Case management: ongoing evaluation of patients' needs in an opioid treatment program.
Case management has been widely used in mental health and substance abuse services. There have been only a few studies that have examined the use of case management in opioid-treatment programs. In a project funded by the Centers of Substance Abuse Treatment, we looked at the use of case managers and specifically at the treatment needs of this unique population. Our case managers, with the aid of research assistants, surveyed the treatment needs of 189 patients entering an opioid-treatment program over a 3-year period. Patients completed the Needs Assessment Instrument at intake, 6 months, and 12 months. The use of case managers to assess the needs of opioid-dependent patients is applicable to substance abuse treatment setting especially in opioid-treatment programs that provide methadone or buprenorphine maintenance. The critical services most requested were vocational, employment, transportation, dental, emotional, and smoking cessation. There were changes over the 12-month follow-up period in the types and priority of services requested. IMPLICATION FOR CASE MANAGEMENT PRACTICE: The Needs Assessment Instrument is a useful tool for case mangers to assess treatment needs of patients and the overall clinic population. Once sufficient patients have been surveyed, the opioid-treatment program can plan needed services for the clinic. Specific social agencies can be contacted to provide key services. Service needs are not static and as patients improve they may need a different mix of services to support their continued abstinence.