January 2022 Post Article

Walking the Walk in 2022:
Embracing SAMHSA Priorities and the Intersection of Harm Reduction, Prevention, and Recovery

 

Planning for 2022

I went to my first 12 step recovery support group meeting in 1976. I was twenty years old and attended the open meeting as part of a community psychology class assignment. I didn’t begin working as a prevention specialist for another 10 years but something the lead speaker said has resonated with me for more than 40 years. “It’s not enough to talk the talk, you have to walk the walk.” 

Each year, many of us make New Year’s resolutions that never make it past the talking stage. Resolutions and goals take more than words, they need actions that are put into practice. Sometimes, like newly walking toddlers, we take two steps forward, one step back, and an occasional fall along the way. Changing behavior and learning new practices takes time, a plan, support from peers, a way to measure success, and resources from trusted experts.  

In 2022, as we develop prevention goals, plans, and resolutions, the Substance Abuse Mental Health Services Administration (SAMHSA) serves as a trusted expert resource with a roadmap of priorities and principles to guide our work. All of our work should be guided by the SAMHSA core principles of equity, workforce, and financing that cut across five priority areas:

  1. Preventing overdose
  2. Enhancing access to suicide prevention and crisis care
  3. Promoting children and youth behavioral health
  4. Integrating primary and behavioral healthcare
  5. Using performance measures, data, and evaluation

 

 

Identifying our Goals 

Often our goals and resolutions are determined by a problem or setback that we recognize needs to be changed. Many of us take the opportunity of a new year to put an end to tobacco use, unhealthy eating, or a lack of exercise. Most of our personal resolutions focus on wanting to live longer, healthier, and more productive lives. We take stock of what is- and determine what needs to be done. As we take stock of the nation’s behavioral health and determine our professional resolutions and goals, we are faced with some grim realities that need to be addressed if we are to support longer, healthier, and more productive lives for everyone. 

Overdose Deaths Increase Dramatically

Provisional data from CDC’s National Center for Health Statistics indicate the United States experienced an estimated 28.5% increase in drug overdose deaths from April 2020 to April 2021. The CDC estimates that there were 100,306 drug overdose deaths compared to 78,506 during the same period in the year before. The image below illustrates the increase in U.S. deaths.

 

 

 

 

There is no race-specific data available yet for the latest overdose death numbers but prior research has pointed to a continued increase in deaths among non-Hispanic Black individuals. According to a recent study National Institute of Health Study (NIH), non-Hispanic Black individuals in four U.S. states experienced a 38% increase in the rate of opioid overdose deaths from 2018 to 2019, while the rates for other race and ethnicity groups held steady or decreased. NIH emphasizes the need for equitable, data-driven, community-based interventions that address these disparities.

SAMHSA’s Response for Preventing Overdose and Decreasing Disparities

To address this alarming increase in overdose deaths, SAMHSA has announced a funding application opportunity for the first-ever SAMHSA Harm Reduction grant program and expects to issue $30 million in grant awards. This funding, authorized by the American Rescue Plan, will help increase access to a range of community harm reduction services and support harm reduction service providers as they work to help prevent overdose deaths and reduce health risks often associated with drug use. SAMHSA will accept applications from State, local, Tribal, and territorial governments, Tribal organizations, non-profit community-based organizations, and primary and behavioral health organizations.
 

Harm Reduction as a Prevention Strategy

As part of SAMHSA’s priority of preventing overdose, SAMHSA has recognized the importance of harm reduction in preventing overdoses and overdose-related deaths, reducing disparities, and increasing access to healthcare, support services, and treatment. 

SAMHSA identifies harm reduction as a comprehensive prevention strategy and an integral part of the continuum of care. “Harm reduction is an important part of the Biden-Harris Administration’s comprehensive approach to addressing substance use disorders through prevention, treatment, and recovery where individuals who use substances set their own goals. Harm reduction organizations incorporate a spectrum of strategies that meet people “where they are on their own terms, and may serve as a pathway to additional prevention, treatment, and recovery services. Harm reduction works by addressing broader health and social issues through improved policies, programs, and practices.

Moving from Talking to Walking: The Intersection of Harm Reduction, Prevention, and Recovery

Without support, resources, and expert guidance, most resolutions and goals never make it past the initial talking phase. The Prevention Technology Transfer Center Network Coordinating Office (PTTC NCO) and the Peer Recovery Center of Excellence (PRCoe) have collaborated to provide expert guidance, resources, and opportunities for professionals in the prevention, harm reduction, treatment, and recovery fields. Many of us have difficulty knowing where to begin with an important goal or change process. The PTTC NCO and the PRCoe have provided the perfect launching point for any individual or organization striving to bridge differences and increase collaboration with other components of the behavioral health, primary health, and social service delivery system. To facilitate communication, collaboration, and a more comprehensive continuum of care, the PTTC NCO and PRCoe hosted three webinars on the topic of the intersection of prevention and recovery, followed by a two-part series on the intersection of harm reduction, prevention, and recovery. The first two webinars in the series, The Intersection of Prevention & Recovery, Parts I & II,  were designed to inform and raise awareness of prevention and recovery community professionals about the intersection between substance use disorder (SUD) prevention and recovery approaches followed by the third webinar, Where Prevention and Recovery are Working, with panelists discussing the experiences of multiple recovery and prevention communities and provided models of successful community-based programs working within the intersection of prevention and recovery. The goal for the panel was not to provide a set of complete solutions, but rather to stimulate discussion, highlight practical approaches to advancing community resilience and collaboration that are applicable to many communities across the nation. The final two-part series of webinars, The Intersection of Harm Reduction, Prevention & Recovery Parts I & II, illustrated the common goals within the fields of prevention, recovery, and harm reduction such as: reducing the adverse health and social consequences of chaotic substance use, demonstrate the multiple points of intervention across the spectrum of substance use, and how to develop coordinated strategies at individual and community levels to address chaotic substance use. The panelists took a close look at how race and social determinants of health influence the frequency, access, and type of services provided to diverse populations. This series demonstrated how the fields of prevention and recovery share common goals and explore ways professionals can collaborate and coordinate activities that work toward improving community health and wellness.
 

Taking the First Steps: The Learning Community Toolkit

Once the energy and excitement from participating in a webinar have worn off, it may be difficult to take the first steps toward practical application. Recognizing that participating in the webinar series and discussions is only the beginning of the intersection of harm reduction, prevention, and recovery, the PTTC NCO, PRCoe, and the Great Lakes PTTC  have developed The Intersection of Harm Reduction, Prevention, and Recovery: Learning Community Toolkit.  As with any new process, expert guidance and user-friendly resources are key to continued collaboration, sustainability, and improved outcomes. The toolkit walks you through the process of developing a series of Learning Labs (facilitated virtually) from start to finish. The toolkit includes the facilitator’s agenda, the participant application process, screening applications, sample timelines, and email templates, and PowerPoint template slides. The toolkit can be facilitated by any interested organization or community that would like to create action steps toward breaking down silos and nurturing relationships between the fields of harm reduction, prevention, and recovery.

Additional Resources for Prevention Professionals

To get prevention professionals started, the PTTC NCO has created a one-page information sheet for Prevention practitioners, Harm Reduction through a Prevention Lens.  Harm Reduction provides a brief overview of Harm Reduction and its connection with Prevention. It also includes basic Harm Reduction strategies for commonly used substances and viral infections that are a heightened risk for people who use substances. Prevention Professionals who are incorporating harm reduction strategies as part of their selective and indicated prevention plans can find more information at the one-hour webinar hosted by the PTTC NCO that explores Harm Reduction Strategies Through the Lens of Selective and Indicated Prevention. The webinar recording, session slides, and other resources from presenters and participants are available from the PTTC NCO.  

Walking the Walk Together in 2022

As we begin 2022, let’s resolve to walk together to use the resources, funding, and collaborations available to prevent health disparities, inequities, injustices, and harm associated with substance use and SUDs through improved policies, programs, and practices.
 
Author's Note
Cele Fichter-DeSando, MPM (She, Her) is a consultant and trainer in substance use and gambling prevention and tobacco prevention and control. Cele has a Master’s degree in Public Management from Carnegie Mellon University and more than 35 years of experience in the management, training, and implementation of research-based prevention programs in Pittsburgh Pennsylvania. In 2020, Cele started a certified woman-owned business, CFD Consulting LLC, and has provided consulting for numerous organizations including Tobacco-Free Allegheny, the PTTC Network, and the Danya Institute Central East ATTC. She is passionate about providing resources, materials, and practical applications for evidenced-based prevention programs and prevention science to prevention practitioners.
Cele Fichter-DeSando, MPM 
CFD Consulting, LLC
[email protected]
412-580-3089
 

References

Hoopsick RA, Homish GG, Leonard KE. Differences in Opioid Overdose Mortality Rates Among Middle-Aged Adults by Race/Ethnicity and Sex, 1999-2018. Public Health Rep. 2021 Mar-Apr;136(2):192-200. doi: 10.1177/0033354920968806. Epub 2020 Nov 19. PMID: 33211981; PMCID: PMC8093836.

Whitehouse.gov. 2021. https://www.whitehouse.gov/ondcp/briefing-room/2021/11/17/fact-sheet-actions-the-biden-harris-administration-has-taken-to-address-addiction-and-the-overdose-epidemic/

National Harm Reduction Coalition 2021. https://harmreduction.org/

NIDA. 2021, September 9. Disparities in opioid overdose deaths continue to worsen for Black people, study suggests. Retrieved from https://www.drugabuse.gov/news-events/news-releases/2021/09/disparities-in-opioid-overdose-deaths-continue-to-worsen-for-black-people-study-suggests on 2021, December 10

Prevention Technology Transfer Center Network, 2021. https://pttcnetwork.org/centers/content/harm-reduction

SAMHSA Harm Reduction Grant Program 2021. https://www.samhsa.gov/grants/grant-announcements/sp-22-001

 

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