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Treatment and Recovery Support Services

Treatment for substance abuse is part of a continuum of care that involves:

  • Screening, diagnosis, and assessment
  • Active treatment
  • Continuing engagement with recovery

This means that services in addition to treatment are needed for complete recovery. Effective treatment must address all aspects of a person's life, including any challenges that can contribute to, exacerbate, and prevent recovery from substance abuse.

The Substance Abuse and Mental Health Services Administration (SAMHSA) lists a number of services beyond medication and counseling that may be needed for successful treatment of substance abuse. This section presents an overview of relevant services that may need to be integrated as part of a rural substance abuse treatment program.

  • Clinical Case Management: Case managers can support individuals with substance abuse issues by referring them to needed health and human services. Case managers may work with providers to discuss the individual's progress and can be social workers, nurses, counselors, or students in these fields. Individuals with substance abuse issues may also need to be linked to healthcare and dental services as part of a comprehensive treatment plan. Healthcare navigators and case managers can help individuals access Medicaid or other insurance for which they are eligible.
  • Housing and Transportation Assistance: Lack of stable affordable housing may contribute to substance abuse, inhibit recovery, and harm overall health in people with substance abuse issues. Individuals with substance abuse issues may need assistance in accessing affordable, safe, and drug-free housing. They may also need transportation to their healthcare and counseling appointments. Treatment should include access to transportation and housing assistance. Module 1 of the Rural Services Integration Toolkit includes a list of government programs that these individuals can be referred to.
  • Mental Health Services: Individuals suffering from substance abuse often have co-occurring mental health issues. These individuals will likely need access to mental health services in addition to treatment for their substance abuse. The Community Mental Health Services Block Grant provides funding for community-based mental health services.
  • Trauma-Informed Services: Individuals with substance abuse issues may require a trauma-informed treatment approach, as trauma may impact their substance abuse. SAMHSA defines a trauma-informed treatment approach to mental health treatment as one that:
    • Understands the impact of trauma
    • Recognizes signs and symptoms of trauma in the patient as well as friends and family
    • Integrates knowledge of trauma into treatment systems and practices
    • Works to prevent re-traumatization in the individual
    Models of trauma-specific interventions generally use a multicomponent approach consisting of working collaboratively with patients, families, friends, and human services providers to empower the patient; education about trauma and its effects; and training in coping and interpersonal skills.
  • Family Engagement and/or Therapy: Substance abuse often affects not only the individual, but also his or her family members. Thus, family engagement and/or family therapy may help the substance abuser address any family-related factors contributing to their substance abuse, as well as help improve family relationships. Family therapy may involve educating the family about substance abuse and its psychological, medical, and behavioral effects, or it may actively engage all family members in psychological therapy to address how family relationships may affect or be affected by substance abuse.
  • Behavioral Therapy: Behavioral therapies help individuals with substance abuse issues change substance abuse-related attitudes and behaviors, increasing their ability to handle situations that may lead to substance abuse. For more information, please see: Behavioral Therapy Model in Module 2.
  • Vocational and Educational Services: SAMHSA recommends integrating employment services into substance abuse treatment. Substance abuse treatment programs can accomplish this by:
    • Hiring a vocational rehabilitation counselor
    • Developing relationships with local employers
    • Providing employment opportunities within a treatment facility
    • Establishing a referral system between substance abuse treatment providers and organizations such as job placement agencies, vocational/technical and community colleges, adult education programs, and programs that offer job-related communication and interpersonal skills training
    Individuals can also be connected to federal Job Centers, which connect people to nearby resources for identifying jobs, locating training opportunities, and building new skills.
  • Financial Services: People with substance abuse issues may require financial assistance to seek treatment services. Module 1 of the Rural Services Integration Toolkit lists several federal financial assistance programs that can help individuals with substance abuse issues access Temporary Assistance for Needy Families (TANF) and Supplemental Security Income (SSI).
  • Child Care Services: People with substance abuse issues who have dependent children will need child care services to enable them to participate in treatment programs. Available government assistance programs include the Child Care and Development Fund (CCDF) and Head Start. For more information, see Programs for Children and Families in RHIhub's Rural Services Integration Toolkit.
  • Primary Care and Oral Health: It is important to identify and treat all aspects of a person's health, not just his or her substance abuse. Individuals may be eligible for health insurance programs including Medicare, Medicaid, the State Children's Health Insurance Program (SCHIP), and state/federal health insurance marketplaces.
  • HIV/AIDS Services: Injection drug users who have HIV/AIDS will need treatment not only for substance abuse but also for HIV/AIDS. They can access HIV screening and early intervention services at Federally Qualified Health Centers (FQHCs) and Ryan White HIV/AIDS providers. See RHIhub's Rural HIV/AIDS Prevention and Treatment Toolkit for more information.

The National Institute of Drug Abuse also lists a number of recovery support services specific to adolescents that may be effective in helping people to recover from substance abuse, including recovery high schools, Assertive Continuing Care programs, peer recovery support services, and mutual help groups such as Narcotics Anonymous and Alcoholics Anonymous.

Resources to Learn More

Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide
Document
A comprehensive, research-based guide to substance abuse geared specifically toward treating adolescents. Includes information on research-based principles of adolescent substance abuse treatment, answers to frequently asked questions, different types of treatment settings, evidence-based treatment approaches, and links to resources that help users find substance abuse treatment facilities.
Organization(s): National Institute on Drug Abuse
Date: 1/2014

Principles of Effective Treatment: A Research-Based Guide
Document
An outline of research-based principles of effective substance abuse treatment, including discussion of the importance of recovery support services, frequently asked questions about substance abuse, and evidence-based models for treating substance abuse.
Organization(s): National Institute of Drug Abuse
Date: 12/2012

Recovery and Recovery Support
Website
An overview and definitions of recovery support services and additional resources for learning more about recovery support services.
Organization(s): Substance Abuse and Mental Health Services Administration

Trauma-Informed Approach and Trauma-Specific Interventions
Website
Defines a trauma-informed approach to mental health treatment, outlines the Substance Abuse and Mental Health Service Administration's six principles of a trauma-informed approach, and provides several examples of trauma-specific interventions for various mental health issues.
Organization(s): Substance Abuse and Mental Health Services Administration

Treatments for Substance Use Disorders
Website
An overview of various methods of effective treatment for substance abuse and suggested additional resources for specific substance abuse.
Organization(s): Substance Abuse and Mental Health Services Administration