Addressing the Treatment Gap

A recently published article in Addiction Professional entitled, “New research is redefining alcohol disorders” raises several interesting and timely questions.  Authored by Dr. Mark Willenbring, Director of the Treatment and Recovery Research Division of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the article suggests that attempts to address the treatment gap will fail if they are not based on the best and most current research, research he argues, that challenges “what has become conventional wisdom among addiction professionals.”  Dr. Willenbring makes the case for the need for a new model of consumer-oriented treatment, treatment in his view that will reach more people with a broader mix of services.  After inquiring whether the new research will be viewed “as a threat or as an opportunity” by addiction professionals, Dr. Willenbring closes with “how we respond is up to us and will determine the future of our field.”

The National Council believes that new research offers new opportunity and possibility.  As reform of health and healthcare systems becomes a focus of the next Administration and Congress, new research can be used to support the inclusion of care for mental and substance use disorders as part of routine health care and to argue for stronger collaboration between behavioral and primary health. Research indicates that health is not possible without behavioral health, and engaging the primary healthcare field in order to connect more people to care at earlier stages of their illness is critical to improving rates of recovery, reducing unnecessary loss of life, and targeting scarce dollars.  We look forward to working with our members from across the country and allied organizations to advance a policy agenda that prevents more individuals and families from being affected by substance use disorders and increases access to early intervention, treatment and recovery for those individuals and families in need.  I invite you to review the attached draft document, entitled “Advancing Prevention, Treatment & Recovery for Substance Use Disorders [insert link]” which lays the foundation for the National Council’s substance use disorder policy agenda and offer your suggestions and feedback. 

Dr. Willenbring’s article can be viewed in full at http://www.addictionpro.com/ME2/Default.asp.   

On the Hill

Congratulations on Parity!

The National Council would again like to congratulate all those who worked tirelessly to enact the Paul Wellstone and Pete Domenici Mental Health Parity & Addiction Equity Act of 2008. Passage of this legislation is a huge victory for millions of individuals across the country and shows that political participation can make a difference. To learn more about coverage and benefits under the new parity legislation, as well as impact and opportunities in the states:  http://www.thenationalcouncil.org/galleries/policy-file/Parity%20Fact%20Sheet_National%20Council.pdf  

U.S. House of Representatives Passes "We Don't Serve Teens Campaign" Resolution
Noting the dangers of underage drinking, Congresswomen Lucille Roybal-Allard (D-CA) and Mary Bono Mack (R-CA) praised House passage of H. Res. 1042, supporting the We Don't Serve Teens campaign on September 23rd, 2008. Rep. Bono Mack was joined by Roybal-Allard in introducing this resolution to commend the united efforts of the Federal Trade Commission (FTC) and industry and community partners to raise awareness for the importance of preventing underage access to alcohol.
President Bush Signs the Veterans Mental Health and Other Care Improvements Act of 2008: Bill Includes Emphasis on Addiction Treatment

On October 10, President Bush signed S. 2162, the Veterans Mental Health and Other Care Improvements Act of 2008, into law. The bill pays tribute to Justin Bailey, an Iraq war veteran who died in a domiciliary facility of the Department of Veterans Affairs while receiving care for post-traumatic stress disorder and a substance use disorder.  The findings of the bill highlight that “while the Veterans Health Administration has dramatically increased health services for veterans from 1996 through 2006, the number of veterans receiving specialized substance use disorder treatment services decreased 18 percent during that time. No comparable decrease in the national rate of substance use disorder has been observed during that time.”  Additionally, “while some facilities of the Veterans Health Administration provide exemplary substance use disorder treatment services, the availability of such treatment services throughout the health care system of the Veterans Health Administration is inconsistent.”

Key Sections of the bill include:

• Section 103. Expansion of Substance Use Disorder Treatment Services. The Secretary of Veterans Affairs is required to ensure that each veteran enrolled in the health care system of the Department of Veterans Affairs who is in need of services and treatments for a substance use disorder shall receive it, including intensive outpatient or residential care services; opiate substitution therapy services; pharmacological treatments; and coordination with groups providing peer to peer counseling. Services and treatment may be provided at Department of Veterans Affairs medical centers or clinics; by referral to other facilities of the Department that are accessible to such veteran; or by contract or fee-for-service payments with community-based organizations for the provision of such services and treatments.

• Section 104. Care for Veterans with Mental Health and Substance Use Disorders.  Care for a substance use disorder and a co-morbid mental health disorder shall be provided concurrently through a service provided by a clinician or health professional who has training and expertise in treatment of substance use disorders and mental health disorders; by separate substance use disorder and mental health disorder treatment services when there is appropriate coordination, collaboration, and care management between such treatment services; or by a team of clinicians with appropriate expertise.

• Section 105. Pilot Program for Internet-Based Substance Use Disorder Treatment. The pilot program will assess the feasibility and advisability of providing veterans who seek treatment for substance use disorders access to a computer-based self-assessment, education, and specified treatment program through a secure Internet website operated by the Secretary.

Research Spotlight:

Drinking alcohol before 15 years of age is risky for later alcohol problems

Researchers have known that age of first drink (AFD) is associated with the later development of alcohol-use disorders (AUDs).  New findings show that an early AFD, before the age of 15, is especially risky for later AUDs.  Experts recommend delaying the onset of drinking behavior as late as possible, until 18 or older.  Results will be published in the December issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.  http://www.eurekalert.org/pub_releases/2008-09/ace-dab092208.php  

Alcohol, Other Drugs, and Health: Current Evidence. 
http://www.bu.edu/aodhealth/index.html  

Model Policies for Juvenile Justice and Substance Abuse Treatment

Robert Wood Johnson Foundation's Reclaiming Futures initiative releases report on recommendations to improve policies at the federal, state, and local levels for providing alcohol and drug treatment for youth in the juvenile-justice system.  The policy recommendations at the federal level included repealing regulations that prevent funding for substance abuse treatment, mandating Medicaid coverage for youth in public institutions, and changing the Juvenile Justice and Delinquency Prevention Act (JJPDA) to specifically include and define substance abuse treatment services. http://www.rwjf.org/files/research/3426.33714.reclaimingfutures1.pdf

Resources:

National Council Webinar:  Advances in Medication Assisted Treatment for Opioid Addiction

Click the following link to access the recording and slides from Dr. Stuart Gitlow’s Oct 7th presentation:  http://www.thenationalcouncil.org/cs/recordings/handouts  

NIDA Announces DrugPubs, a new Research Dissemination Center

DrugPubs is designed to distribute materials to virtually all audiences: drug abuse researchers, health professionals, teachers, advocacy groups, teenagers and the general public. Anyone interested in receiving the latest scientific information about drug abuse and addiction can call the new DrugPubs number: 1-877-NIDA-NIH (1-877-643-2644), or 1-240-645-0228 (TDD). Order requests can also be e-mailed to: drugpubs@nida.nih.gov or faxed to 240-645-0227.

Release Planning for Successful Reentry: A Guide for Corrections, Service Providers, and Community Groups.

This report describes the eight most basic and immediate needs of prisoners leaving prison, recommends policies to meet these needs, and highlights the opportunities and challenges practitioners face when trying to improve their release planning policies. http://www.urban.org/publications/411767.html