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.  In 2012, he was recognized by the Obama White House 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.

Curry presented a webinar on Dryhootch as part of the National Frontier and Rural ATTC's Telehealth Tuesdays series in April 2017.  Click here to view the recorded webinar.

Curry will also be a featured presenter at the National Frontier and Rural ATTC 2017 Technology Summit.

Related Resources

SAMHSA's Efforts to Support Veterans and Military Families 

From the ATTC Network
Great Lakes ATTC:
Finding Balance: Understanding and Optimizing your Stress System after Deployment

National Hispanic and Latino ATTC:
Latino Veterans and the Cultural Aspects that Influence their Treatment Needs

Southeast ATTC
How do we pave the way home?

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? 

The National Frontier and Rural (NFAR) Addiction Technology Transfer Center (ATTC) is hosting its 5th Annual Technology Summit at the Whitney Peak Hotel in its hometown of Reno, Nevada, July 26-28, 2017.

The goal of the 2017 NFAR Technology Summit is help attendees gain usable skills and knowledge related to how technology can expand and enhance treatment and recovery services to improve client outcomes.

Following the Summit, attendees will be able to:
  • Explain the use of technology in advancing the treatment of opioid use disorders
  • Address the ethical dilemmas related to using and prescribing new technologies
  • Practice the use of technology-based mediums such as texting, video-conferencing, social media, and apps
  • Plan for implementation of technology-based clinical supervision and services in their clinical settings
  • Identify ways in which technology increases access to care and behavioral health workforce opportunities
Leave Your Legacy at the Opening Reception

You won't want to miss this year's opening reception. The 5th Annual NFAR Technology Summit is proud to introduce an interactive networking reception that will celebrate the legacy of the NFAR ATTC project while also highlighting local culture and the beauty of the Reno/Tahoe region. Attendees will be able to take part in an interactive art display, enjoy local music, network with colleagues, and sample light appetizers from one of the region's top local catering companies. Please join us from 5:00-6:30 p.m. on Wednesday, July 26th in the Whitney Peak Ballroom to make a lasting memories and leave your legacy!

Get Motivated by Expert Conference Speakers

Keynote presentations will be delivered by Dr. Kimberly A. Johnson, Director for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration, and Dr. Tony Rousmaniere, Clinical Psychologist and editor of Using Technology to Enhance Clinical Supervision. The keynote presentations will address how technology can extend the reach and efficacy of substance use disorder (SUD) treatment and improve workforce development. Attendees will also have the opportunity to hear from experts on the use of technology to treat opioid use disorders, how apps can support recovery, and how state license reciprocity rules are changing to support virtual counseling services.

Concurrent breakout sessions will feature in-depth and hands-on experiences on how to incorporate technology into substance use services. The breakout sessions are scheduled to repeat twice to allow participants to attend two of the three sessions. Agencies interested in building skills in all three areas should send at least two participants to the Summit.

Build Relationships

Come prepared with business cards and any questions you have about incorporating technology into behavioral health services. You will be surrounded by experts in the field of technology implementation, so this is an excellent opportunity to get answers to your questions and build a repository of ideas and contacts to assist you in overcoming challenges.
Our speakers and partners are very generous about providing assistance and expertise after the event as well, so be sure to share your business card and connect on Facebook, LinkedIn, or other social media to keep the conversations going.

Get started now by sharing your best tips with us on Twitter with hashtag #2017NFARSummit or post on our NFAR-ATTC Facebook page.

AND…Visit the Beautiful Reno/Tahoe Area

Typical Reno weather in July is sunny and warm, with average temperatures ranging from the mid-50s at night and the high 80s during the day with low humidity. Nestled on the eastern slope of the Sierra Nevada Mountains, Reno has excellent weather and spectacular views within a 40-minute drive, including Lake Tahoe and Mt. Rose Summit at just under 10,000 feet! Need ideas for what to do while in Reno? Visit https://www.visitrenotahoe.com/reno-tahoe/what-to-do.

NO Registration Fee!

Register today to take advantage of this great opportunity! There is no registration fee to attend the Summit.

Visit http://www.nfarattc.org/summit to register.

See you in Reno!

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.

A better answer would be, “We won’t know until 25 years after legalization and, by the way, we haven’t even fully started it yet.” Here, as I’m permitted a blog post not just a sound bite, I’ll try to explain why I say that.

One obvious point is that all of the so-called “legal” cannabis activity is still fully prohibited by the federal Controlled Substances Act (CSA). It is only state-legal, not legal. That matters. Here are a few "for instances."

Many state regulations – including marketing restrictions – will become unconstitutional violations of interstate commerce and/or commercial free speech as soon as marijuana is removed from the CSA. (The 21st Amendment that repealed prohibition grants states special regulatory powers over alcohol, but a similar constitutional provision concerning cannabis is not likely.)

Cannabis clearly meets the definition of a drug under the Federal Food, Drug, and Cosmetic Act (FDCA), so unless Congress grants cannabis an explicit exception, it will come under the FDCA as soon as it is removed from the CSA. Many cannabis industry actions will then immediately be banned by the FDCA.

Traditional production areas and methods may go bankrupt. The national supply of cannabis can be produced on the equivalent of 10 typical Midwest farms, and a year’s supply for a heavy user weighs less than one 22 ounce can of beer. So production will concentrate in whatever town or county offers the lowest production costs and most lenient regulations. Or, production may move off shore, especially for labor intensive flower products.

Legalization-to-date has already changed the industry. A decade ago, many producers tended 99 plants to stay under limits that triggered tougher federal sentences. Now growing 10,000 plants is common. But that only scratches the surface. Here are some predictions.

15 years ago grow operations’ key resource was a master grower. 15 years hence production will be commoditized and the key skills will be marketing and brand management.

Back then, marijuana was so expensive people claimed it was the nation’s leading cash crop. 15 years from now marijuana will be so cheap that convenience stores will use it as a loss leader that brings people in to buy more profitable items, like soda pop and gasoline.

Today public health leaders think using marijuana together with alcohol increases the risk for impaired driving. Tomorrow leaders of multinational corporations will think selling marijuana together with alcohol – and tobacco – increases the opportunity for enhanced profits.

One hundred and forty years ago the invention of machines for rolling tobacco cigarettes radically reduced production costs and prices. That triggered consolidation from regional companies to multinationals, and shifted tobacco consumption from cigars to cigarettes and from men to also women. Now the spread of legalization is radically reducing production costs and prices, rapidly increasing firm size, shifting the favored product forms, and shifting consumption from weekend to daily patterns of use.

I do not expect marijuana legalization to match the public health catastrophe wrought by the tobacco industry. But I expect the dynamic energy of the free market to exploit fully the profit potential of this new (to private industry) dependence-inducing intoxicant, and innovation will carry the markets and consumption to places we would have a hard time imagining today.

Some people used to think legalization meant the same old same old, just without the arrests. We’re far enough into legalization to realize how na├»ve those beliefs were, but we’re not yet far enough in to have much of an inkling of where this movement will take us.

My best guess is that 25 years from now we will rue deeply unleashing those free market forces and wish that we had restricted legal supply to non-profit organizations chartered to operate in the public interest. My greatest comfort is knowing that many predictions of distant futures often fall far from the mark, and so I dearly hope that time proves these predictions of mine to be wrong.

Jon Caulkins is the author, with Angela Hawken, Beau Kilmer, and Mark Kleiman, of Marijuana Legalization: What Everyone Needs to Know.

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.