Substance Abuse

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Substance Abuse Mental Health Services
Administration Center for Substance Abuse
Prevention A Life in the Community
for Everyone
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SAMHSAS Vision A life in the community for
everyone

• Our Mission
• Building resiliency
• facilitating recovery

SAMHSAs MATRIX Strategic Prevention Framework
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The Role of Prevention

• To create healthy communities in which people
  have a quality life

• Healthy environments at work in school
• Supportive communities neighborhoods
• Connections with families friends
• Drug and crime-free

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Role of Government

• The role of the Federal government and States is
  to...

Implement systems which Support community
efforts to Reduce substance abuse related
problems
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Strategic Prevention Framework
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Infusion of theStrategic Prevention Framework
State Systems Prevention Infrastructure
General Public Awareness and Outreach
Community Coalitions Action Mechanism
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Strategic Prevention Framework
Why the SPF?

• Strategic Planning Process
• Community Development Process
• The Change Process at the State
• Community Level

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Key Principles of the SPF
Strategic Prevention Framework

• Public Health Approach
• Data-Driven Strategic Planning Process to inform
  decisions
• Outcomes Based Prevention

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Focus for States and Communities

• Consumption Consequences (prevent the problem
  associated with use)
• Across the lifespan (not just youth)
• Based on evidence-based research empirical data
• Outcomes measured at the population level (not
  just program level)

If we prevent use, we prevent the problem!!
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Strategic Prevention Framework
Cultural Competence Meets the Needs of the
People You Are Working With

• Eliminates service participation disparities
• Improves effectiveness quality of programs,
  policies and practices

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Sustainability - Sustain outcomes,
not programs
Strategic Prevention Framework

• Think sustainability from the beginning
• Look to the system to sustain outcomes
• Sustain prevention by making it everyones job

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Strategic Prevention Framework
Assess -
Using data to determine substance use related
problems

• Assessment of substance use and related problems
• Prioritization of Problems by State and Community
• Documents the extent, scope and nature of
  substance abuse and related problems

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Strategic Prevention Framework
Capacity Building -
Mobilize communities
resources

• Community Level
• Engage Key Stakeholders
• Key Tasks May Include
• Assessing community the prevention system
• Convening community leaders Stakeholders
• Building coalitions
• Training and technical assistance
• Leveraging resources

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State/Community Epidemiological Workgroups
Strategic Prevention Framework

• Systematic, analytical thinking to the causes and
  consequences substance use
• Promote data-driven decision making at all stages
  in the SPF
• Promote cross systems planning, implementation,
  and monitoring efforts

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Data Analysis
Strategic Prevention Framework

• Levels
• Establish baseline
• Trends
• Over time
• Patterns
• By age, gender, race/ethnicity

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Strategic Prevention Framework
Planning -
Design comprehensive interventions to impact
causal factors
Substance-related problems
Intervening Factors
Evidence -Based Strategies
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Intervening Factors
Strategic Prevention Framework

• Community Level Factors
• Availability of substances
• Promotion of substances
• Social Norms regarding use
• Enforcement of Policies and Social Norms
• Individual Level Factors
• Perceptions of risk
• Perceptions of harm

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Strategic Prevention Framework

• Comprehensive Strategies Include
• - Programs
• - Policies
• - Practices
• Strategies should be evidence based (from entire
  body of prevention research)
• Federal Model Program List
• Peer reviewed journal with proven effectiveness
• Documented effectiveness

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Strategic Prevention Framework
Implement -

• Logical connection
  between the problem, the Intervening Factors and
  Strategies Implemented

Intervening Factors
Strategies
Related Problems
Substance Use
Low Perceived Risk of Alcohol Use
Curriculum to Increase Knowledge about Risk
High Rates of Binge Drinking
High Rate of Youth Alcohol-Related Crashes
Social Norms Encouraging Binge Drinking
Media campaign to correct perceptions of normal
consumption
High Rates of Drinking and Driving
Little Enforcement of Drinking and Driving
Enforcement Checkpoints
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Strategic Prevention Framework
Evaluate -
Monitor progress and impact on selected change
indicators

• Community is unit of analysis not the
  individual
• Contribution Not Attribution
• Trends over time
• National Outcome Measures (NOMs) Uniform
  measures for all Federally-funded programs

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Strategic Prevention Framework
Measuring For Success

• Programs
• - Inputs (,Time, Resources)
• - Outputs (Numbers Served Programs )
• - Short Term Outcomes Knowledge,
• Attitudes/Beliefs, Skills
• Community Comprehensive Strategies
• - Long Term Outcomes Behavior Changes (NOMS)
• Community Change
• Incidence Prevalence Rates (Survey Data)

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Measuring Community Outcomes
Short Term Outcomes
Outputs
Inputs
Program 1
Agency A
Long Term Outcomes
Program 2
Community Change
Program 1
Agency B
Program 2
Incidence Prevalence of Problems
Program 1
Agency C
Behavior Outcome Measures
Program 2
ProgramMeasures
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SAMHSA/CSAP National Outcome Domains and
Performance Management Measures

• Abstinence from Drug Use/Alcohol Abuse
• 30-day substance use (non-use/reduction in use)
• Age of first substance use
• Perceived disapproval of substance use
• Perceived risk of substance use
• Binge drinking
• Perceived availability

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National Outcome Domains and Performance
Management Measures

• Increased/retained employment or
• return to/stay in school
• ATOD-related suspensions/expulsionsDevelopmental
  
• Consequences of ATOD use in workplace
• Attendance over EnrollmentDevelopmental
• Decreased criminal justice involvement
• Alcohol-related car crashes
• Drug-related arrests
• Alcohol and drug related arrests
• Antisocial behavior

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National Outcome Domains and Performance
Management Measures

• Increased stability in family and living
  conditions
• No prevention measure
• Increased access to services (service capacity)
• Number of persons served by age, gender, race,
  and ethnicity
• Increased social support/social
• connectedness
• Family Communication drug use
• Collective efficacy
• Community Involvement

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National Outcome Domains and Performance
Management Measures

• Cost-effectiveness
• Increased services provided within cost
  bandsDevelopmental
• Use of evidence-based practices
• Total number of evidence-based programs and
  strategies
• Optional Measures (Not officially approved)

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You Make the Difference