If you’re using, or plan to use, Soberlink as part of your clinical practice, it may relieve you to know that you won’t have to do a lot of guess work to get started. A group of doctors and treatment industry experts recently formed a panel to determine the most effective way to use Soberlink alcohol monitoring in a clinical setting.
In this article, we’ll look into the major decisions made by that expert panel and how those decisions will affect the way you use Soberlink.
Test Frequency
Do not set your patient up with as many tests per day as possible to ensure sobriety.
Excessive testing is actually the biggest and most common mistake to make when setting up a daily test schedule for your patient. While it seems like you should test as much as possible, a schedule that includes more than 3 tests per day will likely become a source of anxiety and quickly intrude on the patient’s life.
Soberlink was designed as a tool to help form healthy habits while in recovery. Setting up a testing schedule is a way to establish an accountability structure that will help keep the patient on track. However, if you overwhelm the patient with required tests, this accountability structure can make the patient feel more criminal than clinical.
Because alcohol use disorders are most effectively treated with a chronic illness approach, the testing schedule needs to be sustainable for a long period of time. In fact, the consensus from the expert panel suggested that patients should use Soberlink for a minimum of one year post discharge from a treatment program. Treatment will likely be ongoing, and overwhelming patients with tests would be counterproductive.
The Expert Panel’s Recommendation
The panel came to unanimous consensus on a recommendation of 3 tests per day at the start of an outpatient program or continued-care program.
Further, in the interest of progress and growth, the panel agreed that the number of daily tests could be reduced to 2 tests after a period of favorable results.
In fact, the panel was so sure of this decision that it required the least amount of time
dedicated to discussion. The panel relied heavily on shared clinical experience within the industry and data about relapse rates after residential and outpatient treatment programs.
Using a 3 test per day schedule with Soberlink will cover more than half of a 24-hour period, including all likely waking hours. In addition to covering most of the day, those 3 tests will act as a psychological deterrent to any alcohol use that could occur between tests.
The panel also noted that if a patient’s circumstances were more challenging, such as an increased exposure to environmental triggers, a maximum of 4 tests per day would be acceptable. However, this should be reduced over time as attitudes and habits adjust.
The Bottom Line
Avoid needless anxiety and complication while keeping the recovery process as smooth as possible by beginning your Soberlink alcohol monitoring program with 3 tests per day and reducing to 2 tests per day after a period of favorable results. Keep in mind, with the expert recommendation of using Soberlink for a minimum of 12 months, it’s important to keep a schedule that is sustainable for a long period of time.
Random vs. Scheduled Testing
It is generally accepted that urine drug screens should be administered randomly and periodically, but Soberlink’s daily testing should be viewed from a different perspective.
While it might seem like a good strategy to try and catch the recovering patient “off guard” with random tests, this will quickly create a toxic and stressful environment around testing. It may further place a strain on the relationship between the patient and clinician.
Those in recovery are using Soberlink as a tool to rebuild trust and establish healthy routine in their lives, and using that tool to create a sense of unease can be threatening to recovery. Random testing can create unnecessary anxiety; and the last thing people in recovery need is more anxiety.
Think of it this way: a schedule of Soberlink tests creates a reliable safety net for the client as well as acting as a non-invasive mental deterrent to a slip and/or relapse.
As part of a recovering person’s arsenal of tools, a consistent Soberlink test schedule will help form healthy habits and reestablish trust.
Because alcohol use disorders are most effectively treated with a chronic illness approach, the testing schedule needs to be sustainable for a long period. And over time, structure and accountability will hopefully work in tandem to form a new routine and outlook.
The Expert Panel’s Recommendation
The panel came to unanimous consensus that scheduled testing at agreed upon times is the best method for patients in early recovery.
The panel also agreed that in special circumstances, unscheduled tests could be requested in addition to the existing test schedule, during specific times of the day when necessary. For example, these tests could be requested if there is a suspicion that a person has consumed alcohol.
The sensitivity of Soberlink ensures that if test times are spread out throughout the day, a patient cannot consistently drink in between tests for consecutive days without detection. The panel agreed that it would be difficult, if not impossible, for someone with an alcohol use disorder to control their drinking in a way that would undermine scheduled testing for any length of time.
Highly sensitive Soberlink technology combined with the reliability of scheduled tests will set recovering clients up for success, and act as a mental deterrent to a slip and/or relapse.
The Bottom Line
The experts are unanimous that scheduled testing with Soberlink proves most effective for clients in recovery.
Eliminate needless anxiety by discussing and setting up a testing schedule to help the client have the best chance at success. Soberlink believes that, given the appropriate tools, clients can be set on a healthy path to maintain recovery.
Responding to a Missed Test
A missed test is a scheduled test that is not submitted within the required test window. The consensus of the expert panel agreed to a test schedule of 2-3 tests per day with a 2 hour test window. This type of schedule was determined by the panel to be convenient enough for a patient for the recommended 12 months of use in continued care.
It is important to note that missed tests happen quite often and there can be a number of reasons for an excused missed test. A patient may have forgotten their device at home, or were unable to break away from their schedule to submit a test.
While a missed test event should be treated with some concern, the approach should include some type of clinical intervention instead of jumping to a hasty conclusion.
We’ve discussed before that Soberlink should ideally be used as a tool to support long-term recovery and not be used to create extra anxiety. Orchestrating a system of hasty conclusions and suspicion, rather than clinical evaluation, can create a hostile environment that we are trying to avoid.
It may be more valuable to think of instances of missed tests as opportunities to reevaluate patient and program needs, request additional testing, or intervene before a slip becomes a full-blown relapse.
However, this is not to say that there shouldn’t be any consequences. Missing tests are serious challenges to any type of monitoring program. But keep in mind that holding patients accountable with agreed-upon consequences, and orchestrating a reactionary system of punishment are two very different things.
The Expert Panel’s Recommendation
The panel came to unanimous consensus that missed test events should be dealt with using clinical intervention rather than immediate consequences.
Because these instances could be caused by any number of circumstances, further evaluation of the situation is almost always warranted. Following a missed test, the panel recommends that a reevaluation take place as soon as possible. The majority of the panel even suggested that a full reassessment of the patient’s status be conducted, including a face-to-face meeting with the patient and approved contacts.
The panel further recognized that though these instances are serious and should be dealt with swiftly and thoroughly, they are not grounds for treatment program dismissal.
The Bottom Line
The experts are unanimous that missed tests should be treated with a simple phone call or a clinical evaluation before they are treated with any rash conclusions or dismissal.
Responding to Positive Tests
Positive tests are defined as a series of submitted tests that indicate alcohol consumption. But as serious as a positive test result may be, leading with punishment is often not the best path. In fact, the most beneficial response may be an assessment followed by an adjustment to treatment or care.
The ideal use of the Soberlink System is as a tool to support long-term recovery. And just like with missed tests, using a system of punishment, rather than one of clinical evaluation and reaction will create the hostile environment that is toxic to recovery.
Just like missed tests, a positive test can be seen as an opportunity to reevaluate patient and program needs, request additional testing, or intervene in the worst case scenario.
However, this is not to say that there shouldn’t ever be consequences. Positive tests can undermine any type of monitoring program. If consequences are appropriate and in the best interest of the patient, then the clinician should address those possibilities as well as any adjustments to a care plan.
The Expert Panel’s Recommendation
The panel unanimously decided that positive test results should be followed by immediate clinical action, including but not limited to, contacting a patient’s support group, clinician’s immediately contacting the patient either by telephone or in person and set up a face-to-face meeting, and possibly increasing the frequency of monitoring.
While the panel agreed that immediate action should be taken, they decided to leave the actual adjustments to the monitoring plan up to the clinician since they can more adequately determine individual patient needs.
Because these instances are serious and vary in the level of severity, the panel stressed the importance of taking into account the prior history of the patient, the point during treatment at which the positive tests occurred (early in the program or after a significant period of sustained sobriety), and whether or not the patient self-disclosed the drinking episode. Again lending priority to the clinician’s assessment of the situation and preferred plan of action.
In some cases, Soberlink monitoring is used in more sensitive situations, like treatment programs for licensed professionals. In these types of cases the panel suggested that positive test results might mean removal from work, reevaluation, and the consideration of residential or day treatment.
The Bottom Line
The experts are unanimous that positive tests should be treated as clinically significant events and be dealt with quickly in order to avoid further issues and get the recovery program back on track.
The first instance of a positive test is an opportunity to address monitoring and treatment plans and be sure that they’re still meeting the patient’s needs. After all, recovery is ongoing and should be treated as such. Finally, if a second, or more, positive test result occurs this may require more serious clinical intervention.
About The Expert Panel & Consensus Paper
The expert panel was comprised of physicians and experts with extensive experience and current knowledge of alcohol use disorders and the addiction treatment industry. The expert panel was assembled to discuss and reach consensus on the best use of remote monitoring in a recovery setting. A paper of their findings was written and published in the Journal of Addiction Medicine. All decisions made by the expert panel were reached by organic consensus and have been determined to be the absolute best practices when using the Soberlink alcohol monitoring.
About the Author
Soberlink supports accountability for sobriety through a comprehensive alcohol monitoring system. Combining a breathalyzer with wireless connectivity, the portable design and technology includes facial recognition, tamper detection and real-time reporting. Soberlink proves sobriety with reliability to foster trust and peace of mind.