Innovations in administering a day treatment program. II. The process group.
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Biomedical subjects
Publications and source records attributed to E C Senay.
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This article describes a 300-bed substance abuse treatment program that is part of a continuum of care focused on preventing drug and criminal recidivism in substance abusing criminals incarcerated in Dallas County, Texas. It is the product of a joint effort of the judiciary, the Dallas County Supervision and Corrections Department, the State of Texas Criminal Justice Division, and Interventions Co., a not-for-profit treatment provider. The program is rooted in over 25 years of treatment experience and incorporates therapeutic community (TC) technology combined with 12-Step programming, behavior modification, job training (having a job is required for graduation), educational, and medical/psychiatric elements. Treatment is conceived as part of a continuum of care to provide substantial and sustained support for the inmate in the difficult process of adapting to the community post incarceration. Treatment plans are individualized and are based on an extended workup in which the individual's status in a number of domains is assessed. Specialized services, such as transportation and childcare, facilitate recovery. Once in the community, urine monitoring, groups, and counseling continue. The program is beginning its fourth year of operation and approximately 600 inmates have started the program. A formal evaluation is in process.
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This paper reviews the world literature on methadone. Methadone has been used in hundreds of thousands of patients, in disparate social, economic, cultural, and geographic situations; it has been evaluated in scores of studies. The large majority of evaluations demonstrate that opioid use, criminality, and general health status are affected positively in many addicts. Smaller gains in job and family functions are noted. Alcoholism and multiple drug use complicate treatment for some addicts. Despite the positive data, public opinion remains negative about this treatment. The use of methadone in withdrawal from opioid dependence and in pregnancy complicated by opioid dependence is discussed.
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