Photo By Marcy Sanchez | (From left) Danya Cheek, medical support assistant, Addiction Medicine Intensive...... read more read more
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The Addiction Medicine Intensive Outpatient Program, the first-of-its-kind at Fort Bliss, opened its doors to offer intermediary rehabilitation for service members at Fort Bliss, July 5.
The program provides a level 2.5 level of care based on the American Society of Addiction Medicine’s (ASAM) continuum of care which describes treatment as a continuum marked by four broad levels of service and an early intervention level. The lowest level of care, according to ASAM, is at level 0.5, early intervention, with the highest being at level 4, medically managed intensive inpatient services.
“The Fort Bliss (AMIOP) has an actual physician trained in addiction medicine embedded to the program,” said Gisela Carter, clinical chief, AMIOP. “(Patients) receive treatment for 30 hours per week for 6 weeks.”
The program, a heightened level of care from the Army’s Substance Use Disorder Clinical Care (SUDCC) treatment program, differs from SUDCC by approaching addiction with a full schedule of therapy modalities designed to keep patients engaged and practicing methods toward rehabilitation.
“Addiction is a neurological brain disease, not a mental disorder,” said Maj. R. Joel Bush, addiction medicine physician. “We need to treat it like diabetes or high blood pressure. If I have diabetes and my diabetes gets bad I’ll have to go to the doctor. If it gets worse, I’ll have to go to the doctor more often. If it gets bad enough, I’ll have to be admitted somewhere.”
Bush adds that patients should be referred to the appropriate levels of care required for their condition, a gap that existed between SUDCC and inpatient admission prior to the opening of the AMIOP.
According to the American Society of Addiction Medicine (ASAM), addiction is defined as a dysfunction in brain reward, motivation, memory and related circuitry leading to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.
“There’s actual tissue damage involved, organs damaged,” said Bush, on the effects of addiction. “It’s not just a chemical imbalance, there’s actual rewiring that happens inside the brain, you have to treat it, there’s no cure but we have good treatments for it.”
“A disease of this magnitude that affects millions of people in the U.S. alone should be regarded with the same respect as any other disease because it is a medical disorder,” said Carter. “The patients are introduced to recovery through a variety of methods including learning about the scientific and medical models of addiction and other components provided by successful 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous.”
The implementation of the program on post may also mean a more seamless transition for service members during rehabilitation.
“Instead of having (service members) go somewhere for inpatient care, they can stay here with their families,” said Carter. “They’re not pulled out of their environment where they have to function after coming back from treatment. If a patient goes to a controlled environment for four to six weeks they might struggle adapting when they return. The AMIOP setting allows them to process their daily challenges as they happen and learn healthier ways to cope and respond.”
Initially the clinic will only be available to active-duty service members but family members are encouraged to play a support role in recovery. The program’s evidence-based treatments include medical, cognitive behavioral, and group therapies, as well as holistic treatments such as meditation, yoga and pain management practices.
The AMIOP’s interdisciplinary approach encompasses various modalities available at Fort Bliss to customize to patient’s needs during their rehabilitation.
“This is what an addiction program should look like, just like any other medical problem, it should be treated with each part of what would help it,” said Bush, a native of Warner Robins, Georgia. “Our goal is to try to be as adaptable as possible to what the patient needs. We don’t want to just blindly adhere to the same approach for everyone.”
Flexibility is also a key element in ensuring a successful rehabilitation as the clinic will be the intermediary level of care between inpatient and SUDCC programs at Fort Bliss. The leeway in the program will also allow for extensions or decreases in admission length, depending on a patient’s progress.
“If a patient isn’t ready to go home, then they’re not ready,” said Bush, one of the Army’s only addiction medicine-trained physicians. “We’ll extend them so they can land as softly as they can. We need to be willing to give the patient the level of care they need.”
“The final goal will always be rehabilitation for the Soldier so they can continue with their mission, we hope to get them to a point where it’s manageable and they know how to deal with addiction, because there is no cure,” said Carter.
Multiple referral options exists for service members seeking treatment including self, physician and command referred. All patients are required to enroll in SUDCC prior to seeking higher levels of care.
| Date Taken: | 07.24.2017 |
| Date Posted: | 07.24.2017 16:13 |
| Story ID: | 242391 |
| Location: | FORT BLISS, TX, US |
| Hometown: | WARNER ROBINS, GA, US |
| Web Views: | 1,045 |
| Downloads: | 0 |
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