AddictionTechnologyTransferCenter Network

National Institute on Drug Abuse Initiative

Quarterly Report

January - March 2008

Table of Contents

Introduction

Pre-training/Infrastructure Development Events/Activities

Official Blending Product Trainings

Post-training/Follow-up Activities

Caribbean Basin & Hispanic ATTC Regional Center

Central East ATTC Regional Center

Great Lakes ATTC Regional Center

Gulf Coast ATTC Regional Center

Mid-America ATTC Regional Center

Mid-Atlantic ATTC Regional Center

Mountain West ATTC Regional Center

ATTC National Office

ATTC of New England

Northeast ATTC Regional Center

Northwest Frontier ATTC Regional Center

Pacific Southwest ATTC Regional Center

Prairielands ATTC Regional Center

Southeast ATTC Regional Center

Southern Coast ATTC Regional Center

Appendix A – Pre-training Activities

Appendix B – Official Trainings

Appendix C – Post-training Activities

January – March 2008 ATTC Quarterly Report

NIDA/SAMHSA-ATTC Blending Initiative

Page 1 of65

Introduction

The NIDA/SAMHSA-ATTC Blending Initiative was developed in 2001 with the goal of melding science and practice together to improve treatment for substance use disorders. The first years of the project focused on the work of "Blending Teams" comprised of staff from SAMHSA/CSAT's Addiction Technology Transfer Center (ATTC) Network and researchers and community treatment providers from NIDA's Clinical Trials Network (CTN). NIDA and CSAT originally convened five separate Blending Teams to develop products that would facilitate the dissemination of research results identified by NIDA as follows: Buprenorphine Treatment: A Training for Multidisciplinary Addiction Professionals (Buprenorphine Treatment), Treatment Planning MATRS: Utilizing the Addiction Severity Index(ASI) to Make Data Collection Useful (Treatment Planning), Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency (MIA: STEP), Short-Term Opioid Withdrawal Using Buprenorphine: Findings and Strategies from a NIDA Clinical Trials Network Study (Buprenorphine Detoxification) and Promoting Awareness of Motivational Incentives (PAMI). All ATTC Regional Centers participated on one of the five Blending Teams. Although the National Office was not directly a part of any Blending Team, as the coordinating center of the ATTC Network, it facilitated the efforts of all five Blending Teams and continues to develop special projects, such as The Training Point, which support the Initiative as a whole.

All five original Blending Teams currently have products in dissemination. One Team, Treatment Planning MATRS, has spawned a sequel that will supplement the original package by including information and resources on the ASI Treatment Planning Software. A new Blending Team related to Buprenorphine/Naloxone-Facilitated Rehabilitation for Heroin Addicted Adolescents/Young Adults held its first “hand-off” meeting in February 2008. Plans for content are still under development; however it is likely that the Team will be assigned to revise the existing Buprenorphine Awareness product to include a module on using buprenorphine with young adults, as well as updating all citations and other information that may have changed since the product was developed in 2005. In addition, ATTC staff has been working with NIDA on its Blending Initiative task force, and, in this capacity, have supported the development ofa guide for selecting, evaluating, and utilizing evidence-based practices.

Pre-training/Infrastructure Development Events/Activities

The ATTC Network has found the need to prime the field on the evidence based practices presented in the Blending packages before actually disseminating the official products. This pre-training/infrastructure development work involves activities such as meetings with SSAs, community treatment programs and other key stakeholders, marketing efforts and product dissemination, foundational trainings, environmental scans and other needs assessments, and overview presentations. From January through March 2008, the ATTC Network reported holding 10 meetings, 5 conferences, 6 technical assistance events, 9 educational events (trainings or academic courses), one product dissemination effort, and 2 regional planning calls related to pre-Blending product training activities. These efforts are displayed on the map on page 4 and are listed in detail in Appendix A.

January – March 2008 ATTC Quarterly Report

NIDA/SAMHSA-ATTC Blending Initiative

Page 1 of65

January – March 2008 ATTC Quarterly Report

NIDA/SAMHSA-ATTC Blending Initiative

Page 1 of65

Official Blending Product Trainings

Once Blending Teams fully complete the development of their packages and receive final approval from NIDA and SAMHSA, they begin disseminating their packages to the public. All five original Teams now have products in dissemination. ATTC Regional Centers work closely with key stakeholders to find opportunities to deliver trainings on Blending products across the nation. During this reporting period, ATTCs held 36 official Blending product events. There were no training-of-trainer events and no pilot events held. In addition, the ATTCs did not hold any events in conjunction with CTNs during the quarter. Please see the table on page 7 for a summary of the official trainings held, the number of contact hours they represent, and the number of participants served. These efforts are also displayed on the map on page 8 and are listed in detail in Appendix B.

Several Regional Centers have encountered challenges to delivering one or more of the Blending product trainings in certain states. In such cases, the ATTC has developed innovative and creative strategies to overcome barriers and implement the trainings. See the individual ATTC reports found later in this document for more details regarding challenges and strategies taken to overcome them.

RegionalCenter / State / Product / Training Hours / Participants
Southeast ATTC / Georgia / Buprenorphine Treatment / 6 / 12
Central East ATTC / Maryland / Buprenorphine Treatment / 3 / 39
Northeast ATTC / Pennsylvania / Buprenorphine Treatment / 6 / 5
Northeast ATTC / Pennsylvania / Buprenorphine Treatment / 6 / 15
Pacific Southwest ATTC / California / MIA:STEP / 6 / 42
Pacific Southwest ATTC / California / MIA:STEP / 6 / 62
Pacific Southwest ATTC / California / MIA:STEP / 6 / 45
Pacific Southwest ATTC / California / MIA:STEP / 6 / 45
Pacific Southwest ATTC / California / MIA:STEP / 6 / 45
Pacific Southwest ATTC / California / MIA:STEP / 6 / 45
Southeast ATTC / Georgia / MIA:STEP / 12 / 15
ATTC of New England / Rhode Island / MIA:STEP / 12 / 10
Mid-Atlantic ATTC / West Virginia / MIA:STEP / 12 / 10
Southern Coast ATTC / Alabama / PAMI / 1.5 / 19
Mountain West ATTC / Colorado / PAMI / 2 / 16
Prairielands ATTC / Colorado / PAMI / 1.5 / 13
Prairielands ATTC / Colorado / PAMI / 1.5 / 15
Northwest Frontier ATTC / Hawaii / PAMI / 1.5 / 36
Great Lakes ATTC / Indiana / PAMI / 1.5 / 8
Mountain West ATTC / Nevada / PAMI / 1.5 / 20
Mountain West ATTC / Nevada / PAMI / 2 / 11
Prairielands ATTC / Nevada / PAMI / 1.5 / 25
Prairielands ATTC / Nevada / PAMI / 1.5 / 8
Southeast ATTC / North Carolina / PAMI / 3 / 17
Northeast ATTC / Pennsylvania / PAMI / 3 / 10
Great Lakes ATTC / Puerto Rico / PAMI / 2 / 90
Southeast ATTC / South Carolina / PAMI / 3 / 41
Mountain West ATTC / Wyoming / PAMI / 2 / 18
Prairielands ATTC / Wyoming / PAMI / 1.5 / 17
Southern Coast ATTC / Alabama / Treatment Planning MATRS / 6 / 45
Southern Coast ATTC / Florida / Treatment Planning MATRS / 6 / 9
Southern Coast ATTC / Florida / Treatment Planning MATRS / 6 / 24
Northwest Frontier ATTC / Hawaii / Treatment Planning MATRS / 6 / 16
Mountain West ATTC / Idaho / Treatment Planning MATRS / 6 / 34
Mountain West ATTC / Idaho / Treatment Planning MATRS / 6 / 28
Gulf Coast ATTC / Texas / Treatment Planning MATRS / 6 / 27

The table above shows the number of contact hours and the number of participants for each of the official blending product trainings held by the ATTC Network between January 1 and March 31, 2008.

January – March 2008 ATTC Quarterly Report

NIDA/SAMHSA-ATTC Blending Initiative

Page 1 of65

January – March 2008 ATTC Quarterly Report

NIDA/SAMHSA-ATTC Blending Initiative

Page 1 of65

Post-training/Follow-up Activities

Research is constantly contributing new knowledge to the substance use disorder and recovery services field. Yet this new knowledge often is not used in service settings. Implementing changes based on research can be difficult for treatment agencies and professionals. Technology transfer involves creating amechanism by which a desired change isaccepted, incorporated and reinforced at alllevels of an organization or system. Although training is one strategy in the technology transfer “tool box,” technology transfer’s scope is much broader than training alone.

The ATTC Network is specifically charged with accelerating the pace of research to practice by elevating the capacity of the substance abuse treatment workforce to understand and adopt cutting edge treatment practices that provide sound and effective treatments for individuals suffering from addiction. The Network’s vision is to “unify science, education and services to transform lives.” Technology transfer is at the heart of all ATTC work.

The ATTC Network utilizes its expertise in technology transfer to extend the reach of the Blending Initiative by re-packaging the approved information and materials in creative and innovative ways. ATTC Regional Centers create products to supplement and enhance the Blending products and conduct follow-up activities and ongoing technical assistance with participants of Blending product trainings to increase the likelihood that research-based practices will be implemented. Follow-up activities for this reporting period are displayed on the map on page 10 and are listed in detail in Appendix C.

January – March 2008 ATTC Quarterly Report

NIDA/SAMHSA-ATTC Blending Initiative

Page 1 of65

January – March 2008 ATTC Quarterly Report

NIDA/SAMHSA-ATTC Blending Initiative

Page 1 of65

CaribbeanBasin & HispanicATTCRegionalCenter

(1)Blending Team (BT) Product Development

Not currently involved in an active Blending Team.

(2)Challenges and Strategies Taken

a.The state agencies,community-based organizations (CBOs), and private service contractors in Puerto Rico and United States Virgin Islands have limited knowledge about evidence-based approaches to treat drugaddiction. In order to conduct related educational events an extensive infrastructure development is required to persuade and influence providers to develop skills, gain additional knowledge,and change attitudes. The activities during this pre-implementation phase include orientation to agencies and CBOs administrators, coordination (logistic process) and identification of potential training participants.

b.The Caribbean Basin & Hispanic ATTC uses e-mail communications, faxes, telephone calls and face to face encounters as strategies to disseminate information regarding BT products among governmental agencies, CBOs, and private service contractors. In that way, CHATTC addresses the lack of information about BT products on a continuous basis. The table below presents additional challenges identified during this reporting period and actions taken to overcome them.

City and State / Challenges identified / Strategies, action steps utilized
to address challenge(s) / Outcomes pending, resolved
San Juan, PR / Mental Health and Anti- Addiction Service Administration (ASSMCA) service providers trained in the MI TOT on March 1st-2nd, 2006 developed a Motivational Interviewing Training inside the agency. / Strategies included NIDA Liaison Coordinator participation in the rehearsal meetings to support in the booster trainer skills and the adherence of the MI Approach in the training content. / Pending -
The first in-house ASSMCA training will be schedule for April 3rd, 2008.
San Juan, PR / The Mental Health and Anti- Addiction Service Administration (ASSMCA) open the first treatment center for opioid dependence patients with Buprenorphine. ASSMCA and La Fondita de Jesús (CBO currently referringclients to this treatment center); service providers need to increase skills in this treatment modality. / This initiative begins with petition of service providers. The challenge was tofamiliarize supervisors and administrators with service providers’ needsthrough face to face meetings and coordination support. / Pending -
ASSMCA and CBOs’ administrators are identifying service providers in this area to recommend to attend the training scheduledfor April 3, 2008.
Saint Croix and Saint Thomas, VI / Introduce MI Approach, Buprenorphine and MATRS Treatment Planning to service providers in USVI state agency and its CBO’s. / Strategies included face to face meeting with Mental Health Acting Director in USVI, identify contact persons in the agency, and establish communication lines by e-mail, fax, telephone calls and face to face encounters to facilitate the recruitment of substance abuse treatment service providers in the State Agencies and CBO’S. / Pending -
Mental Health Department in St. Thomas and St. Croix is promoting the training and registering candidates to participate.
(San Juan, Ponce , Mayaguez), PR / Introduce MI Approach to Program Coordinators and Clinical Supervisors in the agencies and CBO’s in the Region. / Strategies included sent e-mails and faxes, telephone calls and face to face meetings to administrators of the private service contractors, governmental agencies and CBO’S. / Pending -
Governmental agencies, private service contractors and CBOsare in the process to designate a list of trainee candidates to participate in the MI Technical Assistance.
(San Juan, Ponce , Mayaguez), PR / Search out an appropriate location to deliver trainings in different regions of PR. / CBHATTC is searching for locationswithin the agencies and/or CBO’s facilities. / Pending -
Approval for training facility by CBO in the San Juan and Ponce Region, and State Agency in the Mayaguez Region.

(3)Liaison Activities with CTN Nodes; CTPs; and /or NIDA Researchers

a. The CBHATTC, as part of the CTN (Florida Node following the BSFT protocol), participates in national conference calls relevant to this specific protocol as well as Florida Node conference calls. The lead NIDA investigator for this protocol is Dr. Mike Robbins. Another NIDA researcher who participates in this protocol is Dr. Varda Shoham. Dr. Shoham also served as the principal investigator for a NIDA funded research project that is using Brief Strategic Family Therapy (BSFT) as their platform.

(4) Development of Ancillary Products

This quarter CBHATTC developed a libretto of the Motivational Interviewing Demonstration in Spanish language to be disseminated in DVD format. The libretto is currently undergoing into revision process to evaluate the adherence to the MI Approach.

CentralEastATTCRegionalCenter

(1)Blending Team (BT) Product Development

Use of Buprenorphine with Adolescents and Young Adults/Update of Buprenorphine Awareness Package

  1. Thomas Durham, PhD, has been assigned to this Blending Team.
  2. Role and task related to BT product development have yet to be decided.
  3. Participated in February 28, 2008, Hand-Off Meeting in Bethesda, MD.
  4. Content plans are still under development; the BT will likely be assigned to update the existing Buprenorphine Awareness product to include a module on using buprenorphine with adolescents and young adults, based on experience gained through a NIDA Clinical Trials Network (CTN) study.
  5. Hand-off meeting occurred in February 2008.
  6. See response to (d).

(2)Challenges and Strategies Taken

City and State / Challenges identified / Strategies, action steps utilized
to address challenge(s) / Outcomes pending, resolved
DE / Workforce has inconsistent skill level in Motivational interviewing, which limits Central East ability to disseminate MIA:STEP / Central East has planned a number of basic MI trainings in the state, in order to build capacity in MI. Central East will move into MIA:STEP training once basic trainings are complete / Outcomes pending
NJ / Workforce has inconsistent skill level in Motivational interviewing, which limits Central East ability to disseminate MIA:STEP / Central East has planned a number of basic MI trainings in the state, in order to build capacity in MI. Central East will move into MIA:STEP training once basic trainings are complete / Outcomes pending

(3)Liaison Activities with CTN Nodes; CTPs; and /or NIDA Researchers

  1. Central East ATTC continued conversations with Mid-Atlantic CTN node around upcoming meeting and to obtain an overview of current CTN projects and discuss current and future plans for collaboration.
  1. On March 28TH the MID-Atlantic CTN node held its annual Research to Practice Symposium entitled: Sex and Drugs: Reducing Risky Behaviors for Men, Women, and Adolescents. The event was co-sponsored by the Central East and the Maryland Office of Education and Training in Addiction Services. 169 participants attended this event.

(4) Development of Ancillary Products

None this period.

Great LakesATTCRegionalCenter

(1)Blending Team (BT) Product Development

Not currently involved in an active Blending Team.

(2)Challenges and Strategies Taken

City and State / Challenges identified / Strategies, action steps utilized
to address challenge(s) / Outcomes pending, resolved
Cleveland, Ohio / Need for foundational training re: motivational interviewing in preparation for MIA:STEP /
  1. Motivational Interviewing (MI)trainings scheduled July-Aug
  2. Manager from this county’s system change network accepted and attending the June MIA:STEP TOT
/ Pending
State of Ohio / SSA has identified motivational interviewing as a preferred EBP for all funded treatment providers. Competency re: motivational interviewing is unclear /
  1. In partnership with the SSA’s workforce development Administrator, Great Lakes developed a survey tool to collect information from all licensed clinicians
  2. Regional MI trainings are being planned
  3. Regional trainers certified in delivering MIA:STEP (including one from Ohio) will provide subsequent training for supervisors
  4. Cleveland’s July & August foundational trainings will be included in the state’s plan to train all providers
/ Pending
Regional / Unclear about interest and relevance for Treatment MATRS and Buprenorphine products / Presentation on all blending products; survey and input will be solicited from key partners at the May 21-22, 08 Regional Advisory Board Meeting to generate interest and development of a Blending Products training calendar. / Pending

(3)Liaison Activities with CTN Nodes; CTPs; and /or NIDA Researchers

  1. Ongoing discussions with Ohio Valley Node (OVN) re: participation and support of the June NIDA Blending Conference. Great Lakes providing marketing efforts, workshop, exhibit and 10 scholarships
  2. Great Lakes Director is chairing a panel, Integrating EBP and Community Treatment Centers at the NIDA Blending Conference. Prepared and submitted workshop description to NIDA and Synergy in partnership with other panelists. Co-presenters are Dr. Dwayne Simpson and Dean Babcock (OVN CTP)

(4)Development of Ancillary Products