1. T RENDS IN C HEMICAL D EPENDENCY T REATMENT Coralee Goni, MS, MBA, MAC Rimrock Foundation

2. RIMROCK FOUNDATION Montana’s oldest and largest Addiction Treatment Facility- 1968 – Billings, MT. Care is delivered through multiple levels of Service: Medical Detoxification Medically Monitored Inpatient Partial Hospitalization Residential Intensive Outpatient Treatment Community-based Sober Housing

3. A DVANCED I NTEGRATED M ODEL OF A DDICTION T REATMENT Psychological dependency — an irrational belief in and reliance on mood-altering chemicals or experiences for the purpose of achieving welcomed changes in moods and feeling states. Mental obsession — an intense, uncontrollable preoccupation with the anticipated changes in moods and feeling states that will occur with the drug or activity. Emotional compulsion — an intense, emotional impulsiveness to obtain the immediate gratification produced by a chemical or activity.

4. Length of treatment is directly correlated to lasting reductions in criminal activity Greatest reductions are seen in those who complete a full continuum of care 90+ Days L ENGTH OF T REATMENT 4

5. Purpose of treatment Break old patterns of thinking and behaving Learn new skills for avoiding drug use and criminal behavior Replacing drug use and criminal activities with constructive activities Understanding consequences “Hey, you can’t pin my problems on drugs. I wasn’t high when I was caught stealing a case of beer. I wasn’t fiending for alcohol. I just liked the thrill of stealing and getting away with something…Now I’m locked up for 30 days.” --Jordan, 17 T REATMENT 5

6. Effective treatment will take into account Differences in age, gender, ethnicity, and culture Differences in problem severity and recovery stage Different treatment approaches should be utilized Facilitate healthy relationships Family, peers, and others in the community I NDIVIDUALIZED T REATMENT 6

7. High rates of mental health problems are found in both Offender Populations and Substance Abuse Populations Treatment should address Depression Anxiety Other identified mental health concerns Medications Typically need longer treatment (minimum of 3 months) I NTEGRATED T REATMENT 7

8. Triggers for relapse Stress Associations with using peers Social situations linked to drug use Collaboration between probation officers and treatment providers is essential to effective monitoring of recovery “Sometimes I have failed. But I am not a failure; I have made mistakes, but I am not a mistake.” –AA Booklet D RUG USE DURING T REATMENT 8

9. Depends… On the individual On the treatment provider Treatment must address: Attitudes, Behaviors and Beliefs Outcome studies show that those who participate in drug abuse treatment programs commit fewer crimes than those who do not participate. H OW EFFECTIVE IS TREATMENT FOR CRIMINAL JUSTICE - INVOLVED INDIVIDUALS ? 9

10. Determining appropriate level of care is essential to meeting the needs of the client Low motivation for treatment should not deter access to treatment. Legal pressure for treatment encourages participation, abstinence and improves retention. A RE ALL DRUG ABUSERS IN THE CRIMINAL JUSTICE SYSTEM GOOD CANDIDATES FOR TREATMENT ? 10

11. YES!! I S L EGALLY M ANDATED T REATMENT E FFECTIVE ? 11

12. Problems contributing to relapse Family difficulties Limited social skills (Involvement with peers) Educational and employment problems Mental heath disorders Stress W HAT ARE THE RELAPSE AND RISK FACTORS FOR CRIMINAL OFFENDERS WHO COMPLETE TREATMENT ? 12

13. T REATMENT AND T REATMENT N EED Source: Substance Abuse Mental Health Association, www.SAMHSA.gov

14. R EASONS FOR NOT SEEKING TREATMENT Source: Substance Abuse Mental Health Association, www.SAMHSA.gov

15. N ATIONAL T RENDS

16. 2011 D RUG U SE Source: Substance Abuse Mental Health Association, www.SAMHSA.gov

17. N ATIONALLY … In 2011, marijuana was the most commonly used illicit drug, with 18.1 million current users. (14.5 million in 2007) Used by 80.5 percent of current drug users. (64% of all drug users ONLY use marijuana.) Source: Substance Abuse Mental Health Association, www.SAMHSA.gov

18. 8.0 million people aged 12 or older were current users of drugs other than marijuana in 2011. 6.1 million of those persons were nonmedical users of psychotherapeutic drugs, including: 4.5 million users of pain relievers 1.8 million users of tranquilizers 970,000 users of stimulants 231,000 users of sedatives. Source: Substance Abuse Mental Health Association, www.SAMHSA.gov

19. I LLICIT D RUG D EPENDENCE OR A BUSE IN THE P AST Y EAR AMONG P ERSONS A GED 12 OR O LDER Source: Substance Abuse Mental Health Association, www.SAMHSA.gov

20. S PECIFIC I LLICIT D RUG D EPENDENCE OR A BUSE IN THE P AST Y EAR AMONG P ERSONS A GED 12 OR O LDER : 2011 Source: Substance Abuse Mental Health Association, www.SAMHSA.gov

21. C ONCLUSION Watching trends Marijuana Pain Relievers Process addictions Synthetic Drugs Spice Bathsalts