An Interview with Anthony Marengo, CEO at The River Source
Anthony Marengo, who is in long-term recovery himself, has worked his way over the last 15 years from his first job as a behavioral health technician to becoming the new CEO of one of Arizona’s premier addiction treatment centers, The River Source.
In his commitment to helping The River Source create the best possible outcomes for their clients, one primary question has stuck with him: Why do doctors, pilots, and those in the legal system have better addiction recovery rates?
Below, he explains the answer and talks about how the Reclaim-120 program at The River Source — the idea that clients who stay in rehab for at least 120 days have the best chance for long-term success in recovery — is born out of a commitment to keeping with best practices in addiction treatment.
Q: What is the Reclaim-120 Program?
I’ve worked in treatment for over 15 years, and the big question on my mind has always been, “what’s going to be the most impactful for the most amount of people?” There are a couple of groups that treat addiction very successfully, with success rates 80% or higher, year after year. Those are state medical boards who treat impaired physicians and commercial airlines who treat pilots with substance use disorders. Drug courts in this country also have above-average outcomes.
These three groups all have some kind of connection with the client for anywhere from 2 to 5 years. Addiction and other mental health disorders are long-term, chronic problems: The longer you can keep someone engaged in treatment programs, receiving professional help, the better their outcomes. The difficult part is providing that longer treatment while in-network with insurance companies, who often want to treat addiction on a short-term, acute basis.
Our 120-day program strives to maximize insurance coverage for our clients as much as possible to keep their out of pocket costs down. Our goal is to get them on a plan and give them the same recovery support as doctors, or pilots, in an affordable way.
Q: Why 120 days, and not the more common 30, 60, or 90 days?
Insurance used to mainly cover 28 to 30-day programs, but even they are seeing the need for more long-term care. That’s why they’re starting to authorize outpatient care after inpatient. There was a shift where the treatment industry started to realize, “If we can get 90 days of care, we can get better success rates.” And that’s based on real data — The National Institute on Drug Abuse (NIDA) recommends at least 90 days of treatment and states that longer is better.
We believe success rates will be even higher with 120 days. We’re just beginning to get data back about outcomes, but anecdotal evidence from our alumni supports our theory. The River Source alumni program is full of people that have done the 120-day program and are maintaining their sobriety, staying connected, and supporting one another.
We’re also not doing 90 days of inpatient; we’re doing 30 days inpatient and 90 outpatient. Spending more time split between these programs helps us make sure clients absorb the tools and skills necessary for long-term sobriety. We also recognize that many adults do not have an ability to remain at an inpatient setting for 90 days so our Reclaim-120 program allows for the support of treatment to occur alongside those individuals transitioning back into their everyday responsibilities.
Q: What challenges do most people face in shorter treatment programs?
The biggest obstacle is that clients underestimate the length of time that’s needed for rehab. Addiction is a chronic problem that you can’t fix with short-term care. Most people think their intentions to get better will be enough, but anyone who has found recovery from addiction can tell you they are not. We educate our clients on the need to create a long-term strategy for success and help them understand the need for additional support in order to realize their intentions to get better and recover.
Q: How do loved ones and peers factor into a person’s commitment to recovery?
Most people I know in long-term recovery didn’t want to get sober, they had to. It’s one of the takeaways from doctors, pilots, and those in our country’s drug courts, there’s an incredible amount of leverage — either a license to fly, a license to practice medicine, or jail time that’s hanging over their head. I encourage loved ones to not be scared to use the leverage they have, so their loved ones can accept what’s at stake for them.
A positive peer culture is at the forefront. You want to create an environment where clients can help each other. Sometimes it’s easier, if you’re at day one of getting sober, to listen to the person that’s got two weeks instead of the person that’s got two years. You can’t even imagine two years, but two weeks seems manageable. We help each of our clients realize they have something to offer a peer no matter what stage of healing they are at.
Our gender-specific treatment programs at the inpatient level also greatly help to foster a sense of safety among peers. We have found men and women tend to communicate better and more openly when isolated to their own gender during the vulnerable early stages of inpatient care.
Anything else you’d like to say to people interested in The River Source?
I really want to highlight our Recovery Guarantee. If someone makes the 120-day commitment, and goes through our full continuum of care, we make sure that they have access to treatment again should they need it during the year following the completion of treatment. So, if relapse does occur, we’re 100% committed to doing everything we can to make sure they have a chance to succeed, at no additional cost. We can’t guarantee that any given client will stay sober or achieve recovery, but we can promise that we’ll give our maximum effort to make sure our clients succeed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704134/