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Finding sobriety at home
New kind of in-home drug treatment underway in NH

02/02/17
By Ryan Lessard news@hippopress.com



 Getting the intensive care of an inpatient treatment program while living at home is now an option for addicts in New Hampshire.

Aware Recovery Care, a for-profit company, opened its Bedford location Dec. 1, and Anthem Blue Cross and Blue Shield, which has contracted to cover the program, hails it as a game-changer. But state officials say it’s too soon to tell how big a difference it will make.
 
The traditional model
In order to best understand how it works, it’s important to look at the traditional addiction treatment models and how they differ. 
“The old model of 25 days in a residential setting and then you go home and you have nothing has really been shown that that doesn’t solve the problem,” said Anthem Chief Medical Officer Dr. Richard Lafleur. 
A press release from Anthem cites research that shows traditional treatment is a revolving door; some shows 87 percent of patients admitted to detox units in New England have previously been admitted and more than half have been there more than five times. 
Data also show about 75 percent of patients in residential treatment programs have been in the programs multiple times.
 
Matt’s story
Matt Eacott, 33, is the vice president of Aware Recovery Care, a certified recovery advisor and a former patient in the program. Before enrolling in the in-home treatment program, he had taken part in numerous treatment programs.
“In 10 years, I had gone to 15 treatment centers, I had violated probation seven times, I had gotten arrested probably eight or nine times and it would happen almost yearly or more often than that,” Eacott said. 
Drugs had played a role in Eacott’s life since high school. It started with marijuana and mushrooms. When he got into Clark University in Massachusetts, he fell into a bad crowd and neglected his studies. After he was placed on academic probation, his drug use escalated. 
Eacott was introduced to pills: Vicodin, Percocet and OxyContin. He was soon addicted and began robbing people to feed his habit. He eventually had to move back to Connecticut to live with his parents and participate in a court-mandated six-week IOP program. 
It wasn’t until after he completed that program, around the early 2000s, that he started using heroin.
Over the course of a single year, Eacott’s usage ramped up from five bags of heroin a day (each bag is about .1 grams) to 85 bags a day. He started to sell heroin to afford the hundreds of dollars required to pay for his daily diet of opioids and even devised a scheme to create counterfeit heroin to stretch his profits.
Whenever he was in traditional treatment programs, Eacott was enthusiastic about getting sober and engaged in the process. But within days or weeks of being released, he was back to using again.
“At least for me, I couldn’t transfer what I had learned to the real world,” Eacott said.
The problem, Eacott said, is he would have all kinds of support when he was in a controlled environment, but once he graduated from a program, drugs were more available and he didn’t have the same supports.
Finally, Eacott got to be part of an experimental new program that would become Aware Recovery Care. With the in-home treatment, a team of specialists is assigned to a patient and gets their family involved in the treatment and recovery process. Based on the visiting nurse model, the team includes an addiction psychiatrist, an addiction nurse, a licensed marriage and family therapist, and individual therapist and a certified recovery advisor. 
And the program lasts for a whole year.
“Having a team of professionals basically following me and supporting me and at my disposal and guiding me, mentoring me all throughout the year, while I was experiencing triggering events and just basically life on life’s terms, made the difference for me,” Eacott said.
 
Limited scope
Eacott said that since the home environment plays such a critical role in the program, some homes are more ideal than others.
“Our ideal client is someone who has a home environment that is somewhat stable,” Eacott said.
The state’s drug czar, James Vara, said since it’s only available right now to private payers and Anthem members, it’s not likely to make a huge dent in the addiction problem facing the state.
Eacott said right now there are about 12 to 15 patients in the state  in Aware, which is available in the six southern counties. He said in-home treatment is so new, other insurers don’t recognize the model yet, but he hopes to change that. Right now the company is working to get covered by Medicaid.
Still, it’s unclear if this model would be possible for a larger population. While it saves overhead by not relying on its own residential facilities, it is labor-intensive and New Hampshire is struggling with a medical workforce shortage.
“Is it scalable? I think time will tell,” Lafleur said. 





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