America is in the grip of a drug epidemic and it is quite evident that traditional, inpatient treatment modalities were unable to dent the addiction curve. Consequently, it is imperative to support innovative, outpatient treatment models that deliver better outcomes. The cost in human lives of sticking to the status quo is just too great!
Addiction treatment pioneer, Dr. Indra Cidambi, introduced the Ambulatory (Outpatient) Detox model at the Center for Network Therapy (CNT) in New Jersey because she believed that integrating treatment with the patient’s home environment delivered better outcomes. The initial response from the treatment community to her innovative approach to detox individuals off of alcohol, benzodiazepines, and opiates in an outpatient setting can be summed up in one word: “Madness!” And, they had reasons – detoxification for alcohol and benzodiazepines was never attempted on an outpatient basis due to risk of stroke and seizures, also patients would be returning home at the end of treatment each day.
However, Dr. Cidambi put in place innovative processes and techniques, which, when combined with longer length of stay, delivered stellar results. She has proven the model to be safe – with nearly 1,000 patients detoxed over 4 years without a single untoward incident, and effective – it has delivered vastly better outcomes relative to inpatient treatment. Additionally, this model saves payors significant money when compared to inpatient detoxification. Ambulatory Detox delivers “nirvana” because, in the field of medicine, better outcomes usually come at a significantly higher cost.
CNT surveyed total 136 detox former patients at random and found that over 70% of them were sober longer than 90 days after completing Ambulatory Detoxification at CNT. In stark contrast, statistics shows that less than 40% remained sober for 90 days after the inpatient detoxification.
Why does Ambulatory Detox Deliver Better Outcomes?
Dr. Cidambi has made numerous adjustments to detox-medication protocols and introduced more innovative therapeutic approaches, that also includes network therapy, that drive better outcomes. Some of them are:
Individualized Treatment: Medication titration is specially customized for every patient depending on the substance of choice, severity of use and other medications the patient is currently on. This ensures patient comfort and aids compliance.
Integration with home environment: The patient will eventually have to learn to live in his or her home after treatment. At CNT, the integration starts on day one! Therapy is tailored to meet the patient’s home environment so that the patient would learn to cope with his/her specific living situation.
Family Involvement: The permanent support system for any patient is her or his loved ones. At CNT, our focus is to involve them in treatment, with the patient’s consent. Family interventions assure that the patient receives an elevated level of support at home for maintaining sobriety over the long-term.
Longer Length of Stay: Health insurance providers are able to extend stay, as ambulatory detox is more economical. Consequently, medication can be tapered more gently and patients will be able to engage in therapy and starts making lifestyle changes that contribute to sobriety.
The treatment community is now much more comfortable that ambulatory detox is a safer alternative way over the inpatient treatment. If imitation is the sincerest form of flattery, incumbent substance abuse treatment providers are now following in Dr. Cidambi’s footsteps.
(Inpatient opiate detoxification in Geneva: Follow-up at 1 and 6 Months. Barbara Broers, Patricia Dumont, Francisco Giner, Annie Mino. University Hospital Dept. of Psychiatry, Switzerland)
(Society for the Study of Addiction: Predictors of relapse to heavy drinking of alcohol-dependent subjects following alcohol detoxification— ethnicity, the role of quality of life measures, social class, cigarette and drug use. J.H. Foster, E.J. Marshall, T.J. Peters)