6.3 Lesson: Treatment Planning: Special Populations

Special Populations

It is recommended  that providers which serve an injection drug user population shall give preference to treatment as follows:

1. Pregnant injection drug users;

2. Pregnant substance users;

3. Injection drug users;

4. Overdose survivors; and

5. Veterans

Interim Services are defined as services to reduce adverse health effects of substance abuse; to promote the health of the individual, and to reduce the risk of transmission of a disease until the individual is admitted to a treatment program.

Injection Drug Users (IDU)

At a minimum, interim services include:
1. Counseling and education about HIV and TB;
2. Counseling and education about the risks of needle sharing;
3. Counseling and education about the risks of transmission to sexual partners and infants;
4. Counseling and education about the steps that can be taken to ensure that HIV and TB transmission do not occur; and
5. Referral for HIV and TB treatment service, if necessary

Pregnant Women

At a minimum, interim services include:
1. Counseling and education about HIV and TB;
2. Counseling and education about the risks of needle sharing;
3. Counseling and education about the risks of transmission to sexual partners and infants;
4. Counseling and education about the steps that can be taken to ensure that HIV and TB transmission do not occur;
5. A referral for HIV and TB treatment services, if necessary;
6. Counseling on the effects of alcohol and drug use on the fetus; and
7. A referral for prenatal care.

Women with Children

At a minimum, treatment programs providing treatment services to pregnant women and women with dependent children treat the family as a unit, when appropriate, and also provide or arrange for the provision of the following services to these women, including women who are attempting to regain custody of their children:
1. Primary medical care for women, including a referral for prenatal care as well as child care while the women are receiving such services;
2. Primary pediatric care, including immunization, for their children;
3. Gender-specific substance abuse treatment and other therapeutic interventions for women which may address issues of relationships, sexual and physical abuse, family therapy, nutrition education and education to GED level;
4. Therapeutic interventions for the children in the custody of the women receiving treatment services which may address, among other things, the children’s developmental needs, issues of sexual and physical abuse, and neglect; and
5. Sufficient case management and transportation to ensure those women and their children have access to the services provided in the four items listed above.

Overdose Survivors

Overdose is defined as a situation in which an individual is in a state requiring emergency medical intervention as a result of the use of drugs or alcohol. Priority should be given to identifying individuals who have overdosed as an additional priority in an effort to better facilitate access to care directly following an overdose event.  In order to ensure expedient, appropriate and seamless care for an individual who has overdosed, the case manager should develop, implement, and maintain a plan for screening, assessment, treatment, and tracking of individuals who have survived a recent overdose. 

Veterans

If it is suggested that a VA facility is the most appropriate facility to provide treatment for the veteran. Case management services may continue to be provided while the veteran is in the VA facility.

1. Provide the full continuum of treatment services to veterans;
2. Conduct screening and assessment services;
3. Determine the appropriate level of care;
4. Make a referral to treatment; and
5. Provide additional case management services as appropriate.