ONDCP Blog

Guest Post: Small Business at Work to Improve Treatment & Recovery Services

During Small Business Week, we are highlighting a few examples of small businesses working in prevention, treatment or recovery.  Today’s guest blog post comes from the Co-Deputy Directors of NIATx, an organization that helps lower costs and improve effectiveness in the field of mental health care. For more information about Small Business Week, please visit www.nationalsmallbusinessweek.com, and join in the conversation on Twitter using the hashtag #sbw2012.

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Small Business at Work to Improve Treatment & Recovery Services
By: Kim Johnson, MBA, and Todd Molfender, Ph.D, Co-Deputy Directors at NIATx

Kim Johnson, MBA, and Todd Molfender, Ph.D, are Co-Deputy Directors at NIATx (formerly the acronym for the Network for the Improvement of Treatment), a part of the University of Wisconsin-Madison’s Center for Heath Enhancement Systems Studies (CHESS).

The business model for substance abuse prevention and treatment is undergoing a sea change. Prevention has transitioned from a sole focus on school-aged children to a lifespan view that involves community engagement and policy-level initiatives. Treatment is evolving from primarily a grant-funded service to part of the specialty care system within the health care infrastructure.

What do these changes mean for the future of organizations that treat substance use disorders?  First and foremost, we need to think about customer service. Who are our customers, and how do we meet their changing needs and demands?  Second, we must become more efficient.  Fading fast are cost-based contracting systems that encourage increasing costs and reducing units of service. No more can clinical effectiveness and business efficiencies be considered separate and apart.
 
NIATx is part of the University of Wisconsin-Madison’s Center for Health Enhancement Systems Studies.  We are dedicated to making improvements to the cost and effectiveness of the substance use disorder care delivery system while helping remove barriers to treatment and recovery. At the heart of our work is the research-based NIATx model of process improvement designed specifically for behavioral health care settings to improve access and retention.  Through the NIATx Learning Collaborative, members share innovative ideas with each other via learning sessions, interest circles, and coaching sessions.

Having worked with over 3,000 prevention and treatment organizations, we have learned that efficiency and customer service are actually two sides of the same coin. Addiction treatment providers should offer appropriate medications and effective behavioral interventions, along with ongoing support. As with other chronic diseases, substance abuse treatment should involve addressing acute episodes of illness and providing ongoing monitoring and support.

Substance abuse treatment providers need to develop and improve their billing systems by building the capacity to contract with payers, bill insurers, and Medicaid for services. They should measure and publish outcomes that are of interest to all of their customers—patients, family members, payers, and regulators. These include process measures like wait times and treatment retention rates as well as outcome measures such as reduced use and increased compliance with treatment protocols.

Outcome measures are equally important for prevention service providers.  Companies unable to hire enough job applicants who can pass their drug tests are interested in supporting prevention activities.  The Strategic Prevention Framework developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) consists of identifying goals and measuring outcomes. Prevention activities will be judged by their ability to influence change at the population level. It is essential for prevention and treatment providers to learn about emerging technologies. In addition to ONDCP, SAMHSA, and the National Institute on Drug Abuse are excellent sources to learn of potential changes years before they begin to affect practice.

We live in an exciting time for substance abuse prevention and treatment. The transition presents great opportunities, but organizations will need to rethink all aspects of their business model to thrive in an evolving environment.

Study: more than half of adult male arrestees test positive for at least one drug

This blog post was originally published on The Huffington Post. 

One month ago today, we released the Obama Administration’s 2012 National Drug Control Strategy, a drug policy grounded in sound research from the world’s preeminent drug abuse researchers.  This policy marks a departure from the debate I’ve seen develop during the past few years, which has lurched between two extreme views. On one side are those who suggest that drug legalization is the “silver bullet” solution to our nation’s drug problem.  On the other are those who still believe that the “War on Drugs,” law-enforcement-only strategy is the way forward. Our policies reject both these extremes in favor of a “third way” to approach drug control.

The foundation of this “third way” approach is peer-reviewed, scientific research that provides us insight into the disease of addiction and a roadmap on how to prevent and treat it. The “third way” approach deals in facts—not dogma—and relies on research—not ideology.

Here are what the facts show.  Drug use and related crime strain the resources of this country.  The latest evidence comes from the 2011 Arrestee Drug Abuse Monitoring Annual Report (ADAM II), released today, which tests for drugs in adult males arrested for a wide variety of crimes in 10 sites across the country. This study found a majority of adult males arrested for crimes tested positive for an illegal drug at the time of their arrest.  In fact, positive drug tests among arrestees ranged from 64 percent in Atlanta, GA, to 81 percent in Sacramento, CA.

These data were obtained from individuals booked for all types of crimes, from misdemeanors to felonies, and not just those arrested on drug charges.  The ADAM program tests only for drugs marijuana, cocaine, opiates (including heroin and prescription pain relievers), amphetamines/methamphetamine, Darvon, PCP, benzodiazepines, methadone, and barbiturates—not alcohol. 

This report highlights the urgent need for institutions at the federal, state, and local level to come together to support proven reforms that work to break the vicious cycle of drug use, crime, incarceration and re-arrest.  It’s a cycle my colleagues and I are committed to breaking because we care about the health and safety of our fellow citizens, our healthcare system, and our economy.

Too often, the caustic debate over drug policy in America leaves out some revolutionary and innovative programs taking hold in communities across America. I was pleased to see the Wall Street Journal recently brought attention to some of these programs in an essay by drug policy experts, who argued that there is no quick fix to the complex issue of drug abuse and addiction. These experts pointed to the success of programs such as Drug Market Interventions, which close down open-air drug markets through community-based strategies and offer drug offenders a second chance. Other successful initiatives like Hawaii’s Project Hope probation program, which dramatically reduces probation violations through swift, predictable sanctions, represent the future of a progressive drug control strategy. These programs are part of the President’s drug policy Strategy because they have demonstrated records of success not only in dissipating criminal activity, but in actively building community and reducing incarceration rates.

Although today’s data show a high rate of arrestees testing positive for illicit drugs, over the long term, we are actually seeing declines in drug use rates among the general population.  Over the past 30 years, the overall rate of current drug use in America has dropped by roughly one third. And more recently, the rates of current cocaine and meth use have dropped by 40 percent and 52 percent, respectively, and the number of cocaine overdoses has dropped by 42 percent. 

The 2011 ADAM II findings are clear evidence of the link between drugs and crime. Too often, underlying substance use disorders are the driving force behind criminal activity. It is imperative, then, that we address our nation’s drug problem not just as a criminal justice issue but as a public health issue. We cannot arrest our way out of the drug problem. What we need are evidence-based reforms that break the cycle of drug use and crime, reduce recidivism, and make our communities healthier and safer.

To read the ADAM II report, see an at-a-glance fact sheet on the findings, or view an interactive map reflecting the data by geographic region or drug type, please visit this page on our website.

U.S.-Colombia Trade Agreement Takes Effect Today

We are pleased to add our voice of support for the U.S.-Colombia Trade Promotion Agreement, which goes into force today. The agreement, announced last month by President Obama and Colombian President Juan Manuel Santos, is a historic development in the strong relationship between our two countries, and it reflects our commitment to support democracy and economic growth in that South American nation.

Colombia is a steadfast strategic partner of the United States and a leader in the region. Under the new agreement, which won strong bipartisan approval in Congress last fall, 80 percent of all industrial and manufactured products exported from the United States to Colombia will be duty free, effective immediately.

The result is a clear victory for all concerned. Easing trade restrictions will boost U.S. exports to Colombia, making more American goods available to that country while at the same time strengthening the U.S. economy and helping to support more and better jobs for Americans. The agreement also will provide significant new access to Colombia’s $166 billion services market, supporting increased opportunities for U.S. service providers.

Equally important, the agreement will help Colombia battle the production of illicit crops by creating alternative economic opportunities for its citizens, thus helping to staunch the flow of illegal drugs into America’s neighborhoods and homes.

For an overview of the U.S.-Colombia Trade Promotion Agreement, click here. To learn more about how the agreement will benefit your community, click here. For more, read this blog post from the the Department of Commerce, and head to Twitter to folow @USTradeRep and @CommerceGov.

Summer Jobs+: The Launch Youth Entrepreneurship Program

"America's young people face record unemployment, and we need to do everything we can to make sure they've got the opportunity to earn the skills and a work ethic that come with a job. It's important for their future, and for America's…That's why today, we're launching Summer Jobs+, a joint initiative that challenges business leaders and communities to join my Administration in providing hundreds of thousands of summer jobs for America's youth"

—President Obama

As the White House and Department of Labor kick off the Summer Jobs+ program, we’d like to highlight another Drug Free Communities grantee helping young people find jobs: the Launch Youth Entrepreneurship Program based in Plymouth, New Hampshire.

The Launch is a community-based, 12-month Positive Youth Development program that seeks to empower youth by educating and engaging them in entrepreneurship, offering enriching alternatives to risky behavior, and promoting community development through the preparation and launch of summer businesses and work-based learning.

During the school year, community service opportunities, job shadowing, and skill development workshops with local business experts help young entrepreneurs prepare and plan for a summer business. Their summer business, Frosty Scoops ice cream stand, provides an opportunity to apply the skills they have learned in weekly workshops led by Community for Alcohol and Drug-Free Youth (CADY) staff, volunteers, and community experts. The Launch is the sole youth employment program in the region and since 2005, in collaboration with the Common Man Family of Restaurants, has provided paid summer employment to over 150 local youth.

The Launch Program is divided into three phases:

• Phase One (September – January): Youth explore personal skills, goal setting, communication skills, and teamwork through projects and community service.
• Phase Two (January – June): Youth learn the principles of best practices from local business experts and develop business skills that will help them succeed in the workplace and in their futures.
• Phase Three (Mid-June – August): Youth engage in paid summer employment, supported by the Common Man Family of Restaurants.

ONDCP congratulates CADY on the success of its Youth Entrepreneurship Program, which provides youth with the skills necessary to enter the workforce competent and drug-free. For more information, please visit CADY’s website.