ONDCP Blog

A Visit to Haven for Hope

Today, I visited San Antonio, Texas, to discuss the Obama Administration’s emphasis on treatment and prevention as part of national efforts to reduce drug use and its consequences.  During my stay, I stopped by Haven for Hope– a non-profit organization dedicated to transforming the lives of homeless men, women, and children by addressing the root causes of homelessness through education, job training, and behavioral health services.

As the Nation’s largest campus of its kind, Haven for Hope provides the care and resources that homeless Americans need to overcome substance abuse. I had the honor of touring the campus and discussing Haven for Hope’s success in helping substance users recover from the ravages of addiction.

The important work done at Haven for Hope underscores that we must treat America’s drug problem as a public health issue, not just a criminal justice one. Haven for Hope is a shining example of why it’s important to take this approach and to recognize that recovery is essential to tackling the country’s drug problem. Too many people suffering from addiction aren’t able to receive adequate treatment, so it’s refreshing to see programs and facilities focused on increasing access to treatment for people who need it most.

The 2012 National Drug Control Strategymarked a significant shift in the way we approach the drug problem, with an emphasis on treatment and recovery. To support this shift, the Obama Administration has committed more than $10 billion in FY 2012 for drug education programs and support for expanding access to drug treatment for people suffering from substance use disorders. As we move to put these plans into action and prepare the next Strategy, I look forward to working alongside Haven for Hope and other admirable organizations that are helping those burdened with substance use problems get the care and support they need.

Veterans Treatment Courts: Providing Our Nation's Heroes the Support They Have Earned

Note: This post originally appeared on The Huffington Post.

The Obama Administration is committed to the health and well-being of our armed forces, including support for the physical and mental health needs of service members and their families. This ongoing commitment is part of the Administration's "Joining Forces" initiative, a national effort to mobilize all sectors of society to give our active-duty service members, veterans and their families the opportunities and support they have earned.

An important component of this effort is our work to support the military men and women returning from duty overseas who are suffering from substance use disorders. Too often, when left untreated, these veterans end up in the criminal justice system. But there is hope. In a growing number of communities across America, veterans with substance use disorders who also face a criminal charge are able to participate in Veterans Treatment Courts. With help from the Veterans Administration and local veterans organizations, these specialized courts respond to the needs of former soldiers by diverting offenders into treatment instead of incarceration and providing the social services they need. The first Veterans Treatment Court was launched in January 2008 in Buffalo, New York. Today there are over 95Veterans Treatment Courts in the United States, and another 200 are planned.

Today in Nashville, Tennessee, I had the honor of speaking with veterans and advocates about Federal, local, and community efforts to help them by supporting these types of courts. Joining me were Mike Jones, a participant in the Orange County Combat Veterans Court, and Nick Stefanovic, a graduate of the Rochester Veterans Treatment Court. These two young men told us of the difficulties they faced coming home and how their participation in a Veterans Treatment Court helped them become productive members of their communities again.

In April, the Obama Administration released the 2012 National Drug Control Strategy, the government's primary blueprint for drug policy in the United States. The Strategy rejects a law-enforcement-only approach to drug policy, instead setting a course that relies on evidence-based solutions and views substance use as a public health issue, not just a criminal justice issue. Specifically, the new Strategy is guided by three facts: addiction is a disease that can be prevented and treated; people with substance use disorders can recover; and innovative new criminal justice reforms can stop the revolving door of drug use, crime, incarceration, and re-arrest.

In keeping with this new "third way" direction in drug policy, the Administration strongly supports substance use prevention, treatment, and recovery services, as well as alternatives to incarceration for veterans and other offenders with drug-use problems. There is no better example of a viable alternative to incarceration than Veterans Treatment Courts, which exemplify the Administration's balanced, 21st century approach to drug policy.

To read more about Veterans Treatment Courts, visit JusticeforVets.org.

Guest Post: Small Business at Work to Improve Treatment & Recovery Services

During Small Business Week, we are highlighting a few examples of small businesses working in prevention, treatment or recovery.  Today’s guest blog post comes from the Co-Deputy Directors of NIATx, an organization that helps lower costs and improve effectiveness in the field of mental health care. For more information about Small Business Week, please visit www.nationalsmallbusinessweek.com, and join in the conversation on Twitter using the hashtag #sbw2012.

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Small Business at Work to Improve Treatment & Recovery Services
By: Kim Johnson, MBA, and Todd Molfender, Ph.D, Co-Deputy Directors at NIATx

Kim Johnson, MBA, and Todd Molfender, Ph.D, are Co-Deputy Directors at NIATx (formerly the acronym for the Network for the Improvement of Treatment), a part of the University of Wisconsin-Madison’s Center for Heath Enhancement Systems Studies (CHESS).

The business model for substance abuse prevention and treatment is undergoing a sea change. Prevention has transitioned from a sole focus on school-aged children to a lifespan view that involves community engagement and policy-level initiatives. Treatment is evolving from primarily a grant-funded service to part of the specialty care system within the health care infrastructure.

What do these changes mean for the future of organizations that treat substance use disorders?  First and foremost, we need to think about customer service. Who are our customers, and how do we meet their changing needs and demands?  Second, we must become more efficient.  Fading fast are cost-based contracting systems that encourage increasing costs and reducing units of service. No more can clinical effectiveness and business efficiencies be considered separate and apart.
 
NIATx is part of the University of Wisconsin-Madison’s Center for Health Enhancement Systems Studies.  We are dedicated to making improvements to the cost and effectiveness of the substance use disorder care delivery system while helping remove barriers to treatment and recovery. At the heart of our work is the research-based NIATx model of process improvement designed specifically for behavioral health care settings to improve access and retention.  Through the NIATx Learning Collaborative, members share innovative ideas with each other via learning sessions, interest circles, and coaching sessions.

Having worked with over 3,000 prevention and treatment organizations, we have learned that efficiency and customer service are actually two sides of the same coin. Addiction treatment providers should offer appropriate medications and effective behavioral interventions, along with ongoing support. As with other chronic diseases, substance abuse treatment should involve addressing acute episodes of illness and providing ongoing monitoring and support.

Substance abuse treatment providers need to develop and improve their billing systems by building the capacity to contract with payers, bill insurers, and Medicaid for services. They should measure and publish outcomes that are of interest to all of their customers—patients, family members, payers, and regulators. These include process measures like wait times and treatment retention rates as well as outcome measures such as reduced use and increased compliance with treatment protocols.

Outcome measures are equally important for prevention service providers.  Companies unable to hire enough job applicants who can pass their drug tests are interested in supporting prevention activities.  The Strategic Prevention Framework developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) consists of identifying goals and measuring outcomes. Prevention activities will be judged by their ability to influence change at the population level. It is essential for prevention and treatment providers to learn about emerging technologies. In addition to ONDCP, SAMHSA, and the National Institute on Drug Abuse are excellent sources to learn of potential changes years before they begin to affect practice.

We live in an exciting time for substance abuse prevention and treatment. The transition presents great opportunities, but organizations will need to rethink all aspects of their business model to thrive in an evolving environment.

Study: more than half of adult male arrestees test positive for at least one drug

This blog post was originally published on The Huffington Post. 

One month ago today, we released the Obama Administration’s 2012 National Drug Control Strategy, a drug policy grounded in sound research from the world’s preeminent drug abuse researchers.  This policy marks a departure from the debate I’ve seen develop during the past few years, which has lurched between two extreme views. On one side are those who suggest that drug legalization is the “silver bullet” solution to our nation’s drug problem.  On the other are those who still believe that the “War on Drugs,” law-enforcement-only strategy is the way forward. Our policies reject both these extremes in favor of a “third way” to approach drug control.

The foundation of this “third way” approach is peer-reviewed, scientific research that provides us insight into the disease of addiction and a roadmap on how to prevent and treat it. The “third way” approach deals in facts—not dogma—and relies on research—not ideology.

Here are what the facts show.  Drug use and related crime strain the resources of this country.  The latest evidence comes from the 2011 Arrestee Drug Abuse Monitoring Annual Report (ADAM II), released today, which tests for drugs in adult males arrested for a wide variety of crimes in 10 sites across the country. This study found a majority of adult males arrested for crimes tested positive for an illegal drug at the time of their arrest.  In fact, positive drug tests among arrestees ranged from 64 percent in Atlanta, GA, to 81 percent in Sacramento, CA.

These data were obtained from individuals booked for all types of crimes, from misdemeanors to felonies, and not just those arrested on drug charges.  The ADAM program tests only for drugs marijuana, cocaine, opiates (including heroin and prescription pain relievers), amphetamines/methamphetamine, Darvon, PCP, benzodiazepines, methadone, and barbiturates—not alcohol. 

This report highlights the urgent need for institutions at the federal, state, and local level to come together to support proven reforms that work to break the vicious cycle of drug use, crime, incarceration and re-arrest.  It’s a cycle my colleagues and I are committed to breaking because we care about the health and safety of our fellow citizens, our healthcare system, and our economy.

Too often, the caustic debate over drug policy in America leaves out some revolutionary and innovative programs taking hold in communities across America. I was pleased to see the Wall Street Journal recently brought attention to some of these programs in an essay by drug policy experts, who argued that there is no quick fix to the complex issue of drug abuse and addiction. These experts pointed to the success of programs such as Drug Market Interventions, which close down open-air drug markets through community-based strategies and offer drug offenders a second chance. Other successful initiatives like Hawaii’s Project Hope probation program, which dramatically reduces probation violations through swift, predictable sanctions, represent the future of a progressive drug control strategy. These programs are part of the President’s drug policy Strategy because they have demonstrated records of success not only in dissipating criminal activity, but in actively building community and reducing incarceration rates.

Although today’s data show a high rate of arrestees testing positive for illicit drugs, over the long term, we are actually seeing declines in drug use rates among the general population.  Over the past 30 years, the overall rate of current drug use in America has dropped by roughly one third. And more recently, the rates of current cocaine and meth use have dropped by 40 percent and 52 percent, respectively, and the number of cocaine overdoses has dropped by 42 percent. 

The 2011 ADAM II findings are clear evidence of the link between drugs and crime. Too often, underlying substance use disorders are the driving force behind criminal activity. It is imperative, then, that we address our nation’s drug problem not just as a criminal justice issue but as a public health issue. We cannot arrest our way out of the drug problem. What we need are evidence-based reforms that break the cycle of drug use and crime, reduce recidivism, and make our communities healthier and safer.

To read the ADAM II report, see an at-a-glance fact sheet on the findings, or view an interactive map reflecting the data by geographic region or drug type, please visit this page on our website.