SJR 77: Joint Subcommittee Studying Strategies and Models for the Prevention and Treatment of Substance Abuse

November 18, 2008

The third meeting of the Joint Subcommittee to Study Strategies and Models of Substance Abuse Treatment and Prevention was held at the General Assembly Building in Richmond. Senator Hanger welcomed the members and speakers and gave opening remarks.

Presentations and Reports

Virginia Recovery Community
John Shinholser, Executive Director of the McShin Foundation, a recovery resource foundation, spoke about the importance of including recovering addicts and members of the recovery community in the substance abuse treatment process. Mr. Shinholser gave a brief overview of the history and development of recovery community organizations, then identified ways in which existing clinical and professional networks could better coordinate with the recovery community to enhance services and bring about better results for individuals seeking treatment. In conclusion, Mr. Shinholser recommended reimbursement for recovery support services provided by recovery community organizations, equitable recognition of peer training and credentialing, maximizing the authentic recovery community experience, and increasing the role of recovery-based organizations at every level.

Department of Mental Health
Ken Batten, Director of the Office of Substance Abuse Services, presented information on the Department of Mental Health, Mental Retardation, and Substance Abuse Services' efforts to respond to recommendations made in the Joint Legislative Audit and Review Commission's report on Mitigating the Costs of Substance Abuse in the Commonwealth, and improve quality, capacity, access, and accountability of substance abuse services in the Commonwealth. Mr. Batten pointed out that current data does not allow the Department to accurately report the effectiveness of services provided by the 40 community services boards, that evidence-based practices (EBPs) are not uniformly utilized in service delivery, and that access to services is limited by capacity and other barriers including a lack of funding. To address these problems, the Department is working to establish standards of care; consistent data collection, analysis and reporting services to study treatment and prevention efforts; effective quality and compliance monitoring processes; and effective IT systems. However, efforts are hampered by recent budget cuts and could be further limited by new cuts in funding.

Outpatient Substance Abuse Services
James Stewart, Inspector General for Mental Health, Mental Retardation, and Substance Abuse Services, described recent efforts of the Office of the Inspector General to review substance abuse outpatient services for adults, and to determine the range and capacity of all substance abuse services currently available through community services boards. Mr. Stewart reported that the range, variety, and capacity of substance abuse services available were found to be not adequate to meet the needs of consumers in the majority of Virginia communities. Specifically, many community services boards reported inadequate or no capacity in medical and social detoxification programs, medically assisted outpatient treatment, day treatment, intensive outpatient treatment, group counseling, individual counseling, psycho-education group therapy, family support therapy, aftercare services, residential services, and case management. Further most community services boards reported inadequate or no capacity for jail and prison-based services, or community-based services, including drug courts, for persons involved with the criminal justice system. This lack of availability of services was found to result in an average waiting time from first call to first appointment of 25.4 days. The report also found that for many persons needing services, the services were prohibitively expensive, further reducing access. The full report is available on the website of the Joint Subcommittee Study Strategies and Models of Substance Abuse Treatment and Prevention and the website of the Office of the Inspector General.

Department of Education Substance Abuse Challenges
Jo Ann Burkholder, Coordinator, Department of Education, spoke on the impact of substance use on education. Ms. Burkholder noted that substance use and abuse negatively affects the academic progress and success of students, leading to lower grades, higher truancy, lower expectations, and higher drop-out rates. She stressed the importance of prevention efforts and early intervention among students, pointing out that students' brains are still developing and that the impacts of substance use on adolescent brains can disrupt brain functioning in critical areas. Ms. Burkholder then described the Department's efforts to prevent and reduce substance use among students, highlighting Student Assistance Programming; drug use and violence prevention activities funded with Safe and Drug Free Schools and Communities Act Funds in Virginia's 132 school divisions; and evidence-based curricula and programs implemented in the Virginia educational system.

Medication Therapy for Substance Abuse Disorders
Morrie Olson, Medical Advisor, Reckitt Benckiser Healthcare, presented information on medication therapy for substance abuse disorders, specifically addressing medical treatment of opioid dependency. He described the role of medications in substance abuse treatment, and past and current uses of medication to treat opioid addiction, most notably the use of methadone. Mr. Olson then discussed a second option, buprenorphine, a synthetic opioid, available for medical treatment of substance abuse disorders. Mr. Olson stated that the drug Suboxone can reduce the misuse, abuse, and diversion of buprenorphine, reduce potential public health problems, bring about changes in treatment delivery, and improve treatment.

Discussion of Recommendations

At the end of the meeting, the joint subcommittee solicited suggestions for recommendations from stakeholders and decided to discuss and vote on budget and legislation recommendations for the 2009 Session at the final meeting on December 8, 2008.

Chairman:
The Hon. Emmett Hanger, Jr.

For information, contact:
Sarah Stanton, DLS Staff

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