SAMHSA continued

What You Should Know as a
Substance Use Disorder
DC Impact Statement
What goes on in Washington, DC as it
relates to substance use disorder and the
workforce often trickles down to every state
and impacts what and how you provide
treatment and prevention services.
Knowing who the federal partners are and
issues they are addressing can provide
much needed background to why certain
decisions are made in states and local
Workforce Characteristics
• White, female, over age 45
• 29% of direct staff is in recovery
• 36% master’s degree; 24% bachelor’s
• Median annual wage/2012 = $38,520
• DOL expects a 31% growth for substance
use disorder counselors between 20122022
Workforce continued
• 2012 – total workforce 89,600
• 2022 – total workforce needed 117,700
• Younger professionals from diverse
racial/ethnic backgrounds are needed
Top 10 List
• Based on the DOL expected growth for
SUD counselors, another study captured
the 10 best states to work or live in for
SUD counselors
• Ranked on average income; projected
employment growth; cost of living; alcohol
use rates; illicit drug use rates; and
substance abuse related arrest stats
Best States Are:
1. Colorado
2. Nevada
3. Montana
4. Minnesota
5. Iowa
6. Idaho
7. Wisconsin
8. New Hampshire
9. Wyoming
Sorry Oklahoma – you did not make
the Top 10 list!!!
Federal Partners
• Who are they and what do they do?
SAMHSA – US Department of Health & Human
Services Substance Abuse and Mental Health
Services Administration
• SAMHSA's mission is to reduce the impact of
substance abuse and mental illness on
America's communities
• In existence since 1992; headquarters in
Rockville, MD
• SAMHSA four Centers include: Center for
Behavioral Health Statistics and Quality; Center
for Mental Health Services; Center for
Substance Abuse Prevention; Center for
Substance Abuse Treatment
SAMHSA continued
• 10 regional centers in the US
• 7 advisory councils: national issues;
mental health services; substance abuse
prevention; substance abuse treatment;
women’s services; drug testing; and tribal
• Budget supports programs to reduce the
impact of substance abuse and mental
illness in US communities = $3.6 billion
SAMHSA continued
• 2015-2018 six Strategic Initiatives include:
Prevention of Substance Abuse and
Mental Illness; Health Care and Health
Systems Integration; Trauma and Justice;
Recovery Support; Health Information
Technology; and Workforce
• SAMHSA’s budget fully funds the
prevention and treatment Block Grant
funneled down to states
SAMHSA continued
• Prevention budget covers the Strategic
Prevention Framework and all other
programs of regional and national
SAMHSA continued
• Treatment budget covers criminal justice
activities; minority AIDS; SBIRT; primary
care and addiction services integration;
health information technology; ATTCs;
STAR (business operation practices); and
all other programs of regional and national
Strategic Initiative on Workforce
Development: Goals
• Develop/disseminate workforce training &
education tools and core competencies to
address behavioral health issues
• Develop & support deployment of peer
practitioners in all public health & health
care delivery settings
Goals continued
• Develop consistent data collection
methods to identify & track behavioral
health workforce needs
• Influence & support funding for the
behavioral health workforce
What concerns SAMHSA
about workforce?
• Shortages in the workforce
• Retention/recruitment efforts
• Serving diverse populations with
a workforce that matches these
diverse populations
• Advancement of evidence-based
SAMHSA continued
• August 2014 SAMHSA created the Office
of Tribal Affairs & Policy
• Primary contact for tribal governments,
tribal organizations, federal departments
and agencies and other governments and
agencies on behavioral health issues
facing American Indian and Alaskan
Native populations
SAMHSA Resources
TIPS and TAPS available free of charge
(Treatment Improvement Protocol)
(Technical Assistance Publication)
Webinars & Listening Sessions
Reports & National Surveys
Grants, Data, TA
The problem with funding
• Funding initiatives are great but are often
not refunded
• Funding for special projects needs to be
sustained by the receiver of the funding
which is often not occurring
• Funding comes and goes depending on
what the climate is/issues are in DC
• SAMHSA-HRSA Center for Integrated
Health Solutions
• Workforce development is essential to
integrated care. Resources are organized
in six categories that capture the essential
components of this unique labor force.
They are: Recruitment/Retention;
Education/Training; Supervision;
Partnerships; Leadership; Team Members.
• Who is HRSA? Health Resources & Services
Administration under HHS
• HRSA is the primary Federal agency for
improving access to health care by
strengthening the health care workforce, building
healthy communities and achieving health
equity. HRSA’s programs provide health care to
people who are geographically isolated,
economically or medically vulnerable.
• HRSA also supports the training of health
professionals, the distribution of providers
to areas where they are needed most and
improvements in health care delivery.
• DATA driven – Loans & Scholarships for
workforce – Grants for health care
• MDS – collecting data on all professionals
that touch substance use disorder
ONDCP – Office of National Drug
Control Policy
• Executive Office of The President within
The White House
• Director Michael Botticelli (MA) former
SSA Director and a person in long-term
• ONDCP was created by the Anti-Drug Abuse Act
of 1988. ONDCP advises the President on drugcontrol issues, coordinates drug-control activities
and related funding across the Federal
government, and produces the annual National
Drug Control Strategy, which outlines
Administration efforts to reduce illicit drug use,
manufacturing and trafficking, drug-related crime
and violence, and drug-related health
The National Drug Control Strategy
A 21st Century Approach to Drug Policy
• Addressing the National Opioid Epidemic
• Preventing Drug Use Before it Begins
• Intervening Early, Before a Medical
Condition Becomes Chronic
• Making Access to Treatment a Reality for
Millions of Americans
• Eliminating Barriers to Recovery
• Taking a ‘Smart on Crime’ Approach to
Drug Enforcement
A Look at Each Strategy
Addressing the National Opioid
• Fast-track approval by the FDA of an auto-injector for opioid
overdose reversal (Naloxone);
• Release of an Opioid Overdose Toolkit by the Substance Abuse and
Mental Health Services Administration (SAMHSA);
• Public Education and Prevention efforts through 670 Drug-Free
Communities (DFC) Support Program coalitions;
• The launch of approximately 60 new continuing education or
continuing medical education programs on safe prescribing and
substance misuse that health care personnel and prescribers may
take for credit toward licensure requirements;
• Interstate data-sharing by 24 of 49 state PDMPs (prescription drug
monitoring programs); and
• Issuance of boxed warnings concerning the effect of long-acting
extended-release opioids on newborns.
Preventing Drug Use Before it
• Promote national, state, and community-based programs
that are evidence-based and work to prevent substance
use in schools and in the workplace;
• Provide information on effective prevention strategies,
including environmental approaches, for use by youth
advocates, parents, local prevention service providers,
law enforcement officers, faith-based representatives,
health care workers, and community organizers
nationwide; and
• Spread prevention to the workplace through programs
that ensure the safety and wellness of employees and
their families.
Intervening Early, Before a Medical
Condition Becomes Chronic
• Support education and legislation aimed at
providing health care professionals with
continuing education and training on addiction
and safe prescribing practices for opioid
painkillers; and
• Seek to reduce opioid overdose deaths by
expanding comprehensive overdose prevention
measures, including the use of the lifesaving
overdose-reversal medicine Naloxone among
first responders.
Making Access to Treatment a
Reality for Millions of Americans
• Detail actions to implement the Affordable Care Act,
which ends discrimination against people with substance
use disorders by requiring insurance companies to cover
treatment for these disorders just as they would cover
any other chronic disease;
• Promote the use of medication-assisted treatment to
help guide people into recovery;
• Work to expand treatment and re-entry services for
those incarcerated; and
• Expand health insurance coverage for all Americans,
including college and university students and Native
Eliminating Barriers to Recovery
• Work to lift the stigma associated with substance use
disorders by partnering with those in the recovery
community to speak out about their successes and
encourage others to seek treatment;
• Review and reform laws and regulations that unfairly
target those with substance use disorders and impede
recovery, including laws and regulations that restrict
access to housing, employment, and obtaining a driver’s
license or student loan; and
• Support youth and young adults in recovery and promote
approaches for assisting youth in recovery via schooland campus-based recovery efforts, including recovery
schools and collegiate recovery communities.
Taking a ‘Smart on Crime’
Approach to Drug Enforcement
• Focus limited law enforcement resources to address the
greatest threats to public safety;
• Promote the diversion of non-violent drug offenders into
treatment in lieu of incarceration through innovative
programs like Drug Courts and other community
services; and
• Highlight innovations that show promise in reducing
rates of incarceration while protecting public safety, such
as such as Hawaii’s Opportunity Probation with
Enforcement (HOPE) and the Drug Market Intervention
ONDCP Celebrates 25 Years
of Recovery Month
• Held September 17 at The White House and
streamed live;
• Panel of recovery advocates sharing their stories
of hope;
• Raise awareness of substance use disorders
and recovery, highlight Administration priorities
and accomplishments in this area, educate the
public and policymakers, and help dispel stigma
by promoting the understanding that addiction is
a disease and not the result of a personal or
family failing.
NIDA – National Institute on
Drug Abuse
• Established in 1974; under National Institutes of Health;
current Director Dr. Nora Volkow
• NIDA's mission is to lead the nation in bringing the
power of science to bear on drug abuse and addiction
• How?
• By the strategic support and conduct of research across
a broad range of disciplines
• By ensuring the rapid and effective dissemination and
use of the results of that research to significantly improve
prevention and treatment and to inform policy as it
relates to drug abuse and addiction
For professionals:
• Research Studies & Reports
• DrugFacts
• E-newsletters
• Journals
• Education materials
• Podcasts
NIAAA – National Institute on
Alcohol Abuse & Alcoholism
• NIAAA supports and conducts research on
the impact of alcohol use on human health
and well-being. It is the largest funder of
alcohol research in the world.
• Current Director Dr. George Koob
• Conducting and supporting research in a wide range of
scientific areas including genetics, neuroscience,
epidemiology, health risks and benefits of alcohol
consumption, prevention, and treatment
• Coordinating and collaborating with other research
institutes and federal programs on alcohol-related issues
• Collaborating with international, national, state, and local
institutions, organizations, agencies, and programs
engaged in alcohol-related work
• Translating and disseminating research findings to
health care providers, researchers, policymakers, and
the public
For professionals:
• Publications, brochures, fact sheets
• Research
• Clinical Trials
• Grants
• Journals & Videocasts
• Educational materials
Climate in DC
• A cultural shift in Congress is emerging on
addiction; more willingness to deal with
addiction-related issues in a bi-partisan
• Recent public attention given to overdoses
- be they celebrity or the everyday person
in our communities - is creating motivation
for lawmakers to care about addiction
• This short window of opportunity must be
Feds watching closely
• Opioid epidemic
• Marijuana legalization in states
and its impact on prevention,
treatment, crime, etc.
• Integration of SUD into primary
Recent Legislation
• Sept. 17 – Bi-partisan legislation introduced by
Senators Portman (R-OH) and Whitehouse (DRI); The Comprehensive Addiction &
Recovery Act of 2014
• $80 million to states and local governments
• Well-documented stats used as rationale for this
legislation included:
• More Americans die every day from drug
overdoses than from car accidents – an
average of 110 people per day, according
to the Centers for Disease Control &
• 22.7 million Americans needed treatment
for a SUD in 2013 but only 2.5 million
received it
• Death rate from heroin overdoses doubled
from 2010 to 2012 per the CDC (cheaper,
easier to access, more potent than
• The Northeast saw the largest increase in
heroin deaths, followed by the South
What would the legislation do?
• Expand prevention and education efforts
to prevent abuse of opioids and heroin and
promote treatment & recovery;
• Expand availability of Naloxone;
• Expand resources to identify & treat those
incarcerated with addiction disorders;
• Expand disposal sites for unwanted
prescription medications;
• Launch an evidence-based opioid and
heroin treatment and intervention program
via training & resources to expand
treatment best practices;
• Strengthen prescription drug monitoring
More Legislation
• The Expanding Opportunities for Recovery Act
introduced in August 2014 by Congressmen
Foster (D-IL) and Maloney (D-NY)
• To increase low-income and uninsured patients’
access to inpatient rehabilitation services for
heroin and other opioid abuse
• Up to 60 days of treatment - evidence-based,
clinically appropriate and may include MAT
• States apply for the funding through SAMHSA
What else in DC about
• Language shift needs to occur to
stop the stigma
• Stop the negative & blaming
language such as addicts,
abusers, etc.
• Instead use “people with
substance use disorders”
Other Federal Partners
• DOT (Transportation)
• Assessment and referral required for DOT
employees for violation of drug and
alcohol regulations
• DOJ (Criminal & Juvenile Justice)
• Treatment for SUDs and Mental Health in
• Crime related to alcohol and drug use
• Diversion programs and drug courts
• Shift towards treatment, not incarceration
• DOA (Aging)
• Alcohol abuse is the biggest problem
among older adults but illicit drug use for
50-64 year old adults is rising
• DOVA (Veterans Affairs)
• Access to treatment for veterans with
SUDs is on the rise. A critical issue facing
our federal government.
National (NGO’s) Organizations
The National Council/SAAS
298 South Progress Avenue
Harrisburg, PA 17109
T: +1 717.540.4457
F: +1 717.540.4458
[email protected]

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