SUDS Telemedicine Detox Pilot

Recovering from addiction can be an extremely stigmatizing and isolating experience for many of our clients. Telecare recently conducted a pilot on Telemedicine Detoxification (Tele-Detox) to see if we could help clients overcome this isolation, while getting the right treatment support at their own pace, in the safety of their own home or within a program.

“Tele-Detox is detox treatment provided via live video calls at the convenience of where our clients are,” said Scott Madover, Director for Specialty Product Services, Substance Use Disorder Services (SUDS). “Through this online process, clients can get connected with an addiction physician who can walk them through their detox, answer any of their questions, and prescribe medications so that their substance use withdrawal symptoms can be as mild as possible.”

The nine-month pilot started June 2016 and was conducted at our CHANGES program in Oakland, CA. CHANGES is Telecare’s first co-occurring program and has been instrumental in helping Telecare identify effective and collaborative ways to treat co-occurring substance use disorders. CHANGES clients receive both mental health and substance use services, but in this program, are not required to be abstinent. Staff encourage clients to reduce their substance intake through a harm reduction model and can refer clients to more robust inpatient detox services.

The Tele-Detox program came about because we wanted to help clients overcome the isolation of addiction recovery, while getting the right treatment support at their own pace, in the safety of their own home or within a program.

The Tele-Detox approach is promising because it supports these goals, as well as offers other system benefits. It’s less expensive than inpatient detox, enables clients to start the detox process faster because it does not require waiting for an available inpatient bed, and alleviates pressures on those inpatient beds for people who need inpatient care the most.

Through the Tele-Detox process, clients are screened and connected with an addiction physician through Clinics On Demand. Clients are loaned a personal computer or a tablet if they do not already have one, a blood pressure cuff, and a finger oxygen device. The blood pressure and finger oxygen devices connect automatically and wirelessly with a monitoring system at Clinics On Demand.

Clients who participated in the demo had regularly scheduled telephone visits with physicians and clinical staff to discuss progress, address concerns, resolve problems, and refer to higher level of care if needed. CHANGES staff could contact the client’s physician to report any change of condition they observe during the detox treatment. Once detox treatment was completed, CHANGES staff would help and support clients in their chosen Intensive Outpatient Programming (IOP) treatment in addition to the services at CHANGES.

“Although the turnout for the pilot program was modest, the support and encouragement clients received by participating really helped them understand their addiction,” Scott said. “As a company, we are looking to continue to have the opportunity to build expertise within Telecare around substance use for our staff.”

Michelle Norris worked on the Tele-Detox program pilot when she was a Personal Service Coordinator II at CHANGES. As someone with lived experience herself, she knows that there is a lot of stigma surrounding addiction, and that having more personalized access to help can make taking those first steps towards recovery a little easier.

“There's still a lot of misconceptions around addiction, like the thought that people could just stop if they wanted to,” she said. “You know what? If I could've stopped, I would have, but I couldn't until I got more education. Having the right education and being provided the steps you need to take to help the client is so important because recovery can be a lot harder than you think.”  

Michelle uses the experience from her own recovery to help guide others on their journey. She is now a Licensed Clinical Social Worker (LSCW) at Telecare’s Villa Fairmont Mental Health Rehabilitation Center.