Substance Use Monitoring that Works

Substance Use Monitoring that Works

Joel Mader,
M. Ed., R. Psych. 

Substance use monitoring (SUM) provides a reliable and objective measurement of substance use. SUM can enhance accountability and assist with substance use treatment. For persons struggling with addiction, SUM can be used to inform treatment planning and manage risk, ultimately allowing individuals to resume contact with their children and other family members. 

The benefits of SUM are contingent on well-developed monitor-ing protocols. Effective protocols address what substances are to be monitored, methods of testing, as well as practical issues including who is responsible for gathering samples and the frequency of collection. 

Unfortunately, all too often SUM protocols are poorly designed and implemented. From inappropriate testing methods (e.g., using commonly available urine tests) to a failure to use randomized sampling, poorly designed SUM protocols undermine the credibility of results, reduce confidence in findings and have the potential to cause substantial harm, as false positives can have major implications in legal and workplace contexts. 

Similar problems exist when SUM results are interpreted by under-qualified professionals, often resulting in overly simplified, generic, or even inaccurate interpretations. 

In contrast, properly interpreted results can inform care for those with addiction, allowing treatment to be “stepped up” or “stepped down” based on the most recent data collected. 

The relapse of substance use is a common part of substance use recovery, and the finding of a substance use relapse should not automatically lead to a substantial decrease in contact between parent and child. Rather, a case-by-case analysis of the parent’s relapse and the child’s needs and functioning shape the parenting plan response to relapse. 

Research has consistently indicated that SUM is one of the most effective behavioural interventions for initiating and maintaining abstinence or reducing harm from alcohol and drugs. When properly implemented, SUM can provide significant benefits to our clients and their families. 

Contact Mr. Mader at jmader@lionheartpsych.ca 

Poorly designed SUM protocols undermine the credibility of results, reduce confidence in findings and have the potential to cause substantial harm.

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