ASSESSMENT ISSUES FEBRUARY 27, 2012

ADSAC CONTACT INFORMATION Ray Caesar Director of Addiction Specialty Programs Oklahoma Department of Mental Health & Substance Abuse Services (405)522-3870 (405)522-4470 rcaesar@odmhsas.org

ADSAC CONTACT INFORMATION Ray Caesar 405-522-3870 rcaesar@odmhsas.org Patty Patterson 405-522-8537 ppatterson@odmhsas.org Linda Clark 405-522-5837 lclark@odmhsas.org John Bureman 405-522-8024 jbureman@odmhsas.org

PROBLEMS WITH ALCOHOL AND OTHER DRUGS

Public Intoxication

Vandalism

Homelessness

Inappropriate aggression

Paranoia

Criminal behavior

Compromising situations

ADSAC ADSAC is an acronym for; ALCOHOL AND DRUG, SUBSTANCE ABUSE SERVICES This phrase is found in Title 47 Motor Vehicle Code and refers to the entire process of assessment, education and treatment. Authority for the ADSAC process comes from Titles; 43A Mental Health Law, 47 Motor Vehicle Code, 22 Criminal Code.

ADSAC ODMHSAS has specific responsibility for; ASSESSMENT ~ defining type, duration and intensity of intervention. FACILITATION ~ 10 & 24 hour courses CERTIFICATION ~ Assessors ~ Assessment Agencies ~ Facilitators ~ Course Organizations TRAINING ~ Assessors Instruments, Interview Technique, Oklahoma Administrative Code Adult Education, Interactive Journaling and Oklahoma Administrative Code

ADSAC 230 Certified ADSAC Assessors 25 Certified ADSAC Assessment Agencies 2012

ADSAC Access to ADSAC services may be required of almost the entire population of Oklahoma * Only a very small percentage of the population will not be possible candidates for ADSAC services. Those who never drink or use mood altering drugs and who never associate with those who do. *

ADSAC ================================== * * * * 25% to 40% of 30% of the population the population consume 90% of never drink the alcohol ================================== * * * * Of this group only 30% or (10% of the total population) are physically dependent

ADSAC Alcohol or other drug related driving offenses (upon arrest) DUI DUI D DWI APC Drug convictions (with a vehicle involved) Possession Transportation Distribution Paraphernalia

ADSAC HISTORY OF THE PROCESS November 1, 1985 10 hour DUI school (Testing suspensions) July 1, 1991 10 hour DUI school (All alcohol related suspensions) May 26, 1993 10 hour DUI school (Drug convictions) September 1, 1993 Assessment required November 1, 1996 24 hour DUI school July 1, 2003 Assessment driven July 1, 2008 Recommendations in code November 1, 2008 Change in assessment fee collection

ADSAC ADSAC COURSES

ADSAC TITLE 450 Chapter 21 Certification of Alcohol and Drug Substance Abuse Courses (ADSAC), Organizations and Facilitators Effective July 1, 2009

ADSAC The journals are interactive, requiring the participation of the offender

ADSAC 10 Hour Course (sub-clinical) Conducted in no less than three sessions of three to three and one half hours each 24 Hour Course (sub-clinical) Conducted in no fewer than twelve sessions of two hours each, twice weekly for six weeks 24 Hour Course (clinical) Conducted in no fewer than twelve sessions of two hours each, twice weekly for six weeks and offered in conjunction with a group intervention

ADSAC Both the Ten and Twenty-four hour ADSAC journals contain two distinct, interrelated journals The larger section of each journal is an interactive workbook addressing issues related to substance use, decision making and coping strategies The smaller but, possibly more important section of each journal is a personalized change plan based on the transtheoretical model of change and allow the development of an individualized action plan based on the beliefs and decisions of the offender

ADSAC INSTRUCTION COUNSELING THERAPY FACILITATION

ADSAC ASSESSMENT PROCESS

ADSAC TITLE 450 Chapter 22 Certification of Alcohol and Drug Assessment and Evaluations Related to Driver’s License Revocation Effective July 1, 2009

ADSAC The ADSAC assessment is often the first clinically driven intervention The ADSAC assessor has the opportunity to provide what may be the only assessment the offender will receive The ADSAC assessment serves as a critical point of entry

ADSAC Requirements for the assessment process Face to face interview Bio-psych-social ASI Drivers Risk Inventory, revised DRI II Defendant Questionnaire DQ Additional supportive instrument

ADSAC ADSAC assessments completed after July 1, 2008 are valid for six months. If services have not been initiated within six months, successful completion of a new assessment is required.

ADSAC All requirements must be able to be completed within ninety days (twelve weeks).

ADSAC ADSAC assessors must be a current LADC or CADC in good standing. An LADC under supervision may work as an assessor for a Certified ADSAC Assessment Agency.

ADSAC Drivers Risk Inventory, revised (DRI II) Presumes an alcohol or drug related driving offense has occurred Appropriate for all alcohol and/or drug related driving offenses resulting in license revocation

ADSAC Drivers Risk Inventory revised (DRI II) Six scales Truthfulness Alcohol Drug Substance Abuse/Dependency Drivers Risk Stress Coping Abilities

ADSAC Defendant Questionnaire Presumes a drug related criminal offense has occurred Appropriate for drug convictions for possession, transportation, distribution or paraphernalia

ADSAC Defendant Questionnaire Seven scales Truthfulness Alcohol Drug Substance Abuse/Dependency Violence Antisocial Stress Coping Abilities

Assessed areas in common ADSAC Assessed areas in common Truthfulness Alcohol Drug Substance Abuse/Dependency Stress Coping Abilities

ADSAC ASSESSMENT INTERVENTION CATEGORIES

ADSAC Intervention Category I 0 – 39 Low Risk Intervention Category II 0 – 39 Low Risk (Second offense) Intervention Category III 40 – 69 Moderate Intervention Category IIIB Override - IV or V Intervention Category IV 70 – 89 Problem Intervention Category V 90 – 100 Severe

ADSAC INTERVENTION CATEGORY I LOW RISK Scoring 0 to 39 on the DRI II or DQ supported by the information from the additional instrument. 10 hour ADSAC course Victims Impact Panel

ADSAC INTERVENTION CATEGORY II LOW RISK Scoring 0 to 39 on the DRI II or DQ supported by the information from the additional instrument and having a prior offense. 24 hour ADSAC course Victims Impact Panel

ADSAC INTERVENTION CATEGORY III MODERATE RISK Scoring 40 to 69 on the DRI II or DQ supported by the information from the additional instrument. 24 hour ADSAC course Victims Impact Panel Six weeks substance abuse group

ADSAC INTERVENTION CATEGORY IIIB from OVER RIDE Scoring 70 to 100 on the DRI II or DQ supported by the information from the additional instrument & appropriate for over ride from Intervention Category IV or V. Twelve weeks substance abuse group (one or two times weekly) Twelve weeks Mutual Support group

ADSAC INTERVENTION CATEGORY IV PROBLEM RISK Scoring 70 to 89 on the DRI II or DQ supported by the information from the additional instrument. Intensive Outpatient Mutual Support Group Aftercare if recommended by provider

ADSAC INTERVENTION CATEGORY V SEVERE RISK Scoring 90 to 100 on the DRI II or DQ supported by the information from the additional instrument. Residential Treatment Mutual Support Group Aftercare if recommended by provider

ADSAC Intervention Category I 0 – 39 Low Risk Intervention Category II 0 – 39 Low Risk (Second offense) Intervention Category III 40 – 69 Moderate Intervention Category IIIB Override - IV or V Intervention Category IV 70 – 89 Problem Intervention Category V 90 – 100 Severe

ADSAC OVERRIDES Services not available Geographic accessibility On waiting list for appropriate level of care Language barriers Sustained abstinence

ADSAC Supportive Instruments Juvenile Automated Substance Abuse Evaluation (JASAE) Multidimensional Addictions and Personality Profile (MAPP) NEEDS Assessment (NEEDS) Triage Assessment for Addictive Disorders (TAAD)

ADSAC Sixty million Americans are functionally illiterate or illiterate.

According to the U.S. Census of 2000 ADSAC According to the U.S. Census of 2000 20% of Oklahoma residents are illiterate 40% of the residents in some Oklahoma Counties have less than a twelfth grade education

ADSAC Generational issues 1922 to 1943 “The Greatest Generation” Comfortable in formal settings Dislike too much familiarity Require respect Do not volunteer feedback, need encouragement Incorporate life experiences Tend not to accept the concepts related to addiction

ADSAC Generational issues 1944 to 1960 “Baby Boomers” Value teamwork May resist concept that certain drugs can be problematic Value learning Value self-help strategies Incorporate life experiences

ADSAC Generational issues 1961 to 1980 “Generation X” See change as a norm Respect must be earned Value self-directed learning Expect learning to be fun Comfortable with technology Appreciate “hands on” activities

ADSAC Generational issues 1981 to 1992 (1997) “Generation net” Technology is taken for granted Diversity is valued Respect for expertise Flexible Require variety in learning

ADSAC STAGES OF CHANGE ~ Precontemplation ~ Contemplation ~ Preparation ~ Action ~ Maintenance

ADSAC M I TECHNIQUES ~ Express empathy ~ Avoid arguments ~ Support self-efficacy ~ Roll with resistance ~ Develop discrepancy

ADSAC CONTACT INFORMATION Ray Caesar 405-522-3870 rcaesar@odmhsas.org Patty Patterson 405-522-8537 ppatterson@odmhsas.org Linda Clark 405-522-5837 lclark@odmhsas.org John Bureman 405-522-8024 jbureman@odmhsas.org