A realist review of residential treatment for adults with substance use disorder

Salis, Henry F. De; Martin, Rachelle; Mansoor, Zara; Newton‐Howes, Giles; Bell, Elliot

doi:10.1111/dar.13615

Cited by 3 publications

(6 citation statements)

References 77 publications

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“…Of note, data on programs that initiate clients on OAT were unavailable. Several residential addiction treatment programs in the Toronto [ 2 ] and West [ 8 ] regions provide specialized programming to accommodate clients on OAT, which typically include on-site OAT clinics or offer specific provisions available for clients on OAT.…”

Section: Resultsmentioning

confidence: 99%

“…Options for SUD treatment varies widely depending on the preferences and needs of the individual, the type of substances being used, the intensity or severity of their symptoms, and the availability and accessibility of services [ 6 , 7 ]. SUD treatment options can include detoxification/withdrawal management, pharmacotherapy (e.g., opioid agonist treatment [OAT]), and non-pharmacological approaches such as behavior therapy (e.g., cognitive behavioral therapy [CBT]) and counselling [ 7 , 8 ]. Residential programs are another treatment option, aimed at providing an integrated and holistic approach to SUD treatment that includes supporting individuals throughout the continuum of care upon treatment discharge [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…SUD treatment options can include detoxification/withdrawal management, pharmacotherapy (e.g., opioid agonist treatment [OAT]), and non-pharmacological approaches such as behavior therapy (e.g., cognitive behavioral therapy [CBT]) and counselling [ 7 , 8 ]. Residential programs are another treatment option, aimed at providing an integrated and holistic approach to SUD treatment that includes supporting individuals throughout the continuum of care upon treatment discharge [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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An environmental scan of residential treatment service provision in Ontario

Ali,

Law,

Russell

et al. 2023

Subst Abuse Treat Prev Policy

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Background Ontario has one of the highest rates of substance-related harms in Canada. Residential treatment programs in the province provide a variety of in-house treatment services to support the needs of individuals with substance use disorders (SUD). However, these programs are not standardized, often varying in the type, quality, and availability of services offered, including evidence-based interventions such as Opioid Agonist Treatment (OAT). Local treatment systems are also rather fragmented and complex to navigate, creating barriers for potential services users to identify and make informed choices on available treatment options. Methods Between May to August 2023, we conducted an environmental scan to capture available information on all publicly-funded residential treatment programs in Ontario using the ConnexOntario service portal, a government-funded, health services information platform. Data were captured on organization name, geographical location, program description, program type (residential addictions treatment or supportive recovery programs), eligibility criteria, target population, the program’s OAT policies, number of available beds, minimum and maximum length of stay, projected wait times, funding source, and associated fees for program admission. Data were extracted and organized by geographic region, and findings were presented descriptively. Results A total of 102 residential addiction treatment programs and 36 residential supportive recovery programs in Ontario were identified. The scan noted substantial regional variations in program availability and wait times, along with a lack of programs tailored to unique populations such as women, youth, and Indigenous peoples. There is also a paucity of publicly-available information on program offerings, including detailed specifics on OAT policies within residential treatment programs that are crucial to ensuring that the services being offered are safe and grounded in evidence-based practice. Conclusions Findings from the scan highlight notable gaps in program types, offerings, and availability among residential treatment programs in the province, including a lack of standardization on OAT policies across programs. Efforts should be made to ensure access to treatment-specific program information relevant to potential service users and to enhance coordinated access to residential treatment services in the province.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An environmental scan of residential treatment service provision in Ontario

Ali,

Law,

Russell

et al. 2023

Subst Abuse Treat Prev Policy

View full text Add to dashboard Cite

show abstract

“…Additionally, this study could be couched in a different theory. De Salis et al (2023) assessed the outcomes of residential treatment programs using a realist review of the literature. Reviewing literature about substance abuse residential treatment programs, they discovered that “the need to belong, meaning in life, and self-determination theory” (p. 827) were the best explanations of residential treatment outcomes.…”

Section: Future Considerationsmentioning

confidence: 99%

“…For example, when clients of similar backgrounds (context) developed trust/friendship/resources (mechanism), they felt connected (outcome). De Salis et al (2023) identify the challenge of naming a single theory as foundational to residential treatment programs due to the complexity and interrelatedness of the interventions used. As the residential treatment program for spouses of first responders moves forward, it would behove the service providers to attend to the interrelated theories supporting program foundation as they seek to make programmatic changes for the benefit of the people they serve (De Salis et al, 2023).…”

Section: Future Considerationsmentioning

confidence: 99%

Spouses of First Responders: Support for Living With Posttraumatic Stress

Geiger

2024

The Family Journal

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Emergency first responders (police, fire, paramedic, dispatch) engage in work that includes multiple traumas, sometimes leading to posttraumatic stress. Due to work spillover at home, spouses are susceptible to vicarious and secondary trauma. While there are debriefings for traumatic calls for first responders, no such thing exists for the spouses who are the first to provide support at home. There is a lack of availability of resources supporting first responder spouses, particularly those whose first responders are diagnosed with posttraumatic stress disorder. Stepping into this gap is a unique 6-day residential treatment program provided in a secluded location in Northern California, where a small number of clients engage in a program directed by peers who have been through the program themselves, culturally competent clinicians, and chaplains. The therapeutic milieu is supported by psychoeducation, group processing, nutritious meals, daily activity, and an optional daily chapel program. Based on a dissertation, and using Gass’ wheel of change as a framework, this article shares the results of a qualitative study of eight participants' experiences of the program gleaned from in-depth interviews, a review of program agendas, and self-assessment scores pre- and postprogram. Inductive analysis resulted in common themes including a reduction in isolation, anxiety, and depression symptoms, normalization of experiences, and community. Like the insider-researcher author, individuals finding that they have “lost themselves” in the role of first responder spouse identify this residential treatment experience as a “back to myself” program. Further research on program effectiveness via program evaluation is recommended.

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Characteristics of drug users admitted in Lido Rehabilitation Center during 2022

Putri,

Ayuningtyas

2023

IJPHS

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The increasing trend of illicit drug use leaves a huge concern for health and behavioral changes, including in Indonesia. Rehabilitation is a series of treatments designed to help them recover from addiction and its impacts comprehensively. The present study aimed to explore the demographic characteristic and drug use profiles of clients admitted in Lido Rehabilitation Center, the national referral center for drug use treatment in Indonesia, during 2022. A survey study was carried out quantitatively using a 2022 database of client admission in February 2023. Descriptive analysis was performed to present the data as appropriate. The overall total of drug users was 592 clients (569 males, 23 females). The demographic characteristics were dominated by young adults (79.90%), voluntary (74.70%), Muslims (86.80%), high-school-to-higher graduates (74.70%), and employers (61.80%). The drug mostly used was methamphetamines (69.80%) with duration being less than 10 years (75.50%) and addiction level being mild-to-moderate (92.80%). The main reasons for starting drug use were peer/partner pressure (37.18%) and curiosity (29.92%). From this study, we can see that the trend of methamphetamine use in productive ages is still dominating in 2022. Further study is needed to evaluate the outcomes of the treatment they have received during the rehabilitation program.

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A realist review of residential treatment for adults with substance use disorder

Cited by 3 publications

References 77 publications

An environmental scan of residential treatment service provision in Ontario

An environmental scan of residential treatment service provision in Ontario

Spouses of First Responders: Support for Living With Posttraumatic Stress

Characteristics of drug users admitted in Lido Rehabilitation Center during 2022

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