ATTC’s Pearls of Wisdom: Innovative partnerships + hard work help tackle stimulant use in the Western U.S. & beyond

By: Beth A. Rutkowski, MPH, co-director, Pacific Southwest ATTC

I’ll never forget the first time we met Tom Donohoe back in spring 2004. Tom is a colleague from the UCLA Department of Family Medicine and Director of the LA Region of the HRSA-funded Pacific AIDS Education and Training Center (PAETC). UCLA Integrated Substance Abuse Programs had become the administrative home of the Pacific Southwest ATTC (PSATTC) in 2002, and many potential community partners were requesting meetings with us to see how we could collaborate and share PSATTC resources.

But Tom Donohoe was different. He said he had resources to share with us, and he meant it. This initial meeting marked the beginning of a nearly 20-year collaboration that has impacted thousands of HIV and SUD clinicians throughout Region 9 and beyond.

Tom Freese and I had been conducting dozens and dozens of trainings on methamphetamine throughout Region 9 (and beyond) and had established a recurring educational series called the California Addiction Training and Education Series (CATES). The first several rounds of CATES trainings focused on the many different facets of methamphetamine use. We had more material than we knew what to do with, and we were constantly updating our training slides to make sure we were teaching others the latest science-based information for providing services to people who used methamphetamine.

Similar to the PSATTC, the PAETC had been working to develop training curricula and resources on the topic, and when Tom Donohoe received supplemental funding through the PAETC to work on the U.S./Mexico border, he immediately contacted us to help conduct needs assessments and deliver trainings. The first series we co-sponsored was “HIV, Methamphetamine, and Women along the U.S.-Mexico Border.”

A few years after the PAETC and PSATTC initiated the U.S./Mexico Border Training Series, we were encouraged to expand our partnership to encompass the other Region 9 Federal Training Centers, including the Curry International Tuberculosis Center, California STD/HIV Prevention Training Center, and Cardea Services. The resulting product was the development and delivery of multiple one- and two-day training events focused on the treatment of HIV, STDs, TB, Hepatitis C, family planning, and substance use. Each event also featured simultaneous English/Spanish translation. All were held along the U.S./Mexico Border in California, Arizona, and New Mexico. In each of these endeavors, the focus was on the provision of high quality, up-to-date data, and best practices on how to treat people with HIV, TB, STIs, and substance use. We made a lot of amazing friends along the process, and trained hundreds of clinicians.

Traveling and training with the PAETC and PSATTC faculty not only improved our respective knowledge of substance use disorders and HIV, but it helped us all sharpen our skills as trainers and content developers. We were cross training each other as much as the bi-national participants who came to our trainings. In addition, the four-city tour of the border was fun. Often, the events that most shape us as trainers are learning and having fun with other experts in our respective priority areas. One of the most impactful results was the development of a “Methamphetamine TIP sheet” for HIV clinicians. The tip sheet has been revised a few times over the years, and is one of the most downloaded products from the AETC National Resource Center website.

Flash forward to 2019, when the ATTC Network received a request from SAMHSA leadership to establish a national workgroup on stimulants. While so much recent attention had been focused on the opioid epidemic that was killing Americans at record rates, drug poisoning deaths related to cocaine and methamphetamine were on the rise, as well. It was only natural for me and Tom Freese to volunteer to co-chair the newly established work group, and we were lucky to have Jeanne Pulvermacher agree to be our third co-chair. Little did we know in fall 2019 that a global pandemic was on the horizon that would challenge us to adapt our in-progress curriculum development efforts and pivot to create a national product that would be immediately useful to the SUD treatment and Recovery workforce and not sit on a shelf in someone’s office waiting for the return to in-person training.

The Stimulant 101 National Core Curriculum is a comprehensive set of training materials focused on the latest evidence related to the impact of stimulants on brain and behavior and best practice approaches for effective treatment and recovery. More than 50 ATTC-affiliated trainers participated in a modified training of trainers process in summer 2020, and to this day, these trainers are delivering the curriculum around the country. The National Core Curriculum features the following components:

• Daylong Face-to-Face Curriculum (with a fully articulated Trainer Guide & Reference List)
• Three-Hour Live Virtual Overview
• 70-minute Keynote Presentation
• Seven Supplemental Video Modules and Reference Lists
• Considerations for Families in the Child Welfare System Affected by Stimulant Use
• Gender Differences and Stimulant Use
• Methamphetamine Use and HIV among Men Who Have Sex with Men
• Polysubstance Use among Stimulant Users
• Overview of Recovery and Recovery Supports
• Stimulant Use in Rural and Remote Areas
• Stimulants and HIV
• Three Video Cultural Modules and Reference Lists
• Stimulant Use among African Americans
• Stimulant Use among the Latinx Population
• Stimulant Use among the American Indian and Alaska Native Population

The stimulant-focused work that we’ve had the privilege and honor of conducting through the PSATTC, and by extension, through our partnership with the PAETC represents one of the most challenging and fulfilling experiences of my career. This experience has taught me that you should never say no when someone new reaches out to you with an idea to collaborate, because who knows, that initial conversation can blossom into a decades long innovative partnership, with a lot of hard work making a huge difference in the quality of training/TA services provided to the community-at-large.