My parents have been dealing drugs their whole lives.
As general practitioners, they spend their days listening carefully to the patient's ailment and deciding which drug will be most likely to help them achieve their medical aims. You're depressed? Try these antidepressants. High cholesterol? Take a statin. Diabetic? Here is a syringe full of insulin. And through this ongoing dance between diagnosis and dose they are able to adjust a person's biology to help them live better, longer, and happier (most of the time).
I was never smart enough to get into medicine (thankfully) but I did manage to find myself picking up the family business of dealing drugs from a young age. From the age of 15 right through to 22, I made a career out of prescribing copious doses of the drug that billions of people consume but rarely consider its diagnosis: alcohol. It all started with selling bootlegged alcohol to other awkward high school boys at my boarding school. I made a tidy little profit selling it for all sorts of teenage boarding school ailments. Nervous about talking to girls at a party? "This here is called Dutch Courage." Want to do something you would never do sober? "Take four swigs of this." Can't dance? "Shots!"
December 21, 2016 Maureen Fitzgerald Editor, NIATx and ATTC Network Coordinating Office
You probably know that the ATTC Network serves the 50 U.S. states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific Islands of Guam, American Samoa, Palau, the Marshall Islands, Micronesia, and the Mariana Islands.
But did you know that the Network includes international Centers?
An additional VHATTC site opened in Ho Chi Minh City in 2014. And in 2016, the Southeast Asia Regional HIV ATTC was established in Chiang Mai, Thailand.
Tracey M. Duncan, Ed.S., Ph.D., LPC, ACS Assistant Professor Department of Counselor Education New Jersey City University
tduncan2@njcu.edu
It’s been well-documented that addiction is a family disease, affecting every member of the family in some way. Family members organize themselves according to their behavioral and emotional reactions to the loved one suffering from a substance use disorder. In many families, these responses flare up during the holiday season, when spending time with a sibling, parent, or child with an untreated substance use disorder can make family gatherings more stressful than joyful.
If you scan the headlines in newspapers from across the country, you’ll see a few common words:opioids, heroin, Naloxone, prescription pain medications, drugs, overdose, HIV.You may recall the 2015 HIV outbreak in Indiana that was fueled by injection drug use, mainly of oxymorphone (Opana), oxycodone, and methadone—all opioids.
Sean A. Bear, 1st Training Coordinator and Senior Research Consultant National American Indian and Alaska Native Addiction Technology Transfer Center
My name is Sean A. Bear, 1st. I am a member of the Meskwaki Tribe in Iowa and the Training Coordinator and Senior Research Consultant at the National American Indian and Alaska Native Addiction Technology Transfer Center (National AI/AN ATTC) located in the University of Iowa College of Public Health, Department of Community and Behavioral Health. After a training event in Fargo, North Dakota, Dr. Skinstad (Director, National AI/AN ATTC) and I decided that it was important for me to make a site visit to the Standing Rock site of the pipeline protests to evaluate if there was any need for assistance from our Center to the participants of the demonstration and their providers.
Outcome studies and research will help get some patients, staff, and community members on board for medication-assisted treatment. But scientific evidence may not convince everyone to embrace a treatment such as buprenorphine (Suboxone®) for opioid use disorders.
And in treatment agencies, lack of staff buy-in can easily sabotage the potential success of any MAT program.
Obviously, history has been made since the beginning of time but wasn’t recorded until relatively recent times. One thing certain is that the travelers, teachers, and troubadours of old told and sang stories that informed and entertained. Circles around campfires and huddles around hearths created communities. The means of the telling have changed dramatically but the personal stories with the important element of humanity provide the power. Tahir Shah, a travel writer, said, “Stories are a communal currency of humanity.” We can read and enjoy stories; however, a story’s power comes from seeing the face and hearing the voice of the person with feeling, gestures, smiles, and tears. This is the case for the stories of cancer survivors and of those who have overcome addiction to alcohol and other drugs. Read the complete post.
Recovery Day Canada also celebrates recovery in September, and has been since 2012.
And in Ghana, Recovery Africa held its second annual Recovery walk this year.
Bill White has written a lot about the Recovery Movement, and he shares perspectives from people in recovery from around the globe in these Leadership Interviews on Recovery Around the World.
Marijuana continues to make headlines daily, and it can be hard to stay on top of the latest news about marijuana research, trends, and legalization. To help you stay in the know, we've collected some of the most recent and relevant resources and news items in one compact blog post.
1. "Does smoking marijuana make me stupid?"
Short answer: Yes.
Find this infographic and more on the
ATTC Network's Marijuana Lit page!
A recent Canadian study adds to the body of research showing that marijuana does affect IQ. This is one study to turn to when talking to teens and others who think that marijuana is harmless.
The late Peter Drucker, an influential business
thought leader and educator, once stated: Almost all quality improvement comes via
simplification of design and processes.
Recently, I was reminded of the
simple elegance of NIATx model.
A friend came to me and asked what I would do
if faced with the following problem: His organization struggled to make timely
improvements to their operations. When a change was finally implemented, it
often reverted back to the old process after a few months.
Having guided change teams for years in organizations both large and small, I was
all too familiar with the challenge he presented.
“There was always a need for more Big Brothers,” says
Fayetta. “We had little trouble finding Big Sisters, but Big Brothers were in
short supply.”
That’s what gave her the idea to create My Brother’s Keeper,
a support group that offers positive male mentoring for the
fathers involved with the women in the MIRRORs program.
MIRRORS, a grantee of SAMHSA’s Pregnant and Parenting Women
(PPW) project, provides medical and behavioral health services for pregnant and
postpartum women and their families.
“One of the main goal of the MIRRORS program is family
reunification,” explains Fayetta. “Many of the women in our program will return
to the men in their lives, who will have a strong influence on the family. And
if the father is going to be in the lives of the mother and children, we need
to start working with the family as a unit.”
In their book, Under
the Influence: A Guide to the Myths and Realities of Alcoholism (2011),
authors James Milam and Katherine Ketcham discuss worldwide research that
suggests that the longer a society or culture has been exposed to alcohol, the greater
the decrease in the rates of alcohol use disorders. The passage of time allows
groups to develop cultural norms that support more responsible or ceremonial
use of alcohol. The Jewish community is highlighted as an example of a group with a low rate
of alcoholism compared with other groups, due to their long exposure to
alcohol and clearly defined rituals around use (Kinny, 2014).
In 1981, the same authors predicted that longer exposure to alcohol would increase rates of
recovery among Native Americans, where alcohol had limited use among most
tribes until arrival of the first European settlers. They were correct! At the time of this writing,
groups like White Bison are helping
tribes return to culture, dispel the myth that alcoholism is a part of their
culture, and achieve recovery rates as high as 50-70%. The Alkali Lake Tribe in
British Columbia, Canada went from 100% alcoholism to 95% recovery (Sanders,
2011).
The United States, with just 240 years as a nation, has
evolved from heavy, regular alcohol consumption during colonial times (see Colonial
Americans Drank Roughly Three Times as Much as Americans Do Now)—to beginning
to create sober rituals. During September, National Recovery Month, we celebrate
recovery from substance abuse and mental health disorders with marches,
rallies, parades, and other community events.
Laurie Krom, MS
Director, ATTC Network Coordinating Office
Last week the East Liverpool, Ohio police department decided
to fight the opioid use disorder epidemic by posting two images to their
Facebook page. The images show a man and a woman passed out in the two front
seats of their vehicle, with a young child in the back seat.
The child is looking
at the camera.
The woman is turning blue.
The text associated with the post
explained that the police department decided to share the images so that the
public could see “the other side of this horrible drug.” They also mentioned
that the man and woman both lived, after receiving lifesaving care from a
medical team. The Facebook post went viral almost immediately and was picked up
by many local and national news outlets. I am not included a link to that post
here. I do not want to give it more legs.
Maureen Fitzgerald ATTC Network Coordinating Office/NIATx National Recovery
Month 2016:
Join the Voices for
Recovery: Our families, our stories, our recovery
This year, SAMHSA observes the 27th year of National Recovery Month. With the
theme “Join the Voices for Recovery: Our families, our stories, our recovery,”
National Recovery Month 2016 acknowledges and celebrates the millions of
Americans who are living in recovery from mental and substance use disorders.
Here’s a sampling of just some of the great resources the
National Recovery Month website offers to help you organize and promote an
event in your community, share stories, or broadcast the message that recovery
in all its forms is possible:
The symposium will include presentations by researchers, clinicians, and Latinas in recovery. Their presentations will address the particular issues that may affect Latinas’ recovery processes. Presenters will also offer recommendations for professionals in the field.
The New England ATTC Network Regional Center Staff Dan Squires, PhD, MPH, Director Leslie Cohen, BS, Co-Director Sara Becker, PhD, Evaluation Director Denise Bayles, BM, Project Coordinator Raymond Sanchez, Application Coordinator Stacey Howley, BS, Workforce Development Coordinator
The language used to refer to people can exert a powerful impact on both perceptions and expectations.
For example, if someone is referred to as a “survivor”, assumptions—likely favorable—are made immediately, and without specific details. Likewise, however, if someone is referred to as a “victim”, assumptions—likely more variable and less favorable—are made, even though both references could easily refer to the same individual in the same context.
Beth Rutkowski, MPH Pacific Southwest ATTC On behalf of the ATTC Network's Cannabis Blending Team
In a Brooklyn neighborhood in New York City, 33 people were suspected of overdosing on synthetic cannabinoids in a single day in July 2016. (What's a cannabinoid? It's any one of many psychoactive compounds in marijuana--with "THC" being the most widely known.) Synthetic cannabinoids with names like "K2" and "Spice" are herbs that have been sprayed with chemical additives to mimic the psychoactive effects of botanical marijuana. They're sold for recreational drug use as commercial products through convenience stores, tobacco shops, or head shops.
Organizational cultures often resist change. But that doesn't mean that cultures can't change.
Organizational culture refers to beliefs, values, and norms commonly held among an organization's members. Describing their organization's culture, staff might say: "This is the way we do things around here."
Organizational cultures are a good thing. Commonly held beliefs and values are important because they tend to minimize the likelihood that individual staff members are working at cross purposes. Cultures also help to ensure that staff members consistently apply effective and efficient ways to achieve organizational objectives. Commonly held beliefs comprise the "tried and true" ways staff members achieve mission goals. Each time a practice produces good outcomes, its value as tried-and-true increases, along with the likelihood that it will be used again in a similar situation. As beliefs and values become more widely held, they become reinforced throughout the day by social norms.
The National Frontier
and Rural (NFAR) ATTC is hosting its 4th Annual Technology Summit in
Wilmington, Delaware on August 3-5, 2016
The focus of the 2016 Technology Summit, Mind the Gap: Using Technology to Connect People to Care is to help practitioners bridge the gap between knowledge and skills. All breakout sessions are designed to promote skill development. The following are some tips to help participants have a successful experience at the NFAR Technology Summit.
Ned Presnall
Executive Director
Clayton Behavioral
Adjunct Professor, Washington University
"The idea that somehow, someday he will control and enjoy his drinking is the great obsession of every abnormal drinker. The persistence of this illusion is astonishing. Many pursue it into the gates of insanity or death." (The Big Book of Alcoholics Anonymous, Chapter 3)
The founders of AA suggest that attempts at moderation provide the best litmus test for alcoholism. In their view, drinkers that are able to cut back without abstaining are not alcoholics because they haven’t become powerless over alcohol.
Words fail in expressing sympathy for the friends and family members of those whose lives were lost in the horrific massacre in the Orlando night club nearly three weeks ago. Words also fail in conveying the fear now experienced by members of the LGBTQI community.
Fear has replaced what for many had been a growing sense of acceptance and affirmation.
Can a telenovela (soap opera) change attitudes and behaviors about HIV testing, treatment, and prevention?
Hilda Sandoval, PhD, and Natalie Sanchez, MPH, think so. They both work at AltaMed, a federally qualified health center (FQHC) in Los Angeles. In fact, AltaMed is the nation's largest FQHC. It's also the largest HIV medical provider for Latinos in Southern California. Sanchez is the Clinic Administrator of Alta Med's HIV Department, and Sandoval serves as the Mental Health manager.
They've teamed up to create Sin Vergüenza, (Without Shame) the gripping story of three generations of the Salazar family: a fictional Mexican-American family living in Los Angeles and dealing with HIV/AIDs. The seven episodes of the mini series are available for viewing in English or Spanish. Sin Vergüenza does not air (yet) on network television.
The Center for Health Enhancement at the University of Wisconsin-Madison developed A-CHESS, a smartphone app for recovery support, based in part on ideas that emerged from experts in diverse fields and people suffering from addiction or affected by it. In 2009, in a Behavioral Healthcare article, I talked about key ingredients that a technology-based addiction treatment systems such as A-CHESS would need.
A lot of the identified, necessary ingredients weren't yet available when we first started thinking about a mobile app to assist those in recovery.
Some managers think that they should have all the answers. This may be because they think that their subordinates will disrespect them if they are not perceived to be technically competent.
You could call this style "leading by telling."
Perhaps such managers think that telling people how to do their jobs demonstrates technical expertise--without realizing that being "told how" can also signal disrespect for someone else's technical competence.
Leading by telling risks creating a disempowering work climate, one that can lead lead to "satisficing": doing exactly what one is told, sufficient to satisfy the boss. No more, no less.
Ned Presnall
Executive Director, Clayton Behavioral, St. Louis, Missouri
Adjunct Professor, Washington University
PlanYourRecovery.com was originally launched in 2011 as a platform for documentary testimonials about the effectiveness of methadone, buprenorphine, and extended-release naltrexone in the treatment of opioid dependence.
Lamenting the stigma against Medication-Assisted Treatment in Missouri, I had lured my high school friend and artist, Nick Niles, from his home in Zurich to join me in traveling around eastern Missouri, filming persons in recovery with their families. It was a shoe-string operation. We had each taken a week off from work and were interviewing and filming from morning to night. Today, two 15-minute videos are still available on our website and YouTube channel, one of a person recovering with buprenorphine maintenance and the other with methadone.
May 24, 2016
Maureen Fitzgerald
ATTC Network Coordinating Office
The ATTC Network brings the addiction treatment and recovery services field a range of new publications, webinars, and training resources each week. This week, for example, brings you a new resource on integrating substance use disorder treatment with other health care, a webinar on teen use of e-cigarettes, vaping, and dipping, and easier access to ATTC bilingual resources.
One process improvement myth that resurfaces regularly like a sighting of the Loch Ness monster is that change takes time. A lot of time. Because trying out new procedures takes so long, staff might be convinced that change is just not worth the effort. And they'll quietly go back to doing things the comfortable old way.
But I'm here today to bust the myth that change takes time.
The month of May is designated as Hepatitis Awareness Month in the United States, and May 19 is Hepatitis Testing Day. During May, many public health partners will work to shed light on this hidden epidemic by raising awareness of viral hepatitis and encouraging priority populations to get tested (CDC, 2016).
With much gratitude I was able to attend the conference as a student in recovery, President of RooCovery, a newly formed Collegiate Recovery Community at the University of Missouri – Kansas City (UMKC), and a representative of theATTC Network Coordinating Office.
Rev. David Martins
Interim Director
Rhode Island Communities for Addiction Recovery Efforts (RICARES)
"Everyone has inside of him a piece of good news. The good news is that you don't know how great you can be! How much you can love! What you can accomplish! And what your potential is!"
These words are taken from The Diary of Anne Frank. While they were not intended for the Recovery Community, they certainly apply. As one of the 23 million Americans in recovery, I can tell you firsthand the truth that it is indeed good news--in fact, it's incredible news, to continue to discover the latent potential of how great life is, and how much we can love.
The journey to recovery is strengthened by the knowledge that we are part of a community, and not trying to get through this experience of rebirth alone.
A frequently-mentioned myth NIATx coaches encounter is the perception by managers that their staff do not want to help find solutions to the organization’s problems. That impression may seem valid to managers because they tend to focus on matters external to daily operations while staff, on the other hand, have to live with annoying redundancies, conflicting demands, and other inefficiencies that the boss seems to ignore at their, and the clients’ expense.
Past attempts at change within the organization – or past resistance to change by managers – may have built a culture of suspicion and indifference in the workforce. When this is the case, management initiatives often flounder in the "Wait’n Sea" unless there is clear evidence that the staff are empowered to change how they do things.
Disruption is a word often used to describe what's happening in health care today. And providers are encouraged to "think outside the box" to adapt to this disruption.
But have you ever wondered just howto "think outside the box?"
In this five-minute video, Andrew Isham, research scientist at the Center for Health Enhancement Systems Studies (which also houses NIATx), offers a strategy: opportunity based thinking. It might be one way to think different and identify solutions that are sometimes so obvious they're easily overlooked.
For example, how did Steve Jobs found the solution to the problem of the stylus that was once ubiquitous with mobile devices? Literally, at his fingertips.
This video was part of Isham's presentation for the BHBusiness Plus Innovator's Network at the National Council Conference, NatCon16.
How do you use opportunity based thinking in your organization? Has letting go of assumptions given you insight into opportunities? Share your story in the comment section below.
Andrew Isham, M.S., is a researcher at the Center for Health Enhancement Systems Studies, based at the University of Wisconsin-Madison. His focus is on the innovative adaptation of information technologies to support behavior change in people with chronic health conditions. Isham has a BS in mechanical engineering, a minor in psychology, and an MS in industrial and systems engineering, with a specialization in health systems engineering. In both the academic research and commercial realms, Andrew has experience and knowledge of many of the links in the health IT chain, including testing, implementation, patient/clinician engagement, and sustainability.
Today, it is widely accepted that examining the role of sex and gender in health is vital to conducting rigorous research, developing effective public health policies and enhancing clinical treatment. In the past, however, health research has not always adequately addressed sex and gender. This oversight was characteristic of early research on gambling addiction because so many investigations were focused on veterans and because many more men gambled than women. Although men still outnumber women as gamblers in the US, women are catching up, thanks in part to the expansion of legalized gambling during the past 30 years. During the past 20 years, gambling researchers have not only included women as research participants but also have increasingly addressed the role of gender in studies of gambling disorder. As is common in young fields of research, we still don’t have a strong consensus on the gender issue in the gambling field. Here are a few of the questions that are driving research on the relationship between gambling disorder and women.
The NAADAC Minority
Fellowship Program for Addiction Counselors (NMFP-AC), funded by SAMHSA, awards tuition stipends of up to
$20,000 to qualified students who are eligible for graduation from an
accredited Master’s program in addiction/substance use disorders counseling and
are committed to working with minority or transition age clients (ages 18-25).
The goal of the fellowship is to build the addiction
treatment workforce that treats underserved communities and populations,
including minority populations, LGBT populations, and transition-age youth.
The program launched in 2014, selecting 13 fellows for the
first cohort. Two of those fellows interviewed recently, Tanya Richem and Nil Shores, describe
receiving the award as “life-changing.”
In fall 2014, baseline data showed that only 33% of Ministry Behavioral Health (now known as Ascension) clients in Stevens Point, Wisconsin, transferred from detoxification services to continuing care.
Participating in a NIATx project helped the Change Team boost continuation to continuing care to 63% by June 2015 - an increase of 91%!
How did they do it? “Rapid-cycle testing was key,” says Change Leader Kathleen Olszewski, MBA, CRCE-I Manager of Business Operations at Ministry Behavioral Health.
Mark Sanders, LCSW, CADC, of On the Mark Consulting, is an international speaker on addiction and mental health treatment. He's written several books, along with the recovery monograph, Recovery Management.
This week, Sanders is presenting a webinar as part of the Great Lakes ATTC Behavioral Health webinar series: Counseling African Americans with Substance Use Disorder Thursday, February 25, 2016
12:00-1:30pm CT (10:00am PT, 11:00am MT, 1:00pm ET)
Providing culturally competent care the considers age, race, ethnicity, culture, language, disability and gender is increasingly important as U.S. society grows more diverse. As the United States Census Bureau reported in March 2015:
"Around the time the 2020 Census is conducted, more than half of the nation's children are expected to be part of a minority race or ethnic group."
The ATTC Network offers an array of training and education resources to help addiction treatment professionals address the needs of the diverse populations they serve.
Back in 2004, NIATx Director Dave Gustafson got together with a group of creative thinkers from around the world. Their goal was to create a vision for the addiction treatment system of the future. The result, after a couple of days of serious brainstorming, was a vision for addiction treatment that included virtual counselors and technology tools to track moods, manage cravings, and prevent relapse.
Dave wrote about that vision in Automating Addiction Treatment, published in Behavioral Healthcare in 2009. At the time, he and his team were just starting to develop A-CHESS, a mobile app to help people with alcohol dependence maintain their recovery after leaving residential treatment.
Financial sustainability is a hot topic in the recovery organization world. Most if not all recovery community organizations (RCOs) are highly dependent on public sector funding. This has left them vulnerable to budget cuts, shifting priorities, and broader economic downturns.
As a result of this unpredictability, RCOs are often forced to focus on the short term, with little opportunity to plan and execute long-term strategy or invest in innovations.
Our experience with Face It TOGETHER Sioux Falls has been driven by a business orientation and a belief that we could harness the forces of the market to transform how our community deals with drug and alcohol addiction.
Behavioral health disorders are highly prevalent in many
American Indian and Alaska Native communities, both urban and tribal.
Combined
2003 to 2011 data indicate that American Indians or Alaska Natives are more
likely than persons from other racial ethnic groups to have needed treatment for alcohol or illicit drugs in the past year (17.5 vs. 9.3 percent).
Substance
Abuse and Mental Health Services Administration, Center for Behavioral Health
Statistics and Quality. (November
2012). The
NSDUH Report: Need for and Receipt of Substance Use
Treatment among American Indians or Alaska Natives.
Treatment approaches need to consider American Indian and Alaska Native cultures and healing practices, as well as the generational and historical trauma that affects native communities. In addition, the changing health care system in the US requires health
care that health care leaders acquire additional knowledge and enhanced
leadership skills to navigate both public and private funding opportunities, as
well as administer a complex behavioral health agencies.
“Our goal was to create an interactive course that keeps
learners engaged and motivated,” she says.
Dr. Alagoz, Assistant Scientist at NIATx, specializes in
educational technology. She teamed up with Amy McIlvaine, NIATx Educational
Services Director, to create "Planning for the Next Generation of HIT."
Games and health information technology may seem like an unlikely combination--but games are already appearing in health information and will have an even bigger presence in the next "generation."
And there's a growing research base for games in health. The digital game SuperBetter, created by game developer Jane McGonigal, has proven effective at relieving depression in a randomized controlled trial.
ATTC Center of Excellence on Behavioral Health for Pregnant and Postpartum Women and Their Families: Working to Strengthen the Behavioral Healthcare Workforce's Ability to Serve Pregnant and Postpartum Women
Sarah Knopf-Amelung, MA-R
Research Associate, Special Projects Mid-America ATTC
It’s hard to read the news without coming across an article relating to pregnant and postpartum women (PPW) and substance use. Whether it is states’ efforts to criminalize substance use during pregnancy or innovative treatment programs transforming the lives of pregnant women and their families, this topic is at the forefront of national media, as it should be. Perhaps one of the most discriminated groups of people who use substances, pregnant and postpartum women face extensive barriers to treatment and recovery. And yet, their success in accessing such services and achieving recovery has far-reaching implications for not only their personal well-being but that of their families and our communities as well.
