Recovery Management Checkups with Adult Chronic Substance Users

Abstract

Models of ongoing monitoring and early reintervention occupy a central role in the long-term management of several chronic medical conditions. Such models require adaptations to address additional challenges that are common in addiction management, such as social isolation, alienation, residential instability, and multiple co-occurring problems. While the addiction field has historically been plagued by high attrition rates, utilizing a standardized tracking model (Scott, Drug Alcohol Depend 74:21–36, 2004) demonstrates the feasibility of providing ongoing monitoring via quarterly checkups. This chapter describes the Tracking, Assessing, Linking, Engaging and Retaining (TALER) protocol that was used to successfully implement Recovery Management Checkups (RMC) in two experiments involving approximately 900 participants. Results from the two experiments also demonstrate that random assignment to RMC (1) reduces both the time to readmission and the time spent in the community using and (2) increases both levels of treatment participation and rates of abstinence. In addition, the size of the effects was larger, depending on (a) the modifications made to the second experiment and (b) the length of time that RMC was used in the second experiment. Several potential benefits from adapting the RMC approach have been identified. They include better linkage to recovery support services, greater frequency of monitoring, expansion of the protocol to address co-occurring problems; and replication in other communities or subgroups such as offenders and adolescents.