Substance Misuse Treatment Services

The treatment system in NH consists of an array of levels of care including outpatient, intensive outpatient, partial hospitalization, residential, withdrawal management, and peer and non-peer recovery support services.  Many of these services are paid for by public and/or private insurance programs as well as funding from the Department to assist individuals with accessing treatment services.

Substance Use Disorder (SUD) Services

Screening

The process by which the client is determined appropriate and eligible for admission to a particular SUD program. Evaluate psychological, social, and physiological signs and symptoms of alcohol and other drug use and abuse. Determine the client’s appropriateness for admission or referral. Determine the client’s eligibility for admission or referral. Identify any coexisting conditions (medical, psychiatric, physical, etc.) that indicate need for additional professional evaluation and/or services. Adhere to applicable laws, regulations and agency policies governing alcohol and other drug abuse services.

The screening is completed by a trained professional using the SBIRT tool. SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders.
 

Evaluation

The procedures by which a SUD professional /program identifies and evaluates an individual’s strengths, weaknesses, problems and needs for the development of a treatment plan. This accomplished by Gathering relevant history from client including but not limited to alcohol and other drug abuse using appropriate interview techniques. Identify methods and procedures for obtaining corroborative information from significant secondary sources regarding client’s alcohol and other drug abuse and psycho-social history. Identify appropriate evaluation tools. Explain to the client the rationale for the use of evaluation techniques in order to facilitate understanding. Develop a diagnostic evaluation of the client’s substance abuse and any coexisting conditions based on the results of all evaluations in order to provide an integrated approach to treatment planning based on the client’s strengths, weaknesses, and identified problems and needs.

 

Outpatient and Residential

Outpatient SUD Services

Individual, Family, and Group Counseling for Substance use disorders. These services are provided by a SUD clinician to assist individuals and their families to achieve treatment objectives through the exploration of substance use disorders and their ramifications, including an examination of attitudes and feelings, and consideration of alternative solutions and decision making with regard to alcohol and other drug related problems.

  • Intensive Outpatient (IOP)
  • Partial Hospitalization (PH) done at an Outpatient Clinic

Residential SUD Services 

Twenty-four hour, non-acute care in a non-hospital, residential treatment program. There are two residential levels of care; Low-Intensity Managed Residential Services (LI), and High-Intensity Managed Residential Services (HI).

  • Low-Intensity (LI)
  • High-Intensity (HI)
  • Opioid Treatment Program (OTP)
  • Office Based Medication Assisted Treatment (MAT)
  • Withdrawal Management Program (WM)
  • Recovery Support Services (RSS)
  • Case Management / Intensive Case Management (ICM)

     

    State Funded Treatment Providers

    Better Life Partners / Belonging Medical Group
    •    Outpatient: OP Individual + Group; MAT
    •    Telehealth

    Bridge Street Recovery
    •    Outpatient: OP; IOP; PH
    •    Recovery housing

    Cheshire Medical Center
    •    Outpatient: OP Individual + Group; MAT
    •    Telehealth
    •    Doorway

    Dismas Home of NH
    •    Residential:  LI
    •    Recovery housing for women previously incarcerated

    Farnum Center
    •    Outpatient: MAT; IOP; PH
    •    Residential: HI (men + women); WM
    •    Recovery Services

    Families In Transition
    •    Outpatient: OP Individual + Group; IOP
    •    Residential: TL, RSS=ICM

    Grafton County Department of Corrections
    •    Outpatient: OP Individual + Group; IOP
    •    Residential: RSS=ICM

    Greater Nashua Mental Health Center
    •    Outpatient: OP Individual + Group; IOP; MAT
    •    Residential: RSS=ICM

    Headrest
    •    Outpatient: OP; IOP

    Hope on Haven Hill
    •    Outpatient: OP Individual + Group; IOP
    •    Residential:  LI

    Southeastern NH Services
    •    Outpatient: OP Individual + Group; IOP
    •    Residential:  LI
     

    Online Resources

    • The Doorways
      Whether you are seeking help for yourself or a loved one, or are simply looking for information on resources related to substance misuse, http://thedoorway.nh.gov is the right place. Doorways NH will direct you to the help you need, from screening to treatment including medication-assisted treatment, to recovery supports.

    • 2-1-1 NH
      2-1-1 NH is the connection for New Hampshire residents to the most up to date resources they need from specially trained Information and Referral Specialists.

    • The Recovery Friendly Workplace
      Promotes individual wellness for Granite Staters by empowering workplaces to provide support for people recovering from substance use disorder.

     

    Definitions of Outpatient and Residential Services

    Intensive Outpatient (IOP) Treatment 

    Intensive outpatient (IOP) programs for substance use disorders (SUDs) offer services to clients seeking primary treatment; step-down care from inpatient, residential, and withdrawal management settings; or step-up treatment from individual or group outpatient treatment. IOP treatment includes a prearranged schedule of core services (e.g., individual counseling, group therapy, family psychoeducation, and case management [CM]) for a minimum of 9 hours per week for adults or 6 hours per week for adolescents.

    Partial Hospitalization (PH)

    PH is a time limited, ambulatory treatment program offered during the day or evening hours, and is considered an acute day hospital or a level 2.5 program per American Society of Addiction Medicine (ASAM) guidelines. This level of care is used for individuals suffering from co-occurring substance use disorders that do not require an inpatient level of care, but still require intense monitoring and would not be appropriate in the outpatient level of care based on their symptoms.  It is recommended per ASAM criteria (2013) that member’s needing PHP for substance abuse treatment attend a minimum of 20 hours per week of programming to ensure the most effective treatment response is received.

    Low-Intensity (LI)

    Called Clinically Managed Low-Intensity Residential Services, this adolescent and adult level of care typically provides a 24 hour living support and structure with available trained personnel, and offers at least 5 hours of clinical service a week. Residents are typically able to go out into the community to work, attend recovery meetings, and other activities of daily living.

    High-Intensity (HI)

    Called Clinically Managed Medium-Intensity Residential Services for adolescents and Clinically Managed High-Intensity Residential Services for adults, this level of care provides 24-hour care with trained SUD clinicians to stabilize multidimensional imminent danger and prepare for outpatient treatment. Patients in this level are able to tolerate and use full active milieu or therapeutic communities. Residents are not typically able to go out into the community except for planned recovery activities that are monitored by program staff.

    Opioid Treatment Programs (OTPs)

    Treatment for opioid use disorders using a combination of methadone or buprenorphine and counseling services, delivered by an agency certified as an opioid treatment program.

     

    Medication Assisted Treatment (MAT)

    Medication prescription and monitoring by a licensed prescriber for the purpose of treating a SUD, including clinically appropriate referral to, and coordination with, SUD treatment providers within the prescriber’s practice or externally. Medications used include, but are not limited to, Suboxone, Naltrexone, and Vivitrol.

    Withdrawal Management (WM)

    Medically Monitored Intensive Inpatient Services Withdrawal Management for adults, this level of care provides 24-hour nursing care with a physician’s availability for significant problems with subacute biomedical and emotional, behavioral, or cognitive problems that are so severe that they require inpatient treatment. Patients in this level of care require medication and have a recent history of withdrawal management at a less intensive level of care, marked by past and current inability to complete withdrawal management and enter into continuing addiction treatment.

    Recovery Support Services (RSS)

    Recovery support services include culturally and linguistically appropriate services that assist individuals and families working toward recovery from mental and/or substance use problems. They incorporate a full range of social, legal, and other services (PDF | 409 KB). That facilitates recovery, wellness, and linkage to and coordination among service providers, and other supports shown to improve quality of life for people (and their families) in and seeking recovery. Recovery support services may be provided before, during, or after clinical treatment, or may be provided to individuals who are not in treatment but seek support services. These services, provided by professionals and peers, are delivered through a variety of community and faith-based groups, treatment providers, schools, and other specialized services. The broad range of service delivery options ensures the life experiences of all people are valued and represented.

    Case Management / Intensive Case Management (ICM)

    ICM is a coordinated, individualized approach that links patients with appropriate services to address their specific needs and help them achieve their stated goals. The types of settings offering SUD case management include specialty treatment programs, federally qualified health centers, rural health centers, community mental health centers, veterans’ health programs, and integrated primary care practices. Intensive case management is differentiated from other forms of case management through factors like a smaller caseload size, team management, outreach emphasis, and an assertive approach to maintaining contact with clients. Research has demonstrated that case management, in particular, intensive case management, can improve clients' and families’.