Links to other resources: Detox, Residential, My Last Article

Last week we began discussing a pilot program in North Sydney, Australia that could eventually lead to better access to care and more treatment options for patients seeking alcohol treatment in Florida, drug addiction treatment in Florida, and hopefully could help improve outcomes for patients in various treatment contexts. The new technique that was implemented in North Sydney’s health system and discussed in a study that was produced by two specialists in addiction treatment in Sydney is nurse-led alcohol withdrawal treatment. I believe we should go into more depth on the results of that study, because it could provide a path forward for increasing access to things like alcohol and drug addiction treatment in Florida and the Panhandle region where our Florida Springs Wellness and Recovery Center is located. If you would like more information on alcohol withdrawal treatment in Florida call us today at the number listed above.

Of the patients who participated in the nurse-led alcohol treatment program, over 50% were prescribed medication to help with alcohol cravings. 85% of patients completed the first 4 days of treatment, which could also be called the initial detox phase of the program. 39% of patients were still sober from alcohol use after one month based on self-reporting. Less than 10% of patients waited more than a week to enter treatment after being accepted. I was also interested in some of the discussions that the authors included with their results. According to the author, Malise Ammet, in the “discussion” section of the study,

“Admitting the need for treatment can be hindered by ignorance of treatment availability or lack of understanding about what treatment entails. Separate silos of care exist and the nomenclature of alcohol treatment and the intake procedure can be confusing; patients are often unsure whether they need ‘detox’, ‘rehab’, ‘counselling’, ‘pharmacotherapy’, ‘a specialist’ or all of the above.”

As a person who works in this area of specialization, I can say with confidence that most patients seeking treatment for substance use disorder need everything in that short list. It is confusing for patients, however, to try to decide what type of treatment makes sense for them or a family member with so many different options discussed much of the time. Even if a patient were to learn the individual strengths of these different modes of treatment, such as inpatient or outpatient treatment, they are still likely to run into problems when they go to find help that is close to where they live. We discuss many treatment options that are becoming less and less available to the average patient, whether because of cost or because of the many other factors that limit access. Research-based and medically supervised inpatient treatment for alcohol withdrawal and alcohol use disorder is being discussed in this study. In the United States right now, you would have trouble finding open beds that are taking patients within a week of acceptance to a program such as that. If we also discussed patients on a Medicaid plan, those same options would be further limited, to the point that almost anyone in the U.S. on a Medicaid plan would have trouble finding access to an inpatient alcohol use disorder treatment program near their home right now.

Lower Costs Can Increase Access for Patients

That is the main point of increasing efficiency with ideas like nurse-led approaches. Lower the cost and more facilities can take more Medicaid patients. If you need fewer doctors, you can increase access to care while also bringing costs down, hopefully. We don’t have enough nurses and doctors to treat all the people that need help with alcohol and drug addiction treatment currently, but there are more nurses available than doctors to begin with. Nurses end up spending more time with the patients anyway, because doctors are busy doing required paperwork for the DEA or whatever else we have them doing. Nurses care for patients that are sick with withdrawal symptoms during detox, it was never a doctor doing that. The doctors help. We are all safer with great doctors around and supervising, but if doctors are needed elsewhere, there will always be patients who need help with alcohol and drug addiction treatment, especially in Florida, the home of the pill mills and Oxycontin doctor shopping, and all the things that brought us to this point. It should be noted that this study was, by no means, the end of the story on this issue. It was the very beginning. They had few total patients in this study, and they said no to the more difficult patients for safety concerns. The numbers were likely to look better than what we might have expected if they were taking people with a history of co-occurring mental disorders and people addicted to more than one substance. We need many more studies on nurse-led alcohol and drug treatment programs. This program in Sydney didn’t treat anything other than alcohol use disorder, but it is a great starting point and a great idea. We need more studies because we need more data, but we also need more people having these conversations. Nurse-led treatment approaches are a great opportunity to discuss the current treatment access challenges we are facing when we try to treat alcohol withdrawal in Florida.

Alcohol and drug addiction treatment in Florida is too expensive right now for many providers to take on more Medicaid patients, because providers are concerned that they cannot survive if they take too many Medicaid patients and lose too much money treating them. This Sydney study was an opportunity for us to talk about those issues. We need providers to be more comfortable taking on patients who have less money, and nurse-led approaches would help keep costs down, in my opinion, but we need more data and more discussion of these topics. If you or a loved one needs alcohol treatment in Florida, call Florida Springs today to speak to a counselor.

By T.A. Cannon (Contact me at TACannonWriting@gmail.com)

References

“Nurse-led alcohol clinic: Increasing access to drug & alcohol treatment” by Melise Ammit and Nick Miles.