Date: 05/01/2016

A college junior, injured playing lacrosse, switches to heroin when post-surgery painkillers run out. His anxiety disorder complicates his wish to get clean. A woman struggling with depression leaves addiction treatment and goes back to drug use.

Both enjoy financial stability, family support and a desire to stay sober.

But Beth Kane-Davidson, director of the Addiction Treatment Center (ATC) at Suburban Hospital, saw that they needed more.

So In 2010, she, along with the help of the entire clinical team, added Dual Outpatient Treatment (DOT) to the center’s roster of services. Previously, this dual-diagnosis population would receive addiction treatment at the Rockville clinic and treatment for the other illness somewhere else. “We came to recognize that another diagnosis is playing a part in the person’s inability to be successful in recovery,” says Kane-Davidson.

DOT features treatment programs specifically for adults with substance use disorder and a second psychological condition, such as depression. It starts with an intensive six-week program for eight to 10 clients at a time. Participants attend five days a week, arriving at 10:15 a.m. and leaving at 2 p.m. 

The day begins with clients recounting the hours since they left the Rockville clinic. Did they eat well and get enough sleep? Did anything happen to trigger cravings or relapse?

In the second session of the day, clients learn anger management techniques and other skills for coping with the stresses and setbacks of life. The third session provides education about addiction, mental health and recovery. Patients also receive care from a psychiatrist who can prescribe medications for the secondary illness.

DOT provides several treatment options to help patients at different stages of substance use and recovery.

“Addiction recovery is a process, not an event,” says Kane-Davidson. Treatments, she says, “are not one size fits all.”

Before DOT, dual-diagnosis clients in the ATC would be referred elsewhere for the second condition. “We would tell people to ignore their feelings and focus on addiction,” says Kane-Davidson. “Now we know it’s important to treat both together. We are reaching people who have not been able to complete an outpatient program.”