Recovering as a community: Hancock County, Ohio

September 20, 2017

Maureen Fitzgerald
Communications Coordinator, ATTC Network Coordinating Office
Editor, NIATx 

The Hancock County 3rd Annual March for Recovery
attracted hundreds on  Sept.9  Photo: The Courier  
Hancock County, Ohio, is located on the I-75 corridor, known by some as the "oxy express"-- a pipeline for the opioids that are fueling the state's overdose epidemic.

In spite of that, Hancock County has not been hit as hard as other Ohio counties, ranking 67th of 88 counties in terms of overdose deaths, says Precia Stuby, Executive Director at the Hancock County Alcohol Drug and Mental Health Services (ADAMHS) Board. 

But in 2013, the increasing opioid problem inspired the Board to look for ways to expand services. The Great Lakes ATTC put Stuby in touch with Michael Flaherty, a consultant on Recovery-Oriented Systems of Care (ROSC).

How to secure buy-in for medication-assisted treatment: Information and pilot-testing

September  14, 2017

Maureen Fitzgerald
Communications Coordinator, ATTC Network
Editor, NIATx

The APT Foundation in New Haven, CT, provides substance use disorder treatment and recovery services to nearly 8,000 adults. APT began to offer methadone treatment in 1971 and today, its  medication-assisted treatment (MAT) program also includes buprenorphine and extended release naltrexone.

Lynn Madden,  President and CEO of the APT Foundation, told us about the organization's open access to treatment policy in one of the first posts on this blog: No appointment necessary. In this less than two-minute video, Dr. Madden shares two strategies that organizations can use to secure buy-in for MAT:
1) Sharing information on best practices and
2) Starting small with a pilot test, also known known as a rapid-cycle test or PDSA Cycle in the NIATx model.



The Power of Peers

September 1, 2017

Caroline Miller, MSW
Director, Wisconsin Voices for Recovery
University of Wisconsin-Madison
Division of Continuing Studies



We know that recovery is more than just an individual journey.

People in recovery strengthen not only their own lives, but the lives of their family members and their entire community. There are countless examples of how a person in recovery can positively influence the world around them. One such way is by providing peer support – to be a part of recovery support services that help people in or seeking recovery to find and maintain healthy and fulfilling lives.

Preparing for the 2017 National Opioid Emergency

August 29, 2017

Thomas F. Hilton and Dennis McCarty


Never invest money you cannot afford to lose.
That admonition came from the late stock market expert, Louis Rukeyser, in his 1976 book, How to Make Money on Wall Street. This remains wise advice for anybody wanting to invest a sudden windfall. Financial planners will tell you that there are three things you can do with money. First, you can spend it. Spending is buying something that will depreciate over time like a car. Second, you can invest it. Investing is buying something that you hope will appreciate in time like stocks or a house. Third, you can let it sit in the bank for a rainy day where it may not do anybody any immediate good. Moreover, it might disappear on its own as states often recoup unspent funds.

We're all connected: National Recovery Month 2017

August 23, 2017

Maureen Fitzgerald
Communications Coordinator, ATTC Network Coordinating Office
Editor, NIATx

"Recovery: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”
National Recovery Month 2017 is just around the corner. This year’s theme, Join the Voices for Recovery: Strengthening Families and Communities, highlights the important role that families and communities play in helping others achieve recovery and reach their full potential. After all, as it's often said, people receive treatment for a substance use or mental health disorder in a healthcare setting, but they recover in the community

Predicting risky drinking: It might be all in the words


August 15, 2017

Rachel Kornfield
PhD Candidate
School of Journalism and Mass Communication
Research Assistant 
University of Wisconsin-Madison 






The A-CHESS smartphone app provides addiction recovery services on-demand.  Analyzing the language used in A-CHESS discussion forums is helping researchers predict the likelihood of relapse. 
The words we say in daily conversation can provide a powerful window into our state of mind, including our moods, concerns, and priorities. General topics of discussion can be revealing (for example, if we’re talking about friends, the weather, or problems at work). But even more is often revealed by subtler styles of speech, including the pronouns we use, our emotional tone, and how we put our sentences together. These subtle linguistic differences are especially meaningful in an age when computers play an ever-increasing role in our lives. Technology and social media provide an array of new outlets through which to communicate. At the same time, computer science offers new tools to automatically measure subtle qualities of language. At the Center for Health Enhancement Systems Studies (CHESS), our research uses social media language not only to understand people better, but also to help people improve their health.

Responding to the opioid epidemic

August 3, 2017

Ned Presnall
Executive Director
Clayton Behavioral
Adjunct Professor, Washington University


David Wojnarowicz at ACT UP's "Seize Control of the FDA" demonstration in Rockville, Maryland, on October 11, 1988. (Photograph by William Dobbs)

We should be marching in the streets over the state of opioid use disorder treatment.

The epidemic of accidental opioid poisoning has received increasing media coverage as opioid-related deaths have skyrocketed. But the magnitude of the problem is still largely unappreciated. The New York Times recently illustrated that annual drug-related mortality in the United States has surpassed peak annual deaths related to AIDS, gun violence, and car accidents. What’s most troubling is that the rate of opioid-related deaths is rising faster than ever.

Marijuana policy: Science matters

July 24, 2017

Susan R.B. Weiss, Ph.D.
Director, Division of Extramural Research

Eric M. Wargo, Ph.D
Science Writer
Office of Science Policy and Communications, Science Policy Branch 
National Institute on Drug Abuse

On August 28, 2017, the National Council for Behavioral Health, Advocates for Human Potential (AHP) and the ATTC Network are partnering to host the  2017 National Cannabis Summit in Denver: An objective national forum for changing public policy, public health, treatment and research. In today's blog post, plenary speaker Dr. Susan Weiss of the National Institute on Drug Abuse calls for science to lead our thinking about the complex subject of marijuana policy and public health. 



Laws around marijuana in many parts of the United States as well as around the world are rapidly changing. This is partly due to shifting attitudes: The public is becoming more supportive of policies that decriminalize or legalize marijuana, because prohibition has not prevented access to the drug and is seen as disproportionately harming minority lives and communities. Eight states plus the District of Columbia (DC) have now legalized recreational marijuana use for adults. There is also a widespread belief that marijuana may have therapeutic benefits, leading 29 states plus DC to legalize the medicinal use of marijuana. (Sixteen additional states have legalized a non-psychoactive component of the marijuana plant, cannabidiol).

The quickest way to reduce time to treatment

July 17, 2017

Maureen Fitzgerald
Communications Coordinator, ATTC Network Coordinating Office
Editor, NIATx



What's the quickest way to reduce waiting time to treatment?

Two NIATx coaches, Scott Gatzke and Elizabeth Strauss, were quick to offer the same answer:

"Stop scheduling appointments."

Throwing out your appointment book might seem an unlikely solution to the wait-time problem. But walk-in appointments or "open access" have helped transform organizations like The APT Foundation in New Haven, Connecticut. In the first year of offering same-day service, average time to treatment decreased from 22 days to 8 days. 
"By the second year, it was down to 2 days, and today most people receive their first treatment or medication, or both, on the same day they walk in.”

Project ECHO LGBT: Making System Change to Address a High-Risk Population


Artist/photographer: Lavinia Solano
June 27, 2017


How can you effectively treat a high risk population without knowing which patients make up the population? The answer is: you can’t. 

To treat the complex needs of LGBT patients, it is necessary to remove the veil hiding this population from their health care providers. This removes stigma and increases the availability of treatment options based off of the specific needs of this population.

In collaboration with the Centers for Disease Control (CDC) and the National Association for Community Health Centers (NACHC), Dr. Wanda Montalvo of the Weitzman Institute at Community Health Center, Inc. led an initiative entitled “Transforming Primary Care for LGBT People” to improve the quality of care LGBT patients receive at 10 Federally Qualified Health Centers (FQHCs). 

Honoring Pride Month 2017: YMSM + LGBT Webinar Series

June 20, 2017


Brandy T. Oeser, MPH
Project Director
YMSM+LGBT ATTC Center of Excellence 

LGBT Pride Month is celebrated each year in the month of June to honor the 1969 Stonewall riots in Manhattan. As part of the Center for Substance Abuse Treatment's recognition of LGBT Pride Month, the YMSM+LGBT Center of Excellence would like to encourage you to visit our archived webinars, where you can learn more about the LGBT Community. We have webinars available on many topics, including:
  • Creating an LGBT Affirming Organization
  • Supporting Change for LGBTQ Young Adults
  • Working With and For Two-Spirit Individuals

Cannabis News Roundup: June 2017

June 14, 2017 
Maureen Fitzgerald
ATTC Network Coordinating Office
NIATx 


The cannabis news deluge continues, with no sign of letting up.  Here's a roundup of some of the latest: 

Dryhootch: Coffee shops and technology-based peer support for Veterans

May 29, 2017


Bob Curry is a Vietnam veteran who founded Dryhootch.com to provide support for veterans returning to their communities after deployment. He was inspired to launch the project after his own experience with PTSD and a substance use disorder.  In 2012, the Obama White House recognized Curry as a Champion for Change.

Today, Dryhootch has seven brick and mortar coffee shops/ community centers across the U.S.  Curry has combined his understanding of veterans' needs with his expertise in technology to create virtual supports like the digital Forward Operating Base, or "FOB."  He's also partnered with IntheRooms to test virtual support meetings for veterans in recovery.

No More Excuses: Implementing Technology to Improve Substance Use Disorder Services


May 23, 2017

Terra Hamblin, M.A., NCC, DCC
Project Manager
National Frontier and Rural ATTC

  • Seven billion people (95% of the global population) live in an area covered by a mobile-cellular network. (Bhuyan et al., 2016) 
  • By 2018, an estimated 50% of the more than 3.4 billion smartphone and tablet users will have downloaded mHealth apps. (Kuersten, 2010) 
  • Use of online and mobile technologies is increasing as consumers rely on Internet and smartphone-based tools for health information and tracking. (Ramsey et al., 2016) 
  • 80% of providers want to be alerted if their client is at risk of relapse; only 8% would want an immediate alert (Muench, 2015).  Current evidence demonstrates patients use and are interested in using technologies as part of their treatment or continuing support. Understanding how technology can be implemented is a critical first step towards successful adoption of technology-assisted care.
Technology can be a powerful partner in helping people manage their health conditions. Are you prepared to offer technology-based services? 

Marijuana Legalization is a Process and We Haven't Reached the Midway Point

May 11, 2017

Jonathan Caulkins, PhD
H. Guyford Stever University Professor of Operations Research and Public Policy
Carnegie Mellon University, Heinz College

On August 28, 2017, the National Council for Behavioral Health, Advocates for Human Potential (AHP) and the ATTC Network are partnering to host the  2017 National Cannabis Summit in Denver: An objective national forum for changing public policy, public health, treatment and research. In today's blog post, drug policy researcher and National Cannabis Summit plenary speaker Jon Caulkins muses on how marijuana legalization might evolve over the next 25 years. 



Colorado and Washington State legalized large-scale commercial production and marketing of cannabis for non-medical use in November, 2012. Almost immediately reporters started asking: “How has legalization turned out?”

I try to answer helpfully. Some results were predictable, such as declining prices. Others were less anticipated and so are truly news. My top three might include the proliferation of extract-based products, consumption increases coming largely from increased intensity of use rather than increased prevalence, and industry lobbyists replacing do-gooders as the drivers of liberalization.

Yet such comments, though true, are woefully incomplete.

National Academies Report Charts Course to Elimination of Hepatitis B & C

May 1, 2017


Cross-posted from Viral Hepatitis Blog at HHS.gov

By: Richard Wolitski, Ph.D., Director, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services and Corinna Dan, R.N., M.P.H., Viral Hepatitis Policy Advisor, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services

A new report from the National Academies makes recommendations for eliminating hepatitis B & C in the U.S. by 2030, complementing National Viral Hepatitis Action Plan.

Read the complete post

Myth busters #5, Part 2: There's no right way to make promotion decisions

April 25, 2017

Thomas F. Hilton, PhD

In Myth busters #5, Part 1, guest blogger Tom Hilton talked about the importance of leadership competencies in improving organizational performance. Part 2 continues the discussion


Why do leadership competencies matter? 


Researcher and Harvard psychology professor David McClelland found that as you move to higher and higher levels of responsibility, leadership ability begins to overshadow technical skill. Of course, in the health field, many supervisory positions in clinics require educational credentials, licensure, and technical skills. However, if people cannot also lead, they will make ineffective bosses regardless of their professional accomplishments. Bill Gates might be a technological wizard, but Microsoft would never have become the corporate giant it is today without his ability to energize, inspire, and animate a rapidly growing workforce. 

How do you stop the downward spiral due to bad leadership? The answer depends. Surely replacing the person in charge can be a solution—when it is feasible. That is not always the case. Another strategy is for directors to diffuse leadership responsibilities by creating self-managed teams (SMTs) where workgroups report to the boss as a group—no supervisor. SMTs usually reinfuse empowerment among team members and begin to turn things around. Creating SMTs usually requires an outside consultant to coach the change. 

Alcohol in the Dairy State: Can Wisconsin Change its Drinking Culture?

April 10, 2017


Maureen Fitzgerald
Communications Coordinator, ATTC Network Coordinating Office
Editor, NIATx

Wisconsin gets a lot of attention for its alcohol culture. And during April, Alcohol Awareness Month, it’s hard not to be reminded of the news and statistics about alcohol use in the Dairy Stateespecially if it’s your home state.  (The NIATx main office and the ATTC Network Coordinating Office are both located at the University of Wisconsin-Madison.)

For example, last year, Wisconsin made national headlines as the location of 12 (yes, 12!) of the “drunkest” cities in the United States. The online news outlet 24/7 Wall St. published the report, which was based on a review of self-reported data on heavy and binge drinking rates across the country.

Julia Sherman, Coordinator of the Wisconsin Alcohol Policy Project  (WAPP) at the University of Wisconsin Law School, says the report is misleading, but acknowledges Wisconsin has a serious alcohol problem. “The writers at 24/7 Wall Street used aggregated county-wide data and made a judgement about individual municipalities. Interesting story but flawed analysis,”  says Sherman.

Still, there’s no doubt that Wisconsin has a serious problem with over consumption of alcohol:
  • A 2012 National Survey on Drug Use and Health (NSDUH) report estimated Wisconsin’s rate of impaired driving at 24 percent—almost twice the national average of 13 percent. [1]
  • In 2014, Wisconsin had the nation’s third-highest rate of adult binge drinking.[2] (That’s an improvement from previous years when the state ranked highest in that category.)
  • Each year, Wisconsin residents (age 18 or older) consume 143 more serving of alcohol than the average American. [3]

Myth buster #5, Part 1: There's no right way to make promotion decisions

March 21, 2017


Thomas F. Hilton, Ph.D.


Although this topic might seem to be aimed at clinic directors and their oversight boards, there is also useful information for counselors and other clinic staff members. The more you understand about leadership, the more everybody in the organization can contribute to a better workplace climate and a more therapeutically effective enterprise. 

Promoting the wrong person can have dire consequences for both staff members and clients. There is a mountain of research showing that poor leadership leads to staff turnover, lowers morale, and erodes job performance. As each staff member quits in order to escape a negative work climate, the remaining workforce is increasingly drained of experience and corporate knowledge (how we do things around here). Because remaining staff need to orient, train, and supervise new hires, they are distracted from their primary roles as therapists, receptionists, etc. The increased patient load on remaining staff can eventually lead them to burn out and leave the clinic as well. Role overload coupled with a decline in staff experience will eventually impact treatment effectiveness and recovery rates. Unless the downward spiral is reversed, the very survival of the clinic is threatened. 

Introducing The BASIS: Your Portal to Addiction Science and Resources

March 14, 2017


Heather Gray, Ph.D.
Senior Editor, The BASISAssociate Director of Academic Affairs, Division on Addiction


Do you struggle to keep up with the latest addiction research? Do you spend too much time search for trusted, evidence-based addiction resources? If so, The BASIS (Brief Addiction Science Information Source) is for you!

The BASIS is a product of the Division on Addiction at Cambridge Health Alliance, a Harvard Medical School teaching hospital. Each week, Division on Addiction faculty members select a recent scientific article related to drinking, smoking, other drug use, or gambling, and summarize its key details: What was the purpose? What did the authors do, and what did they find? What are the implications for treatment and public health? Our science reviews are brief, engaging, and designed to appeal to a general audience. Subscribe to our mailing list to get each science review delivered straight to your inbox. It's a quick and easy way to keep on top of emerging scientific literature.

Take the quiz: How much do you know about problem gambling?

March 1, 2017
Maureen Fitzgerald
Communications Coordinator, ATTC Network Coordinating Office
Editor, NIATx


The National Council on Problem Gambling (NCPG) sponsors Problem Gambling Awareness Month each March to increase awareness of problem gambling and of the availability of prevention, treatment and recovery services.

What kind of people become problem gamblers? 

According to the NCPG FAQ page, "Anyone who gambles can develop problems if they are not aware of the risks and do not gamble responsibly. When gambling behavior interferes with finances, relationships, and the workplace, a serious problem already exists. "

Tips for Navigating 508 Compliance

February 22, 2017


Kendra Barker, M.Ed.Instructional Designer-SpecialistCollaborative for Excellence in Behavioral Health Research and PracticeUniversity of Missouri-Kansas City


Think 508 compliance is just for other people to worry about?

Think again. Disabled World reported in 2015 that people with disabilities experience substance use disorders at a rate two to four times higher than the general population.  CDC reported in 2015 that one out of every five people in the U.S. has a disability.

It's important that people with disabilities have access to information and resources on the Web. That's where 508 enters the picture.  Yet, for many people, 508--what it is, and what rules must be followed--is a bit of a mystery.  In this blog post, I hope to clear up some of that mystery by defining 508 compliance and why it's important to you, your organization, and those you serve (clients, patients, colleagues, and staff).

PPW Project Echo: Building capacity to provide care for pregnant and postpartum women with substance use disorders

February 21, 2017

Sarah Knopf-Amelung, MA-R
Senior Project Manager
ATTC Center of Excellence on Behavioral Health for Pregnant and Postpartum Women and Their Families 




Providing evidence-based, family-centered care to pregnant and postpartum women with substance use disorders is extremely complex. In addition to the pressing medical concerns associated with substance use during pregnancy, it also has far-reaching impacts on family members, necessitating providers to care for the whole family. Recognizing the need for training, technical assistance, and support for the behavioral health workforce serving this population, the ATTC Center of Excellence on Behavioral Health for Pregnant and Postpartum Women and Their Families (CoE-PPW) and the ATTC Network Coordinating Office partnered to develop the PPW Project ECHO. This ECHO is the first of its kind to address the behavioral health needs of pregnant and postpartum women, taking a family-centered approach to the recovery process that is inclusive of family members ranging from the infant to older children, fathers to extended family.

What do med students and prescribers need to know about opioid use disorders?

February 8, 2017


Caroline Miller, MSW
Outreach Specialist,
University of Wisconsin-Madison Division of Continuing Studies


Wisconsin Voices for Recovery partnered with the University of Wisconsin-Madison School of Medicine and Public Health on a Community Engagement Project to conduct a statewide survey of practicing physicians and medical students. The survey was a student-led effort and initiated because medical students felt that their current education on issues related to addiction, specifically the opioid epidemic, was inadequate. The findings highlight where Wisconsin needs to commit resources to improve the education of both students and prescribers, along with end stigma within the medical community.

African American History Month and Addictions Recovery: Featuring the Online Museum of African American Addictions, Treatment, and Recovery

February 1, 2017

Mark Sanders, LCSW, CADC
Gabriela Perez, BA



Frederick Douglass:
"We cannot stagger to freedom."
In seminars, I ask audiences, “What is the reason that African American History Month is in February?” There is always a pause, followed by the same answer, “Because it’s the shortest month of the year,” which brings about laughter. The answer, though, to why African American History Month is in February is to honor the birthdays of AbrahamLincoln (February 12) and Frederick Douglass (February 14). Douglas was the first prominent American recovering alcoholic (White, Sanders, Sanders, 2006). Douglass was also the leader of the Black Temperance movement. This history has been shared with audiences of addictions counselors and inmates in prisons (disproportionately African Americans with substance use disorders). Most are unaware of this history, and many are inspired by it.



National Drug and Alcohol Facts Week: Shattering the Myths

January 23, 2017

Maureen Fitzgerald
Editor, NIATx
Communications Coordinator, ATTC Network Coordinating Office 


This week, January 23-29, NIDA's  National Drug & Alcohol Facts Week returns to shatter the myths  that contribute to underage drinking and experimentation with other drugs and tobacco.

Teens are bombarded with conflicting messages that can leave them feeling confused and unsure of who to ask for information about drug use. With 12.9% of 12th graders reporting abuse of prescription drugs in the past year and 21.3% reporting use of marijuana in the past month, there is no better time than now to help teens understand the serious consequences of drug and alcohol use (data is from the Monitoring the Future Study: Trends in Prevalence of Various Drugs).

Shared Decision Making: Helping prescribers taper opioid prescriptions in Maine

January 12, 2017

Maureen Fitzgerald
Editor, NIATx and ATTC Network Coordinating Office

Image: CDC Injury Prevention & Control
States across the country are taking a variety of actions to respond to the opioid crisis. Forty-nine states have established Prescription Drug Monitoring Programs that track prescription and dispensing data as a way to reduce misuse and diversion, particularly of prescription pain medication.

Three states, Maine, Washington, and Massachusetts, have added additional regulations that limit the daily amount of opioid pain medications doctors can prescribe. Maine’s law, the most restrictive of the three states’, went into effect this month. It sets a 100 morphine milligram equivalent (MME) for new patients, and 300 MME for current patients.

The law does not place daily MME limits on medications prescribed for treating substance use disorders. It’s intended to keep people with chronic pain from the taking higher doses of opioid pain medication that increase the risk of overdose and death.