Co-occurring Disorders Going Home

Many patients have co-occurring disorders (COD) substance use disorders. Opioids are often involved and put patients at risk of frequent re-hospitalizations due to poor follow up with outpatient treatment and relapse.

Several years ago, we added the innovative Ongoing Abstinence Recovery Schedule™ (OARS) to our COD program. OARS participation is voluntary and open to all MCES co-occurring inpatients. In OARS, staff guides patients in developing a personal OARS daily/weekly recovery schedule geared to sustain a sober lifestyle after discharge.

OARS has proved effective in reducing readmissions for a significant number of participating COD patients. OARS works because it aids patients in retaining the benefits of inpatient treatment and maintaining a structured life style and self-discipline on return to community living. Individuals with both psychiatric and substance use disorders may struggle more to comply with aftercare plans than those dealing with only one of these conditions.

However, for various reasons, some COD patients appear to need ongoing support to use their OARS daily plan effectively. In many cases, family situations and housing arrangements may not be conducive to maintaining sobriety and working toward recovery. Even when attended, supports such as AA or NA groups, and appointments with outpatient providers may leave large swaths of open time that can be problematic.

MCES plans to expand OARS to include a substance use counselor to identify patients likely to have problems after discharge and continuing to work with them on at least a weekly basis in their home settings. This is expected to lessen both the likelihood of both re-hospitalization and possible overdoses due to resumption of substance use.