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The Recovery Center of AADP is a deterrent program that was established in 1989. We provide a service of community safety and supervision. Most of our clients have been arrested twice for Operating While Intoxicated; many have been arrested several times. The client can make a Plea Agreement through his/her attorney to be supervised through our agency rather than serve a jail sentence. This allows offenders to maintain employment, pursue education, and support their family while reducing their risk of continued drinking and driving. Clients are 100% responsible for the cost of the program. AADP does not receive money from taxes, grants, charities or any other source. The program was established to give offenders a supervised setting to repair their lives while being closely monitored. We prescribe and distribute Antabuse (disulfram) to our clients who are medically eligible. Medical eligibility is determined by a physical exam and liver function test. If eligible the program’s Medical Director will prescribe the Antabuse (disulfram). The Court is then notified of the client’s eligibility status. Clients are started on 500 mg MWF for 14 doses and then reduced to 250 mg for the remainder of their sentence which is approximately 2 ½ years. Liver function is evaluated approximately two weeks after starting the medication and then approximately every 6 months thereafter. Like all medications, Antabuse has the potential for side-effects. And like most medications these side-effects diminish over time. It should be noted that the side-effects listed in the PDR are often exacerbated with continued drinking. Interesting note: Clients do not seem to mention the bothersome side-effects of their alcohol and/or illegal drug abuse. When a client is found to have elevated liver function of ALT and AST two times the upper limit or GGT three times the upper limit, the client is immediately taken off of the Antabuse and monitored with a daily breath test and random urine alcohol screens. After 2-4 weeks the liver function test is repeated and evaluated. If the client is found to be ineligible to take Antabuse, alternative supervision is implemented. This supervision may include halfway house residency, Home Detention, or any other suitable supervision as determined by the court. If the agency doctor has any concern about the client’s ability to tolerate Antabuse he will rule the client ineligible. Clients may also be ruled ineligible by incurring or having a medical condition or being on a medication that is contraindicated with Antabuse. The medical department is overseen by a committee of psychiatrists, doctors, and advanced practice nurses. This committee sets policy and reviews all areas of concern. The medical committee is overseen by a general board comprised of community professionals who oversee the agency. Clients are monitored for the top 10 drugs of abuse, alcohol use, synthetic and designer drugs. If they test positive for any of these, probation officers are notified and program counselors intervene. Supervision is increased from three day a week reporting to five day a week reporting. Clients will be monitored closely with forensic tests and face-to-face contact with their probation officer and the counseling staff. If the client tests positive for cocaine, ecstasy, methamphetamine, synthetic or designer drugs, they are immediately taken off of the Antabuse. If they stop usage of these drugs they will be returned to Antabuse. If the client continues to test positive they will be taken back to court for further disposition.
All clients will meet with agency counselors to be referred for drug/alcohol classes as a matter of program and court requirement. Agency counselors also do ongoing intervention and trouble shooting. Clients may speak with probation officer, medical staff and counselors at any time. Our goal first and foremost is to help keep the community safe from repeat drinking and driving offenders. Our success comes from the constant multifaceted monitoring inherent in the program’s design. In the process, clients are given the opportunity to re-assess their behavior and their options regarding their alcohol and/or drug use. The program is both a tool of change and a consequence for illegal dangerous repetitive choices. We have learned a great deal over the years about addiction, dependence, and substance abuse. Our staff is well trained in this area. We do offer voluntary programs as well that are not court related. Our greatest success is to educate and interrupt the cycle of addiction. The rest is up to the client.
Veterinaria, Anno 16, n. 3, Ottobre 2002 APPROCCIO TERAPEUTICO ALLE PIÙ COMUNI CARDIOPATIE DEL CANE E DEL GATTO: RUOLO CARDINE DEI FARMACI DIURETICI CLAUDIO BUSSADORI Med.Vet., Med. Chir. Dipl. ECVIM (Cardiology) * DANITZA PRADELLI , Med. Vet * * ORIOL DOMENECH , Med. Vet * * Clinica Veterinaria Gran Sasso, via Donatello 26, 20131 Milano * * Sezione di Clinica Medica V
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