More than one in 10 Veterans have been diagnosed with a substance use disorder, slightly higher than the general population, according to the National Institutes for Health. Couple that with mental health issues and dealing with the challenges caused by the COVID-19 pandemic, and it would not be surprising to hear of Veterans struggling to maintain their sobriety.

The Minnesota Veterans Homes’ Domiciliary Program, however, is reversing that assumption.

Home to 157 Veterans who reside at the Hastings Veterans Home, as well as on the campus of the Minneapolis Veterans Home, the Domiciliary (Doms) Program provides a supportive, independent living environment that includes medication management, mental health care and therapeutic recreation among other services. While sobriety support has always been an area of focus, last year the Doms Program reimagined their approach with amazing results.

“In the past, we were reacting instead of being proactive with sobriety management. Being proactive has led to our success,” says Mike Anderson, Doms Program Administrator. “It’s our job to create programming and an environment where Veterans can succeed.”

In April 2019, Doms staff began researching opportunities for improvement in sobriety management. They looked at root causes of relapses, completed data analyses, and took best practices from experts in the field of addiction recovery, including the U.S. Veterans Administration Health Care System and private providers such as Betty Ford/Hazelden. In addition, they recommitted to modeling respect for their Veteran Residents.

The biggest change to the programming was getting Veterans help as it was needed. In the past, a relapse was seen as an infraction of rules and was punishable. Now, the Doms team provides Veterans with a safe and confidential outlet. “Instead of waiting to get caught, the Veterans are now comfortable coming forward to ask for help without the looming threat of a negative consequence,” Anderson says.

The team articulated a purpose statement for the Sobriety Support Program:

“The entire team is here to support Veterans with their sobriety management needs, to get them help when needed, and to maintain a healthy and sober environment.”

That environment includes working with the Veterans to create individualized sobriety management plans, facilitating peer support and self-help groups, providing individual counseling, and referring Veterans to the VA Health Care System, a Vet Center, or independent treatment programs, as needed.

To ensure an objective approach to an oftentimes frustrating situation, the team developed tools that include a Chemical Use Relapse Intervention Matrix, an Under the Influence Protocol Flowsheet, and a Resident Chemical Use Policy. Along with these tools, it has been an “all-hands-on-deck” approach by the team. While the Behavioral Health team and the Chemical Dependency Counselor are at the center of this approach, all team members have stepped up to make a difference to every Veteran we serve.

But most important was reinforcing the already strong and trusting relationships that the Veteran Residents have with the staff. “We had to build trust with the staff and develop relationships to encourage the Veterans to make the right decisions,” says Anderson. “The Veterans have to make choices; now it’s cooler here to be sober than to be drunk and partying.”

The numbers demonstrate the success of the new approach. In 2019, the Doms Program experienced 79 relapses. In 2020 through November, there have been only 16 and the team is working toward zero.

For many Veteran Residents, this success is lifesaving. “We don’t give up or quit on people; we don’t label people as a ‘lost cause,’ even if it may seem that they have given up on themselves,” Anderson says. The Residents acknowledge the importance of the program, with more than one stating: “If I wasn’t living here, I’d be dead.”

You may know someone who is struggling with alcohol or drug abuse in this season. Tom Waugh, the Doms Program Chemical Dependency Counselor, says the most important thing is recognition that there is an issue: “The first step in getting help or staying sober is that a person needs to acknowledge that there is a need for change.” He also notes, “Making change is difficult on your own. Reaching out for help can be a powerful and difficult thing to do, but we have made is safe and available. In the Doms, we are ready to be there for those Veterans.”