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  • Innovation in Substance Use Disorders and Mental Health Treatment

    Today, the Office of National Drug Control Policy hosted a conference at the White House to highlight innovative technologies for substance abuse treatment, wellness, mental and behavioral health.  Supported by the Substance Abuse and Mental Health Administration (SAMHSA), the Office of National Coordinator for Health Information Technology (ONC), and the Office of Science and Technology Policy (OSTP), the conference was kicked off by U.S. Chief Technology Officer Todd Park and Office of National Drug Control Policy Director Gil Kerlikowske.

    Mr. Park previously served as Chief Technology Officer of the U.S. Department of Health and Human Services, where he helped HHS harness the power of data, technology, and innovation to improve the health of the Nation.

    Conference panelists presented on a range of innovative health technologies—from smartphone apps that help people stay sober to biosensors that can detect human emotion.  You can find the full conference agenda online here and archived video of the conference will be available here.

    During the conference, ONC’s Jodi Daniel announced the winner of the Behavioral Health Patient Empowerment Challenge, the Hazelden Foundation's Mobile MORE smartphone app. We congratulate Hazelden and thank all conference participants for a lively, engaging day discussing some of the most forward-leaning innovations in behavioral health.  

    Search for the hashtag #InnovateBH on Twitter to see more from today's conference. 

  • Substance Abuse Prevention is Suicide Prevention

    When we prevent or successfully treat substance abuse, we prevent suicides. There is a powerful connection between the missions of the substance abuse prevention and treatment communities and the suicide prevention community – and  much to be gained when these groups come together around their common goals.

    Drug poisoning deaths have increased 120 percent in recent years – from 17,415 in 2000 to 38,329 in 2010.  The majority (58 percent) of the drug deaths involved pharmaceuticals, and 75 percent of those deaths involved prescription pain relievers.[i] In 2010, U.S. emergency departments treated 202,000 suicide attempts in which prescription drugs were used as the means, 33,000 of which were narcotic pain relievers.[ii]

    The suicide and substance abuse prevention fields need to align their efforts to promote healthy individuals and healthy communities.

    Many of the factors that increase the risk for substance abuse, such as traumatic experiences, also increase the risk for suicidal thoughts and behaviors,[iii],[iv]  and substance abuse, like mental health problems, is linked with a several-fold increase in suicide risk.[v],[vi]

    There is hope, however: Prevention works, treatment is effective, and recovery is possible. Life skills that support effective problem-solving and emotional regulation, connections with positive friends and family members, and social support can protect individuals from both substance abuse and suicide. Treatment and support are important precursors for recovery from substance abuse as well as recovery from suicidal thoughts.[vii],[viii]

    In September 2012, a newly revised National Strategy for Suicide Prevention (NSSP) was released by the National Action Alliance for Suicide Prevention (Action Alliance) in conjunction with the Office of the Surgeon General.  The Action Alliance is a public-private partnership, jointly launched in 2010 by the Secretaries of Health and Human Services and Defense, envisioning a Nation free from the tragic experience of suicide. The connection between suicide prevention and the prevention and treatment of substance abuse is either implicit or explicit in each of the 13 goals of the NSSP, as it should be.  Recognizing this, the NSSP calls for several actions, including:

    • Train staff in substance abuse treatment settings to ask their clients and patients directly and in a non-judgmental way whether they are having thoughts of suicide or think things would be better if they were dead. Ask on intake and periodically throughout the course of treatment, and ask in a way that opens the door for a truthful response.
    • Work with individuals, families and other social groups, and communities to reduce access to drugs, especially access to lethal quantities of drugs among individuals at increased risk for suicide.  This includes reducing stocks of medications kept in the home, locking up commonly abused medications, and encouraging the proper disposal of unused and unneeded prescription drugs, a key component of the 2013 National Drug Control Strategy.

    Let us commit to stronger collaboration between substance abuse and suicide prevention efforts at all levels: community, state, tribal, and national. And let’s take action. The stakes are too high to do otherwise.

    Dr. Litts is the Executive Secretary for the National Action Alliance for Suicide Prevention.  Previously, David held a variety of leadership positions in the Nation’s suicide prevention movement, including the Air Force’s pioneer suicide prevention program (1996-1999) and development of the 2001 National Strategy for Suicide Prevention.

    Ms. Carr is a Senior Policy Analyst with the National Action Alliance for Suicide Prevention. Previously, she was the Suicide Prevention Specialist for the Massachusetts Department of Public Health and the Education Coordinator for the Massachusetts/Rhode Island Regional Center for Poison Control and Prevention.

    The National Action Alliance for Suicide Prevention is the public-private partnership advancing the National Strategy for Suicide Prevention (NSSP) by championing suicide prevention as a national priority, catalyzing efforts to implement high priority objectives of the NSSP, and cultivating the resources needed to sustain progress.

    [i] Centers for Disease Control and Prevention.  National Vital Statistics System. 2010 Multiple Cause of Death File.  Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2012.

    [iii] Dube, S, Felitti V et all. (2003). Childhood Abuse, Neglect, and Household Dysfunction and the Risk of Illicit Drug Use: The Adverse Childhood Experiences Study. Pediatrics, Vol. 111 No. 3.

    [iv] Afifi T, Murray W, et al. (2008) Population Attributable Fractions of Psychiatric Disorders and Suicide Ideation and Attempts Associated With Adverse Childhood Experiences. American Journal of Public Health 2008, Voi 98, No. 5.

    [v] Conwell Y, Duberstein PR, Cox C, Herrmann JH, Forbest NT, Caine ED (1996). Relationships of age and axis I diagnoses in victims of completed suicide: A psychological autopsy study. American Journal of Psychiatry, 153(8): 1001-1008.

    [vi] Moscicki EK (2001). Epidemiology of completed and attempted suicide: Toward a framework for prevention. Clinical Neuroscience Research, 1, 310-323.

    [vii] Brown, G. K., Ten Have, T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive Therapy for the Prevention of Suicide Attempts: A Randomized Controlled Trial. JAMA: Journal of the American Medical Association, 294(5), 563-570.

    [viii] Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., et al. (2006). Two-Year Randomized Controlled Trial and Follow-up of Dialectical Behavior Therapy vs Therapy by Experts for Suicidal Behaviors and Borderline Personality Disorder. Archives of General Psychiatry, 63(7), 757-766.


  • Announcing the Opioid Overdose Toolkit

    Approximately 100 Americans died from overdose every day in 2010. In just one year, we lost 38,000 people to overdose—more than the number who died from either homicides or traffic crashes. 22,000 of those deaths involved prescription drugs, and more than 3,000 involved heroin. Frighteningly, other data show that opiate use among young people is increasing. 

    These numbers are staggering. Here’s what makes them heartbreaking: every overdose death is preventable. Two years ago, we released a comprehensive plan to address our nation’s prescription drug abuse epidemic. This plan supports prescription drug monitoring programs, convenient and environmentally responsible drug disposal methods, education for patients and prescribers, and law enforcement efforts to decrease diversion of prescription drugs.  

    In honor of International Overdose Awareness Day, this Saturday, August 31, we are joining other federal partners to announce the release of the Opioid Overdose Toolkit. The Toolkit, developed by the Department of Health and Human Services, provides information on overdose prevention, treatment and recovery for first responders, prescribers, and patients.

    This toolkit builds upon our efforts to expand prevention and treatment.  It also promotes the use of naloxone, a life-saving overdose reversal drug which we believe should be in the patrol cars of every law enforcement professional across the nation. We have lost too many loved ones to overdose, and the deadly disease of addiction has remained for too long in the shadows. It is time to speak out. By raising awareness, we can honor those we’ve lost by preventing future losses. 

    Get the facts on preventing, treating and surviving overdose.

    Michael Botticelli is the Deputy Director of National Drug Control Policy. 

  • Real #DrugPolicyReform: DOJ’s Change in Mandatory Minimum Policies

    Today, the Department of Justice refined its charging policies regarding mandatory minimums for certain nonviolent, low-level drug offenses. The policy changes are part of the Department of Justice’s “Smart on Crime” initiative, a comprehensive review of the criminal justice system aimed at ensuring federal laws are enforced more fairly, and federal resources are used more efficiently, by focusing on top law enforcement priorities.

    Until 2010, federal prosecutors were required to pursue the most serious, readily-provable charges in every case and for every defendant. Recognizing that equal justice depends on individualized justice, Attorney General Holder rescinded that policy in 2010 and now requires prosecutors to make charging decisions in the context of an individualized assessment of the specific circumstances of the case. These assessments take into account numerous factors, such as the defendant’s conduct and criminal history and the circumstances relating to the commission of the offense, the needs of the communities we serve, and federal resources and priorities.

    It is with full consideration of these factors that the Attorney General further refined DOJ’s charging policy for certain low-level non-violent drug offenses. The Attorney General has instructed prosecutors to (1) decline to pursue charges that would trigger a mandatory minimum sentence in the case of certain low-level, non-violent drug offenses; (2) in these cases, consider recommending a below-guidelines sentence to the court; and (3) decline to charge an enhancement that would double the sentences of certain second-time drug offenses unless the defendant is involved in conduct that makes the case appropriate for severe cases.

    With this policy, DOJ seeks to ensure that the most severe mandatory minimum penalties are reserved for serious, high-level, or violent drug traffickers. In some cases, mandatory minimum and recidivist enhancement statutes have resulted in unduly harsh sentences and perceived or actual disparities that do not reflect the Department’s Principles of Federal Prosecution. Long sentences for low-level, non-violent drug offenses do not promote public safety, deterrence, and rehabilitation. Moreover, rising prison costs have resulted in reduced spending on criminal justice initiatives, including spending on law enforcement agents, prosecutors, and prevention and intervention programs. These reductions in public safety spending require us to make our public safety expenditures smarter and more productive.

  • Real #DrugPolicyReform: DOJ’s New Criteria on Compassionate Release Requests

    In a new Bureau of Prisons (BOP) Program Statement issued today, the BOP will clarify and expand the criteria the BOP uses to review compassionate release requests – which are also referred to as “reduction in sentence” (RIS) requests.  The BOP is implementing these changes as part of the Department of Justice’s “Smart on Crime” initiative, a comprehensive review of the criminal justice system aimed at ensuring federal laws are enforced more fairly, and federal resources are used more efficiently, by focusing on top law enforcement priorities.

    Congress gave the BOP authority to ask a court to grant an inmate’s RIS request, prior to completion of the inmate’s sentence, for extraordinary and compelling circumstances.  If a judge grants the BOP’s motion, the judge will order the inmate’s release, and the inmate will usually begin serving a term of supervised release.

    Within the BOP’s authority under the existing statutory framework, the updated policy broadens the circumstances in which the BOP will consider RIS requests. These include:

    • Terminal and non-terminal medical circumstances;
    • Circumstances for elderly inmates;
    • Circumstances in which there has been the death or incapacitation of the family member caregiver of an inmate’s child; and
    • Circumstances in which the spouse or registered partner of an inmate has become incapacitated.

    In all cases, the BOP will continue to consider whether an inmate’s release would pose a danger to the safety of any other person or the community before submitting a RIS request to a court.  Each RIS request continues to be subject to multiple levels of careful review within the BOP.  Further, in circumstances in which a victim or witness has elected to be notified, the BOP will solicit comments regarding an inmate’s possible release. For each RIS request, the BOP will also continue to consult with the U.S. Attorney’s Office responsible for the criminal prosecution.

    The new criteria are consistent with other federal government standards and programs.  For example, the criteria concerning the death or incapacitation of the family member caregiver of an inmate’s child are consistent with guidelines issued by the United States Sentencing Commission.  The criteria concerning elderly inmates are based on existing statutes and a pilot program enacted by Congress as part of the Second Chance Act. In addition, the new policy is responsive to reviews of the RIS policy by the Office of Inspector General of the Department of Justice, and external advocacy groups.

  • Honoring National Minority Mental Health Awareness Month

    This is a cross-post from the National Partnership for Action, a division of the U.S. Department of Health & Human Services. 

    Since 2008, July has been recognized as Minority Mental Health Awareness Month, providing an opportunity to explore issues concerning mental health and substance use disorders in our communities. As a 2012 National Survey on Drug Use and Health (NSDUH) illustrates, substance abuse and mental illness remain intricately linked.  In 2001, approximately 42 percent of adults who reported substance use within the last year – or 8 million out 18.9 million – also reported suffering from a mental illness as well.[i] In light of these staggering numbers it is important that we join with our many partners to raise awareness about substance use disorders and mental health, and to provide resources to support individuals, families, and communities across the Nation.

    A priority of the Obama Administration’s National Drug Control Strategy (Strategy) is to reduce the demand for drugs significantly through effective prevention, intervention, treatment, and recovery support. Looking closely at the NSDUH data, we can see trends in drug use among various ethnic and cultural groups and in different geographic regions. These trends compel us to seek approaches tailored to specific groups and parts of the country. For example, among persons aged 12 or older in 2011, American Indians or Alaska Natives had the highest rates of illicit drug use (13.4 percent), followed by Native Hawaiians or Other Pacific Islanders (11 percent).[ii]

    While the Federal Government plays a vital role in developing policies, these broad approaches only work if they meet the needs of local communities.


    Encouraging our family and friends to live free of the influence of substance abuse is one of the most important steps we can take. Drug Free Communities coalitions are a crucial component to prevention.  By bringing together the various sectors of a community to address substance use and working with schools, parent groups, businesses, youth, and others, these coalitions implement environmental strategies to raise awareness of the consequences associated with drug and alcohol use. Coalitions also provide access to resources to help individuals and families affected by substance use disorders. You can learn more about what coalitions are doing in communities around the country and in your state at http://www.whitehouse.gov/ondcp/state-map.

    There are a number of tools available to assist communities with assessment, planning, implementation, and outcome evaluation of substance abuse prevention programs. One such tool, the National Registry of Evidence-based Programs and Practices (NREPP), is a searchable database of programs shown to be effective at helping community leaders select target populations. For example, there are more than 70 substance abuse prevention programs for assisting Latino youth, more than 40 for helping Native American youth, and others designed specifically for girls.


    In 2011, only about 11 percent of those with a diagnosable substance use disorder received treatment at a specialty facility. Effective treatment models incorporate features such as trauma-informed care, developmentally appropriate interventions, and culturally and linguistically sensitive practices. You can find more information on principles of effective treatment and how to integrate them into practice in Principles of Drug Addiction Treatment: A Research-Based Guide, provided by the National Institutes of Health. To find a treatment program in your community, you can search SAMHSA’s interactive Behavioral Health Treatment Services Locator.


    Millions of people are successfully in recovery from substance use disorders, working hard to reclaim their lives and positively contributing to their families and communities. Building a strong network of peers, family, and professionals is key, and helps communities promote cultural mores and norms that promote improved health and wellness for everyone. For more information on building a recovery supportive community, visit the Partners for Recovery page on SAMHSA’s website.

    Minority Mental Health Awareness Month provides a catalyst to highlight the link between mental health, substance abuse, and minority communities, but let us all make mental health and substance use disorder services a priority throughout the year; to help empower individuals, strengthen families, and save lives. With dedication and focus, and the support of our family, friends, and neighbors, we can work together to make a difference for those who know the challenges of substance use disorders, and continue to face them.

    David K. Mineta is the Deputy Director of the Office of Demand Reduction (ODR) for the Office of National Drug Control Policy. Ben Ray Luján is a United States Congressman representing New Mexico's 3rd district.


    [i] Figure 4.2 Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-45, HHS Publication No. (SMA) 12-4725. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012

    [ii] Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-44, HHS Publication No. (SMA) 12-4713. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012. Figure 2.11


  • 2013 National Southwest Border Counternarcotics Strategy Released

    Today, the Office of National Drug Control Policy released the 2013 National Southwest Border Counternarcotics Strategy, a key component of the Obama Administration’s unprecedented work to strengthen security along the Southwest border.

    Since the implementation of the inaugural 2009 National Southwest Border Counternarcotics Strategy, significant progress has been made to secure our border with Mexico while reducing the demand for drugs in the United States.

    The Strategy released today shows that the Southwest border is better patrolled now than at any other time in history. The Department of Homeland Security (DHS) has increased on-the-ground personnel from 9,000 Border Patrol agents in 2001 to 21,000 agents today.  A focus on interdiction efforts, improved cooperation with the Mexican government, and legislation such as the Border Tunnel Prevention Act of 2012 have resulted in significant currency, drug, and weapons seizures.

    During 2010-2012, DHS seized 71 percent more currency, 39 percent more drugs, and 189 percent more weapons along the Southwest border as compared to fiscal years (FY) 2006-2008. These are just some of the metrics reported in the 2013 Strategy. Equally important, the Strategy defines new goals to build upon these successes and focuses on border-specific challenges to reducing both drug demand and supply. The timing of the Strategy’s release could not be more appropriate, coming only days after a vote in the U.S. Senate to reform our Nation’s immigration system. Sixty-eight Senators – Democrats and Republicans – voted for a bill that provides undocumented immigrants with a way to earn citizenship so they can come out of the shadows. If enacted, the Senate bill would also establish the most aggressive border security plan in our history.

    The 2013 National Southwest Border Counternarcotics Strategy complements the President’s plan for drug policy reform, which is rooted in evidence-based programs that treat substance use as a public health issue, not just a criminal justice problem. We have seen encouraging trends in drug use in this country over the past three decades. Since 1979, the rate of overall drug use has declined by roughly 30 percent. More recently, the number of current cocaine users has dropped by 44 percent since 2007, and the number of meth users has been cut by 40 percent. To build on this progress and support public health approaches to drug control, the Obama Administration has requested more than $10 billion in FY 2014 for drug education programs and expanding access to drug treatment for people suffering from substance use disorders. This includes a requested increase of $1.4 billion to expand treatment and prevention, the largest percentage increase in at least two decades. 

    The full text of the 2013 National Southwest Border Counternarcotics Strategy is available here.

  • Guest Post: A Policy Focus on Recovery in New York

    On June 4th, Deputy Director Michael Botticelli joined public health officials in New York to discuss integrating a focus on recovery into alcohol and substance abuse treatment services.

    The half-day conference, hosted by the State of New York Office of Alcoholism and Substance Abuse Services (OASAS), was led by Commissioner Arlene Gonzalez-Sanchez and attended widely by state and city public health experts, treatment providers and social workers.

    Entitled “Recovery 2013: Charting the Future of Policy and Practice,” the event emerged from the state’s participation in the ONDCP ROSC Learning Community. With a current membership of 10 states and two local governments, the ONDCP ROSC Learning Community gives members access to expert presentations, group consultation, and opportunities for cross-jurisdictional sharing and collaboration. It receives ongoing support from the SAMHSA Addiction Technology Transfer Center (ATTC) Network Coordinating Office and from various regional ATTCs.

    The conference raised awareness about the state’s ROSC efforts and helped expand their base of support. Mr. Botticelli spoke of the importance of developing recovery-oriented systems and services, which helps lay the groundwork for health reform implementation, and how states such as New York  (who participates in the ONDCP ROSC Learning Community), are national leaders who serve as examples for other state and local governments.

    The State of New York has been working on ROSC implementation for the past five years. To date, it has begun establishing recovery community centers, has instituted training for Recovery Coaches, and has taken significant strides in developing sustainable mechanisms for reimbursing peer-to-peer services provided in outpatient treatment settings.  Since joining the ONDCP ROSC Learning Community in March 2012, the State of New York team has focused its participation on developing flexible funding mechanisms to develop, sustain, and integrate peer recovery support services.

    With the implementation of the Affordable Care Act and the concurrent charge from New York Governor Andrew Cuomo to make sweeping changes to the structure of the State Medicaid system, New York State stands poised to make bold leaps toward a more recovery -oriented system of behavioral health care.  Participating in the learning community gives the state a mechanism for better guiding its ongoing ROSC efforts.

    Lureen McNeil is a Program Manager at the State of New York Office of Alcoholism and Substance Abuse Services (OASAS). Peter Gaumond is the Recovery Branch chief at ONDCP.

  • Cross Post: Statement by HHS Secretary Kathleen Sebelius on Supreme Court Ruling on Defense of Marriage Act

    Posted: June 26, 2013

    Today’s Supreme Court decision finding the Defense of Marriage Act unconstitutional is a victory for equality, which is a core belief of this administration.

    It is also a victory for families, especially those children whose parents’ legal same sex marriages can now be recognized under federal law.

    As a result of today’s ruling, the federal government is no longer forced to discriminate against legally married same sex couples.

    The Supreme Court’s decision on DOMA reaffirms the core belief that we are all created equal and must be treated as equal.

    The Department of Health and Human Services will work with the Department of Justice to review all relevant federal statutes and ensure this decision is implemented swiftly and smoothly.