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Case management for substance abusers. More issues than answers

R S Ashery

    Journal of Case Management
    |January 1, 1994
    PubMed
    Summary
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    Case management for substance abuse treatment faces challenges due to client relapse and resource demands. A cautious approach is advised, favoring community systems advocacy over traditional cost-containment models.

    Area of Science:

    • Addiction Medicine
    • Public Health
    • Social Work

    Background:

    • Case management is a proven model in medical settings.
    • Its application to substance abuse treatment, involving multiple services, is under scrutiny.
    • Existing research highlights potential conflicts between case management demands and healthcare system constraints.

    Purpose of the Study:

    • To evaluate the efficacy and applicability of case management for substance abuse.
    • To identify challenges in implementing case management for this population.
    • To propose alternative approaches for delivering comprehensive services to substance abusers.

    Main Methods:

    • Review of existing research on case management in substance abuse treatment.
    • Analysis of factors influencing program success, including client-to-worker ratios and relapse rates.

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  • Comparative assessment of different service delivery models.

    • Main Results:

    • Low client-to-worker ratios and frequent client relapse complicate traditional case management.
    • Emphasis on cost-containment and 'successful' outcomes often clashes with the realities of substance abuse treatment.
    • The effectiveness of current case management models for substance abusers is questioned.

    Conclusions:

    • Implementation of case management for substance abusers requires careful consideration and a modified approach.
    • A community systems advocacy model may be more effective than traditional case management.
    • Future strategies should prioritize holistic support and address systemic barriers.