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Substance Abuse Case Management: The Quick Guide

Case managers are like traffic cops. They play a vital role in a multi-faceted substance abuse treatment plan. While each organisation may have a slightly different definition of the role, case managers are generally responsible for coordinating the delivery of healthcare, including substance abuse treatment modalities. This article serves as a quick reference guide to the role of a case manager handling addiction treatment in the patient population.


The Substance Abuse and Mental Health Services Administration (SAMHSA) suggests that case managers are particularly valuable in substance abuse treatment settings. Because these cases are generally complex, and treatment is typically long-term, these professionals can help patients coordinate care across the mental and behavioural health paradigm as well as the healthcare field. Case managers serve as the hub for treatment that could include inpatient or outpatient care and long-term psychological counselling. They can provide assistance with healthcare specialists and testing procedures. Case managers are the conduit and navigator into a complex system of treatment and can open doors when the average patient may end up on a waiting list. They can help develop a treatment plan that could include a variety of approaches:

  • Detox, including medically-assisted programs

  • Residential inpatient care

  • Hospitalisation

  • Long-term or intense outpatient treatment

  • Traditional outpatient services

  • Mental health

  • Family counselling

  • Housing

  • Aftercare and follow-up

Case managers improve patient retention in substance abuse treatment programs. The complexity of substance abuse treatment encompasses a variety of treatment modalities. SAMSHA cites the available scientific literature that seems to suggest the benefit of case management in substance abuse treatment. The research suggests:

  • Case managers aid patients by improving retention outcomes in treatment; research shows patients with case managers stay in recovery longer and have a lower recidivism rate.

  • Substance abuse treatment is more likely to succeed when co-morbidities are addressed. Case managers ensure patients are more likely to receive and follow through on all of their problems, not just the physical addiction component of their disease.

  • Comprehensive treatment is a necessity in substance abuse treatment; the case manager can assist the individual in using all of the resources available to fight his or her affliction.

While job descriptions vary, SAMHSA suggests the case management role include five key components:

  1. Assessment of the patient’s situation

  2. Treatment/case planning

  3. Linkage/referrals to other programs and services

  4. Monitoring and follow up

  5. Advocacy and support

Case managers become a single source of truth for patients, helping them organise a dispersed healthcare environment. In this role, they become extremely valuable, adding their voice throughout the community-centred treatment process, which could span weeks or years.


Case managers must understand the architecture of traditional healthcare as well as the behavioural and mental health treatment field. Their job is to serve as referrer and service coordinator while advocating for their client. Other skills include:

  • Understanding substance abuse

  • Compassion and tenacity

  • Recognising the value of family and community support systems

  • Patience for dealing with insurance carriers

  • The embrace of cultural diversity

  • Supporting the value of a multi-faceted approach to addiction treatment

Case managers are the backbone of many substance abuse treatment programs. They serve an important role in the patient’s road to recovery from addiction.

Are you interested in learning more about case management? Have a look at ACCSA Module 19 -Comprehensive Case Management in Substance Abuse Treatment.


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