Substance abuse in the United States is a major health concern regardless of the kind of substance that is in question. While some people are more likely to deal with drug addiction of illicit drugs that bring up a slew of legalities, others will become addicted to those substances that are otherwise legal but still can have long term ramifications on one’s health. When looking at these different kinds of addiction, the development and maintenance of successful substance abuse prevention programs is even more important for long term community health. Through a breakdown of the different aspects of these kinds of programs, it is possible to see not only the need but also the difficulties faced in developing and maintaining these resources on a large scale. In conjunction with this research, an interview with Pat Wegleitner, a prevention specialist at The House of Extra Measures in Houston Texas, adds to this breakdown with first hand thoughts and perspectives on the issue of maintenance and development of these kinds of programs.
The first thing to understand is what constitutes a substance abuse prevention program and what it means for the discussion of maintenance. Substance abuse prevention programs are key parts of businesses and organizations nationwide due, in part, to government movements in recent decades to help curb these issues as an issue of public health. With regard to schools, “the Drug-Free Schools and Communities Act Amendments of 1989… require institutions of higher education (IHEs) to develop and implement programs to prevent the abuse of alcohol and the use of illicit drugs by students and employees, including faculty” (Alcohol & Drug Abuse Prevention Program, 2015). The development of these kinds of programs are meant to help curb these problems before they start and yet this is only one form of prevention program as some people had already fallen off the metaphorical wagon and need additional care. While the initial version of preventing substance abuse is admirable, it is far from perfect and it is those who relapse into abuse that need a greater amount of care from these programs to prevent further abuse. According to Wegleitner, The House of Extra Measures includes a variety of services including, but not limited to, health promotion, prevention, intervention, treatment, and ongoing recovery support (Wegleitner). When dealing with people recovering from addiction, it is the balance of all of these different factors that can minimize chances of relapse while maximizing the possibility that someone striving to avoid further abuse have for a positive outlook in their future. In either case, prevention programs are essential to help with alleviating the issue of substance abuse as a health concern on a national level both before and after issues arise regardless of the age of those patients helped.
When developing this kind of program, there are a number of key points that must be taken into consideration as development of this kind of program requires for the administration to take the needs of everyone into account. Planners of the programs“should recognize that treatment may occur in different settings over time (i.e., residential, outpatient) and that much of the recovery process typically occurs outside of or following treatment” (Substance Abuse Treatment for Persons With Co-Occurring Disorders, 2005). Long term participation in this kind of program is also stressed since program developers understand that the relapse is more likely with substance abuse than in other kinds of recover programs. In fact, prevention of initial abuse is difficult enough, but the focus of prevention in relapse is another point of contention because relapsers need even more help maintaining sobriety. “Relapsers need to learn about the relapse process and how to manage it. It’s not a bad idea to get their family and Twelve Step Sponsors involved. The education needs to reinforce four major messages” including that it is normal and not to be ashamed of, there are warning signs of relapse, management is possible, and there is always hope (Gorski, 2003). This is a point that The House of Extra Measures must deal with regularly because they are a transitional program. When transitioning from a rehab facility to living in a world of temptation, Wegleitner points out that the prevention of further relapse is a continuing point of worry as staff is concerned that patients cannot easily stave off temptation alone. As a result, these kinds of programs do have a number of difficulties in both the development but also the maintenance of these programs.
Regardless of whether or not the program is meant to prevent substance abuse from ever occurring in the first place or if it is designed to prevent relapse, problems will invariably arise as the program takes shape and evolves over time. One of the key problems for this kind of program stems from the issue of individual actions taken by those who are participating in their own recovery. While the intention of those taking part in these programs is often noble and necessary for their own health, many programs are developed like The House of Extra Measures as a high structure and high accountability environment where those who are part of the program are held accountable for their actions (Wegleitner, 2017). This is because of the fact that these programs do not usually succeed if people are left to their own devices and fail to receive support and feel that others have faith in their ability to change their lives for the better. “Relapse prevention planning probably won’t work unless the relapser is sober and in control of themselves. Detoxification and a few good days of sobriety are needed in order to make relapse prevention planning work” (Gorski, 2003). Additionally, these prevention strategies have a number of concerns dealing with how to achieve target goals for those involved in the program through an open, honest, and supportive environment. This method of pushing for a specific goal through implementation is often done through keeping tabs on risk and protective factors. These factors “are the primary targets of effective prevention programs used in family, school, and community settings. The goal of these programs is to build new and strengthen existing protective factors and reverse or reduce risk factors” (Preventing Drug Use among Children and Adolescents, 2003). By focusing on the ways to protect the interests of those taking part in the program, its overall sustainability is more manageable even when there are so many factors working against it. Therein, while the problems that arise with the maintenance of substance abuse prevention programs are commonplace and are often dealt with at a number of levels in the organization, maintenance then becomes key to both the success of the program but also in mitigating risk that it faces.
The House of Extra Measures offers “a save, supportive community that is Peer Support driven” where they “teach young men skills that will help them in realizing there is a wonderful life free from alcohol and drugs” (Wegleitner, 2017). The maintenance of the administrative processes of this kind of program is difficult because it is not simply a program of volunteers or of community support. As an organization that must be funded in order to provide healthcare and administrative personnel in order to function, those who are in charge of this form of initiative deal with different issues than other non-profit groups. Unlike other kinds of public initiatives, outpatient treatment programs to prevent relapse into substance abuse must deal with administration much as a hospital or business would need. As outpatient programs have evolved, so have their complexity and “to ensure that programs are effective and financially successful, OT administrators need to be skilled in managing the business aspects of treatment. As they develop strategies, plans, and professional relationships for their programs, executives also need to be efficient, creative, innovative, and future oriented, actively looking for new opportunities” (Substance Abuse: Administrative Issues in Outpatient Treatment, 2006). The development of new methods of peer support and innovative activities can help to promote wellness while working to also prevent future abuse of substances. As a result, these program require constant maintenance and adaptation in order to both remain effective but also to prevent further problems and issues of substance abuse.
In terms of substance abuse prevention when leaving rehabilitation programs, groups such as The House of Extra Measures have a number of key tenets that must be agreed to by anyone who wants to take part in the program. After leaving rehabilitation centers, many people feel as though they are in a position where they are unable to function normally in society or else they might relapse. These programs, as a result, require the attendees to be accountable for a variety of responsibilities in the program itself including a curfew, chores, volunteering, and even counseling if the substance abuse program caused problems with loved ones or spouses before admittance (Wegleitner, 2017). This is important because these kinds of sober homes do not have the same restrictions are rehabilitation clinics and other kind of closed campus programs. “Residents aren’t bound to the sober living home’s campus and can come and go as they please. This allows individuals in recovery to feel like they are easing back into normal life and can start going back to their daily tasks and responsibilities. Although sober living homes are less restrictive than inpatient facilities” they still require structure and a supportive environment to be successful (Sober Living,2016). Many programs like this exist around the country but they are difficult to maintain from an administration’s point of view because every individual must be accountable for their actions even when they are not inside the walls of the building or complex. This reinforces the need for a sense of understanding and group support in these kinds of situations. If a patient does not feel that they are supported or if their stress level increases because of discord within the group home, it is more likely that they will regress into dangerous habits which defeats the program’s purpose. “Part of staying in a sober living home is creating positive camaraderie to reinforce the desire to abstain from drugs and alcohol. This support system allows residents to avoid the isolation that can sometimes come with returning home while in recovery” (Sober Living, 2016). Staying sober is not something that many addicts can do alone and even if the addiction does not exist due to previous issues of abuse, even those who are dealing with programs designed to prevent before substance abuse starts must still overcome peer pressure and personal desire.
Overall, programs such as The House of Extra Measures and other substance abuse prevention programs serve a purpose that is both necessary and honorable in society. People have natural predilection toward certain tendencies and abuse of various substances is just one of these kinds of personal issues. Through maintenance of these programs by strict administrative guidelines, substance abuse prevention programs can flourish and grow. Individuals who enter into these programs need support and reassurance from others and through careful planning and maintenance, the success rate of these kinds of programs can reach levels that would otherwise be impossible.
References
Alcohol & Drug Abuse Prevention Program. (2015). University of St. Augustine. https://www.usa.edu/legal/alcohol-drug-abuse-prevention-program/.
Gorski, T. (2003). How to develop a RP plan. http://www.tgorski.com/gorski_articles/developing_a_relapse_prevention_plan.htm.
Preventing Drug Use Among Children and Adolescents. (2003). National Institute on Drug Abuse. https://www.drugabuse.gov/publications/preventing-drug-abuse-among-children-adolescents-in-brief/chapter-3-applying-prevention-principles-to-drug-abuse-prevention-programs/how-are.
Sober Living. (2016). Avenues, A Recovery Community. https://www.avenuesrecovery.com/our-services/sober-living/.
Substance Abuse: Administrative Issues in Outpatient Treatment. (2006). Treatment Improvement Protocols. (46). https://www.ncbi.nlm.nih.gov/books/NBK64075/.
Substance Abuse Treatment for Persons With Co-Occurring Disorders. (2005). Treatment Improvement Protocol. https://www.ncbi.nlm.nih.gov/books/NBK64185/.
Wegleitner, P. (2017, December). E-mail interview.
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