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Treatment and Recovery Support Services

Treatment for substance use disorder 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 a substance use disorder.

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 use disorders. This section presents an overview of relevant services that may need to be integrated as part of a rural substance use disorder treatment and prevention program.

  • Clinical Case Management: Case managers can support individuals with substance use disorder 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 use disorders 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 use disorders, inhibit recovery, and harm overall health in people with substance use disorders. Individuals with substance use disorders 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 to which these individuals can be referred.
  • Mental Health Services: Individuals suffering from substance use disorders often have co-occurring mental health issues. These individuals will likely need access to mental health services in addition to substance use disorder treatment. The Community Mental Health Services Block Grant provides funding for community-based mental health services.
  • Trauma-Informed Services: Individuals with substance use disorders may require a trauma-informed treatment approach, as trauma may impact their substance misuse. 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 for substance use disorders 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 misuse often affects not only the individual, but also his or her family members. Thus, family engagement and/or family therapy may help the person who is misusing substances to address any family-related factors contributing to their substance misuse, as well as help improve family relationships. Family therapy may involve educating the family about substance use disorders and their 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 misuse.
  • Behavioral Therapy: Behavioral therapies help individuals with substance use disorders change their attitudes and behaviors, increasing their ability to handle situations that may lead to substance misuse. For more information, please see: Behavioral Therapy Model in Module 2.
  • Vocational and Educational Services: SAMHSA recommends integrating employment services into treatment for substance use disorders. 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 use disorder 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 use disorders issues may require financial assistance to seek treatment services. RHIhub's Rural Services Integration Toolkit lists several federal financial assistance programs that can help individuals with substance use disorders access Temporary Assistance for Needy Families (TANF) and Supplemental Security Income (SSI).
  • Child Care Services: People with substance use disorders 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 use disorder. 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 use disorder 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 use disorders, 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 use disorders geared specifically toward treating adolescents. Includes information on research-based principles of adolescent substance use disorder treatment, answers to frequently asked questions, different types of treatment settings, evidence-based treatment approaches, and links to resources that help users find substance use disorder treatment facilities.
Organization(s): National Institute on Drug Abuse
Date: 1/2014

Principles of Drug Addiction Treatment: A Research-Based Guide
Document
An outline of research-based principles of effective treatment for addiction, including discussion of behavioral therapies medications, and testing.
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 use disorders and suggested additional resources for specific substance use disorders.
Organization(s): Substance Abuse and Mental Health Services Administration