August 6, 2012
By Kristin Ellis
Though an average civilian substance abuser requires six to seven admissions to a treatment facility before achieving sustained sobriety, a new military addictions program at Fort Belvoir Community Hospital aims to expedite that process and yield better, more long-lasting results.
“The military can’t wait that long,” said Fort Belvoir Community Hospital’s Chief of Addiction Medicine Dr. Anthony Dekker. “We need higher success rates, to be cost-efficient, and to serve the mission of the military to maintain the fighting force.”
In partnership with Joint Task Force National Capital Region Medical, Belvoir Community Hospital launched an intensive Substance Abuse Residential Treatment Program in May for active-duty service members with alcohol and substance dependent disorders and dual diagnosis disorders such as post-traumatic stress disorder, known as PTSD, and traumatic brain injury, or TBI.
The residential program is the last piece to the comprehensive model aimed at reducing relapse rates, ensuring continuity of care and providing proper oversight to military members in the National Capital Region.
The 20-bed, inpatient section is one of nine departments in Behavioral Health at Belvoir Community Hospital and offers round-the-clock comprehensive care for those in need of the highest level of intervention. In a military population, there is a higher incidence of PTSD, combat trauma, and chronic pain than in the civilian world, and the hospital’s residential program specifically addresses those issues.
“We have thought of the adjacencies and integration of the different services from the beginning,” said Lt. Col. Jeffrey Yarvis, deputy commander for Behavioral Health. “We’re not looking at one piece of the puzzle, we are looking at the whole system so the warrior is not out there alone and isolated. Occupational therapy, physical therapy, TBI, we all stand shoulder-to-shoulder here.”
Prior to the start of this program, service members with substance abuse disorders would be sent out to civilian treatment centers around the country, making it difficult to monitor their recovery. Joint Task Force CapMed evaluated the current model, the challenges, and designed this program to ensure no warriors are lost in the system.
For many, the military is like a pseudo family, explained Maj. Joshua Morganstein, behavioral health officer for JTF CapMed. In a sense, that gets broken when a service member is removed from his unit. The likelihood of a service member returning to their unit decreases the farther he is from his command.
“We’re keeping people inside the fold here,” he said. “The civilian world is vastly different than the world of a service member. It’s not that they don’t deliver quality care, but they are unable to reproduce the environment that a military treatment facility can.”
By having all aspects of care being met at one place, service members are treated by a continuous team and don’t require an extensive repeat assessment any time the level of care changes. It’s in these gaps of time in treatment where accidents and relapses can happen.
Although relapse is expected, by keeping all of the services in one place the continuum of care can be maintained and service members won’t have to be sent back and forth to different facilities.
“Multiple admissions are the rule, not the exception,” Dekker said.
About 50 percent of civilians will be using drugs or alcohol within the first year after they have completed treatment. The residential treatment facility at Eisenhower Army Medical Center at Fort Gordon, Ga., has a relapse rate of 27 percent, Morganstein said.
“In the military world there is a high level of monitoring, command-directed intervention,” Dekker said. “This is not the case in the civilian world. If they had the same level of scrutiny in the civilian world, they would have higher rates of success.”
Family and environment also play a big role in relapse and recovery and the Substance Abuse Residential Treatment Program is designed to engage the family in intervention strategies.
“There is a very subtle but powerful impact on the family structure,” Yarvis said. “Just like you transmit your healthy values, you transmit the toxic.”
With the “one team” approach, the command, patient, treatment team, and family all have one objective: successful treatment.
“Treatment is more than just four weeks in a hospital,” Dekker said. “It’s a commitment to a change in how someone lives. By helping this person become sober, we help them become human again; to live again.”
The residential treatment program provides service members with those tools through evidence-based addiction intervention for successful recovery.