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Alcohol monitoring promotes accountability

October 5, 2011
by Lavance Northington, MBA
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Technology is exploding, changing our world by the minute. Medical equipment is transforming the medical profession rapidly. Computers grow old in months. Cell phones are constantly updating from 3G to 4G to 5G and beyond, faster than we can purchase them. Technology is literally changing the way we do everything, but are we leveraging technology to our advantage in the substance abuse treatment profession?

According to National Survey on Drug Use and Health data from the Substance Abuse and Mental Health Services Administration (SAMHSA), 23.5 million people ages 12 or older needed substance abuse treatment for an illicit drug or alcohol problem, but only 2.6 million were treated in a specialty facility. Most people admitted (41.4 percent) were treated for alcohol abuse.

Along with the specialty facilities, there are many options available for the general public, including 12-Step programs and court-mandated treatment services. Alcoholics Anonymous (AA) has an estimated 1.3 million members in the U.S., but because anonymity constitutes a major focus of the program, it is very difficult to determine success rates accurately. Critics of court-mandated rehab point out that a large number of the people assigned to these programs fail to complete treatment, and therefore relapse rates are high.1 And to top it off, statistics show that 90 percent of alcoholics who go through any form of treatment will relapse at least once in the first four years following treatment.

In contrast, Physician Health Programs (PHPs) have developed one of the most successful models of recovery management. PHPs treat addictions as long-term chronic disorders, and in the process have set a new and far higher standard for outcomes.2 Two programs with above-average success rates are Hawaii's Opportunity Probation with Enforcement (HOPE) program designed for probationers and the 24/7 Sobriety Project in South Dakota focusing on driving while intoxicated (DWI) offenders.

HOPE intensely monitors through use of randomized drug testing. After a year, probationers were 55 percent less likely to be arrested for a new crime, 72 percent less likely to use drugs, 61 percent less likely to miss appointments with their supervisory officers, and 53 percent less likely to have their probation revoked than standard probationers.3

24/7 Sobriety utilizes intensive alcohol and drug testing as well, and further monitors offenders by twice-daily alcohol breath tests (conducted at a local police station) or transdermal alcohol monitoring bracelets. In data collected from 24/7 Sobriety, the vast majority of all tests were negative: 99.6 percent for twice-daily alcohol breath tests, 98 percent for urinalysis tests, and 92 percent for drug patches.3

What the PHPs, HOPE and 24/7 Sobriety have figured out is that monitoring promotes accountability. We must stop treating the symptoms and make people accountable for their behavior. People struggling with addiction need to know that their actions have consequences.

Process takes time

Long-term behavioral changes take time. PHPs monitor doctors for up to five years. The recovery process does not end when an individual completes a rehabilitation program. Treatment is just the beginning of a lifelong process of growth in all areas of life that have been affected by addiction.

According to an independent market research study conducted by Jeri Davis International, “The future window of opportunity lies in monitoring client progress and intervening in the time between treatment admissions.”

A few of the downfalls cited by opponents to long-term monitoring are cost; uncomfortable and bulky monitoring devices; and daily schedule interruptions due to randomized testing. We believe that our new technology coming to the market, SOBERLINK, offers an attractive option.

Regular monitoring

SOBERLINK'S technology remotely monitors a person's blood alcohol content. SOBERLINK is a patent pending medical breath analyzer that simultaneously determines one's blood alcohol content, takes the person's photograph, and gathers his/her GPS location. The device then compiles that information into a sobriety report that is transmitted to a web-based monitoring portal for a rehab facility or other designee to review. Because breath assays are insurance reimbursable via the American Medical Association CPT codes, SOBERLINK will generate an additional income stream for aftercare support.

Technological breakthroughs such as this can increase success rates for a variety of treatment programs. They can allow residential facilities to monitor clients who receive a “day pass” from their primary facility. In step-down, aftercare programs, monitoring can become part of a client's behavioral contract, providing a transitional bridge when preparing clients to re-enter society. SOBERLINK can provide substance abuse professionals with immediate feedback of their clients' sobriety, establishing a sense of mutual trust and accountability.

Similar uses are envisioned in corporate employee assistance programs (EAPs), the justice system, and child and family services. Corporate America can implement intense alcohol monitoring for employees recommended for long-term monitoring by SAPs, for example.