It's not as simple as some may think

Dear Editor,

In response to statements published recently by The Evening Sun regarding the growing drug and alcohol abuse problems in our community; and as a member of the treatment team at Chenango County Alcohol and Drug Abuse Service (ADAS), I want to the share a little bit of what we have to offer.

We are a county-operated program, licensed by the New York State Office of Alcohol and Substance Abuse Services (OASAS) and are required to follow state and federal regulations regarding outpatient treatment. We currently have seven counselors who work with individuals and their families, many with both substance abuse and mental health issues. We offer a variety of services including individual and group counseling, psychiatric services, vocational case management, and medical screening.

We accept referrals from multiple sources. In general, referrals are from hospitals, primary care physicians, probation, court, drug treatment court, employers, inpatient substance abuse treatment programs, psychiatric hospitals and the DMV. We also welcome “self-referrals;” people who identify themselves as having a problem with substances and would like services to assist with living a life in recovery. It doesn't matter where the referral is coming from, we make every effort to engage and understand each unique individual.

The first thing you can expect to happen when you arrive at the ADAS is to meet with a clinician who will gather information and seek to better understand you and your situation. This involves talking and exploring several areas of your life, not just substance abuse and mental health, but also family, legal issues, physical health, social and leisure activities, and community supports. During this appointment we will explore your wants and needs regarding treatment, and what you hope to achieve as a result of treatment.



During the evaluation process, we are also assessing the level of care that will be most appropriate and effective. Most often outpatient treatment is appropriate; however, at other times a more intensive or immediate level of care is indicated. And, in some cases inpatient care may be necessary.

One of the levels of inpatient care is known as detoxification or "detox." Because, in some circumstances, attempts to withdraw “cold turkey” from alcohol or benzodiazepines can be life threatening, medical detox treatment takes place in a medically supervised setting. Withdrawing from opiates can be difficult and extremely uncomfortable. Many people suffering from opiate withdrawal would prefer to be medically detoxed to manage the symptoms; but, due to the low risk of death most insurance companies will not pay for medical detoxification services for opiate withdrawal. The reality is that opiate addicts have a higher risk of death from using and overdosing, than they do from withdrawing. There are medical detoxification programs in the area, and if indicated, our agency will refer individuals to those programs.

A recently published Viewpoints article once again suggested the need for an inpatient treatment program to be located in Chenango County. The reality is that there are multiple licensed inpatient treatment programs within New York State. We work with programs which are geographically close, such as New Horizons in Binghamton; Delaware Valley Hospital in Walton; Tully Hill in Tully; McPike in Utica; Syracuse Behavioral Health in Syracuse; and Conifer Park in Glenville.

It may surprise you to know that there are plenty of inpatient beds available throughout the state; and each day, many of these beds remain empty. You may ask, “How can this be when so many are seemingly in need of that level of care? Why are some inpatient programs closing because they are no longer fiscally sustainable?” The answer is because the decision to access is primarily made by the payer - the insurance company. Every day we work to navigate a very complex insurance reimbursement network in order to advocate for the needs of our clients. We work with people on a daily basis that we know require a higher level of care, but are unable to access that care because we cannot obtain pre-authorization from their health insurance company.

The rules within the insurance networks are constantly changing and we, as providers, are required to stay informed of these changes. For example, if an individual is covered by a Medicaid managed care product, they must first be unsuccessful two (2) times in one calendar year at the outpatient level before approval will be granted to access inpatient care. The reality is, there are very few people who get approved for inpatient care and the associated costs make it impossible for most to pay privately.

It's also important to know that inpatient programs have reduced their length of stay. Insurance companies typically will not pay for stays longer than 14-21 days. That doesn't allow for much time to address an addiction that has a strong hold on an individual's life. Due to the shortened length of stay, individuals discharged from inpatient programs are often in a very fragile condition and at risk for relapse, further complicating treatment at the outpatient level.

Not all people suffering from addiction need the intensity of an inpatient program. Many are able to work on recovery in an outpatient setting and make the necessary changes in their life to avoid the people, places and things that prompted the abuse. This can be done with the assistance of individual counseling, group therapy and healthy/sober community supports, such as Alcoholics or Narcotics Anonymous. We need to make sure there are options in the community to fit the individual’s specific needs.

During one of my group therapy sessions, I asked a room of 16 people who have struggled with addiction, “What are the answers?” Many are aware of the recent articles in the newspaper, and certainly are aware of the “drug epidemic” we are facing in Chenango County because they are living and breathing it. Their answers were honest. "People have to WANT it.” When asked for clarification, they responded, “People have to want to be clean and sober. People have to want recovery. People have to reach their own breaking point".

Everybody’s breaking point is different. For some, it may be getting arrested and going to jail, for others it may be having their children taken away, and for others, it may take a near death experience.

Hopefully, this article has provided information about the services offered at ADAS for individuals and family members who are struggling with an addiction. My name is Amber Oliver. I am a New York State Licensed Clinical Social Worker at Chenango County Alcohol and Drug Abuse Services. If you have any questions, comments or suggestions, please feel free to contact me or any of my colleagues at (607) 337-1680.

ADAS is an NYS OASAS licensed program and operates under the auspice of Chenango County Community Mental Hygiene Services. For more information about the services we offer, please visit our website at www.co.chenango.ny.us/mental-hygiene-services/.

Signed,

Amber Oliver

Chenango County Community Menal Hygiene Services

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