Programs available through Inroads
Inroads to Recovery will assist individuals sustain substantial stabililty and recovery from mental health and addiction to alchol and other drugs. We offer the following programs:
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Psychiatric Evaluations and Medication Management
We provide evaluations and assessments for all mental health and behavioral health issues as well as help in management of the psychiatric symptoms with medications and psychotherapy.
Our approach is to look at the individual as a whole and assess all biological, psychological as well as social risk factors that may be impacting and / or causing the symptoms of mental illness.
This approach allows us to make treatment recommendations based on the bio-psycho-social factors, and recommend medications, only when needed. We also are cognizant of the addictive nature of medications and will restrict and/or minimize the use of these types of medications.
Emotional health and well-being is directly related to our overall physical health. Just as it’s important to have our physical body checked by the primary care providers, it’s just as important to have our mental health evaluated and treated. Life stressors or trauma can leave us depressed, anxious, overwhelmed, hopeless, agitated and possibly suicidal. Untreated, these feelings can lead to threats to life as well as major psychological and physical illnesses or to behaviors that can become addictive as well as destructive.
Our mental health providers will perform an initial checkup of mental health and its symptoms similar to what a primary care provider might do by asking questions about physical health. This checkup, called a mental health assessment or a psychiatric assessment, includes an overview of the individual’s symptoms and a determination of whether or not medication is a good option for the treatment of the individual’s mental health. Where our primary care colleagues address more physical aspects of treatment, we utilize discussion to get to the root of the mental health care needs.
Based on this discussion and assessment, a diagnosis is made and a treatment plan is developed with the patient at the center. If it’s in the patient’s best interests, medications will be discussed and education will be provided on the actions, uses, and side effects of the suggested medication options. When the patient agrees on the use of a medication or multiple medications as the need might be, these will be prescribed for a trial period to observe the effectiveness. This is the “medication management,” aspect of psychiatric care. We monitor the effectiveness of medication over a course of time to determine if the treatment meets the patient’s goals. Due to how psychiatric medications react differently within a patient’s body, the effectiveness of the medications may vary from person to person.
Every individual is unique. Medications are often utilized at the same time as other forms of treatment such as counseling, life management skills, and/or behavioral therapies. Through careful monitoring and on-going discussion we find the right medication and treatment plans to improve the patient’s mental health.
The use of psychiatric medications introduces potential risks and side effects, as with any medication. These are all discussed and weighed against the benefits of the medications, with each patient. Not all patients and not all psychiatric problems need medicines, but there are certainly instances where prescription medicines are the best treatment available to relieve a patient’s suffering.
Medicines are commonly an important and effective part of the treatment of many mental illnesses to include depression, schizophrenia, schizoaffective disorder, bipolar disorder, post traumatic stress disorder, anxiety, panic attacks and disorder, sleep problems, and several other disorders.
If you are experiencing mental health issues, and would like to discuss whether medication is a good option for you, please call our clinic at (402) 932-2248.
Whenever stress leads to emotional and physical manifestations of illness, psychological as well as social interventions can be very effective in helping individuals resolve these. While medications are a relatively faster method of treating and resolving symptoms, they rarely offer a cure. This is where psychotherapy can help. Psychotherapy, especially insight oriented psychotherapy and psychoanalysis, can provide an understanding of the basis of human behaviors and resulting conflicts and through this understanding, help resolve several of these underlying issues.
Depending on individual preference and priorities, we can help patients explore past experiences using psychodynamic and psychoanalytic therapy and resolve their symptoms, or if individual preference is to not delve into their past and stay in the present, we can use cognitive behavioral techniques to help alter and control symptoms.
For individuals dealing with substance use disorders, addictions and addictive behaviors, we provide Motivational Enhancement Therapy (MET) to help breakthrough the resistance and facilitate change.
Intensive Outpatient Therapy (IOP)
When substance use disorders are not controlled with individual therapy, medication management, or attendance at self-help group meetings like Alcoholics Anonymous (AA) Narcotics Anonymous (NA), Intensive Outpatient Treatment is the next level of care.
For this level of treatment, patients are required to attend three hours of treatment for at least three days a week. This may be paired with psychiatric assessments and medication management when patients are dealing with mental health issues along with the substance use disorder.
Inroads To Recovery provides after hours intensive outpatient treatment in order to facilitate the individuals’ return to and maintenance of gainful employment.
Substance Use Evaluations
We provide standardized and clinical assessment based substance use evaluations that include Substance Abuse Subtle Screening Inventory (SASSI) as well as other standardized testing as might be necessary. These evaluations meet the criteria and the standards for all court ordered substance use evaluations. These evaluations are generally used to assess the appropriate level of treatment for the individuals struggling with substance use disorders.
When an individual’s ability to stay sober and off of alcohol and drugs in an unstructured environment is compromised, residential treatment may be needed. Our 30-day or longer, in-house treatment program provides individuals with opportunities to come off and stay off of alcohol and drugs. Mental health treatment as well as medication assisted substance use treatment is offered to maximize an individual’s ability to stay off substances, and address underlying issues that prompted their self-medication of their symptoms.
The program is based on the 12 step recovery model, but is not religion based. Relapse prevention and recovery based therapy are the mainstay.
Individuals are encouraged to find a mind-body-soul balance to help the recovery process.
- The program delivers its treatment interventions in a manner that fits the individual’s specific needs.
- Like most research studies indicate, the effective approach at Inroads to treating substance use disorders and mental health issues is to use a combination of medication and psychotherapy. Psychotherapy is available for individuals in a group format as well as in individual therapy sessions.
- Inroads staff initially perform a comprehensive assessment of the person’s psychiatric, physical, cognitive, emotional, and social functioning and then develop a treatment plan based on these findings. The treatment plan is continually reviewed, updated, and altered as needed based on the individual’s progress in treatment.
Opiate Use Treatment
We provide ‘medication-assisted treatment,’ for opiate use disorders using naltrexone, and buprenorphine (Suboxone). We DO NOT provide methadone treatment, or stock any opiates at Inroads to Recovery.
Most people cannot just walk away from opioid addiction. They need help to change their thinking, behavior, and environment. Unfortunately, “quitting cold turkey” has a poor success rate – fewer than 25 percent of patients are able to remain abstinent for a full year. This is where medication-assisted treatment options like naltrexone, and Suboxone benefit patients in staying sober while reducing the side effects of withdrawal and curbing cravings which can lead to relapse.
Naltrexone is an opioid blocker that is also useful in the treatment of opioid addiction. Naltrexone blocks the euphoric and pain-relieving effects of heroin and most other opioids. This type of medication-assisted treatment does not have addictive properties, does not produce physical dependence, and tolerance does not develop. Unlike methadone or Suboxone, it has several disadvantages. It does not suppress withdrawal or cravings. Therefore, many patients are not motivated enough to take it on a regular basis. It cannot be started until a patient is off of all opioids for at least two weeks, though many patients are unable to maintain abstinence during that waiting period. Also, once patients have started on naltrexone the risk of overdose death is increased if relapse does occur.
Buprenorphine / Subutex / Suboxone
In 2002, the FDA approved the use of the unique opioid buprenorphine (Subutex, Suboxone) for the treatment of opioid addiction in the U.S. Buprenorphine has numerous advantages over methadone and naltrexone. As a medication-assisted treatment, it suppresses withdrawal symptoms and cravings for opioids, does not cause euphoria in the opioid-dependent patient, and it blocks the effects of the other (problem) opioids for at least 24 hours. Success rates, as measured by retention in treatment and one-year sobriety, have been reported as high as 40 to 60 percent in some studies. Treatment does not require participation in a highly-regulated federal program such as a methadone clinic. Since buprenorphine does not cause euphoria in patients with opioid addiction, its abuse potential is substantially lower than methadone.
Medication-assisted treatment for opioid dependence can include the use of buprenorphine (Suboxone) and to complement the effects of this medication, education, counseling and other support measures that focus on the behavioral aspects of opioid addiction are provided. This medication can allow one to regain a normal state of mind – free of withdrawal, cravings and the drug-induced highs and lows of addiction. Medication-assisted treatments for opioid addiction and dependence is much like using medication to treat other chronic illnesses such as heart disease, asthma or diabetes. Taking medication for opioid addiction is not the same as substituting one addictive drug for another.
What Is Suboxone and How Does it Work?
There are two medications combined in each dose of Suboxone. The most important ingredient is buprenorphine, which is classified as a ‘partial opioid agonist,’ and the second is naloxone which is an ‘opioid antagonist’ or an opioid blocker.
What Is a ‘Partial Opioid Agonist’?
A ‘partial opioid agonist’ such as buprenorphine is an opioid that produces less of an effect than a full opioid when it attaches to an opioid receptor in the brain. Oxycodone, hydrocodone, morphine, heroin and methadone are examples of ‘full opioid agonists.’ For the sake of simplicity from this point on we will refer to buprenorphine (Suboxone) as a ‘partial opioid’ and all the problem opioids like oxycodone and heroin as ‘full opioids.’
When a ‘partial opioid’ like Suboxone is taken, the person may feel a very slight pleasurable sensation, but most people report that they just feel “normal” or “more energized” during medication-assisted treatment. If they are having pain they will notice some partial pain relief.
People who are opioid dependent do not get a euphoric effect or feel high when they take buprenorphine properly. Buprenorphine tricks the brain into thinking that a full opioid like oxycodone or heroin is in the body and this suppresses the withdrawal symptoms and cravings associated with that problem opioid.
Buprenorphine is a long-acting form of medicated-assisted treatment, meaning that it gets ‘stuck’ in the brain’s opiate receptors for about 24-72 hours. When buprenorphine is stuck in the receptor, the problem ‘full opioids’ can’t get in. This gives the person with opioid addiction a 24-72-hour reprieve each time a dose of Suboxone is taken. If a full opioid is taken within 24-72 hours of Suboxone, then the patient will quickly discover that the full opioid is not working – they will not get high and will not get pain relief (if pain was the reason it was taken). This 24-72 hour reprieve gives the patient time to reconsider the wisdom of relapsing with a problem opioid while undergoing medication-assisted treatment.
Another benefit of buprenorphine in treating opioid addiction is something called the ‘ceiling effect.’ This means that taking more Suboxone than prescribed does not result in a full opioid effect. Taking extra Suboxone will not get the patient high. This is a distinct advantage over methadone. Patients can get high on methadone because it is a full opioid. The ceiling effect also helps if buprenorphine is taken in an overdose – there is less suppression of breathing than that resulting from a full opioid.
Alcohol Use Disorder
Alcoholism is a treatable disease and many treatment programs and approaches are available to support alcoholics who have decided to get help, but no medical cure is available.
Regardless of how someone is diagnosed as alcohol dependent or how they came to realize they have a serious drinking problem, the first step to treatment is a sincere desire to get help. Alcoholics who are pressured into treatment by social pressures or forced to quit by circumstances have a harder time in succeeding in the long run.
Even many alcoholics who seek treatment on their own volition have at least one relapse before they obtain long-term sobriety. For those alcoholics who have a strong motivation to quit, a relapse can be just a bump in the road to recovery, but for those less committed, it can be an excuse to return to a full blown relapse and a drinking lifestyle.
Almost all alcoholics who have been heavy drinkers, will experience some level of withdrawal symptoms when they suddenly stop drinking. These symptoms can range from mild shakes and discomfort to life-threatening delirium tremens — which can include confusion, hallucinations, convulsions, autonomic instability, and death. Long-time, heavy drinkers who decide to quit drinking should seek medical assistance first.
Detoxification treatment includes abstinence from alcohol in a controlled environment and close monitoring of vital signs and any withdrawal symptoms.
In some cases, detox treatment can also include the temporary administration of benzodiazepines (tranquilizers such as Valium, Librium, Ativan or Serax). The tranquilizers help reduce the shakes and other unpleasant symptoms during early alcohol withdrawal and help to reduce the risk of seizures.
Alcohol Rehab and Treatment
The process of detoxification from alcohol takes three to seven days, after which the alcoholic’s dependency on alcohol is primarily psychological, rather than physical or chemical. The goal after detox is to prevent a relapse of excessive drinking.
For many addicts and alcoholics, getting clean and sober is just the first step in a process to try to rebuild their lives. We try to teach them the skills to return to a happy, productive life.
Pharmaceutical Treatment for Alcoholism
Although there is no “magic pill” that will cure alcoholism, there are medications approved by the Food and Drug Administration that are used to help people who have stopped drinking to remain sober. Currently, three medications are approved in the U.S. for the treatment of alcoholism.
Antabuse (disulfiram) works as a deterrent against drinking by making the person sick if they consume any alcohol. Naltrexone (Revia) blocks the effects of alcohol in the brain and reduces alcohol craving. Acamprosate (Campral) relieves the distress and discomfort alcoholics experience when they stop drinking.
Again, pharmaceutical treatments work best when the alcoholic has a sincere desire to quit. For those who are committed to remaining sober, medications can give them the extra help they need to avoid relapse.
Alcoholism Support Groups
One of the oldest and most well-known “treatments” for alcoholism is Alcoholics Anonymous (AA), a fellowship of men and women who share their experience, strength, and hope with each other to solve their common problem and help others to recover from alcoholism. Participation in A.A. is free.
Scientific research has shown that participation in support groups, combined with other treatment efforts, is more effective in helping alcoholics remain sober than participating in any treatment by itself. For those who do not prefer the 12-step approach, there are other secular support groups available like Rational Recovery.
The fellowship and accountability that mutual support groups provide have helped many with a desire to quit drinking establish and maintain a clean and sober lifestyle.
Methamphetamine Use Disorders
We provide evidence based treatment options for methamphetamine use disorders. The most effective treatments for methamphetamine addiction at this point are behavioral therapies, such as cognitive-behavioral and contingency-management interventions. For example, the Matrix Model, a 16-week comprehensive behavioral treatment approach that combines behavioral therapy, family education, individual counseling, 12-Step support, drug testing, and encouragement for non-drug-related activities, has been shown to be effective in reducing methamphetamine abuse.
Contingency management interventions, which provide tangible incentives in exchange for engaging in treatment and maintaining abstinence, have also been shown to be effective. Motivational Incentives for Enhancing Drug Abuse Recovery (MIEDAR), an incentive-based method for promoting cocaine and methamphetamine abstinence, has demonstrated efficacy in methamphetamine abusers through NIDA’s National Drug Abuse Clinical Trials Network.
Although medications have proven effective in treating some substance use disorders, there are currently no medications that counteract the specific effects of methamphetamine or that prolong abstinence from and reduce the abuse of methamphetamine by an individual addicted to the drug. Severally psychotropic medications have been reported to be helpful in case reports or small studies. We try to make these options available to patients along with the non-medication treatment options to maximize recovery opportunities.