Interventions: A Reachable Moment

An intervention offers a lifeline…

We know what a teachable moment is…

Hardly a news cycle goes by that we don’t hear the expression “This is a teachable moment!” It is one of those phrases that catches our attention and makes us consider what we have learned from a particular life event. Educators really like the term. Politicians like the term. Medical professionals like the term.

Just today if you search the news for the term teachable moment, here are a couple of headlines that stand out:

 

Have you heard of a reachable moment?

The word reachable is adjective that we often use to better define a goal, like a reachable milestone. We might think of the word attainable or possible.  Or we might think of the verb “reach” and consider how we often find ourselves wondering if all of our love and concern actually “reaches” our loved one.

In late June we happened upon a news story that talked about “reachable moment,” it took us by surprise.

 

Mass General will screen all patients for substance abuse…

On June 30, 2014, The Boston Globe published this article: MGH to screen all patients for substance abuse…Querying part of effort to treat addiction.

When you first peruse the headline you might find yourself thinking “doesn’t every hospital in the United States screen patients for substance abuse?” For the most part, it is true that if you present yourself to an emergency department, then during the quick history and physical you most likely will be asked questions about alcohol use or drug use, particularly if you appear to be impaired and suffering from trauma.

However, according to CBS Boston: “Massachusetts General Hospital (MGH) plans to begin questioning all patients about their use of alcohol and illegal drugs starting this fall, even if they are at MGH for a totally unrelated issue.”

 

A bedside intervention…

Dr. Sarah Wakeman is the medical director for substance use disorders at MGH’s Center for Community Health Improvement. She shared with The Boston Globe that nearly 25% of all patients hospitalized for routine medical problems also have active substance abuse disorders. So by asking critical questions of each patient during the hospital stay becomes “a reachable moment” or a bedside intervention. 

The particular questions might include:

  • How often have you had six or more drinks on one occasion?
  • How often have you used illegal drugs in the past year?
  • Do you use prescription medication for nonmedical reasons?

“Mass. General recently studied 2,583 patients with identified substance abuse disorders who were in the hospital for various medical problems — some related to addiction — and found they had longer stays and higher readmission rates than other patients. The cost of their care averaged nearly $10,000 per admission, 40 to 50 percent higher than the cost of treating patients with other chronic conditions such as congestive heart failure and pneumonia.” 

So how will this all work?

Well, in the first place, this new program will cost a considerable amount of money.  Mass General is planning to spend $1.4 million per year on this new addiction screening and treatment program. If the patient answers the screening questions in such a way that indicates overuse, then one of the hospital addiction team will visit the patient and encourage a more in depth conversation about their life and habits.

Mass General plans to hire five “recovery coaches.” They will work at the main hospital and the three community health centers. The coaches are former substance abusers and are certified by the state. Coaches will take people to Alcoholics Anonymous and work with them to follow a treatment plan both inpatient and outpatient.

Interventions require a plan…

In life even the best laid plans can go by the wayside, but to start a new treatment modality requires arduous planning and fine tuning. We are anxious to see how the Mass General plan works out. Interventions require planning.

The interventionist will then derive a treatment action plan that can be executed immediately. The immediacy of getting a loved one the help they need is well understood and the interventionist will act with the same immediacy to fulfill the treatment action plan, which will consist of the following:

  • A determination of the need for an intervention – sometimes when the loved one has already agreed on receiving treatment, a recommendation will be made that don’t involve an intervention.
  • Arrangements to execute the intervention (travel, timing, special needs and considerations for the time, place and type of intervention).
  • Pre-intervention counseling and advisement – thorough determination of what families need to prepare such as verbal or written statements to the loved one and what to expect emotionally during an intervention.
  • The intervention.
  • Transport to treatment, either with the addicted, family or interventionist or via scheduled travel arrangements to the recommended treatment center.

This process highlights that in challenging and emotionally vulnerable situations, we can’t do things alone. Just as people need support groups and spiritual practice to lessen their burdens, loved ones of addicts need professionals to guide them through the process of getting addiction help – it cuts the stress and turmoil tenfold and can end of being the best investment to make in the life of a loved one.

If you would like to consider a treatment action plan for a loved one, please click here to learn more about the exact next steps to take and click here to learn about the success rates of the Southern California interventionist.

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