Retaining Patients While They Contemplate Change: A Model to Curb Discharge

  • K. Michelle Peavy, PhD, Evergreen Treatment Services, Seattle, WA
  • Paul Grekin, MD, Evergreen Treatment Services, Seattle, WA
  • Molly Carney, PhD, Evergreen Treatment Services, Seattle, WA

Opioid Treatment Programs (OTPs) face a dilemma when it comes to discharging or not discharging unstable drug using patients. Premature death looms as a possible outcome for discharged patients; however, dangling the threat of discharge can serve as a powerful motivator for change. Furthermore, active drug users may be perceived as hazardous to a safe and therapeutic environment. In this workshop we will: describe an OTP policy that enhances retention by discontinuing discharge due to ongoing drug use; examine how this policy change affected the milieu; and discuss clinical implication of this policy in the context of the current heroin epidemic.

 

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