery.

While many standard facilities do include evidence-based therapeutic practices like CBT and DBT, they often don’t include hands-on medical and psychiatric support or deep clinical therapy for trauma or family systems with seasoned providers. Field case management and other valuable elements to build life skills, gain employment or secure stable housing are almost non-existent (as insurance companies try hard not to cover these costs). Rehabs simply need to conform to state and local guidelines as to what they are required to provide clients—there are no national standards for treatment—but these requirements differ widely by state. Even more concerning is that the standards that are set are abysmally low, and in many cases even prohibit exceptional care by providers with advanced degrees over the use of addiction counselors.

In addition to these issues, the emergence of rehab as a profitable business has created an incentive for facilities to do “minimal compliance” with state-certified standards. In other words, many facilities may simply do the bare minimum required to legally operate—all on the back of relatively unstandardized guidelines in the first place, such as substituting licensed psychotherapy for AOD counseling, and having a “Medical Director” who never conducts patient care.

Finally, studies have shown that 30-day programs are too short to create a lasting change in addicts and alcoholics. The emphasis in these short term programs is to teach clients what addiction is and how it affects the body. Given that most folks are in detox the first two weeks of their recovery journey, one might deduce that little, if any, of this information is retained.

The process of detox, then medical stabilization, then introduction to the AA model—you have a disease, admit you have a disease, then turn your life over to God—can take up the full month without creating any lasting strategies that participants can take with them into their lives. And without ever addressing the disease of which they speak. Moreover, the 12 steps have little instruction in them about what to do once treatment ends. Many clients suffering from chronic pain receive no help whatsoever on how to deal with these pain management concerns during treatment. Once a program ends, the chronic pain, trauma, undiagnosed psychological conditions and related physical, emotional and social issues resurface as revolving door issues, which leads, once again, to relapse and often, another stint in rehab. One must question the motivation of so many uninspired rehabs who reinforce the idea that it is perfectly “normal” to go to rehab anywhere from 6-20 times.

While CHI Recovery could be called a non-standard rehab, the terminology is not entirely accurate. While it is clearly non-standard even among non-standard rehabs, it is more akin to an integrative healthcare organization. While individualized care is often a stand-in phrase for a relatively unstructured approach, CHI Recovery treats clients using a unique, and radial model with the client at the center, currently referred to in the news as the “Hub and Spoke” model. Instead of being treated from one deeply rooted perspective, each person works with a collaborative clinical team consisting of medical doctors, alternative health practitioners, nutritionist, psychotherapists and case managers. Dual diagnosis support is provided along with medical care, independent living skills, self-care and discharge planning. Most intriguing, flying in the face of conventional wisdom, CHI Recovery’s programs are all delivered in an outpatient model and most services occur within the community at large. Participants are challenged to gain sobriety over three to six months while having to encounter and deal with the environment where drugs and alcohol are plenty.

Every client has a customized care plan specific to their clinical needs and wants. Spirituality does play a role in the programs at CHI Recovery, but even this is uniquely customized to the individual in hopes of fostering a spiritual practice consistent with the individual’s authentic beliefs and desires. The principal approach to recovery is to reinforce collaborative care from holistically-integrative providers; an approach that is supplemented by medical oversight, evidence-based therapy and even nutritional supplements and amino acid therapy. Though each program may differ depending on the client’s needs, programs generally last a minimum of three months (though they often continue for as long as a year, especially when factoring in aftercare services). While the latest research knowledge on Substance Use Disorder is applied to treat clients, so are ancient Eastern medicinal approaches like acupuncture, meditation and yoga.

As addiction and substance misuse have continued to grow into increasingly challenging problems, the treatment industry has grown alongside it. Unfortunately, this rapid expansion has created problems with standardization of treatment, scientific accuracy and ongoing care. While individualized and luxury rehabs have tried to address some of these problems, they have done so with mixed success.

As the field has expanded, a need has emerged for facilities like CHI Recovery which embrace all the latest science from addiction medicine along with the best wisdom from other related disciplines. While many questions remain about how addiction works and how it can be treated, innovative programs like those offered at CHI Recovery are leading the way into the future.

For more information, call CHI Recovery at 707-824-0222 or visit their website.

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