Alcohol and Other Drug Abuse Services in Milwaukee County A report prepared for Greater Milwaukee Foundation May 2014
. Alcohol and Other Drug Services in Milwaukee County TABLE OF CONTENTS Overview............................................................ p 1 Milwaukee County AODA Services....................................... p 3 Treatment Services............................................. p 4 Counseling Services............................................. p 8 Facilities (Housing, Treatment, Other)............................ p 10 Assessment/Evaluation Services................................. p 13 Support Groups............................................... p 15 Detox/Crisis Intervention Services............................... p 17 Need for AODA Services in Milwaukee County............................ p 19 Intoxicated Driver Program..................................... p 19 Calls to IMPACT 2-1-1.......................................... p 21 IMPACT Client Help Calls....................................... p 24 IMPACT Online Screening Tool.................................. p 26 Suggestions for Next Steps............................................ p 27 Methodology...................................................... p 28 Appendices A: AODA Treatment & Counseling Services in Milwaukee County...... p 29 B: IMPACT Intoxicated Driver Program Statistics.................... p 36 C. IMPACT 2-1-1 Data.......................................... p 38
Alcohol and Other Drug Services in Milwaukee County Overview We re number one! is generally something any community would be proud to proclaim, however, Wisconsin s continual top ranking on many measures of alcohol use is an achievement of which few would boast. Wisconsin consistently reports higher binge drinking rates than any other state in the nation. In 2011 (the most recent year for which there is data), 24.3% of Wisconsin adult males reported binge drinking within the last 30 days. 1 Similarly, Wisconsin s per capita consumption of alcohol is consistently higher than the national average, as are underage drinking and other common measures of alcohol abuse. Within the state, Milwaukee County fares somewhat better, ranking 63 rd out of 72 counties for percent of the population (21%) that drinks excessively, 2 Other drug use is another challenge faced by many in Milwaukee County. The Milwaukee Journal Sentinel recently reported a number of disheartening statistics: In 2013, 67 people died of heroin-related overdoses in Milwaukee County a 34% increase from the prior year and an increase of more than 600% from 10 years ago; Milwaukee County had a record 216 reported drug overdose deaths in 2013 the highest number ever and a 29% increase from 2012; Fatal heroin-related overdoses have been steadily increasing in Milwaukee County in the last several years, reaching 44 in 2011 and 50 in 2012; and Fatal heroin-related overdoses surpassed cocaine for the first time in Milwaukee County in 2012. 3 Substance abuse impacts people of any age, race, ethnicity, and economic status. But some groups are more likely to be affected than others. For instance, the rate of drug-related mortality among American Indians and African Americans in Wisconsin is consistently two to three times higher than among Whites. 4 And Wisconsin youth, exposed to the state s drinking culture, are at high risk as well. For instance, in 2013, one in five (20.6%) Milwaukee Public School (MPS) high school students reported riding in a vehicle driven by someone who had been drinking alcohol in the past 30 days. 5 Wisconsin youth are ranked seventh in the nation for binge drinking 6, and 18.4% of MPS youth report binge drinking in the past 30 days. 7 Alcohol and drug abuse are problematic behaviors on many different levels. Individuals face destroyed relationships, ruined finances and compromised health. Society also experiences losses, for instance, in 1 Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Alcohol consumption 2011. 2 County Health Rankings, BRFSS data for 2006-2012. 3 Milwaukee Journal Sentinel (4/14/14). Heroin-related overdose deaths spike 34% in 2013 in Milwaukee County. 4 Wisconsin Department of Health Services (July 2010). Alcohol and Other Drug Use Focus Area Profile. 5 Wisconsin Department of Public Instruction. Wisconsin High School Youth Risk Behavior Survey 2013. 6 Centers for Disease Control and Prevention, High School Youth Risk Behavior Survey 2011. 7 Wisconsin Department of Public Instruction. Wisconsin High School Youth Risk Behavior Survey 2013.
Milwaukee County, 39% of driving deaths involve alcohol. 8 It has been estimated that 1,529 deaths, 48,578 hospitalizations, 46,583 treatment admissions, 60,221 arrests, and 5,751 motor vehicle crashes are related to problem drinking. 9 Alcohol and Other Drug Abuse (AODA) services in Milwaukee County are provided by hundreds of organizations and cover a wide range of substances from tobacco to opiates. In fall 2013, the Greater Milwaukee Foundation requested that IMPACT Planning Council create an inventory of AODA services and the organizations that provide them in Milwaukee County. In the course of this research, we found 197 different organizations with 308 different sites providing services throughout Milwaukee County. Data from several sources were used to create the services portion of the inventory. The sources were: IMPACT 2-1-1 online database of services; Private lists kept by IMPACT intake counselors; and Clinical Providers list for Wiser Choice (Milwaukee County Behavioral Health Division). There is also a substantial amount of data on the magnitude of need for AODA services in Milwaukee County. During the twelve-month period from November 2012 through October 2013, there were 3,554 calls to IMPACT related to substance abuse. The largest proportion of these requests (20%) were for general assessment of substance abuse, followed by requests for inpatient drug detoxification information (17%) and for central intake/assessment for drug abuse (17%). Women were more likely to call (58.9% of all callers) than men (41.0% of all callers). Female callers also skewed younger than did male callers; about one in four (28.3%) women callers were between the ages of 26-35 while one in four (27.8%) male callers were between the ages of 46-55. The sources for this data were: Data from the IMPACT Intoxicated Driver Program from November 2012 October 2013; Calls to IMPACT 2-1-1 for substance abuse services from November 2012 to October 2013; and Calls to the IMPACT AODA line from November 2012 to October 2013. The AODA services and providers listed in this report do not represent all those available to Milwaukee County residents. Residents with insurance coverage or the wherewithal to privately pay for AODA treatment can choose any one of hundreds of providers within or outside of the county or even the state. People who are under- or uninsured have far fewer options. Some of the people most likely to have trouble finding affordable services within the county to meet their needs are: Pregnant women, or women in need of residential treatment who have children; and Adolescents in need of residential treatment. 8 County Health Rankings, FARS data for 2008-2012. 9 University of Wisconsin Population Health Institute (March 2013). The burden of excessive alcohol use in Wisconsin. IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 2
Milwaukee County AODA Services The taxonomy used by the 2-1-1 online database 10 served as a template to organize the services found in the three databases examined for this portion of the report. That database considers substance abuse services to be: Programs that provide preventive, diagnostic and inpatient, outpatient and residential treatment services as well as transitional support for people who have a physical and/or psychological dependency on one or a combination of addictive substances including tobacco, alcohol and/or other drugs; or whose use of these substances has impaired their physical or mental health or their personal, social or occupational functioning. The IMPACT 2-1-1 online database organizes substance abuse services into several categories, each of which is further subdivided. These categories and subdivisions are the same ones used by all 2-1-1s around the country, based on the AIRS/211 LA County Taxonomy. Following this taxonomy, this report provides detailed information on six service areas: treatment, counseling, facility-based, assessment/evaluation, support groups, and detoxification/crisis intervention. For each area, the variety of services is described. Two service categories were not examined for this report (education/prevention and programs for offenders) but could be analyzed at a future date. 10 http://www.referweb.net/ipct/ IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 3
Treatment Services Treatment services are the most numerous category of AODA services in Milwaukee County, with 252 services provided by 125 different organizations. The most frequently provided service was specialized treatment and referral (72 services found). Other frequently provided services included drug and alcohol day treatment and case/care management. A listing of the organizations found that provide treatment services is included as Appendix A. Treatment Services Specialized Information and Referral Alcohol/Drug Day Treatment Case/Care Management Comprehensive Outpatient Alcohol/Drug Treatment Smoking Cessation Residential Alcoholism/Drug Prenatal Care Independent Living Skills Instruction Inpatient Alcoholism /Drug Suboxone/ Subutex Maintenance Treatment Smoking Cessation Support Alcohol & Drug Related Crisis Intervention Vivitrol Methadone Maintenance 36 35 26 20 17 12 8 7 6 5 3 3 2 72 Number of Services in Milwaukee County Descriptions of the various treatment services: Specialized information and referral: Programs that maintain information about community resources that are appropriate for a specific target group or human services sector (for example, youth programs or addiction services) and which link individuals who are in need of specialized services with appropriate resources and/or which provide information about community agencies and organizations that offer specialized services. Drug day treatment: Programs that provide supervised, structured, full-day daytime activities which may include individual and group counseling, 12-step meetings, social and recreational activities, educational and vocational services, a program for family members, relapse prevention services and a continuing care program for individuals who have problems related to drug abuse, who need treatment that is more intensive than an outpatient program but do not require 24-hour hospital care and are currently sober. Most participants attend day treatment programs eight hours per day Monday through Friday with part-day sessions on the weekends though some programs are available as little as five hours per day or as long as 12 hours per day. Alcoholism day treatment: Programs that provide supervised, structured, full-day daytime activities which may include individual and group counseling, 12-step meetings, social and IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 4
recreational activities, educational and vocational services, a program for family members, relapse prevention services and a continuing care program for individuals who have problems related to alcohol abuse, who need treatment that is more intensive than an outpatient program but do not require 24-hour hospital care and are currently sober. Most participants attend day treatment programs eight hours per day Monday through Friday with part-day sessions on the weekends though some programs are available as little as five hours per day or as long as 12 hours per day. Case/Care management: Programs that develop plans for the evaluation, treatment and/or care of individuals who, because of age, illness, disability or other difficulties, need assistance in planning and arranging for services; which assess the individual s needs; coordinate the delivery of needed services; ensure that services are obtained in accordance with the case plan; and follow up and monitor progress to ensure that services are having a beneficial impact on the individual. Residential alcoholism/drug abuse treatment facilities: Community-based residential facilities that provide a long or short-term (usually one to nine month) alcohol and drug-free supportive environment in which individuals who abuse alcohol or other drugs can achieve and/or maintain sobriety. Residential programs are usually staffed by recovering alcoholics or addicts and offer services that differ widely among facilities, but which may include personal recovery planning services, 12-step or other mutual support groups, alcoholism/addiction education, family support, recreation and social activities and assistance in obtaining vocational and social services. Comprehensive outpatient drug abuse treatment: Supervised, structured programs that offer a wide range of outpatient services which may be coordinated by a case manager and may include individual and group counseling, 12-step meetings, social and recreational activities, educational and vocational services, life skills training, primary health care, perinatal health care, a program for family members, relapse prevention services, a continuing care program and supportive services (such as child care, transportation and parenting skills development) for individuals who have problems related to drug abuse, who need access to treatment to maintain their individual recovery plans but do not require the intensity of a day treatment program or 24-hour hospital care. Participants attend the program on a regularly scheduled basis at least once a month but usually more frequently depending on their individual needs. Intensive outpatient programs are usually available three or four days per week for three or four hours per day. Comprehensive outpatient alcoholism treatment: Supervised, structured programs that offer a wide range of outpatient services which may be coordinated by a case manager and may include individual and group counseling, 12-step meetings, social and recreational activities, educational and vocational services, life skills training, primary health care, perinatal health care, a program for family members, relapse prevention services, a continuing care program and supportive services (such as child care, transportation and parenting skills development) for individuals who have problems related to alcohol abuse and who need access to treatment to maintain their individual recovery plans but do not require the intensity of a day treatment program or 24-hour hospital care. Participants attend the program on a regularly scheduled basis at least once a IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 5
month but usually more frequently depending on their individual needs. Intensive outpatient programs are usually available three or four days per week for three or four hours per day Smoking cessation: Programs that utilize one or a variety of techniques including aversion therapy, hypnosis, acupuncture, acupressure, and individual and/or group therapy or mutual support groups to help people who wish to control their dependence on nicotine and give up cigarettes, cigars, pipe tobacco, chewing tobacco, snuff or other substances containing nicotine. Included are smoking quitlines which provide information and counseling about tobacco use for people who prefer a telephone-based service. Prenatal care: Programs that provide medical care for expectant mothers from the time of conception to the onset of labor to ensure their own physical well-being and the healthy development and birth of their child. Services generally include identification of risk factors based on age, health and/or personal and family history that may affect a woman s pregnancy; diet and lifestyle advice; routine checkups to look for signs of problems associated with pregnancy (such as edema, preeclampsia, or gestational diabetes) and to assure that the pregnancy is progressing well; ultrasound and other forms of prenatal testing to monitor fetal development and check for possible birth defects; and general information about being pregnant, e.g., what is normal and what is cause for concern, remedies for morning sickness or sleeplessness, managing weight gain and other common issues. Independent living skills instruction: Programs that assist people who have disabilities to learn the basic skills of daily living through individual and group counseling and instruction, experience and practice in coping with real or simulated life situational demands; or through the use of assistive devices, special equipment and specialized assistants. Services include but are not limited to training in the ability to travel about the community alone; to live independently in a private residence; to maintain health through self-care and use of medical services; to live within personal income; to maintain acceptable grooming and appearance; to deal with legal, family or social problems; and to cope with other requirements for successful independent living. Smoking cessation support: Programs that provide support which helps people who have quit smoking sustain their commitment during the period of time following treatment when the urge to smoke is still strong. Suboxone/Subutex maintenance treatment: Programs that prescribe Suboxone and/or Subutex, medications that contain buprenorphine hydrochloride, to reduce the symptoms of opiate dependence in order to support the ability of abusers to abstain from use of heroin. Subutex is given during the first few days of treatment and Suboxone, which contains an additional ingredient called naloxone to guard against misuse, is given during the maintenance period. Unlike methadone, which can be dispensed only by clinics that specialize in addiction treatment, Suboxone and Subutex can be prescribed in a doctor s office by physicians with the necessary DEA (Drug Enforcement Agency) identification number. As patients progress in their therapy, their doctor may write a prescription for a take-home supply which can be filled in most commercial pharmacies. IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 6
Methadone maintenance: Programs that utilize controlled dosages of methadone, an addictive synthetic opiate which prevents the symptoms associated with heroin withdrawal, in order to support the efforts of abusers to abstain from use of heroin. The dosage of methadone is gradually reduced so that the individual s dependency is reduced and, if possible, eventually eliminated. Vivitrol: Programs that utilize Vivitrol, a non-narcotic, non-addictive, extended release medication approved by the FDA for the treatment of opioid dependence. Inpatient drug abuse treatment facilities: Health care facilities that provide long or short-term (usually three week to nine month) inpatient treatment programs which may include medical evaluation and treatment, detoxification, personal recovery planning, individual and group therapy, 12-step meetings, recreational and social activities and family support for individuals who abuse drugs. Outpatient counseling and continuing care services are usually available on an ongoing basis following discharge. Included are hospitals that are totally devoted to treatment for drug dependency and drug dependency recovery programs that are within general inpatient health care facilities. Inpatient alcoholism treatment facilities: Health care facilities that provide short-term (usually one to four week) structured inpatient treatment programs which may include medical evaluation and treatment, detoxification, personal recovery planning, individual and group therapy, alcohol education, 12-step or other mutual support groups, recreational and social activities and family support for individuals who abuse alcohol. Outpatient counseling and continuing care services are usually available on an ongoing basis following discharge. Included are hospitals that are totally devoted to treatment for alcoholism and alcoholism programs within general inpatient health care facilities. Alcohol & drug related crisis intervention: Programs that provide in-person, immediate response services including the administration of insulin, dextrose, thiamine and/or oxygen for acutely intoxicated individuals who are comatose or otherwise in life-threatening situations. Also programs that provide in-person, immediate response services for individuals who have had adverse or psychotic-like reactions to drugs, who have taken an overdose of drugs or who are otherwise in life-threatening situations because of drugs. Included are 24-hour facilities that have emergency intake capabilities and organizations that have mobile units which allow staff to intervene directly at the scene. IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 7
Counseling Services AODA counseling services in Milwaukee County include services for individuals and families. Special populations like teens, veterans and victims of crimes can find services tailored to their needs. The inventory includes 120 different organizations providing a total of 175 counseling services. The most common services were alcohol and drug abuse counseling. A listing of the organizations found that provide counseling services is included in Appendix A. Counseling Services Alcohol/Drug Counseling Adolescent/ Youth Counseling Case/Care Management Faith Focused Counseling Independent Living Skills Instruction Activities of Daily Living Assessment 15 9 6 27 41 77 Number of services in Miilwaukee County Descriptions of the various counseling services: Drug abuse counseling: Programs that provide individual, group or family therapy for individuals who abuse drugs and/or for their families to help them better understand the nature of their physical and/or psychological dependency or impairment and to support their efforts to recover. Alcoholism counseling: Programs that provide individual, group or family therapy for people who abuse alcohol and/or for their families to help them better understand the nature of the disease of alcoholism and to support their efforts to recover. Adolescent/youth counseling: Programs that specialize in the treatment of adolescents, usually age 12 or 13 through 17, who have adjustment problems, behavior problems, emotional disturbance, a personality disorder or incipient mental illness. The programs may help youth troubled by low self-esteem, social isolation, peer pressure, bullying, school performance issues, truancy, anger management issues, family problems, grief and loss, sexual promiscuity, sexually transmitted disease, alcohol or drug addiction, eating disorders, oppositional and defiant behaviors, depression and anxiety, suicidal thoughts or other difficult issues. Case/care management: Programs that develop plans for the evaluation, treatment and/or care of individuals who, because of age, illness, disability or other difficulties, need assistance in planning and arranging for services; which assess the individual s needs; coordinate the delivery of needed services; ensure that services are obtained in accordance with the case plan; and follow up and monitor progress to ensure that services are having a beneficial impact on the individual. Independent living skills instruction: Programs that assist people who have disabilities to learn the basic skills of daily living through individual and group counseling and instruction, experience and practice in coping with real or simulated life situational demands; or through the IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 8
use of assistive devices, special equipment and specialized assistants. Services include but are not limited to training in the ability to travel about the community alone; to live independently in a private residence; to maintain health through self-care and use of medical services; to live within personal income; to maintain acceptable grooming and appearance; to deal with legal, family or social problems; and to cope with other requirements for successful independent living. Faith-focused counseling: Programs that provide individual, group or family therapy for people who abuse alcohol and/or for their families to help them better understand the nature of the disease of alcoholism and to support their efforts to recover, with a focus on respecting the client s beliefs and assisting them in discovering how their faith may apply to their situation. Activities of daily living assessment: Programs that evaluate an individual s capacity for self-care and his or her ability to function independently in the context of everyday living and which, where necessary, may recommend rehabilitative services (e.g., independent living skills instruction), supportive services (e.g., attendant care, personal care or home health care), or an alternative residential setting (e.g., an assisted living center or nursing facility). Activities of daily living include bathing, eating, dressing, mobility, transferring from bed to chair and using the toilet. Most assessments also include instrumental activities of daily living such as using the telephone, taking medication, money management, housework, meal preparation, laundry and grocery shopping. Evaluation services are generally provided for individuals who have physical and/or mental limitations or for people whose age may constitute a temporary (children) or developing (elderly) limitation. IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 9
Facilities: Housing, Treatment, Other Facilities-based housing and treatment services in Milwaukee County include services for individuals and families. Special populations like teens, veterans and victims of crimes can find services tailored to their needs. The inventory includes 36 different organizations providing a total of 64 facilities-based housing and treatment services. By definition, 100% of these services are inpatient. The most common service was transitional housing/shelter, followed closely by residential alcoholism/drug abuse treatment facilities. Many shelters restrict their services to a single gender. Shelters exist to serve the needs of families and youth, and some services cater to the needs of other individuals such as parolees or people with AIDS/HIV. Facilities-based Services Residential Alcohol/Drug Abuse Transitional Housing/ Shelter Alcoholism Related Recovery Homes/ Halfway Houses Drug Related Recovery Homes/ Halfway Houses Inpatient Alcohol/Drug Sober Living Homes for Recovering Alcoholics 17 14 9 7 7 5 Number of services in Milwaukee County Descriptions of the various facilities-based services: Transitional housing/shelter: Programs that provide a treatment-oriented living experience in a community-based facility for adults who have emotional disturbances and who, because of their disabilities, are unable to succeed in other placements, but who do not require inpatient psychiatric hospitalization. The service is geared to the specific needs of individual residents and their eventual return to the community as soon as their personal and social adjustment and development permit. Residential alcoholism treatment facilities: Community-based residential facilities that provide a long or short-term (usually one to nine month) alcohol and drug-free supportive environment in which individuals who abuse alcohol can achieve and/or maintain sobriety. Residential alcoholism programs are usually staffed by recovering alcoholics and offer services that differ widely among facilities, but which may include personal recovery planning services, 12-step or other mutual support groups, alcoholism education, family support, recreation and social activities and assistance in obtaining vocational and social services. Residential drug abuse treatment facilities: Community-based facilities that provide a 24-hour, supervised, supportive, drug-free environment in which people who abuse drugs can learn to deal with their lives and remain drug-free upon return to the community. Services may include individual and group counseling and 12-step and other mutual support groups, drug education IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 10
and structured social activities which may be available to family members or significant others as well as to residents. Alcoholism-related recovery homes/halfway houses: Community-based, peer-group-oriented, residential facilities that provide food, shelter and recovery services in a supportive, nondrinking, drug-free environment for people who have completed a hospital or residential primary alcoholism rehabilitation program and need continued support in a residential setting to sustain their recovery. Services may include case management, relapse prevention counseling, 12-step meetings, educational and vocational planning, recreational activities and assistance in obtaining health, social, vocational and other services available in the community. Residents are expected to abide by house rules which vary from facility to facility. The objective is to help people who are recovering from alcohol abuse bridge the gap between intensive treatment and independent sober living. Drug-related recovery homes/halfway houses: Community-based, peer-group-oriented, residential facilities that provide food, shelter and recovery services in a supportive, nondrinking, drug free environment for people who have completed a hospital or residential primary drug abuse rehabilitation program and need continued support in a residential setting to sustain their recovery. Services may include case management, relapse prevention counseling, 12-step meetings, educational and vocational planning, recreational activities and assistance in obtaining health, social, vocational and other services available in the community. Residents are expected to abide by house rules which vary from facility to facility. The objective is to help people who are recovering from drug abuse bridge the gap between intensive treatment and independent drug-free living. Sober living homes for recovering drug abusers: Alcohol and other drug-free residences (which may be single family dwellings, duplexes, multiplex apartment buildings or communal residential facilities) for people who are recovering from drug abuse and need a sober environment in order to sustain an abstinent lifestyle. Residents are free to organize and participate in support group meetings or any other activity that helps them maintain sobriety, but neither the homes nor the residents provide treatment, recovery, detoxification services or other supportive services and supervision of individual recovery is not provided. Sober living homes for recovering alcoholics: Alcohol and other drug-free residences (which may be single family dwellings, duplexes, multiplex apartment buildings or communal residential facilities) for people who are recovering from alcohol abuse and need a sober environment in order to sustain an abstinent lifestyle. Residents are free to organize and participate in support group meetings or any other activity that helps them maintain sobriety, but neither the homes nor the residents provide treatment, recovery, detoxification services or other supportive services and supervision of individual recovery is not provided. Inpatient drug abuse treatment facilities: Health care facilities that provide long or short-term (usually three week to nine month) inpatient treatment programs which may include medical evaluation and treatment, detoxification, personal recovery planning, individual and group therapy, 12-step meetings, recreational and social activities and family support for individuals who abuse drugs. Outpatient counseling and continuing care services are usually available on an IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 11
ongoing basis following discharge. Included are hospitals that are totally devoted to treatment for drug dependency and drug dependency recovery programs that are within general inpatient health care facilities. Inpatient alcoholism treatment facilities: Health care facilities that provide short-term (usually one to four week) structured inpatient treatment programs which may include medical evaluation and treatment, detoxification, personal recovery planning, individual and group therapy, alcohol education, 12-step or other mutual support groups, recreational and social activities and family support for individuals who abuse alcohol. Outpatient counseling and continuing care services are usually available on an ongoing basis following discharge. Included are hospitals that are totally devoted to treatment for alcoholism and alcoholism programs within general inpatient health care facilities. IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 12
Assessment/Evaluation Services AODA assessment/evaluation services in Milwaukee County include services like central intake for individuals who are abusing alcohol and drugs, as well as specific testing services like urinalysis, breath and other tests that determine whether an individual has alcohol or an illegal drug in his or her system. The inventory catalogued 49 different organizations providing a total of 70 assessment/evaluation services. The most commonly provided service was urine tests. Assessment/Evaluation Services Urine Tests 57 Drug/Alcohol Testing 7 Central Intake/Assessment for Alcohol Abuse Central Intake/Assessment for Drug Abuse Home Drug Testing Kits Court Ordered DUI Evaluations 2 2 1 1 Number of services in Milwaukee County Descriptions of the various assessment/evaluation services: Urine tests: Programs that offer urinalyses, a screening procedure that is used to detect cellular material or substances in the urine that are associated with a variety of metabolic and kidney disorders, and can help to find abnormalities that require follow-up. In many cases, substances such as protein or glucose will begin to appear in the urine before patients are aware that they may have a problem. The test is also used as a diagnostic tool that can identify or confirm the specific nature of a problem when a patient presents certain symptoms (e.g., a urinary tract infection when the individual complains of abdominal pain, back pain, painful or frequent urination or blood in the urine). The test may also be performed to help diagnose specific disorders such as endocrine diseases, bladder cancer, osteoporosis and porphyrias (a group of disorders caused by chemical imbalance); and for patients with acute or chronic conditions such as kidney disease, a urinalysis may be ordered at intervals as a method to help monitor organ function, status and response to treatment. Drug/alcohol testing: Programs that administer blood, urine or breath tests or utilize other screening techniques to determine whether the individual has alcohol or an illegal drug in his or her system and to identify the substance involved. Sweat, saliva, tears and hair can also be analyzed for the same purpose. IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 13
Central intake/assessment for alcohol abuse: Programs that evaluate individuals who abuse alcohol and triage them for the limited number of subsidized beds that may be available in the community. Central intake/assessment for drug abuse: Programs that evaluate individuals who abuse drugs other than alcohol and triage them for the limited number of subsidized beds that may be available in the community. Home drug testing kits: Programs that provide kits which enable individuals (usually parents) to test urine samples for the presence of illegal drugs in the privacy of their homes. Court-ordered Driving Under the Influence (DUI) evaluations: Programs that provide a courtordered assessment of individuals who have been convicted of driving under the influence of drugs and/or alcohol to evaluate the severity of their problem and make a recommendation to the court regarding appropriate treatment. IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 14
Support Groups The majority of Milwaukee County AODA support groups concentrate on individuals with alcoholism and drug dependencies, but there are also groups for families and friends. No groups were found that support individuals with a dual diagnosis (A condition in which individuals have a diagnosed mental illness which interferes with their functioning in a substantial way in combination with a chemical dependency problem which aggravates their ability to become stabilized or recover). There are support groups for women only, for people of tribal ancestry and for older adults. A total of 57 support group services, provided by 32 different organizations, were found. Support Group Services Alcohol Dependency Support Groups Drug Dependency Support Groups 19 25 Smoking Addiction Support Groups Families/Friends of Alcoholics Support Groups 5 5 Victim/ Offender Mediation Programs Dual Diagnosis Support Groups 2 1 Number of services in Milwaukee County Descriptions of the various support group services: Alcohol dependency support groups: Mutual support groups whose members are individuals who abuse alcohol. The groups meet in-person, by telephone or via the Internet; provide emotional support, information and resources to help participants overcome their dependency; and may include faith-based and secular 12-step groups as well as non-12 step groups, and groups for anesthetists, pharmacists, psychologists, physicians or other health care professionals who are recovering from alcoholism. Drug dependency support groups: Mutual support groups whose members are individuals who abuse drugs including prescription and over-the-counter medication. The groups meet inperson, by telephone or via the Internet; provide emotional support, information and resources to help participants overcome their dependency; and may include faith-based and secular 12- step groups as well as non-12 step groups, and groups for anesthetists, pharmacists, psychologists, physicians or other health care professionals who are recovering from drug dependency. Smoking addiction support groups: Mutual support groups whose members are individuals who wish to recover from their dependence on nicotine and give up cigarettes, cigars, pipe tobacco, chewing tobacco, snuff or other substances containing nicotine. The groups meet in-person, by IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 15
telephone or via the Internet; provide emotional support, information and resources to help participants come to terms with their addiction; and may include faith-based and secular 12- step groups as well as non-12 step groups. Families/friends of alcoholics support groups: Mutual support groups whose members are the spouses/partners of people who abuse alcohol; children of all ages whose parents, guardians or other parent figures are involved in alcohol abuse; and/or friends of those individuals. The groups meet in-person, by telephone or via the Internet; and allow participants to share their experience, strengths and hopes to solve the problems they have in common, and to support the recovery of their loved one. Victim/offender mediation programs: Programs that provide opportunities for crime victims to meet with offenders in a safe, structured setting, discuss the circumstances and impact of the crime and participate in the formulation of a restitution plan which may be monetary, consist of work for the victim, entail community service, or involve other forms of compensation for harm that was caused. With the assistance of a facilitator, victims have an opportunity to ask questions and describe how the crime has affected them and/or their families. The focus of victim/offender conferencing is on victim healing, offender accountability and restoration of losses. Dual diagnosis support groups: Mutual support groups whose members are individuals who have a diagnosed mental illness which interferes with their functioning in a substantial way in combination with a chemical dependency problem which aggravates their ability to become stabilized or recover. The groups meet in-person, by telephone or via the Internet; provide emotional support, information and resources to help participants stop using drugs and/or alcohol and find ways to manage their emotional or psychiatric problems; and may include faithbased and secular 12-step groups as well as non-12 step groups. IMPACT Planning Council May 2014 AODA Services in Milwaukee County Page 16