For decades, the traditional thinking in recovery communities was that getting sober was mind over matter, and that with enough support and dedication anyone could overcome addiction. However, the opioid epidemic and the fierce physical dependency that opioids cause has challenged that idea and shown the need for a new approach to treatment that combines traditional treatments with medication-assisted treatment.
The Hazelden Betty Ford Foundation has long been at the forefront of addiction recovery science, and is again leading the change with its medication-assisted opioid treatment program, called Comprehensive Opioid Response with 12 Steps (or COR-12).
“Our clinical leaders felt this was something we needed to do because people were leaving our programs before treatment was complete. And some were dying,” said Terri Hayden, executive director of the Hazelden Betty Ford Foundation’s St. Paul campus.
The Hazelden Betty Ford foundation conducted a “searching and fearless moral inventory” of its best practices, and realized that more could be done to save the lives of people addicted to opioids by helping them succeed in treatment.
The result was the COR-12 program. The program uses medications as well as psychological and psychiatric care and addiction treatment including 12-step counseling in order to best serve people who are addicted. The program is unique in that it uses medication-assisted treatment in conjunction with, but never as a replacement for, 12-step recovery. While the goal will always be abstinence, patients in the COR-12 program stay on their assistive medications through detox and beyond.
Rather than being physically uncomfortable during treatment, patients who are receiving medication-assisted treatment can focus on making progress with their emotional and mental health, an important step toward long-term recovery.
The program offers long-term engagement of at least four months, with the possibility for support for up to two years, and fully integrates a patient’s mental health, medical and addiction treatment.
The results were striking. While 21.55 percent of opioid-dependent clients using traditional non-medication-assisted treatment discharged before completion, only 6.24 percent of patients in the COR-12 program did so. That means that the odds of an early discharge resulting in not completing treatment were 3.5 times higher for opioid-dependent clients who did not receive the COR-12 program.
People engaged with the COR-12 program also had longer lengths of stays (nearly double those of people treated without medication-assisted treatment), and were more likely to engage with another program after upon completion.
The increased engagement meant better sobriety outcomes. Six months after beginning treatment, 71 percent of the COR-12 clients were abstinent from opioids, compared with just 52 percent of clients receiving traditional treatment.
“The longer you’re engaged, the better the outcome will be,” Hayden explained. “Those patients that were prescribed medications and stay on them have better outcomes.”
The COR-12 program was piloted as both residential and outpatient treatment programs in Minnesota, but The Hazelden Betty Ford Foundation has expanded the offering to other locations throughout the United States.
Overall, practitioners and administrators at the foundation are happy to have found a solution that is improving outcomes in the fight against opioid addiction.
“It’s exciting,” Hayden said.
Although the approach was controversial in the 12-step community at first, The Betty Ford Foundation realized that saving lives was their most important goal.
“Opioids are very different because they’re so physically addicting. We have to address this population differently than people who abuse alcohol, meth or cocaine,” Hayden said. “We have to adapt to a changing drug culture. If we stay the same, people die.”
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