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Research supports recovery-oriented systems of care
Posted in Recovery, Research, Treatment - 0 Comments

supports recovery-oriented

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), a recovery-oriented system of care (ROSC) is “a coordinated network of community-based services and supports that is person-centered and builds on the strengths and resiliencies of individuals, families and communities to achieve abstinence and improved health, wellness, and quality of life for those with or at risk of alcohol and drug problems.” SAMHSA’s 2010 ROSC resource guide outlines the history, planning and practices for their use.

Recovery-oriented care in greater detail

SAMHSA also reports 7.9 million American adults had co-occurring mental and substance use disorders in 2014. Also known as a dual diagnosis, the combination of addiction and mental health issues is frequently difficult to treat – often a patient will simply receive treatment for one disorder while the other disorder is ignored. Traditionally, substance abuse issues are treated in acute settings. Patients undergo short treatment settings that focus on abstinence; often, there’s also an expectation that once sober, patients will stay that way.

However, with their role on providing both acute and chronic care, ROSC programs can play a strong role for people who need dual diagnosis treatment. SAMHSA provides four examples of recovery-oriented activities in ROSC programs:

  • Prevention: Activities include early screening before addiction along with referral to intervention services, working with other health welfare systems including child welfare and the Veterans’ Administration and engaging in activities to reduce the stigma around addiction.
  • Intervention: Activities include early intervention, focusing on pretreatment along with services which support recovery and outreach.
  • Treatment: Activities include providing a range of treatment services and support for recovery, along with alternative therapies and substance use prevention for the family of the person in treatment.
  • Post-treatment: Activities include continuing care programs, more recovery support services and emphasis on check-ups and self-monitoring.

In June, the Journal of Addictions Nursing published a special issue on ROSC and its increasing role in recovery. Articles include stories on ROSC programs in Houston as well as ways the programs can help reduce the amount of readmissions to psychiatric units. The issue also examines another treatment model, SBIRT:

  • S: Screening
  • BI: Brief Intervention
  • RT: Referral to Treatment

SBIRT helps care providers better identify substance abuse signs and refer their patients to treatment much more quickly. Although some studies have shown the SBIRT model has promise, not much research has been done on it. However, last year a study published in JAMA Pediatrics took a closer look.

Studying SBIRT

In the study, 52 pediatricians were sent to work in three different areas of medicine using the SBIRT model: other pediatricians, behavioral health care practitioners (BHCPs) and usual care. The patients in the study were aged between 12 and 18 years.

Patients who were sent to the BHCPs had a higher chance of receiving SBIRT treatment than those who were sent to pediatricians and usual care. “Patients in the pediatrician-only and UC arms had higher odds of being referred to specialty treatment than those in the embedded BHCP arm, suggesting lingering barriers to having pediatricians fully address substance use in primary care,” the authors wrote in their conclusion. “Findings also highlight age and ethnic groups less likely to receive these important services.” An additional study conducted in Poland in 2009 found the SBIRT model may have particular use in treating alcoholics.

However, some recent studies are critical of SBIRT. For example, a study published in the Journal of the American Medical Association in 2015 found a single brief intervention had no effect on its subjects’ drug use.

The importance of treatment

The twin prongs of dual diagnosis make treatment particularly important for those patients dealing with both mental health and substance abuse disorders. According to SAMHSA, co-occurring disorders are common in the homeless, those involved in the criminal justice system and veterans.

Sovereign Health is a leading provider of dual diagnosis treatment. Our Chandler, Arizona, facility specializes in treating women, providing a safe, comfortable environment in which to heal. We offer effective, evidence-based treatment modalities to ensure our patients have the best chance at a lasting recovery. For more information, please contact our 24/7 helpline.

About the author

Brian Moore is a staff writer and graphic designer for Sovereign Health. A 20-year veteran of the newspaper industry, he writes articles and creates graphics across Sovereign’s portfolio of marketing and content products. Brian enjoys music, bicycling and playing the tuba, which he’s done with varying degrees of success for over 25 years. For more information and other inquiries about this media, contact the author and designer at

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