Bridges have been built: Is anyone using them?
|
|
- Osborne Conley
- 8 years ago
- Views:
Transcription
1 Bridges have been built: Is anyone using them? Richard A. Rawson, Ph.D, Professor Supported by: National Institute on Drug Abuse (NIDA) Pacific Southwest Technology Transfer Center (SAMHSA) United Nations Office of Drugs and Crime Integrated Substance Abuse Programs
2 The Problem in 1996 The US Substance Abuse Research and Treatment Systems each spend billions of dollars per year on the problem of substance abuse treatment. However, the efforts have traditionally been completely disconnected. Despite over 30 years of research findings, most treatment services are based on practices developed during the 1950s and 1960s.
3 U.S. Agencies Involved with Substance Abuse Research and Treatment Research Agencies NIH National Institutes of Health NIDA National Institute on Drug Abuse NIAAA National Institute on Alcohol Abuse & Alcoholism
4 U.S. Agencies Involved with Substance Abuse Research and Treatment Service Agencies SAMHSA Substance Abuse, Mental Health Services Administration CSAT Center for Substance Abuse Treatment CSAP Center for Substance Abuse Prevention
5 Traditional Culture of U.S. Substance Abuse RESEARCH System University-based, academic personnel Minimal community involvement Treatment viewed condescendingly Publish data in professional journals Little systematic attempt to transfer knowledge Topics of research omit clinical concerns
6 Traditional Culture of U.S. Substance Abuse SERVICE Delivery System Recovering/paraprofessional staff Minimal connections with academic tradition Personal ideology determines treatment choices Generally anti-medication Uneven and inadequate treatment funding Little attention to data Science viewed as irrelevant
7 Bridging the Gap : : A Benchmark Institute of Medicine (1998). S. Lamb, M.R. Greenlick,, & D. McCarty, D. (Eds.), Bridging the gap between practice and research: : Forging partnerships with community-based drug and alcohol treatment.. Washington, DC: National Academy Press.
8 THE NATIONAL INSTITIUTE ON DRUG ABUSE (NIDA) CLINICAL TRIALS NETWORK (CTN)
9 NIDA Clinical Trials Network (CTN) Mission The mission of the Clinical Trials Network (CTN) is to improve the t quality of drug abuse treatment throughout the country using science as the vehicle. The CTN provides an enterprise in which the National Institute on Drug Abuse, treatment researchers, and community-based service providers cooperatively develop, validate, refine, and deliver new n treatment options to patients in community-level clinical practice. This unique partnership between community treatment providers and academic research leaders aims to achieve the following objectives: es: Conducting studies of behavioral, pharmacological, and integrated behavioral and pharmacological treatment interventions of therapeutic eutic effect in rigorous, multi-site clinical trials to determine effectiveness across a broad range of community-based treatment settings and diversified patient populations; and Ensuring the transfer of research results to physicians, clinicians, providers, and patients.
10 The NIDA CTN: What is it? Network Organization The CTN framework consists of seventeen Nodes (Regional Research and Training Centers, linked with five to ten or more Community-based Treatment programs), a Clinical Coordinating Center, and a Data and Statistical Center. This allows the CTN to provide a broad and powerful infrastructure for rapid, multi-site testing of promising science-based therapies and the subsequent delivery of these treatments to patients in community-based treatment settings across the country.
11 The Pacific Node of the CTN The Pacific Region Node is a partnership between the Regents of the University of California, Los Angeles and several community treatment programs in the State. The Pacific Node incorporates researchers and clinicians from throughout California. Many of the clinical networks have been involved in the transfer of research into practice for over a decade
12 NIDA CTN: How does it work? Research concepts are generated at each of the Nodes after discussion between researchers and clinicians. These concepts are proposed to the CTN group and are voted on. Those receiving highest vote go to director of NIDA for approval.
13 Pacific Region Protocol Involvement PROTOCOL0001 Buprenorphine/Naloxone for Opiate Detoxification - INpatient PROTOCOL0002 Buprenorphine/Naloxone for Opiate Detoxification - OUTpatient PROTOCOL0004 Motivational Enhancement Treatment (MET) PROTOCOL0006 Motivational Incentives - Drug Free Clinics PROTOCOL0007 Motivational Incentives - Methadone Clinics PROTOCOL0008 A Baseline for Investigating Diffusion of Innovation
14 Pacific Region Protocol Involvement PROTOCOL0009 Smoking Cessation Treatment With Transdermal Nicotine Replacement Therapy In Substance Abuse Rehabilitation Programs PROTOCOL0012 Characteristics of Screening, Evaluation, and Treatment of HIV/AIDS, Hepatitis C Viral Infection, and Sexually Transmitted Infections in Substance Abuse Treatment Programs PROTOCOL0014 Brief Strategic Family Therapy (BSFT) For Adolescent Drug Abusers
15 Pacific Region Protocol Involvement PROTOCOL0018 Reducing HIV/STD Risk Behaviors: A Research Study for Men in Drug Abuse Treatment PROTOCOL0019 Reducing HIV/STD Risk Behaviors: A Research Study for Women in Drug Abuse Treatment PROTOCOL0027 Starting Treatment with Agonist Replacement Therapies START PROTOCOL0030 Prescription Opioid Addiction Treatment Study (POATS)
16 CTN: Strengths Has provided a true forum for researchers and clinicians to interact cooperatively and collaboratively Has generated a significant amount of new published research Research and surrounding publications do appear to be promoting some transfer of research to practice in CTN-affiliated treatment organizations Annual Blending Conference and Journal
17 CTN: Limitations (opinion) Extremely expensive Extremely bureaucratic and committee heavy Productivity not commensurate with budget Bi-directionality of effort is only moderately successful (mostly researcher driven) Impact on the larger US treatment system is unknown
18 Running the Trials is not enough Diffusion of Innovations. 4 th Edition Everett M. Rogers New York: Free Press
19 Research Questions NIDA s s CTN offers an important opportunity to examine if and how inter-organizational relationships promote innovation adoption Focus on buprenorphine and voucher-based motivational incentives Are CTPs in the CTN protocols significantly more likely to adopt bup and/or vouchers? Is trialability a predictor of adoption? Does membership in the CTN confer advantages to CTPs that are not involved in these protocols? Is exposure a predictor of adoption?
20 Adoption of Buprenorphine 60% 46.0% 40% 20% 16.0% 11.1% 0% CTPs in Trial Other CTPs Non-CTN CTPs that participated in the buprenorphine trials were significantly more likely to have adopted buprenorphine than CTPs not in the trials and non- CTN centers
21 Logistic Regression Model of Buprenorphine Adoption Controlling for other organizational factors: CTPs in the buprenorphine protocols were 5.2 times more likely to use buprenorphine (at the 6-month 6 follow-up) than non-ctn programs (p<.01) Other significant predictors, net of effects of CTN exposure: Center offers detox services (O.R. = 3.59) Center has a physician on staff or contract (O.R. = 3.94) The percentage of primary opiate clients (O.R. = 1.009)
22 Adoption of Voucher-Based Motivational Incentives 60% 44.4% 40% 32.8% 31.2% 20% 0% CTPs in Trial Other CTPs Non-CTN These differences in adoption were not statistically significant
23 Discussion The ability to compare CTN vs. non-ctn centers provides a unique opportunity to examine a variety of factors that influence innovative behavior and the adoption of evidence-based practices at the organizational level. The longitudinal design of these studies will allow for observation of continued trends in adoption of these techniques. Future research is planned to examine the use of MET and motivational interviewing in CTN and non-ctn samples.
24 From a clinical trial to technology transfer S. Kellogg, M. Burns, P. Coleman, M. Stitzer, J. Wale, M. Jeanne Kreek,, M.D. Something of value: The introduction of contingency management interventions into the New York City Health and Hospital Addiction Treatment Service. Journal of Substance Abuse Treatment, 2005, Volume 28, Issue 1, Pages 57-65
25 The NIDA Methamphetamine Clinical Trials Group (MCTG)
26 MCTG: The Problem NIDA has a desire to speed up the development of medications for the treatment of methamphetamine use disorders. Too few research groups available in areas of the US with extensive methamphetamine use. As complexity of medication testing and regulatory system becomes more complex it is difficult for new investigators to initiate research
27 MCTG: The Solution Establish a training/coordinating center to train, organize and monitor sites. Establish a set of medication testing sites in regions with extensive methamphetamine use and an MD and team that can conduct trials. Decide on a medication(s) and protocol for study Initiate studies
28 Methamphetamine Clinical Trials Group UCLA is the coordinating center for clinical studies 5 Sites participate on a contractual basis Primary focus-reduction of methamphetamine use All trials use a behavioral platform for all treated subjects
29 Methamphetamine Clinical Trials Group (MCTG) Los Angeles, CA UCLA Coordinating Center Richard Rawson, PI Des Moines, IA Powell Chemical Dependency Center Dennis Weis, PI Costa Mesa, CA Friends Research Institute Michael McCann, PI Honolulu, HI John A. Burns School of Medicine & Queens Hospital William Haning, PI San Diego, CA South Bay Treatment Center Joseph Mawhinney, PI Kansas City, MO University of Missouri, Kansas City Services, Inc. Jan Campbell, PI Division of Treatment Research & Development 19 September 2000
30 MCTG Studies Behavioral Platform Study (Completed Oct, 2002). (N=60) Ondansetron Study ( Completed Dec 1, (N=120 Bupropion Study (Completed June 1, 2005) (N=120) Topirimate Study (Underway, projected completion, April 1, 2007 (N=120) Modafinal Study (Projected to begin April 2007)
31 MCTG: Accomplishments Transferred state-of of-the-art clinical trials methods to clinical sites with no previous research experience. Successful conducted 3 studies to date with one (bupropion) showing significant promise Sites now are capable of applying for independent research funding
32 Process Improvement 101 Reduce Waiting & No-Shows Increase Admissions & Continuation
33 Why Process Improvement? Customers are served by processes 85% of customer related problems are caused by organizational processes To better serve customers, organizations must improve processes
34 NIATx Four Project Aims Reduce Waiting Times Reduce No-Shows Increase Admissions Increase Continuation Rates
35 NIATx Results Reduce Waiting Times: 51% reduction (37 agencies reporting) Reduce No-Shows: 41% reduction (28 agencies reporting) Increase Admissions: 56% increase (23 agencies reporting) Increase Continuation: 39% increase (39 agencies reporting)
36 Five Key Principles Evidence-based predictors of change Understand & Involve the Customer Focus on Key Problems Select the Right Change Agent Seek Ideas from Outside the Field and Organization Do Rapid-Cycle Testing
37 Understand and Involve the Customer Most important of all the Principles What is it like to be a customer? Staff are customers, too! Walk-through, focus groups
38 Focus on Key Problems What is keeping the executive director awake at night? What processes have staff and customers identified as barriers to excellent service?
39 Detour 1 Unclear purpose! Where are you going? How will you know you have arrived?
40 Aim Statement Example Improve 30-day continuation rates from 30% to 80% in outpatient services. Need Target Scope of work
41 Detour 2 No feedback! Need a tracking measure. Have a simple measure.
42 California s s Proposition 36:Did it Work?
43 50,000 40,000 The Problem: California Prison Population, Drug Offenses, ,947 30,000 20,000 23,853 33,513 10, ,778 5, Source: California Department of Corrections.
44 Increase in California Prison Population, Drug Offenses, Rate per 100,000 Population Source: California Department of Corrections. Year
45 Solutions?
46 Proposition 36 Substance Abuse & Crime Prevention Act (SACPA) 2000 Ballot Measure: Passed by 61% of California voters in 2000 Authorized $600,000,000 in new funds for implementation Drug offenses: Non-sales, non- manufacturing. Restrictions on offenders with histories of serious or violent crimes Results in community supervision and treatment instead of: Incarceration or supervision without treatment
47 2000 Proposition 36 Ballot Wording: Proposition 36.. Drugs. Probation and Treatment Program. Requires probation and drug treatment, not incarceration, for possession, use, transportation of controlled substances and similar parole violations, except sale or manufacture. Authorizes dismissal of charges after completion of treatment.
48 Result 6,199,992 / 60.8% Yes votes 3,991,153 / 39.2% No votes Proposition 36 passed and was enacted as the: Substance Abuse & Crime Prevention Act (SACPA)
49 Pipeline Arrest or Parole Violation Conviction and Court Order of Probation and Treatment; or Parole Referral Assess ment Treatment Treatment Completion Conviction Dismissed (probation) Ineligible No shows No shows Repeated violation and dropouts No petition, petition denied Attrition
50 Implementation Show Rates Referred Assessed Placed Show rate (%) Year 1 7/01-6/02 44,043 37,495 30, Year 2 7/02-6/03 50,335 42,972 35, Year 3 7/03-6/04 51,033 42,880 37, Total 145, , ,
51 Client Characteristics Half use methamphetamines Half used primary drug more than 10 years Half are in treatment for first time
52 Treatment Summary 34% of clients who enter treatment complete it Most clients are sent to outpatient treatment Heroin users rarely get methadone treatment Heroin users are least likely to complete
53 Re-offending 100 New Arrests One Year After Offense, Year 1 (7/01-6/02) Population Percent of offenders New drug arrest New property arrest New violent arrest Referred but untreated (N = 10,196) Entered but did not complete treatment (N = 14,597) Completed treatment (N = 5,176)
54 Any Work in the Past 30 Days 100 Percent of offenders a 42.2 b 53.9 a,b 0 Assessed but untreated (N = 178) Entered but did not complete treatment (N = 425) Completed treatment (N = 149) a,b Group differences are statistically significant, p =.04. Pre-post differences (not shown) are all statistically significant, p <.0001.
55 Any Drug Use in the Past 30 Days Percent of offenders a 27.4 b 17.7 a,b 0 Assessed but untreated (N = 178) Entered but did not complete treatment (N = 426) Completed treatment (N = 149) Group differences are statistically significant. a p<.05, b p<.02.
56 Outcome Summary: Effect of SACPA As Policy SACPA-era offenders have more drug arrests in the initial 12 months Initial re-offending is affected by differences in incarceration rates Violent re-offending is low in all groups
57 What about costs?
58 SUMMARY OF FINDINGS $2,000 $1,326 Dollars per offender $1,000 $0 -$1,000 -$2,000 Prison Jail -$1,531 $198 Probation Parole -$221 Arrest and Conviction $743 Treatment $230 Health Tax -$59 Total -$3,000 -$2,861 -$4,000 -$3,547 Notes: Figure provides a summary of cost offsets. The zero-line can be interpreted as cost neutral. Any bar above the line represents a cost increase and any bar below the line represents a cost saving.
59 COSTS UNDER SACPA Savings primarily from prison, jail reductions. Cost increases primarily from increased treatment, new crimes. Costs are $2,861 per offender lower than what we would expect in the absence of SACPA. Benefit-to-cost ratio of about 2.5:1. For treatment completers, the cost savings reflect a benefit-to-cost ratio of about 4:1
60 KEY COST ANALYSIS FINDINGS Substantially reduced incarceration costs. Greater cost savings for some offenders than for others Can be improved
61 California Prison Population, Drug Offenses, ,000 40,000 42,947 30,000 20,000 23,853 33,513 10, ,778 5, Source: California Department of Corrections.
62 California Prison Population, Drug Offenses, ,000 40,000 42,947 30,000 23,853 33,513 33,777 20,000 10, ,778 5, Source: California Department of Corrections.
63 Conclusion 70% of referrals have entered treatment Methamphetamine is the most common drug Half are in treatment for the first time 34% of clients have completed treatment Initial re-offending is lowest for completers Employment is highest for completers Abstinence is highest for completers, but overall drug use outcomes are uneven
64 Prop 26 (SACPA): Is it good policy? Approximately 200,000 individuals will have received treatment over program Final report currently in process Fiscal impact appears quite positive No group has come out to revoke SACPA Disagreements concern exact provisions Failure to pass revised SACPA provisions could result in funding responsibility being passed on to counties.
65 UNODC International Network of Treatment and Rehabilitation Resource Centres
66 Recognizing and Addressing the Need to Expand Training and Treatment Capacity to Address Substance Abuse Problems There is a need for trained professionals to deliver effective rehabilitation and harm reduction interventions for substance abuse and dependence around the world The paucity of properly trained professional is a barrier to the development and delivery of effective treatment services, especially regarding underserved and inappropriately served populations of drug abusers, including women and children There is a worldwide shortage of qualified training experts and educational settings in which drug abuse treatment training is provided, particularly in developing regions A goal of this training effort is to train clinicians and educate academics who will train additional professionals to address the problems of drug abuse in an empirically rational method
67 Capacity Building Plan In short, the goal of the capacity building plan is to increase the number of personnel who can disseminate and promote the use of effective, scientifically-supported supported and practical drug abuse treatment practices around the world.
68 Treatnet Members RS Ketergantungan Obat The Drug Dependence Hospital, Indonesia Iranian National Prison Organisation /Iranian National Centre for Addiction Studies INCAS, Iran National Research and Clinical Centre on Medical and Social Problems of Drug, Kazakhstan Drug Rehabilitation Unit, Mathari Hospital, Kenya Centros de Integración n Juvenil A.C., Mexico Neuropsychiatric Hospital Aro, Nigeria
69 Treatnet Members Shanghai Drug Abuse Treatment Centre, China Carisma Centre for Attention and Integral Mental Health, Colombia General Secretariat of Mental Health, Egypt TT Ranganathan Clinical Research Foundation, India Regional Research Centre of Narcology and Psychopharmacology affiliated to St. Petersburg Pavlov State Medical University, Russia Psychosocial Attention Centre for Alcohol and other Drugs, Brazil
70 Treatnet Members Turning Point Alcohol and Drug Centre Inc., Australia Centre for Addiction and Mental Health CAMH, Canada Mudra, Germany Asociación n Proyecto Hombre, Spain Maria Ungdom, Sweden Cranstoun Drug Services, United Kingdom Fayette Companies, U.S.A. Stanley Street Treatment & Resources (SSTAR) Inc., U.S.A.
71 Capacity Building Plan for UNODC Treatnet Program: What are we trying to do? The purpose of the capacity building component for the UNODC Treatnet Program is to develop a set of training materials and a training plan for trainers from 20 Resource Centres established by UNODC. To accomplish this task, we will: 1. Conduct a training needs assessment. 2. Determine priority training/skill development topics. 3. Create a set of training modules to address #2. 4. Conduct a set of training, supervision and mentoring activities with two trainers from each of the resource centres. 5. Collect information to contribute to the project evaluation.
72 Need Assessment: A Brief Summary The following topics received the most interest. Motivational Interviewing Relapse Prevention (CBT) Assessment Program management Outreach strategies Youth Building Service Networks Family Co-occurring occurring Drugs and the brain Brief interventions Outpatient treatments Harm minimization Basic knowledge of drugs Research and evaluation methods
73 Summary The issue of research practice integration has been a priority in the US for almost a decade. Major initiatives have been established to cross the research-practice gap. Clinicians are more aware of research value and findings Quality research can be done in clinical service delivery settings It continues to be a challenging, expensive, time consuming process
74 THANK YOU
NIDA/SAMHSA Blending Initiative Overview: A Focus on Medication Assisted Treatment
NIDA/SAMHSA Blending Initiative Overview: A Focus on Medication Assisted Treatment Thomas E. Freese, Ph.D., & Beth Rutkowski, M.P.H. AHSR, October 2011 What s the Issue? A significant delay exists between
More informationTreatment for Addiction in the Community Reduces Drug Use, Crime and Recidivism
Treatment for Addiction in the Community Reduces Drug Use, Crime and Recidivism Richard A. Rawson, Ph.D, Professor Semel Institute for Neuroscience and Human Behavior David Geffen School of Medicine University
More informationKathryn P. Jett Director
Kathryn P. Jett Director California Department of Alcohol and Drug Programs ADP Mission To lead efforts to reduce alcoholism, drug addiction and problem gambling in California by developing, administering
More informationTreatment Approaches for Drug Addiction
Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call 1-800-662-HELP(4357)
More informationAN ACT RELATING TO SUBSTANCE ABUSE; PROVIDING FOR TREATMENT, BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
AN ACT RELATING TO SUBSTANCE ABUSE; PROVIDING FOR TREATMENT, PREVENTION AND INTERVENTION EXPANSION; MAKING APPROPRIATIONS; DECLARING AN EMERGENCY. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
More informationTreatment Approaches for Drug Addiction
Treatment Approaches for Drug Addiction [NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call
More informationFree Additional Resources
Free Additional Resources Substance Abuse and Mental Health Services Administration Treatment Improvement Protocols The Substance Abuse and Mental Health Services Administration (SAMHSA) offers free Treatment
More informationImplementation in Community
Medication-Assisted i t d Treatment t Implementation in Community Correctional Environments (MATICCE) CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA. What is Medication-Assisted Treatment
More informationAlcohol and Prescription opiate abuse: Responsibilities of Stakeholders to reduce the problem. Thomas Kosten MD
Alcohol and Prescription opiate abuse: Responsibilities of Stakeholders to reduce the problem Thomas Kosten MD Waggoner Chair & Professor of Psychiatry & Neuroscience Baylor College of Medicine Past-President,
More informationWelcome. This presentation is designed for people working in criminal justice and drug abuse treatment settings. It provides an overview of drug
Welcome. This presentation is designed for people working in criminal justice and drug abuse treatment settings. It provides an overview of drug abuse treatment principles for individuals involved in the
More informationSpecial Treatment/Recovery Programs -- Participant Demographics
Chapter 3 Special Treatment/Recovery Programs -- Participant Demographics Chapter 3 describes the participants who received services provided by the following special programs during the : Adolescent Intervention,
More informationSEEKING DRUG ABUSE TREATMENT: KNOW WHAT TO ASK
National Institute on Drug Abuse SEEKING DRUG ABUSE TREATMENT: KNOW WHAT TO ASK U.S. Department of Health and Human National Institutes of Health SEEKING DRUG ABUSE TREATMENT: KNOW WHAT TO ASK The goal
More informationUTAH DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH SUBSTANCE USE DISORDER SERVICES MONITORING CHECKLIST (FY 2014) GENERAL PROGRAM REQUIREMENTS
UTAH DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH SUBSTANCE USE DISORDER SERVICES MONITORING CHECKLIST (FY 2014) Program Name Reviewer Name Date(s) of Review GENERAL PROGRAM REQUIREMENTS 2014 Division
More informationPerformance Standards
Performance Standards Co-Occurring Disorder Competency Performance Standards are intended to provide a foundation and serve as a tool to promote continuous quality improvement and progression toward best
More informationMental Health & Addiction Forensics Treatment
Mental Health & Addiction Forensics Treatment Sheriffs: Help needed to cope with September 15, 2014 mentally ill INDIANAPOLIS - A sheriff says county jails have become the "insane asylums" for Indiana
More informationONDCP. Drug Policy Information Clearinghouse FACT SHEET John P. Walters, Director www.whitehousedrugpolicy.gov 1-800-666-3332
UNUM Executive Office of the President Office of National Drug Control Policy E PLURIBUS OFFICE OF NATIONAL POLICY D RUG CONTROL ONDCP March 2001 Drug Policy Information Clearinghouse FACT SHEET John P.
More informationFindings and Recommendations
6 Findings and Recommendations The committee s review of current research, models for collaboration between research and practice, community-based organizations, and dissemination strategies led to findings
More informationEvaluation of the Substance Abuse and Crime Prevention Act 2004 Report
Evaluation of the Substance Abuse and Crime Prevention Act 24 Report Prepared for the Department of Alcohol and Drug Programs California Health and Human Services Agency By Douglas Longshore, Ph.D., Darren
More informationIntroduction - Description of Proposition 36 Provisions
IMPLEMENTING PROPOSITION 36: ISSUES IMPACTING DRUG TREATMENT SERVICES IN LOS ANGELES COUNTY The Substance Abuse and Crime Prevention Act of 2000 (Proposition 36) requires that qualifying persons who have
More informationTreatment of Methamphetamine Dependence: A brief overview
Treatment of Methamphetamine Dependence: A brief overview Richard A. Rawson, Ph.D Adjunct Associate Professor Semel Institute for Neuroscience and Human Behavior David Geffen School of Medicine University
More informationImpact of Systematic Review on Health Services: The US Experience
Impact of Systematic Review on Health Services: The US Experience Walter Ling MD Integrated Substance Abuse Programs (ISAP) UCLA The effectiveness of interventions for addictions: The Drug and Alcohol
More informationTREATMENT MODALITIES. May, 2013
TREATMENT MODALITIES May, 2013 Treatment Modalities New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) regulates the addiction treatment modalities offered in New York State.
More informationBUPRENORPHINE TREATMENT
BUPRENORPHINE TREATMENT Curriculum Infusion Package (CIP) Based on the Work of Dr. Thomas Freese of the Pacific Southwest ATTC Drug Addiction Treatment Act of 2000 (DATA 2000) Developed by Mountain West
More informationDrugFacts: Treatment Approaches for Drug Addiction
DrugFacts: Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please
More informationTreatment Approaches for Drug Addiction
Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call the
More informationDepartment of Health Services. Alcohol and Other Drug Services Division
Department of Health Services Alcohol and Other Drug Services Division Summary of Programs and Services Rita Scardaci, MPH, Health Services Director Gino Giannavola, AODS Division Director Alcohol and
More informationEvidence Based Practice in the Treatment of Addiction Treatment of Addiction. Steve Hanson
Evidence Based Practice in the Treatment of Addiction Treatment of Addiction Steve Hanson History of Addiction Treatment Incarceration Medical Techniques Asylums What We Learned These didn t work Needed
More informationMST and Drug Court. Family Services Research Center Medical University of South Carolina Funded by NIDA and NIAAA
MST and Drug Court Family Services Research Center Medical University of South Carolina Funded by NIDA and NIAAA Project Staff Scott Henggeler Jeff Randall Phillippe Cunningham Colleen Halliday-Boykins
More information406 TH JUDICIAL DISTRICT sobriety treatment program Participation agreement
406 TH JUDICIAL DISTRICT sobriety treatment program Participation agreement The State of Texas vs. Cause# The 406 th Judicial District Drug Court Program is a drug intervention program. The program is
More informationPresentation to Senate Health and Human Services Committee: Prescription Drug Abuse in Texas
Presentation to Senate Health and Human Services Committee: Prescription Drug Abuse in Texas David Lakey, MD Commissioner, Department of State Health Services Lauren Lacefield Lewis Assistant Commissioner,
More informationyouth services Helping Teens. Saving Lives. Healing Communities. ventura county Alcohol & Drug Programs
ventura county Alcohol & Drug Programs youth services Helping Teens. Saving Lives. Healing Communities. 1911 Williams Drive, Oxnard, CA 93036 (805) 981-9200 www.venturacountylimits.org VCBH Alcohol & Drug
More informationBRIDGING THE GAP. between een Research and Practice. The First Decade. National Drug Abuse Treatment Clinical Trials Network
BRIDGING THE GAP between een Research and Practice National Drug Abuse Treatment Clinical Trials Network The First Decade CTN Across the Nation Regional Research and Training Center (RRTC) States with
More informationLos Angeles County Department of Health Services Alcohol and Drug Program Administration
Los Angeles County Department of Health Services Annual Review of Participants in Alcohol and Drug Programs Contracted by the 2003-04 Fiscal Year Prepared by Research and Evaluation Planning Division Los
More informationEvaluation of the Substance Abuse and Crime Prevention Act Final Report
Evaluation of the Substance Abuse and Crime Prevention Act Final Report Final Report of the 2001-2006 SACPA Evaluation, also known as the 2005 Report. Prepared for the Department of Alcohol and Drug Programs
More informationRecovery Outcomes for Opiate Users. FRN Research Report November 2013
Recovery Outcomes for Opiate Users FRN Research Report November 2013 Introduction Opiate use in America is at epidemic levels. The latest surveys show 4.5 million Americans using prescription painkillers
More informationCommunity Based Treatment and Care for Drug Use and Dependence
CBTx Community Based Treatment and Care for Drug Use and Dependence Information Brief for Southeast Asia Community Based Treatment refers to a specific integrated model of treatment for people affected
More informationCare Management Council submission date: August 2013. Contact Information
Clinical Practice Approval Form Clinical Practice Title: Acute use of Buprenorphine for the Treatment of Opioid Dependence and Detoxification Type of Review: New Clinical Practice Revisions of Existing
More informationPatients are still addicted Buprenorphine is simply a substitute for heroin or
BUPRENORPHINE TREATMENT: A Training For Multidisciplinary Addiction Professionals Module VI: Myths About the Use of Medication in Recovery Patients are still addicted Buprenorphine is simply a substitute
More informationThe Facts on Drugs and Crime in America
The Facts on Drugs and Crime in America Our nation s prison population has exploded beyond capacity. 1 1 in 100 U.S. citizens is now confined in jail or prison. The U.S. incarcerates more people per capita
More informationCurrent Models of Recovery Support Services: Where We Have Data and Where We Don t
Current Models of Recovery Support Services: Where We Have Data and Where We Don t Richard Rawson, Ph.D. Integrated Substance Abuse Programs University of California, Los Angeles 1. Define recovery Talk
More informationDeveloping Medications to Treat Addiction: Implications for Policy and Practice. Nora D. Volkow, M.D. Director National Institute on Drug Abuse
Developing Medications to Treat Addiction: Implications for Policy and Practice Nora D. Volkow, M.D. Director National Institute on Drug Abuse Medications Currently Available For Nicotine Addiction Nicotine
More informationALAMEDA COUNTY SUBSTANCE USE DISORDER (SUD) SERVICES
ALAMEDA COUNTY SUBSTANCE USE DISORDER (SUD) SERVICES Current Configuration and Vision for the Future Presentation to Board of Supervisors Health Committee March 23, 2015 1 Presentation Overview Demographic
More informationJail Diversion & Behavioral Health
Jail Diversion & Behavioral Health Correctional Health Reentry Meeting Mandy Gilman, Director of Public Policy & Research Association for Behavioral Healthcare Association for Behavioral Healthcare Statewide
More informationTreatment of Opioid Use Disorders in Jails and Prisons Why, When, and How
Treatment of Opioid Use Disorders in Jails and Prisons Why, When, and How Kevin Fiscella, MD, MPH Professor, Family Medicine, Public Health Sciences, Community Health University of Rochester School of
More informationIowa Department of Corrections. Report to the Board of Corrections
THOMAS J. VILSACK, GOVERNOR SALLY J. PEDERSON, LT. GOVERNOR DEPARTMENT OF CORRECTIONS GARY D. MAYNARD, DIRECTOR Iowa Department of Corrections Report to the Board of Corrections Substance Abuse First in
More informationDrug Court as Diversion for Youthful Offenders
Drug Court as Diversion for Youthful Offenders Juvenile Drug Courts in Hawaii: A Policy Brief Introduction The problem of drug abuse among the general population in the United States began to escalate
More information2011 State Profile California
20 State Profile California National Survey of Substance Abuse Treatment Services (N-SSATS) The National Survey of Substance Abuse Treatment Services (N-SSATS) is an annual survey of facilities providing
More informationPhoenix House. Outpatient Treatment Services for Adults in Los Angeles and Orange Counties
Phoenix House Outpatient Treatment Services for Adults in Los Angeles and Orange Counties Phoenix House s outpatient programs offer comprehensive and professional clinical services that include intervention,
More information# Surveyed Courts 76 132 208 % Responding Courts 72% 65% 68% % with Responding Treatment Providers
The National Drug Court Survey Lead Research Center Faye Taxman, Doug Young, Anne Rhodes, Matthew Perdoni, Stephen Belenko, Matthew Hiller Collaborating Research Centers National Institute on Drug Abuse
More informationFrequently Asked Questions (FAQs) of Drug Abuse Treatment for Criminal Justice Populations
Frequently Asked Questions (FAQs) of Drug Abuse Treatment for Criminal Justice Populations From The National Institute on Drug Abuse (NIDA) 2. Why should drug abuse treatment be provided to offenders?
More informationCo-Occurring Substance Use and Mental Health Disorders. Joy Chudzynski, PsyD UCLA Integrated Substance Abuse Programs
Co-Occurring Substance Use and Mental Health Disorders Joy Chudzynski, PsyD UCLA Integrated Substance Abuse Programs Introduction Overview of the evolving field of Co-Occurring Disorders Addiction and
More informationThe Substance Abuse and Crime Prevention Act: Challenges and Promises for Public Health
The Substance Abuse and Crime Prevention Act: Challenges and Promises for Public Health Behjat Sharif California State University, Los Angeles Abstract The Substance Abuse and Crime Prevention Act of 2000
More informationThe National Community Detoxification Pilot
The National Community Detoxification Pilot Aoife Dermody, Progression Routes Initiative NDCI, 2011 Community Detoxification Protocols Guidelines for outpatient detoxification from methadone or benzodiazepines
More informationVarious therapies are used in the
National Survey of Substance Abuse Treatment Services The N-SSATS Report January 28, 2010 Overview of Opioid Treatment Programs within the United States: 2008 In Brief In 2008, a total of 1,132 (8 of all
More informationhttpjlceo.lacounty.gov
WILLIAM T FUJIOKA Chief Executive Offcer County of Los Angeles CHIEF EXECUTIVE OFFICE Kenneth Hahn Hall of Administration 500 West Temple Street, Room 713, Los Angeles, California 90012 (213) 974-1101
More informationAmerican Society of Addiction Medicine
American Society of Addiction Medicine Public Policy Statement on Office-based Opioid Agonist Treatment (OBOT) BACKGROUND Methadone maintenance treatment of opioid addiction was developed in 1965 and implemented
More informationyouth services Helping Teens. Saving Lives. Healing Communities. ventura county Alcohol & Drug Programs
ventura county Alcohol & Drug Programs youth services Helping Teens. Saving Lives. Healing Communities. 1911 Williams Drive, Oxnard, CA 93036 (805) 981-9200 www.venturacountylimits.org VCBH Alcohol & Drug
More informationA Drug Policy for the 21st Century. Office of National Drug Control Policy
A Drug Policy for the 21st Century October 18, 2014 International Nurses Society on Addictions Health Care Reform & Its Impact on Addictions Nursing: Navigating Change through the Rapids David K. Mineta,
More informationOpioid Agonist Treatment in Correctional Settings
Opioid Agonist Treatment in Correctional Settings Robert P. Schwartz, M.D. Friends Research Institute Open Society Institute - Baltimore Treating Heroin-Addicted Prisoners Opioid agonist treatment is widely
More informationSocial and Rehabilitation Services
Kansas Department of Social and Rehabilitation Services Gary Daniels, Secretary Joint Committee on Corrections and Juvenile Justice Oversight November 2, 2006 Overview of Substance Abuse Treatment Services
More informationHOPE Helping Opiate- Addicted Pregnant women Evolve
HOPE Helping Opiate- Addicted Pregnant women Evolve Medical Director: Michael P. Marcotte, MD TriHealth-Good Samaritan Hospital Cincinnati Ohio MHAS MOMs Grant 2014-2016 Ohio MHAS MOMs Grant 2014-2016
More informationChapter 4 STRATEGIC GOALS AND OBJECTIVES
Chapter 4 STRATEGIC GOALS AND OBJECTIVES PRINCIPLES OF A COMPREHENSIVE, BALANCED STRATEGY This urban-based Substance Abuse Strategy (the Strategy) is built on the premise that no single approach can end
More informationEvidence-Based Corrections & Treatment
Evidence-Based Corrections & Treatment Faye S. Taxman, Ph.D. ftaman@gmu.edu How are Correctional Agencies Doing in Adopting Evidence-Based Substance Abuse Treatment Programs and Services? Offenders are
More informationVCBH CLINICAL TRAINING
VCBH CLINICAL TRAINING Alcohol and Drug Counseling Internship VENTURA COUNTY BEHAVIORAL HEALTH (VCBH) FACT SHEET VCBH is part of the Ventura County Health Care Agency s integrated public health care system
More informationSEEKING DRUG ABUSE TREATMENT: KNOW WHAT TO ASK
National Institute on Drug Abuse SEEKING DRUG ABUSE TREATMENT: KNOW WHAT TO ASK U.S. Department of Health and Human National Institutes of Health SEEKING DRUG ABUSE TREATMENT: KNOW WHAT TO ASK The goal
More informationHow To Save Money On Drug Sentencing In Michigan
Drug Policies in the State of Michigan Economic Effects Executive Summary News Walker: Keep reforming drug laws Home» Publications» Drug Policies in the State of Michigan Economic Effects» Drug Policies
More informationTestimony of The New York City Department of Health and Mental Hygiene. before the
Testimony of The New York City Department of Health and Mental Hygiene before the New York City State Assembly Committee on Alcoholism and Drug Abuse on Programs and Services for the Treatment of Opioid
More informationIN THE GENERAL ASSEMBLY STATE OF. Ensuring Access to Medication Assisted Treatment Act
IN THE GENERAL ASSEMBLY STATE OF Ensuring Access to Medication Assisted Treatment Act 1 Be it enacted by the People of the State of Assembly:, represented in the General 1 1 1 1 Section 1. Title. This
More informationResources for the Prevention and Treatment of Substance Use Disorders
Resources for the Prevention and Treatment of Substance Use Disorders Table of Contents Age-standardized DALYs, alcohol and drug use disorders, per 100 000 Age-standardized death rates, alcohol and drug
More informationQuestions to ask before going to rehab by Rehab-Programs.org 2011
Table of Contents Questions to Ask Before Going to Rehab... 1 Do I really need to check into an inpatient drug rehab center?... 2 How long will I stay in the rehab center?... 2 What is the track record
More informationOffender Screening. Oklahoma Department of Mental health and Substance Abuse Services
Offender Screening Oklahoma Department of Mental health and Substance Abuse Services Presenters DR. DAVID WRIGHT, EVALUATION PROJECTS MANAGER NISHA WILSON, STATE DIRECTOR OF SPECIALTY COURTS The Problem
More informationThe Heroin and Prescription Drug Abuse Prevention and Reduction Act Section by Section
The Heroin and Prescription Drug Abuse Prevention and Reduction Act Section by Section TITLE I: PREVENTION SUBTITLE A- PRESCRIBER EDUCATION PRACTITIONER EDUCATION This subtitle requires practitioners who
More informationStates In Brief. The National Survey on Drug Use and Health. texas. Prevalence of Illicit Substance 1 and Alcohol Use
texas States In Brief Substance Abuse and Mental Health Issues At-A-Glance a short Report from the Office of applied studies Prevalence of Illicit Substance 1 and Alcohol Use The National Survey on Drug
More informationA Family-Based Substance Abuse, Delinquency and HIV Prevention Intervention for Detained Adolescents
A Family-Based Substance Abuse, Delinquency and HIV Prevention Intervention for Detained Adolescents CRAIG HENDERSON a, GAYLE DAKOF b, CINDY ROWE b CINDY MENA a, HYEMIN JEON a, SCHOLAR COLBOURN a, & HOWARD
More informationStrategic Plan for Alcohol and Drug Abuse
Strategic Plan for Alcohol and Drug Abuse Created: July 15, 2007 Updated: January 2, 2008 1 GARRETT COUNTY, MARYLAND STRATEGIC PLAN FOR ALCOHOL AND DRUG ABUSE Vision: Mission: A safe and drug free Garrett
More informationFRN Research Report January 2012: Treatment Outcomes for Opiate Addiction at La Paloma
FRN Research Report January 2012: Treatment Outcomes for Opiate Addiction at La Paloma Background A growing opiate abuse epidemic has highlighted the need for effective treatment options. This study documents
More informationWeb-based Interventions for the Prevention and Treatment of Substance Use Disorders
Web-based Interventions for the Prevention and Treatment of Substance Use Disorders Lisa A. Marsch, Ph.D. Director, Center for Technology and Health (CTH), National Development & Research Institutes (NDRI)
More informationREVISED SUBSTANCE ABUSE GRANTMAKING STRATEGY. The New York Community Trust April 2003
REVISED SUBSTANCE ABUSE GRANTMAKING STRATEGY The New York Community Trust April 2003 1 I. INTRODUCTION Substance Abuse is defined as the excessive use of addictive substances, especially narcotic drugs,
More informationOverview of Chemical Addictions Treatment. Psychology 470. Background
Overview of Chemical Addictions Treatment Psychology 470 Introduction to Chemical Additions Steven E. Meier, Ph.D. Listen to the audio lecture while viewing these slides 1 Background Treatment approaches
More informationCURRICULUM VITAE. Veterans Administration Medical Center, Psychiatry Service 1984-1986 San Francisco, CA Fellow in Substance Use Disorders
CURRICULUM VITAE H. Westley Clark, M.D., J.D., M.P.H., CAS, FASAM Director, Center for Substance Abuse Treatment Substance Abuse and Mental Health Services Administration Department of Health & Human Services
More informationReport to the Commission on Narcotic Drugs on Supporting recovery from substance use disorders
American Model United Nations Commission on Narcotic Drugs Report to the Commission on Narcotic Drugs on Supporting recovery from substance use disorders Contents 1 Executive Summary 2 2 Matters calling
More informationOn-line Continuing Education. Course Material: Exam Questions Packet
BREINING INSTITUTE 8894 Greenback Lane Orangevale, California USA 95662-4019 Telephone (916) 987-2007 Facsimile (916) 987-8823 On-line Continuing Education Course Material and Exam Questions Packet Course
More informationSubject: Health; food and drugs; treatment of opiate addiction. Statement of purpose: This bill proposes to require the department 6of health to
2012 Page 1 of 6 1 2 3 4 5 H.627 Introduced by Representative Pugh of South Burlington Referred to Committee on Date: Subject: Health; food and drugs; treatment of opiate addiction Statement of purpose:
More informationStrategic Plan for Alcohol and Drug Abuse. 2014-2016 December 2013 Update. 6 Month Update 1 Approved: 1/8/14
Strategic Plan for Alcohol and Drug Abuse 2014-2016 December 2013 Update 6 Month Update 1 Approved: 1/8/14 GARRETT COUNTY, MARYLAND STRATEGIC PLAN FOR ALCOHOL AND DRUG ABUSE Vision: Mission: A safe and
More informationFISCAL IMPACT STATEMENT. LS 7351 NOTE PREPARED: Feb 6, 2015 BILL NUMBER: SB 464 BILL AMENDED: Feb 5, 2015
LEGISLATIVE SERVICES AGENCY OFFICE OF FISCAL AND MANAGEMENT ANALYSIS 200 W. Washington, Suite 301 Indianapolis, IN 46204 (317) 233-0696 http://www.in.gov/legislative FISCAL IMPACT STATEMENT LS 7351 NOTE
More informationThe FUNDAMENTALS Of DRUG TREATMENT COURT. Hon. Patrick C. Bowler, Ret.
The FUNDAMENTALS Of DRUG TREATMENT COURT Hon. Patrick C. Bowler, Ret. Drug Treatment Courts A New Way Partner with Treatment Transform Roles Non-adversarial/Team Shared Goal of Recovery Communication Immediate
More informationProposition 5. Nonviolent Offenders. Sentencing, Parole and Rehabilitation. Statute.
Proposition 5 Nonviolent Offenders. Sentencing, Parole and Rehabilitation. Statute. SUMMARY This measure (1) expands drug treatment diversion programs for criminal offenders, (2) modifies parole supervision
More informationTreatment System 101
Treatment System 101 A brief overview for courtroom decision-makers and people working in criminal justice sectors March 11, 2015 West Toronto Human Services & Justice Coordinating Cttee. Agenda Introduction
More informationSENTENCING REFORM FOR NONVIOLENT OFFENSES: BENEFITS AND ESTIMATED SAVINGS FOR ILLINOIS
SENTENCING REFORM FOR NONVIOLENT OFFENSES: BENEFITS AND ESTIMATED SAVINGS FOR ILLINOIS LISE MCKEAN, PH.D. SUSAN K. SHAPIRO CENTER FOR IMPACT RESEARCH OCTOBER 2004 ACKNOWLEDGEMENTS PROJECT FUNDER Chicago
More informationOUR MISSION. WestCare s mission. is to empower everyone whom. we come into contact with. to engage in a process of healing, growth and change,
OUR MISSION WestCare s mission is to empower everyone whom we come into contact with to engage in a process of healing, growth and change, benefiting themselves, their families, coworkers and communities.
More informationJohn R. Kasich, Governor Orman Hall, Director
John R. Kasich, Governor Orman Hall, Director 2 3 Epidemics of unintentional drug overdoses in Ohio, 1979-2011 1,2,3 1800 1600 1400 1200 1000 800 Prescription drugs are causing a larger overdose epidemic
More informationApplicant Webinar for BJA s Drug Court Discretionary Grant Solicitation
Applicant Webinar for BJA s Drug Court Discretionary Grant Solicitation Cynthia Caporizzo, Senior Criminal Justice Advisor, Office of National Drug Control Policy (ONDCP) - Review of the administration
More informationTough and Smart: Opportunities for Kansas Policymakers to Reduce Crime and Spending
Tough and Smart: Opportunities for Kansas Policymakers to Reduce Crime and Spending Dr. Tony Fabelo, Senior Research Consultant Marshall Clement, Policy Analyst Overview Tough and Smart Criminal Justice
More informationAssisted Outpatient Treatment (W&I Code 5345~5349) (AB 1421) Laura s Law
Assisted Outpatient Treatment (W&I Code 5345~5349) (AB 1421) Laura s Law ~April 23, 2015~ The Nevada County Experience 1 Objectives Explain Assisted Outpatient Treatment (AOT) in the context of Assertive
More informationSUBSTANCE ABUSE OUTPATIENT
SUBSTANCE ABUSE OUTPATIENT Service Category Description Substance abuse services - outpatient is the provision of medical or other treatment and/or counseling to address substance abuse problems (i.e.,
More informationUpdate on Buprenorphine: Induction and Ongoing Care
Update on Buprenorphine: Induction and Ongoing Care Elizabeth F. Howell, M.D., DFAPA, FASAM Department of Psychiatry, University of Utah School of Medicine North Carolina Addiction Medicine Conference
More informationSTRUCTURED OUTPATIENT ADDICTION PROGRAM (SOAP)
STRUCTURED OUTPATIENT ADDICTION PROGRAM (SOAP) Providers contracted for this level of care or service will be expected to comply with all requirements of these service-specific performance specifications.
More informationIt s all apples and oranges. January 31, 2012 Nathan Brady OLRGC
It s all apples and oranges. January 31, 2012 Nathan Brady OLRGC What is recidivism and what is the impact on the state? How does Utah compare nationally? What is Utah doing to address inmate recidivism
More informationPresented by. 13 Principles 10/27/09. Principles of Drug Addiction Treatment: A Research Based Guide
Presented by Principles of Drug Addiction Treatment: A Research Based Guide Rick Moldenhauer, MS, LADC, ICADC, LPC Treatment Services Consultant, Alcohol and Drug Abuse Division PO Box 64977, St Paul,
More information