Prevention Services can include programs that target all residents in the community, programs that focus on particular groups of individuals who are at high-risk in a community, and coalitions that work with multiple systems in a community.
Regional Centers for Healthy Communities (RCHCs)
The Regional Centers for Healthy Communities (RCHCs) help build healthier communities by addressing alcohol, tobacco, and other drug use prevention and youth development issues at the local level. Community efforts focus on availability, community norms, and regulations related to alcohol, tobacco and other drugs. Strategies for changing the larger environment include policy change and implementation, enforcement, education and communication. Each Center has a Resource Library addressing a broad range of public health issues and providing access to a number of online substance addiciton prevention services. The Resource Libraries also have access to curriculums for psycho-educational groups for youth and adults.
Prevention Programs are community-based programs that work to prevent alcohol, marijuana, and other drug use among children (pre-K to youth up to 18 years of age) and their families. Each program focuses on a specific municipality or neighborhood and is carried out by a coalition of organized community members that have an interest in helping their community prevent substance misuse.
The Bureau of Substance Addiction Services funds two youth intervention programs that are designed to intervene with youth who have already begun to use substances and participate in risky behaviors. These programs include activities such as street outreach and youth organizing.
Residential Treatment Under 30 Days
Residential Treatment Programs under 30 days provide short-term acute treatment for individuals who require intensive care and support due to their alcohol and/or other drug use. Residential Treatment Services under 30 days include Acute Treatment Services (ATS), Transitional Support Services (TSS), and the Tewksbury Stabilization Program.
Acute Treatment Services (ATS) (Detoxification)
ATS programs are medically monitored detoxification services. Programs provide 24-hour nursing care, under the consultation of a medical director, to monitor an individual's withdrawal from alcohol and other drugs and alleviate symptoms.
Eligibility and Priority Populations: Individuals, 18 years and older, who are at risk for acute withdrawal from alcohol and other drugs. High-risk priority populations include injection drug users, homeless individuals, pregnant women, and individuals with chronic medical diagnoses.
Transitional Support Services (TSS)
Transitional Support Services (TSS) are short-term residential, support services for clients who need a safe and structured environment to support their recovery process after detoxification. These programs are designed to help those who need services between acute treatment and residential rehabilitation, outpatient or other aftercare.
Eligibility: Only those age 18 or older who are referred by a publicly funded ATS (detox) program, a homeless shelter, or homeless outreach worker.
Tewksbury Stabilization Program
The Tewksbury Stabilization Program provides a structured, residential, and substance-free environment for homeless and imminently homeless chemically dependent men. Services include case management for a variety of service needs, psycho-educational groups, and connections with self-help groups. Referrals to placements that support ongoing recovery are provided.
Eligibility: Homeless and/or uninsured adult males who enter the system through utilization of the acute substance addiction treatment services, or who are referred from homeless shelters or other medical or mental health facilities
Residential Treatment Over 30 Days
Residential Treatment over 30 days are services for individuals who have recently stopped using alcohol and/or other drugs, have been stabilized medically and are able to participate in a structured residential treatment program. Residential Treatment Over 30 Days include Recovery Homes, Social Model Homes, Therapeutic Communities, Specialized Residential Services for Women, Specialized Residential Services for Families, and Youth Residential Programs.
Recovery Homes provide a structured, sober environment for individuals recovering from addiction to alcohol and/or other drugs. These programs emphasize recovery and treatment within a structured, therapeutic setting. Residents are encouraged to integrate with the community and to access community resources, including self-help groups and employment. Some Recovery Homes offer enhanced services for pregnant and post-partum women and their infants, which include coordination of prenatal/pediatric care.
Therapeutic Communities provide a highly structured environment that emphasizes resident treatment and recovery within the parameters of the program structure. The residents take an active role in this mode of treatment helping them to take responsibilities and become positive role models. Some Therapeutic Communities offer enhanced services for pregnant and post-partum women and their infants, which include coordination of prenatal/pediatric care.
Social Model programs emphasize a sober living environment, peer counseling and case management. The emphasis of these programs is to assist residents to provide each other with a culture of recovery, support, sharing and positive role modeling. Residents are expected to be involved in the external community (through work, education, volunteer activities, etc.)
Eligibility: For all three types of residential services, individuals, eighteen years and older who are in early recovery from alcohol and/or other drug addiction. Priority is given to people with disabilities, cultural and linguistic minorities, homeless individuals, injection drug users, persons involved with the criminal justice system and persons with or at risk for HIV/AIDS.
In addition, pregnant women in early recovery who need assistance in developing and maintaining life skills necessary to implement drug-free living are eligible for the programs that offer enhanced services for pregnant and postpartum women and their infants.
Specialized Residential Services for Women (SRW)
These programs provide a safe and structured therapeutic environment where women may obtain residential substance addiction treatment services while still maintaining custody and care of their children. Reunification with children can occur while the mother is staying at the program.
Eligibility: Women with children who are in early recovery and need assistance in developing and maintaining life skills necessary to achieve drug free living.
Specialized Residential Services for Families
Specialized Residential Services for Families (also known as Family Substance Abuse Shelters) provide a safe and supportive treatment environment for homeless families when the caretaking parent(s) has a chronic substance addiction problem. Programs provide shelter, coordination and case management of substance addiction treatment and other services for homeless families in order to support and sustain sobriety.
Eligibility: The targeted population is identified as homeless caretaking parents or pregnant women, referred by the Department of Transitional Assistance, who have physical custody of at least one child and who have a chronic substance addiction problem. The Institute for Health and Recovery at (617) 661-7277 coordinates access to these programs.
Youth Residential Programs provide short-term residential rehabilitative services to youth between the ages of fourteen and eighteen years who need a supervised environment to strengthen their recently acquired sobriety. Includes diagnostic, counseling, educational and pre-vocational, recreational, and HIV/AIDS related services.
Eligibility: High-risk youth between 14 and 18 years of age who are experiencing emotional/ behavioral, family, developmental and/or social dysfunction as a result of their alcohol and other drug use.
Ambulatory Services are provided in community-based settings and involve attending scheduled appointments for counseling and treatment.
Outpatient Counseling provides treatment for adults and adolescents, their families, and/or their significant others who are affected by the use of alcohol or other drugs. Clients are assisted in gaining and maintaining skills for a substance-free lifestyle. Services include assessment and treatment planning, individual, group, and family counseling.
Eligibility: Any person with concerns about a substance addiction problem, or a family member/significant other who has concerns about someone else's substance addiction problem. Individual must be medically stabilized and not in need of acute inpatient services.
Day Treatment / Intensive Outpatient Treatment
Day Treatment and Intensive Outpatient Treatment are more intensive than Outpatient Treatment. Programs provide each client with several hours of counseling per day, up to four days a week including: individual, group and family counseling, relapse prevention, communicable disease prevention, case management, and encouragement of the use of self help groups.
Eligibility: Clients must be medically stabilized and require more than once per week counseling to maintain stability.
Acupuncture and recovery maintenance programs provide services for individuals with histories of substance addiction that require treatment for mild to moderate withdrawal symptoms. Services include limited medical screening and intake, motivational counseling/case management and acupuncture treatments.
Eligibility: Open to clients with mild to moderate withdrawal symptoms. Service is not appropriate for clients in need of a medically monitored detox.
Compulsive Gambling Services
Compulsive Gambling Services are specialized outpatient services for compulsive gamblers and their families. These programs include individual, family, and group counseling and case management services.
Eligibility: Clients must meet the criteria of pathological gambling.
Opioid Treatment provides medically monitored treatment services for clients who are addicted to opiate drugs such as heroin or pain medications and have a history of chronic relapse. Opioid Treatment services combine medical and pharmacological interventions (such as methadone or buprenorphine) with professional outpatient counseling, education, and vocational services. Services are offered on both a short and longer-term basis.
Aftercare/ Recovery Support
Aftercare/ Recovery Support Services provide case management services to help link individuals and families to community supports such as self-help, housing, educational/vocational services and employment.
Peer Recovery Support Centers
The Massachusetts Department of Public Health Bureau of Substance Addiction Services supports seven Peer Recovery Support Centers throughout the Commonwealth. These centers, located in Brockton, Greenfield, Lawrence, Marlborough, Roxbury, South Boston, and Worcester serve as safe places for people in recovery from substance use disorders to support each other’s recovery. For more information about a Peer Recovery Support Center, please visit the Massachusetts Substance Use Helpline.
Recovery High Schools
Since 2006, Massachusetts has been a leader in the development of Recovery High Schools. These schools aim at meeting both the educational and recovery related needs of students with substance use disorders, by providing a safe and supportive alcohol and drug free environment. Recovery schools have been shown to reduce student’s rates of relapse and increase their graduation rates. Currently BSAS supports four Recovery High Schools located in Beverly, Boston, Brockton, and Springfield.
Supportive Case Management
The overall goal for Supportive Case Management is to assist adults and/or families in recovery to help them achieve self-sufficiency. This goal is achieved through case management services within an alcohol and drug-free living environment that reinforces recovery through establishing community-based supports to maintain ongoing goals in the recovery process. The two program types in this category are Supportive Housing and Community Housing programs.
Eligibility: Men or women who have been sober for at least three (3) months, and have a severely limited ability to live independently because of a lack of income, diminished social skills, and/or insufficient social supports. Community Housing programs identify the targeted population as homeless families and individuals affected by substance addiction. Community Housing participants must meet the HUD McKinney Program definition of homelessness (see Homeless Services section for definition). The Institute for Health and Recovery at (617) 661-7277 coordinates access to the Community Housing Programs.
Community-Based Case Management
Community based case management programs provide support services for people throughout the course of recovery and aftercare. Case management services enhance access to care, provide additional support for clients to improve treatment outcomes and help clients develop community contacts and supports for long-term recovery.
Eligibility: Persons who are currently not utilizing, or have difficulty accessing, traditional substance addiction treatment services, and persons with histories of chronic relapse.
Homeless Services provide substance addiction services to homeless individuals with alcohol and other drug problems. Most of these services are provided within the homeless shelter system.
Substance Abuse Shelters for Individuals
Substance Abuse Shelters for Individuals (SASI) and the Pine Street Inn Night Center provide shelter for substance abusing homeless individuals whose behavior is difficult to manage and less appropriate for shelter in the general shelter system due to their current substance use. The SASI shelters also maintain a number of stabilization beds for those who seek a referral for substance addiction treatment and demonstrate a desire to remain substance free.
Post Detox-Pre-Recovery Programs (PDPR)
PDPR is a HUD-funded transitional supportive housing program that provides subsidized rooms with some case management services to individuals in early recovery, primarily after detoxification. The intent is to bridge, in the short term, the time between discharge from detox and admission into residential treatment, transitional or permanent housing.
Eligibility: Homeless individuals age 18 and older referred by a public ATS (detox) program, a homeless shelter, or outreach worker. Clients must meet the McKinney definition of homelessness. The McKinney definition includes individuals living either: on the streets; in a car; in a shelter; in a transitional housing program having originally come from the streets or a shelter; and, those at immediate risk of homelessness due to a discharge or eviction within one week.
Driving Under the Influence
The Bureau of Substance Addiction Services oversees the provision of substance addiction education and treatment alternative sentencing programs for those convicted of first or second offenses of driving under the influence. These programs include First Offender Driver Alcohol Education, Second Offender Driving Under the Influence Residential Programs, and Second Offender Aftercare.
First Offender Driver Alcohol Education (DAE)
The Driver Alcohol Education (DAE) programs are available to those individuals who agree to the alternative sentencing sanction as specified within Massachusetts General Laws for the offense of driving under-the-influence. Specifically, each DAE program participant is provided with a structured group where they receive educational material to help them identify and understand alcohol addiction issues and drinking-and-driving behaviors. While the major focus of these programs is on alcohol, other substances are also discussed. The program provides 40 hours of services conducted over 16 weeks and includes an assessment, participation in self-help and victim-impact community meetings.
Eligibility: Individuals convicted for the first time for drunk driving and who choose this option as an alternative to losing their license or possible incarceration. Referrals are generally made by the adjudicating district court; however, if the client is under 21, the Registry of Motor Vehicles may mandate the offender's participation.
Second Offender 14-Day Residential Program for Driving Under the Influence of Liquor (DUIL)
Considered phase one of the three-phase treatment model, the Second Offender Residential Programs are 14-day residential programs targeted towards individuals convicted of their second driving-under-the-influence offense. These services include: medical evaluation, individual and group counseling, educational sessions including the introduction to self-help, recreation, and assurance that assignment has been made to an approved Second Offender Aftercare Program.
Eligibility: Individuals convicted for drunk driving for a second time may choose this option as an alternative to 30 days incarceration. The adjudicating District Court makes all referrals.
Second Offender Aftercare (SOA)
The Second Offender Aftercare (SOA) Programs continue the treatment efforts of those convicted of their second driving-under-the-influence offense. SOA programs conduct the aftercare portion when the client completes the 14 –day Residential portion. During this portion the client is assessed and an individually- crafted program involving individual, group and family services will be designed. The design of the programming can fluctuate during the course of treatment depending on the needs of the client. Each client will be involved in treatment for the one year (1) of their probation supervision.
Eligibility: Individuals convicted for drunk driving for a second time. Individuals may choose this option as an alternative to at least 30 days incarceration. The adjudicating District/Boston Municipal Courts makes all referrals. Completion of this program is one of several requirements that an individual must fulfill in order to be considered for a hardship driver's license from the Registry of Motor Vehicles.
Statewide Support Services
Statewide Support Services support the Bureau of Substance Addiction Services funded system of prevention and treatment programs statewide with technical assistance, project coordination, and training on a range of topics. In addition, the Bureau funds Substance Addiction Information and Referral Helpline and a Revolving Loan Fund for Alcohol and Drug Free Housing.