As many of you know, Reclaiming Futures was awarded a Conrad N. Hilton Foundation grant in September 2014. The purpose of this grant is to develop, pilot test, evaluate, and disseminate a new version of SBIRT for youth at risk for deeper involvement with the juvenile justice system. As a first step, Reclaiming Futures issued a request for proposals and awarded five sites to help us in the endeavor. The sites selected, through a competitive process, were:… Read More »
Reasons why I am proud to write this blog…
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.
It is widely known that arrest rates for adolescents have steadily declined over the past two decades. During this time, we’ve also seen a gradual shift in the nation’s juvenile justice practices away from the use of out-of-home placement for minor, non-violent offenses and toward more treatment-oriented, trauma-sensitive and community-based responses.
This, unfortunately, has not been the story for girls involved in the juvenile justice system. In fact, the proportion of girls involved at all stages of the juvenile justice continuum increased over this time period. Experts and policymakers agree that the system remains insensitive and ill-equipped to serve the needs of girls – particularly girls of color – at all levels of juvenile justice continuum.… Read More »
In 2008 my colleagues and I wrote for and were awarded a recovery-oriented systems of care grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). The primary goal of this grant was to develop and implement a trauma-informed and recovery-oriented system of care for adolescent girls. My colleagues and I were concerned about the increasing juvenile justice involvement and substance use rates among adolescent girls with little to no increases in their rates of enrollment in treatment. Our previous research highlighted the significant levels of trauma and other co-occurring mental health problems among girls. In addition, we found girls had higher rates of “harder” drug use such as cocaine, amphetamines, and heroin/opiates as compared to boys. And on the positive side, we also found that girls who accessed treatment responded really well and made significant behavioral improvements over time.
Other juvenile justice and behavioral health policy makers and program developers have recognized the importance of responding to these increased rates of behavioral health and substance use problems among adolescent girls. We now have a better understanding that while males and females are equally vulnerable to addiction, that from a physiological standpoint, females can have lower tolerance and may progressive to physical dependence at different rates. We also have a better understanding of the critical role played by trauma in substance use and addiction as well as a broader range of available approaches for providing gender-specific and trauma-informed treatment. The positive news is that we have seen the rates of illicit substance use significantly decrease for girls from 2008 to 2014 (26.5% versus 23.7%) and decreases in comparison to boys.… Read More »
On June 1, 2016, our Reclaiming Futures national executive director Evan Elkin spoke at Red Emma’s in Baltimore for Open Society Institute-Baltimore’s second event in their “Talking About Addiction” series. Elkin was accompanied on the panel by Dr. Hoover Adger from Johns Hopkins Children’s Center and by Carin Callan Miller, who founded Save Our Children Peer Family Support. The conversation was moderated by Scott Nolen, director of OSI-Baltimore’s Drug Addiction Treatment Program. A full room of community members joined them for the evening, including families affected by adolescent addiction.
Youth, Addiction and the Juvenile Justice System
Whereas the first “Talking About Addiction” event explored alternative law enforcement approaches to addiction, this event focused on youth, addiction, and the juvenile justice system. Despite public acknowledgment of the failures of the “War on Drugs,” and an increased understanding of addiction as a public health issue rather than a criminal justice issue, OSI-Baltimore recognizes that research and policy around adolescent addiction are slow to reach the mainstream. Indeed, during the discussion, some attendees expressed frustration with how long addiction treatment reform is taking; OSI moderator Nolen suggested reassurance that the addiction paradigm is finally shifting.… Read More »
- 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]
America is facing a heroin and opiate crisis. Heroin is increasingly popular – a report by the federal Substance Abuse and Mental Health Administration indicates that first-time heroin users doubled between 2006 and 2013 and data from the National Institute on Drug Abuse indicate that deadly heroin overdoses increased sixfold in the years between 2001 and 2014. More than ever before, this crisis is addressed as a public health issue more than a public safety or criminal justice issue. This shift has sparked much public debate about why this is the case. Have we finally reached a tipping point as a society in our views of addiction as a health concern? Have irresponsible pain management prescription practices contributed to opening our eyes to one of the epidemic’s root causes? Some argue that race is a critical part of the story and feel that the shifting demographic – with an apparent increase in the proportion of white heroin and opiate users – is what has changed the perception of heroin abuse and finally mobilized policy makers. In this month’s Reclaiming Futures newsletter, we focused our attention on the issues surrounding the opiate crisis and featured a new blog post by Reclaiming Futures Program and Policy Analyst Bridget Murphy.… Read More »
On March 29, 2016 President Barack Obama communicated support for addressing the opiate and heroin crisis in the United States. Joined by physicians and individuals in recovery on a panel at the National Rx Drug Abuse and Heroin Summit in Atlanta, GA, President Obama announced several private and public sector supports including access to treatment, medical coverage and physician training, enforcement to combat distribution, and a number of other services. At the same time, the Centers for Medicare & Medicaid Services finalized “a rule to strengthen access to mental health and substance use disorder treatment.”
These services and supports are specific to opiates and heroin and this is good news for the juvenile justice and substance use disorders fields. Why….? Let me explain.
Although the majority of adolescents present to treatment for alcohol or cannabis problems and disorders, intervening early may prevent the onset of heroin and non-prescription use of pain relievers. Adolescent use of opiates has not significantly changed in recent years; however, for transitional aged youth it has. According to the 2014 National Survey on Drug Use and Health found that as compared to the 2009 rates, past year heroin use among 18 to 25 year olds has significantly increased (0.5 vs. 0.8). Additionally, the Center for Disease Control (CDC) reported a 14% increase in opioid overdoses in one year. Providing the necessary services and supports to adolescents and their families involved with the juvenile justice system, including education of heroin and opiate addiction, has the potential to change these significant increases in use and deaths.… Read More »
We’re very excited to announce the launch of Reclaiming Futures Data Briefs, a new series of brief reports developed in partnership with the John Jay College of Criminal Justice’s Research and Evaluation Center and the Center’s Director, Dr. Jeffrey Butts. The series will highlight current data trends at the intersection of the fields of criminal and juvenile justice, law enforcement and the epidemiology of behavioral health and substance use. The reports are intended for a wide range of youth justice and treatment stakeholders including practitioners, policymakers, advocates, researchers and juvenile justice professionals. The reports are designed to be clear and concise and to provide useful information that will help readers to put our efforts to reform the juvenile justice systems and improve outcomes for youth in a broader, more data-driven context. Dr. Jeffrey Butts from John Jay College says: “I’m pleased to be a part of the new series of data briefs because the goal of Reclaiming Futures is to distribute data in focused and accessible ways.” The first Reclaiming Futures Data Brief examines trends in drug-related arrests within adolescent, young adult and adult populations across both the juvenile and adult justice systems. We hope you find this new series useful in your work.
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.