Products and Resources - SAMHSA Reporting

TAY Series: Substance Use Interventions for Adolescents and Transitional Age Youth Recording

TAY Series: Substance Use Interventions for Adolescents and Transitional Age Youth Presentation Slides

The MESSENGER December 2020

The MESSENGER January 2021

The MESSENGER February 2021

The MESSENGER March 2021

The MESSENGER October 2020

ATTC Network and PTTC Network Resources to Support the Crisis at the Southern Border

ATTC and PTTC Network Resources for the Southern Border that may be Helpful in the Long Term

Learn about current trends in Latino demographics Recognize differences in stimulant use when compared to other demographic groups Learn about risk and protective factors for Latino communities Acknowledge the need for more research in trends of use and successful treatment options Reference to Video: Stimulant Use Among the Latinx Population from ATTC Network on Vimeo.

Learn about current trends in Native American demographics Recognize differences in stimulant use when compared to other demographic groups Learn about protective factors for Native communities Acknowledge trends of use and successful treatment options for Native populations Reference Video: Stimulant Use among the American Indian/Alaska Native Population from ATTC Network on Vimeo.

Distinguish  at least  two (2) ways that cocaine influences  the progression  of HIV in the human body. Identify  at least  two (2) effects  of methamphetamine  on HIV transmission  and progression.

This is a compilation of ATTC trainings with a focus on Children and Youth. Topics include: Transitional Age Youth, Adolescent Brain Development, CLAS Standards, Population Specific, use of typical treatment with Adolescents.

June 2021 Directors Report

By Caroline Kuo, DPhil, MPhil Associate Professor, Brown University School of Public Health Honorary Associate Professor, University of Cape Town As we work to close disparities in substance use prevention and treatment, we need to turn to the evidence-base and choose interventions that not only work, but are likely to have the largest impact upon the health behaviors we are trying to address. However, interventions are designed and tested in a particular population and context. The transportability of evidence-based models is not always appropriate or guaranteed. Culture, language, poverty, health systems differences, and other social and structural determinants of health may adversely affect engagement in, and response to evidence-based intervention models that are applied to new populations and settings unless the interventions are adapted. Such adaptations to existing evidence-based programs should not alter the core components of the intervention in order to maintain the intervention’s efficacy and effectiveness. Ideally, adaptation procedures strike a delicate balance between the idea of interventions being “universally applicable” to all contexts with the notion that “custom tailoring” is necessary to address inevitable differences in populations, settings, and cultures. The following six sequential steps can guide the process of assessing, and if necessary, adapting existing interventions to new populations and settings. Click on View Resource to read more.

By Jesse Heffernan CCAR Core Trainer and Recovery Coach Professional, Helios Recovery Services As we start to prepare, or continue, to celebrate the 2020 holiday season, it goes without saying that this will be perhaps one of the most stressful and difficult ones in recent times. The pressure and influence of the COVID-19 pandemic has caused many folx in recovery and supporting fields to assess this year differently. For many in or seeking recovery, the holidays may already activate any number of traumas or personal “stuff” causing some to be more susceptible to symptoms of recurrence or heavier use. We may also experience the effectiveness of our self-care strategies lessening through this time, which does not mean we are failing, it instead indicates we are experiencing something new or extra challenging. We need to remember there are ways to successfully navigate the holidays — and we can ask family, friends and colleagues to help. One of the ways we can mitigate the stress of the season is planning and boosting our self-care before the holidays kick in. We can do this by focusing not just on engagement in recovery supports, but also on staying on track with a holistic approach to support our physical, emotional, mental, and spiritual well-being. Every individual's recovery looks different and with the help a counselor, mentor, recovery coach, or sponsor we can have a plan ready. (We also want to consider other factors, like equitable access to services and promoting multiple pathways of recovery, which includes medications and moderation.) Here are some suggestions that may help you out. Click on View Resource to read the full article.

Revisit these ATTC Messenger Articles from 2020: ATTC Messenger January 2020: The Intersection of HIV and SUD: An Innovative Partnership to Educate and Support Two Critically Important Workforces ATTC Messenger February 2020: New Toolkit on Using MAT for Opioid Use Disorder in Jails and Prisons ATTC Messenger March 2020: Shedding Light on Gambling Disorder as an Addiction: A Guide for Practitioners ATTC Messenger April 2020: A Roadmap to a Better Alcohol Environment ATTC Messenger May 2020: Responding to the Silent Epidemic ATTC Messenger June 2020: Zooming through a Pandemic ATTC Messenger July 2020: Emerging Issues Around COVID-19 and Social Determinants of Health for the Substance Use Prevention, Treatment, and Recovery Workforces ATTC Messenger August 2020: Minority to Priority ATTC Messenger September 2020: Building Leaders to Advance Recovery ATTC Messenger October 2020: In Honor of Domestic Violence Awareness Month: Responding to Substance Use Coercion in Treatment and Recovery Services ATTC Messenger November 2020: Adapting evidence-based programs to diverse populations and settings ATTC Messenger December 2020: Thriving in Survival - Holidays 2020

Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder On Jan. 27, 2021, the Office of National Drug Control Policy issued a statement regarding the announcement from the Department of Health and Human Services (DHHS) about forthcoming Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder. The initial DHHS announcement generated a lot of discussion in the field around the pros and cons of the X waiver for buprenorphine prescribers. To provide clarity, the ATTC Network Coordinating Office (NCO) asked H. Westley Clark, MD, JD, MPH to write a summary of the proposal and the field’s reaction. The article below was written prior to ONDCP’s Jan. 27 statement, which postponed the new Guidelines indefinitely. Nevertheless, the ATTC NCO felt it was important to publish Dr. Clark’s article to provide context to a conversation which will undoubtedly be ongoing. By Westley Clark, MD, JD, MPH Dean's Executive Professor of Public Health Santa Clara University Santa Clara, California On Jan. 12, 2021, a week before the Trump Administration left office, the U.S. Department of Health and Human Services (DHHS) submitted to the Federal Register for publication new Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder. In a questionable interpretation of the Drug Addiction Treatment Acts of 2000 (DATA 2000), the Comprehensive Addiction and Recovery Act (CARA) and the Substance Use Disorder Prevention Opioid Recovery and Treatment For Patients and Communities (SUPPORT) Act, DHHS concluded that Practice Guidelines could eliminate the requirement that physicians with a Drug Enforcement Administration (DEA) registration number apply for a separate waiver to prescribe buprenorphine for opioid use disorder treatment. The Office of the Assistant Secretary for Health (OASH) in DHHS determined that the need for physicians to make all of the certifications under DATA 2000 represented a significant perceived barrier to prescribing buprenorphine in the United States and removing the certification requirements would dramatically improve access to buprenorphine and save lives. The proposed guidelines applied only to licensed physicians who possess a DEA registration and only to buprenorphine, not methadone. They required physicians who use the exemption to place an ‘X’ on the prescription, clearly identifying the prescription as being written for opioid use disorders. They required that charts for patients being treated for OUD be maintained separately from other patients to ensure confidentiality and required physicians to maintain and retain records of prescriptions issued. Physicians became limited to no more than 30 patients; however, they exempted hospital-based physicians, such as emergency department (ED) physicians who initiated treatment in the ED, from the 30-patient limit if they did not engage in a long-term treatment relationship. Finally, the guidelines restricted the exemption to patients in the states where physicians have a license. The proposal included information about implementation of the guidelines. DHHS would establish an interagency working group to monitor the implementation and results of the guidelines, as well as the impact on diversion. The working group would be chaired by a representative from the Immediate Office of the Secretary of HHS. To read the full article, click on View Resource.

An Evaluation of Recovery Housing in Missouri: Key Outcomes and Recommendations By Claire Wood, PhD; Brenna Lohmann, MSW; Kori Richardson, MPP; Alex Duello, MPH; Marsha Hourd; Rosie Anderson-Harper, MA; and Rachel Winograd, PhD Between legislative advances for increasing recovery budgets, creation of recovery housing standards by the National Alliance for Recovery Residences (NARR), and increasing support of the use of Medication for Opioid Use Disorder (MOUD) as part of an abstinence-based recovery path, recovery housing has made substantial progress in finding ways to support individuals in their recovery. As part of SAMHSA-funded awards focused on addressing the opioid crisis, the State Targeted Response (STR) (2017-2019) and State Opioid Response (SOR) grants (2018-present), a team based out of the University of Missouri, St. Louis–Missouri Institute of Mental Health (UMSL-MIMH) conducted a robust mixed methods evaluation of recovery homes across the state. The goal of the evaluation was to provide insights to the Missouri recovery system and identify gaps and strategies to better support individuals in their recovery. The two-part evaluation of the recovery housing system included: 1) A Community Based System Dynamics (CBSD) evaluation, and 2) A survey of recovery housing characteristics. Click on View Resource to read the full article.

Introducing NIDA's Justice Community Opioid Innovation Network (JCOIN) By Tisha R.A. Wiley, PhD, and Lori J. Ducharme, PhD National Institute on Drug Abuse In the context of addressing the overdose epidemic, the U.S. criminal justice system presents significant opportunities for intervention, challenges for service delivery, and potential for creating essential linkages to community-based services for individuals upon release. More than half of individuals in U.S. jails and prisons meet diagnostic criteria for substance use disorder, and a substantial proportion report regular opioid use (Bronson et al., 2017). Research that can inform and improve service delivery and treatment engagement is critical for this vulnerable population. In 2019, the National Institutes of Health (NIH) launched the Helping to End Addiction Long-term Initiative, or NIH HEAL InitiativeSM, an ambitious effort to address the opioid crisis through research on the effective management of chronic pain, and the prevention and treatment of opioid misuse and opioid use disorder (OUD). As part of that initiative, the National Institute on Drug Abuse (NIDA), established the Justice Community Opioid Innovation Network (JCOIN) to study approaches to improve OUD treatment services for individuals involved in the justice system. The delivery of substance use treatment services within correctional settings remains rare, and is challenged by a number of logistical, regulatory, philosophical, and resource hurdles (Fiscella et al., 2018). Continuity of care, both upon incarceration and upon release, is a particular challenge (Joudrey et al., 2019). JCOIN provides an opportunity to test alternative service delivery models to better engage individuals in ongoing treatment, and to support interagency collaborations that can facilitate the transition between criminal-legal and community settings. JCOIN is a cooperative agreement that supports an array of clinical trials, pilot studies, stakeholder engagements, and dissemination activities. It begins with the perspective that every individual involved in the justice system should have access to evidence-based SUD treatment services, while detained and while in the community. Thirteen large clinical trials are designed to generate evidence about “what works” in these settings and how best to implement those services. Briefly, they can be described in four thematic clusters...click on View Resource to read the full article.

The Power We Hold The ATTC Network is funded by SAMHSA and the author’s opinions do not necessarily represent the opinions of SAMHSA or the ATTC. We respectfully offer this article to encourage healthy discussion to advance our field.  By Sandeep Kapoor, MD Northwell Health Without mainstream advocacy, like we witness for heart disease, diabetes, and cancer, substance use disorders (SUD) have long been viewed as an “individual’s problem,” not as a healthcare issue deserving of championship. The alarming stigma that plagues the chronic medical condition of SUD has driven inaction in many healthcare arenas. The lack of investment, education, and humanistic individualized care has created industry-wide fractures in how we approach those with a SUD. The cries of our families and our communities fall on deaf ears — ears that are attuned to understand diseases of the heart, pancreas, and cells — though are unable to understand the science behind addiction. The lack of medical education fuels the lack of motivation to change, very quickly making SUD a problem for individuals, having to navigate on their own, without the support or empathy of others. The journey we travel is populated by an inherent need for acknowledgement—that feeling of being heard, understood, respected, and valued. Click on View Resource to read the full article. 

HealtheKnowledge Learning Platform has New Look, Robust Course Offerings By Alex Skov ATTC Network Coordinating Office In the modern world, business is done online. From buying groceries and booking vacations to searching out do-it-yourself maintenance tips, the digital world is often intertwined with each aspect of daily life. Education is no exception, evolving rapidly with everyone from elementary school students to seasoned professionals utilizing the tools available at the touch of a button to learn new skills and refine their practices. In the realm of behavioral health and substance use disorders (SUD), studies have shown that teaching basic knowledge of SUD through e-learning results in higher test scores for all the educational objectives regardless of the learner’s previous subject familiarity, and that digital tools can serve as important supplementary companions to formal education in addiction studies. Likewise, there is evidence that online learning effectively reduces knowledge gaps and stigma for patients and providers when it comes to subjects such as hepatitis C. With online learning showing no signs of slowing down, the e-learning platform HealtheKnowledge recently debuted an update that prioritizes user-friendliness and easy navigation. The update signifies a new step in the platform’s successful history of administering continuing education courses and learning opportunities for organizations in the health care space while maintaining an active user base of approximately 35,000 individuals in any given six-month period. The learning platform’s new design features an updated theme that renews its aesthetic appeal and adds descriptive pictures to each of the nearly 150 courses offered on HealtheKnowledge, while the updated interface puts users in the driver’s seat of a simple-to-navigate experience from start to finish. Beginning with a new user sign-up display that is easier to find and complete than ever before, users can then choose their desired courses from a categorized list that expands to show overviews of individual courses, or search for specific course titles and topics...click on View Resource to read the full article.

African American Behavioral Health Center of Excellence: Building Equity in Responses to Substance Use Disorders, Mental Health and More By Alex Skov ATTC Network Coordinating Office As the past year’s public health crisis has raised our consciousness of the effects of historic inequities on the physical and behavioral health of African Americans, it has also demonstrated again and again that the need for accessible and culturally responsive services far exceeds our capacity. For example: In 2019, 6.5 million African Americans in the U.S. reported having first-hand experience with a substance use disorder, mental illness, or both, according to data collected by the Substance Abuse and Mental Health Services Administration (SAMHSA). This marked a 10.1 percent increase over 2018. Similarly, overdose deaths caused by synthetic opioids have risen sharply among Black Americans during the past decade, with fentanyl-related overdose deaths climbing nearly 1,000 percent from 2013 to 2016 alone, per the Agency for Healthcare Research and Quality. The COVID-19 pandemic has further complicated these issues for racial and ethnic minority groups as it became more challenging to access mental health and substance use treatment services throughout 2020 and the first half of 2021. As the country strives to return to its pre-pandemic normalcy, the African American Behavioral Health Center of Excellence is prepared to help transform behavioral health services for African Americans by endeavoring to making these services safer and more culturally appropriate and responsive while also improving accessibility and effectiveness. “When we in behavioral health look at the racial, ethnic, gender and sexual minorities who often suffer from poor mental health outcomes, we sometimes need to dig deeper to see all the factors that are driving that,” the Center’s Principal Investigator Dawn Tyus said. “Yes, the inaccessibility of high-quality care is a significant problem, but that problem is being compounded by the taboo or stigma attached to needing or receiving...click on View Resource to read the full article.

September is recovery month; this is a time where we reflect on how far many individuals have come along in their journey to sobriety and their commitment to their recovery. It is also a time to be honest about what recovery looks like, and why it may not be inclusive to marginalized individuals who experience discrimination based on gender, race, and sexuality. So, you want to be an addictions counselor? You decided that you want to help people overcome adversities and help them become their best self. Congratulations, you have spent many years in school, interning at some of the best rehabilitation centers and medical facilities that you were able to get into, and now you have the degrees and certification to prove this. You’re all set to go! However, what if I told you that treating addiction requires more than what is brought to you in a classroom or clinical setting? What if I told you that in order to be an effective therapist you are going to have to do the inner work and dismantle your own white supremacy? Now, I know the knee-jerk reaction is to declare that you don’t contribute to white supremacy, or that you’re not racist. However, I encourage you to really look at how white supremacy and racism has contributed to the foundation of our society today, which includes the substance use and mental health treatment systems. We also must be mindful that to talk about white supremacy and colonialism, is to talk about the binary of gender and sexuality; we must be honest about how marginalized people are affected in every part of society, including in substance use treatment and recovery services. I have worked in HIV prevention for over a decade, with an emphasis on educating and advocating for transgender women of color; the issues of homelessness, substance use disorder, and mental health were some of the main themes that constantly reappeared whether it was on the prevention side of HIV or maintaining care.