1. Empowering the Family and Engaging the Community to Prevent Overdose www.OverdoseFreePA.pitt.edu Public Curricula – Essential Knowledge for Families and Communities Core Components 3 & 4 © 2014, Overdose Prevention Coalition

2. The OverdoseFreePA website is brought to you by the Overdose Prevention Coalition, a collaborative between: The Pennsylvania Department of Drug and Alcohol Programs (DDAP) The Single County Authorities (SCAs) of: Allegheny County Blair County Bucks County Butler County Dauphin County Delaware County Westmoreland County The Allegheny County Medical Examiner’s Office The Program Evaluation Research Unit, University of Pittsburgh School of Pharmacy The project is supported by a generous grant from the Pennsylvania Commission on Crime and Delinquency.

3. It’s Good to Know … The role of family is vital in Substance Use Disorder (SUD) treatment. Substance Abuse and Mental Health Services Administration (SAMHSA), 2009

4. Who is Considered to be “Family?” Family of Origin – a person’s biological family. Family of Choice – a person’s “kinship network.” DDAP, 2014 By Juergen Ohm (Own work) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY- SA-3.0-2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

5. Families Need Help, Too SUDs affect everyone who knows the person with the SUD. Those closest to the person can suffer the most and can be consumed by the behavior caused by the disease. Families and friends of people with SUDs sometimes need help in dealing with someone else’s SUD. Safe Landing, 2011

6. What is Recovery? SUD treatment professionals and researchers are beginning to understand that the definition of recovery is different for everyone. In order to recover from SUD, an individual must believe that recovery is real. Pennsylvania Drug and Alcohol Coalition (PDAC), 2010

7. Recovery = Hope People with SUDs and their families must maintain the hope that recovery is possible. PDAC, 2010

8. There are Multiple Pathways to Recovery SAMHSA, 2012 Each person’s recovery needs are different. People have different strengths, goals, preferences, cultures and backgrounds. These things affect a person’s pathway to recovery.

9. There are Multiple Pathways to Recovery (cont’d) SAMHSA, 2012 Recovery is built on the multiple capacities, strengths, talents, coping abilities, resources and inherent value of each individual.

10. Recovery May Include: SAMHSA, 2009; SAMHSA, 2012 Professional clinical treatment The use of medications Support from families and in schools Faith-based approaches Peer Recovery Support Services – Peer Services are designed and delivered by people who have experienced both SUD and recovery – Examples: Alcoholics Anonymous (AA), Narcotics Anonymous (NA) Other approaches

11. Medication-Assisted Treatment (MAT) MAT is the use of medications, in combination with counseling and behavioral therapies, in SUD treatment. For opioid dependence, the combination of MAT and behavioral therapy is most successful. DDAP, 2014

12. Some People Experience Setbacks SAMHSA, 2012 Setbacks are natural, but not everyone experiences them. Keep moving forward no matter what. Abstinence from all substances is recommended as an important part of recovery.

13. If Someone Refuses Treatment Individuals with SUDs frequently refuse treatment. This can cause significant distress for family members, who see their relatives struggling and feel powerless to stop it. Meyers, 1999; Roozen, 2010 By SRA JOSHUA STRANG, USAF [Public domain], via Wikimedia Commons

14. If Someone Refuses Treatment (cont’d) Family intervention has been proven effective via the CRAFT method, where Concerned Significant Others (CSOs) are taught skills for modifying a loved one’s drug using behavior and enhancing treatment engagement. Meyers, 1999; Roozen, 2010

15. If Someone Refuses Treatment (cont’d) For more information about the CRAFT method, visit: https://www.robertjmeyersphd.com Do not give up! Continue trying to engage your loved one in treatment! Meyers, 1999; Roozen, 2010

16. Types of Treatment Let your loved one know there are many different SUD treatment options. Treatment doesn’t have to involve staying in a facility overnight. Every person’s treatment needs and treatment plan are different. For more support, contact case management in your county. NIDA, 2009

17. Types of Treatment (cont’d) MAT – With behavioral counseling Outpatient Treatment – Individual, Group or Family Treatment – Patients can attend treatment during the day and go home at night Halfway House – A live-in, work-out environment Inpatient Treatment – A live-in environment NIDA, 2009; DDAP, 2014

18. Family Support Groups Alcoholics Anonymous Family Groupshttp://www.al- anon.alateen.orghttp://www.al- anon.alateen.org Nar-Anon Family Groups http://www.nar-anon.org/naranon Families Anonymous www.familiesanonymous.org Learn 2 Cope http://www.learn2cope.org NIDA, 2009; DDAP, 2014

19. Recovery-Oriented System of Care (ROSC) Pennsylvania’s Substance Use Disorder (SUD) treatment system is moving toward a ROSC. This approach meets the person in recovery’s specific needs and chosen pathways to long-term recovery. Hanna, 2013

20. ROSC (cont’d) One of the essential elements of a ROSC is that treatment systems are anchored in the community. This community role includes connections to peer support and recovery organizations. SAMHSA, 2012

21. Cultivating Community Solutions In the U.S., overdose deaths doubled from 1999-2010. Prescription drugs are responsible for approximately 60% of overdose deaths. It’s important for people with SUDs to have support from their communities. Jones, 2013

22. Objectives of an Overdose Prevention Coalition To increase… 1.General public awareness and knowledge of the overdose problem. 2.Number of interventions, policies and programs within the community. 3.Prevention and intervention knowledge of professionals, agencies, family members and caregivers. Pringle, 2013

23. SAMHSA’s Strategies to Prevent Overdose Deaths STRATEGY 1: Encourage providers, persons at high risk, family members and others to learn how to prevent and manage overdose. STRATEGY 2: Ensure access to treatment for individuals who have other SUDs. SAMHSA, 2013

24. SAMHSA’s Strategies to Prevent Overdose Deaths (cont’d) STRATEGY 3: Ensure ready access to naloxone (Narcan ® ). STRATEGY 4: Encourage the public to call 911. STRATEGY 5: Encourage prescribers to use state Prescription Drug Monitoring Programs (PDMPs). SAMHSA, 2013

25. In Review … Recovery from SUD is possible. Family support is essential for individuals with SUDs. Family members are encouraged to join support groups to learn how to help their loved ones, and to learn how to cope themselves. Education and awareness of overdose-related issues is important in every community. PDAC, 2010; Jones, 2013