Chapter 2 - Stabilization Procedures

The first step in treating cocaine addiction is detoxifying the client from cocaine and other addictive drugs. Immediately upon entering treatment, the client participates in a brief stabilization phase designed to detoxify him or her from addictive drugs, to assess psychosocial stability, and/or to begin to establish basic recovery supports. The group counselor works with the client throughout the stabilization period.

The goals of the stabilization phase of treatment are to:

• Help the client establish abstinence from cocaine and other drugs.
• Help the client become motivated to participate in ongoing treatment sessions.
• Assess the client’s psychosocial stability, i.e., whether he or she lacks a stable, drug-free living environment or has significant psychopathology that may interfere with his or her benefiting from the cocaine recovery program.
• Provide education and support to help the client increase his or her knowledge of cocaine addiction and recovery and encourage him or her to engage in treatment and the recovery processes.

This phase of treatment lasts up to 2 weeks. Some clients complete detoxification from cocaine use before they start group treatment. Others continue to use cocaine or other substances even though they have started treatment. In such cases, treatment aims to help them focus on strategies to initiate abstinence. Not all clients begin the treatment program with the same level of motivation or become substance free before attending actual treatment sessions.

Brief, frequent contact with a counselor is helpful for the cocaine addict attempting to detoxify and stabilize on an outpatient basis. Of course, some clients with severe addiction problems are best detoxified in a hospital or addiction rehabilitation program and may enter outpatient treatment following an inpatient stay. Others enter outpatient treatment after completing a brief residential addiction program.

During the detoxification and stabilization phase, the group counselor sees the client 2 to 5 days each week. Clients typically attend treatment sessions two to three times a week. Clients may attend as many as five sessions of treatment a week if they are detoxifying from alcohol or another substance in addition to cocaine, or if they express a need for additional support. Each stabilization visit lasts 10 to 30 minutes.

The stabilization visits focus on;

• Monitoring and discussing any cocaine or other substance use, cravings, or close calls to use with the client.
• Educating the client about the detoxification process, including the physical and psychological symptoms that may be experienced during withdrawal. The counselor monitors withdrawal symptoms and teaches the client about cocaine-related medical problems and other types of substance use disorders.
• Helping the client identify the people, places, and things that can trigger cocaine cravings, and encouraging the client to find ways to avoid these triggers or cope with them without using addictive substances.
• Encouraging the client to participate in self-help programs such as AA, CA, or NA, or other self-help groups. The counselor provides the client with information about different types of meetings of these programs, the location of meetings, etc. The counselor answers the client’s questions about the philosophy of 12-step programs and other self-help programs that might be available to the client. Any concerns the client has about participating in a self-help program are discussed.
• Conducting Breathalyzer testing and urinalysis at each visit during the stabilization phase of treatment.
• Referring the client to needed ancillary services such as medical care, welfare, food stamps, vocational assistance, and stable living arrangements.

Drug testing with urinalysis and Breathalyzer is an important component of the treatment program. Frequent drug testing helps support the client’s abstinence by holding that person accountable for his or her behavior. Accountability, responsibility, and honesty must be consistently fostered in recovery because these values are often displaced by one’s addictive behavior. Therefore, the addicted person benefits from reclaiming these values in recovery.

Throughout treatment, clients’ urine is screened routinely for the presence of drugs. The group counselor collects the urine at the group sessions. For the first 2 months of treatment, following stabilization, clients’ urine is collected twice a week. During the 3rd through 6th month of treatment, the clients’ urine is collected for analysis once a week, at the group sessions. Breathalyzer data is collected on the same schedule used to collect the urine.

Results of urinalyses are returned to the group counselor. When a client’s urine tests positive for cocaine or other drugs, the group counselor is responsible for discussing this information with the client individually. Clients are strongly encouraged to discuss any cocaine or other drug use in their group sessions. However, it is the client’s decision whether to disclose his or her drug use to the group, although disclosing this information is encouraged.

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