October 03, 2017
WASHINGTON — The phone calls come — from fellow scientists and desperate strangers — with a single question for the alcohol chief at the National Institutes of Health: Where can my loved one find good care to get sober?
Tuesday, the government is releasing a novel online tool to help — directories of alcohol treatment providers paired with key questions patients should ask for a better shot at high-quality care.
"Most people think treatment is detox for 28 days or Alcoholics Anonymous. There's a vast in-between," said George Koob, director of NIH's National Institute on Alcohol Abuse and Alcoholism.
More than 15 million adults in the U.S. have what's called alcohol use disorder, meaning they either misuse or are addicted to alcohol, and fewer than 10 percent get treatment, according to federal estimates.
Many who do get treated don't receive quality care that best fits their needs, Koob said. He ordered development of the Alcohol Treatment Navigator after realizing if medical professionals were confused, families must be lost.
"It's the hardest thing, navigating how do you find treatment," agreed Linda Rosenberg, president of the nonprofit National Council for Behavioral Health. She wasn't involved with the tool but praised NIAAA for developing it. "It's desperately needed."
The tool can't solve issues of affordability or accessibility. Insurance coverage varies, and some parts of the country have shortages of providers that may leave patients traveling or turning to telemedicine, Rosenberg cautioned.
The Navigator offers a step-by-step guide to assessing additional options beyond the well-known AA and detox. First, it links to existing directories of thousands of board-certified addiction doctors or psychiatrists, accredited alcohol treatment centers and licensed therapists, searchable by ZIP code. Licensing and accreditation information mark an initial filter.
Next, the NIH defined five signs of quality to check:
Credentials. For example, look for a therapist who holds at least a master's degree and has specialized training in addiction treatment, the tool advises.
A comprehensive assessment. Providers can use a battery of tests to determine the type and severity of alcohol disorders.
Customized treatment. There is no one-size-fits-all approach, Koob stressed.
Evidence-based practices. NIH wants patients to consider scientifically proven options, including behavioral therapies and three FDA-approved medications.
Continuing recovery support. "It's not just an acute disorder," said Lori Ducharme, a NIAAA specialist who led the Navigator's development. "You want someone who will stick with you for the long-term."
How do you know if a potential provider meets those quality indicators?
"You need to call them and ask them questions to see if they'll be the right fit for you," Ducharme said.
The Navigator provides a script, lists of questions targeted to each type of provider plus an explanation of why each question is important and what answer to listen for.
For example, addiction is a disease, not a weakness, so watch out for providers who use stigmatizing language such as "drunk," the tool advises. And if a provider automatically dismisses medication, that's a warning sign about not practicing evidence-based care.