Building Healthy Native Communities: National American Indian & Alaska Native ATTC



December 11, 2018

Jeff Ledolter & Anne Helene Skinstad
National American Indian & Alaska Native Addiction Technology Transfer Center



On November 14, 2018, the National American Indian & Alaska Native Addiction Technology Transfer Center (ATTC), Mental Health Technology Transfer Center (MHTTC), and Prevention Technology Transfer Centers (PTTC) gathered at the University of Iowa’s College of Public Health for its fifth annual symposium titled “Building Healthy Native Communities.” After a blessing from Robert Begay, MA, a member of the Navajo Nation and the Advisory Council for the three centers, native guest speakers from across the nation came together to discuss the issues facing native communities today.

Building Rural and Technology Literacy Skills

December 11, 2018

Nancy Roget
Thomasine Heitkamp
Joyce Hartje
Mountain Plains Addiction Technology Transfer Center


Since its inception in 1993 (one of the original ATTCs), what is now the Mountain Plains ATTC has focused on creating research-based SUD treatment/recovery products that can easily be inserted into existing curricula by behavior health faculty, which helps make research functionally relevant within the context of a discipline. Typically, these Curriculum Infusion Products (CIPs) include PowerPoint slides, videos, classroom exercises, and case scenarios.  Recently, the Mountain Plains ATTC created a new product called Slide Decks for You (Slidedecks4you), which is a shorter version of the CIPs. Both types of products are available on the Mountain Plains ATTC website.

Building a Science of Recovery: The Pinnacle ATTC Achievement?

November 6, 2018

Mike Flaherty, PhD
Founder, Institute for Research, Education, and Training in the Addictions
Former Director, Northeast ATTC





In 25 years of service to our nation, providers, and the public, the Addiction Technology Transfer Center Network (ATTC) has achieved many accomplishments capable of being referred to as its “pinnacle” achievement. Indeed, reaching 25 years itself via SAMHSA support and guidance as a “model” to bring science into adopted practice, while building workforce development, advancing innovation in prevention and more recently mental health could each be peak accomplishments. The ATTCs, regional beacons of “what works” taken to those who “need to know”and “can do something with it” are without parallel in any other nation of the world. Universities and institutions of higher learning would do well to emulate them.

Help people with opioid use disorders with ATTC Network Educational Packages: TwitterChat on Oct.30!

October 29, 2018














What do you need to know to help people with opioid use disorders?

Finding the answer to that question is now easier with the ATTC Educational Packages for Opioid Use Disorders.

Each digital guide offers information and links to the latest resources on how to:
  • Prevent opioid misuse
  • Intervene with individuals at risk for opioid use disorders
  • Provide safe, informed, person-centered care for people with opioid use disorders
  • Understand your role 

We All Know Someone: Northwest ATTC Co-Sponsors Recovery Month Event: Solution to Addiction

October 11, 2018

Meg Brunner, MLIS
Northwest ATTC


On September 26, 2018, the Northwest ATTC in conjunction with the Skagit County Public Health Department and Swinomish Indian Tribal Community, co-sponsored a community-based Recovery Month event in Skagit County called “Solution to Addiction: Know the Facts. Join the Conversation. Be Part of the Solution.”

The event, held at the Swinomish Casino & Lodge in Anacortes, WA, brought together 500 community members, county and public health officials, Swinomish tribal representatives, providers, and recovery coalitions to begin an inclusive conversation about addiction and how communities can work together to bring about lasting change.

For National Hispanic Heritage Month: Build Your Skills with ATTC Network Tools and Trainings

October 4, 2018

Maureen Fitzgerald
ATTC Network Coordinating Office/NIATx

September 15-October 15
Find out more
What's one thing that Haner Hernandez would like people to know about the Latino population in the United States?

"It's that we're so diverse," says Hernandez, who provides training and technical assistance for the ATTC Network on topics such as health disparities, cultural elements of Latino populations, and the National Standards for Culturally and Linguistically Standards in Health and Health Care

Hernandez has served as an Expert CLAS Consultant and Technical Assistance Provider for the New England ATTC for over a decade.

Helping African-American Emerging Adults At Risk for Substance Use Disorder: Developing Resilience


October 2, 2018


Fred Dyer, Ph.D., CADC



Given the multiple risk factors for heavy substance use which impacts many African America Emerging Adults, ranging from easy access to drugs, poorly performing schools, father hunger, the presence of gangs within communities, early criminal justice involvement and discrimination, how can those of us who are committed to working with this population assist them in living a drug free life?

Recovery Month 2018: A Roundup of Resources from the ATTC Regional Centers

September 17, 2018

Maureen Fitzgerald
ATTC Network /NIATx





Recovery Month celebrates the message that behavioral health is essential to overall health, prevention works, treatment is effective, and people can and do recover. ATTC Regional Centers across the U.S. are helping to spread that message through presentations, publications, conferences, and by supporting local and regional Recovery Month activities. Most of the products developed by the Regional Centers are relevant and available to all, no matter where you live. You can find them on Products and Resources page on the ATTC Network website.

Here's a roundup for your reference:

Joining the Voices of Recovery: Joseph Green Inspires Through Spoken Word

August 24, 2018

Maureen Fitzgerald
ATTC Network Coordinating Office/NIATx



Joining the voices of recovery this September—and all year long— is spoken word artist Joseph Green.

Green is a motivational speaker, educational consultant, poet, and former Director of Youth Programs at Split This Rock, a Washington D.C. based organization that harnesses the power of poetry for social change. He's also a professional spoken word artist and storyteller, drawing on his recovery journey and other facets of his life to shape compelling narratives to inspire and help others.

Like this one, titled St. Jude:



Drug Contamination Crisis: Connecticut and Beyond

August 21, 2018

Tonya Tavares and the New England ATTC (HHS Region 1)


New Haven, Connecticut, recently faced a rash of overdoses linked to a suspected fentanyl-contaminated supply of K2, a synthetic marijuana also known as Spice. Taken alone, the effects of K2 can be unpredictable and even life-threatening. Fentanyl, a synthetic opioid that is approximately 50 times more potent than heroin, is often clandestinely combined with other drugs and greatly increases the risk of lethal outcomes.

In the past week, over 70 people have overdosed, with a large majority centered around New Haven’s Green Park. Connecticut is not alone in facing drug contamination, specifically with K2. Brooklyn, NY, faced similar tragedy in May of 2018, with 87 people overdosing because of a particularly toxic batch of K2. Washington, DC, and Austin, TX, have also seen large numbers of overdoses, some fatal, resultant from K2 and contaminated batches of K2.

Addiction Docs On Call: Wisconsin Warmline Answers Doctors' Questions About SUD Treatment

August 15, 2018

Maureen Fitzgerald
ATTC Network/NIATx

Say you're a primary care doctor in northern Wisconsin treating a patient with alcohol use disorder who is also using methamphetamine. Your med school training may not have covered substance use disorder treatment in depth, and you're not sure of the best treatment and prevention options for your patient. But thanks to a new warmline just launched in Wisconsin, you can pick up the phone and get immediate advice from an addiction treatment specialist at UW Health and  the UW Department of Family Medicine and Community Health.

Culturally Appropriate Mental Health Care to Address American Indian/Alaska Native (AI/AN) Mental Health Disparities

August 6, 2018

Sean A. Bear, BA, CADC
Co-Director, National American Indian and Alaska Native Addiction Technology Transfer Center

Originally posted  in the National Partnership for Action to End Health Disparities blog, In the Spotlight

Non-Hispanic American Indian and Native American (AI/AN) adults and children are at greater risk than all other racial groups of experiencing poor mental health outcomes and unmet medical and mental healthcare needs. For instance, suicide rates for AI/AN adults and youth are higher than the national average.

Community Resilience: Recovering Together

July 30, 2018

Caroline Miller, MSW
Director, Wisconsin Voices for Recovery
Associate Researcher, UW-Madison Department of Family Medicine and Community Health


Rally for Recovery, State Capitol, Madison WI, September 2017

Wisconsin Voices for Recovery is actively building community resilience through its events and programming across the state. Two initiatives in particular, the ED2Recovery program and the Rally for Recovery in celebration of 2018 National Recovery Month, demonstrate the important ways that people in recovery, their friends and families, have come together to support recovering together in Wisconsin.

Opioid Treatment and Recovery News Roundup

July 12, 2018

Maureen Fitzgerald
ATTC Network/NIATx 


Have you been taking a summer break from the news? Get caught up with five recent news and research headlines, plus a great new Road to Recovery TV episode from SAMHSA

1. Expanding primary care buprenorphine treatment could curb opioid overdose crisis
Science Daily
Research published by Drs. Sarah Wakeman and Michael Barnett describes barriers to wider use of buprenorphine treatment for opioid use disorder, and how to overcome them.

Among the most persistent barriers? Stigma.

Celebrate PRIDE Month: Visit the YMSM+LGBT CoE Website


June 21, 2018
Brandy Oeser, MPH
Project Director
YMSM + LGBT 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 ATTC’s recognition of LGBT Pride Month we would like to encourage you to visit the YMSM + LGBT CoE website, which features archived webinars where you can learn more about the LGBT community. Webinars are available on many topics, including Creating an LGBT Affirming Organization, Supporting Change for LGBTQ Young Adults, and Working with and for Two-Spirit Individuals. To learn more, please visit LGBT Webinar Recordings.

About the YMSM + LGBT CoE


Between September 30, 2014, and September 29, 2017, the Center of Excellence for Racial/ethnic Minority Young Men Who Have Sex with Men and other Lesbian, Gay, Bisexual, and Transgender populations (YMSM+LGBT COE) provided training and technical assistance to providers on culturally responsive prevention and treatment services to decrease rates of substance use and HIV infections among YMSM and LGBT communities. A collaborative team from the PS-ATTC, NeC-ATTC and National American Indian and Alaska Native ATTC led the COE, in partnership with the National Hispanic and Latino ATTC and Charles R. Drew University.

The YMSM+LGBT COE generated innovative curricula, developed 97 trainers and established a national training infrastructure. The YMSM+LGBT COE also hosted monthly webinars and created a website to serve as an information clearinghouse for research articles and best practices to serve YMSM and LGBT clients. The website also contains information and other resources for providers who serve YMSM and LGBT clients. 

Continuing our work   


Though funding for the COE has ended, the work has continued thanks to the dedicated and passionate trainers affiliated with the project. LGBT trainings have recently been conducted in Arizona, California, Colorado, North Carolina, New Hampshire, Pennsylvania, New York, Massachusetts, American Samoa and Bermuda! YMSM and LGBT related presentations are being conducted at conferences throughout the country. We are moving to quarterly webinars now thanks to the support of the PS-ATTC and UNR CASAT.

For more information or to request a training please email Brandy Oeser at boeser@mednet.ucla.edu

Is your organization observing PRIDE Month?  Tell us how in the comments section below.

How to Become a Best Place to Work for 10 Years in a Row


June 19, 2018

Maureen Fitzgerald
ATTC Network/NIATx



Horizon Health Services began in 1975 with a single location in Buffalo, NY.  Today, the agency has more than 600 employees providing a full continuum of services at more than 20 locations in three counties.

At Horizon, staff satisfaction and growth are at the heart of workforce development. 

Really—the agency trains all new staff on the Communicate with H.E.A.R.T. model, a communication model developed by the Cleveland Clinic.

"The H.E.A.R.T. (Hear, Empathize, Apologize, Respond, and Thank) model differentiates us," says Veronica Meldrum, Vice President of Employee Services. "It provides a framework for a collaborative work environment,  solving problems, and keeping the customer at top of mind in all of our day-to-day operations."

Staff Surveys 


For Meldrum, The H.E.A.R.T. model is one factor that has helped Horizon Health Services earn the distinction of being a Best Place to Work in Western New Yorkfor the 10th year in a row.

"We are as proud today as we were the first time we received the award," says Meldrum.

Another critical factor? Continually seeking staff feedback.


Benefits and Compensation Study


In addition to engaging in surveys with external vendors, Horizon also conducts internal surveys to assess employee engagement. Surveys are just one way for agency leadership to stay connected with employees and address any workforce issues. For example, information from staff surveys was key in a recent revamp of Horizon's benefits and compensation plan.

"Being named a Best Place to Work is a huge honor because it largely depends on results of anonymous surveys our employees complete," explains Meldrum.

Meldrum says that Horizon takes a creative approach to addressing the many factors that complicate staff recruitment and retention today. "We will continue to strive to improve our workplace and the work experience of our employees. Every single person at our organization, whether providing direct service or working behind the scenes, has a critical role."


ATTC Resources for Workforce Recruitment and Retention

Publications: National Workforce Study
National Workforce Report 2017: A National Qualitative Report
Vital Signs: Taking the Pulse of the Addictions Treatment Workforce

Webinar: Workforce Recruitment and Retention: A Review of Strategies
June 28, 2018, 11:00am CT


How does your organization recruit, retain, and reward your staff?  Share your strategies in the comments section below.

Help for the Opioid Crisis: STR-Technical Assistance Available to States and Territories





June 5, 2018

Swan Capris
STR-TA Project Manager 
www.AAAP.org


The State Targeted Response Technical Assistance (STR-TA) Consortium website (www.getSTR-TA.org) and technical assistance (TA) portal is now live and ready to support efforts to address opioid use disorder prevention, treatment, and recovery across the country.

On February 1, 2018, the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded the American Academy of Addiction Psychiatry (AAAP) and a coalition of 22 national healthcare organizations a two-year grant to provide all 50 U.S. States and 7 territories with assistance targeting the opioid crisis. The Consortium has been accepting technical assistance requests for MAT (Medication-Assisted Treatment) waiver trainings, mentorships, systems work, and peer recovery support aftercare programs.

The STR-TA Consortium is focusing on making use of evidence-based resources that have already been created and reviewed to avoid recreating the wheel or wasting resources, including those from: AAAP/Providers Clinical Support System, ATTC Network,  Center for Social Innovation, CADCA, Boston Children’s Hospital on SUD, Columbia University, and Research Triangle International, also funded by SAMHSA.

The goal of STR-TA is to be responsive to meet community’s needs by providing training and TA on evidence-based practices in the prevention, treatment, and recovery of opioid use disorders through local experts. This effort has been designed as a tailored, locally driven approach to TA delivery.

We urge you to share this flyer with your colleagues and community. The STR-TA Consortium and a team of TA consultants stand ready to assist STR grantees and others in prevention, treatment, and recovery as they relate to opioid use disorders.

Together we CAN make a difference!


About AAAP:

We’re an organization focused on helping those with substance use disorders and mental disorders by educating, influencing and encouraging excellence in practice, policy and prevention for the field of Addiction Psychiatry and beyond through our partnerships with psychiatrists, faculty, medical students, residents and fellows, non-psychiatrists and related health professionals.

Funding for this initiative was made possible (in part) by grant no. 1H79TI080816-01 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

GetNaloxoneNow: Everything You Need to Know to Save a Life

May 30, 2018

Earlier this year, Dr. Jerome Adams, the Surgeon General of the United States, issued the following  advisory on naloxone and opioid overdose

I, Surgeon General of the United States Public Health Service, VADM Jerome Adams, am emphasizing the importance of the overdose-reversing drug naloxone. For Patient currently taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids, individuals using illicit opioids such as heroin or fentanyl, health care practitioners, family and friends of people who have opioid use disorder, and community members who come into contact with people at risk for opioid overdose, knowing how to use naloxone and keeping it within reach can save a life.
BE PREPARED. GET NALOXONE. SAVE A LIFE. 

Janie Simmons, EDD, Developer of GetNaloxoneNow
One way that you can be prepared, get naloxone, and save a life is with the online resource, GetNaloxoneNow.  

We posed a few questions about GetNaloxoneNow to Janie Simmons, EDD, principal investigator at NDRI, and one of the developers of the product.

As you'll see from her answers that follow, GetNaloxoneNow is a versatile product that provides rapid training for professionals as well as laypeople.

What is GetNaloxoneNow.org? 

GetNaloxoneNow.org is a novel website (operating out of NDRI-USA and NDRI, Inc.) which houses two overdose prevention, recognition and response trainings; one for laypeople and the other for professional first responders (police officers, firefighters and EMTs). The training for laypeople, which we call the Bystander training, takes approximately 20 minutes while the training for professional first responders takes about 40 minutes.

Each training was put together by an experienced team of overdose specialists (MDs, prevention researchers, curriculum designers and experts with experience training first responders) as well as top-notch graphic designers, animators and professional voice narrators with funding from the National Institutes of Health/National Institute of Drug Abuse (1R43DA029358-01A1 and 1R43DA033746-01). Both trainings were modeled after best-practice models used in Massachusetts and New York and were developed in accordance with theories of multimedia learning to enhance retention.

Anyone with a computer, notebook, tablet or smartphone can access the trainings from work or home. The website also houses numerous links to relevant articles and other online sites supporting overdose education and naloxone dissemination, as well as articles and informational sites on effective drug treatment, harm reduction, and other proven strategies to address the epidemic. In addition, there are links for support for family members and additional info (i.e. on fentanyl risks) for professional first responders. A certificate of completion is provided to those who pass two interactive quizzes and a post-test administered online at the end of the 40-minute training. GetNaloxoneNow.org is supported by the GetNaloxoneNow Facebook page and the #GetNaloxoneNow twitter account. New information (news, articles, studies, reports, commentary) are provided almost daily on these sites.

How many people have been trained through GetNaloxoneNow.org? 

As of May 29th, over 70,000 people have taken the trainings since they went online on August 31st, International Overdose Day, in 2014. Currently, an average of 100 individuals register for the trainings (approx. 65 laypeople and approx. 35 first responders) every day.

Is there a cost for the training? 

The trainings are free and we are committed to providing them at no cost to individuals. However, we need to be able to sustain this life-saving project so, beginning in early June, we will be asking $10 for Certificates of Completion. We have found that many organizations, including for-profit and non-profit organizations, schools, universities, drug-treatment programs, and police and fire departments require their staff or students to provide Certificates as proof of completion. We support this practice, of course, but we will start to request a small fee.

The Bystander training also carries one Continuing Education CASAC credit. These credits are required in NY State, and there are reciprocity agreements in place for 47 other states and territories, as well as the US military, to honor these credits for continuing professional education in the field of substance use/misuse. We hope to provide CE credits for other professional groups in the future.

How can states use GetNaloxoneNow.org? 

We have a special subscription service for states. States that subscribe receive monthly registration data. For example, we share how many people register for the training, demographic data, where they get on the site (by zipcode) and a visual state-wide map, as well as data on how they answer a series of questions (Have you overdosed; Have you witnessed an overdose; Why you are taking the training (for work, for a family member, etc.).

For First Responders, we also ask if they carry naloxone; if not, if they'd like to carry it; and if they have witnessed or intervened in overdose emergencies. We work with state and/or local DOH representatives to target particular areas of the state or particular demographics with social media campaigns advertising GetNaloxoneNow.org. We also either provide a unique page for each state on our website that is made visible and accessible to anyone registering for the training from that state (recognized by zipcode) or we lead the trainee to a web page designated by the state (usually the overdose page of the state DOH) once they successfully complete the training in order to find out more information about overdose and naloxone in their state, and where to obtain naloxone.

What kind of feedback have you received from people who have completed the training? 

Feedback has been overwhelmingly positive. My colleagues and I evaluated both trainings with funding awarded to us through the Center for Drug Use and HIV Research (CDUHR) at New York University (Grant # P30 DA011041). These evaluations assessed the impact of the training on self-reported confidence, knowledge and skills to intervene successfully in an opioid-related overdose emergency among a sub-sample of laypeople and professional first responders and assessed satisfaction with the trainings. Analysis of the post-training surveys indicated high satisfaction with content, format and mode of delivery, and high satisfaction with items related to confidence and overdose reversal preparedness. The study demonstrated the feasibility and preliminary acceptability of the trainings as well as suitability for rapid, cost-effective dissemination. 

Our findings were published in Drug and Alcohol Dependence (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5140716/)
and Substance Use and Misuse (https://www.tandfonline.com/doi/abs/10.1080/10826084.2018.1451891?journalCode=isum20)

We have also translated the Bystander training in Spanish and plan to have that online within a few weeks (if not sooner).

Do you have an additional question about GetNaloxoneNow.org? Post it in the comments section below: 

5 Things Dr. Dennis McCarty Wants You to Know About Treatment and Prevention of Opioid Use Disorder

May 22, 2018

Veronica Wang
Great Lakes ATTC


Dr. Dennis McCarty covered a lot of information in the webinar on April 3, Treatment and Prevention of Opioid Use Disorder: An Overview. The webinar began with a brief history of federal drug policy in the U.S. and medication-assisted treatment of opioid use disorder, and ended with a lively Q&A session with participants.

10 Things to Know About Hepatitis

Maureen Fitzerald
ATTC Network Coordinating Office/NIATx
May 14, 2018

1. May is Hepatitis Awareness Month.

One of the most important things to know is that many (millions) may be infected without knowing it. And people who use drugs and alcohol are at greater risk of getting and transmitting viral hepatitis.

Reduce Underage Drinking Today and You Prevent Opiate Use Tomorrow

April 16, 2018



Wisconsin, like many states, has seen its rate of underage drinking drop in the last decade. Over that period, law enforcement worked with community groups and coalitions to reduce youth access to alcohol. A new state law made it illegal to provide a location for underage drinking—even when adults did not provide the alcohol. In some communities, groups worked with police to make sure residents didn’t leave alcohol in unlocked garages or storage areas—where youth could pilfer it. 

Sometimes we are asked why efforts to prevent and reduce underage drinking should continue when opiate abuse is at crisis levels. The answer is clear—alcohol prevention today is illicit drug prevention for the future. Alcohol is widely available and most often, first substance youth use, earlier than parents realize.  Research has proved that alcohol use in the sixth, seventh and eighth grades has an “especially powerful influence” over lifetime illicit drug use.[i]  Reducing underage drinking today is preventing a future opiate epidemic.

Looking for a job in behavioral health?

April 4, 2018

Maureen Fitzgerald
ATTC Network Coordinating Office/NIATx




You can job hunt from the comfort of  your own home at The Behavioral Health Virtual Job Fair, coming up on Wednesday, April 11, 2018. This online event is designed to help you connect with potential employers in areas with limited access to care.

The Health Resources and Services Administration’s (HRSA) is offering the Virtual Job Fair (VJF) to make it easier for employers and job seekers to find each other, says Leah Henao, Branch Chief, Outreach, Recruitment and Partnership Branch, Bureau of Health Workforce, Health Resources & Services Administration.

Surgeon General's Report: An Essential Tool for Addressing Substance Use Disorders


April 2, 2018
H. Westley Clark MD, JD, MPH, DFASAM
Dean's Executive Professor
Public Health Program
Santa Clara University


Facing Addiction in America image

I spent 16 years as the Director of the Center for SubstanceAbuse Treatment trying to elevate the discourse about substance use, misuse and dependence.  It was not until I retired, that the discourse about addiction was joined by the Office of our Nation’s doctor, the Surgeon General

In November of 2016, The Surgeon General’s Office released the groundbreaking document, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health (SG Report). This document, which was the first from a Surgeon General, thoroughly outlined the neurobiological underpinnings of substance use, misuse and dependence, as well as effective, evidence-based treatment and prevention strategies for facing addiction in America. Please join Dr. Clark on the 

Reducing Stigma and Improving Quality of Care: Shatterproof

March 27, 2018

Samantha Arsenault,
Director of National Treatment Quality Initiatives
Shatterproof



More than 42,000 opioid-related overdose deaths last year. Over 2 million people addicted to opioids. Costs to society exceeding $500 billion per year in lost productivity, healthcare, and criminal justice costs. The tragic opioid-related statistics continue to soar—and so too does public awareness about this crisis. Newspaper headlines share heartbreaking stories of loss, advocates work diligently to spread messages of hope, providers deliver care to those in need even in trying conditions, and the President declared a public health emergency. Despite these facts, too few understand that addiction is a chronic disease, and that decades of medical research show it can be treated with the same effectiveness as other chronic diseases. 

Midwest Consortium on Problem Gambling and Substance Abuse: Upcoming Conference Celebrates 15 years

March 20, 2018

Carol Spiker, LAC, CPP, KCGC
Problem Gambling Program Manager
Behavioral Health Services Commission
Kansas Department for Aging and Disability Services


Image of a man and a dice


Gambling is an activity in which something of value is risked on a chance that something of value might be obtained, the outcome based on chance. Organized gambling has grown tremendously in the U.S. since the 1980’s because many people have been willing and eager to spend money in exchange for a chance at something bigger and better than what they have.  States have legalized and expanded gambling with the promise of substantial economic benefit and tax revenue.

Responsible Gambling Programs



March 13, 2017
Christine Reilly
Senior Research Director
National Center for Responsible Gaming


Warning messages on gaming machines. Self-exclusion programs. Programs to limit money and time spent gambling. These are just a few responsible gambling strategies in use around the world. Responsible gambling (RG) refers to programs that seek to prevent or reduce gambling-related harms. The impetus behind these programs derives from the public health shift from a reactive posture of trying to eliminate disorders that have already occurred, to a proactive force that seeks to promote positive health behaviors and prevent diseases before they emerge (or at least mitigate their effects).

Source: Independent Gambling Authority


The rise in responsible gambling strategies is a response to this trend of health promotion. Enacted in government regulations, as well as in voluntary programs developed by gambling operators, responsible gambling programs have proliferated in legalized gambling jurisdictions throughout the world. However, are these programs safe? Are they effective? A review of the scientific literature by the leading gambling researchers indicates a dearth of science-based, peer-reviewed programs in this area. Why is peer-reviewed research important? Quality research will answer questions about safety and effectiveness. For example, is self-exclusion an effective intervention? Are limits on time and money wagered safe or do they in some cases cause people to gamble even more than they intended? These questions must be answered to protect people and to ensure that the considerable expense of these programs can be justified as effective. Here a few examples.

Voluntary self-exclusion programs, typically operated by
casinos, online gambling sites and gaming regulators, give individuals the opportunity to exclude themselves from gambling opportunities. Typical programs remove the enrolled person from marketing databases. Some authorize staff to remove the enrolled person from the premises and to deny cash prizes to those on the self-exclusion list.

What the research says


Research indicates that self-exclusion is safe and, for some gamblers, an effective intervention. However, more research is needed to ascertain the long-range impact of the program and to determine the most effective features of the program. For example, it is not clear what the optimum time limit for the ban should be.

Another responsible gambling strategy is to educate gaming employees about responsible gambling and gambling disorder. Research indicates that employee training can improve employees’ knowledge of responsible gambling. However, there is no evidence that increasing knowledge among casino staff can help employees accurately identify casino patrons with a gambling disorder.

In conclusion, the field does not yet have a systematic approach for assessing the quality of research on RG. Instead, a haphazard approach to developing and adopting RG programs has characterized RG efforts. Policymakers and the gambling industry should take a cautious and conservative approach to RG until quality scientific research provides a roadmap to safe and effective programming.

Winning Reads for Problem Gambling Awareness Month

March 5, 2018
Maureen Fitzerald
ATTC Network Coordinating Office/NIATx



We've rounded up a few great resources to help you stay up-to-date on the latest in prevention, education, and treatment for problem gambling--not just during Problem Gambling Awareness Month, but year-round:

Everything you need to know about medications for treating opioid use disorders: SAMHSA TIP 63

February 20, 2018

Maureen Fitzgerald
ATTC Network Coordinating Office/NIATx




Finding the most up-to-date information on how to support people with opioid use disorder (OUD) just got easier with the release of SAMHSA's  TIP 63: Medications for Opioid Use Disorder.  An expert panel of researchers, policy makers, treatment providers, and others helped to develop TIP 63. 

Research supports the use of the three FDA-approved medications—methadone, extended-release naltrexone, and buprenorphine—for treatment of OUD. As TIP 63's Executive Summary states, randomized controlled trials have shown these medications to be effective in reducing illicit opioid use and overdose deaths.  (You'll find citations to latest research throughout TIP 63.)
Patients with OUD should have access to mental health services as needed, medical care, and addiction counseling, as well as recovery support services, to supplement treatment with medication.   SAMHSA TIP 63, Executive Summary 
Source: SAMHSA TIP 63
Yet these medications remain underused in the United States. Researchers from the Foundation for AIDS Research (amfAR) shared an analysis of SAMHSA's National Survey of Substance Abuse Treatment Services in a recent post in the Health Affairs Blog, Where Multiple Modes of Medication-Assisted Treatment Are Available. They found that of the 12,029 U.S. treatment facilities:

  • 41% of treatment facilities offer only one of the medications
  • 23% offer two or more 
  • 2.7 % report offering all three medications
The Health Affairs blog post  includes information on geographic availability of medication-assisted treatment with a link to amfAR's interactive map, Facilities Providing Some Medication Assisted Treatment.

TIP 63: Developed by an expert panel


With TIP 63, SAMHSA provides an essential resource to treatment organizations that want to start or expand their use of medications for opioid use disorders. The TIP includes an Executive Summary followed by five sections:

Part 1: Introduction to Medications for Opioid Use Disorder Treatment, presents information on medications, their effectiveness, how they're prescribed, and barriers to their use.

Part 2: Addressing Opioid Use Disorder in General Medical Settings, covers OUD screening, assessment, treatment, and referral.

Part 3: Pharmacotherapy for Opioid Use Disorder gets into the specifics of prescribing and dispensing OUD medications.

Part 4: Partnering Addiction Treatment Counselors With Clients and Healthcare Professionals,  offers guidance on how substance use disorder counselors and other health care professionals can work together to help people with OUD.

Part 5: Resources Related to Medications for Opioid Use Disorder, includes a glossary, a resource list, and sample forms.

Download for free today 


SAMHSA Tip 63 is free, and you can download digital versions of each section or the entire document from the SAMHSA website. You can also place an order for hard copies on SAMHSA's Publications Ordering page. 

Have you started to use SAMHSA TIP 63?  What's been most useful to you in starting or expanding your use of medications for OUD?  Let us know in the comment section below. 

Understanding Substance Use Disorders: New online course covers the basics

February 6, 2018


Heather Gotham, PhD
Associate Research Professor
Mid-America ATTC


The newest course on HealtheKnowledge, Understanding Substance Use Disorders, is a collaborative effort between the UMKC-SBIRT Project (a SAMHSA-funded SBIRT health professions training grant; www.sbirt.care) and the Mid-America ATTC. Through UMKC-SBIRT we had several requests for a basic training on substance use disorders, as several of the health professions training programs with which we work did not provide even basic instruction on SUD. They wanted a primer course that students could take prior to SBIRT training (SBIRT for Health and Behavioral Health Professionals, also on www.HealtheKnowledge.org).

In addition, through Mid-America, we had received multiple requests for basic SUD training that could be used during the orientation of new behavioral health staff, as well as training for child welfare, corrections, or other allied professionals. The course is also currently being implemented in baccalaureate nursing and health studies curricula. We hope that other programs will find value in the course and will use it with other student groups.

SoberBowl II: Stealth recovery advocacy

January 29, 2018

Maureen Fitzgerald
ATTC Network Coordinating Office/NIAtx



Tracy Abbott is Director of the ARK, a Houston-based nonprofit dedicated to producing alcohol-free entertainment events. In the fall of 2016, Houston was abuzz with excitement about Super Bowl 2017, which was held at Houston's NRG Stadium. Billboards and restaurants advertised the big game, with accompanying big entertainment and watch parties.

"That's when I realized that people in recovery need an alcohol- and drug-free space where they can participate in all the energy surrounding the Super Bowl," says Abbott.

And in just 60 days, she raised $100k to launch SoberBowl I in Houston, an alcohol- and drug-free Super Bowl party that attracted nearly 1,000 attendees. Athletes and entertainers in recovery provided entertainment and inspiration for the event as they will again this year—with SoberBowl II events scheduled for both Houston and Minneapolis.

The Opioid Crisis: Community is Key to Addressing the Epidemic

January 22, 2018

Holly Ireland, LCSW-C
Co-Project Director
Central East ATTC 


In the spirit of collaboration and given our proximity, the Central East ATTC has offered to attend relevant national policy activities in Washington, D.C. to represent the ATTC Network and to support us all in staying abreast of what's happening and assess any potential future impact on our work or potential collaborations for the Network.

The Opioid Crisis: An Examination of How We Got Here and How We Move Forward
Senate Health, Education, Labor and Pensions (HELP) Committee Hearing, January 9, 2018

The Network Coordinating Office asked the Central East ATTC to attend this particular hearing, given the topic. This was an unexpected and welcome benefit of my new role as the Central East ATTC Co-Director, having joined the team in November 2017. I was excited and honored to go, given my increasing interest in public welfare policy, especially as it relates to the behavioral health of our communities, our states, and our nation. Until now, I have mainly been directly involved in policy action at local and state levels of government. I have always followed national policy action, and have inspired others to do so as a Social Work educator, most recently teaching social welfare policy practice for Salisbury University’s Social Work Department in the semester just ending in December 2017.

The morning of the hearing, my four-block walk from the metro station to the Dirksen Senate Building took me past the Capitol, the Library of Congress, and the Supreme Court. Walking along, I recalled the last time I had been in view of the Capitol: almost a year ago, participating in the Women's March with my then 11-year old daughter. Once I arrived at the Senate Building, I proceeded through security and navigated the halls filled with citizens, media, staffers, and elected officials. I shared an elevator with several others, including a senator, and found my way to the hearing room, where an audience of about 70 journalists, staffers, and citizens awaited the hearing.

Sam Quinones, featured witness and author of Dreamland, The True Tale of America's Opiate Epidemic, was already at the witness table, with his wife and daughter in the first row to his right. Several of the senators greeted him personally, expressing their appreciation for his journalistic insights and willingness to testify. All took their seats and the hearing began on schedule.


The HELP Committee 

All Committee Members are listed and those present for the hearing are in bold:

Democrats: Patty Murray (WA) (ranking), Bernie Sanders (VT), Robert P. Casey, Jr. (PA), Al Franken  (MN), Michael F. Bennet (CO), Sheldon Whitehouse (RI), Tammy Baldwin (WI), Christopher S. Murphy (CT), Elizabeth Warren (MA), Tim Kaine, (VA), Maggie Hassan (NH)
Republicans: Lamar Alexander (TN), Chair; Michael B. Enzi (WY), Richard Burr (NC), Johnny Isakson (GA), Rand Paul (KY), Susan Collins (ME), Bill Cassidy, M.D., (LA), Todd Young (IN), Orrin Hatch (UT), Pat Roberts (KS), Lisa Murkowski (AK), Tim Scott (SC) (Scott attended briefly, but did not speak.) 

During opening remarks, Senator Alexander stated that the opioid epidemic is the number one public health problem in America, with overdose deaths now exceeding the number of motor vehicle accident deaths per day. Alexander emphasized that this was a bipartisan hearing with full support of all committee members, and remarked on the CARA and CURES Acts to address the effort. Senator Murray specifically addressed the committee’s commitment to move supplemental funding state’s need for implementing evidence-based practices (EBPs) to address the epidemic. This was the most direct reference to the work of the ATTCs.

Mr. Quinones testified for about 10 minutes, and then each of the Senators asked at least one question. Several of the Senators had in front of them a copy of Mr. Quinones book, referring to it directly.

There was no remarkably new information regarding the causes of the epidemic or strategies to address it. Mr. Quinones emphasized several times that this crisis has been in the making for more than two decades and that addressing it will take sustained efforts, resources, and funding. The CARA and CURES Acts are solid beginnings but only that, beginnings.


Major themes of Quinones' testimony


  • Prevention, emphasizing community building, investing in recovery, increasing education about the addictive qualities of prescription medications, and decreasing the number and amount of prescriptions provided by health care professionals to the public. Senator Warren specifically spoke to the need for DEA and states to comply with the "Partial Fill" provision in CARA. 
  • Criminal Justice intersection: Retooling law enforcement agency and detention center responses to treatment needs.
  • Public/Private Sector Partnerships: Increase accountability of the private sector that is profiting from this crisis to support and align with the public sector that is bearing the costs.
  • Intervention: Expand access to care, specifically MAT, in detention centers, and also in the community. Increase access to alternative pain management—teach both health care professionals and the public about these alternatives—and make them reimbursable).
  • Funding: Sustain the CDC’s role in funding Prescription Drug Monitoring Program (PDMPs), public awareness campaigns, and national surveillance data for both fatal and non-fatal overdose deaths.
  • Research: Increase funding for research for addiction treatment and pain management and local community partnerships with law enforcement agencies, coroners, public health, health care, courts, detention centers, social services, and community members (persons in recovery, family members and advocacy groups - my editorial definition). 
  • Overcome access barriers: Develop resources in in rural areas and services to families (parents with addictions, parents with addicted children of all ages, grandparents as parents). Fund infrastructure: current CARA and CURES allocation fund interventions (e.g., Naloxone) but not the infrastructure to support it (e.g., personnel to educate and distribute to the public).
  • Stigma: Address and defeat stigma by mainstreaming storytelling of addiction and recovery to create a social movement of recovery. 
  • Build a global partnership to address supply of heroin, fentanyl, and carfentanyl. Build partnership and community with Mexico and other source countries to stem the supply flow.

Community is key

The hearing was scheduled to end at noon, but continued beyond. When finally adjourned, it was with many questions remaining unasked and unanswered, and several senators requesting follow up discussion with Mr. Quinones. It was clear the senators were cognizant of the impact of the opioid epidemic on citizens, families, communities, states and the nation. It was also evident how thoughtful and contemplative the committee members were about the responsibility in addressing this epidemic. However, it was also clearly recognized by all that to bring the opioid epidemic to an end, effort and engagement is needed from all, from everyone throughout the country, from every state, and from every strong and ever-strengthening community.

Read the transcript of Quinones testimony
Watch the video of the session 

About our blogger: 


Holly Ireland, LCSW-C, joined The Danya Institute/Central East ATTC team as Co-Project Director in November 2017.

Holly has 27 years’ experience working in the behavioral health field, beginning her career as a Residential Rehabilitation Counselor while working on her undergraduate degree in psychology at Towson University. She graduated from University of Maryland, Baltimore with a master’s in Social Work with a primary concentration of Clinical and a secondary concentration of Management and Community Organization. During her career, she has provided direct service in outpatient behavioral health and recovery support settings, including individual, group and family therapy for co-occurring disorders, crisis intervention, trauma treatment, Assertive Community Treatment, and advocacy. Holly currently serves as adjunct faculty for Salisbury University’s Social Work Department, teaching social welfare policy and advanced practice courses.

Most recently she provided leadership and administration of Mid Shore Behavioral Health, Inc., a non-profit organization responsible for planning and management of the continuum of services in Public Behavioral Health System in Caroline, Dorchester, Kent, Queen Anne’s and Talbot Counties on the Eastern Shore of Maryland. Holly joined the MSBH team in 2006, serving as executive director since 2010.

A native of Easton, Holly loves the Eastern Shore of Maryland, its culture, its people, and its ecology. When not serving as a clinician, administrator or advocate, Holly enjoys spending time with her family and friends, traveling, being an active member of the community, and being outdoors – basically doing anything that advances health and wellbeing.






New Year--New Web Accessibility Laws

January 8, 2018

Kendra Barker, M.Ed.
Instructional Designer – Specialist
Collaborative to Advance Health Services
University of Missouri - Kansas City | School of Nursing and Health Studies



It’s that time when we start planning for the New Year: budgets, conferences, marketing materials, and more. As we ring in 2018, it's also time to be thinking about 508 compliance—the laws that require an organizations websites and other electronic publications accessible to people with disabilities. Updates to these laws take effect January 18, 2018, making it vitally important for ATTC to make any changes needed.

See related blog post: Tips for Navigating 508 Compliance

There are new updates of Section 508 Standards and Section 255 Guidelines for Information and Communication Technology (ICT), often referred to as the Section 508 Refresher, or the Final Rule. Section 508 Standards and Section 255 Guidelines relate to the accessibility of information and resources managed through websites, blogs, web content, etc.

The United States Access Board website states that Section 508 Standards and Section 205 Guidelines apply “to ICT development, procured, maintained, or used by federal agencies,” meaning that any federally-funded agency must follow the new Section 508 Refresher when creating anything that will go on the Internet and out to the public. However, it does not apply to websites or web content created before this date.

Web Content Accessibility Guidelines (WCAG)


The main goal of the law is to ensure that newly developed webpages and content will pass the Web Content Accessibility Guidelines (WCAG) version 2.0, Levels A and AA. WCAG 2.0 was developed by the World Wide Web Consortium (W3C) and sets international accessibility standards. The law not only includes web-based content, but all electronic content.

The best way to make sure you are addressing these changes to the accessibility laws is to plan your project from the beginning with WCAG 2.0 Levels A and AA in mind. It is much more difficult and time-consuming to make websites, web content, etc., compliant after they are created. This includes Word documents, PowerPoints, online courses, marketing material, videos, etc.


Here are some useful resources for you to check out:

About_W3C
How_to_Meet_WCAG2.0
Overview_of_the_Final_Rule
WebAim (includes training)
Web_Content_Accessibility_Guidelines_Overview

The new web accessibility laws affect the entire ATTC Network. The ATTC Network Coordinating Office will take the lead in keeping us compliant with the accessibility laws and keep the will ATTCs informed.