I believe outpatient counseling, medication when necessary and monitoring of substance use in addition to social support groups such as AA or narcotics anonymous to be the most effective for clients.
There are a couple different scenarios. One of them is a situation where a client may need to demonstrate abstinence from alcohol for family court or in response to some kind of custody agreement. The second is for clients who have trouble remaining abstinent at home or have certain unique circumstances where an extra level of accountability can be helpful in them being more successful.
For example, there may be college students who were away at school and they have had problems with alcohol in the past and they are away from family members who can monitor their consumption, so the device helps us to be assured that they are remaining abstinent.
There are working professionals who live alone and they don’t have a spouse or partner to be who they are accountable to and it is difficult to stay sober at home by themselves.
A third scenario would be someone who does have family and friends that care about them but there has been a major loss of trust over the years and they need reassurance and some type of evidence that their loved one is continuing not to drink. The device provides that for them—help rebuild that trust.
It is becoming much more important. My practice has been 100% telehealth for the last 2 years. I think with the COVID-19 situation, there are more clients who are isolated and do not have accountability than normally wouldn’t be, and Soberlink provides us with a tool to provide them extra accountability and improve their success rates.
With devices that a client has to wear, they typically just outright reject that as a possibility. Most people don’t want to have to wear something that they can’t take off on their own which prevents them from doing things like swimming, wearing shorts, going on vacation or doing other activities without exposing the fact that they are being monitored. For a lot of people, it creates a great sense of shame and it can actually be counterproductive in recovery.
Recovery isn’t about canceling all the fun stuff in your life, it is about having fun while you’re not drinking and really enjoying life. To curtail those activities because you are being monitored and you don’t want people to see that can be detrimental to people’s recovery.
With the Soberlink device, people can take it with them. It can literally fit in someone’s pocket, purse, backpack, glove compartment and they could step away to go in a bathroom stall if they needed to, and quickly do the test in about one minute and then return to their activity. Oftentimes, the testing times are scheduled so they can plan for what they are going to be doing at those times and have the device in the appropriate location. It allows the client to monitor without adding increased stigma or shame by having to wear something that is obvious to everyone.
The system with Soberlink is set up in a way that's automated and you don’t really have to review the report unless you have some reason to generate them for some to her third party that needs to view them. The Soberlink system can be set up to alert you by email or text if a client misses a test or has a positive test or doesn’t pass the identity verification. You are only spending additional time on cases where there is an actual problem. You have this confidence factor that you are not going to miss anything if a client misses a test or fails his identity since the system automatically notifies you. Whereas with drug testing systems, you have to get that report, print it off, review it and it is an extra time investment. When you have 20-50 clients, just a few minutes having to look at reports, printing them off and adding them to files, that time then adds up quickly.
I think some of the key components to a continued success for clients is that they develop the appropriate tools and strategy that they need to get through cravings and also make lifestyle changes to address any issues that may have been triggering or driving their use. Social support is another important component whether that's through a 12 step group, church group or self-help group and it has been shown to boost success rate.
Monitoring has increased my clients success rate because the longer they have the device and that they are testing and having accountability, the more likely they are to be successful. Clients who are willing to do the monitoring for 6 months or a year oftentimes have a higher success rate than someone who is not willing to do monitoring at all or for someone who is only willing to do it for a short period of time. I think that has to do with their willingness to do what it takes for them to be okay and for them to recover.