Program Components and Key Concepts for Drug Court Services Matrix Institute on Addictions Rancho Cucamonga, California – 2001

Program Components Multi-Level Care  Evaluation Assessments  Long/Short Term Residential Treatment  Detox  Psychiatric Care  Medical Services  Public Assistance: Social/Vocational/Educational  Case Management

Evaluation Assessments  Severity of Addiction  Medical Issues  Psychiatric Disorders  Psychosocial Status  Determine Appropriate Level of Care Program Components

Long/Short Term Residential  Used for Severe Addictions  Lack of Resources to Stabilize Client  Chronic Relapsing in Lower Level of Care Program Components

Detox  Medical versus Non-Medical  24 hour Monitored Supervision  3-7 Day Detox  Outpatient Detox Program Components

Psychiatric Care  Dual Diagnosis  Medication Management  On-Sight versus Off-Sight Services Program Components

Medical Services  Physical and T.B. Exams  Medications Program Components

Public Assistance: Social/Vocational/Educational  Government Assistance  Medical/Welfare  Rehabilitation Programs –JTPA –Cal Works –Private GED/College Program Components

Case Management Team  Legal System  Law Enforcement  Probation  Public Health  Treatment Providers Program Components

Case Management Issues  Team Cohesiveness  Problem Resolution  Effective Use of Community Resources  Education/Training  Communication  MIS (Management Information System) Program Components

Outpatient Treatment: Key Concepts for Clinical Care

Engagement and Retention Structure Information Relapse Prevention Materials Family Involvement 12-Step Program Involvement Urinalysis and Breath Testing Behavioral Therapy Key Concepts

Engagement and Retention Strategies Nonjudgmental, Supportive Attitude Strong Bond with Individual Counselor or Group Minimal Use of Confrontation Use of Recovering Staff and/or Co-Leaders Ability to Work with Relapse Medications Key Concepts

Structure Regularly Scheduled Program Activities Assist Patients in Creating Routine Schedule Activities in High Risk Periods New Activities to Increase Drug-Free Options 12-Step Attendance

Information Biobehaviors/Disease Concepts Physiology of Addiction/Alcoholism Conditioning/Neurochemistry Knowledge of AIDS, TB and Medical Issues Stages of Recovery Awareness of Other Treatment Options Sexual Behavior and Addictions Key Concepts

Relapse Prevention Material Triggers and Cravings Relapse Warning Signs Addict/Alcoholic Behavior Addict/Alcoholic Thinking Methods for Coping with Emotions Slips/Lapses/Relapses Exercise and Nutrition Key Concepts

Family Involvement Family Education Family Support Groups Conjoint Sessions Encouraging Family to Get Assistance Encouraging Family to Support Sobriety 12-Step/Alanon Key Concepts

12-Step Program Involvement Source of Support and Camaraderie Source of Spiritual Strength Source of New Activities and Friends Lifelong Support System Multiple Forms of 12-Step Groups Alternative to 12-Step Groups Sponsorship Key Concepts

Urinalysis and Breath Testing Method for Monitoring Treatment Progress Treatment Accountability Assistance for Patient Reduce Arguments Provides Data for Drug Court Case Management Team Key Concepts

Behavioral Therapy: Contingency Management Goal — To Reinforce Healthy Behaviors in Recovery Key Concepts

Specific Target Behaviors  Clean Urine Test  Program Attendance  12-Step Involvement  Employment  Education/Vocational Rehabilitation  Medication Compliance  Re-Unification of Family

Key Concepts Negative Reinforcements  Incarceration  Community Service  Inability to Advance through Program or Graduate  Discharged from Program to Serve Prison Term

Key Concepts Positive Reinforcements  Vouchers  Certificates  Verbal Praise from Clinical, Legal Staff, or Peers  Keychains, Chips  Completion of Program, All Charges Dismissed

Factors in Outpatient Treatment

Pharmacologic Agents for Opiate Addiction Methadone Clonidine Naltrexone Acetylmethadol (LAAM) Buprenorphine

Pharmacologic Agents for Stimulants Desipramine Carbamazepine Bromocriptine Amantadine Fluoxetine Flupenthixol Ritanserin Setraline Factors in Outpatient Treatment

Addressing Drug Use in Treatment Issues in Stopping Drug Use Issues in Addressing Relapse Issues in Addressing Return to Readdiction Factors in Outpatient Treatment

Treatment Priorities Engagement in treatment Retention in treatment Attention to medical concerns Reduction/elimination of drug/alcohol use Attention to psychiatric concerns Social/vocational/educational rehabilitation Family/relationship issues Crime reduction Factors in Outpatient Treatment

Matrix Drug Court Statistics Female 39.85% Male 60.15%

EthnicityAge

Drug of Choice Years of Use

12,530 Drug Tests Administered Pregnancies

Matrix Drug Court Program Model