El Camino program targets 'functioning' addicts

New outpatient drug and alcohol treatment option lets patients keep jobs, stay in school

El Camino Hospital has opened an addiction treatment service aimed at helping local professionals and students struggling to kick their dependence on drugs and alcohol, while still going to work or school during the day.

The Addiction Services Program expands on the hospital's existing dependency treatment options by targeting "functioning addicts" -- individuals who, in varying degrees, manage to hold their own in society, despite their substance abuse.

"There are some very high-functioning folks out there -- drinking amounts and using amounts that would knock anybody else out," says Diana O'Rourke, program head and clinical coordinator of behavioral health at El Camino.

All treatment sessions will be held at night, after standard 9-to-5 working hours, O'Rourke explains. And, as an outpatient program, it is offers much more flexibility than stricter rehabilitation programs -- which may require patients to spend upwards of eight hours a day at a treatment facility or live on site.

Functioning alcoholics and drug abusers are an underserved population in Silicon Valley, O'Rourke says. Government numbers indicate that more than 9 percent of Americans struggle with addiction. And while nearly 75 percent of those individuals are employed in some capacity, El Camino's program will be the first of its kind between Redwood City and San Jose.

"I believe this is a program that can be helpful to a large number of people," O'Rourke says. "There is so much information to be given to people about this illness."

Disease, not a decision

O'Rourke stresses that substance dependance is an illness. "There are a lot of people who still believe that addiction is just a matter of choice, and if an addict only put their mind to it, they could be better," she says.

However, according to O'Rourke, research is increasingly showing that addictive compounds "hijack" the brain, rewiring neurotransmitters responsible for survival instincts. "The drug becomes as important to the addict as food or oxygen," she says.

On the less severe end of the spectrum, users may require significant moral support and coaching to return to a state where they no longer lump their drug of choice in with such necessities, she says.

Uppers, like methamphetamine and cocaine, along with opiates, like prescription painkillers and heroin, can lead to a physical dependence that is extremely painful to shake.

Alcohol and sedatives commonly prescribed by doctors to treat anxiety, such as Xanax and Valium, cause the most serious withdrawal symptoms -- heavy users who attempt to cut out such drugs cold turkey run the risk of seizures, hallucinations and even death.

El Camino's program combines a number of methodologies, O'Rourke says, including one-on-one counseling, group therapy and, in certain cases, prescription medications that can help ease the painful or dangerous side effects of withdrawal.

Social stigma

The psychological and physical challenges posed by quitting are only exacerbated by the social stigmas surrounding addiction.

"There will be no judgment or censure" at the Addiction Services Program, O'Rourke says. "We are here to help. This is a community service."

Just like with a doctor's visit, all information divulged within to any of the sessions is confidential. And, just as health insurance companies will help pay for a physical evaluation, most will cover a significant percentage of a drug treatment program, O'Rourke says. Physician fees will be extra.

O'Rourke emphasized that while kicking drugs can be quite difficult, neglecting to do so carries much graver consequences. "If you truly are an addict, it's only going to get worse," she says. "It's not going to get better. And the ultimate outcome for a lot of addicts is death."

The process

From the very start of enrollment, which begins with a phone interview and is followed by an in-person consultation, the Addiction Services Program will focus on tailoring every recovery plan, O'Rourke said.

Patients will attend four sessions per week -- each session lasting at least three hours -- for two months. From there, however, each individual's plan will be different.

Once a patient's needs are assessed, they will be treated using what O'Rourke called "evidence-based" methods -- treatment protocols that have been proven effective through careful scientific research.

Arguably the most important step in the healing process isn't actually getting a person to stop using, O'Rourke says. More important is giving an individual the necessary tools to live a sober life.

"Relapse prevention is about 70 percent of the work we need to do with people," she says -- "getting them to deal with the contingencies in their lives that were making them drink or do drugs in the first place."

Dialectical behavior therapy is aimed at building skills that will help people deal with a wide range of difficult and distressing emotions without picking up a bottle or popping pills, O'Rourke says.

The program also incorporates what is called the "stages of change" theory in its treatment methodology. This model assumes that addicts will go through a series of phases on their way to sobriety. "It's important to know where people are in that process," she says. "This is where interviewing and screening comes in. Are they really serious about change or are they not?"

El Camino's program approaches addiction recovery differently than the longstanding 12-step programs.

"We really have worked hard to address the whole person with this program."

The program will accept 10 patients initially, O'Rourke says, and may expand if demand warrants it. Information is available by calling 650-988-7700, toll free at 866-789-6089, or at the Addiction Services Program website.


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