Medical Services
ATCNE is a clinically operated drug treatment program, designed to provide a safe and therapeutic environment so that clients may gain control over their drug problems and learn alternatives to their addictive behaviors. Methadone services are an effective treatment for narcotic dependence. The administration of methadone helps clients cease illicit narcotic use and begin the process of recovery and abstinence from all drug use. However, outpatient methadone treatment is not always sufficient to achieve this goal. It is the responsibility of ATCNE staff to determine which clients can benefit from outpatient methadone treatment. The policies described in this manual are designed by the administrative, medical, nursing and clinical staffs to help clients realize these and other treatment goals.
- The Dwyer Program - The Addiction Treatment Center of New England provides an outpatient treatment program designed specifically for individuals whom are being treated for opiate addiction with Suboxone. The full program is designed to operate in cooperation with the prescribing doctor, and works to promote recovery principles and support through group and individual therapy.
- Methadone Detox - This service is available to clients who are addicted to opiates and desire detoxification from them...
- Methadone Maintenance - This service is available to clients who need longer-term methadone treatment than that offered for detoxification...
- Drug Free Counseling - Individual, group, couples and/or family therapy is available to clients who have problems with drugs, but are not in need of methadone detoxification or maintenance...
- Medical Care - The ATCNE Medical Director or designee will perform a physical examination on each client prior to admission...
- Voluntary Pre & Post-Test HIV Counseling and Antibody Testing - Confidential pre- and post-test counseling and HIV antibody testing is available to any and all clients on a voluntary basis...
- "Orientation" & Health Education Groups - ATCNE requires that all new clients complete a 4-week orientation/education group...
- Case Management - Case management services are available to all ATCNE clients...
- Service Delivery Staff - Decisions about qualifications to deliver services are made by the ATCNE Administrative Staff...
- The Dwyer Program
The Addiction Treatment Center of New England provides an outpatient treatment program designed specifically for individuals whom are being treated for opiate addiction with Suboxone. The full program is designed to operate in cooperation with the prescribing doctor, and works to promote recovery principles and support through group and individual therapy.
After an initial screening to determine eligibility for the program, clients are given a full psychosocial assessment and are drug-tested. Random drug tests are also performed throughout the program, and results of these screens will be available to the prescribing doctor. Each month a status report will be compiled on each client in the program, and this report will also be sent to the prescribing doctor in order to better monitor each client's progress.
Group and individual counseling occurs on a weekly basis, and will primarily utilize Cognitive Behavioral and 12-Step Recovery principles. Case management services are also available to assist with referrals to other resources and further treatment. It is the goal of the Addiction Treatment Center of New England to provide a comprehensive treatment program that will better support individuals being treated with Suboxone in cooperation with the medical professionals whom are prescribing the medications.
Services Provided by the Dwyer Program
- Initial intake and psychosocial assessment.
- Weekly group and individual therapy.
- Treatment planning services.
- Random drug screening.
- Case management and referral services.
- Monthly status reports to prescribing doctor outlining progress of client.
- Methadone Detox
This service is available to clients who are addicted to opiates and desire detoxification from them. The medical director prescribes an initial stabilizing dose of methadone, which is then decreased over a period of 30 to 180 days to gradually reduce the client's physiological need for opiates. Decisions as to length of time needed to complete detoxification will be made by the clinical, medical and nursing staffs based on the individual's addiction history, physical condition and other related factors. A minimum of one individual and one group therapy session per week are required while the client is being detoxified. These sessions may continue at the client's request and at the discretion of the ATCNE staff, once detoxification is completed. Decisions about the need for additional weekly individual and group therapy will be made on a case by case basis. Medical care, family therapy and social service referrals are also available to clients. Transfers between detoxification and maintenance programs will only be made with Medical Director's authorization.
Return to Top - Methadone Maintenance
This service is available to clients who need longer-term methadone treatment than that offered for detoxification. In maintenance treatment, the client receives an initial dose of methadone, which is increased to a level where the client feels stable. All maintenance clients are required by ATCNE to complete a treatment orientation workshop during the initial weeks of treatment. Weekly individual and group therapy at ATCNE is required of all clients. The clinical team will determine the need for additional individual and group therapy sessions. Medical care and social service referrals are also available.
Return to Top - Drug Free Counseling
Individual, group, couples and/or family therapy is available to clients who have problems with drugs, but are not in need of methadone detoxification or maintenance. Medical care and social service referrals are also available to these clients. Drug free counseling is encouraged as a form of aftercare for clients who have successfully detoxified from methadone treatment.
Return to Top - Medical Care
The ATCNE Medical Director or designee will perform a physical examination on each client prior to admission. The physician will confer with the client to prescribe a dose level according to state and federal regulations and admit the client. Any lab tests required by State and/or Federal regulations and any additional lab tests and follow-up care deemed necessary will also be ordered.
By accepting admission to ATCNE, each client makes a commitment to obtain necessary medical care, as determined by the ATCNE medical staff. The Medical Director or program physician does not serve as the client's primary physician. ATCNE recognizes a client's right to refuse unwanted tests or medical care. However, ATCNE also retains the right to discontinue provision of services (including methadone) to any client who, in the informed opinion of the Medical Director or program physician, is not benefiting from treatment. This includes, but is not limited to situations in which a client's health status may be jeopardized by receiving methadone without the recommended and adequate medical care, or the lack of medical attention to an identified problem jeopardizes the health of others who may come into contact with that individual.
Clients with significant medical and/or psychiatric problems will be referred to appropriate providers for care. If a client repeatedly or consistently fails to access or follow-up with such treatment, ATCNE medical staff, with the approval of the Medical Director, may determine that continued treatment with methadone constitutes a risk to the client. In such cases, continued failure to access and/or follow-up with necessary treatment may result in detoxification and termination from the program.
Clients who are taking prescribed medications, including but not limited to tranquilizers, sedatives, sleeping pills, antidepressants, anti-psychotic drugs, and over-the-counter medications, must inform ATCNE Nursing staff of the medication and dosage of every prescription and refill. Clients are responsible for informing the ATCNE Nursing staff of any changes in their medication. The Center medical staff, with the approval of the Medical Director, may determine that the use of such medication, whether prescribed or non-prescribed, constitutes a danger to the client who is receiving methadone. In such cases, ATCNE staff, after discussion with the prescriber and the client, will attempt to achieve a mutually satisfactory solution, which may include a recommendation for outpatient or inpatient detoxification. Client failure to follow such a recommendation may result in termination from the program after detoxification.
Return to Top - Voluntary Pre & Post-Test HIV Counseling and Antibody Testing
Confidential pre- and post-test counseling and HIV antibody testing is available to any and all clients on a voluntary basis. The counseling component includes a risk assessment to evaluate client behavior that may lead to risk of exposure to infection and to educate the client about behavioral changes that reduce the risk of exposure once pre-test counseling is completed, the client will be referred for testing at the mutual agreement of the client and his/her therapist. Clients are expected to continue meeting with their therapist while awaiting test results as well as after receiving the results. HIV infection is a reportable condition in Massachusetts. Positive HIV results will be reported to the Department of Public Health using a code that does not identify the client by name.
Return to Top - "Orientation" & Health Education Groups
ATCNE requires that all new clients complete a 4-week orientation/education group, to learn information about the policies and procedures of ATCNE, methadone maintenance, HIV, and Hepatitis C.
ATCNE may also offer other health maintenance educational groups such as Health and Nutrition Issues, Stress Management, Medical Aspects of Substance Abuse and other health related concerns, based on client need.
Return to Top - Case Management
Case management services are available to all ATCNE clients. Case management services include referral for benefit programs, vocational training, job placement, housing, legal services, child care, psychiatric services, self help programs, HIV services, medical and dental care, detoxification and alternative substance abuse programs.
Return to Top - Service Delivery
Decisions about qualifications to deliver services are made by the ATCNE Administrative Staff. ATCNE employs staff, which is, by virtue of their experience, training, and/or education, qualified to deliver treatment services.
Physicians and nurses must hold current and valid Massachusetts's licenses to practice in their respective professions.
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