1. Building Drug-Free Communities—The CADCA Model
Arkansas Prevention Summit
General Arthur T. Dean
Chairman and CEO, CADCA
May 30, 2019

2. CADCA History and Overview
CADCA’s Vision
A world of safe, healthy and drug-free communities
CADCA’s Mission
To strengthen the capacity of community coalitions to create and maintain safe, healthy and drug-free communities globally
Founded in 1992 as a recommendation from the President’s Drug Advisory Council
CADCA represents more than 5,000 community coalitions in the United States and more than 500 around the world.

3. CADCA’s Core Services Public policy and advocacy
Training and technical assistance
Research dissemination and evaluation
Special events and trainings
Communications
International programs
Youth programs

4. CADCA’s International Programs Currently Support Communities in 23 countries on 5 continents​
CADCA assists government, non-government organizations and community groups in developing effective community coalitions to prevent and reduce rates of illicit drug use.

5. CADCA’s Youth Leadership Initiative
Trainings are youth-led, adult-guided, which helps coalitions build capacity to foster youth leadership in design, implementation, and evaluation of action strategies addressing community problems
“Youth In Action” projects employ seven evidence-based behavioral change strategies with an emphasis on environmental change to effectively address the problem behavior identified.
Engage. Develop. Inspire
CADCA's Youth Leadership is adaptable and has been evaluated by Michigan State University.
Source:

6. CADCA’s Youth Leadership – ‘Youth Led – Adult Guided’
Youth trained by CADCA’S Youth Leadership experience an increase and significant change in the following aptitudes:
Leadership Competencies
Community Organizing
Problem-Solving Abilities
Current and Future Civic Activism
Civic and Political Engagement
Youth-Adult Partnerships

7. What are Coalitions?
A coalition is a formal arrangement for cooperation and collaboration between groups or sectors of the community, in which each group retains its identity but all agree to work together towards a common goal of building a safe, healthy and drug-free community.

8. CADCA’s Coalition Model
Essential Sectors for Success

9. Coalition 5-Step Evidence-Based Process
DRUG FREE COMMUNITIES APPLICATION WORKSHOPS
Coalition 5-Step Evidence-Based Process
Assess prevention needs
Build prevention capacity
Develop strategic plan
Implement effective community prevention programs, policies, and practices
Evaluate efforts for outcomes 9

10. Seven Strategies for Community Change Environmentallyfocused
Provide information
Build skills
Provide social support
Individually focused
Reduce barriers/enhance access
Change consequences/incentives
Alter the physical design of the environment
Change policies and rules
Providing Information – Educational presentations, workshops or seminars or other presentations of data (e.g., public announcements, brochures, dissemination, billboards, community meetings, forums, web-based communication).
Enhancing Skills – Workshops, seminars or other activities designed to increase the skills of participants, members and staff needed to achieve population level outcomes (e.g., training, technical assistance, distance learning, strategic planning retreats, curricula development).
Providing Support – Creating opportunities to support people to participate in activities that reduce risk or enhance protection (e.g., providing alternative activities, mentoring, referrals, support groups or clubs).
Enhancing Access/Reducing Barriers- Improving systems and processes to increase the ease, ability and opportunity to utilize those systems and services (e.g., assuring healthcare, childcare, transportation, housing, justice, education, safety, special needs, cultural and language sensitivity).
Changing Consequences (Incentives/Disincentives) – Increasing or decreasing the probability of a specific behavior that reduces risk or enhances protection by altering the consequences for performing that behavior (e.g., increasing public recognition for deserved behavior, individual and business rewards, taxes, citations, fines, revocations/loss of privileges).
Physical Design – Changing the physical design or structure of the environment to reduce risk or enhance protection (e.g., parks, landscapes, signage, lighting, outlet density).
Modifying/Changing Policies – Formal change in written procedures, by-laws, proclamations, rules or laws with written documentation and/or voting procedures (e.g., workplace initiatives, law enforcement procedures and practices, public policy actions, systems change within government, communities and organizations).
Environmentallyfocused

11. CADCA’s Framework for Community Change
CADCA Training and Technical Assistance
Establish Coalition & Enhance Capacity
Coalitions Implement Essential Processes
Coalitions Pursue Comprehensive Strategies
Create Community Change
Improve Population Level Outcomes
Institute of Medicine, 2002; KU Work Group for Community Health and Development, 2007

12. CADCA Training is Effective
Coalitions receiving Training and TA from CADCA:
Report higher levels of effectiveness
Are engaged in a more comprehensive set of strategies to address substance misuse
Are more likely to have in place the essential processes to create community change
Source: Independent evaluation of the National Coalition Institute by Dr. Pennie Foster-Fishman, Michigan State University
We train 10,000 individuals and 2,000 youth each year!

13. Signature Training Events
2019 National Leadership Forum
SAMHSA 15th Annual Prevention Day – held in February 2018
29th Annual Forum held February 4-7, 2019 at the Gaylord Hotel and Convention Center, National Harbor, Md.
Over 3,000 attendees last year – record crowd
All federal agencies involved in substance abuse prevention, treatment, interdiction and research played a role
Members of Congress participated in plenary roundtable
2019 Mid-Year Training Institute
July 14-18, 2019 in Dallas, Texas – 2,000 attendees
In-depth courses, application-based training
International attendees received specialized training as well as peer-to-peer learning and dialogue opportunities with U.S. attendees

14. Drug-Free Communities Program
The U.S. has invested a total of $1.45 billion in the DFC program since it began in 1998.
The DFC Program has funded more than 2,000 coalitions since it began.
Currently, the U.S. has 719 DFC Grantees.
CADCA was the driving force behind the passage of this program and is the primary training and technical assistance provider for the program.

15. National Evaluation of the DFC Program

16. Impacting Change in Communities
Annually, we distribute a survey to coalitions across the United States. Here are some statistics related to the outreach of the survey.

17. Coalition Composition

18. What’s Happening in Arkansas?
In 2017, there were 188 overdose deaths involving opioids in Arkansas—a rate of 6.5 deaths per 100,000 persons ,compared to the national rate of 14.6 deaths per 100,000 persons. The number of deaths involving opioids included 125 prescription opioids, 68 related to synthetic opioids (mainly fentanyl), and 15 related to heroin. In recent years, drug overdose deaths involving prescription opioids have decreased while those related to synthetic opioids have increased.

19. Arkansas rate of overdose deaths—prescription opioids
In 2017, Arkansas providers wrote opioid prescriptions for every 100 persons---nearly twofold greater than the average U.S. rate of 58.7 opioid prescriptions while the opioid prescribing rate has ticked up and down since Overall, there has been a decline since 2007, with a 4.4 overdose deaths per 100,000 persons in a total of 125 deaths.

20. Prevention – Needed More Than Ever
While teen drug use in many categories is down, youth marijuana use has rapidly increased over the past few years.
Youth perceptions of risk related to marijuana continue to decline.
The rapid rise in the use of electronic nicotine delivery systems (e-cigarettes) is disconcerting.
Despite positive news of reductions in youth prescription drug abuse, opioid addiction and overdose deaths remain a major national epidemic.

21. Challenges
Opioid and heroin addiction usually start with young people who misuse alcohol and marijuana. Therefore, a focus on prevention is even more critical
Focus on environmental strategies continues to be a barrier
Funding for substance use needs to be a higher priority
Inconsistent messaging related to prevention
Opioid and heroin addiction usually start with young people who misuse alcohol and marijuana, therefore, we need to focus on prevention strategies.
We need to focus on environmental strategies related to the coalition model as these strategies have the greatest impact with respect to population level impact.
Finally, funding for substance use prevention needs to be a higher priority. With all the new funding the US to address the opioid crisis, almost no emphasis has been put on upstream approaches to stop misuse before it starts.

22. Increasing Awareness
“The most important thing that we can do with any public health intervention is what CADCA does—focus on prevention.”
Dr. Nora Volkow
Director, National Institute on Drug Abuse

23. Prevention Efforts
Dispel myths related to substance misuse by providing evidence based strategies and information
Provide opportunities for youth to get involved
Pursue partnerships and relationships with others who are committed to the cause
Bring key sectors together to expand reach and impact
Create forums to share best practices, strategies and successes with one another

24. Call to Action!
If we want the tide of the opioid epidemic to shift, we must absolutely stop the pipeline to addiction and PREVENT use and misuse before it starts.
Did you know that every dollar invested in prevention efforts saves communities on average $18.00? We want communities to save money, but more importantly, we want to save lives!
Prevention of substance use before it begins---particularly among children and youth, is the most cost-effective way to reduce substance use and its associated costs.
Ongoing dialogues about promoting positive lifestyles should happen early, often and in unison with educators, counselors, community leaders and youth.
Again, prevention of substance use before it starts requires our collective focus. Our collective prevention efforts need to start early. Teachers, parents, and healthcare professionals can shape children’s perceptions of substance abuse. We need your help to shift the dialogue of substance use and misuse—the results are life changing.
The CADCA model works around the world and in all cultural settings and all substances.

25. Two New Best Practice Publications (Opioids & Ends)
The Practical Theorist is part of a series of publications designed to summarize field research on key substance misuse issues, and to present it in a concise, practical format, with strategies for using the data to mobilize communities and support the mission of coalitions.  

26. Stay Connected and Join the Conversation!
CADCA
@CADCA
@CADCAcoalitions
CADCAorg
Building Safe, Healthy, and Drug Free Communities