|
I am a grateful recovering alcoholic, and
every day I do healthy, positive things so I wont take another
drink. My own experience has led me to work to combat the number
one public health issue facing our country: chemical addiction.
Expanding access to treatment is a matter of life and death for
26 million Americans."
|
Jim Ramstad
U.S. House of Representatives Minnesotas
3rd District |
|
Overview of Co-occurring and Co-existing Disorders,
Substance Abuse Disorders, Treatment, and Recovery
Substance abuse disorder refers to alcohol abuse as
well as use or misuse, dependence, and addiction to legal and illegal
drugs. Mental disorders represent the continuum of psychiatric severity
from less to more severe.
Substance abuse disorder. Mental disorder. Alone, each
wreaks havoc on the lives of millions in this country, and both require
intensive treatment. When afflicted with these simultaneously, the result
can be debilitating for an individual.1
Commonly referred to as a co-occurring disorder, people
with these conditions either abuse substances as a means of dealing with
the mental disorder or complicate their mental disorder through substance
abuse. While these disorders can interact differently in any one person,
at least one disorder of each type can be diagnosed independently of the
other.
Seven to ten million individuals in the United States
have at least one mental disorder as well as an alcohol or drug use disorder.2
Some examples of co-occurring disorders that can exist with drug and alcohol
abuse include depression, anxiety, mood and eating disorders.3
Nearly one-sixth of all Americans have a disability
that limits their activity; countless others have disabilities (mostly
cognitive in nature) that go unrecognized and undiagnosed.4
When a pre-existing condition, such as mental retardation, learning disorders,
HIV/AIDS, spinal or brain injuries, hypertension, heart disease, or diabetes,
is present with addiction, this is known as a co-existing disorder. Co-existing
disorders involve physical and cognitive disabilities coupled with a substance
abuse disorder. The statistics surrounding these disorders are startling:
|
People with conditions such as deafness, arthritis,
or multiple sclerosis have substance abuse rates at least double the
general population estimates.5, 6 |
|
Based on a Wisconsin survey, persons with spinal
cord injuries, orthopedic disabilities, vision impairment, and amputations
can be classified as heavy drinkers in approximately 40 to 50 percent
of cases.7 |
|
The presence of severe mental illness may create
additional biological vulnerabilities such that even small amounts
of psychoactive substances may have adverse consequences for individuals
with schizophrenia or other brain disorders.8 |
Why does this occur? One problem may be that treatment
for co-occurring substance abuse and mental disorders is inadequate compared
to the treatment programs of other disorders. Two-thirds of adults with
mental illness do not get help.9 Many individuals with a co-occurring
disorder are misdiagnosed. Also, these individuals, depending on the severity
of their illnesses, may not be able to be treated at home or tolerated
in a treatment facility.10 Service organizations inconsistently
design coordinated treatment programs to address the needs of individuals
with co-occurring disorderstreatment for a mental disorder is separate
from treatment for a substance abuse disorder. Development of integrated
and coordinated comprehensive programs that can treat co-occurring disorders
is desperately needed.11
In order to address this issue, the U.S. Substance Abuse
and Mental Health Services Administration has issued the Report
to Congress on the Prevention and Treatment of Co-occurring Substance
Abuse Disorders and Mental Disorders. Within this report is a recommendation
for an integrated treatment model based on cooperation, consultation,
and collaboration. Provision of integrated treatment ranges across a continuum
spanning from single cross-referral and linkage; through cooperation,
consultation, and collaboration; to integration in a single setting or
treatment model. Such treatment is provided through three levels of service
provision:
|
Integrated Treatment interaction between
the mental health and/or substance abuse clinician(s) and the individual,
which addresses the substance abuse and mental health needs of the
individual. |
|
Integrated Program(s) the organizational
structure for providing integrated treatment, whereby the mental health
and/or substance abuse program is responsible for ensuring an array
of staff or linkages with other programs to address all of the needs
of its clients. The program is responsible for ensuring that services
are provided in an appropriate and easily accessible setting and that
services are culturally competent. |
|
Integrated System the organizational structure
for supporting an array of programs for people with different needs,
including individuals with co-occurring substance abuse and mental
disorders. The system is responsible for ensuring appropriate funding
mechanisms to support the continuum of service needs, addressing credentialing/licensing
issues, and establishing data collection/reporting systems, needs
assessment, planning, and other related functions.12 |
What you can do is celebrate those already in treatment
and recovery and get involved at the local level by speaking out about
the need for effective, coordinated services for people with co-occurring
and co-existing disorders. The Recovery
Month 2003 theme is Join the Voices for Recovery: Celebrating Health. Please consider
the facts on the following pages in your efforts to educate others.
General Facts about Mental Disorders and Substance
Abuse Disorders, Treatment, and Recovery
As we celebrate Recovery
Month, all individuals and groups should be well-informed on the
subjects of substance abuse disorders, mental disorders, treatment, recovery,
co-existing and co-occurring disorders. Please note the following facts
and statistics:
Understanding Mental Disorders
|
More than 54 million Americans have a mental disorder
in any given year, although fewer than 8 million seek treatment.13 |
|
About half of people with a lifetime addictive
disorder also experience a lifetime history of at least one mental
disorder. Roughly 50 percent of those with a lifetime mental disorder
also have a lifetime history of at least one addictive disorder.14 |
|
In 2001, there were an estimated 14.8 million
adults age 18 or older with serious mental illness (SMI). This represents
7.3 percent of all adults. Of those with SMI, 6.9 million received
mental health treatment in the 12 months prior to the interview. Among
adults with SMI, 20.3 percent were dependent on or abused alcohol
or illicit drugs; the rate among adults without SMI was 6.3 percent.
An estimated 3 million adults had both SMI and substance abuse or
dependence problems during the year.15 |
Societal Benefits of Drug and Alcohol Treatment
|
The social cost of drug and alcohol addiction treatment
in the U.S. is estimated at $294 billion per year in lost productivity
and costs associated with law enforcement, health care, justice, welfare,
and other programs and services.16 |
|
Conservative estimates note that for every $1 invested
in addiction treatment, there is a return of between $4 and $7 in
reduced drug-related crime, criminal justice costs, and theft. When
savings related to health care are included, total savings can exceed
costs by a ratio of 12 to 1.17 |
Illicit Drugs18
|
An estimated 16 million Americans (7.1 percent
of the population 12 and older) were current users of illicit drugs
in 2001, meaning they had used an illicit drug at least once during
the 30 days prior to being interviewed. |
|
Illicit drug use among youth was highest for those
between the ages of 18 and 25 (18.8 percent) in 2001. |
|
The rate of illicit drug use in metropolitan counties
was higher than the rate in nonmetropolitan counties. Current drug
use rates were 7.6 percent in large metropolitan counties, 7.1 percent
in small metropolitan counties, 5.8 percent in nonmetropolitan counties,
and 4.8 percent in completely rural, nonmetropolitan counties. |
|
The rates of current illicit drug use for major
racial/ethnic groups in 2001 were similar to previous years: 7.2 percent
for whites, 6.4 percent for Hispanics, and 7.4 percent for African
Americans. Rates were highest among American Indian/Alaska Natives
(9.9 percent) and persons of multiple race (12.6 percent). Asians
had the lowest rates (2.8 percent). |
Prescription Drugs
|
Prescription drugs can be broken down into three
distinct categories: Opioids, which are most often prescribed to treat
pain; CNS depressants, which are used to treat anxiety and sleep disorders;
and stimulants, which are prescribed to treat narcolepsy, ADHD, and
obesity.19 |
|
In 2001, approximately 957,000 persons aged 12
or older had used Oxycontin nonmedically at least once in their lifetime.
This number is higher than estimates for both 1999 (221,000) and 2000
(399,000).20 |
Alcohol and Tobacco
|
Tobacco use, particularly cigarette smoking, is
the leading cause of preventable illness in the United States; in
fact, nearly one in four adults and one in three teenagers smoke.21 |
|
A little over 29 percent of the American population
aged 12 and older, or 66.5 million people, reported current use of
a tobacco product in 2001.22 |
|
About 10.1 million persons aged 12 to 20 reported
current use of alcohol in 2001. This number represents 28.5 percent
of this age group, for whom alcohol is an illicit substance.23 |
Other Important Information Regarding Specific Illicit
Drugs
Marijuana
|
Marijuana is the most commonly used illicit drug
in the United States.24 |
|
More than 83 million Americans (37 percent) age
12 and older have tried marijuana at least once.25 |
|
Depression, anxiety, and personality disturbances
are all associated with marijuana use. Research clearly demonstrates
that marijuana use has the potential to cause problems in daily life
or make a persons existing problems worse.26 |
|
More than two-thirds of the 2.3 million new users
reported in 1999 were under the age of 18 |
|
Marijuana is much stronger and more addictive than
it was 30 years ago. Average THC levels rose from less than 1 percent
in the late 1970s to more than 7 percent in 2001. Sinsemilla potency
increased from 6 percent to 13 percent. THC levels of 20 percent and
up to 33 percent have been found in samples of sinsemilla at the University
of Mississippi, Marijuana Potency Monitoring Project, 2001. Of those
who try marijuana at least once, nearly one in ten become dependent.27
|
Cocaine/Crack28
|
Cocaine is a powerfully addictive stimulant that
directly affects the brain and is available in two forms: a hydrochloric
salt or white powder that dissolves in water and can be taken either
intravenously or through the nose. The other form, freebase, is cocaine
that has been neutralized by an acid. Freebase cocaine can be smoked. |
|
Crack is the street name for freebase cocaine that
has been processed with baking soda. Someone who smokes crack can
experience a high in less than 10 seconds. This, along with the fact
that it is inexpensive and easy to produce, has led to the enormous
popularity of this drug. |
|
Cocaine use, which was extremely popular in the
1980s, stabilized in the United States between 1992 and 1999. However,
despite the stabilization, the rate of cocaine use still continues
to rise. |
Hallucinogens
|
Hallucinogens include LSD (lysergic acid diethylamide,
also known as acid, blotter, boomers, cubes, microdot, or yellow sunshines),
mescaline (also known as buttons, cactus, mesc, or peyote), psilocybin,
(also known as magic mushrooms, purple passion, or shrooms).29 |
|
Approximately 1.3 million (0.6 percent of the population
aged 12 or older) were current users of hallucinogens.30 |
|
In 2001, the percentage of 12th graders who used
hallucinogens in the past year was up from 8.1 percent to 8.4 percent.
Past-month usage was also up from 2.6 percent to 3.2 percent.31 |
Heroin
|
Heroin mentions in hospital emergency departments
increased 15 percent (from 82,192 to 94,804 mentions) from 1999 to
2000.32 |
|
Current heroin use was reported by an estimated
123,000 Americans in 2001. This represents 0.1 percent of the population
aged 12 and older and is similar to the number estimated for 2000
(130,000).33 |
|
Among past year users of heroin in 2001, 50 percent
(0.2 million) were classified with dependence on or abuse of heroin.34 |
|
Almost 90 percent of people who abused heroin were
white; over 50 percent were employed full-time; and almost 89 percent
had a high school diploma or higher level of education.35 |
|
Estimates of multi-drug use among heroin-addicted
people range from 30 to 70 percent. The most common co-occurring addictions
are cocaine, benzodiazepines, alcohol, nicotine, and marijuana. Rates
of marijuana use by heroin addicts seeking treatment have been reported
to be as high as 66 percent.36, 37, 38 |
|
Estimated costs associated with heroin addiction
in the United States were 21.9 billion dollars in 1996.39 |
Methamphetamine
|
Methamphetamine is a powerfully addictive stimulant
that dramatically affects the central nervous system.40 |
|
The abuse of methamphetaminea potent psychostimulantis
an extremely serious and growing problem. Although the drug was first
used primarily in selected urban areas in the Southwestern part of
the United States, high levels of methamphetamine abuse are now seen
in many areas of the Midwest, in both urban and rural settings, and
by very diverse segments of the population.41 |
|
Incidence of methamphetamine use rose steadily
between 1990 (164,000 new users) and 2000 (344,000 new users). Methamphetamine
incidence was at its highest level since 1975.42 |
MDMA or Ecstasy (Club Drugs)
|
This category of drugs is most commonly encountered
at nightclubs and raves. It includes Ecstasy (MDMA), Ketamine (Special
K), GHB, GBL, Rohyphnol, LSD, and PCP.43 MDMA, commonly
called Ecstasy, is the number one club drug in use. |
|
These types of drugs have gained popularity due
to the false perception that they are not as harmful or as addictive
as mainstream drugs, such as heroin. This is false. In
fact, people who use these substances are at risk for dehydration,
hyperthermia, or heart or kidney failure. The combination of the stimulant
effect of the drug and the hot, crowded atmosphere of parties or clubs
can lead to fatalities.44 |
|
Among 12th graders, past-year use of MDMA increased
46 percent, from 5.6 percent to 8.2 percent. Also, the perceived availability
of MDMA increased sharplyup 28 percent. This is the largest
one-year percentage point increase in the availability measure among
12th graders for any drug class in the 26-year history of the Monitoring
the Future study.45 |
Important Information Regarding Other Misused and
Potentially Addictive Substances
Inhalants46
|
The term inhalants refers to more than
a thousand different household and commercial products that can intentionally
be abused by sniffing or huffing (inhaling through ones
mouth) for an intoxicating effect. These products are composed of
volatile solvents and substances commonly found in commercial adhesives,
lighter fluids, cleaning solutions, and paint products. |
|
There is a common link between inhalant abuse and
teenagers. Some problems include: failing grades, memory loss, learning
problems, chronic absences, and general apathy. Inhalant users also
tend to be disruptive, deviant, or delinquent as a result of the early
onset of use, the users lack of physical and emotion maturation,
and the physical consequences that occur from extended use. |
|
Between 1994 and 2000, the number of new inhalant
users increased more than 50 percent, from 618,000 new users in 1994
to 979,000 in 2000. These estimates were higher than a previous peak
in 1978 (662,000 new users).47 |
Steroids48
|
Steroids are synthetic derivatives of the male
hormone testosterone. Scientifically referred to as androgenic anabolic
steroids, these derivatives promote the growth of skeletal muscle
and increase lean body mass. |
|
Steroids can be taken orally or via injection with
a needle. Some consequences of steroid abuse are: higher blood pressure,
liver problems, stunted growth, infertility, irregular menstrual cycles,
and testicular shrinkage. Over time, steroid use can cause violent
behavior, delusions, and paranoid jealousy. |
|
The 1995 Youth Risk
and Behavior Surveillance System showed that of 9th to 12th
graders in public and private high schools in the U.S., 4.9 percent
of males and 2.4 percent of females have used anabolic steroids at
least once in their lives.49 |
To learn more about drug and alcohol addiction,
treatment, and usage rates, you can access many of the materials cited
in this fact sheet by contacting an information specialist at SAMHSAs
National Clearinghouse for Alcohol and Drug Information toll-free at 1-800-729-6686. You can also access the Clearinghouse via the Internet
at
http://ncadi.samhsa.gov or by email at recoverymonth@samhsa.hhs.gov.
You are encouraged to share your plans and activities
for Recovery Month 2003 with SAMHSAs
Center for Substance Abuse Treatment, your colleagues, and the general
public by posting them on the official Recovery Month web site at http://www.recoverymonth.gov.
We would like to know about your efforts during
Recovery Month. Please complete
the Customer
Satisfaction Form enclosed in the kit. Directions are included
on the form.
For any additional Recovery
Month materials visit our web site at
http://www.recoverymonth.gov or call 1-800-729-6686.
Sources
1 |
Co-occurring
addictive and psychiatric disorders. Public Policy of the American
Society of Addiction Medicine, December 2000/updated September 2001.
|
2 |
Improving
services for individuals at risk of, or with, co-occurring substance-related
and mental health disorders. Substance Abuse and Mental Health
Services Administrations National Advisory Council. Rockville,
MD: U.S. Department of Health and Human Services, Substance Abuse
and Mental Health Services Administration, 1998. |
3 |
Co-occurring addictive and
psychiatric disorders. |
4 |
Substance
Use Disorder Treatment for People with Physical and Cognitive Disabilities.
Treatment Improvement Protocol (TIP) Series 24. DHHS Publication
No.(SMA) 98-3249. Rockville, MD: U.S. Department of Health and Human
Services, Substance Abuse and Mental Health Services Administration,
Center for Substance Abuse Treatment, 1998. |
5 |
Sylvester, R.A. Treatment of
the deaf alcoholic: A review. Alcoholism
Treatment Quarterly 3(4), 1986. |
6 |
Preliminary
findings from the medication and other drug use survey. Rehabilitation
Research and Training Center on Drugs and Disability. Unpublished
summary. Dayton, OH: Wright State University, 1995. |
7 |
Buss, A. and Cramer, C.
Incidence of alcohol use by people with disabilities: A Wisconsin
survey of persons with a disability. Madison, WI: Office of
Persons with Disabilities, 1989. |
8 |
Drake R.E., Mercer-McFadden,
C., Muser K.T., et. al. A review of integral mental health and substance
abuse treatment for patients with dual disorders.
Schizophrenia Bulletin 24: 589-608, 1998. |
9 |
Mental
Health: A Report of the Surgeon General. Washington, DC: U.S.
Department of Health and Human Services, Public Health Service, 1999. |
10 |
Dual
Diagnosis: Mental Illness and Substance Abuse, Helpline Fact
Sheet. National Alliance on Mental Illness. Arlington, VA, 2002. |
11 |
Report
to Congress on the Prevention and Treatment of Co-occurring Substance
Abuse Disorders and Mental Disorders. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002. |
12 |
ibid. |
13 |
Mental
Health: A Report of the Surgeon General. 19 Prescription Drugs:
Abuse and Addiction, National Institute on Drug Abuse Research Report
Series. NIH Publication No. 01-4881. Rockville, MD: U.S. Department
of Health and Human Services, National Institutes of Health, National
Institute on Drug Abuse, printed April 2001. |
14 |
Kessler, R.C., Nelson, C.B.,
McGonagle, K.A., et al. The epidemiology of co-occurring addictive
and mental disorders: Implications for prevention and service utilization.
American Journal of Orthopsychiatry
66(1), January 1996. |
15 |
Summary
of Findings from the 2001 National Household Survey on Drug Abuse.
DHHS Publication No. (SMA) 02-3758. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002. |
16 |
Coffey, R.M., Ph.D., et al.
National Estimates of Expenditures for Substance Abuse Treatment,
1997. U.S. Department of Health and Human Services, Substance Abuse
and Mental Health Services Administration, Center for Substance Abuse
Treatment, Medstat Group, February 2001. |
17 |
Principles
of Drug Addiction Treatment: A Research-Based Guide. NIH Publication
No. 00-4180. Bethesda, MD: U.S. Department of Health and Human Services,
National Institutes of Health, National Institute on Drug Abuse, printed
October 1999/reprinted July 2000. |
18 |
Summary of Findings from
the 2001 National Household Survey on Drug Abuse. |
19 |
Prescription
Drugs: Abuse and Addiction, National Institute on Drug Abuse Research
Report Series. NIH Publication No. 01-4881. Rockville, MD:
U.S. Department of Health and Human Services, National Institutes
of Health, National Institute on Drug Abuse, printed April 2001. |
20 |
Summary of Findings from
the 2001 National Household Survey on Drug Abuse. |
21 |
Reducing
Tobacco Use: A Report of the Surgeon General. U.S. Department
of Health and Human Services, Centers for Disease Control, National
Center for Chronic Disease Prevention and Health Promotion, Office
on Smoking and Health, 2000. |
22 |
Summary of Findings from
the 2001 National Household Survey on Drug Abuse. |
23 |
ibid. |
24 |
Marijuana
Abuse, National Institute on Drug Abuse Research Report Series.
NIH Publication No. 02-3859. Rockville, MD: U.S. Department of Health
and Human Services, National Institutes of Health, National Institute
on Drug Abuse, printed October 2002. |
25 |
Summary of Findings from
the 2001 National Household Survey on Drug Abuse. |
26 |
Marijuana Abuse, National
Institute on Drug Abuse Research Report Series. |
27 |
Anthong, J.C., et al. Comparative
epidemiology of dependence on tobacco, alcohol, controlled substances,
and inhalants: Basic findings from the National Comorbidity
Survey Experimental and Clinical
Psychopharmacology 2:244-268, 1994. |
28 |
Cocaine:
Abuse and Addiction, National Institute on Drug Abuse Research Report
Series. NIH Publication No. 99-4342. Rockville, MD: U.S.
Department of Health and Human Services, National Institutes of Health,
National Institute on Drug Abuse, printed May 1999. |
29 |
Commonly
Abused Drugs. Chart produced by U. S. Department of Health
and Human Services, National Institutes of Health, National Institute
on Drug Abuse, printed August 2000. |
30 |
Summary of Findings from
the 2001 National Household Survey on Drug Abuse. |
31 |
Monitoring
the Future: National Results on Adolescent Drug Use, Overview of Key
Findings, 2001. NIH Publication No. 02-5105. Bethesda, MD:
U.S. Department of Health and Human Services, National Institutes
of Health, National Institute on Drug Abuse, 2002. |
32 |
Emergency
Department Trends from the Drug Abuse Warning Network Preliminary
Estimates January-June 2001 with Revised Estimates 1994-2000.
DHHS Publication No. (SMA) 02-3634. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Administration,
2001. |
33 |
Summary of Findings from
the 2001 National Household Survey on Drug Abuse. |
34 |
ibid. |
35 |
Honer, J., Gordon, S.M., and
Snyderan, R. Heroin-addicted patient characteristics and drug use
histories. Caron Foundation unpublished data, 2001. |
36 |
Epstein, J.F. and Gfroerer,
J.C. Heroin abuse in the United States (OAS working paper, RP0919).
Rockville, MD: U.S. Department of Health and Human Services, Substance
Abuse and Mental Health Services Administration, August 1997. |
37 |
Amass, L., Bickel, W.K., and
Budney, A.J. Marijuana use and treatment outcome among opioid-dependent
patients. Addiction 93(4), 1998. |
38 |
Matching
treatment to patient needs in opioid substitution therapy.
Treatment Improvement Protocol (TIP) 20. DHHS Pub. No. 95-3049. Rockville,
MD: U.S. Department of Health and Human Services, Substance Abuse
and Mental Health Services Administration, Center for Substance Abuse
Treatment, 1995. |
39 |
Mark, T.L., et al. The economic
costs of heroin addiction in the United States. Drug
and Alcohol Dependence 60, 2001. |
40 |
Methamphetamine:
Abuse and Addiction, National Institute on Drug Abuse Research Report
Series. NIH Publication No. 02-4210. Rockville, MD: U.S. Department
of Health and Human Services, National Institutes of Health, National
Institute on Drug Abuse, printed April 1998. |
41 |
ibid. |
42 |
Summary of Findings from
the 2001 National Household Survey on Drug Abuse. |
43 |
The
National Drug Control Strategy: 2001 Annual Report. The high
intensity drug trafficking area program. Office of National Drug Control
Policy, White House Executive Office, 2002. |
44 |
ibid. |
45 |
Monitoring
the Future: National Results on Adolescent Drug Use, Overview of Key
Findings, 2000. NIH Publication No. 01-4923. Bethesda, MD:
U.S. Department of Health and Human Services, National Institutes
of Health, National Institute on Drug Abuse, 2001. |
46 |
The National Drug Control
Strategy: 2001 Annual Report. |
47 |
Summary of Findings from
the 2001 National Household Survey on Drug Abuse. |
48 |
Steroids. Posted on Freevibe
at http://www.freevibe.com/headsup/steroids.shtml#whatare. Freevibe
is sponsored by the Office of National Drug Control Policys
National Youth Anti-Drug Media Campaign. |
49 |
Anabolic
Steroids. Current Comment. American College of Sports Medicine.
Indianapolis, IN. April 1999. |
|
I have been public about my addiction and
recovery for almost a year. Im still amazed by the reaction.
Often the response is shock and bewilderment. These reactions result
from societys stereotype of alcoholics and addicts, but I
am neither a drunk on the corner, nor a social or academic
failure. I have dreams for the future."
|
Youth
Adolescence is a time of experimentation for young
men and women, and many who are exposed to alcohol and drugs give in to
curiosity or temptation, with potentially damaging results. For instance:
|
Today over half (54 percent) have tried an illicit
drug by the time they finish high school.1 |
|
Three out of ten (29 percent) have used some illicit
drug other than marijuana by the end of 12th grade.2 |
|
Alcohol use remains extremely widespread among
todays teenagers. Four out of every five students (80 percent)
have consumed alcohol (more than just a few sips) by the end of high
school and about half (51 percent) have done so by 8th grade.3 |
|
In 2001, approximately 10.1 million persons aged
12 to 20 reported drinking alcohol in the past month.4 |
|
Approximately 2 million youths aged 12 to 17 (nine
percent) had used inhalants at some time in their lives as of 2001.5 |
|
In 2001, 3.7 percent of 12th graders reported
using steroids in their lifetime. That is an increase of 1.2 percent
from 2000.6 |
Unfortunately, these trends in substance abuse often
lead to more serious problems for young men and women, including academic
difficulties, health-related problems, eating disorders, poor peer relationships,
and involvement with the juvenile justice system. Mental/emotional disorders
such as depression, developmental delays, conduct problems, personality
disorders, suicidal thoughts, apathy, withdrawal, and other psychological
dysfunctions frequently are linked to substance abuse among adolescents.
Moreover, many substance-abusing youths engage in behavior that places
them at risk of HIV/AIDS or other sexually transmitted diseases, unintended
pregnancy, and sexual violence.7
Studies show that about half of all adolescents receiving
mental health services have a co-occurring substance use disorder, and
as many as 75-80 percent of adolescents receiving inpatient substance
abuse treatment have a co-existing (e.g., co-occurring) mental disorder.8
In response to this problem, the U.S. Substance Abuse and Mental Health
Services Administration (SAMHSA) completed a Report
to Congress on the Prevention and Treatment of Co-occurring Substance
Abuse Disorders and Mental Disorders. In this report SAMHSA outlines
the scope of the problem, identifies current treatment approaches, best
medical practices, and seeks to highlight prevention opportunities. Also,
included in the report is the recommendation that prevention and treatment
services for co-occurring disorders must be culturally competent and age
and gender appropriate.9
What can be done? Substance abuse treatment programs
specifically designed for adolescents, as well as family-oriented approaches,
can make a difference. For example, a national study of community-based
treatment programs for adolescents found that reported weekly marijuana
use dropped by more than half in the year following treatment. Clients
also reported less heavy drinking, less use of hard drugs, and less criminal
involvement. Other benefits included better psychological adjustment and
improved school performance after treatment.10
Making a Difference: What Can I Do?
1. |
Recognize the Signs
of Addiction. If you are regularly interacting with young people,
it is important to know about the symptoms of substance abuse. Be
on the lookout for the following warning signs, which may indicate
that alcohol or drugs have become a part of an adolescents life:
|
|
|
Sudden changes in personality without another
known cause |
|
|
|
Loss of interest in once-favorite hobbies,
sports, or other activities |
|
|
|
Sudden decline in performance or attendance
at school or work |
|
|
|
Changes in friends and reluctance to talk
about new friends |
|
|
|
Deterioration of personal grooming habits |
|
|
|
Difficulty in paying attention, forgetfulness |
|
|
|
Sudden aggressive behavior, irritability,
nervousness, or giddiness |
|
|
|
Increased secretiveness, heightened sensitivity
to inquiry |
|
2. |
Take Advantage of the
Power of Parenting. As a parent or legal guardian of an adolescent,
make all efforts to become a hands-on parent, consistently
establishing rules and expectations for your teen and regularly monitoring
his or her behaviors. Parent power is the most underutilized tool
in combating substance abuse. Nearly one in five teens (18 percent)
lives with hands-off parentsparents who fail to
consistently set down rules and expectationsand faces four times
the risk of substance abuse as teens with hands-on parents.
In a 2000 survey, far more teens who had not tried marijuana credited
their parents (49 percent) with this decision than any other influence.11 |
3. |
Address the Specialized
Treatment Needs of Youth. When referring youth with alcohol
or drug problems to treatment and recovery services, make every effort
to identify programs that are specifically designed for their age
group. Adolescents have special developmental needs and benefit from
treatment approaches that increase their motivation and commitment
to recovery.12 Treatment approaches should also be tailored
to take into account the childs age, gender, ethnicity, cultural
background, family structure, cognitive and social development, and
readiness for change.13 Sober schools that provide an alcohol-
and drug-free learning environment are available in some parts of
the country for students in recovery. In addition, because young people
with substance abuse problems are also often suffering from mental
disorders, there is a critical need for concurrent psychiatric treatment,
both during and following treatment.14 |
4. |
Open the Lines of Communication.
If you have direct contact with young men and women, take the opportunity
to become a mentoran authority figure whom young people in your
community feel comfortable with and can turn to for advice, for help
with problems, and as an advocate for their positions. Children who
live in alcohol- and drug-dependent families learn not to trust adults.
By offering your time and an open ear to provide assurance and validation,
you can counteract much of that mistrust and make a positive impact
on a childs life.15 |
5. |
Offer Training in Schools.
Educators who interact with youth on a daily basis can have a tremendous
impact on their students by modeling positive behaviors, providing
guidance and support on a personal level, building self-esteem, and
helping them to make smart decisions. Schools can support treatment
efforts and help youth suffering from co-occurring disorders by offering
training for all administrators, teachers, coaches, counselors, nurses,
and other school staff to spot the signs of substance abuse and mental
disorders and know how to respond; providing strong no-use messages
every year from preschool through the 12th grade, tailored to the
age, culture, and sophistication of the child; developing and enforcing
strong and commonsense substance abuse and treatment policies; improving
and expanding existing prevention and intervention programs; and creating
a school environment to engage parents (family members) in each childs
education. School personnel should develop student attachment to schools,
and help students build supportive peer groups so they can resist
negative peer pressures.16 |
Making a Difference: How Can I Focus My Efforts
During Recovery Month?
September 2003 marks the 14th annual observance of Recovery
Month, promoting the effectiveness of substance abuse treatment
nationwide. People who interact with young men and women on a regular
basis, including parents, teachers, youth group leaders, coaches, clergy,
counselors, health professionals, social workers, and others, can all
take actions to contribute to this national education effort. Adults should
support youth in need of treatment and recovery services, and those who
are suffering from co-occurring disorders. Following are a few suggestions:
1. |
Personalize Addiction.
Encourage young people in recovery who are willing to share their
stories with others to speak to their peers by conducting presentations
at area schools. In addition, a young person could author a first-person
account of his or her experience in an article for placement in a
school newspaper or a local community newspaper. |
2. |
Get the Word Out.
Distribute educational information about alcohol and drug addiction
and treatment to young people directly by setting up an exhibit booth
in high-traffic areas in your community such as shopping centers,
grocery stores, public libraries, places of worship, county or state
fairs, coffeehouses, book stores, movie theaters, and large-arena
concerts. Hand out flyers with information about effective treatment
options and contact numbers for local substance abuse recovery programs. |
3. |
Unite the Community.
Establish a substance abuse treatment task force that can address
alcohol- and drug-related issues that face your community and support
and expand existing treatment and recovery services. Enlist the participation
of leaders of relevant organizations who care about youth and have
an interest in this issue, such as representatives from the treatment
community, criminal justice system, religious institutions, social
and child welfare services, educational system, and parenting organizations
as well as policymakers. |
4. |
Equip Parents with the
Facts. Conduct an informational seminar for parents, grandparents,
stepparents, foster parents, and legal guardians to educate them on
how to recognize the signs and symptoms of substance abuse, what to
do if they suspect their child has a problem, and where to turn for
help in their community for counseling and treatment services. Publicize
the seminar through local newspapers and by posting flyers at area
schools, in grocery stores, community centers, libraries, and other
central locations. There are many resources available that can help
parents and other adults who encounter youth on a daily basis. One
resource is SAMHSA/CSATs A Quick Guide to Finding Effective
Alcohol and Drug Addiction Treatment (Publication Number: PHD877).
Another resource is SAMHSA/CSATs You
Can Help: A Guide for Caring Adults Working with Young People Experiencing
Addiction in the Family (Publication Number: PHD878). Order
free copies and other materials by contacting SAMHSAs National
Clearinghouse for Alcohol and Drug Information (NCADI) at 1-800-729-6686
or 1-800-487-4889 (TDD). |
5. |
Put the Kids to Work.
Work with a local youth-related organization to organize a poster,
song, or essay contest for young people during Recovery
Month highlighting the importance of substance abuse treatment.
Work with area schools to encourage student participation, encourage
a local radio station to promote the contest to its listeners as a
public service, and enlist businesses in the community to demonstrate
their support by donating prizes. |
You are encouraged to share your plans and activities
for Recovery Month 2003 with SAMHSAs
Center for Substance Abuse Treatment, your colleagues, and the general
public by posting them on the official Recovery
Month web site at http://www.recoverymonth.gov.
We would like to know about your efforts
during Recovery
Month. Please complete
the Customer
Satisfaction Form enclosed in the kit. Directions are included on the form.
For any additional Recovery
Month materials visit our web site at
http://www.recoverymonth.gov or call 1-800-729-6686.
Additional Resources
Federal Agencies |
|
|
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
200 Independence Avenue, SW
Washington, DC 20201
877-696-6775 (Toll-Free)
www.hhs.gov
HHS, Substance Abuse and Mental Health Services Administration
(SAMHSA)
5600 Fishers Lane
Parklawn Building, Suite 13C-05
Rockville, MD 20857
301-443-8956
www.samhsa.gov
HHS, SAMHSA
National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847-2345
800-729-6686 (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
www.ncadi.samhsa.gov
HHS, SAMHSA
National Directory of Drug Abuse and Alcoholism Treatment Programs
www.findtreatment.samhsa.gov
SAMHSA National Helpline
800-662-HELP (800-662-4357) (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
(for confidential information on substance abuse treatment and referral)
www.findtreatment.samhsa.gov
HHS, SAMHSA
Center for Substance Abuse Treatment
5600 Fishers Lane
Rockwall II
Rockville, MD 20857
301-443-5052
www.samhsa.gov
HHS, SAMHSA
Center for Mental Health Services
5600 Fishers Lane
Parklawn Building, Room 17-99
Rockville, MD 20857
301-443-2792
www.samhsa.gov
HHS, SAMHSA
Center for Substance Abuse Prevention
Youth Substance Abuse Prevention Initiative
301-443-1845
www.samhsa.gov
|
|
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
National Institutes of Health (NIH)
9000 Rockville Pike
Bethesda, MD 20892
301-496-4000
www.nih.gov
HHS, NIH
National Institute on Alcohol Abuse and Alcoholism
Keeping Kids Alcohol Free Campaign
Willco Building
6000 Executive Boulevard
Bethesda, MD 20892-7003
301-443-3860
www.niaaa.nih.gov
HHS, NIH
National Institute on Drug Abuse
Office of Science Policy and Communication
6001 Executive Boulevard
Room 5213 MSC 9561
Bethesda, MD 20892-9561
301-443-1124
Telefax fact sheets: 888-NIH-NIDA (Voice) (Toll-Free)
or 888-TTY-NIDA (TTY) (Toll-Free)
www.drugabuse.gov
U.S. DEPARTMENT OF EDUCATION (ED)
400 Maryland Avenue, SW
Washington, DC 20202-6123
800-872-5327 (Toll-Free)
www.ed.gov
ED, Safe and Drug-Free Schools
400 Maryland Avenue, SW
Washington, DC 20202-6123
202-260-3954
www.ed.gov/offices/OESE/SDFS
U.S. DEPARTMENT OF JUSTICE (DOJ)
950 Pennsylvania Avenue, NW
Washington, DC 20530-0001
202-353-1555
www.usdoj.gov
DOJ, Drug Enforcement Administration
Demand Reduction Section
600 Army Navy Drive
Arlington, VA 22202
202-307-7936
www.dea.gov
|
|
|
|
Other Resources |
|
|
Al-Anon/Alateen
For Families and Friends of Alcoholics
Al-Anon Family Group Headquarters, Inc.
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
888-4AL-ANON/888-425-2666 (Toll-Free)
www.al-anon.alateen.org
Alcoholics Anonymous
475 Riverside Drive, 11th Floor
New York, NY 10115
212-870-3400
www.aa.org
American Psychological Association
Policy and Advocacy in the Schools
750 1st Street, NE
Washington, DC 20002-4242
800-374-2723 (Toll-Free)
202-336-6123 (TTY)
www.apa.org
Community Anti-Drug Coalitions of America (CADCA)
901 North Pitt Street, Suite 300
Alexandria, VA 22314
800-54-CADCA (Toll-Free)
www.cadca.org
Child Welfare League of America
440 1st Street, NW, 3rd Floor
Washington, DC 20001
202-638-2952
www.cwla.org
Childrens Defense Fund
25 E Street, NW
Washington, DC 20001
202-628-8787
www.childrensdefense.org
Join Together
One Appleton Street, 4th Floor
Boston, MA 02116-5223
617-437-1500
www.jointogether.org
Latino American Youth Center
1419 Columbia Road, NW
Washington, DC 20009
202-319-2225
www.layc-dc.org
Mothers Against Drunk Driving
1025 Connecticut Avenue, NW, Suite 1200
Washington, DC 20036
202-974-2497
www.madd.org
National Asian Pacific American Families Against Substance Abuse
340 East 2nd Street, Suite 409
Los Angeles, CA 90012
213-625-5795
www.napafasa.org
National Association for Children of Alcoholics
11426 Rockville Pike, Suite 100
Rockville, MD 20852
888-55-4COAS (888-554-2627) (Toll-Free)
www.nacoa.org
National Association for Equal Opportunity in Higher Education
8701 Georgia Avenue, Suite 200
Silver Spring, MD 20910
301-650-2440
www.nafeo.org
|
|
National Association of School Psychologists
4340 East West Highway, Suite 402
Bethesda, MD 20814
301-657-0270
www.nasponline.org
National Association of Social Workers
750 1st Street NE, Suite 700
Washington, DC 20002-4241
202-408-8600
800-638-8799 (Toll-Free)
www.socialworkers.org
National Association of State Alcohol and Drug Abuse Directors
808 17th Street, NW, Suite 410
Washington, DC 20006
202-293-0090
www.nasadad.org
National Council on Alcoholism and Drug Dependence, Inc.
20 Exchange Place, Suite 2902
New York, NY 10005-3201
212-269-7797
800-NCA-CALL (Hope Line) (Toll-Free)
www.ncadd.org
National Education AssociationHealth Information Network
1201 16th Street, NW, Suite 521
Washington, DC 20036
202-822-7570
www.neahin.org
National Indian Child Welfare Association
5100 SW Macadam Avenue, Suite 300
Portland, OR 97239
503-222-4044
www.nicwa.org
National Latino Childrens Institute
1325 North Flores Street, Suite 114
San Antonio, TX 78212
210-228-9997
www.nlci.org
National PTA Drug and Alcohol Abuse Prevention Project
330 North Wabash Avenue, Suite 2100
Chicago, IL 60611-3690
800-307-4782 (Toll-Free)
www.pta.org
Partnership for a Drug-Free America
405 Lexington Avenue, Suite 1601
New York, NY 10174
212-922-1560
www.drugfreeamerica.org
Phoenix House
164 West 74th Street
New York, NY 10023
212-595-5810
www.phoenixhouse.org
Wellbriety for Youth Movement
P.O. Box 6201
Scottsdale, AZ 85261
877-871-1495 (Toll-Free)
www.whitebison.org
|
Sources
1 |
Monitoring
the Future: National Results on Adolescent Drug Use, Overview of Key
Findings, 2001. NIH Publication No. 02-5105. Bethesda, MD:
U.S. Department of Health and Human Services, National Institutes
of Health, National Institute on Drug Abuse, 2002. |
2 |
ibid. |
3 |
ibid. |
4 |
Summary
of Findings from the 2001 National Household Survey on Drug Abuse.
DHHS Publication No. (SMA) 02-3758. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002. |
5 |
ibid. |
6 |
Monitoring the Future: National
Results on Adolescent Drug Use, Overview of Key Findings, 2001. |
7 |
Drug
Identification and Testing in the Juvenile Justice System.
Ann H. Crowe, Editor. Washington, DC: U.S. Department of Justice,
Office of Justice Programs, May 1998. |
8 |
Greenbaum, P., Foster-Johnson,
L., and Petrila, A. Co-occurring addictive and mental disorders among
adolescents: Prevalence research and future directions. American
Journal of Orthopsychiatry 66(1), 1996. |
9 |
Report
to Congress on the Prevention and Treatment of Co-occurring Substance
Abuse Disorders and Mental Disorders. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002. |
10 |
Hser, Y., Grella, C., Hsieh,
S., and Anglin, M.D. National Evaluation
of Drug Treatment for Adolescents. Los Angeles, CA: University
of California at Los Angeles Drug Abuse Research Center. Paper presented
at the College on Problems of Drug Dependence Annual Meeting, June
1999. |
11 |
National
Survey of American Attitudes on Substance Abuse VI: Teens.
New York, NY: National Center on Addiction and Substance Abuse, Columbia
University, February 2001. |
12 |
Gordon, S.M. Adolescent
Drug Use: Trends in Abuse, Treatment and Prevention. Wernersville,
PA: Caron Foundation, 2000. |
13 |
Teen
Tipplers: Americas Underage Drinking Epidemic. New York,
NY: National Center on Addiction and Substance Abuse, Columbia University,
February 2002. |
14 |
Foxhall, K. Adolescents arent
getting the help they need. Monitor on
Psychology 32(5), June 2002. |
15 |
You
Can Help: A Guide for Caring Adults Working with Young People Experiencing
Addiction in the Family. DHHS Publication No. (SMA) 03-3785.
Rockville, MD: U.S. Department of Health and Human Services, Substance
Abuse and Mental Health Services Administration, Center for Substance
Abuse Treatment, 2001. |
16 |
Malignant
Neglect: Substance Abuse and Americas Schools. New York,
NY: National Center on Addiction and Substance Abuse, Columbia University,
August 1997. |
|
Weve had people with breast cancer
and no one would ever suggest to us, while theyre going through
chemo, You should just get rid of them. To say that
about alcoholism or an abuse situation makes no sense to us. We
can be a voice in the community and say, 'Its time to step
up to the plate and do something.'"
|
Diane
Crookham-
Johnson
Vice President of Administration
Musco Lighting |
|
Workplace
Most people who are addicted to alcohol or illicit
drugs are employed. According to the 2001
National Household Survey on Drug Abuse, 76 percent of illicit
drug users are employed either full- or part-time.1 More than
60 percent of adults know someone who has reported for work under the
influence of alcohol or other drugs.2
Rates for current alcohol use were 59 percent for full-time
employed adults aged 18 or older in 2001 compared with 52 percent of their
unemployed peers.3 In fact, alcohol is the most widely abused
substance among working adults. Most binge (five or more drinks on the
same occasion at least once in 30 days) and heavy (five or more drinks
on the same occasion on at least five different days in the past 30 days)
alcohol users are employed. Among the 43.9 million adult binge drinkers
in 2001, 35.4 million (81 percent) were employed either full- or part-time.4
Similarly, 9.8 million (80 percent) of the 12.4 million adult heavy drinkers
were employed.5 These disturbing data underscore the point
that all businesses, regardless of their size, may at some point need
to deal with an employee who has an alcohol or drug addiction.
Substance abuse in the workplace can cause a myriad
of problems for businesses, including increases in absenteeism, on-the-job
accidents, errors in judgment, legal expenses, medical insurance claims,
and illness rates, and decreases in productivity and employee morale.
For example:
|
Alcohol and drug abuse has been estimated to cost
American businesses roughly $81 billion in lost productivity in just
one year$37 billion due to premature death and $44 billion due
to illness.6 |
|
Alcoholism is estimated to cause 500 million lost
workdays annually.7 |
|
Individuals who are current illicit drug users
are also more likely (12.9 percent) than those who are not (5 percent)
to have skipped one or more work days in the past month.8 |
|
Results from a U.S. Postal Service study revealed
that employees who tested positive in a pre-employment drug test are
66 percent more likely to be absent and 77 percent more likely to
be discharged within three years than those who tested negative.9 |
The good news for employers is that the benefits of
achieving an alcohol- and drug-free workplace through substance abuse
treatment and recovery for employees are substantial. Results can include
improvements in performance, motivation, and morale, increases in overall
customer satisfaction, and financial savings through incentive programs
offered by insurance carriers. In addition, a commitment to alcohol and
drug abuse treatment for employees in need can help reduce accidents,
absenteeism, employee theft and fraud, insurance claims, and workers
compensation costs. Numerous studies have shown that the resources required
to support such treatment and recovery programs are well worth the investment.
For example, full parity for alcohol and drug treatment services in private
health insurance plans that tightly manage care would increase family
insurance premiums less than one percent.10
Making a Difference: What Can I Do?
1. |
Set the Tone.
Demonstrate your companys commitment to operating a drug-free
workplace by establishing a comprehensive workplace drug education
program, including a drug-free workplace policy, supervisor training,
employee education, and employee assistance. There is a wealth of
information available to help you get started. Begin by contacting
some of the resources listed at the end of this fact sheet. In addition,
SAMHSAs Workplace Resource Center provides centralized access
to information about drug-free workplaces and related topics at www.drugfreeworkplace.gov.
Also consider the Substance Abuse Information Database located at
www.dol.gov/asp/programs/drugs/said.htm.
It is a one-stop source for businesses seeking information about workplace
substance abuse. This site contains hundreds of documents, including
sample policies, articles, research reports, training and educational
materials, and legal and regulatory information. Another important
resource is the Drug-Free Workplace Advisor, an online interactive
system containing free, ready-to-use presentation materials for supervisor
training and employee education. It can be found on the Internet at
www.dol.gov/elaws/drugfree.htm. |
2. |
Make It Easy for Your Employees to Get
Help. Smaller businesses cannot always afford to provide
in-house resources, but this need not prevent a company from referring
its employees to appropriate local organizations and professionals
for help in confronting a substance abuse problem, as well as any
co-occurring and co-existing conditions such as psychiatric disorders,
medical problems, or physical disabilities. Even those with co-occurring
substance abuse and mental disorders can return to useful and productive
lives. As the U.S. Substance Abuse and Mental Health Services Administrations
Report to Congress on the Prevention
and Treatment of Co-occurring Substance Abuse Disorders and Mental
Disorders points out, people with co-occurring disorders
can and do recover when they have access to appropriate treatment
services.11
Examples of addiction treatment referrals might include certified
chemical dependency counselors and therapists, Alcoholics Anonymous,
Narcotics Anonymous, or Al-Anon/Alateen. In addition, there are
resources available to assist individuals within a particular field.
For example, a law firm may refer an addicted attorney to Lawyers
Concerned About Lawyers, the ABA Commission on Lawyer Assistance
Programs, or its bar associations lawyer assistance program.
|
3. |
Hire Individuals in
Recovery. Many businesses across the nation have worked with
substance abuse treatment programs to recruit people in recovery who
are highly motivated to succeed and prove themselves and take tremendous
pride in their achievements. The National Association on Drug Abuse
Problems (NADAP) is a private, nonprofit organization founded in 1971
to provide individuals the opportunity to become self-sufficient,
productive, employed, and free of substance abuse. Nationally acclaimed
for its employment programs, curriculum development, counselor training,
research studies, and community involvement, NADAP has helped nearly
10,000 men and women recovering from substance abuse problems return
successfully to work. Through its effective partnership with business
and labor, more than 1,000 companies, including Au Bon Pain, Federal
Express, Coca-Cola Bottling Company, Macys, Omni Park Hotel,
Radio Shack, Inc., and Staples, Inc., have hired NADAP applicants.
For more information, call 1-800-435-2818 or visit them online at
www.nadap.org. |
4. |
Provide Inclusive Health
Insurance Coverage. The cost of obtaining treatment for addiction
can be prohibitive for many individuals who are in need of these services.
In addition, people in recovery who do have health insurance often
find that coverage for treatment of their addiction is limited or
nonexistent. Demonstrate your commitment to supporting your employees
by negotiating with your health insurance company for coverage of
behavioral health services, including alcohol and drug abuse treatment
and counseling. |
Making a Difference: How Can I Focus My Efforts
During Recovery Month?
Each September, Recovery
Month is observed and celebrated by hundreds of organizations across
the country to spotlight the importance of substance abuse treatment.
This years theme is Join the Voices for Recovery: Celebrating Health. Your company can
make a difference by taking part in outreach efforts to promote and observe
Recovery Month. Here are a few ideas
to help you begin:
1. |
Educate Your Employees.
The most important audience you can reach with information about substance
abuse treatment is your own staff. Provide your employees with basic
facts on the signs and symptoms of alcohol and drug addiction, treatment
options, and the companys policy in supporting employees in
recovery. Information about Recovery
Month can be delivered through a variety of communication vehicles,
including interoffice newsletters, electronic mail messages, an internal
or intranet web site, paycheck inserts, or bulletin boards
in common areas throughout the office. |
2. |
Contribute to Local
Efforts. An important way for your business to demonstrate
its corporate citizenship during Recovery
Month is to support a local substance abuse treatment organization.
Make a financial donation, organize a group of employees to volunteer
their time, sponsor a Recovery Month
educational or publicity event, or offer pro bono company services
to a local treatment provider. |
3. |
Go Public about Your
Program. Write and distribute a press release to the local
media about your companys drug education program and Recovery
Month activities. Or byline a news article for placement in
a business publication expressing your opinion about the extent of
the problem of substance abuse and what can be done about it. Support
your position with relevant statistics or scientific study results,
personal anecdotes, or references to recent news events. |
4. |
Evaluate Your Efforts.
Survey your employees to obtain feedback on your companys workplace
drug education program and determine what elements are not effective.
Ensure your staff of the confidentiality of their responses, and use
the findings to make decisions regarding any modifications to the
program. |
You are encouraged to share your plans and activities
for Recovery Month 2003 with SAMHSAs
Center for Substance Abuse Treatment, your colleagues, and the general
public by posting them on the official Recovery
Month web site at http://www.recoverymonth.gov.
We would like to know about your efforts during Recovery
Month. Please complete
the Customer
Satisfaction Form enclosed in the kit. Directions are included on the form.
For any additional Recovery
Month materials visit our web site at
http://www.recoverymonth.gov or call 1-800-729-6686.
Additional Resources
Federal Agencies |
|
|
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
200 Independence Avenue, SW
Washington, DC 20201
877-696-6775 (Toll-Free)
www.hhs.gov
HHS, Substance Abuse and Mental Health Services Administration
(SAMHSA)
5600 Fishers Lane
Parklawn Building, Suite 13C-05
Rockville, MD 20857
301-443-8956
www.samhsa.gov
HHS, SAMHSA
National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847-2345
800-729-6686 (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
www.ncadi.samhsa.gov
HHS, SAMHSA
National Directory of Drug Abuse and Alcoholism Treatment Programs
www.findtreatment.samhsa.gov
SAMHSA National Helpline
800-662-HELP (800-662-4357) (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
(for confidential information on substance abuse treatment and referral)
www.findtreatment.samhsa.gov
HHS, SAMHSA
Center for Substance Abuse Treatment
5600 Fishers Lane
Rockwall II
Rockville, MD 20857
301-443-5052
www.samhsa.gov
HHS, SAMHSA
Center for Substance Abuse Prevention
Workplace Helpline
800-967-5752 (Toll-Free)
www.samhsa.gov
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
National Institutes of Health (NIH)
9000 Rockville Pike
Bethesda, MD 20892
301-496-4000
www.nih.gov
|
|
HHS, NIH
National Institute on Alcohol Abuse and Alcoholism
Willco Building
6000 Executive Boulevard
Bethesda, MD 20892-7003
301-443-3860
www.niaaa.nih.gov
HHS, NIH
National Institute on Drug Abuse
Office of Science Policy and Communication
6001 Executive Boulevard
Room 5213 MSC 9561
Bethesda, MD 20892-9561
301-443-1124
Telefax fact sheets: 888-NIH-NIDA (Voice)
(Toll-Free) or 888-TTY-NIDA (TTY)
(Toll-Free)
www.drugabuse.gov
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
Office of Minority Health Resource Center
P.O. Box 37337
Washington, DC 20013-7337
800-444-6472 (Toll-Free)
301-230-7199 (TDD)
www.omhrc.gov
EXECUTIVE OFFICE OF THE PRESIDENT
White House Office of National Drug Control Policy
Drug-Free Workplace Programs Information
P.O. Box 6000
Rockville, MD 20849-6000
800-666-3332 (Toll-Free)
www.whitehousedrugpolicy.gov
U.S. DEPARTMENT OF LABOR (DOL)
200 Constitution Avenue, NW
Washington, DC 20210
866-4-USA-DOL (Toll-Free)
www.dol.gov
DOL, Working Partners for an Alcohol- and
Drug-Free Workplace
200 Constitution Avenue, NW, Room S-2312
Washington, DC 20210
202-693-5959
www.dol.gov/dol/workingpartners.htm
www.dol.gov/asp/programs/drugs/party/party.htm
|
|
|
|
Other Resources |
|
|
Al-Anon/Alateen
For Families and Friends of Alcoholics
Al-Anon Family Group Headquarters, Inc.
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
888-4AL-ANON/888-425-2666 (Toll-Free)
www.al-anon.alateen.org
Alcoholics Anonymous
475 Riverside Drive, 11th Floor
New York, NY 10115
212-870-3400
www.aa.org
Employee Assistance Professionals Association
2101 Wilson Boulevard, Suite 500
Arlington, VA 22201-3062
703-522-6272
www.eapassn.org
Employee Assistance Society of North America
230 East Ohio Street, Suite 500
Chicago, IL 60611-4607
312-644-0828
www.easna.org
|
|
Institute for a Drug-Free Workplace
1225 I Street, NW, Suite 1000
Washington, DC 20005
202-842-7400
www.drugfreeworkplace.org
National Association on Drug Abuse Problems, Inc.
355 Lexington Avenue, 2nd Floor
New York, NY 10017
212-986-1170
www.nadap.org
National Drug-Free Workplace Alliance
6868 S. Plumer
Tucson, AZ 85706
877-817-6809
Partnership for a Drug-Free America
405 Lexington Avenue, Suite 1601
New York, NY 10174
212-922-1560
www.drugfreeamerica.org
|
Sources
1 |
Summary
of Findings from the 2001 National Household Survey on Drug Abuse.
DHHS Publication No. (SMA) 02-3758. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002.
|
2 |
Addiction
in the Workplace Survey. Center City, MN: Hazeldon Foundation,
1996. |
3 |
Summary of Findings from
the 2001 National Household Survey on Drug Abuse. |
4 |
ibid. |
5 |
ibid. |
6 |
Substance
Abuse and Mental Health Statistics Sourcebook. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and
Mental Health Services Administration, 1995. |
7 |
Treatment
Is the Answer: A White Paper on the Cost-Effectiveness of Alcoholism
and Drug Dependency Treatment. Laguna Hills, CA: National Association
of Treatment Providers, 1991. |
8 |
Worker
Drug Use and Workplace Policies and Programs: Results from the 1994
and 1997 National Household Survey on Drug Abuse. Rockville,
MD: U.S. Department of Health and Human Services, Substance Abuse
and Mental Health Services Administration, 1999. |
9 |
Maloney, J., Normand, J., and
Salyards, S. An Evaluation of Pre-Employment Drug Testing. Journal
of Applied Psychology, 75(6), 1990. |
10 |
The
Costs and Effects of Parity for Mental Health and Substance Abuse
Insurance Benefits. Washington, DC: U.S. Department of Health
and Human Services, Substance and Mental Health Services Administration,
1998. |
11 |
Report
to Congress on the Prevention and Treatment of Co-occurring Substance
Abuse Disorders and Mental Disorders. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002. |
|
Id been a heroin addict for years.
My first days of awakening were walking into a faith-based community
organization [Teen Challenge International]. I graduated in 1974.
[Since then,] Ive walked the excellence that I know is there
to be walked. The man Ive been now for 29 years is who I am."
|
Henry Lozano
White House Advisor on Substance Abuse and
Addiction |
|
Community-Based and Service Organizations
Substance abuse is prevalent in America, affecting
both families and individuals. The 2001
National Household Survey on Drug Abuse highlights the following
facts about substance abuse:1
|
An estimated 16 million Americans (7.1 percent
of the population 12 and older) were current users of illicit drugs
in 2001, meaning they had used an illicit drug at least once during
the 30 days prior to being interviewed. |
|
Illicit drug use among youth was highest for those
between the ages of 18 and 25 (18.8 percent) in 2001. |
Recent events in the world have triggered Post-Traumatic
Stress Disorder (PTSD) in people who also have substance abuse problems.
In fact, an estimated 5.2 million American adults between the ages of
18 and 54 have PTSD. This is a dangerous situation for someone in treatment
or recovery. Today, PTSD is clinically recognized as one of the symptoms
of a co-occurring disorder when coupled with drug and alcohol abuse. According
to the U.S. Substance Abuse and Mental Health Services Administrations
recently released Report to Congress on
the Prevention and Treatment of Co-occurring Substance Abuse Disorders
and Mental Disorders, 7 to 10 million individuals in this country
have at least one mental disorder accompanied by an alcohol and drug abuse
addiction. However, with the help of community-based organizations and
faith organizations, people with co-occurring disorders can seek treatment
and get the support they need to face their illness.
Why are faith-based and community organizations so successful?
Consider these facts:
|
For 6 out of 10 Americans, religious faith is the
most important influence
in their lives; for 8 out of 10, religious beliefs provide comfort
and support.2 |
|
Ministries can prevent substance abuse by reaching
out to youth and getting them involved in positive activities (i.e.,
scouts, camping, or sports).3 |
|
For teens, only 13 percent of those who attend
religious services four or more times a month have smoked marijuana
compared to 39 percent of those who attend services less than once
a month.4 |
|
Only 19 percent of teens who attend religious services
four times or more a month have drunk alcohol in the past month, compared
to 32 percent of those who attend religious services less than once
a month.5 |
|
There is evidence that social support from friends
and outside influences can moderate the effects of a family history
of drug and alcohol problems.6 |
|
Children who coped effectively with the trauma
of growing up in families affected by alcoholism often relied on the
support of a non-alcoholic parent, stepparent, grandparent, teacher,
or others when they were growing up.7 |
|
Factors that have been cited in fostering student
ability to resist drugs include positive peer affiliations, bonding/involvement
in school activities, relationships with caring adults, opportunities
for school success and responsible behavior, and the availability
of drug-free activities.8 |
Making a Difference: What Can I Do?
1. |
Educate Yourself and the Community about
Substance Abuse Addiction and Treatment. The key to spreading
correct messages about addiction starts with leaders who truly understand
the disease of addiction. Seek out people in recovery in your community
who are willing to speak openly about their addictions; contact
local support groups or local religious organizations for spokespeople
who might be willing to educate your leaders. Demonstrating to the
local community that addiction is a treatable disease may encourage
other community-based organizations to work aggressively for more
community programs.9
For example, the One Church-One Addict program, created with grants
from the Robert Wood Johnson Foundation, organizes and trains volunteers
from churches and other religious organizations to support people
in need of treatment and those in recovery from addiction. By the
end of 2000, One Church-One Addict reported that approximately 750
religious congregations had either established a volunteer team
or had begun training.10
|
2. |
Work with Existing Channels in Your
Community. Local community-based organizations can work with
store owners to enforce a crackdown on alcohol sales to underage
youth. You can also support local schools and enlist the help of
parents to spread the message that not all children do drugs
but that treatment is available for those that abuse substances.
Most importantly, community-based organizations and faith communities
can support those already working in the treatment field, celebrating
the accomplishments of these often hidden heroes.11 In
addition, many community-based organizations are a wonderful resource
for those who have problems as many leaders are skilled in assisting
with stress and trauma.
Create a community anti-drug coalition. These coalitions combine
existing resources into a single community-wide system of prevention
and treatment.12
Some things to consider when evaluating this option for your community:
The Community Anti-Drug Coalitions of America (CADCA) is a great
example of the power of community coalitions. This organization
has over 5,000 members committed to building and strengthening the
capacity of community coalitions to support a drug-free community.
Another example is Join Together, a national organization that supports
community-wide efforts to reduce substance abuse. Information on
both organizations, along with several others, is in the resource
section at the back of this fact sheet.
|
3. |
Be Informed.
Make sure your community-based organization or faith community leaders
are kept up-to-date on the latest substance abuse and mental health
information. This includes the latest figures on the types of substances
being abused, the ages of people abusing these substances, the current
statistics on mental disorders, how to screen for co-occurring disorders,
and the newest types of treatments for both disorders. Possible resources
for this type of information are listed in the back of this fact sheet.
|
4. |
Get Involved.
Have Elders in the Native American communities involved in forming
wellness and recovery related practices. Use their experience and
position to establish programs and activities based on culture and
teachings. |
5. |
Seek Alternative Solutions. Sometimes
your community may have special needs that common solutions to substance
abuse problems cannot solve. However, these challenges do not have
to be daunting; they will just require more creative solutions.
For example:
Do you live in a college town? Then you might want to consider
partnering with your local university/college or community college
to sponsor sober dorms. Sober dorms can be one of two things: either
living environments for students who choose not to get involved
in drugs or alcohol, or places for students in recovery to receive
support for both their school work and their treatment.
Do you live in a community with large numbers of Native Americans?
Think about becoming involved in prevention and treatment programs
at tribal colleges. Tribal colleges were created to serve the needs
of Native Americans. Tribal colleges not only provide higher education
for those graduating from high schoolthey also reach geographically
isolated populations. Because of the high rate of substance abuse
among Native Americans, most tribal colleges provide counseling.13
|
Making a Difference: How Can I Focus My Efforts
During Recovery Month?
Recovery Month
is celebrated each year during September. This years theme, chosen
to reflect the thousands of organizations who support Recovery
Month, is Join the Voices for Recovery: Celebrating Health. Whether your community-based
organization or faith community is large or small, you are encouraged
to participate in this years celebration. Here are some ideas on
how to get involved:
1. |
Be Creative.
Work with local volunteer performance organizations (i.e., dance troupes,
theater companies, choral and chamber groups) to create shows that
help get the message out that substance abuse is a treatable disease.
Make sure the show or concert targets both children/teens and adults/families.
The shows or concerts could be offered free to the community and take
place at the performance groups venue or at your organization.
Make information about substance abuse treatment available for those
attending. Also, spokespeople from local treatment centers could hold
a question-and-answer session before or after the show. Place advertisements
about the upcoming show or concert in your organizations newsletter
or church bulletin and in windows of local stores and restaurants.
|
2. |
Integrate Your Message
into Activities for the Community. Get involved in local sports,
whether it be at the high school or college level. Work with the schools
and coaches to educate students on the dangers of steroids and other
performance-enhancing drugs. Sponsor a night at a local
minor league hockey or baseball game and during the event distribute
handouts with substance abuse information or fun giveaway items such
as key chains or whistles with your organizations name, phone
number, and web site address, if applicable. Help sponsor a run or
walk for a substance abuse cause in your community. Donate the money
you raise to a local treatment center for new programs, new staff,
or a new facility. |
3. |
Sponsor a Health and Community Fair.
If your community does not have a local summer fair, start one and
make it health-focused. Have booths for local treatment centers
to offer information and speak to their neighbors. Offer treatment
materials for those who might be in need. Invite local politicians
and celebrities to speak on substance abuse topics. Make sure that
there are activities for children as well.
If your community already sponsors a local summer fair, make sure
your organization has a booth or space. Gather substance abuse information
from treatment centers and have it available for those in attendance.
|
You are encouraged to share your plans and activities
for Recovery Month 2003 with SAMHSAs
Center for Substance Abuse Treatment, your colleagues, and the general
public by posting them on the official Recovery
Month web site at http://www.recoverymonth.gov.
We would like to know about your efforts during Recovery
Month. Please complete
the Customer
Satisfaction Form enclosed in the kit. Directions are included on the form.
For any additional Recovery
Month materials visit our web site at
http://www.recoverymonth.gov or call 1-800-729-6686.
Additional Resources
Federal Agencies |
|
|
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
200 Independence Avenue, SW
Washington, DC 20201
877-696-6775 (Toll-Free)
www.hhs.gov
HHS, Substance Abuse and Mental Health Services Administration
(SAMHSA)
5600 Fishers Lane
Parklawn Building, Suite 13C-05
Rockville, MD 20857
301-443-8956
www.samhsa.gov
HHS, SAMHSA
National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847-2345
800-729-6686 (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
www.ncadi.samhsa.gov
SAMHSA National Helpline
800-662-HELP (800-662-4357) (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
(for confidential information on substance
abuse treatment and referral)
www.findtreatment.samhsa.gov
HHS, SAMHSA
Center for Substance Abuse Treatment
5600 Fishers Lane
Rockwall II
Rockville, MD 20857
301-443-5052
www.samhsa.gov
HHS, SAMHSA
Center for Mental Health Services
5600 Fishers Lane
Parklawn Building, Room 17-99
Rockville, MD 20857
301-443-2792
www.samhsa.gov
|
|
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
National Institutes of Health (NIH)
9000 Rockville Pike
Bethesda, MD 20892
301-496-4000
www.nih.gov
HHS, NIH
National Institute on Alcohol Abuse and Alcoholism
Willco Building
6000 Executive Boulevard
Bethesda, MD 20892-7003
301-443-3860
www.niaaa.nih.gov
HHS, NIH
National Institute on Drug Abuse
Office of Science Policy and Communication
6001 Executive Boulevard
Room 5213 MSC 9561
Bethesda, MD 20892-9561
301-443-1124
Telefax fact sheets: 888-NIH-NIDA (Voice)
(Toll-Free)
or 888-TTY-NIDA (TTY) (Toll-Free)
www.drugabuse.gov
U.S. DEPARTMENT OF EDUCATION (ED)
400 Maryland Avenue, SW
Washington, DC 20202-6123
800-872-5327 (Toll-Free)
www.ed.gov
ED, Safe and Drug-Free Schools
400 Maryland Avenue, SW
Washington, DC 20202-6123
202-260-3954
www.ed.gov/offices/OESE/SDFS
|
|
|
|
Other Resources |
|
|
4-H
1400 Independence Avenue, SW
STOP 2225
Washington, DC 20250-2225
202-720-2908
www.4-h.org
Al-Anon/Alateen
For Families and Friends of Alcoholics
Al-Anon Family Group Headquarters, Inc.
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
888-4AL-ANON/888-425-2666 (Toll-Free)
www.al-anon.alateen.org
Alcoholics Anonymous
475 Riverside Drive, 11th Floor
New York, NY 10115
212-870-3400
www.aa.org
Aliviane NO-AD, Inc.
7722 North Loop Road
El Paso, TX 79915
915-782-4000
www.aliviane.org
American Psychological Association
750 1st Street, NE
Washington, DC 20002-4242
800-374-2724 (Toll-Free)
202-336-6123 (TTY)
www.apa.org
American Public Health Association
800 I Street, NW
Washington, DC 20001
202-777-2742 (APHA)
202-777-2500 (TTY)
www.apha.org
Association of State and Territorial Health Officials
1275 K Street, NW, Suite 800
Washington, DC 20005-4006
202-371-9090
www.astho.org
Big Brothers/Big Sisters of America
230 North 13th Street
Philadelphia, PA 19107
215-567-7000
www.bbbsa.org
Boys & Girls Clubs of America
1230 West Peachtree Street, NW
Atlanta, GA 30309
404-487-5700
www.bgca.org
Catholic Charities, USA
1731 King Street, Suite 200
Alexandria, VA 22314
703-549-1390
www.catholiccharitiesusa.org
Child Welfare League of America
440 1st Street, NW, 3rd Floor
Washington, DC 20001
202-638-2952
www.cwla.org
Childrens Defense Fund
25 E Street, NW
Washington, DC 20001
202-628-8787
www.childrensdefense.org
Church of Jesus Christ of Latter-Day Saints
2520 L Street, NW, 2nd Floor
Washington, DC 20037
202-448-3333
www.lds.org
Community Anti-Drug Coalitions of America
901 North Pitt Street, Suite 300
Alexandria, VA 22314
800-54-CADCA/800-542-2322 (Toll-Free)
cadca.org
Congress of National Black Churches
National Anti-Drug Campaign
2000 L Street, NW, Suite 225
Washington, DC 20036-4962
202-296-5657
www.cnbc.org
Connecticut Community for Addiction Recovery
530 Silas Deane Highway
Wethersfield, CT 06109
860-571-2985
www.ccar-recovery.org
Faces and Voices of Recovery
901 N. Washington Street, Suite 601
Alexandria, VA 22314
703-299-6760
General Board of Global Ministries of the
United Methodist Church
Program on Substance Abuse
110 Maryland Avenue, NE, Suite 404
Washington, DC 20002
202-548-2712
www.gbgm-umc.org
Girl Scouts of the U.S.A.
Just for Girls, 15th Floor
420 5th Avenue
New York, NY 10018-2798
800-GSUSA4U/800-478-7248 (Toll-Free)
www.girlscouts.org
|
|
Jewish Alcoholics, Chemically Dependent Persons and Significant
Others
850 7th Avenue, Penthouse
New York, NY 10019
212-397-4197
www.jacsweb.org
Johnson Institute
10001 Wayzata Boulevard
Minnetonka, MN 55305
952-582-2713
www.johnsoninstitute.org
Join Together
One Appleton Street, 4th Floor
Boston, MA 02116-5223
617-437-1500
www.jointogether.org
Miami Coalition for a Safe and Drug-Free Community
University of Miami/North South Center
1500 Monza Avenue
Coral Gables, FL 33146-3027
305-284-6848
www.miamicoalition.org
Mothers Against Drunk Driving
1025 Connecticut Avenue, NW, Suite 1200
Washington, DC 20036
202-974-2497
www.madd.org
National Association for Children of Alcoholics
11426 Rockville Pike, Suite 100
Rockville, MD 20852
888-55-4COAS/888-554-2627 (Toll-Free)
www.nacoa.org
National Association of Community Health Centers
7200 Wisconsin Avenue, Suite 210
Bethesda, MD 20814
301-347-0400
www.nachc.com
National Association of Rural Health Clinics
426 C Street, NE
Washington, DC 20002
202-543-0348
www.narhc.org
National Association of State Alcohol and Drug Abuse Directors
808 17th Street, NW, Suite 410
Washington, DC 20006
202-293-0090
www.nasadad.org
National Council for Community Behavioral Healthcare
12300 Twinbrook Parkway, Suite 320
Rockville, MD 20852
301-984-6200
www.nccbh.org
National Council on Alcoholism and Drug Dependence, Inc.
20 Exchange Place, Suite 2902
New York, NY 10005-3201
212-269-7797
800-NCA-CALL (Hope Line) (Toll-Free)
www.ncadd.org
National Families in Action
2957 Clairmont Road, NE, Suite 150
Atlanta, GA 30329
404-248-9676
www.nationalfamilies.org
Partnership for a Drug-Free America
405 Lexington Avenue, Suite 1601
New York, NY 10174
212-922-1560
www.drugfreeamerica.org
RecoveryWorks
1954 University Avenue West, Suite 12
Saint Paul, MN 55104
651-645-1618
Step One
665 West 4th Street
Winston Salem, NC 27101
336-725-8389
800-758-6077 (Toll-Free)
www.stepone.org
Therapeutic Communities of America
1601 Connecticut Avenue, NW, Suite 803
Washington, DC 20009
202-296-3503
www.tcanet.org
White Bison
6145 Lehman Drive, Suite 200
Colorado Springs, CO 80918
719-548-1000
www.whitebison.org
Young Mens Christian Association of the USA
1701 K Street, NW, Suite 903
Washington, DC 20006
202-835-9043
www.ymca.net
Young Womens Christian Association of the U.S.A.
1015 18th Street, NW, Suite 700
Washington, DC 20036
202-467-0801
800-YWCA-US1
www.ywca.org
|
Sources
1 |
Summary
of Findings from the 2001 National Household Survey on Drug Abuse.
DHHS Publication No. (SMA) 02-3758. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002.
|
2 |
Riccio, P. Breaking Down
the Walls: Connecting Faith with Communities, in Prevention
Pipeline. Rockville, MD: Center for Substance Abuse Prevention,
July/August 1996, p. 11. |
3 |
ibid. |
4 |
So
Help Me God: Substance Abuse, Religion and Spirituality. New
York, NY: National Center on Addiction and Substance Abuse, Columbia
University, November 2001. |
5 |
ibid. |
6 |
Ninth
Special Report to the U.S. Congress on Alcohol and Health from the
Secretary of Health and Human Services. Bethesda, MD: U.S.
Department of Health and Human Services, National Institutes of Health,
National Institute on Alcohol Abuse and Alcoholism, June 1997. |
7 |
Werner, E.E. and Johnson, J.L.
The role of caring adults in the lives of children of alcoholics.
Children of Alcoholics: Selected Readings,
Vol. 2, 2000. |
8 |
McNamara, K.M. Best Practices
in Substance Abuse Prevention Programs. Best
Practices in School Psychology III, A. Thomas and J. Grimes
(eds.). Washington, DC: National Association of School Psychologists,
1995, pp. 369-382. |
9 |
Schroeder, Steven. Grant
Makers Must Attack Substance Abuse. Chronicle of Philanthropy,
July 26, 2001. |
10 |
Support
for One Church-One Addict Program to Assist Recovering Addicts.
Grant Results Report. Princeton, NJ: Robert Wood Johnson Foundation,
May 2000. |
11 |
Schroeder, Steven. |
12 |
Assessing Community Coalitions.
Washington, DC: Drug Strategies. |
13 |
Tribal
Colleges: An Introduction. Alexandria, VA: American Indian
Higher Education Consortium, The Institute for Higher Education Policy,
February 1999. |
|
I got kicked out of pharmacy school twice
due to a full-blown cocaine addiction the school [called it]
academic difficulty. I call it the conspiracy of silence.
People dont know where to turn when [addiction] happens. There
isnt a lot of discussion about what to do and where to go."
|
David Marley
Executive Director of the NC Pharmacists
Recovery Network |
|
Health Care Providers and Payers
Alcohol and drug abuse and addiction continues to be
a huge problem in the United States. Nowhere is this felt more than in
the health care community. Health care providers and those who pay for
medical services feel the impact of a disease that affects millions. According
to the 2001 National Household Survey
of Drug Abuse: 1
|
There are 15.9 million illicit drug users in the
United States7.1% of the U.S. population over 12 years of age. |
|
10.8 percent of youth 12-17 years of age used an
illicit drug in the last 30 days. |
|
28.5 percent of all youth aged 12 to 20 drank in
the last month 10.1 million. Of that total, 6.8 million were
binge drinkers, 2.1 million heavy drinkers. |
|
Almost one in five adult Americans lived with an
alcoholic while growing up.2 |
With so many men, women, and youth using or addicted
to alcohol and illicit drugs, the chances are that anyone engaged in the
provision of health care will encounter people in need of help with alcohol
and drug problems. It is almost certain that primary care physicians in
managed care settings will encounter many of those with substance abuse
problems since many of them have health care insurance and almost 77 percent
of illicit drug users are employed.3 If a primary cause of
their health problemsdrugs and alcoholis not met head-on,
through referrals and support, these patients will continue to tax the
medical care system and cost payers because of the need to treat other
medical conditions exacerbated by substance abuse or addiction. The list
of co-existing diseases is long, ranging from AIDS to hypertension and
cardiovascular disease, from diabetes to hepatitis C.
In the course of practice, health care providers can
also expect to see people with co-occurring disorders, that
is, those with both mental and substance abuse disorders. About half of
people with a lifetime addictive disorder also experience a lifetime history
of at least one mental disorder. Roughly 50 percent of those with a lifetime
mental disorder also have a lifetime history of at least one addictive
disorder.4 Unfortunately, large numbers of these people in
need of treatment do not receive it.
Failure to treat both disorders almost assures an exacerbation
of health problems. The U.S. Substance Abuse and Mental Health Services
Administrations Report to Congress
on the Prevention and Treatment of Co-occurring Substance Abuse Disorders
and Mental Health Disorders points out: If one of the co-occurring
disorders goes untreated, both usually get worse and additional complications
arise. The combination of disorders can result in poor response to traditional
treatments and increase the risk for other serious medical problems.5
According to a substance abuse study of primary care
physicians and patients, 54 percent of patients said their primary care
physician did nothing about their substance abuse43 percent said
their physician never diagnosed it; 10.7 percent said they believed their
physician knew about their addiction and did nothing about it.6
The study bolstered this perception by stating that more than nine
in ten physicians fail to spot substance abuse in adults. Four out of
ten missed it in teens.7 There are several reasons why
physicians miss or misdiagnose substance abuse, including lack of adequate
training in medical school, skepticism about treatment effectiveness,
patient resistance, discomfort in discussing substance abuse with patients,
and time constraints.8
Effectiveness of Treatment
Only a small number of medical practitioners feel that
treatment for drug abuse and alcoholism is very effective.9
Most of these same practitioners consider treatments for other chronic
conditions such as hypertension and diabetes to be very effective.10
Yet, treatment success rates are comparable for these medical conditions.
In a study reported in the Journal of the American
Medical Association (JAMA), drug dependence, including alcohol,
was compared to type 2 diabetes mellitus, hypertension, and asthma. The
study concluded that medical adherence and relapse rates are similar
across these illnesses. Drug dependence generally has been treated as
if it were an acute illness. Review results suggest that long-term care
strategies of medication management and continued monitoring produce lasting
benefits. Drug dependence should be insured, treated, and evaluated like
other chronic illnesses.11
Other studies confirm these findings and even show that
brief interventions are effective in significantly reducing dependence.12,
13
Brief Interventions
Brief interventions can be effective in a variety of
populations. A study was conducted among older problem drinkersmen
who consumed 11 or more drinks per week, women who consumed eight or more
drinks per weekand those who indicated other difficulties with alcohol.
They received two 10-15 minute interventions and reinforcement visits
one month apart. Follow-ups were conducted at three, six, and 12 months.
At 12 months, the intervention group had reduced alcohol consumption by
36 percent. The proportion of drinkers classified as excessive drinkers
declined by 52 percent, and binge drinking declined by 47 percent.14
A second study was conducted in a trauma center. The
study noted that about 50 percent of patients admitted to trauma centers
in the United States are intoxicated and among them approximately 85 percent
have a serious problem with alcohol. Trauma centers routinely treat the
injuries but ignore the underlying alcohol problem. In the study conducted
in a level 1 trauma center, a sample of patients screened for alcohol
problems received either a brief, 30-minute counseling session or standard
trauma center care. Researchers examined records for every hospital in
Washington state to determine if patients were re-admitted. Over the next
three years, among those who received an intervention, there was a 48
percent reduction in injuries requiring hospitalization. In addition to
a decrease in alcohol use and trauma reduction, risk-taking behavior,
DUIs, traffic violations, alcohol-related arrests, and other arrests also
declined.15
Silent Success
It can be argued that one other factor, unique to the
substance abuse field, plays a part in the diminished awareness of treatment
success; that is the long tradition of protecting the anonymity of people
in recovery. In no other field do millions of success stories go untold.
The vast majority of these men, women, and youth in recovery are leading
healthy, active, productive lives. But few outside their families and
close friends are aware of their successes. This years theme, Join the Voices for Recovery: Celebrating Health, underscores
the importance of sharing the successes of recovery with the public.
Making a Difference: What Can I Do?
1. |
Get the Facts.
Learn about the newest science-based treatment protocols through education
and training. Learn about the nature of addiction and increase your
understanding of the recovery process. |
2. |
Examine Your Own Perceptions
of Substance Abuse. A study states the effects of drug
dependence on social systems have helped shape the generally held
view that drug dependence is primarily a social problem, not a health
problem.16 It is hard even for health professionals
to entirely escape this perception, but research clearly establishes
that addiction to alcohol and drugs is a medical problem, not a moral
weakness. The stigma associated with addiction compromises the ability
of people in need from getting treatment. The best way to combat stigma
is by educating and informing ourselves and others about the disease.
In that manner we can change attitudes and actions. |
3. |
Recognize that One
Size Does Not Fit All. Nowhere is this more true than
in the field of substance abuse treatment. To be fully effective,
service plans should be individualized to the needs of the client.
Cultural background and special needs must be recognized. It is important
to take into account the needs of those with co-existing disorders
including HIV/AIDS and physical and cognitive/developmental disabilities. |
4. |
Take a Holistic Approach
to Those with Co-occurring Disorders. Make every effort to
identify those with co-occurring substance abuse and mental disorders
and treat the whole person. For treatment to be fully effective, it
is vital that health care providers expect that patients will exhibit
both mental and substance abuse problems and will need coordinated
treatment for both conditions. |
5. |
Re-evaluate Mental Health
and Substance Abuse Benefits. Many assumptions about the cost
of benefits were made based on actuarial assumptions which reflected
utilization patterns from the 1970s and 1980s. They do not reflect
todays private sector treatment systems.17 Rand Health
conducted a study of 24 plans that had no limits on mental health
or substance abuse care, $10 co-payments for outpatient visits, and
$100 co-payments for inpatient care. Services were managed through
a managed behavioral health organization. Providing unlimited mental
health benefits in these plans resulted in about $45 per plan member
per year of insurance payments to providers.18 Unlimited
substance abuse benefits alone accounted for about an additional $5
per plan member per year.19 |
6. |
Employ Screening Instruments
to Help Identify Those in Need of Services. Experts in substance
abuse treatment recommend that primary care clinicians periodically
and routinely screen all patients for substance use disorders.20
In addition to questioning patients, a variety of screening instruments
are available for use. A number of these instruments, including CAGE,
CAGE-AID (CAGE adapted to include drugs), AUDIT, TWEAK, and MAST,
are described in depth in Treatment Improvement Protocol (TIP) Series
#24, A Guide to Substance Abuse Services
for Primary Care Clinicians (DHHS Publication No. (SMA) 97-3139).
It can be ordered free of charge from SAMHSAs clearinghouse,
the National Clearinghouse for Alcohol and Drug Information (NCADI),
at 1-800-729-6686 or 1-800-487-4889 (TDD). |
Making a Difference: How Can I Focus My Efforts
During Recovery Month?
We encourage health care providers and payers to take
action in support of Recovery Month,
which begins in September 2003. Your voice is vital to the success of
the 14th annual celebration of Recovery
Month. Here are some thoughts for your consideration:
1. |
Encourage Others to
Take Action. Please encourage fellow health care professionals
in their efforts to improve practices and make changes for the better.
Encourage clinicians to seek out training so that they are better
equipped to identify patients with drug and alcohol problems and refer
them for treatment. Support efforts to increase medical students
knowledge of substance abuse and its treatment. Those of you who are
involved in paying for services can make a great difference by adopting
policies that better support treatment. Promote the facts about treatments
effectiveness and the realities of the recovery process. Talk with
your constituents openly about how to fight their discomfort in tackling
these issues. |
2. |
Examine Your Own Workplace
Benefits. Objectively evaluate your own workplace benefits
to see if there are equal resources for your employees when it comes
to mental health services and treatment for drug and alcohol addiction.
Facilitate the provision of adequate treatment services for family
members as well as the primary beneficiary of services. |
3. |
Participate in a Community
Forum. Many cities around the nation will be hosting Community
Forums during Recovery Month
to talk about drug and alcohol addiction, to discuss recovery-related
topics, and to solve identified problems. Consider becoming a Forum
participant. Your expertise and commitment will be invaluable. |
4. |
Speak Out from a Personal
Perspective, if You Are Comfortable. If you or a loved one
is recovering from a drug or alcohol problem you can be a very powerful
voice for the effectiveness of treatment. As a respected member of
your organization and your community, you may be able to impact benefit
and service delivery decisions. You may want to consult your employee
assistance program or human resources representative first to identify
the most suitable and receptive audience for your disclosure. For
maximum impact, if you have colleagues within the organization who
also are in recovery, ask them if they would like to join you. |
You are encouraged to share your plans and activities
for Recovery Month 2003 with SAMHSAs
Center for Substance Abuse Treatment, your colleagues, and the general
public by posting them on the official Recovery
Month web site at http://www.recoverymonth.gov.
We would like to know about your efforts during Recovery
Month. Please complete
the Customer
Satisfaction Form enclosed in the kit. Directions are included on the form.
For any additional Recovery
Month materials visit our web site at
http://www.recoverymonth.gov or call 1-800-729-6686.
Additional Resouces
Federal Agencies |
|
|
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
200 Independence Avenue, SW
Washington, DC 20201
877-696-6775 (Toll-Free)
www.hhs.gov
HHS, Substance Abuse and Mental Health Services Administration
(SAMHSA)
5600 Fishers Lane
Parklawn Building, Suite 13C-05
Rockville, MD 20857
301-443-8956
www.samhsa.gov
HHS, SAMHSA
National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847-2345
800-729-6686 (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
www.ncadi.samhsa.gov
HHS, SAMHSA
National Directory of Drug Abuse and Alcoholism Treatment Programs
www.findtreatment.samhsa.gov
SAMHSA National Helpline
800-662-HELP (800-662-4357) (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
(for confidential information on substance abuse treatment and referral)
www.findtreatment.samhsa.gov
HHS, SAMHSA
Center for Substance Abuse Treatment
5600 Fishers Lane
Rockwall II
Rockville, MD 20857
301-443-5052
www.samhsa.gov
HHS, SAMHSA
Center for Mental Health Services
5600 Fishers Lane
Parklawn Building, Room 17-99
Rockville, MD 20857
301-443-2792
www.samhsa.gov
|
|
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
Health Resources and Services Administration
Bureau of Primary Health Care
4350 East West Highway
Bethesda, MD 20814
888-ASK-HRSA (Toll-Free)
www.bphc.hrsa.gov
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
National Institutes of Health (NIH)
9000 Rockville Pike
Bethesda, MD 20892
301-496-4000
www.nih.gov
HHS, NIH
National Institute on Alcohol Abuse and Alcoholism
Willco Building
6000 Executive Boulevard
Bethesda, MD 20892-7003
301-443-3860
www.niaaa.nih.gov
HHS, NIH
National Institute on Drug Abuse
Office of Science Policy and Communication
6001 Executive Boulevard
Room 5213 MSC 9561
Bethesda, MD 20892-9561
301-443-1124
Telefax fact sheets: 888-NIH-NIDA (Voice)
(Toll-Free) or 888-TTY-NIDA (TTY)
(Toll-Free)
www.drugabuse.gov
HHS, NIH
National Institute of Mental Health
Neuroscience Center
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
301-443-4513
www.nimh.nih.gov
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
Office of Minority Health Resource Center
P.O. Box 37337
Washington, DC 20013-7337
800-444-6472 (Toll-Free)
301-230-7199 (TDD)
www.omhrc.gov
|
|
|
|
Other Resources |
|
|
Al-Anon/Alateen
For Families and Friends of Alcoholics
Al-Anon Family Group Headquarters, Inc.
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
888-4AL-ANON (888-425-2666) (Toll-Free)
www.al-anon.alateen.org
Alcoholics Anonymous
475 Riverside Drive, 11th Floor
New York, NY 10115
212-870-3400
www.aa.org
Alcoholism and Substance Abuse Providers of New York State
1 Columbia Place
Albany, NY 12207
518-426-3122
www.asapnys.org
American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Avenue, NW
Washington, DC 20016-3007
202-966-7300
www.aacap.org
American Council on Alcohol Problems
2376 Lakeside Drive
Birmingham, AL 35244
205-989-8177
American Medical Association
515 North State Street
Chicago, IL 60610
312-464-5000
www.ama-assn.org
American Mental Health Counselors Association
801 North Fairfax Street, Suite 304
Alexandria, VA 22314
800-326-2642 (Toll-Free)
www.amhca.org
American Psychiatric Association
1000 Wilson Boulevard, Suite 1825
Arlington, VA 22209
888-357-7924 (Toll-Free)
www.psych.org
American Psychological Association
750 1st Street, NE
Washington, DC 20002-4242
800-374-2721 (Toll-Free)
www.apa.org
American Society of Addiction Medicine
4601 North Park Avenue, Upper Arcade Suite 101
Chevy Chase, MD 20815-4520
301-656-3920
www.asam.org
Association for Medical Education and Research in Substance Abuse
125 Whipple Street, 3rd Floor, Suite 300
Providence, RI 02908
401-349-0000
www.amersa.org
Association of American Indian Physicians
1225 Sovereign Row, Suite 103
Oklahoma City, OK 73108
405-946-7072
www.aaip.com
Association of Black Psychologists
P.O. Box 55999
Washington, DC 20040-5999
202-722-0808
www.abpsi.org
Indian Health Service
The Reyes Building
801 Thompson Avenue, Suite 400
Rockville, MD 20852-1627
301-443-2038
www.ihs.gov
International Nurses Society on Addictions
P.O. Box 10752
Raleigh, NC 27605
919-821-1292
www.intnsa.org
Massachusetts Organization for Addiction Recovery
(Affiliate of NEAAR-CSAT RCSP Grantee)
c/o Boston ASAP
30 Winter Street, 3rd Floor
Boston, MA 02108
617-423-6627
www.neaar.org/moar
|
|
National Adolescent Health Information Center
Division of Adolescent Medicine, Department of Pediatrics and Institute
for Health Policy Studies
School of Medicine, University of California, San Francisco
3333 California Street, Suite 245
San Francisco, CA 94118
415-502-4856
National Association for Children of Alcoholics
11426 Rockville Pike, Suite 100
Rockville, MD 20852
888-55-4COAS (888-554-2627) (Toll-Free)
www.nacoa.org
National Association of Addiction Treatment Providers
313 W. Liberty Street, Suite 129
Lancaster, PA 17603-2748
717-392-8480
www.naatp.org
National Association of Social Workers
750 1st Street, NE, Suite 700
Washington, DC 20002-4241
202-408-8600
800-638-8799 (Toll-Free)
www.socialworkers.org
National Center on Addiction and Substance Abuse at Columbia University
(CASA)
633 3rd Avenue, 19th Floor
New York, NY 10017
212-841-5200
www.casacolumbia.org
National Council on Alcoholism and Drug Dependence, Inc.
20 Exchange Place, Suite 2902
New York, NY 10005-3201
212-269-7797
800-NCA-CALL (Hope Line) (Toll-Free)
www.ncadd.org
National Indian Health Board
1385 South Colorado Boulevard, Suite A707
Denver, CO 80222
303-759-3075
202-742-4262
www.nihb.org
National Medical Association
1012 10th Street, NW
Washington, DC 20001
202-347-1895
www.nmanet.org
National Mental Health Association
2001 North Beauregard Street, 12th Floor
Alexandria, VA 22311
703-684-7722
800-969-6642 (TTY) (Toll-Free)
www.nmha.org
National TASC (Treatment Alternatives for Safer Communities)
2204 Mount Vernon Avenue, Suite 200
Alexandria,VA 22301
703-836-8272
www.nationaltasc.org
Phoenix House
164 West 74th Street
New York, NY 10023
212-595-5810
www.phoenixhouse.org
Physician Leadership on National Drug Policy
PLNDP National Project Office
Center for Alcohol and Addiction Studies
Brown University
Box G-BH
Providence, RI 02912
401-444-1817
www.plndp.org
The Association for Addiction Professionals
901 N. Washington Street, Suite 600
Alexandria, VA 22314
703-741-7686
800-548-0497 (Toll-Free)
www.naadac.org
|
Sources
1 |
Summary
of Findings from the 2001 National Household Survey on Drug Abuse.
DHHS Publication No. (SMA) 02-3758. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002. |
2 |
Elgen, L. and Rowen, D. A methodology
and current estimate of the number of children of alcoholics in the
United States. Children of Alcoholics: Selected Readings. Rockville, MD: National Association for
Children of Alcoholics, 1996. |
3 |
Summary of Findings from
the 2001 National Household Survey on Drug Abuse. |
4 |
Kessler, R.C., Nelson, C.B.,
and McGonagle, K.A., et al. The epidemiology of co-occurring addictive
and mental disorders: Implications for prevention and service utilization.
American Journal of Orthopsychiatry
66(1), January 1996. |
5 |
Report
to Congress on the Prevention and Treatment of Co-occurring Substance
Abuse Disorders and Mental Disorders. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002. |
6 |
Missed
Opportunity: National Survey of Primary Care Physicians and Patients
on Substance Abuse. New York, NY: National Center on Addiction
and Substance Abuse, Columbia University, April 2000. |
7 |
ibid. |
8 |
ibid. |
9 |
ibid. |
10 |
ibid. |
11 |
Klebor, H.D., OBrien, C.P.,
Lewis, D.C., and McLellan, A.T. Drug dependence, a chronic medical
illness: Implications for treatment, insurance, and outcomes evaluation.
Journal of the American Medical Association, 284 (13), Chicago, IL: American Medical Association, October 4, 2000. |
12 |
A
Guide to Substance Abuse Services for Primary Care Physicians.
Treatment Improvement Protocol (TIP) Series 24. DHHS Publication No.
(SMA) 97-3139. Rockville, MD: U.S. Department of Health and Human
Services, Substance Abuse and Mental Health Services Administration,
Center for Substance Abuse Treatment, 1997. |
13 |
Dorfman, S. Preventive
Interventions under Managed Care: Mental Health and Substance Abuse
Services. DHHS Publication No. (SMA) 00-3437. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and
Mental Health Services Administration, Center for Mental Health Services,
2000. |
14 |
ibid. |
15 |
Annals
of Surgery, November, 1999. Excerpted by Academic Medical Center,
University of Washington, November 12, 1999. |
16 |
Klebor, H.D. et al. |
17 |
Sturm, Roland. The Cost
of Covering Mental Health and Substance Abuse Care at the Same Level
as Medical Care in Private Insurance Plans. Testimony Presented
to the Health Insurance Committee, National Conference of Insurance
Legislators. Published July 2001 by RAND, Santa Monica, CA. |
18 |
ibid. |
19 |
ibid. |
20 |
A Guide to Substance Abuse
Services for Primary Care Physicians. |
|
I am a public advocate because a CEO of a
very large educational organization withdrew the offer of employment
after we talked about my recovery. Ill never forget the moment
he said, How could you ever begin to think we would want someone
like you to represent us?'"
|
Susan Rook
Director
Communications and Outreach Faces and Voices of Recovery |
|
Treatment and Recovery Communities
Millions of Americans struggle every day with drug
and alcohol problemstheir own or that of a loved one. The lifeline
for many of these individuals in need is treatment. Run by qualified,
accredited, and dedicated professionals, treatment programs and services
that meet rigorous state standards are the backbone of the public health
response needed to address this nationwide epidemic.
The unfortunate reality is that the range of treatment
and recovery program options is not comprehensive, available, or affordable
enough to ensure that everyone who needs effective treatment can get it.
In fact, 76 percent of people in need of treatment for a problem with
illicit drugs did not seek or receive treatment.1
To further compound the problem, about half of people
with a lifetime addictive disorder also experience a lifetime history
of at least one mental disorder. And, roughly 50 percent of those with
a lifetime mental disorder also have a lifetime history of at least one
addictive disorder.2
In an effort to address such co-occurring disorders,
the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA)
prepared a Report to Congress on the Prevention
and Treatment of Co-occurring Substance Abuse Disorders and Mental Disorders
(Co-occurring Report to Congress).3 In this report SAMHSA outlines
the scope of the problem, identifies current treatment approaches and
best medical practice models, and seeks to highlight prevention opportunities.
Included in the Co-occurring
Report to Congress is the recommendation that treatment services
must be integrated to be effective. Integrated mental health and substance
abuse treatment delivered by multi-disciplinary treatment teams can reduce
symptoms and improve functioning in the community.4 Moreover,
successful treatment requires the creation of welcoming, empathetic, hopeful,
continuous treatment relationships, in which integrated treatment and
coordination of care are sustained through multiple treatment episodes.5
As a member of the recovery community, you are in a
position to extend the benefits of professional treatment for those suffering
from addiction and/or co-occurring disorders by implementing some of the
following ideas.
Making a Difference: What Can I Do?
1. |
Recognize the Challenges
Faced by Those with Co-occurring Disorders. The stigma of addiction
is even greater for individuals who are also suffering from a mental
disorder. If you are an individual who is recovering from drug or
alcohol addiction and a mental disorder, know that your success story
may be the strongest weapon the recovery community has in the fight
for services that work to treat the whole person. |
2. |
Acknowledge the Challenges
Faced by Those with Co-existing Disorders. Like those with
co-occurring disorders, the stigma of addiction is even greater for
individuals who also suffer from a pre-existing condition, such as
mental retardation, learning disorders, HIV/AIDS, spinal or brain
injuries, hypertension, heart disease, or diabetes. If you are an
individual who is recovering from a substance abuse disorder and have
a physical or cognitive disability, know that your success story may
help the recovery community in its fight for services that work to
treat the whole person. |
3. |
Consider Your Language.
Language and how we label things have a tremendous influence on how
we think, act, and feel. For centuries, people suffering from addiction
and mental illness and people recovering in this country from these
disorders have been the object of languageoften derogatorycreated
by others. As a result, individuals with substance abuse and mental
disorders have inherited a language that does not accurately portray
their experience to others or serve as a catalyst for change. Until
a new and universally accepted vernacular is established to lessen
stigma and keep the focus on the needs of the individual, each of
us can make an effort to carefully monitor what we say and how we
say it. |
4. |
Build Partnerships.
Changing public attitudes will require that all affected and interested
parties present a united front to educate, inform, and persuade. As
a member of the recovering community, you can play a vital role by
taking part in the partnership-building effort in your community or
city. Work within your local community or city to organize Forums
where government agencies and private organizations can collaborate
on the issues, while providing a public platform to discuss points
of concern. You can work with community-based organizations, foundations,
local businesses, or faith-based groups, to name just a few, to organize
and contribute to this effort. |
Making a Difference: How Can I Focus My Efforts
During Recovery Month?
This year marks the 14th anniversary of Recovery
Month, which is celebrated every year in September. This years
theme is Join the Voices for Recovery: Celebrating Health. Beginning in September, you are encouraged
to use Recovery Month as a platform
to take action to affect positive change. Here are some action steps you
may want to consider to make an impact:
1. |
Take Part in Local Events. A
number of communities, counties, cities, and states undertake various
activities during Recovery Month
in an effort to draw public and media attention to the issues. Volunteer
to assist in organizing or running these events. Offer to be a spokesperson
who can put a face on recovery and testify to its positive impact.
Use your ties to the recovery community to enlist the help of others
to make the event as diverse and representative of the recovering
population in your area as possible.
If you do not know of any particular activities or events taking
place in your area during Recovery
Month 2003, call your local treatment program/services provider,
county or State alcohol and other drug agency, or legislator to
inquire about their knowledge of Recovery
Month. If no activities or events have been scheduled, inquire
as to why not, and then offer to take part in the effort to develop
some.
|
2. |
Write an Op-ed Piece and Submit It to
Your Local Newspaper. Newspapers generally publish a page
of opinion columns and letters from readers opposite the editorial
page; hence the term op-ed. This page presents members
of the general public with a forum to express their thoughts and
opinions on timely issues. Because September is Recovery
Month, the timing could not be better for you to submit your
thoughts on a critical treatment and/or recovery-related topic.
You are encouraged to reference the materials provided in the Media
Outreach section of this years Recovery
Month kit. Use the section titled Sample Op-Ed
as a guide in structuring your piece. Consider topics such as the
problems associated with a fragmented treatment system and the need
for integration as a means of effectively treating the whole person,
the lack of adequate and affordable treatment programs/services
to meet demand, and stigma reduction.
|
3. |
Work through the Media.
One of the greatest forums available for influencing public opinion
and decision-makers is the media. Recovery
Month provides the perfect opportunity to cultivate a one-on-one
interview with the host of your local cable access news or community
issues show. Local community radio programs are a great way to share
your story. Weekend public affairs programs tend to be very social
issues-oriented and are usually open to talking with new guests on
interesting topics. |
You are encouraged to share your plans and activities
for Recovery Month 2003 with SAMHSAs
Center for Substance Abuse Treatment, your colleagues, and the general
public by posting them on the official Recovery
Month web site at http://www.recoverymonth.gov.
We would like to know about your efforts
during Recovery
Month. Please complete
the Customer
Satisfaction Form enclosed in the kit. Directions are included on the form.
For any additional Recovery
Month materials visit our web site at
http://www.recoverymonth.gov or call 1-800-729-6686.
Additional Resources
Federal Agencies |
|
|
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
200 Independence Avenue, SW
Washington, DC 20201
877-696-6775 (Toll-Free)
www.hhs.gov
HHS, Substance Abuse and Mental Health Services Administration
(SAMHSA)
5600 Fishers Lane
Parklawn Building, Suite 13C-05
Rockville, MD 20857
301-443-8956
www.samhsa.gov
HHS, SAMHSA
National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847-2345
800-729-6686 (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
www.ncadi.samhsa.gov
|
|
SAMHSA National Helpline
800-662-HELP (800-662-4357) (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
(for confidential information on substance abuse treatment and referral)
www.findtreatment.samhsa.gov
HHS, SAMHSA
Center for Substance Abuse Treatment
5600 Fishers Lane
Rockwall II
Rockville, MD 20857
301-443-5052
www.samhsa.gov
HHS, SAMHSA
Center for Mental Health Services
5600 Fishers Lane
Parklawn Building, Room 17-99
Rockville, MD 20857
301-443-2792
www.samhsa.gov
|
|
|
|
Other Resources |
|
|
African American Family Services
2616 Nicollet Avenue South
Minneapolis, MN 55408
612-871-7878
www.aafs.net
Al-Anon/Alateen
For Families and Friends of Alcoholics
Al-Anon Family Group Headquarters, Inc.
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
888-4AL-ANON/888-425-2666 (Toll-Free)
www.al-anon.alateen.org
Alcoholics Anonymous
475 Riverside Drive, 11th Floor
New York, NY 10115
212-870-3400
www.aa.org
Campaign for Tobacco-Free Kids
1400 Eye Street, NW, Suite 1200
Washington, DC 20005
202-296-5469
www.tobaccofreekids.org
Children of Alcoholics Foundation
164 West 74th Street
New York, NY 10023
212-595-5810, Ext. 7760
www.coaf.org
Families USA
1334 G Street, NW, 3rd Floor
Washington, DC 20005
202-628-3030
www.familiesusa.org
Mothers Against Drunk Driving
1025 Connecticut Avenue, NW, Suite 1200
Washington, DC 20036
202-974-2497
www.madd.org
|
|
National Asian Pacific American
Families Against Substance Abuse
340 East 2nd Street, Suite 409
Los Angeles, CA 90012
213-625-5795
www.napafasa.org
National Association for Children of Alcoholics
11426 Rockville Pike, Suite 100
Rockville, MD 20852
888-55-4COAS (888-554-2627) (Toll-Free)
www.nacoa.org
National Families in Action
2957 Clairmont Road, NE, Suite 150
Atlanta, GA 30329
404-248-9676
www.nationalfamilies.org
National Latino Childrens Institute
1325 North Flores Street, Suite 114
San Antonio, TX 78212
210-228-9997
www.nlci.org
White Bison, Inc.
6145 Lehman Drive, Suite 200
Colorado Springs, CO 80918
719-548-1000
www.whitebison.org
Young Mens Christian Association of the USA
1701 K Street, NW, Suite 903
Washington, DC 20006
202-835-9043
www.ymca.net
Young Womens Christian Association of the U.S.A.
1015 18th Street, NW, Suite 700
Washington, DC 20036
202-467-0801
www.ywca.org
|
Sources
1 |
Summary
of Findings from the 2001 National Household Survey on Drug Abuse.
DHHS Publication No. (SMA) 02-3758. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002. |
2 |
Kessler, R.C., Nelson, C.B., McGonagle,
K.A., et al. The epidemiology of co-occurring addictive and mental
disorders: Implications for prevention and service utilization. American
Journal of Orthopsychiatry 66(1), January 1996. |
3 |
Report
to Congress on the Prevention and Treatment of Co-occurring Substance
Abuse Disorders and Mental Disorders. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002. |
4 |
Get
the Facts. National Resource Center on Homelessness and Mental Illness.
Under contract to the U.S. Department of Health and Human Services,
Substance Abuse and Mental Health Services Administration, Center
for Mental Health Services. |
5 |
Minkoff, K., M.D. Dual
DiagnosisAn Integrated Model for the Treatment of People with
Co-occurring Psychiatric and Substance Disorders, Dual Diagnosis
Recovery Network, Summer 2001. |
|
My last day [using], I worked 12 hours and
came home to cops opening the door for me. I was taken to jail.
I cried for days and days, [and] admitted that I was an addict.
[The judge] said his conscience would not allow him to find me guilty.
Today, I work for alcohol and drug services in the jail. I was destined
to be there. Today, I give back.
|
Shireda Prince
President
Substance Abuse
Addiction and Recovery Alliance of Northern Virginia |
|
Justice System and Child Welfare Systems
Justice System
Nearly 1.7 million of the 2 million adult Americans
in prison or jail are seriously involved with drugs or alcohol.1
Unfortunately, offenders are faced not only with the legal consequences
of their actions, but also with the often overwhelming stigma associated
with their addiction. This stigma contributes to an environment in which
society views incarceration as the only solution.
The costs of incarceration are staggering. The National
Center on Addiction and Substance Abuse estimates that of the $38 billion
spent on corrections in 1996, more than $30 billion was spent incarcerating
individuals who had a history of drug and/or alcohol abuse, were convicted
of drug and/or alcohol violations, were using drugs and/or alcohol at
the time of their crimes, or had committed their crimes to get money to
buy drugs.2
Most criminal offenders do not receive help for their
addiction; therefore relapse is common. Up to three-fourths of parolees
who leave prison without drug treatment for their cocaine or heroin addictions
resume drug use within three months of release.3 This is not
surprising, given that only about 18 percent of all inmates who need substance
abuse treatment actually receive it.4 However, an abundance
of scientific literature has found that effective substance abuse treatment
for drug-abusing offenders saves money, reduces crime, and lowers relapse
and recidivism rates. Consider the following:
|
Substance abuse treatment cuts drug
use in half, reduces criminal activity up to 80 percent, and reduces
arrests up to 64 percent.5 |
|
Several studies show that treatment and aftercare
in the community are necessary to keep offenders from recidivating.
For example, one study found that three years after release from prison
27 percent of offenders who received in-prison treatment and treatment
after prison had recidivated, while 75 percent of offenders in a comparison
group had gone back to prison.6 |
Substance abuse is rarely the only problem an offender
is facing. Based on the CAGE diagnostic instrument that is used to assess
alcohol dependence and abuse, 34 percent of mentally ill State prison
inmates, 24 percent of Federal prisoners, 38 percent of jail inmates,
and 35 percent of mentally ill probationers have a history of alcohol
dependence.7
There appears to be wide recognition by drug courts
that participants may suffer from mental disorders, including co-occurring
substance abuse and mental disorders. In fact, 61 percent of drug courts
report screening for mental problems.8 In addition, among jail
inmates, those held for drug offenses are the most likely to be HIV positive,
and female inmates have higher rates of HIV infection than male inmates.9
To succeed, a treatment program must include a comprehensive recovery
support system to meet the social, physical, and mental health needs of
the individual. For example, among juvenile offenders, treatment options
that show the best evidence of effectiveness are behavioral therapies,
intensive case management, cognitive-behavioral skills training, family-oriented
therapies, and multi-systemic therapy.10
In an effort to address this important issue, the U.S.
Substance Abuse and Mental Health Services Administration (SAMHSA) prepared
a Report to Congress on the Prevention
and Treatment of Co-occurring Substance Abuse Disorders and Mental Disorders.
In this report, SAMHSA outlines best medical practices and calls for agencies
to collaborate to ensure that individuals with co-occurring disorders
receive the treatment that they need. According to the report, failure
to treat both disorders almost assures an exacerbation of health problems.
If one of the co-occurring disorders goes untreated, both usually get
worse and additional complications arise.11
Child Welfare System
One of the greatest consequences of untreated substance
abuse is the impact on children. Current research indicates that 8.3 million
children in the United States, approximately 11 percent, live with at
least one parent who is in need of treatment for alcohol or drug dependence.12
Because the disease of addiction shows no bias, it impacts all social,
economic, and racial groups. Not surprisingly, the children most severely
affected are those from families without the cushion of financial and
emotional resources.13 These are our countrys most vulnerable
and at-risk children.
Many children impacted by substance abuse come to the
attention of the child welfare system.
Problems with alcohol and drug abuse are estimated to
exist in up to 80 percent of the families known to the child welfare system.14
In most cases, the parents substance abuse is a long-standing problem
of at least five years.15
Children whose families do not receive appropriate treatment
for alcohol and drug addiction are more likely to remain in foster care
longer and to reenter once they have returned home, and their siblings
are also more likely to end up in foster care.16 Moreover,
children of alcoholics and drug addicts are more likely to develop substance
abuse problems, and have higher rates of emotional, psychiatric, and social
functioning difficulties than children from families that do not abuse
alcohol and drugs.17
In addition, there are increasing rates of children
who have incarcerated parents. Estimates suggest that nearly 200,000 children
under the age of 18 have an imprisoned mother and more than 1.7 million
have an imprisoned father.18 This is one aspect of addiction
that is destroying families.
The presence of other factors such as a co-occurring
mental and substance use disorders complicates the recovery from addiction,
further jeopardizing the safety of the child and the possibility of being
reunified with their family of origin. Today, the multiple, complex problems
faced by parents who abuse substances and have co-occurring mental disorders
or co-existing conditions, such as physical or cognitive disabilities,
are likely to require intervention beyond what the child welfare system
can offer. It is essential that caseworkers have access to the services
of professionals who are able to evaluate addiction, mental, and other
complex problems and then provide appropriate treatment services.19
Evidence from various national studies suggests that
these families require access to a comprehensive array of services and
supports to achieve long-term abstinence. Some of these services include
access to housing, transportation, therapy (including family and trauma
recovery services), and childcare, to name a few.
One successful and cost-effective innovation in working
with families involved in the child welfare system that have alcohol and
drug issues is the use of Family Drug Treatment Courts that provide timely
and coordinated access to treatment and support services for families.
This coordination reduces the trauma that families experience when faced
with multiple systems, policies, and competing timelines.
Making a Difference: What Can I Do?
1. |
Address Needs of Families of the Addicted.
It is important to recognize that the children, spouses, siblings,
and/or parents of the addicted offender are frequently in need of
education and support and may require referrals that can help them
understand the recovery process and deal successfully with the situation.
Family members may need to be directed to social services and counseling
professionals to address multiple issues and problems, such as family
dynamics and communication in stressful relationships; childrens
attendance, performance, and behavior in school; or economic needs.
For example, the children of drug abusers are a high-risk group
and treatment for the parent becomes prevention for the child.
Unified family courts combine all the elements and
resources of traditional juvenile and family courts. Within the
court, families can access social services, dispute resolution assistance,
and counseling. Such systems can better address the needs of children
and families, and minimize the reliance on traditional court procedures,
often avoiding costly trials and other direct judicial intervention.20
|
2. |
Integrate and Utilize
All Available Services. In order to make the most efficient
use of limited resources, professionals in the child welfare and criminal
justice systems should work closely with substance abuse and mental
health treatment providers, funding agencies, counselors, local health
officials, social service organizations, state alcohol and drug agencies,
and others in the community to share information, workforce resources,
and recovery materials. Developing and cultivating partnerships can
extend a programs reach, impact, and credibility. Comprehensive
drug courts demonstrate this integration of services well, by forging
partnerships between public agencies, private groups, and community-based
treatment organizations and by generating local support for enhancement
of drug court program effectiveness. Forming such coalitions expands
the continuum of services available to drug court participants and
informs the community about drug court concepts.21 |
3. |
Focus on Prevention,
with Emphasis on Youth. In 1999, about 98,900 juveniles (9
percent of whom were drug offenders) were incarcerated in public or
private juvenile facilities for nonstatus offenses.22 Young
people with drug and alcohol problems often experience a variety of
accompanying problems, including academic difficulties, a decline
in their physical and mental health, ineffective communication and
poor relationships with their families and friends, social and economic
consequences, and delinquency. Identifying alcohol and drug-using
youth in the juvenile justice system is an important first step for
intervening in both their substance use and their delinquent behavior.23
By conducting a comprehensive assessment of a youth when he or she
first enters the justice system, criminal justice professionals can
help youth receive early intervention and treatment that will help
in their efforts to remain free from addiction. |
4. |
Highlight the Significance
of Co-occurring Disorders. It is important for criminal justice
professionals and child welfare caseworkers to become more informed
about the significant problem of co-occurring substance abuse and
mental disorders and the need for a comprehensive care system to address
this issue. Educating yourself and your colleagues about local programs
that employ treatment professionals trained extensively in both disorders
can help you make appropriate referrals for individuals you serve.
Recent research has shown that integrated treatment is superior to
sequential or parallel treatment. With integrated treatment, mental
health and substance abuse treatments are provided by the same clinician
or team of clinicians to ensure that the patient receives a coherent
prescription for treatment rather than a contradictory set of messages
from different providers.24 |
Making a Difference: How Can I Focus My Efforts
During Recovery Month?
Recovery Month
is observed each year in September to promote the importance and efficacy
of substance abuse treatment. This years theme is Join the Voices for Recovery: Celebrating Health.
This is a time for all individuals working in the child
welfare system and criminal justice system, including judges, attorneys,
correctional facility directors, police officers, probation and parole
officers, drug court professionals, and representatives of Federal and
state justice associations and agencies, to get involved. Recovery
Month is an ideal time to take steps to create awareness that treatment
is effective and recovery is possible for those suffering from addiction
and their families. Following are some things you can do to contribute
to this effort:
1. |
Make a Public Statement.
Express your opinion about the importance of substance abuse treatment
in the context of the criminal justice or child welfare system by
sending an op-ed article, a short written piece that appears opposite
the editorial page of a newspaper, to the editor of your local paper.
Include relevant statistics, persuasive examples, and/or a compelling
story of a local person in recovery to illustrate the effectiveness
of treatment programs. |
2. |
Get the Word Out Through
the Web. Promote your support for Recovery
Month through your organizations web site by posting
the Recovery Month logo on your
home page, as well as any relevant criminal justice-related statistics
or fact sheet information. Consider linking your site to some of the
web sites of national or local criminal justice or treatment organizations
listed in the resource section of this kit or in your own community. |
3. |
Form a Speakers Bureau.
Throughout the month of September, organize a small group of criminal
justice professionals to serve as guest speakers at schools, community
events, places of worship, businesses, civic group meetings, and other
venues to deliver clear messages about the link between drug and alcohol
abuse and crime and the need for effective treatment to help combat
addiction. |
4. |
Educate Internally.
Ensure that you and your colleagues know the most current facts about
addiction, its relationship to crime, and the benefits of treatment
by having a representative from a local treatment provider make a
presentation at your office. Becoming more knowledgeable about this
issue will help you to more effectively address the needs of those
you serve. In fact, a 1999 national drug court treatment survey indicated
a need for training and technical assistance among drug court employees
to improve engagement and retention of participants. It emphasized
the need for skills in motivational counseling to encourage clients
to remain in treatment and achieve a drug-free lifestyle, as well
as the importance of using approaches that are culturally relevant,
gender-specific, and include referrals to wraparound services, such
as job preparation, job placement, GED tutoring, childcare, and domestic
violence counseling.25 |
5. |
Support Community Efforts.
Collaborate with a local substance abuse treatment facility in your
community by volunteering time, money, and/or resources to further
their program. You may also consider collaborating with a treatment
organization on a Recovery Month
press event to raise public awareness about alcohol and drug abuse
addiction, treatment, and recovery. For example, reporters could be
invited to a press briefing honoring recent drug court graduates or
families reunited from the child welfare system (who agree to appear
publicly), as well as members of the drug court team and others who
have dedicated themselves to helping those in need of treatment. |
You are encouraged to share your plans and activities
for Recovery Month 2003 with SAMHSAs
Center for Substance Abuse Treatment, your colleagues, and the general
public by posting them on the official Recovery
Month web site at http://www.recoverymonth.gov.
We would like to know about your efforts during Recovery
Month. Please complete
the Customer
Satisfaction Form enclosed in the kit. Directions are included on the form.
For any additional Recovery
Month materials visit our web site at
http://www.recoverymonth.gov or call 1-800-729-6686.
Additional Resources
Federal Agencies |
|
|
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
200 Independence Avenue, SW
Washington, DC 20201
877-696-6775 (Toll-Free)
www.hhs.gov
HHS, Substance Abuse and Mental Health Services Administration
(SAMHSA)
5600 Fishers Lane
Parklawn Building, Suite 13C-05
Rockville, MD 20857
301-443-8956
www.samhsa.gov
HHS, SAMHSA
National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847-2345
800-729-6686 (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
www.ncadi.samhsa.gov
HHS, SAMHSA
National Directory of Drug Abuse and Alcoholism Treatment Programs
www.findtreatment.samhsa.gov
SAMHSA National Helpline
800-662-HELP (800-662-4357) (Toll-Free)
800-487-4889 (TDD) (Toll-Free)
877-767-8432 (Spanish) (Toll-Free)
(for confidential information on substance abuse treatment and referral)
www.findtreatment.samhsa.gov
HHS, SAMHSA
Center for Substance Abuse Treatment
5600 Fishers Lane
Rockwall II
Rockville, MD 20857
301-443-5052
www.samhsa.gov
HHS, SAMHSA
Center for Mental Health Services
5600 Fishers Lane
Parklawn Building, Room 17-99
Rockville, MD 20857
301-443-2792
www.samhsa.gov
|
|
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
National Institutes of Health (NIH)
9000 Rockville Pike
Bethesda, MD 20892
301-496-4000
www.nih.gov
HHS, NIH
National Institute on Alcohol Abuse and Alcoholism
Willco Building
6000 Executive Boulevard
Bethesda, MD 20892-7003
301-443-3860
www.niaaa.nih.gov
HHS, NIH
National Institute on Drug Abuse
Office of Science Policy and Communication
6001 Executive Boulevard
Room 5213 MSC 9561
Bethesda, MD 20892-9561
301-443-1124
Telefax fact sheets: 888-NIH-NIDA (Voice)
(Toll-Free) or 888-TTY-NIDA (TTY)
(Toll-Free)
www.drugabuse.gov
U.S. DEPARTMENT OF JUSTICE (DOJ)
810 7th Street, NW
Washington, DC 20531
202-514-6278
www.usdoj.gov
DOJ, National Institute of Justice
810 7th Street, NW, 7th Floor
Washington, DC 20531
202-307-2942
www.ojp.usdoj.gov/nij
DOJ, Office of Juvenile Justice and Delinquency Prevention
810 7th Street, NW
Washington, DC 20531
202-307-5911
www.ojjdp.ncjrs.org
|
|
|
|
Other Resources |
|
|
Al-Anon/Alateen
For Families and Friends of Alcoholics
Al-Anon Family Group Headquarters, Inc.
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
888-4AL-ANON/888-425-2666 (Toll-Free)
www.al-anon.alateen.org
Alcoholics Anonymous
475 Riverside Drive, 11th Floor
New York, NY 10115
212-870-3400
www.aa.org
American Bar Association
Standing Committee on Substance Abuse
740 15th Street, NW
Washington, DC 20005
202-662-1784
www.abanet.org
Association of Black Psychologists
P.O. Box 55999
Washington, DC 20040-5999
202-722-0808
www.abpsi.org
Black Administrators in Child Welfare, Inc.
440 First Street, NW, Third Floor
Washington, DC 20001
202-662-4284
www.blackadministrators.org
Center on Juvenile and Criminal Justice
1622 Folsom Street, 2nd Floor
San Francisco, CA 94103
415-621-5661
www.cjcj.org
Child Welfare League of America
440 1st Street, NW, 3rd Floor
Washington, DC 20001
202-638-2952
www.cwla.org
Federation of Families for Childrens Mental Health
1101 King Street, Suite 420
Alexandria, VA 22314
703-684-7710
www.ffcmh.org
Join Together
One Appleton Street, 4th Floor
Boston, MA 02116-5223
617-437-1500
www.jointogether.org
|
|
Mothers Against Drunk Driving
1025 Connecticut Avenue, NW, Suite 1200
Washington, DC 20036
202-974-2497
www.madd.org
National Association of Drug Court Professionals
4900 Seminary Road, Suite 320
Alexandria, VA 22311
703-575-9400
www.nadcp.org
National Center on Addiction and Substance Abuse at Columbia University
(CASA)
633 3rd Avenue, 19th Floor
New York, NY 10017
212-841-5200
www.casacolumbia.org
National Council of Juvenile and Family Court Judges
University of Nevada
1041 N. Virginia Street, 3rd Floor
Reno, NV 89557
775-784-6012
www.ncjfcj.unr.edu
National Criminal Justice Reference Service
P.O. Box 6000
Rockville, MD 20849-6000
800-851-3420 (Toll-Free)
301-519-5500
www.ncjrs.org
National Indian Child Welfare Association
5100 SW Macadam Avenue, Suite 300
Portland, OR 97239
503-222-4044
www.nicwa.org
National Mental Health Association
2001 North Beauregard Street, 12th Floor
Alexandria, VA 22311
703-684-7722
800-969-6642
www.nmha.org
National TASC (Treatment Accountability
for Safer Communities)
2204 Mount Vernon Avenue, Suite 200
Alexandria,VA 22301
703-836-8272
www.nationaltasc.org
Physician Leadership on National Drug Policy
PLNDP National Project Office
Center for Alcohol and Addiction Studies
Brown University
Box G-BH
Providence, RI 02912
401-444-1817
www.plndp.org
|
Sources
1 |
Trends
in Substance Abuse and Treatment Needs among Inmates, Final
Reports. Washington, DC: U.S. Department of Justice, 2002. |
2 |
Drug
Treatment in the Criminal Justice System. Drug Policy Information
Clearinghouse Fact Sheet. Office of National Drug Control Policy,
White House Executive Office, March 2001. |
3 |
Lurigio, Arthur J. Drug treatment
availability and effectiveness. Criminal
Justice and Behavior 27 (4), August 2000. |
4 |
Substance Abuse in Brief. Treatment
Succeeds in Fighting Crime. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, Center for Substance Abuse Treatment, December 1999. |
5 |
The
National Treatment Improvement Evaluation Study (NTIES):
Highlights. DHHS Publication No. (SMA) 97-3159. Rockville, MD:
U.S. Department of Health and Human Services, Substance Abuse and
Mental Health Services Administration, Center for Substance Abuse
Treatment, Office of Evaluation, Scientific Analysis and Synthesis,
1997. |
6 |
Wexler, H.K., Melnick, G., Lowe,
L., and Peters, J. 3-Year Reincarceration Outcomes for Amity In-Prison
Therapeutic Community and Aftercare in California. Center for Therapeutic
Community Research at the National Development and Research Institutes,
Inc. The Prison Journal 79(3), 321-336,
1999. |
7 |
Ditton, P. Mental
Health and Treatment of Inmates and Probationers. U.S. Department
of Justice, Bureau of Justice Statistics, 1999. |
8 |
Treatment
Services in Adult Drug Courts: Report on the 1999 National Drug Court
Treatment Survey. Washington, DC: U.S. Department of Justice,
Office of Justice Programs, Drug Courts Program Office, May 2001. |
9 |
ibid. |
10 |
McBride, D., VanderWaal, C.,
VanBuren, H., and Terry, Y. Breaking the
Cycle of Drug Use Among Juvenile Offenders. Manuscript prepared
for the National Institute of Justice, 1997. |
11 |
Report
to Congress on the Prevention and Treatment of Co-occurring Substance
Abuse Disorders and Mental Disorders. Rockville, MD: U.S. Department
of Health and Human Services, Substance Abuse and Mental Health Services
Administration, 2002. |
12 |
You
Can Help: A Guide for Caring Adults Working with Young People Experiencing
Addiction in the Family. DHHS Publication No. (SMA) 01-3544,
U.S. Department of Health and Human Services, Substance Abuse and
Mental Health Services Administration, Center for Substance Abuse
Treatment, 2001. |
13 |
Young, N. K., Wingfield, K.,
and Klempner, T. Child Welfare; Journal
of Policy, Practice, and Program. Child Welfare League of America,
Vol. LXXX, #2, March/April 2001. |
14 |
Young, N. K., Gardner, S. L.,
and Dennis, K. Responding to alcohol and
other drug problems in child welfare: Weaving together practice and
policy. Washington, DC: Child Welfare League of America, 1998. |
15 |
Blending
Perspectives and Building Common Ground: A Report to Congress on Substance
Abuse and Child Protection. Washington, DC: U.S. Department
of Health and Human Services, 1999. |
16 |
ibid. |
17 |
Kumpfer, K. L. Outcome measures
of interventions in the study of children of substance-abusing parents.
Pediatrics, 103 (5), 11281144,
1999. |
18 |
Gilliard and Mumola. Prisoners
in 1998. Bureau of Justice Statistics Bulletin. Washington,
DC: U.S. Department of Justice, Bureau of Justice Statistics, August
1999. |
19 |
ibid. |
20 |
Cutting
Crime: Drug Courts in Action, Washington, DC: Drug Strategies,
1997. |
21 |
Defining
Drug Courts: The Key Components. Washington, DC: National Association
of Drug Court Professionals and Drug Courts. U.S. Department of Justice,
Office of Justice Programs, January 1997. |
22 |
Drug Treatment in the Criminal
Justice System. |
23 |
Drug
Identification and Testing in the Juvenile Justice System.
Washington, DC: U.S. Department of Justice, Office of Justice Programs,
Office of Juvenile Justice and Delinquency Prevention, May 1998. |
24 |
McBride, D. et al. |
25 |
Treatment Services in Adult
Drug Courts: Report on the 1999 National Drug Court Treatment Survey. |
The proudest voices of recovery belong to the people
who live it every day and the people who support them. These inspirational
Americans are at the heart of this years National
Alcohol and Drug Addiction Recovery Month (Recovery Month) theme,
Join the Voices for Recovery: Celebrating
Health. Each day these individuals find strength in the positive
way they have reclaimed their lives, and in the positive messages they
deliver to others. Read on for their unique stories. Share these experiences
with others who are on the road to recovery, and encourage them to share
their success stories as well. Your encouragement can empower them to
raise their own voices and inspire even more people to celebrate health
and recovery.
I
am a grateful recovering alcoholic, and every day I do healthy,
positive things so I wont take another drink. My own experience
has led me to work to combat the number one public health issue
facing our country: chemical addiction. Expanding access to treatment
is a matter of life and death for 26 million Americans.
|
Jim Ramstad,
U.S. House of Representatives, Minnesotas
3rd District |
|
I
am a public advocate because a CEO of a very large educational organization
withdrew the offer of employment after we talked about my recovery.
Ill never forget the moment he said, How could you ever
begin to think we would want someone like you to represent us?"
|
Susan Rook,
Director, Communications and Outreach,
Faces and Voices of Recovery |
|
Weve had people with breast cancer
and no one would ever suggest to us, while theyre going through
chemo, You should just get rid of them. To say that
about alcoholism or an abuse situation makes no sense to us. We
can be a voice in the community and say, Its time to
step up to the plate and do something."
|
Diane Crookham-Johnson,
Vice President of Administration, Musco
Lighting |
|
Father
Vaughan Quinn, who ran the Sacred Heart Rehabilitation Center in
Detroit, and I talked for three hours. The conversation was frank.
I put my life on the table. All the loneliness, the depression,
the anger, frustration with people and jobs, thoughts of suicide
and fears. Quinn listened to all of it without interruption. Finally
it was his turn. There was no hesitation. He said it quietly but
forcefully: The problem in your life is alcohol.
He was right. Father Quinn [then] told me about a group of non-drinking
alcoholic friends he wanted me to meet. They were the ones who helped
me quit drinking. I couldnt do it on my own.
From The Courage to Change: Personal
Conversations About Alcoholism by Dennis Wholey
|
Dennis Wholey,
TV interviewer, Host of This is
America! |
|
I used to be terrified of passing through
the beer and wine aisle to get to the milk section of the supermarket.
Im an alcoholic and a drug addict, you see. My addiction also
came with a criminal record. I had gone from a comfortable life
in New England to a Federal prison in West Virginia for conspiracy
to import cocaine. I got out, discovered crack, and continued my
downward spiral. Eventually, through the support of friends, family,
and others suffering with addiction, I was able to get clean. But
I still had this nagging shame. Then, about eight years into my
recovery, I decided to produce an autobiographical documentary about
my recovery process. It aired in early 2002 on ABCs Nightline.
Addiction is a serious problem that we live with amid temptation
every day. But I have found that my management and openness about
it is a source of pride. And that takes the fear out of getting
milk every week.
|
Peter Nicks,
Producer/Director |
|
I
got kicked out of pharmacy school twice due to a full-blown cocaine
addictionthe school [called it] academic difficulty.
I call it the conspiracy of silence. People dont know where
to turn when [addiction] happens. There isnt a lot of discussion
about what to do and where to go.
|
David Marley,
Executive Director of the NC Pharmacists
Recovery Network |
|
I never felt comfortable in my own skin.
I only felt lovable when I excelled at school or sports. By the
time I was 12, I was drinking and smoking pot every day. I progressed
to cocaine and heroin. By 15, I knew I used differently than others;
ashamed, I knew I was an addict. At 29, my sister and my employer
intervened. Already demoralized, it wasnt a struggle to get
me to an inpatient residential treatment center. My insurance did
not cover my treatment. I am grateful that I had loved ones who
could. I stayed clean for six years. My relationships with my family,
my employer and my past were healed. I made new friends who were
living a recovery lifestyle, and I became a vice president of a
lobbying firm in Washington, DC. My life was flourishing, except
in the area of intimate relationships. After a particularly painful
breakup, I relapsed and went back to treatment. Ive been clean
five years, am happily married, and have helped found a new government
relations firm in Washington, DCone of the few focusing on
addiction and recovery issues. I am grateful that I had two shots
at treatment and that my relapse gave me the gift of learning to
be vigilant about protecting and sustaining my recovery.
|
Carol McDaid,
Principal, Capitol Decisions |
|
When
I was 12, I experimented with inhalants for the first time. A year
later, I was smoking marijuana on a regular basis. Over the next
four years I abused even more serious drugs. I depended on them
to make it through the day, but didnt have the power to stop.
I feared I would never get clean if I didnt get help from
my parents and a residential treatment program. My parents sent
me to the Caron Foundation. I went through the four-week primary
care program and, luckily, the six-week extended care program. I
say luckily because my parents insurance company
only covered my first 19 days. But if I had gone home then, I wouldve
never stayed clean. The Caron Foundation let me stay free for 10
days while my parents gathered money from my family. After treatment,
I returned to society and changed my lifestyle. I started hanging
out with people who were better for me, and going to places that
would not harm my recovery. I will be celebrating five years clean
and sober in March 2003, and I owe it all to God and the Caron Foundation.
Treatment works and saves lives.
|
Tim Bradley,
Uturn Director/Founder |
|
My last day [using], I worked 12 hours and
came home to cops opening the door for me. I was taken to jail.
I cried for days and days, [and] admitted that I was an addict.
[The judge] said his conscience would not allow him to find me guilty.
Today, I work for alcohol and drug services in the jail. I was destined
to be there. Today, I give back.
|
Shireda Prince,
President, Substance Abuse Addiction and
Recovery Alliance of Northern Virginia |
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I
have been public about my addiction and recovery for almost a year.
Im still amazed by the reaction. Often the response is shock
and bewilderment. These reactions result from societys stereotype
of alcoholics and addicts, but I am neither a drunk on the
corner, nor a social or academic failure. I have dreams for
the future.
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My son is five years old. A couple of months
ago, some friends were over and I had a [soda] can in my hand. One
of my friends said to my son, Look, your dad has a beer in
his hand. And my five-year-old said, No, my dad doesnt
drink. He teaches people not to. Ive had three car crashes
and by the grace of God, I never ran into anybody. I got four DUIs
in about four years. The end result was a Class D felony that resulted
in a five-year prison sentence. The lawyer worked out a deal to
get me into treatment in the department of corrections. Now Im
in a masters program in clinical psychology, and things are
unbelievable. I cant even tell you how I got here or how this
is happening. [I went] from a scared, shamed, beat-down little boy
to a flourishing adult, and all because of recovery.
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Darrell Williams,
Prevention Specialist |
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Id
been a heroin addict for years. My first days of awakening were
walking into a faith-based community organization [Teen Challenge
International]. I graduated in 1974. [Since then,] Ive walked
the excellence that I know is there to be walked. The man Ive
been now for 29 years is who I am.
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Henry Lozano,
White House Advisor on Substance Abuse
and Addiction |
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I was 18 years old when I hit bottom. I
[was] on the run from [drug dealers], on the run from the police,
and on the run to get high. The only person I could turn to was
my probation officer. He took me to a treatment center and since
that day Ive been clean. I was that kid that everybody said
wouldnt live to see age 21. I was the kid that society had
practically given up on, but the recovery community embraced me.
I went back to school, got my bachelors, my masters,
and Im planning to start a Ph.D. program. The freedom that
staying clean has given me [has] allowed me to travel, meet people,
and go places. Its just a beautiful feeling. Thats enough
to keep me on this road of recovery.
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Andre Johnson,
Project Officer, Partnership for Drug-Free
Detroit |
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I
was over 40 years old when I first got out of treatment and had
control of my life. I went from riding a city bus and walking the
streets to having two vehicles, a camper and a Harley. It is amazing.
I have a relationship with my daughter. She hadnt acknowledged
that I was her father since she was 11. But we have a real close
relationship now. For her to give me a hug, tell me she loves me,
and call me Dad means a lot. When I went through treatment,
I was an older person. Kids, when they go through it, have to give
up people they have grown up with and people they still go to school
with. That has got to be extremely hard. But recovery works if you
work at it. The main thing is the desire. If you have the desire
and the willpower, you can do it. Ive been in solid recovery
for about four years.
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Dwight Johnson,
Truck Driver |
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I got into cocaine and acid by the time
I was in high school, and I smoked a quarter ounce of pot a day.
I got into a lot of illegal activities. I graduated, got introduced
to crystal methamphetamine, [and] within two years was incarcerated.
I was in prison for a year-and-a-half, got out, continued with my
criminal lifestyle, [and] was again sent to prison, sentenced to
serve four years. On Christmas, 1997, a man in his sixties asked
me for a cigarette. I realized that if I continued the life I was
living, I would end up old, alone and incarcerated for the rest
of my life. From that day on, I stayed clean and sober. I got released
from prison on September 1, 1999, [and] am now involved in a lot
of positive things. My friends and I formed a group called Wai'anae
Men in Recovery. We dedicate our time to sharing our experiences
with drugs and crimes and the pain and consequences. I am proud
that I have friends that care for me. I would not be able to do
this alone. It is only through God and the people in my life that
I look forward to experiencing the fruits of life.
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Willie Leong,
Assistant Chef/Su Chef |
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I am a recovering alcoholic and drug addict.
I am also quadriplegic. When I wanted treatment, I called 32 treatment
programs. Not one could handle my personal care needs. Through an
anonymous recovery program, a great sponsor, and good friends, Im
now in recovery. But I had no help from the county or state. The
Americans with Disabilities Act is over 11 years old, but theres
virtually no compliance with this law when it comes to treatment.
Clearly, people with disabilities need access to high-quality drug
and alcohol treatment, just like everyone else.
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Steven A. Towle,
Washington Liaison, National Association
on Alcohol, Drugs and Disability, Inc. |
|
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Alcoholism has affected my life in many
ways. I grew up with two active alcoholics. I married and divorced
an unrecovered ACOA (Adult Child of an Alcoholic). I remarried,
this time to a now-recovering alcoholic. I was challenged to focus
on recovery, and break the cycle for my children, my grandchildren,
and myself. In doing so, I contributed to my dear husbands
recovery in a significant way. I have been to private counseling,
attended and facilitated ACOA groups, participated in an in-depth
12-step program for ACOAs, and now volunteer as a facilitator for
a family member program offered by a local treatment center. My
daughters have benefited from this program, and I believe in my
heart that due to their knowledge and our now healthy home environment,
they will not continue the cycle. I truly believe in the power of
recovery programs for all family membersfor their own healing
and growth, as well as a powerful aid for the recovering addict
in their lives.
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Kathryn Fitzpatrick,
Information Technology Executive |
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Alcoholism
is a painful disease for those who have it, as well as those who
love them. As I learned about it through a childrens support
group program offered by a local treatment center, I discovered
it is a diseasebut one for which recovery is possible, although
it is very tough. It requires all the energy and effort the person
has. I have watched how it affected my mom. She had a very tough
upbringing with both parents being alcoholics, then marrying an
alcoholic. But instead of having a negative outlook, my mom found
strength and continued to focus on her recovery from being the child
of alcoholics. I look up to no one more than my mom and stepdad.
They have been able to provide a healthy and happy environment for
our family, and I know I will do the same for my own family in the
future.
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I
was using marijuana before I was out of elementary school. By 19,
I started getting into heavier drugs like heroin and cocaine. When
I was 25, my son came up to me and said, You know Dad, Im
almost five years old. I looked at him and it hit me: I dont
even know this boy. It broke my heart, and I thought about committing
suicide. My grandmas teachings saved me because I didnt
think Id be going to heaven if I did. That night, I went to
a meeting for the first time. That was the start of a rocky recovery.
I was still working in the oil fields, which didnt promote
my recovery. So I resigned and started working as a janitor and,
later, as a night monitor in a treatment center. After awhile I
started working with clients. I enjoyed this work and felt I had
a lot to offer since I had been there myself. Within a year, I was
a substance abuse counselor. But soon after, I relapsed. Fortunately,
my boss didnt give up on me. Instead, he said, Victor,
I dont need you to quit. I need you to straighten up and get
back to work. That is what I did. Since then, I have been
sober for over 14 years and have won the 2001 Robert Wood Johnson
Community Health Leadership Award. The award was given to me for
developing a unique substance abuse treatment program that serves
Alaskan Native Families who live in rural Alaskan areas only accessible
by plane, boat, or snowmachine. But the best award I've received
is my sobriety. For that I need to thank the Lord and the clients
I have worked with over the years. The old saying is very true: When you help someone it helps you. Im not a saint. I just
think Im doing what Im supposed to be doing. This is
my path.
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Victor Joseph,
Director, Old Minto Family Recovery Camp
Program, Tanana Chiefs Conference |
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