Finding a Detox
What's proven the most difficult to find is an open bed. There are several resources available for this and we've tried to list them here.
Note: The resources below are not listed in any particular order. Like any other research, please use all the sources available to you. Compare, contrast, compile, and consolidate to find the best solution for you.
Resources for Open Beds
Massachusetts Addiction Recovery Software, Inc. (MARSI):
Keeps an update list of detoxes on their website, marsi.org and you can find the bed list here. They also have an app (android only for now) that gives you access to the open bed list from your phone as well as a number of other resources including Buprenophine clinics and clinicians; as well as local AA, NS, and S.M.A.R.T. meetings. The list is updated sporadically, so depending on when you access the list.
The site will displays when the list was last scraped at the top. For example:
"Last Scraped: 3/2/2018, 6:15:02 PM"
The android app on the other hand will display the last time a particular location was updated below the individual facility (see screenshot below).
Substance Abuse and Mental Health Services Administration
SAMSHA probably has one of the more impressive search features available. The fact that it is so impressive also means that it's a bit complicated and overwhelming. That said, the good people at SAMSHA seem to know that and have provided the tools to help you navigate the site.
They put together this video to walk you through the search process:
And there's this handy widget to get you started from right here on this site:
Massachusetts Behavioral Health Access (MBHP):
A searchable database that is updated by the individual facilities. You can search their database by service, zip code, and proximity. Depending on your search criteria you can get a fairly comprehensive report, including what insurances are accepted.
In the example below we would be searching (1)for an ATS (Accute Treatment Service/Detox). You would also need to provide your age, zip, and how many miles you're willing to travel.
PAATHS (Providing Access to Addictions Treatment, Hope and Support)
A one-stop shop for anyone (individuals, families, community partners, other treatment providers) looking for information about, or access to, substance use treatment services.
They are able to provide phone support, community support and walk-in services to individuals who are seeking immediate placement in a range of substance use treatment programs.
The staff can help you by:
Assessing unique treatment needs
Describing types of treatment available
Making recommendations and referrals
Facilitating access to treatment programs (including detox, CSS/TSS programs, medication assisted treatment and outpatient treatment programs), and
Connecting clients to overdose prevention and risk reduction services
There are many paths to recovery. Let us help you find yours.
Who is eligible?
Eligibility is simple. We serve any individual or family from the Greater Boston area in need of information related to substance use, regardless of insurance status. Spanish speaking staff and assistance with transportation are available.
PAATHS Navigator Model
In addition to the walk-in site at 774 Albany Street and the hotline, the PAATHS program also works with primary care providers and behavioral staff from various sites (including emergency departments and primary care settings) to assess individuals for substance use issues and link them to care as needed. Navigators are also available to provide phone support and trainings to providers upon request.
How to Access PAATHS services
Services are provided on a first come first served basis. We highly encourage arriving early so that you can be sure to connect you with services as soon as possible.
The program is located at 774 Albany street, 1st floor, Boston MA 02118
Please call 311 24/7 from the city of Boston to connect directly to PAATHS. If you are outside of Boston or using a pay phone, call 617-635-450.
The Massachusetts substance use helpline. They are available by phone at 800.327.5050 and they also a provide a comprehensive search form on their site.
You can also search for providers by category, service, and within a particular radius. By using the Advanced Options you can then also search by gender, age, and health insurance coverage. For example, you can drill down to a detox, rehab, CSS, family services, harm reduction, or halfway house offering various services; for a male or female; in a particular town or within a particular radius of that town; and by a health plan.
In addition you can narrow it further by only searching for programs that are funded by the Bureau of Substance Abuse Services (BSAS).
With NCADD recently added an interactive map that you can use to search areas of the country for a variety of resources.
Map Of Services:
A PDF provided by MASS Courts showing the treatment facilities available in the area can be found at www.mass.gov/courts/docs/mapping-of-services.pdf. The multi-page PDF shows all of the treatment facilities by location and by service.
Need a ride? The Sober Shuttle, Inc. mission is to focus on active recovery and how as a team we can assist individuals to transform from a state of sober and clean into the vision of sustained recovery. Our Vision is to experience communities where individual growth and productivity contributes to population stability and security.
Sober Shuttle, Inc.
Members of the Sober Shuttle, Inc. are available upon request. There are no particular office hours and telephone calls (if not answered immediately) will be returned within the hour.
Seeking Drug Abuse Treatment: Know What To Ask
NIDA also provides a guide to questions to ask when seeking treatment that can be found here.
The following are a list of terms you might come across:
Inpatient Detoxification Service/Level 4 Medically Managed Intensive Inpatient Treatment is twenty-four hour medically-managed evaluation and treatment for individuals who are experiencing severe withdrawal symptoms and/or acute biomedical complications that require treatment in an acute care hospital setting.
Access to Service: Direct access. Referrals are made by contacting the provider directly.
Acute Treatment Service (ATS) is a medically-monitored detoxification service for adults (18+) providing twenty-four hour nursing care under the consultation of a medical director to monitor an individual’s withdrawal from alcohol and/or other drugs and alleviate withdrawal symptoms.
Access to Service: Direct access. Referrals can be made by contacting the provider directly.
Clinical Stabilization Service (CSS) provides twenty-four hour clinical stabilization services for adults (18+) leaving detox or needing acute treatment but not meeting criteria for medically necessary Acute Treatment Services (ATS). Services are provided in a non-medical setting that includes observation, support, intensive education and counseling regarding the nature of addiction and its consequences, relapse prevention, outreach to families and significant others, and aftercare planning.
Access to Service: Direct access. Referrals can be made by contacting the provider directly.
Transitional Support Service (TSS) is a twenty-four hour structured, supportive, short-term residential service for adults (18+) that provides intensive case management and psychoeducation for individuals who need further stabilization after treatment in an ATS or CSS, or for homeless individuals in publicly-funded shelters who were recently discharged from an ATS or CSS.
The Path to Recovery
Here's a more in depth look into the process and path:
Just about everyone who loves a person addicted to drugs has seen their loved one hit “rock bottom” time and time again. Events in the life of someone who is addicted are a series of “bottoms”—an arrest, a conviction, a car accident, a divorce, a job loss. Every “bottom” becomes another ledge on an ever-descending fall. The fact is the sooner someone begins treatment, the more rapidly the brain begins to heal and the sooner they can begin to lead a life free from addiction. While there is no single right path to recovery, there are known steps to treatment that can help individuals overcome their addiction and stay in recovery. Additionally, the 12-step community made up of people in recovery supporting each other to lead alcohol and drug free lives has a high success rate for continued recovery. Alcoholics Anonymous and Narcotics Anonymous are two of the most commonly known 12-step programs. Research shows people who are most addicted need at least three months in treatment to significantly reduce or stop their drug use, and that the best results occur with longer durations of treatment. Regardless of the type of addiction—whether to alcohol, opiates, marijuana or stimulants—the overall path in which someone moves from one treatment program to another is called a continuum of care.
The continuum of care is the path along which someone moves from one treatment program to another. While there is no single right path to recovery, steps along the continuum of care can help individuals overcome their addiction and stay in recovery.
Treatment Services on the Continuum of Care
The continuum of care covers a range of services that address different stages of a person’s pathway to recovery.
Acute Treatment Services (ATS or Detox)
Length of treatment: generally 3–5 days
Detoxification is the medical supervision of withdrawal from alcohol or opiates. Medical management is sometimes necessary because the symptoms of withdrawal from certain drugs can be dangerous and even life threatening. For example withdrawal from alcohol can cause seizures and convulsions which can be fatal.
Detoxification takes place in an inpatient or overnight program that provides around the clock evaluation and management of withdrawal symptoms. Counselors work with clients to develop a treatment plan and find services to guide them through the next phase of treatment and recovery.
Clinical Stabilization Services (CSS )
Length of treatment: usually around 14 days but can be longer
Clinical Stabilization Services (CSS) provide short-term inpatient treatment, stabilization, and referral services for clients who don’t qualify for medically monitored detoxification or who have already completed a detoxification program. Stabilization programs include a comprehensive assessment, individual and group counseling, health education, some medical support, and planning for longer-term support services.
Providers contracted for this service and all contracted services are held accountable to the General performance specifications. You can read more in the performance specifications section of the Provider Manual, found at www.masspartnership.com.
Transitional Support Services (TSS or Holding Programs)
Length of treatment: often between 2 and 4 weeks but varies depending on personal need and bed availability at the next level of care. Transitional Support Service (TSS) programs, also known as “holding”, are short-term residential programs that accept clients from detoxification, clinical stabilization services (CSS) programs, or from homeless shelters if the individual is not at risk for medical withdrawal complications. In order to enter a TSS program, the person seeking services must plan on moving on to a Residential Treatment Program, also known as a halfway house.
Residential Treatment / Halfway House (HWH)
Length of treatment: Approximately 4 to 6 months, but can be longer based on need and the type of program. Residential treatment programs or “halfway houses” are licensed and overseen by the Massachusetts Department of Public Health, Bureau of Substance Abuse Services. The goal of treatment is to help the person gain a deeper understanding of addiction, recovery, and the practical skills needed to live alcohol and drug free with a better quality of life. Examples of residential treatment include recovery homes, social model programs, and therapeutic communities (TC).
Residential treatment programs provide:
An alcohol and drug free living environment with meals, case management services, recovery support meetings in the house and in the community where members can find mutual or “peer” support as they focus on recovery.
Residential programs serve different populations. Some admit men or women only, some are for adults only, some are for families, and others are for youth under 18. In Massachusetts, some women’s halfway houses allow children to live with their mothers, and a small number are geared for women who are dealing with domestic violence or sexual abuse. At many programs, the staff supports clients’ efforts to find and keep a job, to enroll in programs with services to aid in their recovery, and help them create an aftercare and post-treatment plan.
Alcohol and Drug Free (ADF) Housing or Sober Homes
Length of stay: varies
Alcohol and Drug Free (ADF) Housing, also known as “Sober Homes”, are an option after completing a halfway house. Sober homes are not regulated or licensed by the Commonwealth, therefore their quality varies dramatically. When considering a sober home, it is critical to visit the site and interview other clients to determine if the culture is supportive to someone in recovery. Sober homes should offer an alcohol and drug-free living environment that is less structured than a halfway house. Most sober homes require that residents be employed, pay rent, remain in recovery and undergo regular drug screenings. They do not offer treatment services.
Length of treatment: varies but often 1 year or longer
When a patient has completed a course of treatment in one or more residential programs, ongoing support through outpatient services will help them stay sober as they return to a healthier pattern of life.
Outpatient treatment programs often include case management, individual and group counseling, support groups and psychiatric services. Intensive Outpatient Programs or IOP’s offer group support sessions that meet several times a week, providing structure, discipline and motivation to maintain progress. Some outpatient programs are designed for adolescents; others provide child care.
Many providers offer morning and evening hours so that clients can keep jobs, look for work, and honor family commitments. Medications such as Methadone, Suboxone, Vivitrol, and Naltrexone may be offered for individuals recovering from opiate addiction.
Medication-Assisted Treatment and Recovery
Medication-Assisted treatment for addiction includes the use of medication often coupled with counseling and other supports. Treatment that includes medication is often the best choice for opiate addiction. Medication gives a person who is addicted to opiates an opportunity to regain a normal state of mind without experiencing the drug induced highs and lows. Medication also can reduce cravings and withdrawal symptoms. Medication-Assisted treatment can give the person a chance to focus on the lifestyle changes that lead back to healthy living.
Taking medication for opiate addiction is like taking medication to control heart disease or diabetes. Some people may need it for a short period of time, and some, just as with other health conditions, may need it for longer periods of time, or even for the rest of their lives. It is not the same as substituting one addictive drug for another. Used properly, the medication does not create a new addiction. It helps people manage their addiction so that the benefits of recovery can be maintained. Medication-Assisted treatment allows many to successfully work, maintain healthy relationships, and participate in their families and communities. The three most common medications used in treatment of opiate addiction are methadone, buprenorphine and naltrexone. Cost varies for the different medications. As with all medications, discussing the pros and cons of different treatment options with trained professionals is the best way to determine which course of treatment might be best for a loved one.
Methadone and buprenorphine trick the brain into thinking it is still getting the drugs the person was using (heroin, OxyContin, etc.). When properly dosed, the person feels normal and does not experience intense cravings. If someone does experience intense cravings, nodding, or appears high while using these medications, they may not be properly medicated. Their medical provider may need to adjust the dose or determine if there are interactions with other medications they may be taking.
Naltrexone helps overcome addiction in a different way. It blocks the effect of opiate drugs and takes away the feeling of getting high if the problem drug is used again.