June 2006 NACBHDD Newsletter
The Newsletter of the National Association of County Behavioral Health and Developmental Disability Directors
In this Issue...
The 2006 NACBHDD Newsletter series is brought to you by:
NACBHD Board Meeting
This year, in a planning effort to more effectively address member advocacy and networking interests, NACBHD will not be holding a summer or fall conference; instead there will be two board meetings. The first will take place August 4 in Chicago in conjunction with the NACo Annual Conference, and the second will take place October 17-18 in Michigan in conjunction with the Michigan Association of Community Mental Health Boards. Hotel information is posted on the website. NACBHD members are encouraged to attend these meetings even if they are not Board members. However, these are meetings at which only the Board votes.
If you have an interest in attending either meeting, please contact Melissa Staats at mstaats@nacbhd.org or Maeghan Gilmore at mgilmore@nacbhd.org for assistance.
Medicaid Update
CMS recently released guidelines for citizenship requirements for Medicaid eligibility under the Deficit Reduction Act. On June 11, the NACBHD membership received the following communication from Melissa Staats regarding CMS guidance on citizenship and Medicaid eligibility, which goes into effect July 1.
Late on Friday evening June 9, the Centers for Medicare and Medicaid (CMS) issued guidance and a Dear State Medicaid Director letter on implementation of the Deficit Reduction Act (DRA) provision 6036--Improved Enforcement of Documentation Requirements. These are two in a series of guidance and letters related to implementation of DRA. It is notable that CMS released this information on a Friday after business hours.
The enclosed guidance and letter delineate acceptable forms of documentation need to prove citizenship. The forms and associated "levels" are described in the attached documents. There are 5 levels. The highest level includes a passport, certificate of naturalization and/or certificate of citizenship. Other levels include a broader range that will need to be coupled with other documents to prove both identify and citizenship.
CMS has indicated in the guidance (and in the regulations to follow) that states "should" assist those individuals with disabilities with the collection of needed documentation. CMS has also indicated that individuals who currently receive Medicaid will not be found "ineligible" as long as they are "showing a good faith effort"--(reasonable opportunity).
CMS has indicated it will use audits to ensure states compliance--states must seek the highest level of documentation. CMS expects that other levels will be used sparingly and that use will decline over time. FFP is dependent upon proper documentation.
In discussions during some of our NACBHD committee meetings, it has been suggested that members work closely with their state Medicaid authority in the identification of individuals who will likely need assistance with documentation requirements.
To view the letter and guidance, click here.CMS Stakeholder Call
Advocates joined Jean Sheil, Director of the Family & Children's Health Programs Group at the Center for Medicaid and State Operations, on a conference call to provide more information on the new requirement effective July 1 that persons receiving and applying for Medicaid document their citizenship. The result of the call is that the advocates are trying to promote a technical amendment. (See below.)
To access a final fact sheet on the requirements, click here or here.
Needed technical corrections to the DRA citizenship requirements for Medicaid
Melissa Staats sent the NACBHD membership a one page explanation of needed technical corrections to the DRA citizenship requirements for Medicaid and asked members to please contact their representatives about amending the current legislation and guidelines in advance of July 1, 2006. To access the document, click here. In addition, a letter was sent by advocates to HHS Secretary Leavitt. To view that letter, click here.
Rehabilitation Option Regulations Pending
In a one page fact sheet, the American Public Human Services Association (APHSA-which includes the State Medicaid Directors) writes, "The administration's fiscal year 2007 budget includes a proposal relating to the rehabilitation option. The budget looks to clarify, through the administrative process, allowable services that can be claimed as rehabilitation services...it is clear that this proposed change would impose stricter reimbursement policies for rehabilitation services, resulting in an estimated savings to the federal government of $225 million in FY 2007 and $2.3 billion over 5 years." APHSA goes on to state that, "Medicaid rehabilitation services have been an integral benefit that has enabled states to ensure that beneficiaries receive services and supports to help them rely less on restrictive levels of services. Limiting these services and the funding available to support them could have profoundly detrimental effects on the access, quality, and necessary services for Medicaid beneficiaries with complex mental and behavioral health needs."
The fact sheet is being widely distributed to Congressional Offices, CMS and the advocacy community.
NACBHD Member State Medicaid News
In North Carolina, the House has voted on a plan that lowers counties Medicaid payments next year. As reported by kaisernetwork.org, the House budget proposal reduces Medicaid payments in varying amounts for different counties. Janet A. Schanzenbach, CAE, Interim Executive Director, NC Council of Community Programs, and NACBHD member, says that it also "needs to be mentioned that the House has a provision that will cap the county share for the 2005-06 fiscal year. The Council is pleased that the NC legislature has taken the step of relieving counties of this burden."
Medicare Update
There were two items of interest in the media recently related to Medicare, and they are linked here for members' information. For a Kaiser Commission article on the outlook for Medicare for 2006, click here.
A recent Kaiser article reported that some patient and advocacy groups have financial ties to pharmaceutical companies, including the National Alliance for the Mentally Ill (NAMI). Some members of Congress are urging legislation that will enforce stricter disclosure laws. To view the article, click here.
TogetherRxAccess Provides Discount Drug Cards Quickly
NACBHD recently spoke with Amy Niles, Chair, Medical Relations and Advocacy, TogetherRx Access, about the organization's discount drug program. TogetherRxAccess is available to:
Niles notes that with 45 million Americans without insurance, there needs to be some program for those individuals who fall into the categories above, and TogetherRxAccess is hoping to fill that gap. Niles' role is to forge alliances with medical and health groups to gain access and provide continuity in coverage, and Together Rx Access is very much interested in reaching out to healthcare professionals, as they are broadly defined, as a way to enroll consumers in the program.
The quick savings card
Niles says mental health is very important to TogetherRxAccess, and that mental health is a primary disease prevention area. Many of their card holders have mental health concerns. Niles noted that she is interested in reaching out to NACBHD members who may be able to offer consumer the quick savings card. With the quick savings card, consumers can activate their cards by calling a number 8:00 a.m. to 12 midnight, Monday through Friday, and they can use the cards at a pharmacy within two hours.
Most card holders save 25-40% on 300 brand name products manufactured by ten member companies. Both the medications and the companies can be viewed on the website. Generic medications are covered as well. The savings are at the pharmacy counter.
The program has enrolled about half a million people in a little over a year, and aims to enroll more. One group they want to reach is baby boomer women who may need the card themselves and also may need it for their families; they are also interested in reaching the Latino and African American populations. While the hope to reach the entire country, there are eight target states with very high uninsured populations: California, North Carolina, Pennsylvania, Georgia, Texas, Florida, Tennessee, and Louisiana. Recently, they did presentations in key hospitals in Louisiana, which opened the door to what Niles calls, "clipboarding," in which ambassadors from TogetherRxAccess enroll patients in the hospital.
How to enroll:
If you have questions or want to obtain quick savings cards contact Amy Niles at amyniles@aol.com.
Downloadable information
Niles provided various information that members can download here for use in their organizations. Flyers can also be obtained in print in English or Spanish.
To access fact sheets:
THE TOGETHER RX ACCESS™ CARD AT A GLANCE
Ten Most Frequently Asked Questions
What is the Together Rx Access™ Card?.
To access a flyer in English, click here.
To access a flyer in Spanish, click here.
To access a "blurb" others have used in newsletters, click here.
Update on the Campaign for Mental Health Reform
The Campaign held a retreat on June 21 to elect new Board members. In addition, the Campaign is working on a paper on Medicaid and the rehab option. More details on the new Board and the Campaign's work on Medicaid will be available in the July newsletter.
Advocates Express Skepticism of Federal Report on Methamphetamine Strategy at Federal Hearing
NACBHD staff recently attended the "Evaluating the Synthetic Drug Control Policy" hearing of the Committee on Government Reform, Subcommittee on Criminal Justice, Drug Policy and Human Resources. The Subcommittee is led by Rep. Mark Souder (R-IN), Chairman, and the most senior Democrat or "Ranking Member" is Rep. Elijah Cummings (D-MD). The report "Synthetic Drug Control Strategy: A Focus on Methamphetamine and Prescription Drug Abuse," from the Office of National Drug Control Policy (ONDCP) was the topic of the hearing, at which the following groups gave testimony: the National Narcotic Officers Association, the National Association of State Alcohol and Drug Abuse Directors, the National Association of Counties, the Community Anti Drug Coalitions of America, the National Alliance for Model State Drug Laws, the Office of National Drug Control Policy, the Drug Enforcement Administration, the Department of Health and Human Services, and the Department of Homeland Security. The group was very skeptical of the strategy presented by ONDCP, and there was a focus on asking how the administration will fight methamphetamine while cutting programs that communities use to fight drug abuse. The group relied heavily on the NACo survey on methamphetamine, which reports that methamphetamine use is of epidemic proportions, while ONDCP says it is not of epidemic proportions.
The same committee will meet June 28 to discuss the treatment aspects of methamphetamine. Patrick J. Fleming, Director Salt Lake County Substance Abuse and NACBHD member will provide testimony to the committee on June 28. This is first for NACBHD and the membership is most appreciative of Patrick Fleming's effort and willingness.
To access the report "Synthetic Drug Control Strategy: A Focus on Methamphetamine and Prescription Drug Abuse," click here.
Details on the testimony
Robert Morrison, Director of Public Policy, NASADAD, forwarded the following testimony from the meeting to Melissa Staats. To read testimony from representatives of the organizations mentioned above, see below.
Lewis E. Gallant, Ph.D., Executive Director of NASADAD, presented testimony.
In an effort to continue to address the myth regarding methamphetamine addiction, Dr. Gallant noted the following at the beginning of his remarks: "The Association's number one message is this: people suffering from methamphetamine addiction, just like those suffering from addiction to other substances of abuse, can recover - and do recover. This message of hope, grounded in science, proven through data, and illustrated every day by the countless Americans living in recovery, serves as the lynchpin of our work."
He then offered the following five core recommendations for the Subcommittee to consider as work continues regarding methamphetamine and prescription drug abuse:
* Coordinate and collaborate with Single State Authorities (SSAs) for Substance Abuse
* Expand access to treatment - and treatment infrastructure
* Strengthen prevention services and infrastructure
* Continue to support research, and
* Enhance tools to share knowledge and best practices.
Dr. Gallant also said "The number one priority for NASADAD is the Substance Abuse Prevention and Treatment Block Grant - the foundation of our treatment system - and a program not mentioned in the Synthetic Drug Control Strategy." He then cited sample data to re-emphasize the effectiveness of treatment and the SAPT Block Grant:
* In Colorado, 80 percent of methamphetamine users were abstinent at discharge in FY 2003,
* In Iowa, a 2003 study found that 71.2 percent of methamphetamine users were abstinent 6 months after treatment, and
* In Tennessee, over 65 percent of methamphetamine users were abstinent 6 months after treatment.
Dr. Gallant then promoted a strong commitment to prevention - reminding the Committee that the SAPT Block Grant dedicates 20 percent of its resources to these important prevention services. He expressed concern with the proposals by the Administration to cut the budget for the State Prevention Infrastructure State Incentive Grant (SPF SIG) program and eliminate the Department of Education's Safe and Drug Free Schools and Communities State Grant program. Finally, Dr. Gallant rounded out his testimony by stressing the value of the Addiction Technology Transfer Centers (ATTCs) and Centers for the Application of Prevention Technology (CAPTs) as critical tools to share knowledge and best practices.
To view Dr. Gallant's entire testimony, click here.
Federal Panel Offers Views on Various Agencies
Scott Burns, Deputy Director, State and Local Affairs, White House Office on National Drug Control Policy:
Mr. Burns outlined the goals of the Strategy: reducing illicit methamphetamine use by 15 percent over the next three years, reducing illicit prescription drug use by 15 percent over the next three years and reducing domestic methamphetamine laboratory seizures by 25 percent over three years. Mr. Burns highlighted SAMHSA's Access to Recovery program and proposed methamphetamine voucher program as key initiatives to achieving these goals.
Uttam Dhillon, Director, Office of Counter-Narcotics Enforcement, Department of Homeland Security: Mr. Dhillon in his testimony focused on efforts to reduce illegal international drug trade - especially along the Mexican boarder and among countries that produce methamphetamine precursors.
Joseph Rannazzissi, Deputy Assistant Administrator, Office of Diversion Control, Drug Enforcement Administration: Mr. Rannazzissi described many of the Department of Justice's (DOJ) international and domestic initiatives to fight the illegal use of methamphetamine, prescription drugs and other synthetic drugs. He also described the Drug Enforcement Agency's (DEA) prevention and educational efforts, including www.justthinktwice.com, which offers teens the "hard facts" on methamphetamine and other drugs.
Don Young, Acting Assistant Secretary of Health and Human Services for Planning and Evaluation: Dr. Young highlighted many of the Department of Health and Human Services (HHS) initiatives to address methamphetamine including the proposed $25 million for methamphetamine vouchers and the Access to Recovery program; HHS's work with NIDA to improve science to service and prevention efforts; and support through the Center for Substance Abuse Prevention's (CSAP) Strategic Prevention Framework State Incentive Grants (SPF SIG). Dr. Young also discussed some of the collaborative efforts between SAMHSA and the Administration for Children and Families (ACF) including the National Center for Substance Abuse and Child Welfare (NCSACW).
Witnesses on the second panel included:
The Honorable Eric Coleman, First Vice President, National Association for Counties (NACo): In his testimony, Mr. Coleman commended ONDCP for recognizing the threats posed by methamphetamine and other synthetic drugs. He stated that he was concerned however, that key stakeholders were not included in designing the Strategy. He continued that he hope this Strategy would boost future budgets for programs such as the Byrne Justice Assistance Grants, High Intensity Drug Trafficking Area (HIDTA) programs and the SAPT Block Grant. Mr. Coleman also addressed the impact of methamphetamine on the child welfare system and the need for increased support for treatment and prevention efforts.
Sherry Green, Esq., Executive Director, National Alliance for Model State Drug Laws (NAMSDL): Ms. Green described in her testimony the work NAMSDL does with States and other national organizations to assist with model laws to address precursor materials, establishment of prescription drug monitoring programs, lab clean-up, drug endangered children and many other issues. Ms. Green also discussed NAMSDL's upcoming work with ONDCP, DOJ and SAMHSA on regional meetings to form multi-State strategies for dealing with methamphetamine.
Sue Thau, Public Policy Consultant, Community Anti-Drug Coalitions of America (CADCA): Ms. Thau expressed in her testimony concern that only three prevention initiatives were highlighted in the Strategy: the National Youth Anti-Drug Media Campaign, the Student Drug Testing Initiative and the Strategic Prevention Framework Stat Incentive Grant (SPF SIG) program. She stated that while CADCA supported all these programs, much more is needed to support a community-based prevention infrastructure.
Ronald E. Brooks, President, National Narcotic Officers' Associations' Coalition (NNOAC): Mr. Brooks described the Strategy in his testimony as a "welcome first step...but there are serious shortcomings which may put the laudable goals of the strategy in jeopardy." Mr. Brooks said that he was concerned about the lack of partnership between ONDCP and interested stakeholders such as law enforcement, treatment and prevention representatives. Mr. Brooks added that while law enforcement continues to make great strides in address methamphetamine and other drugs, this cannot continue without the full funding of programs such as Byrne Justice Assistance Grants, COPS Methamphetamine Hot Spots and others targeted for elimination by the Administration.
Hearing Wrap Up
Mr. Souder, moving toward the next hearing on treatment, did ask for the data examining how treatment effectiveness for methamphetamine compares to other drugs (cocaine, heroin, marijuana and other drugs) in order to see if outcomes are substantially different (e.g. a range of at least five percent). He then said he wanted to know if there was a gap when comparing outcomes between drugs - and if there was indeed a gap - ask the question: has it been closing in the past few years? If there is a gap and it is not closing, then is the problem in part, that long term, more expensive treatment is not available where methamphetamine is a problem (e.g. rural States)?
In the end, Mr. Souder stated he could be persuaded that treatment for methamphetamine need not be entirely different than treatment for other substances of abuse. He also noted that if treatment is indeed very different, his Committee has a responsibility to make recommendations to address this issue.
To download complete testimony from all witnesses, please visit, http://reform.house.gov/CJDPHR/Hearings.
To view a webcast of the hearing, please visit www.c-span.org and do a search for "National Drug Control Policy." This webcast will only be available for a short time.
Faces and Voices of Recovery: New Messaging and Open Letter to IOM Report Available On-Line
Pat Taylor, Campaign Coordinator, Faces and Voices of Recovery, recently provided NACBHD with an update on the organization's activities. Taylor reported that there is focused attention on getting new messaging for recovery out into the general community, especially the concept of long-term recovery, and that the new language is available on the website for use with policymakers and the public, to talk about recovery from addiction to drugs and alcohol.
In addition, Faces and Voices has been involved in responding to the Institute of Medicine's "Crossing the Quality Chasm: Adaptation to Mental Health and Addiction Disorders" and putting together a federal policy agenda based on the report. There is an open letter that calls for implementing the IOM's recommendations on the web site for interested advocates to sign.
Other items available from the Faces and Voices of Recovery web site at www.facesandvoicesofrecovery.org include:
On-Line Training Video Available to Improve Mental Health Provider Skills
Clarke Ross, CEO of Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD), recently forwarded advocates the following information from SAMHSA's Center for Mental Health Services' Consumer Affairs about an online video now available to improve mental health provider skills.
Online Video: Partners in Recovery: Creating Successful Practitioner-Consumer Alliances
SAMHSA's Resource Center to Address Discrimination and Stigma Associated With Mental Illness announces the availability of the "Partners in Recovery" video at www.stopstigma.samhsa.gov/partnersinrecovery.htm.
This videotape was developed and supported by CMHS through a contract with the National Depressive and Manic-Depressive Association (now the Depression and Bipolar Support Alliance). The video is intended to stimulate professionals to look carefully at their own perceptions, assumptions and behaviors, and to search for ways to improve their communication and relationships with mental health consumers.
In this 18-minute video, consumers and practitioners share stories about what worked and what did not work in building constructive relationships. Topics of discussion include recovery, hope and empowerment, information dissemination, consumers as experts, and family and peer support-concepts basic to every mental health professional in developing the therapeutic relationship. Also included with the video is an insert to provide self-evaluation and discussion questions and a list of mental health resources.
In order to access the streaming video, log onto www.stopstigma.samhsa.gov/partnersinrecovery.htm. This product as developed by SAMHSA in response to working group reports that identified specific needs of consumers and potential barriers to self-directed behavioral health care, as well as offered recommendations for transforming the delivery of behavioral health services. The working groups included mental health consumers and survivors, as well as mental health professionals.
We welcome your questions, comments, and suggestions: stopstigma@samhsa.hhs.gov.
The SAMHSA ADS Center is a program of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.
About the SAMHSA ADS Center SAMHSA's Resource Center to Address Discrimination and Stigma (ADS Center) helps people design, implement and operate programs that reduce discrimination and stigma associated with mental illnesses. With the most up-to-date research and information, the ADS Center helps individuals, organizations and governments counter such discrimination and stigma in the community, in the workplace, and in the media.
ADHD Update: House Restores Funding for CDC Prevalence Studies
Clarke Ross forwarded the following memo, sent to the CHADD membership, to NACBHD for information:
House Subcommittee Restores Funding for Nat'l Resource Center on AD/HD
and AD/HD Prevalence Studies
A key House Appropriations subcommittee restored all funding for the Centers for Disease Control (CDC) funded National Resource Center on AD/HD (NRC) and AD/HD prevalence studies. The NRC is currently housed at CHADD. Earlier this year we alerted you that the Administration's FY 2007 budget eliminated all funding for the NRC and the prevalence studies. In response to our alert this past February, CHADD members sent thousands of emails to their US Senators and Representatives in Congress in support of continued funding these key CDC programs on AD/HD. Other alerts followed as Congress debated the budget in March and CDC funding.
Yesterday, June 7, the House Labor-Health and Human Services-Education Appropriations Subcommittee, which appropriates funds for the departments of Labor, Health and Human Services, and Education, including the CDC, restored all funding for the NRC and the AD/HD prevalence studies as part of their FY 2007 appropriations bill. This legislation will now go to the Full Appropriations Committee for a vote on June 13 before heading to the House floor for approval, likely the week of June 19. The US Senate is preparing their own version of the bill and we will keep posted on those developments.
We thank all of you who contacted your US Senators and Representatives.
Your actions help ensure that this valuable resource for persons affected by AD/HD will be preserved.
While this is a tremendous victory for us, we are not out of the woods yet and may ask for your assistance again in the coming months. The appropriations must still be dealt with by the full House Committee, and voted on by the House. Then the same process will move forward in the Senate. Once both bodies have approved bills, then differences are worked out in conference. And finally the President must sign the bill. Only then will we know for sure that funding is restored.
Report to Congress: Supply of Direct-Support Professionals Serving Individuals with Intellectual or Developmental Disabilities Now Available
The report "Supply of Direct-Support Professionals Serving Individuals with Intellectual or Developmental Disabilities" is now available. The report can be accessed at: http://aspe.hhs.gov/daltcp/reports/2006/DSPsupply.htm. There will be a review of the report from NACBHD members in the July newsletter.
Guide for Employment Supports for Individuals with Disabilities Now Available from SSA
CMS recently alerted advocates to the availability of the following Social Security Administration (SSA) publication. SSA's 2006 Red Book is now available on the web and contains "A Summary Guide to Employment Supports for Individuals with Disabilities." It is available at www.socialsecurity.gov/disabilityresearch/redbook.htm.
SAMHSA Announcements
From a June 13 press release:
SAMHSA Releases a Treatment Improvement Protocol (TIP) on Detoxification and Substance Abuse Treatment
SAMHSA has released a new Treatment Improvement Protocol (TIP 45) "Detoxification and Substance Abuse Treatment." The new TIP provides clinicians with the latest information on detoxification; emphasizes that by itself, detoxification does not constitute complete substance abuse treatment; and identifies the necessity for linking patients in detoxification with substance abuse treatment services.
"Detoxification is one component in the continuum of healthcare services for substance-related disorders," said SAMHSA Administrator Charles Curie. "The TIP defines detoxification as a broad process with three essential components - evaluation, stabilization, and fostering a patient's entry into treatment. Each involves treating the patient with compassion and understanding. Patients undergoing detoxification need to know that someone cares about them, respects them as individuals, and has hope for their futures."
Developed by a consensus panel of experts with diverse experience in detoxification services, TIP 45 provides up-to-date information about the physiology of withdrawal, pharmacologic advances in the management of withdrawal, patient placement procedures and managing detoxification services within comprehensive systems of care. Additionally, the TIP provides medical information on detoxification protocols for specific substances, as well as considerations for individuals from diverse cultural and ethic backgrounds or those with co-occurring mental disorders and medical conditions.
This TIP is a revision of TIP 19, Detoxification from Alcohol and other Drugs. The primary audiences for this TIP include: substance abuse treatment counselors, administrators of detoxification programs; state agency directors; psychiatrists and other physicians, nurses, psychologists and clinical staff members working in the field. A secondary audience includes primary care providers, staff of managed care and insurance carriers; and others involved in planning, evaluating and delivering services to patients going through detoxification from substances of abuse.
TIP 45 is available on the web at www.ncadi.samhsa.gov. Copies may be obtained free of charge from SAMHSA's National Clearinghouse for Alcohol and Drug Information at 1-800-729-6686.
From a June 1 press release:
SAMHSA Releases Training Guide to Reduce Seclusion and Restraint Use
A new training curriculum, released today by SAMHSA provides mental health providers with the latest information on prevention strategies and alternative approaches to avoid and reduce the use of seclusion and restraint.
The training curriculum, A Roadmap to Seclusion and Restraint Free Mental Health Services for Persons of All Ages, is organized in seven modules and emphasizes the importance of creating cultural change within organizations to impact seclusion and restraint reduction. Specifically, the document outlines best practices in the use of trauma-informed care and other aspects to support resiliency and recovery of people with mental illnesses while avoiding seclusion and restraint practices that can harm rather than help.
Curriculum modules discuses specific strategies including self-care approaches, peer-provided services, arts programs, comfort rooms, and other approaches designed to enhance service environments and consumer participation as means to avoid the use of restraint and seclusion.
In addition, a range of other approaches are described including advance directives, mediation, service animals, and communication approaches. Each represents a potential tool for providers to ensure consumer safety. Techniques for sustaining reduction efforts via consumer and staff involvement as well as a listing of resources are included. The curriculum employs a unique consumer-driven approach that was successfully pilot-tested prior to publication. It is offered in CD-Rom format, provides complete lesson plans and handouts for each training module and is available at SAMHSA's National Mental Health Information Center at www.mentalhealth.samhsa.gov or 1-800-789-2647.
From a June 8 press release:
SAMHSA Alerts Field To Dangerous Drug Combo
SAMHSA has issued an action alert to substance abuse treatment and prevention professionals about a new combination of street drugs with a potentially lethal effect. The addition of fentanyl, a powerful narcotic analgesic, to heroin or cocaine being sold on the streets is believed to be the cause of clusters of drug-related deaths and even greater numbers of overdoses in east coast and midwest cities in the past few months. In just one week in May, an estimated 33 individuals in the Detroit are reported to have died after using this fatal drug mix. The same drug combination may have been responsible for over 100 deaths in Philadelphia/Camden, Chicago, St. Louis, and Detroit since last September. The alert was issued by SAMHSA's Center for Substance Abuse Treatment Director H. Westley Clark, M.D., J.D., M.P.H., to substance abuse professional organizations, treatment providers, state substance abuse authorities, and recovery community-related organizations and individuals. It highlights the growing concern about the potentially fatal effects of this street-drug combination and encloses a brief fact sheet about preventing as well as detecting and treating overdoses. "Individuals involved in the public health need to be aware of this new dangerous drug combination," Dr. Clark said. "They need to be prepared to alert patients, clients and others to help save lives. After all, fentanyl is 50-100 times more powerful than morphine. When mixed with cocaine or heroin, the results can be lethal." The alert encourages recipients not only to advise their networks of patients and colleagues, but also to join local health authorities to bring information about the drugs to first responders, emergency room personnel, street substance abuse workers, drug treatment facilities, local health care providers, the recovery community, and the public at large. When used illegally, particularly in combination with a drug such as heroin or cocaine, or when used in excessive amounts, fentanyl can result in irregular heart beat, the inability to breathe, and death. In some cases, heroin or cocaine users are aware they are purchasing this dangerous combination of drugs; in other cases, the buyer is not aware that he or she is purchasing this potentially lethal drug combination. The alert advises local vigilance for the possible introduction of this potent drug mixture into circulation on the street and emphasizes the importance of education, particularly on the street.
From a June 9 press release:
New Co-Occurring Disorders Publications Available at SAMHSA
Co-occurring mental and substance abuse disorders affect approximately 4.6 million individuals in the United States. However, only a small percentage of these individuals receive treatment that addresses both disorders. Many receive no treatment of any kind. To better educate states, communities and behavioral healthcare providers, SAMHSA's Co-Occurring Center for Excellence (COCE) has just released in print the first of a series of brief publications for treatment professionals on co-occurring mental and substance abuse disorders. The newly available products include: Overarching Principles to Address the Needs of Persons with Co-Occurring Disorders; Definitions and Terms Relating to Co-Occurring Disorders; and Screening, Assessment, and Treatment Planning for Persons with Co-Occurring Disorders. The publications are the first of ten short papers, spanning topics such as epidemiology, treatment, workforce and systems issues, prevention/early intervention, and evaluation/monitoring. The documents are designed for substance abuse treatment counselors and mental health providers who usually treat one or the other of the two ailments, but it will also be useful for administrators, primary care providers, criminal justice staff and other health care and social service personnel who work with people with co-occurring disorders. Co-occurring substance abuse and mental disorders are more common than most professional counselors, medical personnel or the general public realize. The significant effects of untreated co-occurring disorders - homelessness, unemployment, incarceration, physical health problems, separation from family and friends and suicide - led SAMHSA not only to establish the COCE, but also to create a broad range grant programs, policy academies, a treatment improvement protocol (TIP 42) and training opportunities to bring evidence- and consensus-based best practices to the mental health and substance abuse treatment and prevention communities. As a result, the diagnosis and treatment of co-occurring disorders is now being better defined and treatment approaches are taking a more integrated approach. These steps improve the ability to meet the individual treatment needs of persons with co-occurring mental and substance abuse disorders. These new training materials are part of SAMHSA's promise to Congress following the November 2002 Report to Congress on the Prevention and Treatment of Co-Occurring Substance Abuse Disorders and Mental Disorders to develop and disseminate state-of-the-art information about the treatment of individuals with co-occurring mental and substance abuse disorders. Copies of these publications are available free of charge from SAMHSA's Clearinghouse (800-729-6686 or 301-468-2600) or on the SAMHSA website at www.coce.samhsa.gov.
From a May 31 press release:
SAMHSA Provides "At A Glance" Summary of Anticipated 2007 Grant Opportunities
SAMHSA today announced a preliminary listing of its 2007 Discretionary Grant Funding Announcements. This listing is consistent with priority programs highlighted in the SAMHSA Matrix. It will allow potential applicants the opportunity to identify potential future funding opportunities and plan for the development of applications in their area of expertise and interest. The At a Glance table for 2007 contains a general description of each project; the eligibility criteria; and the approximate funding amounts based on the President's FY 2007 budget. SAMHSA's Center for Mental Health Services may have eleven grant program opportunities: Conference Grants; Jail Diversion; Minority Fellowship; Statewide Family Networks; Statewide Consumer Networks Consumer/Consumer Supporter TA Centers; Alternatives to Restraint and Seclusion; Adolescents at Risk; Campus Suicide; Networking and Certifying Suicide Prevention Hotlines; and National Child Traumatic Stress Network. It is anticipated that approximately 90 grants totaling over $18 million will be awarded. SAMHSA's Center for Substance Abuse Treatment may have six grant program opportunities: Targeted Capacity Expansion HIV/AIDS; Addiction Technology Transfer Centers (ATTCs); Recovery Community Services Program (RCSP); State Incentive Grants for Treatment of Persons with Co-Occurring Substance Related and Mental Health Disorders (COSIG); Access to Recovery Choice Incentive Program; Access to Recovery (ATR) Methamphetamine. It is anticipated that approximately 96 grants totaling over $141 million will be awarded. There may be changes to SAMHSA's grant announcements as mentioned above. Details regarding each specific funding opportunity will be provided on the SAMHSA website. When announced, the RFA can be found on the SAMHSA website at www.samhsa.gov. Call 800-729-6686 for applications kits for CSAT programs. Application kits for the CMHS programs are available by calling 800-789-2647.
From a May 30 press release:
Updated Directory of Drug, Alcohol Abuse Treatment Programs Available
SAMHSA's updated guide to finding local substance abuse treatment programs is now available. The guide, National Directory of Drug and Alcohol Abuse Treatment Programs 2006, provides information on thousands of alcohol and drug treatment programs located in all 50 states, the District of Columbia, Puerto Rico and four U.S. territories. The directory, a nationwide inventory of nearly 11,000 drug abuse and alcoholism treatment programs and facilities, is organized and presented in state-by-state format for quick reference by health care providers, social workers, managed care organizations, and the public. It lists public and private facilities, all of which are licensed, certified, or otherwise approved by substance abuse agencies in each state. The directory is designed to provide the reader quickly with key information about the location of specific facilities and the nature of the programs and services provided. This includes level of care offered and areas of service specialization, such as programs for adolescents, persons with co-occurring substance abuse and mental disorders, individuals living with HIV/AIDS and pregnant women. The 2006 directory identifies long and short-term residential treatment facilities and facilities that provide residential beds for clients' children. The updated directory is a paper-based complement to SAMHSA's Internet-based Substance Abuse Treatment Facility Locator Service. The Internet service, which is continuously updated, provides driving directions to the nearest treatment facilities, as well as descriptions of services available, and contact information, including addresses and telephone numbers. By following simple instructions available online through this service, users can locate public and private substance abuse treatment facilities in any state, city or community anywhere in the nation. The direct website link is http://findtreatment.samhsa.gov. To obtain a free copy of the National Directory of Drug and Alcohol Abuse Treatment Programs 2006, contact SAMHSA's Clearinghouse or call (800) 729-6686.
