Products and Resources Catalog

DESCRIPTION Fatal overdoses and suicides are two of the most severe behavioral health outcomes. They are also growing more common. Suicide rates increased 41% nationally from 1999 to 2022, while fatal overdose rates increased 440%.1 Reducing fatal overdose and suicide is a top priority for the behavioral health field. Fortunately, suicide and overdose share many risk and protective factors. In fact, many interventions designed to address one outcome can simultaneously help address the other. Addiction treatment professionals can play a key role, as ongoing substance use is a shared risk factor for both outcomes.2 To download the entire version of the fact sheet, please use the Overdose and Suicide  button on the right side of the page.

SAMHSA’s new National Guidance on Essential Specialty Substance Use Disorder (SUD) Care provides guidance on an essential set of services for adults with SUD that should be available at any specialty SUD treatment facility in the United States. The intended audiences are states and payers, accreditation entities, adults and families in need of care, specialty SUD treatment facility operators/administrators, behavioral health professionals, researchers, and local governments. Currently, there is a dramatic lack of consistency in services available to adults in need of specialty SUD treatment. The goal of this guidance is for the intended audiences to use this tool to identify treatment gaps, support evidence-based planning, and improve outcomes for adults with SUD.

Who are “leaders” in implementation? Implementation leaders may be people in leadership roles, such as administrators, directors, or supervisors, and/or they may be change leaders, also sometimes referred to as “champions” in the implementation field. You don’t need to have an official leadership title or job role to effect change and lead implementation efforts within your organization.

Naloxone is a safe, life-saving medication that can reverse an overdose from opioids. Termed an ‘opioid overdose reversal medication’, Naloxone is easy to carry and administer. This poster illustrates being prepared for an overdose emergency by having an opioid overdose reversal medication on-hand, just like people commonly have a fire extinguisher on-hand for a fire emergency. NALOXONE TRAINING / VIDEOS CDC Naoloxone Training - From CDC, a free one-hour course titled “Talking about Naloxone.”  This course includes an optional risk factors assessment for opioid-related harms and provides communication tips and strategies for engaging in and conducting a conversation with patients about naloxone. CE is available. CDC NALOXONE VIDEO  From CDC, a 30-second video on how to administer naloxone spray to someone experiencing an opioid overdose. GET NALOXONE NOW: NALOXONE TRAINING From the opioid overdose prevention advocacy group Get Naloxone Now, this free course titled: Bystander Training for Opioid Overdose Prevention,Recognition and Response is now available. This training: Describes the U.S. opioid overdose epidemic; Explains the risk of overdose from opioid analgesics and heroin; Teaches how to recognize an opioid overdose; Demonstrates how to respond effectively to an opioid overdose (using animated scenarios, graphic sequences, and narration provided by professional voice actors) and; Links learners to additional resources, including SAMHSA’s overdose toolkits and drug treatment finder. OTHER NALOXONE RESOURCES NALOXONE FREQUENTLY ASKED QUESTIONS (See attachments) CDC FACT SHEET: WHAT YOU NEED TO KNOW ABOUT NALOXONE: FACT SHEET FOR FAMILY AND CAREGIVERS From CDC, this fact sheet teaches family members and caregivers general facts about naloxone including where to get it and how to prevent an opioid overdose.  CDC FACT SHEET: HOW AND WHEN TO USE NALOXONE FOR AN OPIOID OVERDOSE: FACT SHEET FOR FAMILY AND CAREGIVERS  From CDC, this fact sheet teaches family members and caregivers how to identify an opioid overdose and use naloxone.  It also includes the side effects of naloxone. SAMHSA OVERDOSE AND PREVENTION TOOLKIT SAMHSA’s updated Overdose Prevention and Response Toolkit provides guidance to a wide range of individuals on preventing and responding to an overdose. The toolkit also emphasizes that harm reduction and access to treatment are essential aspects of overdose prevention. The toolkit, designed to augment overdose prevention and reversal training, provides guidance on the role of opioid overdose reversal medications, including naloxone and nalmefene, and how to respond to an overdose. It also contains appendices for specific audiences, including people who use drugs (PWUD), people who take prescription opioids, first responders, healthcare practitioners, and others. To request an 11x17 "Be Prepared" poster to be mailed directly to you, please click Request a Hard Copy  

Naloxone is a safe, life-saving medication that can reverse an overdose from opioids.  Termed an ‘opioid overdose reversal medication’, Naloxone is easy to carry and administer. This poster illustrates the comparison of Naloxone with an automated external defibrillator (AED), another life-saving tool. NALOXONE FREQUENTLY ASKED QUESTIONS  NALOXONE TRAINING / VIDEOS CDC Naloxone Training - From CDC, a free one-hour course titled “Talking about Naloxone.”  This course includes an optional risk factors assessment for opioid-related harms and provides communication tips and strategies for engaging in and conducting a conversation with patients about naloxone. CE is available. CDC NALOXONE VIDEO From CDC, a 30-second video on how to administer naloxone spray to someone experiencing an opioid overdose. GET NALOXONE NOW: NALOXONE TRAINING From the opioid overdose prevention advocacy group Get Naloxone Now, this free course titled: Bystander Training for Opioid Overdose Prevention, Recognition and Response is now available. This training: describes the U.S. opioid overdose epidemic; explains the risk of overdose from opioid analgesics and heroin; teaches how to recognize an opioid overdose; demonstrates how to respond effectively to an opioid overdose (using animated scenarios, graphic sequences, and narration provided by professional voice actors) and; links learners to additional resources, including SAMHSA’s overdose toolkits and drug treatment finder. OTHER NALOXONE RESOURCES CDC FACT SHEET:  WHAT YOU NEED TO KNOW ABOUT NALOXONE: FACT SHEET FOR FAMILY AND CAREGIVERS From CDC, this fact sheet teaches family members and caregivers general facts about naloxone including where to get it and how to prevent an opioid overdose. CDC FACT SHEET:  HOW AND WHEN TO USE NALOXONE FOR AN OPIOID OVERDOSE: FACT SHEET FOR FAMILY AND CAREGIVERS From CDC, this fact sheet teaches family members and caregivers how to identify an opioid overdose and use naloxone.  It also includes the side effects of naloxone. SAMHSA OVERDOSE AND PREVENTION TOOLKIT SAMHSA’s updated Overdose Prevention and Response Toolkit provides guidance to a wide range of individuals on preventing and responding to an overdose. The toolkit also emphasizes that harm reduction and access to treatment are essential aspects of overdose prevention. The toolkit, designed to augment overdose prevention and reversal training, provides guidance on the role of opioid overdose reversal medications, including naloxone and nalmefene, and how to respond to an overdose. It also contains appendices for specific audiences, including people who use drugs (PWUD), people who take prescription opioids, first responders, healthcare practitioners, and others.

This resource helps individuals and organizations navigate the legal landscape in Iowa, Kansas, Missouri, and Nebraska, ensuring that lifesaving harm reduction services, like naloxone distribution and overdose Good Samaritan laws, are accessible to those who need them most. This document was originally created in 2021 and updated in August of 2024.  

The Mid-America Addiction Technology Transfer Center (Mid-America ATTC) Impact Report highlights our contributions to the behavioral and substance use workforce from 2017 to 2024. The report offers an overview of our activities and achievements during this funding cycle.

The Invitation to Change (ITC) is a holistic helping model for families affected by substance use, drawing from concepts also found in CRAFT, MI, and ACT. Participants will leave the training with a complete set of tools for empowering families to support their loved ones effectively. More about the approach here. The deadline to apply is April 19, 2024. This training is a collaboration with the Great Lakes ATTC, South Southwest ATTC, Mountain Plains ATTC, Northwest ATTC, South Southeast ATTC, Mid America ATTC, and the ATTC Network Coordinating Office.

Xylazine (or “tranq”) is a non-opioid sedative and tranquilizer only approved for use in veterinary medicine. However, over the past several years, human consumption of xylazine has begun rapidly increasing. Although initially only identified in illicit drug supplies in limited areas, xylazine has been found in 48 states as of April 2023. Xylazine is frequently, though not exclusively, used in conjunction with opioids, particularly fentanyl—due to xylazine’s ability to prolong their effects. Xylazine use presents many potential dangers to people, including an increased risk of overdose and the development of necrotizing tissue damage. This factsheet details key concerns, overdose responses, harm reduction techniques, and more.   To download the factsheet in English, please click the  "Understanding Xylazine" button on the right side of the page.   This factsheet is now available in Spanish. Translation services by the National Hispanic and Latino Behavioral Health Center of Excellence. Traducido por: To download the full version of the Spanish factsheet, please click the "Comprender la xilacina" button on the right side of the page.  

La hoja informativa provee información sobre la importancia del servicio de navegación de pacientes y su propósito de guiar a la persona a través del sistema de salud. Se le apoya en la identificación del o los diagnósticos, tratamientos y seguimiento de condiciones médicas, incluyendo el trastorno por uso de sustancias. Proveyendo asistencia en la programación de citas, pruebas médicas y en obtener ayuda financiera, legal y social, de ser necesarias. La finalidad de la navegación de pacientes es la eliminación de barreras para lograr la atención adecuada en los servicios de salud que recibe la persona.

Mid-America ATTC partnered with Facente Consulting to launch a harm reduction consultation pilot program in early 2022.  The goal of this program was to act as a harm reduction resource to empower individuals and organizations seeking to implement or improve evidence-based practices within their systems to reduce stigma and promote the safety and well-being of people who use drugs. The poster outlines the findings of the pilot program.

In spring of 2023, Mountain Plains ATTC conducted a survey in an effort to better understand the training and technical assistance needs of individuals providing SUD treatment and recovery services in Region 8. The purpose of the survey was to determine providers’ perceptions, practices, and training/technical assistance needs, specifically in relation to harm reduction (HR) services/activities for SUDs. An invitation to participate in the survey was emailed posted on the Mountain Plains ATTC website and was sent to all constituents within Region 8 for which the Mountain Plains ATTC had email addresses. In addition, participants were asked to invite others within their agencies and networks to participate. The survey was completed between March 9 to April 12, 2023. Approval to conduct the survey was obtained from the University of North Dakota Institutional Review Board. Results from this survey will help Mountain Plains ATTC better collaborate with providers and stakeholders throughout the region in the development of new products, training materials, and technical assistance. It is also hoped that this report will provide readers with a snapshot of the perceptions, practices, and technical assistance/training needs of the SUD provider services workforce in Region 8.

The New England ATTC co-hosted the Recovery Science and Harm Reduction (RSHR) Reading Group meeting on September 21, 2023. This discussion reviewed the article, “Understanding Stigma Through the Lived Experiences of People With Opioid Use Disorder.” Article link: https://pubmed.ncbi.nlm.nih.gov/37390780/ View the September 2023 RSHR Reading group meeting summary that includes a brief article summary and key themes that arose in discussion with the participants.

  Treatment for Individuals who Use Stimulants TRUST A Protocol Using Empirically-Supported Behavioral Treatments for People with Stimulant Use Disorders     Purpose of the TRUST-MAIN Manual The authors of this manual have been involved in StimUD-related research, treatment, and training efforts for over 30 years. Over this period, the research on StimUD and its treatment has vastly increased and there is a great interest in better understanding StimUD and providing effective treatment for people who use cocaine and methamphetamine. We have produced this manual to promote the use of research-supported strategies for StimUD treatment. The manual attempts to combine a number of strategies into a framework that is appropriate for use by clinicians in settings where people with StimUD receive treatment. This manual is not intended to be a cookbook and the materials used and the framework for their use are not intended to be an inflexible, one-size-fits-all prescription. At the end of the manual, we list a variety of treatment materials (see Appendix) that can be added or substituted for the ones we are recommending. We provide the contents of this manual and the framework for combining these treatment materials as one example for how research-supported strategies can be combined into a structured treatment experience. The manual was developed at a time when CM with adequate incentives was considered impossible in the U.S. Hence, this manual was produced to offer a possible, albeit a non-evidence-based and certainly less effective alternative to CM. As evidence-based CM protocols using adequate incentives are increasingly being developed and implemented in the U.S., there is interest in having CM delivered within a framework of other evidence-based behavioral support. The use of the materials in the TRUST Manual to augment CM treatment is another possible use of the manual, either in the form of a 12-week framework, or as ad hoc behavioral support materials. The audience for the manual includes healthcare professionals who provide treatment services for individuals with StimUD. One category of these professionals who we particularly hope will benefit are therapists and other behavioral health clinicians who work in substance use disorder specialty care treatment programs. The manual has been written with this group in mind.   The manual intends to: Provide new information about the use and effects of cocaine and methamphetamine. Present several key clinical challenges that clinicians face when treating this population. Review the evidence-based treatment strategies for StimUD treatment. Discuss how motivational interviewing (MI) is central to the effective engagement of individuals in treatment and to assisting them with behavior change during treatment. Present how elements of community reinforcement approach (CRA) and cognitive behavioral therapy (CBT) can be used to assist individuals with StimUD to reduce/discontinue their drug use and prevent relapse. Describe a procedure for incorporating positive incentives into the treatment milieu and/or support the use of CM for the treatment of StimUD. Provide information and guidance for how physical exercise can benefit individuals who are attempting to reduce/discontinue their use of methamphetamine and cocaine. Describe a plan for providing continuing care to assist individuals to sustain the progress they have made in a structured treatment program. List an array of manuals and training resources for other research-supported substance use disorder treatment approaches.   For those working with people receiving care for Opioid Use Disorder, an adapted version is available Treatment for Individuals who Use Stimulants while on MOUD TRUST—MOUD THERAPIST MANUAL & PATIENT WORKBOOK       Purpose of the TRUST-MOUD Manual The TRUST MOUD Manual is intended to be used with patients who are struggling with stimulant (cocaine/amphetamine) use while in treatment for OUD with methadone, buprenorphine, or naltrexone. Working with patients presenting in MOUD treatment is a challenging, yet incredibly rewarding experience. While it is rewarding, it can also be frustrating. Stimulant use among these patients is common and many patients don’t see their use as problematic. In fact, for some patients who use stimulants sporadically, they may not need treatment. But certainly, for some patients on MOUD, cocaine/meth use is extremely detrimental to the effectiveness of their MOUD treatment and is a serious health problem. However, in many cases, regardless of the severity of use, the patients often don’t recognize their stimulant use as a problem, and they are not interested in intensive treatment. The materials in the TRUST MOUD Manual attempt to provide this patient population with a useful set of information in a format that they find acceptable. The materials adopt CRA, CBT, and MI content and present it in a clear and relevant form that addresses the challenges they face while in MOUD treatment. We try to avoid long, didactic, lecturing materials, but rather try to create accessible topics and examples. TRUST was developed with flexibility in mind to optimize patient engagement and retention. TRUST materials can be presented in 1:1 sessions and can be scheduled with patients or in on-going stimulant treatment groups. Topics can be presented in a sequence and frequency that lets therapists select content to meet patient needs. The 24 TRUST worksheets can be used in a flexible manner to be relevant and useful to patients. Consistency is important when using the TRUST Manual. Set and adhere to meeting days and times. Start and end sessions on time. If used in a group format, have some group participation guidelines. Adhering to a specific session format and timing will enhance patients’ understanding of the group/individual session process and will allow them to focus on acquisition of new material. Patients using stimulants will undoubtedly experience cognitive impairment as they participate in sessions and utilize the TRUST materials. Slowing down to allow patients to gather their thoughts and express themselves during group or individual sessions is important. In addition, using multi-media and repetition can be helpful for patients to grasp new concepts. Use of Motivational Interviewing as a fundamental style and interpersonal approach is essential to success when using TRUST materials. Ideally, TRUST session attendance should be paired with medication visit attendance to reduce the travel burden on patients. This is especially true in rural areas, where public transportation is non-existent, or when a patient has employment, education, or homemaking responsibilities. When possible, patients should have an opportunity to determine therapy visit days and times based upon their scheduling needs. Research has shown that aerobic exercise improves cognitive capacity, reduces depression and anxiety, and improves cardiac and pulmonary function for individuals with stimulant use disorder. Several of the TRUST worksheets discuss the benefits of exercise as part of a treatment effort to reducing stimulant use. Encouraging patients to exercise will also help them to manage emotional highs and lows and help them structure their day. Getting patients to exercise is often difficult and requires ongoing encouragement and support. The TRUST materials and their use with patients on MOUD should be used with a strong harm reduction foundation. The #1 priority for this group of patients is retention in treatment with MOUD. Participation in treatment activities with TRUST materials, when appropriate, should be encouraged, rewarded, and praised. In our opinion, requiring treatment attendance with TRUST materials, with a threat of MOUD discontinuation is never justified. In an era of lethal drugs including fentanyl, retention on MOUD is essential. Other harm reduction activities should be combined with TRUST materials. Access to safe injection supplies, ready access to naloxone and fentanyl test strips, and as new drugs emerge (e.g., xylazine), it is critical to provide new information and test strips as they become available. Many patients in MOUD treatment have multiple life challenges, including use of numerous drugs and alcohol, food insecurity, being unhoused, unemployment, as well as both mental health and physical health issues. To be successful, patients will need to be retained in treatment for a significant period of time, if not for a lifetime. These issues are not going to be resolved overnight, but rather through consistent and prolonged effort. We hope these materials can be useful to your work with patients on MOUD.   Authors Richard Rawson, PhD Richard A. Rawson, PhD, is Professor Emeritus at the UCLA Department of Psychiatry and a Research Professor at the Vermont Center for Behavior and Health at the University of Vermont. He received a Ph.D. in experimental psychology from the University of Vermont in 1974. Dr. Rawson conducted numerous clinical trials on pharmacological and psychosocial addiction treatment and extensive system evaluation activities in a number of states and countries. He has led addiction research and training projects for the United Nations, the World Health Organization, and the U.S. State Department, exporting science-based knowledge to many parts of the world. Dr. Rawson has published 3 books, 40 book chapters, and over 250 peer-reviewed articles and has, for almost 50 years, conducted workshops, paper presentations, and training sessions in many areas of the world.   Albert Hasson, MSW Albert L. Hasson received his MSW from UCLA and has worked in the field of addiction medicine as a researcher and a treatment provider since 1977. Mr. Hasson participated in the development of the evidence-based Matrix Model, a cognitive behavioral intervention for StimUD Treatment, and established the Matrix Institute on Addictions, Los Angeles opioid treatment program. Along with his administrative and clinical experience, Mr. Hasson has extensive experience in implementing and evaluating behavioral and pharmacologic interventions. He has served as a project director and trainer for the Pacific Southwest Addiction Technology Transfer Center at the UCLA Integrated Substance Abuse Programs.   Janice Stimson, PsyD Janice Stimson, PsyD, has worked in the field of addiction treatment since 1998. For 20 years she has worked at the Matrix Institute on Addictions in the role of Clinic Director, overseeing and managing the clinic, seeing clients and supervising staff. At the clinic private adolescent and adult treatment programs coexisted along-side national research studies. Dr. Stimson held key positions in those studies and was responsible for ensuring the success of fulfilling recruitment, training, supervision, and protocol requirements.   Michael McCann, MA Michael McCann, M.A., is one of the founders of the Matrix Institute on Addictions and creators of the Matrix Model. He has overseen the operation of Matrix clinics as well as the integration of many research projects within these sites. He has over 40 years of experience in substance use disorder treatment and research, and has authored or co-authored over 40 articles, books, and manuals. He has trained and lectured extensively on evidence-based behavioral interventions, pharmacologic treatments, methamphetamine dependence, opioid dependence, and on the implementation of evidence-based treatments into clinical practice   Acknowledgements The authors would like to acknowledge the assistance provided by Thomas E. Freese, PhD, Beth Rutkowski, MPH, Gloria Miele, PhD, and Valerie P Antonini, MPH. Christine Morgan provided invaluable support with the production of the manual, along with editing support from Victoria T. Norith and Benjamin Nguyen, MSW, CPH. The materials in this manual include content and worksheets from the Matrix Model Therapist Manual (SAMHSA, 2006); from the Community Reinforcement Approach, plus Vouchers Manual (NIDA, 2020).

The New England ATTC co-hosted the Recovery Science and Harm Reduction (RSHR) Reading Group meeting on July 20, 2023. This discussion reviewed the article, “Meeting People Where They Are: Implementing Hospital-Based Substance Use Harm Reduction.” Article link: https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-022-00594-9 View the July 2023 RSHR Reading group meeting summary that includes a brief article summary and key themes that arose in discussion with the participants.

This infographic discusses xylazine, a non-opioid animal sedative and tranquilizer, also known as "tranq," that is being used as an additive to the illicit opioid supply, particularly fentanyl. It covers key concerns including overdose risk, heart and blood pressure problems, necrotic tissue damage, treatment challenges, and harm reduction barriers. It also contains suggested actions for prevention and treatment professionals.     *Originally published April 27, 2023, revised June 5, 2023

The New England ATTC co-hosted the Recovery Science and Harm Reduction (RSHR) Reading Group meeting on April 20, 2023. This discussion reviewed the article, “Role of Peer Support Workers in Improving Patient Experience in Tower Hamlets Specialist Addiction Unit.” Article link: https://drive.google.com/file/d/1pMWtbaMn6iFGZrHglV7JzAOW1QJL4aCH/view View the April 2023 RSHR Reading group meeting summary that includes a brief article summary and key themes that arose in discussion with the participants.

The use of electronic vaporizing devices (“vaping”) has skyrocketed in popularity since their widespread introduction across the United States. Through these devices, consumers inhale an aerosolized liquid compound, most commonly liquid nicotine or cannabis-derived chemicals (both CBD and THC). Risks stemming from vaping present an important public health challenge, particularly for youth, but also among adults. While significant research gaps remain, a growing number of evidence-based practices are available to behavioral health practitioners.  

The 2023 Leadership Institute presented by the Mid-America Addition Technology Transfer Center (ATTC) is open to persons who work in behavioral health, mental health, or recovery agencies in Iowa, Kansas, Missouri, and Nebraska. Candidates must complete the Candidate Application Form and be nominated by leadership within their agency using the Agency Nomination Form. Both forms must be submitted no later than March 15, 2023. For more information on the Leadership Institute, please download the forms by clicking the "DOWNLOAD" button above.

The 2024 Leadership Institute presented by the Mid-America Addition Technology Transfer Center (ATTC) is open to persons who work in behavioral health, mental health, or recovery agencies in Iowa, Kansas, Missouri, and Nebraska. Candidates must complete the Candidate Application Form and be nominated by leadership within their agency using the Agency Nomination Form. Both forms must be submitted no later than February 16, 2024. For more information on the Leadership Institute, please download the forms by clicking the "DOWNLOAD" button above.

The shifting landscape of regulations related to telehealth can make it difficult for practitioners to keep up with this important area. This document gives a brief overview of national and regional telehealth trends for behavioral health services, with a focus on Health and Human Services (HHS) Region 6 which includes Arkansas, Louisiana, New Mexico, Oklahoma, and Texas. Current laws and administrative codes for behavioral health treatment that use telehealth to deliver services were examined to prepare this document.  

  Mid-America ATTC  (MATTC) partnered with the Ethnic Communities Opioid Response Network in Missouri, the Addiction Policy Forum, and the Opioid Response Network (ORN in IA, KS, MO, and NE) to translate Prevention of Opioid Use Education Materials into ten different languages and ensure they are culturally appropriate.

La falta de aceptación puede interferir con los atentos de ampliar el uso de tratamientos asistidos por medicamentos (TAM) para los trastornos por consumo de sustancias (TCS). Las Hojas Informativas de TAM ofrecen estrategias para generar apoyo para esta práctica basada en evidencia.  Hoja Informativa #1: Asegurando la Aceptación              Hoja Informativa #2: Reduciendo el Riesgo de Uso Indebido y la Desviación              Hoja Informativa #3: Abogando por las Medicamentos 

Lack of buy-in can interfere with attempts to expand use of medication-assisted treatment (MAT) for substance use disorders. These three fact sheets offer strategies to build support for this evidence-based practice.  MAT Fact Sheet #1: Securing Buy-in            MAT Fact Sheet #2: Reducing Risk of Misuse and Diversion          MAT Fact Sheet #3: Making the Case for Medication