The City of Boston has a robust system of care for individuals, families, and communities affected by substance abuse. Programs are offered not only through the Boston Public Health Commission, but also through excellent treatment providers and programs throughout the city.
However, navigating this continuum and understanding the types of services available, and appropriate, can often be confusing. Below is a list of the various types of treatment services available with short descriptions for each to help better understand the services and supports that are available within Boston.
In addition, we have developed 
Substance Abuse Prevention and Treatment Services in Boston 2011.pdf that further describes the variety of prevention and treatment services options available in Boston at this time.
For help identifying which type of treatment is best for you or your loved one, please contact our
Resources and Referrals Center.
Prevention
Effective substance abuse prevention includes education. However, prevention efforts must go far beyond education to provide realistic and attractive alternatives to substance use, change community norms about substance use, and be supported by public health policies and regulations that limit access to legal and illegal substances, including marketing access, for community members, particularly young community members. Consistently, the most effective prevention efforts for young people involve youth in the design and implementation of those efforts- youth voice and beliefs need to be clearly visible.
Risk Reduction
Despite aggressive prevention efforts, substance abuse continues to be a reality in every community in Boston. Risk reduction services are provided for people who use substances because this is a group of people whose health and wellbeing is particularly vulnerable. Risk reduction includes counseling on safer substance use and overdose prevention and providing materials for this such as needle exchange and overdose rescue kits. Risk reduction services are often a substance user’s first entry into the continuum of care and risk reduction program staff are well trained in how to assess treatment readiness and support people’s transition into substance abuse treatment services when appropriate.
Types of Treatment
Acupuncture has been shown to be an important component of substance abuse treatment plans, though it is not usually considered substance abuse treatment by itself. Acupuncture can decrease cravings and anxiety, which is particularly important in preventing relapse during the early stages of treatment. Acupuncture usually takes 30-60 minutes and can be repeated multiple times per week, depending on the plan that the substance user and trained acupuncturist develop.
Aftercare Support and Self Help- AA, NA, SMART Recovery, Rational Recovery and more are groups for addicted people that meet daily, monthly or weekly. The many different groups operate under various models and philosophies. People should experiment with which group resonates the best for them.
Groups such as Al-Anon, Al-ATeen, Learn 2 Cope, GRASP (Grief Recovery After a Substance Passing) and others are for loved ones of substance users or for people who have lost someone to substance use. Because addiction recovery is a process that usually involves family, friends and loved ones, it is worthwhile to consider support and/or self help groups for people close to the substance user as part of a holistic and inclusive treatment plan.
Assessment Counseling, which takes approximately one hour, is a meeting with a specialist who gathers information about the individual’s situation, and helps the individual seeking treatment to identify and plan the most appropriate treatment path with the highest rate of success for the individual. Assessment counseling helps to support and guide the individual through the treatment process and engage their family.
Civil Commitment (also called Section 35) is involuntary and court mandated inpatient substance abuse treatment. Massachusetts General Laws Chapter 123, Section 35 permits the courts to involuntarily commit someone whose alcohol or drug use puts themselves or others at risk. Such a commitment can lead to an inpatient substance abuse treatment for a period of up to 30 days. There are specific criteria for what qualifies for “risk”. Because there are both potential benefits and serious risks to civil commitments, it is important to seek professional opinions and the experiences of other people who have been involved in this process with their loved one.
Detoxification (Detox)/Acute Treatment is a short term (5-7 day stay) treatment designed to alleviate or rid the body of the chemical dependence to drugs in a safe, medically supervised treatment environment. Detoxification is used primarily for patients seeking recovery from substances to which the body has formed a physical dependence such as alcohol and/or opioids[2]. Individuals must be medically cleared prior to admittance. Detox should usually be considered a medical procedure that is part, but not all, of an addiction treatment plan.
Holdings and Transitional Support Services (TSS) are short-term residential settings with structured environments for individuals seeking continued treatment post-detox. These programs are typically accessed directly from detox centers until a long-term residential bed becomes available, usually to a maximum of 30 days. They do not accept anyone in need of medical supervision, such as treatment of infections or acute mental illness.
Medication-Assisted Treatment utilizes medications such as methadone or buprenorphine to treat opioid addiction and minimize cravings. Participants must receive counseling in conjunction with medication-assisted treatment.
Outpatient Treatment provides structured treatment in an outpatient environment. Many types exist which vary in intensity; anywhere from one to three days a week. Methadone maintenance counseling can be included. Individual, group and family therapy services are available at many outpatient centers.
Sober homes (also known as alcohol and drug free housing) are group homes for individuals who are in recovery and wish to begin to re-engage in activities such as school, work, etc. in a supportive, recovery-oriented environment. These programs are not licensed and are not required to provide structured treatment on-site. However, therapy or self-help groups often do run on site. Abstinence from drug and alcohol use is most commonly monitored by regular drug testing. Stays range from three to 12 months.
Rehabilitation (Rehabs) includes detoxification and therapeutic support services provided within a hospital environment. Treatment length is approximately one to two weeks, and payment is typically through private insurance or self-pay.
Residential Rehabilitations (includes recovery homes) are long term residential treatment programs which often require participation in structured treatment, abstinence confirmed by regular drug and alcohol testing and often require that residents seek some level of employment. Stays range from three to 12 months.