Blog: Adolescent Substance Abuse Treatment

As many of you know, in 2016 the Office of Juvenile Justice and Delinquency Prevention (OJJDP) released the Juvenile Drug Treatment Court Guidelines (JDTC). The purpose for developing the Guidelines was to organize the most effective JDTC implementation components based on the best available research. Building on the 2003 Juvenile Drug Courts: Strategies in Practice (JDC: SIP), this systematic and thorough review developed seven objectives, each with corresponding guidelines statements, and supporting information.

Acknowledged as the final signed legislation for President Obama’s Administration, the 21^st Ce​ntury Cures Act is important for behavioral health and juvenile justice. The key components of this Act include provisions for:

• Addressing the heroin and prescription opioid epidemic
• Providing funding for the BRAIN initiative and precision medicine
• Improving mental health care by increasing the availability of treatment and improving justice systems to ensure individuals in need of mental health services - actually get it
• Improving clinical trials
• Expanding cancer research and treatment efforts

In the current Reclaiming Futures newsletter we focus our attention on Screening Brief Intervention and Referral to Treatment (SBIRT). SBIRT is a public health-oriented framework revolutionizing the way we think about behavioral health and substance use screening and prevention. Buoyed by strong evidence from the adult research literature, there has been a surge in national interest in translating the successes of the adult SBIRT model for youth populations.

Reasons why I am proud to write this blog post...

Reason 1: My former colleagues (and friends) at The University of Arizona, Southwest Institute for Research on Women (UA SIROW) (UA SIROW) have been leading the efforts on the national evaluation of Juvenile Drug Courts and Juvenile Drug Courts blended with Reclaiming Futures (JDC/RF).  UA SIROW collaborated with Chestnut Health Systems and Carnevale Associates, LLC to implement a comprehensive evaluation that included data from Juvenile Drug Courts, Juvenile Drugs Courts blended with Reclaiming Futures, and non-justice related intensive adolescent outpatient programs. The purpose was to examine processes, outcomes, and costs.

We round up the latest news on youth justice reform and national public health.

• Compromise reached on "Second Chance" legislation; raising the age debate now closed.  Gov. Dannel P. Malloy argued to raise the age of youth in the state juvenile justice system, but the debate ended last weekend in a compromise with Democratic leadership on bail reform for non-violent, misdemeanor offenses.  [NBC Connecticut]

• White House deletes FDA's planned policy and rationale for restricting flavored e-cigarettes. After demonstrating the appeal of flavored products to youth and young adults, the Food and Drug Administration (FDA) submitted a tobacco regulation on flavored e-cigarettes to the White House Office of Management and Budget (OMB). The FDA policy and rationale for the restrictions were deleted by the OMB; no comments on why at this time. [NBC News] 

Deadline Approaching: Review and comment by April 11, 2016

Have you seen the Substance Abuse and Mental Health Services Administration’s (SAMHSA) proposed changes to 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records? If not, we recommend taking a look and commenting as an individual, agency/organizational, or community collaboration. Feel free to share praises and/or critiques about the proposed changes with SAMHSA.

Here are some key highlights:

• Rewind time to more than four decades ago - 42 CFR Part 2 was conceptualized and approved to provide individuals seeking substance use disorder treatment with protections for privacy and confidentiality. It was acknowledged that stigma and fear of potential repercussions (familial, employment; criminal) prevented people from seeking treatment.
• The last “substantive” update to 42 CFR Part 2 was in 1987 (approaching three decades ago).
• There have been substantial changes in the way substance use disorder treatment is provided including a greater number of integrated health care centers (primary and behavioral health) and greater use of electronic health records. As such, modernizing 42 CFR Part 2 is necessary.
• The proposed regulations will continue to apply to federally-assisted “programs“ which “holds itself out as providing, and provides substance use disorder diagnosis, treatment, or referral for treatment.” General medical facilities have always been included as a “program”, but the proposed change adds “general medical practices” to the definition.
• It proposes if agencies and organizations that have “general designation” on consent form(s) they must provide patients a list of where their information has been shared.
• Proposes agencies and organizations must have policies and procedures in place to sanitize paper and electronic records.

A new report, "Reducing Teen Substance Misuse: What Really Works," calls attention to the rising rate of teen overdose fatalities in the United States, the role of prescription painkillers, as well as research-based solutions for prevention and treatment. The report, supported by a grant from the Conrad N. Hilton Foundation, was authored and produced by Trust for America's Health (TFAH), a Washington D.C.-based nonprofit, non-partisan organization with a focus on public health policy and community prevention and treatment strategies. 

Significant Increase in Teen Overdose Fatalities

TFAH finds that youth drug overdose fatalities, among 12 to 25 year-olds, more than doubled in 35 states over the past ten years, particularly among young men and boys. Fatality rates for youth overdose more than doubled in 18 states, more than tripled in 12 states, and more than quadrupled in five states (Kansas, Montana, Ohio, Wisconsin and Wyoming). Analyses reveals that, while no state had a youth overdose death rate over 6.1 per 100,000 before 2001, 33 states were above 6.1 per 100,000 deaths by the year 2013.

President Obama has proclaimed November as "Native American Heritage Month." This is a time to celebrate the many significant historic and contemporary contributions of American Indians and Alaska Natives, a population of 5.4 million people in the United States, according to the U.S. Census Bureau. In the juvenile justice field, this month is not only a time to celebrate Native American heritage, but also an opportunity to make visible the unique youth justice challenges faced by Native American communities, and to highlight steps for collaboratively working with tribal communities to improve conditions for Native American youth and their families.

Though 1990 was the first year "Native American Indian Heritage Month" was recognized as a national legal holiday, according to the U.S. Bureau of Indian Affairs, the pursuit of a holiday to celebrate heritage began in the early 20th century when Dr. Arthur C. Parker - a Seneca Indian and director of the Museum of Arts and Sciences in Rochester, New York - promoted a day to celebrate "First Americans." In May 1916, the first "American Indian Day" was declared by the state of New York, and many states observed a version of this day for years before official national recognition in 1990 for the month of November.

The National Program Office (NPO) is very pleased to announce Reclaiming Futures' new rural community collaborative site in NW Ohio. The NW Ohio Reclaiming Futures (NORF) Initiative is a collaboration between Defiance, Henry, and Williams Counties, as well as their regionally shared service providers and community stakeholders. As a new example of a Reclaiming Futures rural community collaborative site (the site model also exists in Kentucky and North Carolina), NW Ohio provides an important example of a site tapping into an innovative state justice reinvestment fund in order to join the Reclaiming Futures initiative.

NW Ohio is Reclaiming Futures' fifth site in the state of Ohio. Evan Elkin, Executive Director of Reclaiming Futures, credits the growing presence of Reclaiming Futures in Ohio to the neighborly and supportive tendencies of Ohioans, which creates a grassroots sharing of information. “They share with their communities and around the state - and word of the positive outcomes the existing sites are seeing is getting around,” explains Elkin.

Defiance, Henry, and Williams Counties of NW Ohio provide an excellent example of Ohio's collaborative and supportive nature, and how this quality of working together and sharing resources particularly benefits rural communities. The three counties joined together to propose the NORF Initiative upon recognizing a need in their communities for more consistency and specifically...