MODERATOR: Welcome to the webcast introducing and
demonstrating the new NIAAA Alcohol Treatment Navigator.
Speakers will be Dr. George Koob,
director of the National Institute
on Alcohol Abuse and Alcoholism,
and Dr. Lori Ducharme, lead developer of the Navigator.
They will provide an overview
and a walkthrough of the Navigator tool.
Note that this webcast is being recorded.
We will now start the presentation.
DR. KOOB: Hello, I am George Koob,
the director of the National Institute
on Alcohol Abuse and Alcoholism,
and I would like to thank you for joining us today,
as we launch the new NIAAA Alcohol Treatment Navigator.
As we have recently completed National Recovery Month,
I am happy to introduce you to this exciting and important
new online resource. Our webcast will answer several questions:
What is NIAAA Alcohol Treatment Navigator?
Why did NIAAA develop the Navigator?
How is the Navigator different from other resources?
And, how can individuals, their families, and health
professionals use the Navigator to find alcohol treatment?
The Navigator is a tool designed to help people recognize
and find quality care for alcohol use disorders.
That is, care that is professionally led treatment
grounded in decades of clinical and health services research.
We developed the Navigator to address
the alcohol treatment gap.
In any given year, more than 15 million adults in
the United States meet the diagnostic criterion
for an alcohol use disorder,
but less than 10% of them receive treatment.
Meanwhile, many of those in treatment
may not receive the care that best fits their needs.
There are many reasons why people don't receive
any alcohol treatment --
or the right treatment -- for their needs.
For example, they don't know
all the treatment options that are available.
They don't know where to look.
Their doctors don't know where to refer them.
Or, they don't know how to tell
if a provider is offering good-quality treatment --
what we call "evidence-based care."
Often, people call NIAAA looking for a recommendation
or a referral, because they don't know where else to turn.
In fact, during my tenure as director of NIAAA,
I've received numerous calls from colleagues
and the general public asking for advice
on finding good alcohol treatment providers --
in or near their communities -- for their family and friends.
Those calls inspired us to develop the Navigator,
which makes this complicated process easier
by telling people what they need to know
and what they need to do to recognize and find quality care.
Now, as a federal research agency,
NIAAA cannot endorse or recommend
any particular health care provider or program.
Instead, we have created a resource that explains the steps
to take in searching for an alcohol treatment provider
anywhere in the US.
That strategy is at the heart of the Navigator.
Drawing on nearly two years of development --
with input from patients, their families, treatment providers,
and leading alcohol researchers -- the Navigator
offers an easy-to-use and comprehensive resource
that can inform the search for good-quality treatment.
It includes
an overview of alcohol use disorder,
a description of different kinds of treatment options,
step-by-step instructions for searching
several existing directories of treatment providers,
10 questions to ask and answers to listen for
when interviewing a provider,
five signs of quality to look for,
and a downloadable toolkit
to help organize and simplify the search process.
With the Navigator,
individual adults will be better able
to find treatment options that meet their unique needs.
Family members will feel empowered
to help an adult loved one
who may be struggling with alcohol use disorder.
And primary care physicians and other health providers
will have a tool to share with patients
who may need a referral to alcohol treatment.
We believe that the NIAAA Alcohol Treatment Navigator
will be a game-changer for people
looking for quality treatment for alcohol use disorders.
We hope you will visit the site and go through it,
and share it widely.
And we plan to refine and update the Navigator regularly,
so, please give us your feedback.
It is available at AlcoholTreatment.niaaa.nih.gov.
Again, AlcoholTreatment.niaaa.nih.gov.
I will now ask Dr. Lori Ducharme,
NIAAA's program director for health services research,
and the lead developer of the Alcohol Treatment Navigator,
to explain more about it and show you how it works.
DR. DUCHARME: Thank you, Dr. Koob.
I'm Lori Ducharme, program director
for health services research at NIAAA.
As a researcher who has been studying addiction treatment
programs for more than 20 years,
I can tell you from experience why
the Alcohol Treatment Navigator
is such a unique and important resource.
Alcohol treatment can be very hard to find.
Knowing where to look for treatment is difficult,
mainly because the treatment system
isn't really a system at all.
It's an uncoordinated set of services that exist
in independent settings and silos,
with different funding streams,
that, for the most part, are still not well-integrated
into general health care.
That makes it really hard for people
to find the kind of care that they need, when they need it.
The Navigator is designed to take the mystery and frustration
out of the search process.
Existing online resources are limited,
and there really aren't any sites that bring
all of the information together in one place
to tell you what you need to know,
and what you need to do, to find treatment.
The Navigator does that.
When searching online,
it can be hard to identify good-quality treatment
when you see it.
What are some signs of quality that you should look for?
The Navigator helps with that.
Another issue is that there are a lot of stereotypes
about alcohol treatment.
People often think their only choices are either
a mutual help group or long-term residential rehab.
And while those options certainly work for some people,
they are not a good fit for everyone.
In fact, a theme of the Navigator
is that different people need different options.
What worked for your friend or neighbor
might not be the best fit for you. And that's okay.
We need to help people understand the whole range
of professional treatment options that are available,
and how to find one that meets
your unique needs and preferences.
For all of these reasons, searching for alcohol treatment
can be confusing and overwhelming. We understand.
In the process of developing the Navigator,
we talked to many patients and families
who had been through this process.
And they shared with us their experience and frustrations,
the mistakes they made,
what they know now that they wish they had known sooner,
and information they still have trouble finding.
We're grateful that so many people
were willing to share these experiences with us.
We got input from patients and families
at every step of developing the Navigator
to make sure that our advice made sense, was easy to follow,
and helped them feel more empowered
to make these decisions about seeking treatment.
And, of course, we also involved researchers
and treatment providers in the development of the Navigator
to make sure it reflected the latest research
and was grounded in the reality of today's health care system.
One more thing. We chose the name Navigator deliberately.
The Navigator is not a locator --
although it will give you some tips
on how to search specific provider directories.
Rather, the Navigator offers a comprehensive strategy
to help people search for evidence-based alcohol treatment
that's delivered by skilled health professionals,
and help them choose among the many options
that are out there to find one that best fits their situation.
Through a combination of education,
step-by-step instructions,
resources, and tools, the Navigator is designed to help
point the way to evidence-based alcohol treatment.
Let me show you what it looks like.
This is the home page for the new
NIAAA Alcohol Treatment Navigator.
I'll start here to orient you to the site,
and then we'll go through and highlight some of its contents.
So, the Navigator is all about helping you find your way --
for yourself or an adult loved one -- to alcohol treatment.
The site is organized around two primary sections.
One is informational -- what you need to know
about alcohol treatment.
The other is the road map --
a strategy for searching and finding treatment options.
Let's start with the first section,
"What to know about alcohol treatment."
So, this section covers four topics.
They provide some background and context
to understand why your search for treatment and
the options you need may be different than someone else's.
In "What is alcohol use disorder?", we explain
the signs and symptoms of alcohol use disorder,
and we emphasize that it is a medical condition,
often chronic in nature, that should be assessed
and treated by a trained health professional.
In "What types of treatments are available?", we describe
a variety of professional treatment options,
including licensed professional therapists,
outpatient and inpatient treatment programs,
and physicians who specialize in addiction treatment.
In the section "Why do different people need different options?"
we explain what goes into a clinical assessment,
and how a health professional will use that information
to shape a treatment plan.
That's what determines the type and intensity
of treatment to consider.
And then, finally, we provide some information about
treatment costs, how to find out about insurance coverage,
and we emphasize that the most expensive option
is not necessarily the best.
Again, it depends on your specific needs.
So, let's just click briefly into the
"What is alcohol use disorder?" page.
Here you can see that these pages
are all brief and easy to read,
with links if you are interested in more detail.
And, there are navigation buttons, both on the side
and at the bottom of the page,
so that it's very easy to move through the site.
So, that's the what to know section of the site.
Now, let's go up here to the top navigation bar,
and we'll click over to the section
on how to find alcohol treatment.
Now, this section is really the heart of the Navigator.
This is where we give you a strategy, some tools, and
some step-by-step instructions for searching for treatment.
We know this can be overwhelming,
so we really want to take the stress out of this process
by breaking it down into smaller steps.
There are three parts to this.
First, we'll give you some signs of quality to look for.
Not all treatment programs are the same,
and this will help you differentiate between them.
Next, we'll show you how to find professional treatment
providers, and how to decide if they're a good fit for you.
And finally, once you've come up with a short list of potential
options, we'll give you a tool to help you choose among them.
So first, let's look at what we call
"five signs of higher-quality care."
How can you tell whether a treatment provider
offers good-quality treatment?
This is about helping people become
better consumers of health care information.
It's really important to look beyond the television ads,
and glossy brochures, and websites that promise a cure.
Those can be rather seductive messages
when you are desperate to find help.
But it's important to take a step back
and really look at what a provider is offering.
We looked at both the accumulation
of years of health services research,
as well as the current state of the treatment field
and the consensus of experts.
And from that, we selected five signs of quality that can
be applied to the whole variety of treatment providers
and span the continuum of services from initial assessment
through treatment and long-term recovery.
The five signs that we suggest people look for are,
first, credentials --
the specific licenses, certifications,
education, and training that are associated
with expertise in alcohol treatment.
Second, you want a provider who will conduct
a comprehensive assessment.
That means they don't only focus on the person's
alcohol and substance use issues,
but the whole variety of medical, mental health,
and other issues, including their housing situation,
employment, and social support networks.
Third, it's important that a provider involve the patient
in developing a customized and responsive treatment plan.
This reinforces the idea that there should not be
a one-size-fits-all approach to treatment.
And the treatment plan should be updated
as the patient progresses through treatment
and as their needs and goals change.
Fourth, we talk about the importance of
finding a provider that uses
evidence-based therapies in treatment, including
both behavioral therapies or counseling techniques,
as well as considering the use
of FDA-approved medications, when appropriate.
And finally, we recommend finding a provider
who either offers or will help develop a plan
for long-term continuing recovery support,
reinforcing the idea that alcohol use disorder
should not be addressed as an acute illness,
but rather in a chronic or continuing-care framework.
Each of these expands to provide the kinds of details
I've been describing.
So, for example, here is what
the credentials item looks like when it's expanded.
For each type of provider, we give you the specific
credentials, degrees, licenses, and letters to look for.
OK? So, five signs of quality to look for,
written in a way that's easy for people to understand.
Now, certainly there are more than five indicators of quality,
and these are not a guarantee of success,
but they should help you assess your options.
Now I'll show you the search section.
Here, we orient you to three different types
of professional treatment providers --
licensed professional therapists,
accredited treatment programs,
and board-certified addiction doctors.
At the bottom of this page, we link into a step-by-step
search strategy for each of the those
three provider types.
In each of those sections, we link out to an existing,
publicly available national directory of professional
treatment providers and show you how to search it.
It's important to point out that there is no
one central curated list of treatment providers
across the United States.
This would all be much easier if there were.
But that's exactly the reason why we built the Navigator.
Because it can be very difficult
to understand and find all your options otherwise.
Now, I'm not going to click through all of these pages,
but I do want to show you how this is organized,
so you can see the general strategy involved.
So, let's first look at addiction therapists.
Each of these three sections are organized in the same way.
First, we tell you what you'll be searching.
In this case, it's the Psychology Today directory.
Then, we briefly describe what these providers do.
We alert you to any quality indicators
that may be relevant as you're searching.
And then we lead you through the search itself.
A point we strongly emphasize is that
you should not be making any treatment decisions
based only on what you find in these directories.
It's really important to call up a provider first,
and ask questions to learn more about them,
about their approach to treating alcohol use disorder,
and to see whether they would be a good fit for you.
To help with that, we provide a list of 10 questions
to ask a therapist before your first visit.
You can preview those questions here.
So, let's click on question 2, here.
And, what you'll see is not just the question itself,
but also an explanation for
why we suggest you ask the question,
and what answers to listen for.
And, the idea is, as you interview a provider,
two things will happen.
It will start to shape your opinion about them
and whether they might be a good fit for you.
And their answers will tie back to those five signs of quality
that we talked about earlier.
So, those are questions you'll want to be prepared to ask.
Now, as for searching,
we provide a link out to the Psychology Today directory,
which is here.
Again, this is not an NIAAA resource.
You'll be searching their website directly.
And then, to help you make sense of your search results,
we also have a downloadable set of search tips.
These will show you, click by click,
how to use that directory and how to narrow down your results.
And then we provide similar advice
for searching for specialty treatment programs.
Again, same structure.
What do these providers do?
Signs of quality.
Ten questions to ask and answers to listen for.
And, here we have a simplified search tool
that will pull from the national inventory
of specialty addiction treatment programs
that is maintained by our sister agency, the
US Substance Abuse and Mental Health Services Administration.
And the third of the three sections.
Here we talk about addiction doctors as an option.
Again, what they do.
Signs of quality.
Questions to ask.
Tips for searching.
And in this case, we link out to two existing directories,
one that lists doctors who are
board-certified in addiction medicine,
and the other for doctors
who are board-certified in addiction psychiatry.
OK? So, the search section of the Navigator is very dense,
but we've really tried to break it down into
smaller, more manageable steps with lots of clear instructions.
If you do all that searching, you'll hopefully end up
with a short list of providers in your area,
and you can narrow down that list by calling
and asking questions about their treatment approach.
But then, how do you make a decision?
So, we also created a companion toolkit for the Navigator.
And among other things,
it includes a treatment options chart
that you can download and save.
It looks like this.
Now, this may not be necessary for everyone, but
this may help you organize your notes and compare
apples to apples across the providers you've talked to.
If you've called and interviewed these providers
using the questions that we suggested,
you should then be able to fill out this chart.
These last five columns, here on the right, map onto
those five signs of quality that we mentioned earlier.
And from there, the idea would be that, all else being equal,
people would prioritize those providers
that have more indicators of quality, assuming that they are
a good match for your specific needs and circumstances.
I'll come back to the home page to show you one more section
of the Navigator, and that's this section
on support through the process.
When we did early focus groups with patients
and their families, they encouraged us
to include a section like this,
because these were things they really wished they had known.
So, we talk about how to start the conversation
with a loved one who may need treatment.
We talk about managing expectations around treatment --
how long it may last, and what to expect.
Understanding relapse -- that it's a common part
of the recovery process and does not mean that the patient
has failed, or that treatment didn't work,
and what should happen next.
Long-term recovery support resources --
again, reinforcing that addiction is not something
we address as an acute episode,
but a condition that will require long-term support.
And finally, support for you.
If you are using the Navigator to search for treatment
on behalf of a loved one, how can you be helpful,
and what kinds of help and support are available for you.
So, that was a very quick overview of NIAAA's
Alcohol Treatment Navigator.
I just want to restate how grateful we are
to all of the families and providers and scientists
who provided input into this website.
We hope that it helps inform people
about all of their options.
That treatment is not one size fits all.
That there are some signs of quality to look for,
and that can increase the chances
of finding evidence-based care.
And, that the Navigator's tools can help people search for,
interview, and make informed choices
about treatment options that will meet their needs.