Counselors can assert meaningful role in medication-assisted treatment

Addiction counselors must confront challenges with clients, physicians, and themselves if they hope to play a productive role in furthering the success of medication-assisted treatment, a Massachusetts clinician told a breakout session audience at the National Conference on Addiction Disorders (NCAD).

Gary Blanchard, LADC-1, of Positive Path Counseling Center, urged flexibility on the part of counselors. They should consider meeting with clients at the physician's office to enhance coordinated care, and they should adjust their thinking to acknowledge that for some clients, complete abstinence might be a goal that develops over time.

Blanchard's Aug. 24 talk at the St. Louis conference, produced by the publisher of Addiction Professional and Behavioral Healthcare, identified subgroups of clients taking anti-addiction medications who might resist engaging in counseling. “People will get into medication-assisted recovery because they feel addiction is simply a physical problem that medication will control,” he said.

Also, “When people get addicted because of prescription medications that they had used as directed, they think they don't need counseling,” Blanchard said, not being aware that their misuse also has altered their patterns of cognition.

Blanchard believes that a combination of group and individual therapy works best for clients in medication-assisted treatment. He did warn that placing these clients in groups that also include clients receiving drug-free treatment could lead to distracting arguments about whether medication-assisted recovery constitutes true recovery.

On the issue of when medication-assisted treatment should end for a client, Blanchard said no standard road map exists, and he stressed that the counselor, the physician and the client should arrive at this decision together. “If we partner with the physician, we can convince him that this is a joint decision,” he said.