1. Recovery Oriented Systems of Care in Minnesota
Fridays with ADAD
May 21, 2010
Carol Falkowski
Director, Alcohol and Drug Abuse Division
Minnesota Department of Human Services

2. What is recovery?
A process of change through which an individual achieves abstinence, improved health, wellness, and quality of life. 2
Source: CSAT National Summit on Recovery, 2005

3. ADAD’s Role in Supporting Recovery from Substance Use Problems & Disorders
ADAD administers Substance Abuse Prevention and Treatment (SAPT) Federal Block grant dollars in the form of grants for recovery support, prevention, special populations
ADAD encourages integration of addiction treatment with primary health care and mental health care services.
ADAD partners with multiple organizations to reduce stigma and help advance addiction as a treatable chronic disease with behavioral components and works to enhance public acceptance of that treatment. 3 3

4. ADAD’s Role in Supporting Recovery from Substance Use Problems & Disorders
ADAD works to ensure that science, rather than ideology or anecdote, forms the foundation for Minnesota’s addiction treatment system.
ADAD serves health professionals and the public by disseminating scientifically sound, clinically relevant information on best practices in the prevention and treatment of addictive disorders.
ADAD administers over $100 million in funds to pay for treatment services for those who could not otherwise afford it (CCDTF) 4 4 4

5. The Challenges: Reaching those in need of services
Improving access to services
Providing adequate resources
Developing culturally-appropriate, and emerging evidence-based practices
Building/sustaining a qualified workforce
Integrating substance use disorder services into the primary health care paradigm 5 5

6. Challenges: Traditional Treatment Approach
Traditional treatment approach presents challenges that translate into less cost-effective use of funds:
52.3% of those admitted to U.S. public substance abuse treatment programs in 2006 were re-entering treatment,
21.3% for the second time, 17.4% for the third or fourth time, and 13.6% for the fifth or more time. 1
One recent study found the that median time from first treatment to 1 alcohol- and drug-free year was 9 years – with 3 to 4 episodes of treatment.2
¹SAMHSA, Office of Applied Studies. Treatment Episode Data Set (TEDS). Highlights National Admissions to Substance Abuse Treatment Services
2 Dennis, M.L. et al, The duration and correlates of addiction and treatment careers, Journal of Substance Abuse Treatment 28 (Suppl. 1): S51-S62 6

7. Recovery-Oriented Systems of Care . . .
. . .support person-centered,
self-directed approaches to care that build on the strengths/resilience of individuals, families, and communities to take responsibility for their sustained health, wellness, and recovery from alcohol and drug problems. 7
Source: CSAT National Summit on Recovery, 2005

8. Recovery-Oriented Systems of Care
. . . shift the question from
“How do we get the client into treatment?” to
“How do we support the process of recovery within the person’s environment?”

9. A Traditional Service Approach Discontinuous treatment
Severe
Remission
Acute symptoms
Discontinuous treatment
Crisis management 9
Resource: Tom Kirk, Ph.D 9

10. A Recovery-Oriented Approach
Continuous
treatment response
Severe
Remission
Promote Self Care, Rehabilitation 10
Resource: Tom Kirk, Ph.D 10

11. Helps People Move Into a Recovery Zone
Severe
Recovery Zone
Symptoms
Improved client outcomes
Remission
Time 11
Resource: Tom Kirk, Ph.D 11

12. Recovery-Oriented Systems of Care Approach
The treatment agency is viewed as one of many resources needed for a client’s successful integration into the community.
No one source of support is more dominant than another.
Various supports work with the client’s direction, so that all possible supports work for and with the person in recovery.
Source: Addiction Messenger, November 2007, Vol. 10 Issue 11, published by the Northwest Frontier ATTC.

13. Recovery-Oriented Systems of Care Approach
A chronic care approach, including self-management, family supports, and integrated services, improve recovery outcomes 1
Integrated and collaborative care has been shown to optimize recovery outcomes and improve cost-effectiveness 2
1 Lorig et al, 2001; Jason, Davis, Ferrari, & Bishop; 2001; Weisner et al, 2001; Friedmann et al, 2001.
2 Smith, Meyers, & Miller, 2001; Humphreys & Moos, 2001. 13 13

14. Recovery-Oriented Systems of Care Approach
Encompasses a wide spectrum of State, local, community-based, faith-based, and peer-to-peer supports, services, and systems.
Every resource, system, service, etc., that contributes to the recovery of an individual “owns” a piece of this approach. 14

15. Recovery Health Wellness Abstinence Evidence-Based Practice Employment
Individual
Family
Community
Family/ Child Care
Housing/
Transportation
Financial
Legal
Case Mgmt
Peer Support
Health Care
PTSD &Mental Health
Alcohol/Drug Treatment
Vocational
Educational
Spiritual
Addiction
Services System
Mental Health
System
Primary Care
Child Welfare
and Family
Services
Housing System
Social Services
Health Insurance
DoD & Veterans Affairs
Indian Health
Criminal & Juvenile Justice System
Abstinence
Employment
Crime
Homelessness
Evidence-Based Practice
Cost Effectiveness
Perception
Of Care
Social Connectedness
Access/Capacity
Retention
Vocational Services
HIV Services
Faith Community
Menu of Services
Systems of Care
Recovery
Wellness
Health
Tribal Authorities
Education System
Organized Recovery
Adolescent
Svcs.
Sober Schools

16. Goals: Recovery-Oriented Systems of Care Approach
To support preventive strategies related to substance use problems & disorders;
To intervene early with individuals with substance use problems;
To support sustained recovery for those with substance use disorders; and
To improve individual, family and community outcomes. 16