The World Health Organization Substance Abuse Instrument for mapping services
|
|
- Barrie Barton
- 8 years ago
- Views:
Transcription
1 Thomas F. Babor & Vladimir Poznyak Research report The World Health Organization Substance Abuse Instrument for mapping services Rationale, structure and functions Introduction The development of effective treatment and prevention programs is a crucial part of a public health response to the problems associated with substance use disorders. To promote the orderly planning and dissemination of evidence-based addiction services within national health care and social service systems, the World Health Organization (WHO) Acknowledgements This paper is based on documents commissioned by the World Health Organization (WHO 2006). The authors are grateful to the following individuals for their contributions to the development of the WHO SAIMS: Professor Jacques Besson, Dr. Louisa Degenhardt, Dr. Alexandra Fleischmann, Professor Tarek Gawad, Dr. Steven Gust, Dr. Riaz Khan, Professor Harald Klingemann, Dr. Bronwyn Myers, Dr. Usaneya Perngparn, Dr. Emanuele Scafato, Dr Kerstin Stenius, Dr. Sofia Tomas, Professor Ambros Uchtenhagen, Dr. Jan Walburg, Dr. Daniele Zullino. Both authors were involved in the development of the instrument. Submitted Initial review completed Final version accepted A B S T R A C T T.F. Babor & V. Poznyak: The World Health Organization Substance Abuse Instrument for mapping services: Rationale, structure and functions This paper describes the rationale for and development of the World Health Organization Substance Abuse Instrument for the Mapping of Services (WHO-SAIMS), a new procedure for assessing, monitoring, and evaluating treatment systems for substance use disorders in all UN Member States. The paper begins with a description of the information needed to understand the structure and function of drug and alcohol service systems. A conceptual model is presented to show how service system policies and characteristics impact on population health. Five kinds of research are then reviewed to suggest how the nature and impact of alcohol and drug services can be evaluated: 1) systems mapping studies; 2) assessments of service needs; 3) monitoring system development; 4) analysis of system performance; and 5) comparative studies. Although the WHO-SAIMS has a primarily descriptive function that will allow for gaps in service delivery and areas for system improvement to be identified, it can also be used for monitoring and process evaluation to allow countries to identify changes in the system over time and to assess the extent to which system improvement strategies have been implemented. Key words Substance abuse, treatment systems, monitoring, WHO NORDIC STUDIES ON ALCOHOL AND DRUGS VOL
2 has developed a new procedure for assessing, monitoring, and evaluating treatment systems for substance use disorders (WHO 2006). This development is based on the experience accumulated in the WHO Assessment Instrument for Mental Health Systems (WHO AIMS) that has been used for assessment of mental health systems in many low- and middle income countries (WHO 2004). The purpose of this paper is to describe the rationale for and development of the WHO Substance Abuse Instrument for Mapping Services (WHO- SAIMS), and to consider its potential applications to the understanding of how treatment and prevention services contribute to a comprehensive public health response to substance-related problems in all countries where substance use disorders contribute to the burden of disease and disability. Information needs for understanding treatment and prevention service systems According to the World Drug Report (United Nations Office on Drugs and Crime 2006) and the Global Status Report on Alcohol (WHO 2004), the high prevalence of substance-related problems poses a significant challenge to health care systems and societies. Effective national responses to these problems include the development of prevention and treatment policies and programs. To assist countries in effectively designing and implementing alcohol and drug services, information is required for each level of the health and social service system. At the macro level, information regarding policy frameworks for service provision is needed. For example, the Global Status Report on Alcohol 2004 (WHO 2004) outlines the burden of harm associated with alcohol use disorders and policy responses to these disorders in various countries. At the meso level, information is required on the organization of prevention and treatment systems for substance use disorders. And at the micro level, information concerning client characteristics and how they interact with existing alcohol and drug services is needed. Such information can reflect gaps in service delivery and resource allocation. It can also aid in the strengthening of substance-related programs and policies, and can provide benchmark data for monitoring progress in meeting population needs. Structural components and qualities of service systems To understand the factors that should be included as part of a systems analysis, it is important to discuss the structural components of prevention and treatment services for substance use disorders (Babor et al. 2008). Alcohol and drug services occur along a continuum, ranging from primary prevention activities that ensure a disorder or problem will not occur, to secondary prevention activities, including early identification and management of substance use disorders, and tertiary prevention activities that aim to reduce disability, and health and social consequences of an established disease or a disorder. In many countries, primary, secondary and tertiary prevention services have been developed separately and are rarely integrated into a single system. Yet each of these service components consist of similar core elements: resources (e.g., facilities, personnel and programs), tasks (e.g., prevention, medical care, rehabilita- 704 NORDIC STUDIES ON ALCOHOL AND DRUGS V O L
3 tion services, social control), and linking elements that allow for the coordination of resources to accomplish tasks (including integration of specialist treatment services with other services such as mental health and criminal justice). In addition to these structural features, system qualities inform the organization of prevention and treatment service systems. These qualities include equity, or the extent to which population subgroups have equal access to services; efficiency, defined as the most appropriate mix of services to address population needs; and economy, or the efficient use of available resources to reduce the prevalence of substance use disorders. Resources and system qualities affect the effectiveness of services, although effectiveness is often moderated by factors such as client characteristics and culturally conditioned patterns of alcohol and drug use. Because of the potential impact of these system features, assessments of prevention and treatment services should include an analysis of both the structural elements and system qualities that define alcohol and drug service systems. A conceptual framework Figure 1 describes how the structural resources and service qualities of prevention and treatment systems interact with macro and micro level factors to influence population health (Babor et al. 2008). In this model, alcohol and drug policies (a macro-level factor) are the main determinants of struc- Resources Facilities Programs Personnel Treatment policies Planning Financing Monitoring Regulation Tasks Medical care Social control Prevention Linking elements Effectiveness Population health System qualities Equilty Efficiency Economy Moderating factors Pattern of characteristics Pattern of substance use Macro level meso level micro level Policies System charasteritics Effectiveness Population impact Figure 1. Conceptual model of population on impact of treatment systems NORDIC STUDIES ON ALCOHOL AND DRUGS V O L
4 tural resources for prevention and treatment as well as system qualities. In turn, system resources and qualities contribute to service effectiveness (i.e. the extent to which a specific service is responsible for positive changes in substance-related problems). As effective services hold long-term positive benefits in terms of population health, population rates for substance-related deaths, disease, disability, and social problems are convenient indicators of this factor. The availability of country-specific information on these population indicators (and the feasibility of including these indicators as part of an assessment instrument) should make it possible to evaluate the population impact of service systems. The model also allows for the development level of a particular service system to be examined. Service systems can be characterized in terms of their extensiveness, resources, mix of services, and integration. Four development levels are proposed to account for the range of systems that have evolved in different countries: 1) Minimal/fragmentary; 2) Limited, with some specialized services in medical and psychiatric settings and some delivered in primary care settings; 3) Modest, with a variety of services delivered in most settings and some regional coordination and planning; and 4) Mature, with a variety of integrated services and stable financing for these services. The specification of these levels could be useful for suggesting ways in which these systems can be improved and for monitoring changes in system development over time, but this remains as a task for future systems research. Describing, monitoring and evaluating service systems Five kinds of research are useful for describing, monitoring and evaluating alcohol and drug services, and all are likely to be facilitated by a service mapping assessment instrument that conforms to the conceptual model shown in Figure 1. Systems mapping research This involves the description of system structures and qualities. Treatment mapping research can reflect a variety of perspectives as well as interactions between professionally-run and lay service providers (Gossop 1995). This approach allows for cross-country comparisons of treatment systems in various stages of development and is useful for service planning at local and national levels. Treatment mapping research of this type has been conducted in Hungary, Poland, the Russian Federation, France, Switzerland, Germany, the United Kingdom, the United States, Finland, Sweden and a variety of other countries (Gossop 1995; Klingemann & Hunt 1998; Klingemann et al. 1992; Klingemann et al. 1993). Several data collection tools have been developed for treatment mapping purposes, but these instruments do not examine broad treatment systems issues. Service needs assessment The second type of research is needs assessment studies. The need for substance abuse services in the general population can be estimated through the use of health and social indicators, such as substancerelated mortality, morbidity, and social problem statistics; population surveys that estimate prevalence rates; measures of treatment service demand; and expert 706 NORDIC STUDIES ON ALCOHOL AND DRUGS V O L
5 opinion on treatment needs. The use of these methods to estimate need has not been internationally standardized. Should a formula be developed for assessing need, it would be possible to identify the gap between existing services and population needs. Unfortunately, the information necessary for estimating treatment needs is often not available in low and middle income countries, particularly prevalence data on substance use disorders in the general population, and health and social indicators of substance-related harms. Systems monitoring This involves monitoring the current configuration of treatment and prevention services. Monitoring can provide a longitudinal assessment of the development of services in terms of quantity and quality. It also provides useful descriptive information for planning and evaluation purposes. When systems are monitored over time, questions regarding how resources should be allocated and organized to meet population needs can be addressed. Unfortunately, the collection of information on systems configuration using comparable indicators is not being done in low and middle income countries, as well as in many high income countries. This is partly due to a fragmented or nonexistent system monitoring capability, and a reluctance on the part of service providers to have their performance evaluated. Performance analysis These analyses are rarely conducted, even though they allow policymakers to examine the extent to which services meet clinical standards and population needs. With proper resources, performance analysis could involve the collection of quantitative and qualitative data on service utilization, continuity of care, attrition, service costs, and the impact of treatment services on health and social indicators. Performance monitoring helps system administrators determine whether the system is serving both clinical and public health interests, and how efficiently the system is operating. Comparative research When standardized research methods are used, data collected at the national or subnational levels can be compared across countries or subregions to answer important policy questions. Several compendiums have been created to highlight the capabilities of comparative cross-national treatment research (Gossop 1995; Klingemann & Hunt 1998; Klingemann et al. 1992). These studies also illustrate some of the difficulties of conducting comparative cross-national research, including funding for international collaborative studies, defining the unit of analysis due to the heterogeneity of treatment systems across country contexts, and variability in the availability and quality of treatmentrelated information. The WHO Substance Abuse Instrument for Mapping Services (WHO-SAIMS) Although progress has been made in the development of methods to monitor and evaluate alcohol and drug treatment systems, treatment system research remains sparse (WHO 2006; Babor et al. 2008). In order to address the need for better descriptive and comparative data, the World Health Organization decided to adapt the NORDIC STUDIES ON ALCOHOL AND DRUGS V O L
6 WHO-AIMS (WHO 2009), an instrument currently used to describe, monitor and evaluate mental health treatment systems, for the assessment of prevention and treatment systems for substance use disorders. To this end, the WHO Substance Abuse Instrument for Mapping Services (WHO- SAIMS) has been developed to provide information on prevention and treatment systems that can be used for policy planning, service design and service improvement. In its present form, the WHO-SAIMS has a primarily descriptive function that will allow gaps in service delivery and areas for system improvement to be identified. It can also be used at the national and sub-national levels for monitoring and process evaluation to identify changes in the system over time and to assess the extent to which system improvement strategies have been implemented. Eventually, the instrument can be used for the five kinds of research described above, as data collected in national treatment mapping exercises becomes available for scientific purposes. The boundaries of the WHO-SAIMS are broad enough to reflect cross-country variations in alcohol and drug service systems and are applicable to systems at all developmental levels. The scope of the WHO- SAIMS was designed to include prevention as well as treatment services. A primary purpose of the WHO-SAIMS is to examine the structure of alcohol and drug service systems in terms of resources, facilities, personnel and programs. The instrument provides a functional assessment of treatment and prevention service systems. Indicators of treatment services include pathways to care, patient flow through the system, continuity of care, and service coordination. To assess how well the system functions, indicators include equity, efficiency, and accessibility as well as system malfunctions such as waiting times for services, underutilization of services, and gatekeepers to access. The instrument is designed to assess the provision of alcohol and drug services in multiple sectors and settings, including specialist inpatient facilities, outpatient settings, and community settings. In addition, primary health care, mental health (e.g. psychiatric clinics), social welfare settings, and the criminal justice sector are also covered so as not to exclude country variation in service provision. Treatment is defined broadly in the WHO-SAIMS to include services provided by self-help groups, traditional healers, and other lay service providers. The WHO-SAIMS was designed to describe the linkages between various components of alcohol and drug service systems. It gathers information about the professional substance abuse treatment sector s linkages to (and integration with) services provided by the primary care, mental health, criminal justice and social welfare sectors. It also describes the professional sector s linkages with mutual help organizations and other lay service providers, and examines interactions between different levels of care, such as patient movements from less intensive to more intensive levels of care. The WHO-SAIMS takes into account the limited availability of information relating to system performance and population needs within low and middle-income countries. Based on this recognition, the WHO-SAIMS consists of a core instrument appropriate for use in all countries, irre- 708 NORDIC STUDIES ON ALCOHOL AND DRUGS V O L
7 spective of developmental level, and a set of optional supplementary questionnaires. The latter includes data on population needs, especially the prevalence of substance use disorders and related harms in the general population as well as system performance measures, such as outcome indicators of abstinence and relapse. These complimentary modules reflect both the consumer and the service provider s perspectives on the structure and functioning of alcohol and drug service systems. The scope and configuration of the instrument can be summarized in terms of its major domains. 1. The policy and legislative domain includes items about national alcohol and drug policies; legislation governing drug control, prevention and treatment; strategic plans that address substance use disorders, work-force development for substance abuse professionals, and resource allocation to and the financing of alcohol and drug services. 2. The second domain covers the country s substance abuse situation and current alcohol and drug service needs within the population. This overview of population-related alcohol and drug service needs and current services provided is designed to (i) help identify whether current services match needs and (ii) allow for some claims to be made about service coverage. Due to the limited availability of population indicators in low and middle income countries, the use of qualitative indicators or a narrative overview of available information is encouraged where quantitative data are not available. 3. A description of the country s current alcohol and drug treatment system. This domain describes the current substance abuse system s level of development in terms of the type and mix of services provided, service integration, and system complexity. It also includes a description of the functional aspects of alcohol and drug services that reflect how the system operates, such as referral pathways and ideal treatment algorithms as well as linkages between different actors in the substance abuse system. Given the limited availability of quantitative indicators on the functioning of alcohol and drug service systems, the functional aspects of these systems can also be examined using qualitative methods. 4. The alcohol and drug services domain. This section of the instrument covers: 1) other residential services for alcohol and drug problems such as half-way houses and sober living environments; 2) alcohol and drug services provided by other sectors such as mental health facilities, primary health care services and the criminal justice sector; 3) the linkages between these services and the extent to which services in different sectors are integrated with each other; 4) the availability of psychosocial treatments; 5) the availability of psychotropic medications in these facilities; 6) the treatment modalities used in each setting; 7) the availability of substitution therapies and harm reduction services for opioid dependence and needle exchange, respectively; and 8) equity of access to alcohol and drug services. 5. The substance abuse in primary care domain. Items in this category refer to: physician-based alcohol and drug serv- NORDIC STUDIES ON ALCOHOL AND DRUGS V O L
8 ices; non-physician-based alcohol and drug services (e.g. nurses, health care workers); the types of interventions used in primary care settings; linkages and integration with services provided in other settings; and capacity to provide alcohol and drug services in primary care settings (e.g. training, skills in the work-force, competing priorities). 6. The human resource domain. This domain includes items relating to the quantity of human resources; human resource development such as training and accreditation of professionals for the substance abuse field and training of lay service providers; and user/consumer and family associations in the alcohol and drug field, including mutual-help organizations and recovering communities such as AA and NA. 7. The public education and links with other services domain. This section includes items relating to public education services on substance use disorders and treatment options, as well as formal links between the specialty substance abuse treatment sector and the mental health, social welfare, and criminal justice sectors. 8. The monitoring and research domain. This section describes current efforts to monitor alcohol and drug services in each of the identified sectors (i.e. primary care, mental health, criminal justice, social welfare and specialized alcohol and drug service sector) as well as other relevant research activities that are taking place in the country. The WHO-SAIMS is designed to be completed over the course of several months by government or academic experts familiar with the broad array of treatment and prevention services in a country or region. Questions of data reliability and accuracy are therefore a major concern, but with proper training and supervision, experience with the WHO-AIMS suggests that it is possible to obtain useful data (WHO 2006; Saxena et al. 2007). The involvement of multiple role players including academic institutions, governmental departments, non-governmental organizations, and civil society is necessary for the objectives of the WHO SAIMS to be realized. Eventually, it is hoped that as the instrument achieves widespread dissemination, it may be used to assess the impact of alcohol and drug services on population health, although this may not be feasible due to the lack of populationlevel indicators in many countries. Nevertheless, the instrument may be useful for research on population impact studies in situations where there are clear hypotheses that can be tested and for comparative analyses within regions or countries where data are available to measure treatment system differences at the regional or municipal levels. Conclusion Treatment and prevention services for substance use disorders form a vital part of effective national responses to the burden of disease and disability resulting from substance abuse. While information on the structure and functioning of these systems is needed to guide service development and system modification, this information is often not available in low and middle income countries. In well-resourced countries, there is a relatively integrated body of research that 710 NORDIC STUDIES ON ALCOHOL AND DRUGS V O L
9 includes an examination of services in relation to population needs, treatment mapping, and systems monitoring. In less-resourced settings, information on prevention and treatment systems and service needs in the general population is scanty. Regardless of resources, there is a dearth of research relating to system performance and the impact of treatment and prevention systems on population health. Although the WHO-SAIMS will rely heavily on the use of secondary data from key informant surveys (the reliability of which could be challenged in low and middle-income countries), this should not be a deterrent for the use of such a tool. Instead, the development of a user-friendly instrument that collects reasonably reliable information on existing alcohol and drug service systems may provide a basis for future evaluation research and may stimulate system reform in some countries. For these objectives to be realized, the end-users of the WHO-SAIMS need to apply its findings in developing and implementing service plans based on the recommendations of the assessment process. Thomas F. Babor, Ph.D., MPH Department of Community Medicine University of Connecticut School of Medicine Farmington, CT, USA babor@nso.uchc.edu Vladimir Poznyak, M.D., Ph.D. Department of Mental Health and Substance Abuse (MSD) World Health Organization Geneva, Switzerland poznyakv@who.int REFERENCES Babor, T.F. & Stenius, K. & Romelsjö, A. (2008): Alcohol and drug treatment systems in public health perspective: Mediators and moderators of population effects. International Journal of Methods in Psychiatric Research 17: (S1): S50 S59 Gossop, M. (1995): The treatment mapping survey; a descriptive study of drug and alcohol treatment responses in 23 countries. Drug and Alcohol Depend 39: 7 14 Klingemann, H. & Hunt, G. (eds.)(1998): Treatment systems in an international perspective: Drugs, demons and delinquents. Thousand Oaks, London, New Delhi: SAGE Publications Klingemann, H. & Takala, J.P. & Hunt, G. (1992): Cure, Care or Control: Alcoholism Treatment in Sixteen Countries. Albany, New York: State University of New York Press Klingemann, H. & Takala, J.P. & Hunt, G. (1993): The development of alcohol treatment systems: An international perspective. Alcohol Health Res World 3: Saxena, S. & Lora, A. & van Ommeren, M. & Barrett, T. & Morris, J. & Saraceno, B. (2007): WHO s Assessment Instrument for Mental Health Systems: Collecting essential information for policy and service delivery. Psychiatric Services 58: United Nations Office on Drugs and Crime (2006): World Drug Report, volume 1. Vienna, UNODC World Health Organization (2006): WHO Technical Consultation on the Assessment of Prevention and Treatment Systems for Substance Use Disorders December 2006, World Health Organization, Department of Mental Health and Substance Abuse, Geneva, Switzerland World Health Organization (2009): WHO- AIMS Mental health systems in selected low- and middle-income countries: a WHO-AIMS cross-national analysis. WHO, Geneva, Switzerland WHO (2004): Global Status Report on Alcohol Geneva: WHO, Department of Mental Health and Substance Abuse. NORDIC STUDIES ON ALCOHOL AND DRUGS V O L
10
Treatment Delivery Systems as a Public Health Approach to the Population Management of Substance Use Disorders
Treatment Delivery Systems as a Public Health Approach to the Population Management of Substance Use Disorders Thomas F. Babor, Ph.D., MPH Dept of Community Medicine & Health Care University of Connecticut
More informationATLAS on substance use (2010) Resources for the prevention and treatment of substance use disorders
ATLAS on substance use (2010) Resources for the prevention and treatment of substance use disorders ATLAS on substance use (2010) Resources for the prevention and treatment of substance use disorders
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 informationdrug dependence treatment and care
UNODC-WHO Joint Programme on drug dependence treatment and care The vision Effective and humane treatment for all people with drug use disorders. Nothing less than would be expected for any other disease.
More informationPERFORMANCE MEASURES FOR SUBSTANCE USE DISORDERS: CURRENT KNOWLEDGE AND KEY QUESTIONS
PERFORMANCE MEASURES FOR SUBSTANCE USE DISORDERS: CURRENT KNOWLEDGE AND KEY QUESTIONS Deborah Garnick Constance Horgan Andrea Acevedo, The Heller School for Social Policy and Management, Brandeis University
More informationAmerican Society of Addiction Medicine
American Society of Addiction Medicine Public Policy Statement on Treatment for Alcohol and Other Drug Addiction 1 I. General Definitions of Addiction Treatment Addiction Treatment is the use of any planned,
More informationNHS Swindon and Swindon Borough Council. Executive Summary: Adult Alcohol Needs Assessment
NHS Swindon and Swindon Borough Council Executive Summary: Adult Alcohol Needs Assessment Aim and scope The aim of this needs assessment is to identify, through analysis and the involvement of key stakeholders,
More informationAN OVERVIEW OF TREATMENT MODELS
AN OVERVIEW OF TREATMENT MODELS The 12-step Programs: Self-led groups that focus on the individual s achievement of sobriety. These groups are independent, self-supported, and are not aligned with any
More informationCore Competencies for Addiction Medicine, Version 2
Core Competencies for Addiction Medicine, Version 2 Core Competencies, Version 2, was approved by the Directors of the American Board of Addiction Medicine (ABAM) Foundation March 6, 2012 Core Competencies
More informationKey Questions to Consider when Seeking Substance Abuse Treatment
www.ccsa.ca www.cclt.ca Frequently Asked Questions Key Questions to Consider when Seeking Substance Abuse Treatment The Canadian Centre on Substance Abuse (CCSA) has developed this document to address
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 informationFuture Service Directions
Alcohol, Tobacco and Other Drug Services Tasmania Future Service Directions A five year plan 2008/09 2012/13 Department of Health and Human Services Contents Foreword... 5 Introduction... 6 Australian
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 informationAmerican Society of Addiction Medicine
American Society of Addiction Medicine Public Policy Statement on Core Benefit for Primary Care and Specialty Treatment and Prevention of Alcohol, Nicotine and Other Drug PREFACE Statement of the Problem:
More informationA Recovery Orientated System of Care for Ayrshire and Arran
A Recovery Orientated System of Care for Ayrshire and Arran 1. BACKGROUND 1.1 The national alcohol and drug strategies, Changing Scotland Relationship with alcohol and The Road to Recovery signalled a
More informationSupervision on the borderline of health and social care. Nordic Supervisory Conference Helsinki 1.-2. oktober 2015
Nordic Supervisory Conference Helsinki 1.-2. oktober 2015 Parallel supervisory visits in Denmark Treatment areas with supervisory visits from the Danish health and medicines authority and the Danish social
More informationTreatment of Alcoholism
Treatment of Alcoholism Why is it important Prevents further to body by getting people off alcohol. Can prevent death. Helps keep health insurance down. Provides assistance so alcoholics don t t have to
More informationTravis Baggett, MD, MPH Jessie M. Gaeta, MD Jennifer Brody, MD, MPH Boston Health Care for the Homeless Program
Travis Baggett, MD, MPH Jessie M. Gaeta, MD Jennifer Brody, MD, MPH Boston Health Care for the Homeless Program Substance- attributable mortality Presentation of the data Implications for our model of
More informationUNODC World Drug Report 2016:
UNODC World Drug Report 2016: Launch in Geneva on 23 June 2016 Briefing to the Member States and Civil Society Organizations Remarks by Aldo Lale-Demoz, Deputy Executive Director, UNODC UNODC is honoured
More informationScreening, Brief Intervention, and Referral to Treatment Core Curriculum
Screening, Brief Intervention, and Referral to Treatment Core Curriculum Acknowledgments The material included in this course is based largely on the works of previously funded SAMHSA grantees. Other information
More informationMedical and Professional Education
Medical and Professional Education Presented by the Hazelden Betty Ford Foundation Summer Institute for Medical Students Professionals in Residence Medical Education Partnership Addiction Medicine Fellowship
More informationAmerican Society of Addiction Medicine
American Society Medicine Public Policy Statement on Parity in Publicly Funded Health Insurance Benefits for Treatment 1 Background The American Society Medicine has well-established policy affirming that
More informationWHAT WE KNOW. Collective Action Issue Brief #2 Updated June 2014 PRESCRIPTION PAIN MEDICATION MISUSE
Collective Action Issue Brief #2 Updated June 2014 PRESCRIPTION PAIN MEDICATION MISUSE WHAT WE KNOW The misuse and abuse of prescription drugs has become a leading cause of harm among New Hampshire adults,
More informationThe concept of National guidelines for treatment of alcohol and drug problems/ dependence in Sweden 2007
The concept of National guidelines for treatment of alcohol and drug problems/ dependence in Sweden 2007 Ulf Malmström coordinator, PhD National Board of Health and Welfare Cyprus May 2009 Why establish
More informationFamily interventions for drug. Family interventions for drug. best practice?
Family interventions for drug Family interventions for drug and alcohol misuse: Is there a best practice? Prof Alex Copello Consultant Clinical Psychologist Addiction Services Birmingham and Solihull Mental
More informationDeveloping the Guernsey treatment system for substance misusers: Phases One and Two. Helen Baldwin Linda Prickett Adam Marr Jim McVeigh
Developing the Guernsey treatment system for substance misusers: Phases One and Two Helen Baldwin Linda Prickett Adam Marr Jim McVeigh Roles and responsibilities of the LJMU research team Helen Baldwin
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 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 informationCourse Description. SEMESTER I Fundamental Concepts of Substance Abuse MODULE OBJECTIVES
Course Description SEMESTER I Fundamental Concepts of Substance Abuse MODULE OBJECTIVES At the end of this course participants will be able to: Define and distinguish between substance use, abuse and dependence
More informationMSc International Programme in Addiction Studies. Prospectus 2015-2016
MSc International Programme in Addiction Studies Prospectus 2015-2016 The Institute of Psychiatry, Psychology and Neuroscience www.kcl.ac.uk/ioppn The Institute of Psychiatry, Psychology and Neuroscience
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 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 information4. How does your city fit into the political-administrative structure of your country? Total Partial None. 5. Demographics
. City.Country. Official responsible for providing this information (mandatory) a. Name b. Position Official title c. Institution Name of the institution where you work d. Address Complete postal address
More informationResidential Substance Abuse Treatment: Impact of Concurrent Utilization Review
Report to The Vermont Legislature Residential Substance Abuse Treatment: Impact of Concurrent Utilization Review In Accordance with Act 179 (2014), Section E.300.2, An Act Relating to Making Appropriations
More informationChapter #13: Alcohol-Drug Treatment Program Presented By: Rose Aldan RH320-01
Chapter #13: Alcohol-Drug Treatment Program Presented By: Rose Aldan RH320-01 Classroom Norms Cell phones on silent or vibrate Respect Others Be willing to participate Have FUN Learning Student Learning
More informationGlobal burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level
EXECUTIVE BOARD EB130/9 130th session 1 December 2011 Provisional agenda item 6.2 Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors
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 informationThe Many Facets of Social Work
The Many Facets of Social Work The scope of social work practice is remarkably wide. Social workers practice not only in the traditional social service agency, but also in elementary schools; in the military;
More informationTitle registration for a review proposal: 12-step programmes for reducing abuse of illicit drugs
Title registration for a review proposal: 12-step programmes for reducing abuse of illicit drugs Submitted to the Coordinating Group of: Social Welfare TITLE OF THE REVIEW 12-step programmes for reducing
More informationSENATE... No. 2142. The Commonwealth of Massachusetts. In the Year Two Thousand Fourteen
SENATE.............. No. 2142 Tuesday, May 13, 2014 Text of the Senate Bill to increase opportunities for long-term substance abuse recovery (being the text of Senate, No. 2133, printed as amended). The
More informationAppendix D. Behavioral Health Partnership. Adolescent/Adult Substance Abuse Guidelines
Appendix D Behavioral Health Partnership Adolescent/Adult Substance Abuse Guidelines Handbook for Providers 92 ASAM CRITERIA The CT BHP utilizes the ASAM PPC-2R criteria for rendering decisions regarding
More informationMental Health Needs of Juvenile Offenders. Mental Health Needs of Juvenile Offenders. Juvenile Justice Guide Book for Legislators
Mental Health Needs of Juvenile Offenders Mental Health Needs of Juvenile Offenders Juvenile Justice Guide Book for Legislators Mental Health Needs of Juvenile Offenders Introduction Children with mental
More informationPERSPECTIVES ON DRUGS The role of psychosocial interventions in drug treatment
UPDATED 4.6.2015 PERSPECTIVES ON DRUGS The role of psychosocial interventions in drug treatment Psychosocial interventions are structured psychological or social interventions used to address substance-related
More informationCSAT s Knowledge Application Program. KAP Keys. For Clinicians
The Role and Current Status of Patient Placement Criteria in the Treatment of Substance Use Disorders CSAT s Knowledge Application Program KAP Keys For Clinicians Based on TIP 13 The Role and Current Status
More informationMENTAL ILLNESS AND SUBSTANCE ABUSE
MENTAL ILLNESS AND SUBSTANCE ABUSE PROBLEM What is the problem for Dallas County? Individuals with co-existing conditions of mental illness and substance abuse are a great burden on the mental health system,
More informationADVANCED BEHAVIORAL HEALTH, INC. Clinical Level of Care Guidelines - 2015
The Clinical Level of Care Guidelines contained on the following pages have been developed as a guide to assist care managers, physicians and providers in making medical necessity decisions about the least
More informationREDUCTION OF THE HARMFUL USE OF ALCOHOL: A STRATEGY FOR THE WHO AFRICAN REGION. Report of the Regional Director. Executive summary
15 June 2010 REGIONAL COMMITTEE FOR AFRICA Sixtieth session Malabo, Equatorial Guinea, 30 August 3 September 2010 ORIGINAL: ENGLISH Provisional agenda item 7.2 REDUCTION OF THE HARMFUL USE OF ALCOHOL:
More informationWHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN URUGUAY
WHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN URUGUAY WHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN URUGUAY A report of the assessment of the mental health system in Uruguay using the World Health Organization
More informationNursing research. strategies to achieve excellence in the provision of knowledge-based nursing care
Nursing research strategies to achieve excellence in the provision of knowledge-based nursing care Facts Swedish Society of Nursing is the professional organization for nurses and represents the profession
More informationUTAH STATE UNIVERSITY. Professional School Guidance Counselor Education Program Mapping
UTAH STATE UNIVERSITY Professional School Guidance Counselor Education Program Mapping Course Key: PSY 6130 Evidence-Based Practice: School Intervention PSY 6240 Comprehensive School Counseling Programs
More informationLEVEL III.5 SA: SHORT TERM RESIDENTIAL - Adult (DUAL DIAGNOSIS CAPABLE)
LEVEL III.5 SA: SHT TERM RESIDENTIAL - Adult (DUAL DIAGNOSIS CAPABLE) Definition The following is based on the Adult Criteria of the Patient Placement Criteria for the Treatment of Substance-Related Disorders
More informationTestimony. Thomas A. Farley, MD, MPH Commissioner. and. Adam Karpati, MD, MPH Executive Deputy Commissioner, Division of Mental Hygiene
Testimony of Thomas A. Farley, MD, MPH Commissioner and Adam Karpati, MD, MPH Executive Deputy Commissioner, Division of Mental Hygiene New York City Department of Health and Mental Hygiene before the
More informationLOCAL NEEDS LOCAL DECISI NS LOCAL BOARDS
ALCOHOL, DRUG ADDICTION, AND MENTAL HEALTH BOARDS OF OHIO The Value of Ohio s Alcohol, Drug Addiction, and Mental Health Boards Providing hope and helping local communities thrive ++--------- LOCAL NEEDS
More informationAn Integrated Substance Abuse Treatment Needs Assessment for Alaska EXECUTIVE SUMMARY FROM FINAL REPORT. Prepared by
An Integrated Substance Abuse Treatment Needs Assessment for Alaska EXECUTIVE SUMMARY FROM FINAL REPORT Prepared by William McAuliffe, Ph.D. Ryan P. Dunn, B. A. Caroline Zhang, M.A. North Charles Research
More informationBehavioral Health Provider Implementation of Whole Health Integrative Treatment Services
Behavioral Health Provider Implementation of Whole Health Integrative Treatment Services Maryland Integrative Learning Community Lynn H Albizo, Director of Public Affairs Maryland Addictions Directors
More informationUnderstanding the Disease of Addiction & the Process of Recovery for Healthcare Clinicians and Staff
Understanding the Disease of Addiction & the Process of Recovery for Healthcare Clinicians and Staff Presented by John G. Gardin II, Ph.D., A.C.S. Chief Clinical Officer, ADAPT, Inc./SouthRiver CHC Basic
More informationhttp://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx
http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx Alcohol Abuse By Neva K.Gulsby, PA-C, and Bonnie A. Dadig, EdD, PA-C Posted on: April 18, 2013 Excessive
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 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 informationPublic Act No. 15-226
Public Act No. 15-226 AN ACT CONCERNING HEALTH INSURANCE COVERAGE FOR MENTAL OR NERVOUS CONDITIONS. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section
More informationKenneth Minkoff, MD 100 Powdermill Road, Box 319 Acton, MA 01720 781-932-8792x311 Kminkov@aol.com
Kenneth Minkoff, MD 100 Powdermill Road, Box 319 Acton, MA 01720 781-932-8792x311 Kminkov@aol.com COMPREHENSIVE, CONTINUOUS, INTEGRATED SYSTEM OF CARE MODEL The Comprehensive, Continuous, Integrated System
More informationFact sheet: Brief interventions and treatments for alcohol use disorders across Europe
Fact sheet: Brief interventions and treatments for alcohol use disorders across Europe December 2012 Health systems and treatment for alcohol use disorders (AUD) The provision of screening and brief interventions
More information1. PROFESSIONAL SCHOOL COUNSELOR IDENTITY:
Utah State University Professional School Counselor Education Program Learning Objectives (Adapted from the Standards for Utah School Counselor Education Programs and the Council for Accreditation of Counseling
More informationWHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN EGYPT. Ministry of Health Egypt
WHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN EGYPT Ministry of Health Egypt WHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN EGYPT A report of the assessment of the mental health system in Egypt using the World
More informationAmerican Society of Addiction Medicine
American Society of Addiction Medicine Public Policy Statement on Parity in Benefit Coverage: A Joint Statement by ASAM and AMBHA The American Managed Behavioral Healthcare Association (AMBHA) and the
More informationDisclosure. C.R. Sullivan, MD 1. Carl R. Sullivan, M.D. Professor and Director Addictions Program csullivan@hsc.wvu.edu. The West Virginia Model
West Virginia University School of Medicine BEHAVIORAL MEDICINE & PSYCHIATRY Morgantown, WV Carl R. Sullivan, M.D. Professor and Director Addictions Program csullivan@hsc.wvu.edu Disclosure Reckitt Benckiser
More informationContents. Introduction. Guiding Principles. Shifting Trends. Goals of the Standards. Definitions. Standards. Standard 1.
Contents Introduction Guiding Principles Shifting Trends Goals of the Standards Definitions Standards Standard 1. Ethics and Values Standard 2. Qualifications Standard 3. Assessment Standard 4. Intervention
More informationFirst Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control Moscow, 28-29 April 2011 MOSCOW DECLARATION PREAMBLE
First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control Moscow, 28-29 April 2011 MOSCOW DECLARATION PREAMBLE We, the participants in the First Global Ministerial Conference
More informationCOUNSELOR COMPETENCY DESCRIPTION. ACBHC (Counselor Technician, Counselor I, Counselor II, & Clinical Supervisor)
COUNSELOR COMPETENCY DESCRIPTION ACBHC (Counselor Technician, Counselor I, Counselor II, & Clinical Supervisor) NOTE: The following material on substance abuse counselor competency has been developed from
More informationINSTRUCTIONS AND PROTOCOLS FOR THE IMPLEMENTATION OF CASE MANAGEMENT SERVICES FOR INDIVIDUALS AND FAMILIES WITH SUBSTANCE USE DISORDERS
201 Mulholland Bay City, MI 48708 P 989-497-1344 F 989-497-1348 www.riverhaven-ca.org Title: Case Management Protocol Original Date: March 30, 2009 Latest Revision Date: August 6, 2013 Approval/Release
More informationMaryland Department of Health and Mental Hygiene 201 W. Preston Street Baltimore, Maryland 21201
STATE OF MARYLAND DHMH The Honorable Martin O Malley Governor State of Maryland Annapolis, MD 21401-01991 Maryland Department of Health and Mental Hygiene 201 W. Preston Street Baltimore, Maryland 21201
More informationGraduate Program Objective #1 Course Objectives
1 Graduate Program Objective #1: Integrate nursing science and theory, biophysical, psychosocial, ethical, analytical, and organizational science as the foundation for the highest level of nursing practice.
More informationImplementation Strategies for Effective Integrated Treatment Services
Implementation Strategies for Effective Integrated Treatment Services Ric Kruszynski, LISW, LICDC Center for Evidence Based Practices at Case/Ohio SAMI CCOE Mandel School of Applied Social Sciences Department
More informationTHE OFFICE OF SUBSTANCE ABUSE SERVICES REQUIREMENTS FOR THE PROVISION OF RESIDENTIAL DETOXIFICATION SERVICES BY PROVIDERS FUNDED WITH DBHDS RESOURCES
THE OFFICE OF SUBSTANCE ABUSE SERVICES REQUIREMENTS FOR THE PROVISION OF RESIDENTIAL DETOXIFICATION SERVICES BY PROVIDERS FUNDED WITH DBHDS RESOURCES PURPOSE: The goal of this document is to describe the
More informationFederal Purpose Area 5 Drug Treatment Programs
Federal Purpose Area 5 Drug Treatment Programs State Purpose Areas: 11F Mental Health Services 11F.01 Provide mental health services through various treatment modalities to a specified number of clients.
More informationAlcohol Treatment Systems and Services. Position Paper
Alcohol Treatment Systems and Services Position Paper 2 Alcohol Treatment Systems and Services Foreword...4 Acknowledgements...6 Introduction...7 Policy Context...8 Service Provision...11 Consultations...13
More informationSubstance Abuse Treatment Certification Rule Chapter 8 Alcohol and Drug Abuse Subchapter 4
1.0 Authority Substance Abuse Treatment Certification Rule Chapter 8 Alcohol and Drug Abuse Subchapter 4 1.1 This rule is adopted pursuant to 8 V.S.A 4089b and 18 V.S.A 4806. 2.0 Purpose 2.1 This rule
More informationRECOVERY HOUSING POLICY BRIEF
I. Introduction and Intent As communities implement strategies to end homelessness, they need to be able to provide effective housing and services options for people experiencing homelessness who have
More informationTreatment Services for Individuals with Co-Occurring Mental Health and Intellectual Disability/Developmental Disabilities
Two types of individuals 1. People with primary diagnosis of intellectual disability/developmental disability Mental health diagnosis is secondary Primary services through ID/DD system Residential/Housing
More informationTARGET DATE for completion of this MAPPING is November 30, 2011.
The Behavioral Health Planning Council s Adult and Substance Abuse Subcommittees have undertaken the task of putting together a statewide services directory. The goal of this project is to secure information
More informationQuality Improvement in Mental Healthcare: The Measures Matter
Quality Improvement in Mental Healthcare: The Measures Matter Richard Hermann, MD, MS Associate Professor of Medicine and Psychiatry Tufts University School of Medicine Center for Quality Assessment &
More informationMental Health 101 for Criminal Justice Professionals David A. D Amora, M.S.
Mental Health 101 for Criminal Justice Professionals David A. D Amora, M.S. Director, National Initiatives, Council of State Governments Justice Center Today s Presentation The Behavioral Health System
More informationPEER LEARNING COURT PROGRAM
PEER LEARNING COURT PROGRAM MIAMI-DADE COUNTY DEPENDENCY DRUG COURT LEAD AGENCY Miami-Dade County Dependency Drug Court LOCATION Miami, Florida FIRST DATE OF OPERATION August 2004 CAPACITY Adults: 75 NUMBER
More informationProvider Application Packet
Provider Application Packet Criminal Justice Treatment Programs Administered by the Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) Division of Substance Abuse Services (DSAS)
More informationHow To Know If You Can Get Help For An Addiction
2014 FLORIDA SUBSTANCE ABUSE LEVEL OF CARE CLINICAL CRITERIA SUBSTANCE ABUSE LEVEL OF CARE CLINICAL CRITERIA Overview Psychcare strives to provide quality care in the least restrictive environment. An
More informationUse advanced techniques for summary and visualization of complex data for exploratory analysis and presentation.
MS Biostatistics MS Biostatistics Competencies Study Development: Work collaboratively with biomedical or public health researchers and PhD biostatisticians, as necessary, to provide biostatistical expertise
More informationSTATE SUBSTANCE ABUSE TREATMENT FOR ADULTS
Executive Summary STATE SUBSTANCE ABUSE TREATMENT FOR ADULTS Each year, Connecticut provides substance abuse treatment to thousands of adults with alcoholism and other drug addictions. Most are poor or
More informationNon medical use of prescription medicines existing WHO advice
Non medical use of prescription medicines existing WHO advice Nicolas Clark Management of Substance Abuse Team WHO, Geneva Vienna, June 2010 clarkn@who.int Medical and Pharmaceutical role Recommendations
More informationCOLORADO PUBLIC HEALTH NURSE COMPETENCY SETS User Guide
Part 1. Competency Basics 1 Introduction COLORADO PUBLIC HEALTH NURSE COMPETENCY SETS User Guide The Colorado Public Health Nurse Competency Sets have been created to facilitate the development of a competent
More informationAddiction Counseling Competencies. Rating Forms
Addiction Counseling Competencies Forms Addiction Counseling Competencies Supervisors and counselor educators have expressed a desire for a tool to assess counselor competence in the Addiction Counseling
More informationSubstance Use Disorder Treatment: Challenges and the Future
County of Los Angeles-Department of Public Health Substance Abuse Prevention and Control Substance Use Disorder Treatment: Challenges and the Future Wesley L. Ford, MA, MPH Director 1 Outline Addiction-
More informationDrug Abuse and Alcohol Treatment in California
Drug Abuse Treatment Policy A Report to the Little Hoover Commission Gary Jaeger, MD President, California Society of Addiction Medicine Sacramento, California May 23, 2002 Introduction As President of
More informationCo-occurring Disorder Treatment for Substance Abuse and Compulsive Gambling
Co-occurring Disorder Treatment for Substance Abuse and Compulsive Gambling Midwest Conference on Problem Gambling and Substance Abuse 2006 Problem Gambling and Co-occurrence: Improving Practice and Managing
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 informationThe story of drug treatment
EFFECTIVE TREATMENT CHANGING LIVES www.nta.nhs.uk www.nta.nhs.uk 1 The story of drug treatment The use of illicit drugs is declining in England; more and more people who need help with drug dependency
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 informationProcedure/ Revenue Code. Billing NPI Required. Rendering NPI Required. Service/Revenue Code Description. Yes No No
Procedure/ Revenue Code Service/Revenue Code Description Billing NPI Rendering NPI Attending/ Admitting NPI 0100 Inpatient Services Yes No Yes 0114 Room & Board - private psychiatric Yes No Yes 0124 Room
More informationAlcohol and drugs prevention, treatment and recovery: why invest?
Alcohol and drugs prevention, treatment and recovery: why invest? 1 Alcohol problems are widespread 9 million adults drink at levels that increase the risk of harm to their health 1.6 million adults show
More informationEffectiveness of Case Management in Treating Substance Abusers Selected Results from a Metaanalysis Richard C. Rapp, M.S.W. Center for Interventions, Treatment, and Addictions Research Boonshoft School
More informationWorld Health Organization
myths and facts for policy makers responsible for substance dependence prevention, treatment and support programs World Health Organization Myth 1. Drug dependence is simply a failure of will or of strength
More information