Transcript Hazelden Your Next Step Tobacco Recovery Program 1990 – 2004

Hazelden Your Next Step
Tobacco Recovery Program
National Conference on
Tobacco or Health
Presented by
Barry McMillen, MA, LADC,
TAS
Your Next Step Client Base:
Primarily for those individuals who
have made numerous attempts to stop
using tobacco without success
Those experiencing consequences of
long-term tobacco use
Not limited to those recovering from
another substance
Program Description:
Seven-day residential program for nicotine
addiction
A Twelve-Step, abstinence-based model
that utilizes:
Lectures
Group therapy
Alternative therapies for nicotine withdrawal
and stress reduction: yoga, acupuncture, reiki,
exercise, massage, relaxation and bio-feedback
Individual therapy
Program Philosophy:
Identify nicotine as an addictive
substance:
Long history of continuing use,
Numerous attempts to quit,
Multiple relapses,
Denial,
Consequences
Program philosophy continued…
Peer process and staff support a
serious interpretation of nicotine
dependence
Loss of control
Denial of addiction
Language of tobacco as an addiction
Program philosophy continued…
This program is less about “quitting
smoking”
It is about exploring options for, and
Making significant commitment to,
A lifelong recovery one day at a time
Program Objectives:
Detoxification from Nicotine
Experience seven days of nicotine
abstinence in a supportive atmosphere in
preparation for continuing abstinence
Identify the addictive characteristics of
their use of nicotine including:
Specific ways in which an individual is powerless
over the drug nicotine
Examples of consequences they have
experienced due to nicotine use
Program Objectives continued…
Describe the progression of their addiction
to nicotine
Identify life areas needing to change in
support of recovery
Identify alternative strategies, other than
nicotine use, for coping with life stress
Construct a plan for ongoing
recovery/support
Program Expectations:
Nicotine Replacement Therapies are
strongly discouraged
Welbutron/Zyban is recommended
depending on a physician’s advice
Patients remain on the campus
grounds
Patient commit to attend all program
functions
Program Expectations continued…
Patients stop tobacco use at the same
time, the day after arrival at 8:45 am
No use of any mood altering
substance
Patient is responsible for their own
medications (there are exceptions)
Patient must be able to participate in
program activities
The Twelve Steps as an
appropriate format
Defines problem as addiction
Confronts previous concepts
Confirms the need for help
Provides hope of recovery
Requires review and acceptance of effects
of use on self and others
Provides guided program including
cognitive/behavioral change
Mentoring and support
Abstinence based
Results of Brief Residential
Treatment for Nicotine Dependence:
One Year Outcomes
N = 324
Measures at intake, 6 & 12 months
Average use = 31.79 cigarettes/day (SD =
19.2)
Methods used in prior attempts:
Nicotine patch (41.2%)
Hypnotherapy (33.3%)
Medication (29.4%)
Acupuncture (23.5%)
Results continued…
Tobacco free at intake = 0%
6 month = 59.4%
12 month = 52.9% (Cochran’s Q = 183.37,
p <.001)
Overall 50.0% had remained nicotinefree in the year following the
program
Results continued…
Program participants that returned to
tobacco use at 12 month follow-up:
21% reduced their tobacco use
Participants using Nicotine Replacement
Therapy(NRT)
Gum (1.9%)
Patch (1.6%)
Medication (1.9%)
34% made multiple attempts to quit
Most commonly identified barriers to
quitting
Stress (19.8%)
Cravings (16.5%)