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Credo, others offer alcohol treatment options in north country

Watertown Daily Times (NY) - 11/23/2014

Nov. 23--Alcohol-abuse experts say that for most patients enrolled in treatment programs, the abuse is accompanied by other issues that deserve similar attention.

At the Credo Community Center for the Treatment of Addictions -- the largest such facility in the north country -- patients who struggle with alcohol abuse often have problems with drug abuse and/or mental-health disorders. That's why each patient initially meets with a counselor to develop a treatment plan, according to Executive Director James P. Scordo.

The state-licensed treatment center, based at 595 W. Main St. in Watertown and established in 1970, offers a wide spectrum of outpatient and inpatient programs, Mr. Scordo said.

Credo, just one of the options in Northern New York for those seeking treatment for alcohol dependence, also has an outpatient clinic in Lowville that opened in September 2013. Credo took over the former Lewis County Alcohol and Substance Abuse Treatment Center.

About 90 percent of patients who enroll in treatment programs at Credo have been referred there through the court system, Mr. Scordo said. Of the 724 patients who received outpatient treatment there last year, 35 percent identified alcohol as their primary substance used, and 11 percent named it as their second substance of choice. The majority of patients said they used two or more substances.

"Alcohol continues to be the number one drug of choice, and marijuana is second, but heroin and opiate use has increased significantly over the last two years," Mr. Scordo said.

Credo had a budget of about $5.5 million and provided treatment for 1,300 individuals last year, he said, adding that services are covered by Medicaid and health insurance.

He said those who don't have insurance and pay out-of-pocket usually are eligible for discounts established by the state Office of Substance Abuse Services. Discounts are based on income and number of dependents.

Credo offers inpatient programs at four locations -- three in Watertown and one in Evans Mills -- with a combined 72 beds, along with seven apartments in the Watertown area for patients.

Those programs, which typically last six months, are designed for people who need more intense treatment than outpatient programs offer, Mr. Scordo said.

For males 16 to 20 years of age, an inpatient rehabilitation program is offered on a 115-acre farm in the village of Evans Mills. The program, known as "The Farm," helps young men develop a work ethic by having them do chores and make positive daily choices, Mr. Scordo said.

Oftentimes, he said, the young men enrolled in the program have a lingering alcohol or drug addiction after finishing an outpatient program.

"It provides them an opportunity to care for farm animals and teaches them the benefits of hard work," Mr. Scordo said. "They help out with household duties, too, and plant vegetables in a garden."

Outpatient programs at Credo's West Main Street building in Watertown typically last 12 weeks and include a variety of groups that meet weekly. Patients treated for alcohol addiction start outpatient programs with a course that teaches them how drinking can affect every aspect of their lives, Mr. Scordo said.

Credo specializes in behavioral modification and does not offer medications for alcohol treatment, he said.

Data isn't available on the effectiveness of Credo's treatment programs for alcohol users, according to Mr. Scordo, the center's executive director since 1990. He said Credo soon will begin using an electronic records system that will track the medical history of patients who visit treatment facilities and medical hospitals in the community.

Patients who finish treatment programs generally fall into three categories, Mr. Scordo said.

"About one-third of the people leave here and go on to live productive lives. They have increased self-esteem and confidence in themselves to live with a purpose," he said. "One-third may have trouble down the road but have learned from programs, and the other third will go right back into their old behavior."

Credo patients with addictions to alcohol and other substances often have mental-health disorders, Mr. Scordo said. Roughly half of Credo's patients have a co-occurring disorder. To respond to that need, Credo launched a mental-health clinic in April at its Coffeen Street headquarters in Watertown.

Counselors help patients understand how their addictions are related to mental-health issues.

"We try to find out if people are using alcohol and drugs to self-medicate," Mr. Scordo said.

SAMARITAN MEDICAL CENTER

Samaritan's behavioral health clinic, on outer Washington Street in Watertown, provides outpatient treatment for people with alcohol and drug addictions.

Of the 206 patients treated at the clinic last year, 42 percent identified alcohol as their primary substance used, and 22 percent said it was their second substance of choice, according to Canice L. Fitzgerald, director of outpatient addiction services.

She said about 75 percent of patients with substance addictions have co-occurring mental-health disorders.

Outpatient programs last four to six months and include treatment in individual and group settings, Mrs. Fitzgerald said. An intensive outpatient program also is offered, where patients meet with groups three days a week for six weeks.

Using evidence-based treatment, programs teach patients to view alcohol addiction as a disease, Mrs. Fitzgerald said. She said patients learn to curb their alcohol use and build stronger "recovery networks" with people who provide support.

Twenty to 23 percent of Americans engage in "risky alcohol use," where they often drink more they should but are not alcohol dependent, she said. Patients at the clinic who engage in this risky behavior are taught how their habits can affect relationships and lead to negative health and social consequences, such as high blood pressure or being charged with driving while intoxicated.

"The best description might be the person who's drinking three times a week, but they're exceeding what's considered the safe drinking level," Mrs. Fitzgerald said. "Instead of drinking four drinks (in a day), they're drinking seven. We want to have a conversation with that individual who has some risky use, (saying), 'Do you think you could consider either cutting the number of times a week you're drinking, or the number of drinks in a sitting?'"

"Most people that fall into that risky-use category don't realize it," she added. "They don't see anything because they haven't had negative consequences yet that people with addictive disorders have to experience."

PRIVATE PRACTICES

Private practices are another possibility for those who want treatment for alcohol dependence.

Dr. Jeffrey S. Aronowitz, a psychiatrist who owns NNY Behavioral Health on outer Washington Street in Watertown, has treated patients struggling with alcohol and substance abuse since he began his business in 1994.

He said his patients are working adults who have the convenience of scheduling appointments during the evenings. The patients also tend to carry commercial health insurance.

"One of the advantages here is that it's a streamlined approach in that the patient gets to meet me right off the bat, whereas in the clinics there's a pretty circuitous intake process," said Dr. Aronowitz, estimating he has treated "a couple of thousand" people with addictions. "They may not sit down with their counselor for two or three intake appointments at a clinic, whereas in a private practice, the wheels are in motion. I also have the capacity to prescribe medication, whereas certified alcohol- and substance-abuse counselors don't have that capability."

Another key feature of private practices is that patients come voluntarily, whereas treatment often is court-ordered for those who receive it at clinics, Dr. Aronowitz said.

"They're not mandated ... to be here," he said. "These are people who are struggling, and they come on their own accord because of it."

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