Providers

Month 8: Nonprofits & Service Providers

Theme: The people doing the work

This month focuses on those actively engaged with and doing what is within their capacity for Homeless Addiction Disorders and other mental health challenges: a) How nonprofits develop housing, b) Case management and support services, c) Challenges providers face, and d) How to partner or support responsibly.

One of the most valuable things we can share is knowledge gleaned from a dozen years of working with our HADs (Homeless Addiction Disorders). They are people who live in our world, yet it’s another world. It’s a cultural thing! Let’s begin with a great mentor and our community’s landscape twenty years ago, in 2006.

It’s a cultural thing!

Dear Providers-nim,

Whether a prescribing doctor, group facilitator, sober-house manager, detox facility, or IOP provider: the gravest challenge is coloring within the lines. You remember those coloring books, right? Well, many living with addiction and homeless have a passion for coloring books, colored pencils and crayons. Maybe they like coloring within the lines! All our different providers have certain criteria to follow too, a certain quota to fill, along with professional and ethical boundaries to manage. In other words, we all must color within the lines or lose our coloring privileges.

The insurance and liability dilemma comes to mind first. When anyone decides residential treatment may be what to do next, having the right insurance coverage for admission to a matching facility or program is often problematic. This can become a hinderance and may close that very small window of opportunity for making a recovery decision. When our fentanyl overdosing crisis arrived, 2015 area, a couple fine ladies provided an invaluable resource out of the Methuen Police Station; they would match our clients insurance to an open bed usually within an hour or less. All we needed now was to get that client there and asap, before any change of heart. Thank you, Jennifer and Jacquilyn, from C.A.R.E.S.!  

Medical doctors being compliant with insurance rules and regulations for continued billing privileges, patient care, and prescribing medications may easily become an issue too. As most have learned, a lapse or relapse is more often than not part of a remission process. Of course, insurance companies care about proceeds and convincing politicians of how to play nicely is important. With opioid use cases, MAT (buprenorphine/naloxone), a lapse or relapse can enhance recovery potential. Explained by Modulation, one of the five elements of ARMOR.

One of our best, a more recent prescriber, Dr. D., helped save a young woman’s life, no doubt, via his patience and tolerance. Drug testing is often part of the criteria prescribers must follow. Years ago, bang, no more prescriptions because you slipped up and experienced a minor lapse. You know, color within the lines. This poor guy takes me aside: “your client has only cocaine in her system,” he tells me. In other words, none of her prescribed medications or other opioids are present. I react: “no heroin or fentanyl? …that’s a good thing, right Dr. D.?” Live and learn, Doc, live and learn!  

Kind Regards, Greg (Doc’s retired… lol)

We’re still learning and now from the best suited to teach us, your HADs. Here are a few gifts for you:

SMART Recovery Podcast:

And a recent book from a colleague. Please tell us what you think!