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Authors Posts by Jason Snyder

Jason Snyder

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Pennsylvania’s Behavioral Health Council, created through executive order in October, held its first meeting yesterday.

The council intends to develop and recommend to the governor a statewide action plan to address any gaps in access, affordability, or delivery of services, with the goal of removing silos across state agencies, healthcare providers, payers, state and local government sectors, as well as decreasing the wait time for services for Pennsylvanians in need.

Read the full press release and list of Behavioral Health Council members.

Earlier this week, RCPA submitted its position on SB 962 to the Pennsylvania Senate Health and Human Services Committee. SB 962 would force overdose survivors into treatment for substance use disorder.

RCPA opposes SB 962 because of:

  • The enormous burden placed on providers to manage an unfunded and complex involuntary treatment process;
  • The perpetuation of stigma towards the disease of addiction by introducing the complexity and trauma of the judicial system to the treatment of a disease – not the commission of a crime; and
  • Scant evidence that this approach reduces overdoses and death.

Read RCPA’s full position paper on SB 962. You can also view the memo announcing SB 962 as well as the language of the bill.

Photo by Chris Montgomery on Unsplash

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host a Region 3 virtual town hall, “Expanding the Behavioral Health Workforce: Common Elements Treatment Approach,” from 9:45 am – 12:00 pm on Tuesday, December 5, 2024. The purpose of the town hall is to share information and outcomes about an innovative solution to address workforce challenges with rural, veteran, Certified Community Behavioral Health Clinic (CCBHC), and international examples.

Information is now available about the event’s speakers, including the agenda. Interested participants can register online. For inquiries, contact Jean Bennett or Jeanne Tuono of SAMHSA.

Image by StockSnap from Pixabay

The Pennsylvania Department of Drug and Alcohol Programs (DDAP) will launch a new Training Management System (TMS) in January 2024. To facilitate the transition, the current TMS and DDAP courses in TrainPA will be frozen at 3:00 pm Thursday, December 7, until the system’s launch on January 4, 2024. DDAP emphasizes the importance of verifying matching email addresses in both systems to mitigate potential record loss during the migration process. Users are strongly encouraged to conclude any ongoing TrainPA trainings and finalize pending course evaluations within the current TMS before the freeze period. For further assistance, users may contact the DDAP Training Section via email.

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By Jason Snyder, Director, Substance Use Disorder Treatment Services, BH Division, RCPA

In September 2023, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a report, “Recovery from Substance Use and Mental Health Problems Among Adults in the United States.”

Although the definition and concept of recovery from addiction have been morphing for some time, the self-reported data contained in the report, coupled with SAMHSA’s definition of recovery, lays out starkly that what is considered recovery today is far different from what it has been considered historically. In some ways, it begs the question, then, “What is the purpose of addiction treatment?” What are the implications for addiction treatment providers, who for decades have operated with a mission of helping their patients stop their use of drugs and alcohol?

Using data from the 2021 National Survey on Drug Use and Health (NSDUH), SAMHSA’s report shows that 70 million adults aged 18 or older perceived that they ever had a substance use or mental health problem. For substance use specifically, of the 29 million adults who perceived that they ever had a substance use problem, 72 percent (or 20.9 million) considered themselves to be in recovery or to have recovered from their drug or alcohol use problem (see SAMHSA’s press release).

Of the 72 percent who considered themselves to be in recovery or to have recovered from their drug or alcohol use problem:

  • 65 percent reported using alcohol in the past year;
  • 68 percent reported using marijuana in the past year;
  • 60 percent reported using cocaine in the past year; and
  • 61 percent reported using hallucinogens in the past year.

Curiously, it doesn’t appear that respondents were asked whether they used illicit opioids in the past year.

To the traditional addiction treatment provider and many in the recovery community today, recovery and drug and alcohol use can’t co-exist. One possible but unlikely explanation for the SAMHSA-reported data is that all of the respondents who identified as being in recovery but having used drugs or alcohol in the past year is that their recovery began within the last year. This would presume that their definition of recovery includes abstinence. But this is not likely. Consider SAMHSA’s definition of recovery:

“Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life; and strive to reach their full potential.”

No mention of abstinence from drugs and alcohol. What this means is that for millions of people, recovery can and does include moderated use of drugs and alcohol.

In 2004, SAMHSA’s Center for Substance Abuse Treatment said, “Treatment for substance use disorders is designed to help people stop alcohol or drug use and remain sober and drug free. Recovery is a lifelong process.” Twenty years later, it’s a far different message coming from SAMHSA.

As recently as 2019, the Pennsylvania Certification Board defined recovery as highly individualized, requiring abstinence from all mood and mind-altering substances, and may be supported by using medication that is appropriately prescribed and taken.

Talk about evolution and conflict.

Nora Volkow, director of the National Institute on Drug Abuse, said “Healthcare and society must move beyond this dichotomous, moralistic view of drug use and abstinence and the judgmental attitudes and practices that go with it.”

So what does this mean for addiction treatment providers? What, then, is the purpose of addiction treatment? One managed care organization in Pennsylvania recently talked about the purpose of addiction treatment in much the same way as SAMHSA defines recovery, addressing health, home, purpose, and community. This would seem to mean that providers are now expected to address not only addiction but myriad social determinants of health as well. In fact, it is what payers expect providers to do today.

This is a sea change. The addiction treatment system was not built in this way. This is not to say that it is not evolving or cannot evolve along with the definitions of treatment and recovery. But to do so will require much broader systemic change than philosophical and cultural changes within addiction treatment organizations. Regulation and payment structure must also change to reflect the changing expectations and demands placed on providers.

The Pennsylvania Department of Drug and Alcohol Programs (DDAP) announced today that 312 recovery houses are now licensed throughout the commonwealth.

Since the licensure program began, DDAP has provided hands-on technical assistance to recovery house owners and continues to work individually with applicants to ensure accurate submissions when applying. DDAP developed and now offers a new provider workshop that has helped to increase accuracy of applications, which further streamlines and expedites the licensure process.

The purpose of DDAP’s recovery house licensure program is to help empower sustained recovery for individuals with substance use disorder by ensuring a network of safe drug and alcohol recovery houses across Pennsylvania.

A listing of licensed recovery houses as well as information regarding the licensing application process can be found on the DDAP website.

Read the complete press release.