Community as Treatment: The Therapeutic Community Model in The Era of The Opioid Crisis

Increased attention to additional treatment approaches for Opioid Use Disorder (OUD) is needed amidst the current opioid crisis. The Therapeutic Community (TC) is an effective model that offers a unique treatment frame for patients considered “treatment-resistant”, yet it is rarely considered an option in the United States and has not been included in the federal response to the opioid crisis. We explore the evidence supporting the TC modality as uniquely effective and use a current Italian model-San Patrignano, the largest TC in the world-to identify salient mediators of the outcome, including long-term treatment and removal from the opioid-associated environment. The potential role of the TC in responding to the opioid crisis in the United States and its compatibility with other standard-of-care treatments are reviewed