The Convergence of Events & the Need The Convergence of Events & the Need for Readiness:for Readiness:

Leveraging Change to Serve & Support Young Leveraging Change to Serve & Support Young People in or Seeking RecoveryPeople in or Seeking Recovery

David K. MinetaDavid K. MinetaDeputy DirectorDeputy Director

Office of National Drug Control PolicyOffice of National Drug Control Policy

Association of Recovery Schools Twelfth Annual Conference , Delmar, CAAssociation of Recovery Schools Twelfth Annual Conference , Delmar, CAJuly 11, 2013July 11, 2013

A Time of TransitionA Time of Transition• Times of transition entail both threats and Times of transition entail both threats and

opportunitiesopportunities• Windows of opportunity:Windows of opportunity:

Act too quickly and one may follow the wrong Act too quickly and one may follow the wrong pathpath

Wait too long and the window of opportunity may Wait too long and the window of opportunity may already be closed or the range of options reducedalready be closed or the range of options reduced

Fail to act and others voices and plans will take the Fail to act and others voices and plans will take the place of yours place of yours

Demand ReductionDemand ReductionPreventionPrevention

Strengthen and coordinate prevention across community, school, Strengthen and coordinate prevention across community, school, workplace, and higher education settingsworkplace, and higher education settings

Strengthen Drug Free Communities programStrengthen Drug Free Communities program

TreatmentTreatment Support robust essential benefits packages under health reform, Support robust essential benefits packages under health reform,

inclusion of SUDs in EHRs, advance evidence-based practices, inclusion of SUDs in EHRs, advance evidence-based practices, including use of MAT, and promote innovationincluding use of MAT, and promote innovation

RecoveryRecovery Celebrate recovery, raise awareness, reduce stigma surrounding Celebrate recovery, raise awareness, reduce stigma surrounding

addiction and recoveryaddiction and recovery Expand Recovery Support Services/Recovery-Oriented Systems of Expand Recovery Support Services/Recovery-Oriented Systems of

Care (ROSC) Care (ROSC) Eliminate barriers to recoveryEliminate barriers to recovery

Converging FactorsConverging Factors• Ongoing fiscal constraints Ongoing fiscal constraints • ““Medical” marijuana & legalizationMedical” marijuana & legalization• RX medication abuse & overdose deathsRX medication abuse & overdose deaths• Increasingly mobilized recovery community Increasingly mobilized recovery community • Growing recognition of the need to:Growing recognition of the need to:

Adopt chronic care approaches and integrate Adopt chronic care approaches and integrate recovery support servicesrecovery support services

Integrate SUD and broader behavioral health Integrate SUD and broader behavioral health services with primary care and other services with primary care and other mainstream health care sectorsmainstream health care sectors

Converging FactorsConverging Factors• Emergence of new players:Emergence of new players:

Stacie Mathewson FoundationStacie Mathewson Foundation National Youth Recovery FoundationNational Youth Recovery Foundation Young People in RecoveryYoung People in Recovery Association of Recovery in Higher EducationAssociation of Recovery in Higher Education

• Affordable Care Act implementation:Affordable Care Act implementation: Expansion of Medicaid & affordable private Expansion of Medicaid & affordable private

insuranceinsurance Integration of SUD, mental health, primary careIntegration of SUD, mental health, primary care

• Rapid growth in collegiate recovery Rapid growth in collegiate recovery community start-upscommunity start-ups

Why Young People?Why Young People?• Susceptibility to SUDs during young adulthood:Susceptibility to SUDs during young adulthood:

Nearly 1 out of 5 Nearly 1 out of 5 (18.6%) of young adults aged 18 to (18.6%) of young adults aged 18 to 25 estimated to have substance use disorder25 estimated to have substance use disorder

Rate among youths aged 12 to 17 (6.9% ) higher than Rate among youths aged 12 to 17 (6.9% ) higher than that of adults aged 26 or older (6.3%) that of adults aged 26 or older (6.3%) (SAMHSA, 2012)(SAMHSA, 2012)

• Intervening early reduces costs and saves Intervening early reduces costs and saves liveslives

• Schools provide nexus for:Schools provide nexus for: Focusing education, prevention, treatment and Focusing education, prevention, treatment and

recovery support services recovery support services Mobilizing families and communitiesMobilizing families and communities

• Substance abuse and addiction among students Substance abuse and addiction among students reduce school safety and efficacyreduce school safety and efficacy

Why Young People?Why Young People?

• We can’t arrest our way out of the drug We can’t arrest our way out of the drug problemproblem

• When we don’t offer second chances to When we don’t offer second chances to young people, we:young people, we: Fail them their families, and the broader communityFail them their families, and the broader community

Deprive ourselves of the future these young people Deprive ourselves of the future these young people could have helped bring about.could have helped bring about.

Why Young People?Why Young People?• New mechanisms to create and sustain New mechanisms to create and sustain

community (SMS/MMS, social media, etc.)community (SMS/MMS, social media, etc.)• Greater openness and inclusivity and less Greater openness and inclusivity and less

stigma around addiction and recovery—young stigma around addiction and recovery—young people question many traditional people question many traditional perspectives; they are “changing the perspectives; they are “changing the conversation” on a range of issuesconversation” on a range of issues

• Passion, drive, willingness and ability to take Passion, drive, willingness and ability to take on a cause and advance it to the benefit of allon a cause and advance it to the benefit of all

• You—the young people here today —are You—the young people here today —are building our future right now!building our future right now!

Health Care ReformHealth Care Reform• Affordable Care Act (ACA) requires plans sod in Affordable Care Act (ACA) requires plans sod in

exchanges and expanded Medicaid to include SUD exchanges and expanded Medicaid to include SUD services.services.

• Requires SUD & MH Requires SUD & MH services be provided at services be provided at parity with medical-parity with medical-surgical servicessurgical services

• Extends access to an Extends access to an estimated 62 million estimated 62 million AmericansAmericans

• Will likely create a Will likely create a need for expanded need for expanded service networksservice networks HealthCare.gov

Health ReformHealth Reform• Opportunity to:Opportunity to:• Expand Screening, Brief Intervention, and Expand Screening, Brief Intervention, and

Referral to Treatment (SBIRT) in school and Referral to Treatment (SBIRT) in school and primary care settingsprimary care settings

• Provide Medicaid and possibly third party Provide Medicaid and possibly third party payer coverage for peer-to-peer servicespayer coverage for peer-to-peer services

• Lift financial burdens related to health care Lift financial burdens related to health care from many student’s familiesfrom many student’s families

• Cover young people under parents’ plans up Cover young people under parents’ plans up to the age of 26to the age of 26

ReadinessReadiness• Who will determine the bounds of local service Who will determine the bounds of local service

networks?networks?• Will anyone systematically conduct outreach to Will anyone systematically conduct outreach to

schools about the role ACA might play in:schools about the role ACA might play in: Improving student health?Improving student health? Covering SUD services?Covering SUD services? Improving school outcomes?Improving school outcomes?

• Who are your allies and who needs to become Who are your allies and who needs to become one?one?

• National and local coalitions essential to National and local coalitions essential to effectively leveraging converging eventseffectively leveraging converging events

The Path ForwardThe Path Forward• Inclusive coalitions:Inclusive coalitions:

State, local, and tribal officials (e.g.,):State, local, and tribal officials (e.g.,):

ResearchersResearchers Students and families in recovery and those who Students and families in recovery and those who

have lost loved ones to the disease of addictionhave lost loved ones to the disease of addiction Prevention coalitions, the broader recovery Prevention coalitions, the broader recovery

community, mental health and primary carecommunity, mental health and primary care Local and national press and media outletsLocal and national press and media outlets

– Education officialsEducation officials– School BoardsSchool Boards– Insurance boardsInsurance boards– Law EnforcementLaw Enforcement– Child WelfareChild Welfare

– State Medicaid AuthoritiesState Medicaid Authorities– State SA & MH AuthoritiesState SA & MH Authorities– Elected officialsElected officials– Juvenile JusticeJuvenile Justice– Other Child & family-serving agenciesOther Child & family-serving agencies

Thank you!Thank you!

David K. MinetaDavid K. MinetaOffice of National Drug Control PolicyOffice of National Drug Control Policy

FaceBook.com/AmericansInRecoveryFaceBook.com/AmericansInRecovery