Presentation by Laurence Alvis & Rose McCrohan on ReGen's work developing a range of treatment responses to people seeking treatment for methamphetamine dependence.

1. Tailoring programs and
services to Methamphetamine
Laurence Alvis
& Rose McCrohan
APSAD Perth 2015

2. Who are we?
UnitingCare ReGen is a
not for profit agency with
over 45 years experience
of providing AOD
treatment & education in
Victoria.
ReGen is a leading
provider of treatment
services in Victoria.
ReGen has piloted Non
Resi Rehab Day
Programs in Victoria
since 2009

3. First choice
of substance
2010-2015
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16
YTD
13%
14%
10%
7% 7% 7% 7%
4%
9%
44%
39%
40%
45%
39%
42% 41%
38%
33%
22%
32% 32%
30%
29%
22%
20% 19%
17%
8%
6%
5%
6%
12% 12%
17%
20%
30%
13%
9%
13%
12%
13%
16%
15%
19%
11%
Major Presenting Drug Types 2007 to 2016
Heroin Alcohol Cannabis Ampetamines (Includes Ice) Other

4. What was the
problem?
In 2012/13
• Over 40% of clients were
reporting methamphetamine
as their 1st or 2nd drug of
choice
• Poor retention in adult
withdrawal 48% compared to
90% in youth service
• Poor program participation &
hostility that impacted on
client-staff relationships
• Early discharge and poor
treatment experience
• Increasing serious incidents

5. What did we
do?
• Residential Unit staff raised issues that
treatment wasn’t working for meth clients
• File audit, client feedback - recommended
program changes
• Staff forum – focus on staff & client care
• Implemented program changes from 01.01.13
• Relax program expectations first 72 hours; rest,
minimise stimulation, support & reassurance
• Monitoring (mental state, fluid intake, vital
signs) & withdrawal state (Amphetamine
Cessation Symptom Assess)
• Extended stay from 7 to 10 days (acute
withdrawal phase)

6. During the
trial
• Retention increased from 48%
to 60%, higher now.
• Client staff relationships
improved
• Number and severity of
incidents declined in the final 3
months of the trial and
continued to decrease
• Clients still reported low -
moderate withdrawal symptoms
at discharge
• Over 50% of clients had
experienced no decrease, or an
increase of withdrawal
symptoms on discharge from
residential withdrawal (7 days)

7. What is
stepped care
Stepped care
• Support to engage
and access treatment
• Support to reduce
drug use prior to
residential withdrawal
• Crash at home if
appropriate
• Assertive follow up
and support post
withdrawal

8. Lessons
• Extended withdrawal
duration (for some)
• Support to access
treatment before and after
withdrawal (stepped
care). Easier to do step
down care
• Post withdrawal programs
that cater for these clients
(not just NRW)
• Maintain relationship with
the participant throughout
treatment
• Priority access to the
Torque Program
• Aboriginal inclusion

9. What is Torque?
• Torque is an evidence based structured day non residential rehab program
comprising of a range of individual and group interventions
• Torque is for people involved in the justice system, and is modeled on the
ReGen Catalyst program
• It is a 6 week non-residential rehabilitation program for people who have made
a decision to stop use. The program operates from Monday to Friday with a
maximum 12 participants per group
• The model is designed as an alternative treatment option for Victorians involved
in the justice system for whom residential services are inaccessible or
unsuitable post withdrawal, but who require more intensive support than
individual counselling
• Suitable participants need to be capable of self-management and have at least
a moderate level of intellectual functioning

10. Torque Program
• Based on Cognitive Behavioral Therapy and motivational
enhancement
• Completion of program: 80% of the total hours of the
compulsory sessions
• 4 x Motivational enhancement sessions (Individual counselling
sessions)
• 10 x Cognitive behavioral coping skills training
• 4 x Mood management sessions (Anxiety, depression and
anger)
• 4 x Skills practice sessions
• 18 x Check In & Outs

11. Electives
• The program also offers a range of educational,
complimentary and therapeutic session that
supports retention and specific needs
• Physical activity (Gym)
• Yoga & meditation
• Nutrition
• Family strengthening
• Art therapy
• Music & drumming
• Financial Counselling
• Employment support

12. Results
Substance Use
• At 3 month follow-up sustained abstinence from heroin, and reductions in
cannabis and methamphetamine use still evident
• Reduced rates of substance use at program completion & significant
increases in confidence to manage high risk situations
Offending behaviours
• Decreased prevalence of past month property, drug dealing, fraud and/or
violent offending – example -9 clients reduced to 3 in week 6
Quality of Life (QOL)
• Overall improved QOL, health & life satisfaction, sustained or further
improved at three month follow-up
Evaluation of Torque –LeeJenn Health Consultants January 2015

13. Key Learnings
• Keeping people engaged while they
move through treatment options
• Person centred
• Evidence based and consistent with
best practice
• A suitable intervention for
methamphetamine users
• Post treatment follow up (support
worker refreshers, Momentum)

14. Clients, EOC and Incidents 2007 to 2016
0
1000
2000
3000
4000
5000
6000
2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16
YTD
3104
3481
3785 3727
3292
3613
4049
5025
2416
1723
1864
2027
1901
1807
1982
2136
4242
1830
102 85 133 121 105 87 94 105
386% 5% 7% 6% 6% 4% 4% 2% 2%
Episodes of Care Clients Incidents Incidents by Clients

15. Questions….
http://www.regen.org.au