Managing the Chronic Condition of Substance Abuse

By The Fix staff 05/15/17

"We’re able to break the relapse cycle by providing help with supportive accountability, and giving additional external motivation until internal motivation kicks in."

A man with a laptop computer
The Hazelden Betty Ford Foundation's Recovery Management systems aim to help patients establish long-term success.

Rehabilitation is often thought of as something finite, with an end date, but a new approach to recovery at the Hazelden Betty Ford Foundation provides ongoing support for sobriety and helps people manage the chronic condition of substance use disorder over the course of their lifetime.

“Recovery management is the same thing as disease management with other chronic illnesses,” says Janelle Wesloh, the executive director of recovery management at the Hazelden Betty Ford Foundation. “There is a routine established to provide support after a diagnosis because that improves the outcome and prevents flare ups or symptoms spiraling out of control.” 

It is well-established that the longer someone stays engaged with a recovery community, the better their outcomes are, Wesloh pointed out. For the Hazelden Betty Ford Foundation, establishing recovery management programs to formalize that engagement was a natural step.

“We know that substance abuse is a chronic illness, and if they can successfully manage it people can have a great life,” Wesloh says. The Foundation staff realized that by staying with their patients longer, they are able to give them a better chance for long-term recovery. “This has really helped patients in an on-going way.” 

The recovery management program at Hazelden Betty Ford started around 2006 with MORE®, which stands for My Ongoing Recovery Experience. The web and phone-based supports are aimed at keeping Hazelden Betty Ford Foundation alumni and patients engaged with the community.

Now there are a variety of ongoing supports, including online communities like The Daily Pledge and Connection® recovery coaching and monitoring. Connection® formalizes frequent contact with a recovery coach for the patient and family members, recovery compliance updates, and random drug screenings. The program, based on professional recovery programs for doctors and pilots, boasts an impressive success rate, with an average of 80 to 90 percent of participants remaining abstinent after a year of recovery.

No matter what level of recovery management a patient desires, the staff at the Hazelden Betty Ford Foundation will work to design a program that fits the individual’s needs.

“We have a lot of different tools so we can provide the appropriate support to give each person what works for them,” Wesloh says. Ongoing supports also offer patients and families options to make the best use of their financial resources in order to get the most out of a recovery program, Wesloh notes.

“They’re able to utilize their resources to engage longer, which we know has a bigger impact than front-loading recovery."

The goal of recovery management is to move patients from being clinically-managed to being self-managed. Ultimately that means getting them involved with the recovery community where they live.

“The more we get them into the recovery community the more they’re moving away from the using community,” Wesloh says. Eventually that recovery community becomes the person’s main source of support, and formal recovery management from the Hazelden Betty Ford Foundation tapers off. “The goal is to not be needed any more.”

Many people become entrenched in thinking about recovery as a 30-day process, Wesloh says. The Hazelden Betty Ford Foundation begins immediately introducing the idea of ongoing recovery management, encouraging patients to stay involved in the programs in some way for about 18 months.

“We’re educating patients and families as they’re first talking to us that this is a chronic illness,” Wesloh says. “How your symptoms respond to treatment determines what the next step is.”

Patients come in needing different levels of care. Some start with in-patient rehabilitation, while others go right to an intensive outpatient program. Practitioners at the Hazelden Betty Ford Foundation are trained to use objective milestones to know when someone is ready to step-down to the next level of care, allowing a natural transition through the recovery management process.

Eventually, patients are ready and able to take charge of their own recovery.

“They have tools and resources to handle their own symptoms, and know what to do and who to reach out to if symptoms flare up to get them back under control,” Wesloh says.

The recovery management programs also build in a buffer time while people build up their internal motivation to do the hard work of maintaining recovery. During the tumultuous first three months of recovery, having the added support and accountability of a recovery program is often enough to keep people on track with their sobriety.

“It’s to interrupt that impulsive relapse that may occur,” Wesloh says. “When this tricky brain disease tries to noodle in and say ‘just have one,’ a voice on the other side says ‘wait a minute, you may have to pee in a cup today.’ We’re able to break that cycle by providing help with supportive accountability, and giving additional external motivation until internal motivation kicks in.”

Got more information on the Hazelden Betty Ford Foundation here, and connect with the organization on Facebook.

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