1 The American Indian/Alaska Native National Resource Center for Substance Abuse and Mental Health Services Mini-summit: Alcohol and Native Children CWAG 2005 Annual meeting Kapalua, Maui, Hawaii August 1-4, 2005 Dale Walker, MD Patricia Silk Walker, PhD Douglas Bigelow, PhD Bentson McFarland, MD, PhD Laura Loudon, MS Michelle Singer

2 For information, contact us at Dale Walker, MD Or visit our website:

3 Overview An Environmental Scan Behavioral Health Care Issues Fragmentation and Integration Introduction to One Sky Center Our Children Introduce the SAMHSA Family

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Health Problems 1.Alcoholism 6X 2.Tuberculosis 6X 3.Diabetes 3.5 X 4.Accidents 3X 5.60% Over 65 live in poverty (US 27%)

7 American Indians Have same disorders as general population Greater prevalence Greater severity Much less access to Tx Cultural relevance more challenging Social context disintegrated

8 Agencies Involved in B.H. Delivery 1. Indian Health Service (IHS) A. Mental Health B. Primary Health C. Alcoholism / Substance Abuse 2. Bureau of Indian Affairs (BIA) A. Education B. Vocational C. Social Services D. Police 3. Tribal Health 4. Urban Indian Health 5.State and Local Agencies 6.Federal Agencies: SAMHSA, VAMC

9 How are we functioning? (Carl Bell, 7/03) One size fits all Different goals Resource silos Activity-driven

10 We need Synergy and an Integrated System (Carl Bell, 7/03) Culturally specific Best practice Integrating resources Integrating resources Outcome driven

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12 Program Goals Promote and nurture effective and culturally appropriate prevention and treatment Identify and disseminate evidence-based prevention and treatment practices Provide training and technical assistance Help to expand capacity

13 One Sky Center Partners Jack Brown Adolescent Treatment Center Alaska Native Tribal Health Consortium United American Indian Involvement Northwest Portland Area Indian Health Board Na'nizhoozhi Center Tribal Colleges and Universities One Sky Center National Indian Youth Leadership Project Cook Inlet Tribal Council

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15 Circle of Care Best Practices Child & Adolescent Programs Prevention Programs Primary Care Emergency Rooms Traditional Healers A&D Programs Colleges & Universities Boarding Schools

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17 Lifetime, Annual and 30 Day Prevalence of Intoxication Among 224* Urban Indian Youth R. Dale Walker, M.D. *100% completion sample

18 Changes in Lifetime Substance Use Among Urban Indian Youth * Over Nine Years R. Dale Walker, M.D. * 100% Completion Sample Percentage ever used

19 Age of Onset of Substance Use Among Urban American Indian Adolescents, by Substance Used R. Dale Walker, M.D. (5/2000) *Cohorts 4 & 5 were sampled every third year; recall and sampling bias apply

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SUBSTANCE ABUSE AND MENTAL HEALTH SERVICE ADMINISTRATION (SAMHSA) Grant Opportunities, Website links, Publications (TDD)

22 The SAMHSA Matrix

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24 The State Incentive Grants Implements SAMHSA’s Strategic Prevention Framework to: –24 States, 2 Territories, million per year; –Prevent onset and reduce progression of substance abuse –Reduce community substance abuse problems; –Build State and community prevention capacity and infrastructure; –Uses National Outcome Measures and builds Epidemiological Workgroups at the State and Community level. –Places emphasis on Underage Drinking

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26 Drug-Free Communities Program The GOALS are to: –Reduce substance abuse among youth and adults by addressing the factors in a community that increase the risk of substance abuse and promoting the protective factors that reduce risk of substance abuse. –Establish and strengthen collaboration among communities, drug courts, private nonprofit agencies, and federal, state, local and tribal governments to support the efforts of community coalitions to prevent and reduce substance abuse among youth. The Drug-Free Communities Act (Pub. L. No ) was signed into law on June 27, On December 14, 2001, Public Law , 115 Stat. 814 (2001), reauthorized the program for 5 years.

27 Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence The FASD Center For Excellence builds FASD State systems through: –Drug Courts and Family Courts –Training and technical assistance –Women in recovery summit –Birth mothers video –Materials/ resources for SA treatment systems –Public education materials for general audiences –Data analysis of SAMHSA’s national survey on drug use and health (NSDUH) –Inventory of prevention and treatment programs –State system meetings –Web site:

28 Centers for the Application of Prevention Technologies (CAPTs)

29 Addiction Technology Transfer Centers (ATTC)

30 Prevention Technology Platform Web-based Application To Help Communities: Assess their needs, readiness and resources; Plan strategically to develop infrastructure and sustainability; Select & implement evidence-based prevention approaches; and Conduct evaluations measuring progress, impact, & outcomes. Regularly updated database of on-line training curricula; A readiness roadmap and user-paths customized to individual responses; Geo-mapping resources Access to national databases; and Access to SAMHSA’s National Outcome Measures.

31 National Registry of Effective Programs and Practices (NREPP) SAMHSA’s new and improved NREPP: Will establish review criteria for the identification and rating of strategies, programs, policies, and activities; and Will expand to include community coalitions, which will be rated by criteria that will be developed by a panel of leading researchers, evaluators and coalition experts.

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