Tag: SAMHSA

  • SAMHSA Under Fire For "Meth Monster" PSA

    SAMHSA Under Fire For "Meth Monster" PSA

    While spreading awareness is key, people in the health industry say that the video’s approach is all wrong.

    With methamphetamine addiction and overdose on the rise, the Substance Abuse and Mental Health Services Administration (SAMHSA) is trying to raise awareness about the risks of meth use, but is coming under fire for a new PSA the agency released this week. 

    Stereotypes & Stigma

    As reported by Filter magazine, in the PSA, a man is shown in a boxing ring battling a hideous “meth monster.” In the first round, the man is knocked down, but springs back up. Next, the monster uses pliers to pull out his teeth, a reference to the “meth mouth” stereotype.

    “There goes the teeth,” a sports commentator narrating the video says. “That’s gotta hurt.”

    In the third round, the man is captured by the monster. “He doesn’t seem to be able to get away. He’s trapped. Meth is stealing his soul,” the commentator exclaims. 

    The commercial ends by urging people to get more information or seek help by visiting samhsa.gov/meth or calling 1-800-662-HELP (4357). While awareness is key, people in the health industry say that the approach in the video is all wrong.

    Dr. Sarah Wakeman, an addiction medicine specialist at Massachusetts General Hospital, took to Twitter to express her concern. 

    “Is this a joke?” she wrote. “This makes the old fried egg commercials look mild. ‘Meth will steal your soul’- really @samhsagov ?? How about some fact based, non stigmatizing public health approaches instead of this…”

    Bill Kinkle, co-host of the Health Professionals in Recovery podcast, wrote on Twitter that PSAs show the policy mistakes that can prevent people from getting help. 

    “Everything you need to know about how War on Drugs propaganda operates is in this video. Personifying a drug as an evil monster, filling you with intense fear, portraying drug use always as a boxing match, tons of misinformation and lies, then finishing with ‘get the facts,’” he wrote. He followed up with a simple tweet: “Not helpful.”

    SAMHSA’s web page dedicated to meth information does relay helpful and concerning facts. For example, the agency reports that meth use among adults 26 and older increased 43% between 2017 and 2018. 

    Still, Samatha Arsenault of the advocacy group Shatterproof said PSAs like this one waste resources that could be better spent on getting people with meth addiction real help.  

    “I was appalled by this video,” she wrote. “Sad to see that after knowing for so long that scare tactics not only don’t work but are damaging to ppl impacted by SUD that resources were used to put this together.”

    View the original article at thefix.com

  • Recovery Housing Program For Rural Areas Launched By USDA, HHS

    Recovery Housing Program For Rural Areas Launched By USDA, HHS

    “The opioid crisis has hit rural communities hard, and we need to leverage all possible partnerships to support these communities,” said an HHS official.

    A new federal program will allow nonprofit organizations to purchase homes in rural communities for use as transitional housing for individuals in recovery from substance use disorder.

    The initiative is a joint effort between the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS), and aims to address the national opioid crisis by providing greater access and support to rural areas, which have shouldered a substantial portion of the epidemic’s overdose and death tolls.

    USDA Assistant to the Secretary for Rural Development, Anne Hazlett, said in a press release that the program is part of President Donald Trump’s policy to address opioid dependency, which he declared a national public health emergency in late 2017.

    Through coordinated efforts between the USDA’s Rural Development and HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA), non-profit organizations will be able to purchase USDA’s Real Estate Owned (REO) single-family housing properties in rural communities at a discounted price for use as housing, treatment, job training and other services for individuals in recovery for substance abuse issues.

    The initiative extends the two organizations’ collaborative efforts, which were launched in 2018, when SAMHSA supplemented USDA Cooperative Extension grants to help communities in the fight against opioid abuse.

    “We know that the opioid crisis has hit rural communities hard, and we need to leverage all possible partnerships to support these communities,” said Dr. Elinore McCance-Katz, HHS Assistant Secretary for Mental Health and Substance Use. “Housing plays a vital part in the recovery process for those living with opioid use disorders.”

    The opioid crisis has cut a particularly devastating path through rural communities in America. As the National Rural Health Association (NRHA) noted, only 20% of the U.S population lives in areas designated as rural communities, but the rate of opioid-related overdose deaths in such locations is 45% higher than in metro counties.

    Studies have found that the rate of babies born with opioid withdrawal symptoms and teens who use opioids is much higher in rural communities.

    Adding to the problem is a lack of health care facilities—83 rural hospitals have closed since 2010—and access to mental health and substance treatment facilities. According to the NRHA, in 55% of all American counties, most of which are considered rural, there are no psychologists, psychiatrists or social workers.

    View the original article at thefix.com

  • How Do You Define "Recovery"?

    How Do You Define "Recovery"?

    Our time would be better spent trying to help people recover in whatever way is most effective for them rather than pushing and shaming everyone into one particular recovery pathway.

    I’ve lost count of the number of times I’ve heard someone say that a person might be sober, but that they’re not in recovery, or describe them as a “dry drunk,” because the person doesn’t attend some defined program of recovery. I find that attitude divisive, dogmatic, and unhelpful, particularly because it shames others to believe in only one gold standard of recovery. This simply isn’t true. And it’s harmful; we have too many people dying of substance use disorder. Our time would be better spent trying to help people recover in whatever way is most effective for them rather than pushing and shaming everyone into one particular recovery pathway.

    This kind of mindset originates from 12-step fellowships — where members often believe that these programs, combined with abstinence, are the only effective way to recover — and from the outdated professional definition of recovery provided by organizations like the American Society of Addiction Medicine (ASAM). However, with the emergence of recovery science, this outlook is beginning to change. Leading researchers are painting a much broader, more inclusive picture of recovery. Instead of accepting dogmatic perspectives, we can now turn to science, which shows us how people recover, the impact of the language we use, the complexities we face as people in recovery such as trauma and co-occurring disorders, and offers more cohesive definition of recovery.

    In 2005, according to ASAM: “A patient is in ‘a state of recovery’ when he or she has reached a state of physical and psychological health such that his/her abstinence from dependence-producing drugs in complete and comfortable.” Over the years, this definition has evolved. Other thought and policy leaders in addiction recovery have also updated their definitions, including the Betty Ford Institute (2006), William L. White (2007), the UK Drug Policy Commission (2008), the Scottish government (2008), the Substance Abuse and Mental Health Services Administration (SAMHSA, 2011), researchers John Francis Kelly and Bettina Hoeppner (2014), and the Recovery Research Institute (2017).

    One of the most popular definitions, and one I’ve favored as a writer in this field, is SAMHSA’s: “Recovery from mental disorders and substance use disorders is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” What I like particularly is that SAMHSA doesn’t define how someone should recover and they have no opinion on abstinence or the use of medication in the process of recovery.

    Cognizant of the varying definitions and the lack of general consensus among experts in the field, recovery scientists and professionals from across the country came together to formulate a new concept. The Recovery Science Research Collaborative (RSRC) met in December 2017, evaluated various definitions of recovery, and reviewed essential components of recovery in order to more clearly define the process.

    I spoke with Robert Ashford, one of the recovery scientists in the collaborative, about the process of formulating a new definition.

    The Fix: What would you say were the main limitations of previous definitions that led to your aim to define a new concept of recovery?

    Robert: We were hoping to bring together our understanding of recovery with the real-world empirical and practical evidence. Our desire for inclusivity was due to the high prevalence of co-occurring disorders (mental health and substance use disorder (SUD)) and the lack of inclusion of non-prominent recovery pathways (e.g. medication alongside abstinence modalities). We wanted to give the individual autonomy in self-directing their recovery process, both with and without clinical and other professional or peer recovery supports.

    In reaching a consensus for a new definition, what were the main components that were critical to include?

    It was a direct reflection of previous work describing the contention in recovery definitions, both real and perceived, by those in different “recovery” camps and between mental health and substance use disorder. Personally, I don’t believe recovery is reserved for the most severe and symptomatic individuals. If we conceptualize recovery as a series of interpersonal growth stages over time and in different settings or contexts, then recovery is a broad phenomenon that can apply to a range of issues. Our definition allows this to exist as a self-directed and intentional process that frames recovery as different in approach, style, and intensity depending on the range of diagnosis. Perhaps a good way to frame this, within the context of a continuum of SUD, is that recovery is also possible along a continuum that is proportional to the severity and type of SUD (mild, moderate, or severe), with most not needing to ascend along that continuum completely.

    Our definition: “Recovery is an individualized, intentional, dynamic, and relational process involving sustained efforts to improve wellness.”

    One of the main disputes within the recovery community is the belief that “true” recovery means complete abstinence. How did this belief factor into your discussions? And what would you consider to be the challenges of such a point of view?

    I think the field at large stands to benefit, at least from an empirical perspective, because not having the focus solely on abstinence allows us to capture, estimate, and perhaps even predict, recovery in different pathologies, different severities, and at different life stages. This recovery typology is only possible with an inclusive definition in mind. The advocacy community also stands to benefit. Inclusive definitions allow the size of the population, or the prevalence of recovery, to increase — which is a good talking point and a strong policy lever for behavioral health. There is a potential for the “watering down” of recovery for the most severe of cases and for those traditionally following an abstinence modality, but this potential is moderated in my mind through the potential benefits.

    At the end of the day, abstinence shouldn’t be excluded from the idea of recovery, but it should be situated where it best fits — as a potential outcome for a person who needs it. The definition of recovery can expand without diminishing those who are in abstinence-based recovery, and the expansion doesn’t negate anyone. If anything, not doing it negates the reality of millions of people seeking wellness.

    View the original article at thefix.com

  • Meth Use Rises Among Youth, Heroin Use Declines

    Meth Use Rises Among Youth, Heroin Use Declines

    The results of a new survey from Substance Abuse and Mental Health Administration revealed some positive movement for the opioid crisis.

    In another reminder of how complicated addiction and addiction treatment is, compiled survey results from 67,500 Americans in 2017 found that while new heroin users in certain age groups have almost declined by half, methamphetamine and marijuana use has increased.

    The survey, conducted by the Substance Abuse and Mental Health Administration, (SAMHSA) parsed survey takers by age groups, types of drugs used, amounts of drugs used, and the starting point for the usage or abuse of each drug.

    The most dramatic, positive findings were around new heroin users; 81,000 reported using heroin for the first time in 2017, less than half of the 170,000 reported the year before.

    However, when looking at the age group of 18-25, the decline in new heroin users was “almost imperceptible” according to USA Today

    The 18 to 25 category also reported less prescription opioid abuse. SAMHSA estimated that in 2015 8.5% of people in this vulnerable age range misused prescription opioids; In 2017 the percentage was at 7.

    Yet marijuana and meth use for youths 12-17 increased from all previous years. Marijuana use for both youth and adults was associated with opioid use, heavy alcohol use, and major depressive episodes.

    The concerning effects of heavy marijuana use on mental illness has been somewhat put to the backburner as popular culture embraces the positive aspects of the drug. Some research show a direct correlation between marijuana overuse and mental distress and illness.

    With all the publicity surrounding deaths from heroin laced with fentanyl, addiction specialist Sally Satel says most addiction experts had anticipated a move away from opioids and toward another drug.

    “I was waiting for this,” Satel told USA Today, “This is how it works. People still want to alter their mental state. So they look for what’s cheap and what’s available and the reputation of the drug.” 

    Jim Beiting, CEO of Transitions, Northern Kentucky’s largest drug treatment and recovery organization, told USA Today that meth is “magnetic” for people with addiction trying to move from opioids. “It’s cheaper,” he says. “It’s more readily available, (and) the potency is higher than it used to be.”

    Other positive news from the SAMHSA report reveals that more people struggling with heroin addiction are seeking treatment, up 53.7% from previous years. This seems to reflect on the increased funding, country-wide, into access and quality of addiction treatment services.

    The news is mixed but overall illuminates how bad the addiction crisis remains in our country. James Carrol, acting director of the Office of National Drug Control Policy, told the Washington Times, “Use of marijuana, cocaine and methamphetamine are all up. So we aren’t just in an opioids crisis. It’s an addiction crisis.”

    View the original article at thefix.com

  • SAMHSA Voice Awards Honor Walter Ginter’s MARS™ Project

    SAMHSA Voice Awards Honor Walter Ginter’s MARS™ Project

    Many people on MAT feel unwelcome at meetings, and this sense of alienation and rejection often leads to relapse. That’s where MARS™ comes in. We want people on MAT to be embraced and accepted in recovery.

    Held at Royce Hall on the UCLA campus in Westwood, the 13th annual SAMHSA (Substance Abuse and Mental Health Administration) Voice Awards recognized an essential figure in the national battle against the opioid epidemic. As the founder of the Medicated Assisted Recovery Support (MARS™) Project, Walter Ginter was honored with a Special Recognition Award for his efforts in combating the opioid epidemic and helping people who use Medicated-Assisted Treatment (MAT) stick to the path of recovery. In the greater recovery community– ranging from treatment centers across the country to 12-step groups—many people have a negative view of MAT which has led to a lack of support for people trying to overcome opioid addiction. 

    SAMHSA has been at the helm of national efforts to destigmatize the medications typically used in MAT such as buprenorphine, methadone, and naltrexone. Beyond supporting physicians and researchers, SAMHSA has tried to reduce the negativity associated with traditional perspectives on opioid recovery. According to many loud voices in Narcotics Anonymous (NA), if a person is on medication that has been prescribed to help them overcome opioid withdrawal symptoms or to refrain from using heroin or other illicit opioids, then they are not really clean. In contrast to this judgmental perspective, the SAMHSA website states: “Medicated-Assisted Treatment (MAT) is the use of FDA- approved medications, in combination with counseling and behavioral therapies, to provide a ‘whole-patient’ approach to the treatment of substance use disorders.”

    Indeed, a “whole-patient” approach is what is needed to stem the tide of what has become the greatest drug epidemic in U.S. history. With the introduction of fentanyl and other powerful prescription narcotics to the illegal drug trade, the stakes are higher than ever before. According to the National Institute on Drug Abuse, “Every day, more than 115 people in the United States die after overdosing on opioids.”

    Given such a devastating statistic, Arne W. Owens hopes the SAMHSA Voice Awards can raise awareness by bringing the recovery community together with the entertainment industry. As the Principal Deputy Assistant Secretary, Owens was the highest-ranking member of SAMHSA at the Voice Awards Show on August 8, 2018. Asked by The Fix how the Voice Awards can make an impact on the opioid epidemic, Owens said, “We hope to incentivize more positive portrayals in film and television of treatment and recovery for substance use disorders. We believe hearing positive stories about treatment and recovery helps to inspire others, shifting negative attitudes. For example, it would be good to see writers and directors positively represent MAT in film and television. Beyond raising awareness, such representation would help to reduce stigma.”

    Walter Ginter is an ideal example of someone who has dedicated his life to reducing stigma and raising positive awareness about MAT. Dedicated to improving the recovery community, Ginter has been a board member of both the National Alliance for Medication Assisted Treatment and Faces & Voices of Recovery. In collaboration with the New York Division of Substance Abuse, Yeshiva University and the National Alliance for Medication Assisted (NAMA) Recovery, Walter Ginter became the founding Project Director of the Medication Assisted Recovery Support (MARS™) Project.

    MARS™ is designed to provide peer recovery support to persons whose recovery from opioid addiction is assisted by medication. To be in a MARS™ group through the Peer Recovery Network PORTAL™, a person has to be in a MAT program. As Ginter writes on the MARS™ website, “The Peer Recovery Network was created as a way for peers in recovery to more effectively organize their community, to communicate with each other, and to have a stronger voice for advocacy efforts.”

    In 2012, Ginter helped create the Beyond MARS Training Institute at the Albert Einstein College of Medicine. With a variety of models and options, Ginter created a curriculum where opioid treatment programs and recovery professionals can be trained to implement MARS™. The original MARS™ project has expanded from its beginnings to include 17 programs across the United States and two in Haiphong, Vietnam. Ginter believes this is just the beginning of the expansion, both nationally and internationally.

    On the red carpet before the Voice Awards ceremony, Walter Ginter spoke with us about the struggles he has faced as an early advocate of MAT, revealing both an innate decency and a keen sense of humor. With a smile, he mentioned how people always ask him why MARS™ uses the trademark symbol. Some of them even think that he’s trying to corner the name of the planet for profit.

    But MARS™ has a trademark for a particular reason, Ginter explains. In the vast majority of cases, the organization does not mind when people use the name. They do enforce the trademark, however, when people who are not certified as trainers try to set-up MARS™ groups and conduct MARS™ trainings. In most cases, rather than follow the protocols, they are hijacking the name to do what they want and make a profit. As an organization with a mission that envisions “the transformation of medication-assisted treatment (MAT) to medication-assisted recovery (MAR),” Ginter believes that protecting the integrity of the organization must remain a priority.

    Sitting inside, away from the hot Los Angeles sun and the red carpet, Walter Ginter went into more detail about the early struggles that MARS™ faced. “Very few people come to MAT as their first course of treatment. In the vast majority of cases, they’ve already been to 12-step meetings, particularly Narcotics Anonymous. Although they initially felt welcomed at those meetings, those feelings shift after they start to work a program that includes medication-assisted treatment. Suddenly, you no longer feel welcome at the meetings, and this sense of alienation and rejection often leads to relapse. To fill in the resulting hole, we want MARS™ to give the same type of mutual support that 12-step provides. We want people on MAT to be embraced and accepted in recovery.“

    We asked Walter Ginter to detail this rejection in context. Scratching his chin, he said, “Look, telling people that they are not in recovery is evil. People on MAT were told that they couldn’t share in NA meetings since they weren’t really clean. By not allowing people to talk in meetings, they become alienated. However, it’s worse than alienation because it undermines what they’re doing to get well. The thought process goes something like this: If taking the medication that I need means I’m not in recovery, then why should I act like I’m in recovery? What does it matter if I do a line of coke on the side or have a drink?”

    Walter Ginter saw too many people on the verge of getting well through medication-assisted treatment subvert their recovery with this line of thinking and some other thought processes as well. Not wanting to take any chances, he set up MARS™ as a viable alternative both to treatment centers hostile to MAT and non-supportive recovery support groups like many NA meetings. In the past several years, MARS™ has had remarkable success with people on MAT. It has helped them find true recovery, a fact that has left initial opponents quite frustrated.

    In fact, Ginter ended our talk with a description of one of these encounters. As he told the following story, Ginter’s smile appeared again. “One day an opioid treatment counselor from a local New York rehab burst into my office and banged her fist on my desk. She said ‘What kind of voodoo are you doing here?’ Surprised by such an accusation, I replied “Excuse me?” She went on to explain: “Well. I have a client that wouldn’t stop doing coke. She would get off the heroin, but she always tested positive for cocaine. Since she’s joined your program, now she’s not only off the heroin, she’s no longer testing positive for coke or any other drug. How did you make that happen?’”

    Ginter shook his head as if he’d gone through the same rigmarole many times before. He describes how he sat the recovery counselor down and explained to her quietly: “There’s no magic or voodoo or anything else. We simply gave her medication that worked while telling her that she was now in true recovery. We gave her a vision of medication-assisted recovery, then let her make her own choice. She realized on her own, ‘Well, now I really can be on medication and in recovery. However, I can’t be in recovery if I’m still doing other drugs on the side. Today, I like being in recovery and the future it promises, so I’m going to stop doing the coke. Indeed, I will embrace this path that is set before me.’” 

    Given the promising picture that he painted, it makes perfect sense that Walter Ginter was honored with the Special Recognition Award at the 2018 SAMHSA Voice Awards. After all, how many people are dedicating themselves in such a precise fashion to saving lives by shifting perspectives and offering a viable alternative like Medication Assisted Recovery Support (MARS™)?

    View the original article at thefix.com

  • SAMHSA’s Opioid Overdose Prevention Toolkit Gets An Update

    SAMHSA’s Opioid Overdose Prevention Toolkit Gets An Update

    The refreshed online resource offers a variety of strategies, information and advice on how to prevent opioid overdoses. 

    The Substance Abuse and Mental Health Services Administration (SAMHSA) has updated its Opioid Overdose Prevention Toolkit, which contains resources about opioid overdose prevention.

    The toolkit is divided into various sections, depending on the target audience. 

    The beginning outlines the opioid crisis and strategies that can be implemented to minimize overdose deaths. Such strategies include encouraging people to learn how to prevent/manage an opioid overdose, making sure there is access to treatment, having naloxone be easily accessible, encouraging the public to call 911, and encouraging those prescribing medications to utilize state prescription drug monitoring programs.  

    Five Essential Steps For First Responders

    The guide then shifts into a section geared toward first responders and outlines five steps that they should take. The steps include evaluating a person for signs of an overdose, calling 911, giving naloxone, supporting the person’s breathing and monitoring their response. The guide also warns that what appears to be an overdose can sometimes be something else.

    “If a person does not respond to naloxone, an alternative explanation for the clinical symptoms should be considered,” the guide states. “The most likely explanation is that the person is not overdosing on an opioid but rather some other substance or may be experiencing a non-overdose medical emergency.” 

    Information For Prescribers

    The guide also has a section geared toward prescribers, which outlines 12 prescribing recommendations split into three categories: determining when to initiate or continue opioids for chronic pain; opioid selection, dosage, duration, follow-up and discontinuation; and assessing risk and addressing harms of opioid use.

    “When potentially harmful behaviors are identified (e.g., high-volume use of opioids; taking opioids in combination with alcohol, benzodiazepines, or other respiratory depressants; using illicit opioids where contents of substance cannot be confirmed), it is important to offer education that can reduce that individual’s risk for overdose,” the guide states. “Providing basic risk reduction messaging, overdose prevention education, and a naloxone prescription can be lifesaving interventions.”

    The guide also covers legal and liability topics, as well as claims coding and billing for prescribers.  

    Safety Advice For Patients & Family Members

    This section is geared toward patients and family members of patients and covers an array of topics, from the signs of an overdose to preventing an overdose.

    It also outlines best practices for naloxone use and storage. 

    “Store naloxone in a safe and quickly accessible place at room temperature and protected from light,” the guide reads. “Keep all medicine in a safe place where children or pets cannot reach it.” 

    Recovering From Opioid Overdose

    This is the section for those in recovery from opioid overdose. 

    “Survivors of opioid overdose have experienced a life-changing and traumatic event,” the guide states. “They have had to deal with the emotional consequences of overdosing, which can involve embarrassment, guilt, anger, and gratitude, all accompanied by the discomfort of opioid withdrawal. Most need the support of family and friends to take the next steps toward recovery.”

    The guide talks the user through why support is vital in recovery and also has a lengthy list of helpful resources at the end.

    View the original article at thefix.com