1. Engaging the Community Mary Jo Desprez Director, Wolverine Wellness, UHS University of Michigan June 6, 2014

2. Overview Heroin/opiate abuse and addiction occur within a context of community and individual wellness There is hope---evidence based strategies Early intervention - utilizing brief motivational enhancement techniques Community coalitions Courage and checking our baggage

4. No Problems Universal/Selective Prevention Brief Motivational Intervention Treatment Mild Problems Moderate Problems Severe Problems Thresholds for Action Spectrum of Intervention Responses

5. Screening and Brief Intervention The impact of hazardous alcohol and substance use is far reaching and has significant medical, social, and financial consequences. Little attention has been paid to the large group of individuals who use alcohol or drugs but are not yet dependent and who could successfully reduce their use through evidence-based early intervention. Key professionals within the community (health care, school personnel, courts, probation, etc.) can screen and be trained to provide a brief intervention for at-risk substance use Screening and brief motivational enhancement interventions have been shown to be effective in reducing problematic alcohol consumption and/or drug use in a significant number of individuals. Easy to use screening tools help identify persons that may benefit from a brief intervention. KEY-Information about risk is conveyed in a nonjudgmental way

6. Screening Tools SBIRT Screening, Brief Intervention and Referral to Treatment an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. AUDIT-Alcohol Use Disorder Identification Test – WHO ASSIST- Alcohol, Smoking, Substance Involvement Screening Test Both developed my World Health Organization CUDIT-Cannibis Use Disorder Identification Test Mentalhealthscreening.org

7. 7 - Evidence-based – derived from behavioral science research on college student drinking - Empirically supported - rigorous outcome research, using randomized control trial design - Effective with college students - reduces drinking & harm - “Best Practice” in College Alcohol Abuse Prevention BASICS is a NIAAA Tier 1 Program BASICS is on SAMHSA’s NREPP List (National Registry of Evidence-based Programs and Practices AN EXAMPLE BASICS - Brief Alcohol Screening and Intervention for College Students IMEP - Individual Marijuana Education Program *

8. BASICS Brief Alcohol Screening and Intervention for College Students Brief Alcohol Screening and Intervention for College Students (BASICS) is a prevention program for college students who drink alcohol heavily and have experienced or are at risk for alcohol-related problems. BASICS is delivered in an empathetic, nonconfrontational, and nonjudgmental manner and is aimed at revealing the discrepancy between the student's risky drinking behavior and his or her goals and values. The intervention is delivered by trained personnel proficient in motivational interviewing and may be tailored for use with young adults in settings other than colleges.

10. Community Coalitions A mutually beneficial relationship between individuals, governmental agencies, private sector organizations and/or community-based organizations that seeks to achieve common goals

11. Build a strong coalition membership- individuals from varying sectors and organizations of the community provides an endless amount of knowledge, resources and networks to the coalition. Keep coalition memberships knowledgeable-members need to have knowledge and awareness about what specifically needs to change. Coalition staff and leadership should consistently provide members with accurate, timely and relevant information through training opportunities, presentations, emails or handouts. Implement program and policy community changes - coalitions need to review their local data to determine what strategies most appropriately fit their local conditions and root causes. Source:Javdani, S., & Allen, N.E. (2011). Proximal outcomes matter: A multilevel examination of the processes by which coordinating councils produce change. American Journal of Community Psychology. 47:12-27.

12. Local coalitions Washtenaw County Health Organization http://washtenawcho.org/Pages/WCHO-Home.aspx Ann Arbor Chelsea Dexter Pinckney

13. Ann Arbor Campus/Community Coalition A2C3 A2C3: a group of motivated people who want to improve our campus and community Since 2005 AAPD, UMPD, University of Michigan (Academics, Housing, Greek Life, UHS, Beyond the DIAG), AAPS, DDA, Alano Club, Parents, Students, etc) Relationships, Capacity Building, Advocacy Mission To promote health and wellness by reducing harm from inappropriate alcohol use in the community through involvement of a broad-based coalition of community members. Successful coalitions realize other community organizations have a stake in substance abuse prevention and can support program or policy implementation.

14. Courage Perspective Wellness framework Checking our baggage Advocate for prevention, early intervention, treatment and recovery support resources. People get well!

15. Recommendations Holistic Approach We often discipline/sentence based on the incident—intervention has to be based on the whole story. Issues are often interconnected. Screening and Early Intervention Multiple opportunities Schools, health care providers, courts, social service agencies Motivational Interviewing Ask if the trained professionals working with the referred client have been trained in motivational interviewing. (MINT) Community Coalitions Network of stakeholders Increases awareness and capacity Collect data Use evidence based strategies

16. Sources Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) http://www.who.int/substance_abuse/activities/assist/en/ Alcohol Use Disorder Identification Test, http://www.talkingalcohol.com/files/pdfs/WHO_audit.pdfhttp://www.talkingalcohol.com/files/pdfs/WHO_audit.pdf Community Anti-Drug Coalitions of America, CADCA, http://www.cadca.org/http://www.cadca.org/ Javdani, S., & Allen, N.E. (2011). Proximal outcomes matter: A multilevel examination of the processes by which coordinating councils produce change. American Journal of Community Psychology. 47:12-27. Naar King, S. & Suarez, M. Motivational Interviewing with Adolescents and Young Adults. 2011. Rubak, S, Sandboek, A., Lauritzen, T., & Christensen, B. (2005). Motivational interviewing: a systematic review and meta-analysis. British Journal of General Practice, 55: 513, pp. 305-312.Motivational interviewing: a systematic review and meta-analysis University of California-San Diego, Center for Criminality & Addiction Research, Training & Application (CCARTA) http://www.mentalhealthscreening.org/programs/community/ Screening, Brief Intervention, And Referral To Treatment SBIRT, http://beta.samhsa.gov/sbirt/abouthttp://beta.samhsa.gov/sbirt/about Washtenaw County Health Organization http://washtenawcho.org/Pages/WCHO-Home.aspx http://washtenawcho.org/Pages/WCHO-Home.aspx

17. Contact Information Mary Jo Desprez Director, Wolverine Wellness, UHS University of Michigan 734-615-7694 maryjod@umich.edu