Recovery support included in SAMHSA’s

L
Volume 23 Number 14 final strategic initiatives
April 4, 2011 Last week the Substance Abuse and
Print ISSN 1042-1394 Mental Health Services Administration
(SAMHSA) published the final version
Online ISSN 1556-7591
of its strategic initiatives document,
laying out how the agency will focus
in the first draft (see ADAW, October
11, 2010). This winter an executive
summary came out (see ADAW,
February 15) showing one notable
change: recovery support was add-

In This Issue…
resources in the near future. ed as an initiative, replacing Hous-
The 8 strategic initiatives are: ing and Homelessness.
ASAM paper outlines reasons
1. Prevention of Substance Abuse Jobs/economy was the other
for banning ‘medical marijuana’
and Mental Illness initiative that was dropped between
. . . See page 3
2. Military Families the June and October drafts; this
3. Trauma and Justice was done because other agencies
State Budget Watch: 4. Recovery Support are more active in trying to fix eco-
Treatment and criminal justice 5. Health Reform nomic problems and unemployment
alternatives face cuts in Texas 6. Health Information Technol- nationwide.
. . . See page 4 ogy Throughout the report, called
NIAAA, mindful of merger, speaks
7. Data, Outcomes, and Quality “Leading Change: A Plan for
out on alcohol’s harmful effects
8. Public Awareness and Support SAMHSA’s Roles and Actions 2011-
. . . See page 5
Originally envisioned as 10 (see 2014,” the strategic initiatives break
ADAW, June 14, 2010), the strategic down SAMHSA’s conventional bar-
Pain patients on initiatives where whittled down to 8 See Strategic page 2
opioids not being
adequately monitored Treatment Program Profile
by physicians
HEALTH AND
. . . See page 7
Center’s ability to go smoke-free
bodes well for others in Utah
MEDICAL WRITING
HITECH funding

would go to SA
providers under new
bill . . . See page 7
Md. Senate approves
alcohol tax increase
to benefit the schools
. . . See page 8
Fla. legislators
propose eliminating
all funding for adult
treatment
. . . See page 8
© 2011 Wiley Periodicals,Inc.
View this newsletter online at wileyonlinelibrary.com
DOI: 10.1002/adaw.20276
O
by Gary Enos, Contributing Editor
On the day when an exasperated
staff at The Ark of Little Cotton-
wood in Utah imposed a 30-day
revocation of smoking privileges
for clients, facility operators
thought they were merely impos-
ing a temporary punishment for
bad behaviors that had been on
display. What happened instead
became a permanent change in
policy that has created a smoke-
free culture at the addiction treat-
ment organization, and that in turn
has raised the hopes of state
officials as they seek to make
all publicly funded behavioral
health facilities in Utah tobacco-
free by 2012.
While The Ark, a Sandy-based
private nonprofit center offering res-
idential and outpatient services,
would not have been subject to the
requirements of Utah’s current Re-
covery Plus initiative, its surprising
experience with ridding its campus-
es of tobacco several years ago
could ease some public facilities’
anxiety as Utah prepares to join
New York in making its treatment
center infrastructure smoke-free.
“We were terrified at first about
going tobacco-free,” Jeremy Boberg,
The Ark’s director of admissions,
told ADAW. “Now people come here
because we’re smoke-free.”
See Smoking page 6

A Wiley Periodicals, Inc. publication. wileyonlinelibrary.com

2 Alcoholism & Drug Abuse Weekly April 4, 2011

Strategic from page 1
riers between substance abuse and
mental health.
Response to feedback
The inclusion of recovery sup-
port is a key change from previous
versions, and was made “based on
public feedback,” explained Kana
Enomoto, director of SAMHSA’s Of-
fice of Policy, Planning, and Innova-
tion. “This is where we get recovery
support into the treatment system,”
she said. “One of the major com-
ments that we received from stake-
holders was about employment, and
how important that is to people in
recovery from addiction,” she told
ADAW. “It can be preventive, so we
have the emphasis on supported
employment.”
“We’re pleased to see SAMHSA’s
renewed focus and sense of urgency
and opportunity around recovery,”
Pat Taylor, executive director of Fac-
es and Voices of Recovery, said last
week. “The new recovery support
initiative and the recovery and well-
ness orientation woven into the mili-
tary families, health reform and oth-
er initiatives offers hope for strategies
and programs that will help people
manage their recovery from addic-
tion and mental illness the way they
manage other health conditions.”
The four goals of the new re-
covery support initiative are:
1. P romote health and recovery-
oriented service systems for
individuals with or in recov-
ery from mental and sub-
stance use disorders.
2. Ensure that permanent hous-
ing and supportive services
are available for individuals
with or in recovery from
mental and substance use
disorders.
3. Increase gainful employment
and educational opportuni-
ties for individuals with or in
recovery from mental and
substance use disorders.
4. Promote peer support and the
social inclusion of individuals
with or in recovery from men-
tal and substance use disor-
ders in the community.
Employment is also a concern
for the treatment workforce, but
workforce — one of the original 10
initiatives — was taken out last fall.
“We added a section on workforce
to every one of the initiatives to
show that our commitment spans
them all,” said Enomoto.
Prevention
There are two prevention initia-
tives for substance abuse — one is
focused on reducing problem drink-
ing and underage drinking, and the
other is on reducing prescription
drug abuse. Asked how prescription
drug abuse can be the main target
until 2014 when trends shift — and
heroin may be the main problem
then, for example — Enomoto said
the choice was made because of the
number of “partners” that need to
help in the effort. “It’s not because
of a focus on a drug du jour,” said
Enomoto. But alcohol and prescrip-
tion drugs both involve “multiple
systems” in prevention, and that’s
why they are targeted.
“With alcohol there are differ-
ent players that have to be in-
volved, such as retailers,” she said.
And preventing abuse of medica-
tions involves “different partners”
than preventing abuse of illegal
drugs, she said. “If you’re looking
at it from the perspective of an in-
dividual with an addiction problem,
it doesn’t matter about partners, but
from a policy viewpoint, we need
to focus on partners that we didn’t
have before.” In particular, she
mentioned the National Institute on
Drug Abuse and the Food and Drug
Administration.
Partners outside SAMHSA
Each initiative comes with two
measures to be used for account-
ability: one an “aspirational” or pop-
ulation-based measure that goes be-
yond SAMHSA’s resources, and one
a SAMHSA-specific measure. For ex-
ample, for “Data, Outcomes, and

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Editor Alison Knopf
Contributing Editor Gary Enos
Production Editor Douglas Devaux
Executive Editor Isabelle Cohen-DeAngelis
Publisher Sue Lewis
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It is illegal under federal copyright law to reproduce this publication or any portion of it without the publisher’s permission. Alcoholism & Drug Abuse Weekly DOI: 10.1002/adaw

Quality,” the population-based mea-
sure is to “increase the number of
states adopting the Behavioral
Health Barometer for planning and
reporting purposes.” The SAMHSA-
specific measure is to “reduce con-
tract evaluation expenditures by 10
percent by 2012 through implemen-
tation of a SAMHSA-wide evaluation
strategy.”
SAMHSA is still developing the
“Behavioral Health Barometer, which
“will provide a snapshot of the status
of various behavioral health indica-
tors both nationally and within
states,” showing trends and progress
in mental health promotion and sub-
stance abuse and mental illness pre-
vention and treatment.
“It is important for SAMHSA to
be accountable for achieving out-
comes within its programs,” said
Enomoto. “But we could have the
April 4, 2011 Alcoholism & Drug Abuse Weekly
3
most effective programs in the world other players to help SAMHSA. “If we
— if we’re not moving the needle say only SAMHSA is responsible for
outside our programs as well, it isn’t behavioral health than other people
‘We’re trying to set a tone for the nation,
for states, to see what their responsibility is.’
Kana Enomoto
working.” The “population-based” would abdicate that responsibility,”
measures are “things in which SAM- said Enomoto. “We’re trying to set a
HSA has a role to play,” she said. tone for the nation, for states, to see
“We have the incentive and the con- what their responsibility is.”
vening power to bring together part- The initiatives will guide budget
ners who otherwise might not see decisions, according to SAMHSA,
their roles this way.” with health care reform and parity
The message is that there are driving changes. •
The report is available at
http://store.samhsa.gov/shin/content/SMA11-4629/01-FullDocument.pdf.

ASAM paper outlines reasons for banning ‘medical marijuana’

The American Society of Addic-
tion Medicine (ASAM) has issued a
white paper urging a halt to “medi-
cal marijuana,” even in the 16 states
where it has been declared legal,
and telling physicians that if they
prescribe it, they may be violating
their oath to “do no harm.”
Throughout the white paper,
medical marijuana is in quotation
marks, conveying ASAM’s belief that
as an unapproved substance, it is
not medical.
In the report, first approved by
the ASAM board two years ago, and
then put out for field review, the or-
ganization discourages states from
getting involved in the Food and
Drug Administration (FDA) approval
process of medications. ASAM is-
sued its policy statement against
medical marijuana that is not ap-
proved by the FDA a year ago, when
it also said “ASAM rejects smoking
as a means of drug delivery since it
is not safe.” The white paper ex-
plains how botanical products can
be approved as medications, why
smoking isn’t the best way to get the
right dose, and goes into detail
about the addictive and damaging
properties of smoked marijuana.
“We do not recognize this as a
medication as it has not gone
through an official FDA-approval
process,” said Louis E. Baxter, Sr.,
‘We urge physicians to reject this role,
and remind those who recommend cannabis
that they could fail to meet their professional
obligations to patients and possibly
have their license revoked.’
Andrea G. Barthwell, M.D.
MD, FASAM, president of ASAM and
board chair, in a March 23 state-
ment. “As experts in addiction medi-
cine, we reject having its use as such
foisted upon us to effectively regu-
late a non-FDA-approved substance
to administer as medicine. We also
advise physicians against recom-
mending it, as it is, and possibly for-
saking the Hippocratic Oath of ‘first
do no harm.’”
Medical marijuana laws put
physicians in an “untenable position
as gatekeepers to a controlled sub-
stance still deemed illicit by the fed-
eral government,” said Andrea G.
Barthwell, M.D., former president of
ASAM and CEO of her own consult-
ing firm EMGlobal. “We urge physi-
cians to reject this role, and remind
those who recommend cannabis
that they could fail to meet their
Continues on next page

Alcoholism & Drug Abuse Weekly DOI: 10.1002/adaw A Wiley Periodicals, Inc. publication. View this newsletter online at wileyonlinelibrary.com
4 Alcoholism & Drug Abuse Weekly April 4, 2011
Continued from previous page
professional obligations to patients
and possibly have their license re-
voked.” Barthwell was formerly with
the Office of National Drug Control
Policy in the Bush Administration,
where she championed screening
and brief intervention.
Robert L. DuPont, M.D., who
worked with Barthwell on develop-
ing the policy on medical marijuana
and who was the first director of the
National Institute on Drug Abuse in
the 1970s under President Nixon,
noted that marijuana is “not the
harmless herb many believe it is.”
He added that more than half of the
people who had an illicit substance
use disorder in 2009 were depen-
dent on or abused marijuana.
Smoking marijuana leaves tar in
State Budget Watch
Treatment and criminal justice alternatives face cuts in Texas
Texas reforms instituted four
years ago led to investing funds in
community-based treatment instead
of building more pris-
ons. Those reforms,
which led to a de-
crease in the crime rate
and fewer inmates, are now threat-
ened by budget cuts. So is non-crim-
inal justice related treatment.
The biennial budget is any-
where from $15 billion to $27 bil-
lion short, and the legislature was
spending last week making cuts,
mainly to education, treatment, and
rehabilitation.
Against this backdrop, Treat
Texas is calling on legislators to save
funding for substance abuse treat-
ment programs. A coalition of
groups, Treat Texas notes that if the
legislature slashes “several million
dollars or more” from the budget
currently allocated for those pro-
grams, the state would forfeit the
block grant match.
“We know that the state has a
budget shortfall and that, as a result,
cuts in all areas will be on the table,”
said Cynthia Humphrey, executive
It is illegal under federal copyright law to reproduce this publication or any portion of it without the publisher’s permission. Alcoholism & Drug Abuse Weekly DOI: 10.1002/adaw
the lungs — four times as much as
cigarettes do, because marijuana
smokers take deep breaths and hold
them, said DuPont.
But that does not mean ASAM is
against the development of cannabi-
noids to treat various conditions, in-
cluding those that medical marijuana
is prescribed for (nausea caused by
chemotherapy, for example). “We
are accumulating knowledge about
the body’s cannabinoid receptor sys-
tem,” said DuPont. “ASAM recom-
mends developing ways to manipu-
late the system with standardized
preparations or single molecules to
usher in a new era of medical treat-
ments,” he said. But medical mari-
For the white paper, go to
www.asam.org/pdf/Advocacy/MedMarijuanaWhitePaper20110314.pdf.
director of Treat Texas, which is
based in Austin. “But reducing funds
for drug and alcohol treatment pro-
grams is short-sighted and will ulti-
mately cost taxpayers more in the
long run.”
Rather, Treat Texas is asking
legislators to increase funding for
treatment, to help reduce the budget
shortfall in future years. Humphrey
said drug and alcohol treatment
“represents a miniscule portion of
the state’s overall healthcare spend-
‘But reducing funds
for drug and alcohol
treatment programs
is short-sighted and
will ultimately cost
taxpayers more in
the long run.’
Cynthia Humphrey
juana currently has no quality con-
trol, marijuana bought in dispensaries
can be contaminated with pesticides
and germs, and patients do not get a
reliable and reproducible dose.
“Without a foundation of rigor-
ous data developed in proper clinical
trials and published in peer reviewed
journals, no cannabis product can
gain entrance into the physician’s ar-
mamentarium and thereby become
available to patients as a legitimate
option among various treatment
choices,” said Barthwell. “And ironi-
cally, continued legalized usage un-
dermines any reason to put cannabis-
based products through the FDA
approval process.” •
ing.” Out of every dollar Texas
spends on solving substance abuse
problems, 2 cents is spent on pre-
vention and treatment, she said. In
2008, Texas treated only 5.8 percent
of addicted people who qualified
for state-funded services.
Although Texas has doubled in
population over the past 16 years,
funding for treatment has not kept
pace, according to Humphrey. “With
nearly 1.8 million Texans suffering
from alcohol or drug dependency,
it’s very likely this problem touches
people in everyone’s life,” said
Humphrey. Treat Texas has launched
a grassroots program urging people
to contact their legislators.
Meanwhile, the state budget de-
liberations are continuing. The
House Appropriations Committee
last month approved the $164.5 bil-
lion two-year budget by a vote of
18-7, with all Republicans voting for
it and all Democrats voting against it.
There are many freshmen in the
House with Tea Party connections
who want to cut funding. The cut of
12.3 percent — nearly $23 billon —
is bigger than even the 10.4 percent

cut contained in the initial budget by
House budget leader Rep. Jim Pitts.
The House was scheduled to
debate the budget April 1, but there
is a Republican supermajority and
NIAAA, mindful of merger, speaks out on alcohol’s harmful effects
Although National Institutes of
Health director Francis S. Collins,
M.D., Ph.D., made the decision last
year (see ADAW, December 6, 2010)
to merge the National Institute on
Drug Abuse (NIDA) and the Nation-
al Institute on Alcohol Abuse and
Alcoholism (NIAAA), the battle be-
tween the two research communi-
ties isn’t over.
Last week Bridget F. Grant,
Ph.D., Ph.D., Deborah A. Dawson,
Ph.D., and Howard B. Moss, M.D,
three top scientists at NIAAA, pub-
lished a commentary in the early
view edition of Alcoholism: Clinical
and Experimental Research (ACER)
showing that five times as many
people are dependent on alcohol as
are dependent on all illicit substanc-
es combined. The commentary,
called “Disaggregating the Burden
of Substance Dependence in the
United States,” also noted the para-
dox that while heavy drinking
causes the greatest amount of harm
at the individual level, low to mod-
erate drinking, because it is so prev-
alent, causes the greatest amount of
harm at the aggregate level.
NIAAA’s point, according to
Moss, who is associate director for
clinical and translational research at
NIAAA, is funding. “We had used
this paper internally to deal with
some of the issues related to the
merger,” Moss told ADAW last week.
“Our colleagues at NIDA had over
$1 billion for research in 2010,” he
said. NIAAA had $455 million. “The
real public health needs and the po-
tential for public health benefits lie
in addressing alcohol and tobacco,”
said Moss, who, along with his col-
leagues, is clearly upset about the
funding disparity.
Both NIDA and NIAAA have
Alcoholism & Drug Abuse Weekly DOI: 10.1002/adaw
April 4, 2011 Alcoholism & Drug Abuse Weekly
5
the cuts are likely to pass. The Sen-
ate, however, would rather take For more information on addiction
more of the rainy day fund — the and substance abuse, visit
House budget takes one third of it
— to ease cuts. •
www.wiley.com
Prevalence and population estimates
of past-year substance use among users: U.S.
Adults 18 years of age and older
Substance Prevalence (%) Number
of past year use of past year users
Alcohol 65.44 136,035,000
Tobacco use 27.66 57,503,000
Cannabis 4.07 8,468,000
Opiates 1.81 3,756,000
Sedatives 1.24 2,583,000
Tranquilizers 0.93 1,940,000
Hallucinogens 0.57 1,192,000
Cocaine 0.56 1,169,000
Amphetamines 0.49 1,019,000
Solvents/inhalants 0.11 231,000
Heroin 0.03 64,000
Source: Alcoholism: Clinical and Experimental Research
active medication development Also in the April issue of ACER
programs, and both are doing large was a commentary by Bankole
scale clinical trials. Yet the develop- Johnson, M.D., Professor and Chair-
ment of a medication that works man of the Department of Psychia-
has been elusive. Methadone, try and Neurobehavioral Sciences at
acamprosate, and naltrexone were the University of Virginia, who said
approved decades ago, and bu- that collaboration is important. He
prenorphine was developed more also said that alcohol “generally has
than 10 years ago. low addiction potential” but because
The ACER commentary is the of its wide use, contributed to great-
first time NIAAA publicized this er harm than drugs.
data, said Moss, who said it’s impor- ACER is the publication of the
tant to recognize that the “garden- Research Society on Alcoholism,
variety drinkers” cause public health which strongly opposed a merger. •
harm because there are so many of
them, even if individually they don’t
have alcohol dependence. Distributing print or PDF copies
The new institute, still unnamed, of Alcoholism & Drug Abuse Weekly
would combine relevant portfolios is a copyright violation.
from NIDA, NIAAA, and other NIH If you need additional copies,
institutes and centers, with some of please contact Sandy Quade
the current “organ” research (such at 860-339-5023 or
as liver) expected to go to other in- squadepe@wiley.com.
stitutes.
A Wiley Periodicals, Inc. publication. View this newsletter online at wileyonlinelibrary.com
6 Alcoholism & Drug Abuse Weekly April 4, 2011
Smoking from page 1
Eradicating problems
Boberg explained that The Ark
experienced a number of manage-
ment challenges in the years when it
allowed smoking. A client would
agree to keep another client’s secret
in exchange for cigarettes. On other
occasions, clients would refuse to
share information in group sessions,
only to counsel each other later dur-
ing smoke breaks with no clinician
present.
Clients also would create dan-
gerous situations around smoking,
such as lighting up in a barn on
campus and putting out the cigarette
in a bale of hay. “One time, a group
of ladies went up on the roof of the
building to smoke,” Boberg recalled.
Even a restriction against clients
smoking together didn’t seem to
make the problems go away. Finally,
it was announced at the center one
day back in 2004 that if one more
problem related to smoking oc-
curred, the facility would go smoke-
free for the subsequent 30 days.
It didn’t take long for the threat-
ened ban to go into effect — a prob-
lem triggered it later that day. But
what was designed to be a 30-day
reprimand would eventually be ex-
tended to a permanent ban on
smoking for both residents and staff,
based largely on positive comments
from clients during the initial ban,
Boberg explained.
“After two weeks, we had cli-
ents coming to us and saying, ‘Thank
you,’” Boberg said. “We said,
‘What?’”
Even at that point, facility ad-
ministrators weren’t sure they
would make the ban permanent,
wondering if in some way prohibit-
ing smoking would constitute too
much of a punishment for recover-
ing addicts. But as a 12-Step based
organization that also integrates
other interventions that show effec-
tiveness in research evidence, The
Ark began to be swayed by studies
showing that not addressing smok-
ing among those addicted to other
It is illegal under federal copyright law to reproduce this publication or any portion of it without the publisher’s permission. Alcoholism & Drug Abuse Weekly DOI: 10.1002/adaw
substances can impede their recov-
ery, leaving the tobacco use as a
potential trigger to relapse to other
substance use.
“We decided that if we were go-
ing to end up closing our doors,
we’d close the doors doing the right
thing,” Boberg said.
Now, rather than being seen as
a deterrent to admission for pro-
spective clients and their families,
the smoke-free campus has become
a selling point for The Ark, Boberg
said. Many incoming clients are cur-
rent smokers who want to get off
tobacco as they seek to stop using
other substances, he said.
In addition, “Every family mem-
ber wants to have the person in a
facility that is tobacco-free,” he said.
“We hear in particular from moms
and sisters on this.”
‘I’d much rather hire
staff members who
are in recovery from
tobacco or who have
never smoked.’
Jeremy Boberg
Certainly the ban has brought
some challenges. Boberg said that
over the past four years, The Ark
has lost three clinicians who weren’t
able to live by the smoke-free edict.
Now Boberg says, “I’d much rather
hire staff members who are in re-
covery from tobacco or who have
never smoked.”
Also, some clients still will try to
cheat the system, though Boberg
says most confiscations of cigarettes
take place at admission. Relapse to
tobacco use while in the program
remains more common in The Ark’s
client population than relapse to
other substance abuse is, and Bo-
berg says the facility’s response to
these occurrences depends on indi-
vidual circumstances.
Some of the questions the facil-
ity asks in evaluating a situation in-
clude where the client’s tobacco
was obtained, what problem the cli-
ent might be self-medicating, and
what the client’s intentions are long-
term, Boberg said.
“Sometimes we still get resis-
tance [to the policy],” he said.
“Sometimes I will have someone
sobbing in my office telling me that
I have to give them one more ciga-
rette. The answer is always no.”
State effort
Boberg said that since the time
The Ark was able to go smoke-free,
other private facilities in Utah have
initiated the policy as well. Now at-
tention in the state has turned to
substance abuse and mental health
facilities that receive public funding,
as all of these centers will be re-
quired to go smoke-free by 2012.
Noreen Heid, program manager
with the Utah Division of Substance
Abuse and Mental Health, told
ADAW that while facilities have fo-
cused mainly on the smoke-free
campus aspect of the state’s Recov-
ery Plus initiative, the project actu-
ally involves much more than sim-
ply banning on-site tobacco use by
clients and staff. Treatment centers
also will need to treat nicotine ad-
diction along with the other addic-
tion issues they address, and the dis-
charge planning functions they
conduct will have to include infor-
mation about tobacco relapse pre-
vention, Heid said.
“It’s a real culture change,” she
explained.
The state in early 2010 received
an initial federal grant of $200,000
for activities designed to pave the
way for changing the system. State
officials have emphasized proceed-
ing deliberately on an issue that cer-
tainly generates anxiety for some
treatment centers that can’t envision
taking away something that has be-
come a major part of many of their
patients’ lives.
The state has spent the past year
asking facilities to assess their cur-

rent situation around smoking. Heid
said some of what she termed “old
attitudes” about smoking persist.
“Some people say that they’re al-
ready asking clients to give up so
much, so how can they ask them to
give this up too?” she said.
But the division cites a growing
body of research to support the wis-
dom of helping clients free them-
selves from nicotine dependence.
Studies have shown that cravings for
nicotine can also increase cravings
for other drugs. A 2006 study head-
ed by renowned researcher James
Prochaska stated that individuals
who engage in smoking cessation
efforts simultaneously with other ad-
diction treatment have a 25 percent
greater likelihood of maintaining
long-term abstinence from alcohol
April 4, 2011 Alcoholism & Drug Abuse Weekly
The Ark of Little Cottonwood
Founded: 1999
Capacity: 40 residential beds among
three separate facilities
Treatment Stay: Core program of
90 days
Costs: $12,800 per month for
residential treatment
Payer Source: Primarily self-pay, with
some insurance coverage
and illegal drugs.
State officials would like to see
facilities adopt comprehensive nico-
tine addiction treatment efforts, al-
though centers will have leeway in
determining how to design these ini-
tiatives. “You can’t just give people a
nicotine patch and say that you’re
giving them therapy,” Heid said.
7
Heid added that the division is
trying to leverage state health dollars
that could give treatment centers a
one-time infusion of cash to support
making nicotine addiction treatment
services available to clients.
Heid believes that several fac-
tors, including national health re-
form and its expected emphasis on
wellness and preventive care, will
serve to convince more states and
treatment providers to embrace
smoke-free policies. The Ark of Lit-
tle Cottonwood’s Boberg believes
that smoking simply has proven to
be too big of a problem for treat-
ment centers to ignore.
“This is the number one drug
of choice for humans,” he said. “It’s
the most addictive substance we
know of.” •

Briefly Noted Correction

Pain patients on opioids not being
adequately monitored by physicians
Patients prescribed opioids for
chronic pain were not appropriately
monitored, in many cases, by their
physicians, according to a study
published online February 24 in
the Journal of General Internal
Medicine. For patients with a drug
use disorder, only 29.3 percent had
urine tests at any time, 52.9 percent
saw their physician at least once any
six months, and 66.7 who requested
early refills were not given them
(patients who say they lost their
medication should be red flags for
possible abuse). To view the study,
“Low use of opioid risk reduction
strategies in primary care even for
high risk patients with chronic pain,”
go to http://1.usa.gov/f8ACAF.
Monkey study shows cocaine’s
cognitive deficits can be overcome
Cocaine use impairs visual
working memory and causes other
cognitive deficits, but these can be
overcome by increasing the re-
wards, according to a results of an
animal study published in the
In the March 28 issue, Karen Carpenter-Palumbo was identified as the
new president and CEO of the National Association of Addiction Treat-
ment Providers, which is correct, and also as board chair due to a typo-
graphical error. The board chair is currently Cathy Palm, and a new board
chair will be elected by the board at the NAATP meeting in May. We regret
any confusion.
March 20 issue of The Journal of the National Insintute on Drug
Neuroscience. “It’s well known that abuse and the Veterans Affairs Med-
the level of cognitive deficit can ical Research Service.
predict how successful treatment is
likely to be,” said lead author HITECH funding would go
Charles W. Bradberry, Ph.D., asso- to SA providers under new bill
ciate professor of psychiatry at the Last month Sen. Sheldon White-
University of Pittsburgh School of house (D-R.I.) introduced the Be-
Medicine. “If we understand what havioral Health Information Tech-
the problems are and whether the nology Act, which would extend
drug itself was the cause, then we the Health Information Technology
might be able to design treatments for Economic and Clinical Health
that have a better chance of work- (HITECH) Act portion of the 2009
ing.” The researchers studied mon- stimulus bill, the Center for Public
keys, and found that the cocaine Integrity reported last week. The
users had a harder time maintaining bill, which has been referred to the
focus and attention. When the re- Senate Committee on Finance,
ward value for accomplishing tasks would help fund the use of elec-
was increased, the cognitive deficit tronic health records for substance
was overcome. The next step is to abuse and mental health providers,
use imaging to see how the brain’s who are ineligible to receive HI-
structure changes due to cocaine TECH funds. According to the Cen-
exposure. The study was funded by Continues on next page

Alcoholism & Drug Abuse Weekly DOI: 10.1002/adaw A Wiley Periodicals, Inc. publication. View this newsletter online at wileyonlinelibrary.com
8 Alcoholism & Drug Abuse Weekly April 4, 2011
Continued from previous page
terstone Research Institute, only 8
percent of behavioral health pro-
viders have fully implemented elec-
tronic health records. Senator
Whitehouse authored a similar bill
last year, after then-Representative
Patrick Kennedy offered a House
version. Neither bill made it even as
far as a committee vote.
In the States
Maryland Senate approves alcohol
tax increase to benefit the schools
The Maryland Senate voted
27-19 March 30 to increase a sales
tax on alcohol from 6 percent to 9
percent, Business Week reported.
The increase would raise about $29
million in the next fiscal year. The
money is to be used for the schools,
with $9 million going to Prince
George’s County and $12 million to
Baltimore. It also allocates $5 mil-
lion for the developmentally dis-
abled in fiscal year 2012, $10 mil-
lion in fiscal year 2013, and $15
million in fiscal year 2014. The al-
cohol beverage industry is still
fighting the measure.
Fla. legislators propose eliminating
all funding for adult treatment
Last week the Florida Senate
Subcommittee on Health and Hu-
man Services Appropriations re-
leased a budget proposal that
would eliminate all state funding
for adult substance abuse services.
More than 37,000 adults would lose
access to treatment under this pro-
posal, advocates say. In addition,
each state dollar spent on treatment
generates two dollars from local
and federal matches.
Indiana facility gets $1.4 million
state contract
LifeSpring has won a $1.4 mil-
lion contract from the Indiana De-
partment of Mental Health and Ad-
diction to allow its Turning Point
Center to offer subsidies to patients
who can’t pay for treatment. The
Alcoholism & Drug Abuse Weekly DOI: 10.1002/adaw
Coming up…
The National Association of Addiction Treatment Providers (NAATP) will hold its
annual meeting May 14-17 in Chandler, Arizona. Go to www.naatp.org for more
information.
The annual meeting of the National Association of State Alcohol and Drug Abuse
Directors will be held June 7-10 in Indianapolis, Idiana. For more information, go to
http://nasadad.org/annual-meeting.
subsidies would be for detoxification the standards recommended by the
and residential services for 18 beds. National Association of Drug Court
The program, based in Jeffersonville, Professionals. For the transcript, go
usually only serves nine patients at a to http://bit.ly/ftTrN1.
time due to lack of funding. “We
hope to work closely with local LifeSKills Training top evidence-based
courts and correctional programs to prevention program in schools
maximize the effectiveness of these According to a study published
new treatment opportunities,” said in the Journal of Drug Education,
Terry L. Stawar, Lifespring president the LifeSkills Training program is the
and CEO, last week. top evidence-based drug abuse pre-
vention program used by elementa-
Resources ry schools in the United States. The
study is based on a national survey
of school-based prevention curricu-
When drug court goes wrong… la identified as evidence-based on
To find out what can happen to three registries: the National Registry
someone who gets into the wrong of Evidence-based Programs and
drug court, listen to last week’s “This Practices (NREPP), Blueprints for
American Life” episode (you can get Violence Prevention, and the U.S.
a podcast at thisamericanlife.org). Department of Education’s Office of
Called “Very Tough Love,” the pro- Safe and Drug-free Schools. LifeSkills
gram shows how a teenager who Training was the only program on
forged two of her parents checks all three registries. The study, fund-
ended up in prison for 10 years, ed by the National Institute on Drug
rather than getting probation or Abuse, found that one-third of
drug treatment, because the drug schools use a program that is not
court she was in did not adhere to evidence-based.
In case you haven’t heard…
A group of sixth graders, on a class assignment from Boulder Creek High School
in Anthem, Arizona, got a drug-education bill passed in the state legislature
because they felt their community — especially their parents — weren’t aware
of the extent of the problem, the Arizona Republic reported. They were so excited
that they made a video calling attention to the bill and posted it on Youtube. But
when local business leaders saw the video — “Drugs are consuming Anthem,” a
voice says, as the camera pans a gated community — they complained to school
administrators. Tempers flared, the teacher was almost fired, the principal
threatened to call the police on a parent, and it took spring break for people to
calm down. Now, the teacher, students, and parents say the school administrators
are more concerned about politics than anything else. But they are still going to
pursue getting their bill signed into law.
A Wiley Periodicals, Inc. publication. View this newsletter online at wileyonlinelibrary.com