Transitioning SOR to the SAPT BG: Why not?

It's time to think about transitioning the State Opioid Response (SOR) grants to the Substance Abuse Prevention and Treatment (SAPT) block grant, Robert Morrison, executive director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD), told the House Energy and Commerce Committee at its March 3 hearing on opioid legislation. The STR and SOR grants went directly to single state authorities (SSAs) in charge of the SAPT block grants — NASADAD members — so this makes perfect sense. These are the officials who best know how funding should be spent in their states — on what substances, including alcohol. Instead of having a designated amount set up for opioids — although that was expanded to include stimulants as well (see “FY 2020 Appropriations: Stimulants added to SOR's $1.5 billion,” ADAW, Dec. 23, 2019, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32573 ) — each SSA should just have this funding added permanently to the block grant.     

STR grants: How one physician in rural Florida is trying to help

If the State Targeted Response (STR) and State Opioid Response (SOR) grants from the Substance Abuse and Mental Health Services Administration (SAMHSA) grants are like an elephant — large, especially relative to funding for addiction treatment in general — they are also almost impossible to generalize about. But seeing one piece in context of the whole is essential in trying to find out where the money is actually going. The money goes to the single state authority (SSA) in charge of the Substance Abuse Prevention and Treatment (SAPT) block grant in each state, the person who knows most about what is needed in that state. The funding comes from the Substance Abuse and Mental Health Services Administration (SAMHSA). These grants added $2 billion‐plus to addiction treatment services for opioid use disorders for four years — and many expect this number to be doubled. For perspective, the entire SAPT block grant is under $2 billion and has been for decades.     

NASADAD calls for nominations for annual SSA award

The National Association of State Alcohol and Drug Abuse Directors (NASADAD) is requesting nominations for the annual Ramstad/Kennedy Award, presented to a single state agency (SSA) — the state director who is responsible for the Substance Abuse Prevention and Treatment block grant (and STR and SOR grants, now).     

NASADAD report shows benefits of data mapping

Geographic information system (GIS) technology — a combination of maps and data — is helping state agencies decide how to plan and monitor their prevention, treatment and recovery activities. A new issue brief from the National Association of State Alcohol and Drug Abuse Directors (NASADAD) focuses on how two states — Washington and Pennsylvania — have made GISs a part of their operations, to the benefit of communities.     

NASADAD to NIDA: Connect research to practice

When the National Institute on Drug Abuse (NIDA) sought input on its five‐year plan, the people responsible for publicly funded prevention, treatment and recovery — state directors — called for returning to the days of communication between federal agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA) and between NIDA researchers and the service delivery system. In an Aug. 7 letter to NIDA's strategic planning team, Robert I.L. Morrison, executive director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD), noted that each state alcohol and drug agency has a critical role to play in NIDA initiatives. This role includes.     

Employing policy and purchasing levers to increase the use of evidence-based practices in community-based substance abuse treatment settings: reports from single state authorities

State public health authorities are critical to the successful implementation of science based addiction treatment practices by community-based providers. The literature to date, however, lacks examples of state level policy strategies that promote evidence-based practices (EBPs). This mixed-methods study documents changes in two critical state-to-provider strategies aimed at accelerating use of evidence-based practices: purchasing levers (financial incentives and mechanisms) and policy or regulatory levers. A sample of 51 state representatives was interviewed. Single State Authorities for substance abuse treatment (SSAs) that fund providers directly or through managed care were significantly more likely to have contracts that required or encouraged evidence-based interventions, as compared to SSAs that fund providers indirectly through sub-state entities. Policy levers included EBP-related legislation, language in rules and regulations, and evidence-based criteria in state plans and standards. These differences in state policy are likely to result in significant state level variations regarding both the extent to which EBPs are implemented by community-based treatment providers and the quality of implementation.     

White House budget request decimates substance use prevention

The White House budget request for fiscal year 2021 for the Substance Abuse and Mental Health Services Administration (SAMHSA) proposes to zero out a major prevention program — the Strategic Prevention Framework State Incentive Grant — Partnerships for Success program. This is a cut of $109 million. It recommends using the prevention set‐aside (20%) from the Substance Abuse Prevention and Treatment (SAPT) block grant instead. But it doesn't give any more money to the block grant.     

State profiles on STR and SOR spending released by NASADAD

The Substance Abuse and Mental Health Services Administration (SAMHSA) is keeping its evaluations under wraps, but the National Association of State Alcohol and Drug Abuse Directors (NASADAD) has released a state‐specific list of how the State Targeted Response to the Opioid Crisis (STR) and State Opioid Response (SOR) grants are being spent.     

Table of Contents

NASADAD Inquiry Underscores Need for Collaboration Between SSA, Criminal Justice Okla. Considers Adding Substance Abuse Screening to Protective Custody Screening In Colorado, Closing Two Budget Gaps Hinges on the Stimulus House Passes FY 2009 Spending Bill with SA Funding Increases Briefly Noted OptumHealth Gets New Mexico Contract State News Call for Applications Coming up     

Policy research at the congress: A case study of a research unit at the U.S. senate

The Survey and Statistical Analysis section (SSA) of the U.S. Senate Computer Center is analyzed as a case study of a unit that provides information to the U.S. Congress. Most information processed by the SSA is either gathered or analyzed using sociological research methods. This article discusses the activities of the SSA, uses of SSA information by the Senate, certain special issues affecting policy research for the Senate (the adversarial nature of the Senate, the unsuitability of Neyman-Pearson hypothesis testing, and the ethics of participating in the misinterpretation of data), and the place of sociology in the activities of the SSA. Some attention is given to the skills that are utilized by the SSA in conducting its research. His experience in Washington at the National Science Foundation as well as the U.S. Senate is enriching Buffalo State College’s new program in applied sociology.     

Senate Appropriations Committee hears about funding needs for SAPT block grant

The opioid epidemic is persisting, calling for the need for more funding, according to testimony on Capitol Hill last month. Mark Stringer, director of the Missouri Department of Mental Health and single state authority (SSA) for the state's Substance Abuse Prevention and Treatment (SAPT) block grant. In addition, it's important to transition from opioid‐focused funding to general funding for substance use prevention and treatment in general, via increasing the block grant, he said.     

DEA allows buprenorphine inductions based on telephone only

Last week, the Drug Enforcement Administration (DEA) said opioid treatment programs (OTPs) and Drug Addiction Treatment Act (DATA)–waived prescribers can treat new patients with buprenorphine based on a telephone call only. The Controlled Substances Act (CSA), enforced by the DEA, requires all new patients being treated with controlled substances to have an in‐person — or, for now, telemedicine — physical exam. Now, however, because of the coexisting COVID‐19 pandemic and opioid overdose crisis, the DEA has dropped this requirement. This follows the decision of the Substance Abuse and Mental Health Services Administration (SAMHSA) to allow exemptions from the OTP take‐home regulations allowing stable patients to be given 14 or 28 days of methadone doses, instead of coming in more frequently (see DEA, SAMHSA relax OTP/OBOT regulations due to COVID‐19, ADAW March 23, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32664 ).     

Morrison celebrates 10 years as NASADAD executive director

This year, Robert I.L. Morrison will have been executive director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD) for 10 years (see NASADAD selects Morrison as Executive Director, ADAW, Dec. 14, 2009, https://onlinelibrary.wiley.com/doi/epdf/10.1002/adaw.20213 ) — and 19 years overall at the agency (he was director of public policy before then).     

SAMHSA grantees can't use funds for medical cannabis

Some states are adjusting their contracts to the recent edict from the Substance Abuse and Mental Health Services Administration (SAMHSA) banning grantees, including Substance Abuse Prevention and Treatment (SAPT) and State Opioid Response (SOR) grantees, from.     

Toward an effective treatment system for adolescents with substance use disorders: The role of the states

A 2002 national expert panel found that the treatment system for adolescents with substance use disorders was inadequate and underdeveloped. The panel recommended immediate improvement in five areas: youth-serving agency collaboration, treatment system financing, workforce development, the implementation of evidence-based practices, and family involvement in all aspects of treatment. In 2004, the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA), designed the State Adolescent Substance Abuse Treatment Coordination Grant program (SAC) and implemented it in 2005 to address the critical need in the field. This paper reviews the adolescent substance use disorders treatment system, discusses selected drivers for change and the design of the SAC grant program, and summarizes some of the program's results. Both quantitative and qualitative data analysis document that substantive systems development occurred within each of the sixteen grantees and that federal–state partnerships are useful in creating systemic change.     

Nuggets from AATOD: New CSAT director comments

Here are more reports from last month's American Association for the Treatment of Opioid Dependence (AATOD) conference in Orlando — in particular, insights from Louis Trevisan, M.D., the new director of the Center for Substance Abuse Treatment (CSAT) of the Substance Abuse and Mental Health Services Administration (SAMHSA).     

Study: Elevated risk of substance use if parents use marijuana

Last month, JAMA Network Open published a study indicating that recent and past parental marijuana use confers a heightened risk for use of marijuana — and other substances — by their adolescent and young adult offspring who live in the same household. The article from the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institute on Drug Abuse and McLean Hospital is in line with federal anti‐marijuana policy (marijuana is still illegal under federal law, although states have legalized it, both recreationally, in some cases, and medically, in more).