Bureau of Drug and Alcohol Services (BDAS)

/DHHS

Presentation to theGaming Study Commission

March 16th, 2010Joe Harding – Director271 6104 – jharding@dhhs.state.nh.us

BDAS Mission

Mission:To significantly reduce alcohol and other drug

abuseand its social, health, and behavioral

consequencesfor the citizens of New Hampshire through publicpolicy and resource development, education, and supporting initiatives that ensure the delivery ofeffective and coordinated prevention and treatment services.

BDAS Organizational Chart

Organization Bureau of Drug and Alcohol Services Prevention Services Unit (PSU)

Alcohol & Other Drug Prevention Programs

Strategic Prevention Framework Initiative

Clinical Services Unit (CSU)

Alcohol & Other Drug Treatment Programs

Methadone Treatment Programs

Tirrell Half Way House

Resources and Develop Unit:

Facilitates all State Agency Trainings/Oversees Provider Training

Services; Integration at State Level/Coordination across Communities

Impaired Driver Services Unit

Impaired Driver Intervention (IDIP) Programs

Multiple Offender Programs (MOP)

Business and Financial Services Unit

BDAS Cost DriversTreatment:

100,000 People in NH meet the criteria for substance abuse (National Survey on Drug Use and Health)

60,000 of these individuals meet the criteria for substance dependence (addiction) (National Survey on Drug Use and Health)

44% of clients are criminal justice involved (Client Event Data) 40% to 60% of clients in the system funded by BDAS have a

co-occurring mental health disorder (McGovern, Drake, et al)Prevention:

28.4% of high school students are involved in binge drinking; 5 or more drinks in a row within a couple hours)*

22.9% of the students used marijuana one or more times during the past 30 days* (* NH YRBS, 2007)

BDAS Service Delivery System 23 Treatment providers offering varying

length and intensity of services - Tirrell Halfway House for Men

Administrative oversight of 9 methadone maintenance programs (not funded by DHHS)

Contracts with four Multiple Offender Programs (MOP) and administrative oversight of 6 Impaired Driver Programs

Support 10 Regional Community Prevention Coalitions, 43 Direct Service Prevention Contracts, Media campaign and Clearinghouse

ADMISSIONS TO TREATMENT SERVED BY GENDER – SFY2008

CLIENTS SERVED BY GENDER - SFY2008

2161

3565

0

500

1000

1500

2000

2500

3000

3500

4000

MALE FEMALE

Primary Substances Used by Clients in Treatment – SFY2008

Primary Substance - SFY 2008

3014

360 364

736 659

284

40262

0

500

1000

1500

2000

2500

3000

3500

Alcoho

l

Crack

Cocai

ne

Mar

ijuan

a/Has

hish

Heroin

/Mor

phine

Oxyco

done

Met

ham

phet

amine

All Oth

er D

rugs

Governor’s Commission

Commission Established;

There is hereby established a Commissionwhich shall serve in an advisory capacity to the governor regarding the delivery of effective and coordinated alcohol and drugabuse prevention, intervention, and treatment services throughout the state.

AOD Prevention and Treatment Services Budget Summary – SFY2009

Funding for Services SFY2009 = $11,780,952

$1,171,311Fed Block Grant

Prevention$2,000,000

Gen Fund Treatment

$4,315,593Fed Block Grant

Treatment

$1,196,785Gov Comm Prevention

$235,971Fed Drug Free

Schools Prevention

$2,861,292Gov Comm Treatment

Prevalence - Premise: There are approximately 983,000 adults 21 years of

age or older in New Hampshire 2% or 19,665 will be engaged in problem gambling 60% or 11,800 of problems gamblers will be

engaged in pathological gambling 50% or 5,900 of the Pathological Gamblers may

avail themselves to counseling services if available 550,000 (56%) of NH Adults engage in some form of

gambling (Target for Awareness and Education efforts) Intervention Services for Problem Gambling: 19,666 Clinical Services for Pathological Gambling = 5,900

Prevention Services – Education & Awareness

Target Population: Individuals at some risk: 56% (550,000 - Adults)

of NH population participate in some form of Gambling

Media Campaign Media Development

TV, Radio, Newspaper Ad, Brochures Television and Radio Ads Print Ads (newspapers) Materials Dissemination

Intervention Services -Social Marketing

Targeted Social Marketing Campaign Target Audience: Individuals Engaged in

Problem Gambling (n = 19,665) Media

Television, Radio and Print (newspaper) Ads Materials Dissemination:

Regional (prevention) Networks Health & Social Services Agencies Gaming Establishments

Information and Referral: Hotline Health & Social Services Agencies

Co-occurring Substance Abuse & Pathological Gambling

The rate of co-occurrence of pathological gambling among people with substance use disorders has been reported as ranging from 9 to 30 percent, and the rate of substance abuse among individuals with pathological gambling has been estimated at 25 to 63 percent.

At a minimum, the rate of problem gambling among people with substance use disorders is four to five times that found in the general population.

Among pathological gamblers, alcohol has been found to be the most common substance of abuse. Even though pathological gambling is often viewed as an addictive disorder, clinicians cannot assume that their knowledge or experience in substance abuse treatment qualifies them automatically to treat people with a pathological gambling problem.

Ref; SAMHSA CSAT Tip 42: Substance Abuse Treatment for Persons with Co-occurring Disorders

Prevalence of Suicide and Pathological Gambling

A 1999 study conducted by Maccallum et al.

found that 38% of suicidal ideation is related

to gambling, of which 8% of the subjects

were actively suicidal.

Clinical Services

Screening / Brief Intervention / Referral Hot Line Health and Social Service Agencies

Crisis Evaluations (n = 236)

Out Patient Services (n = 5310)

Intensive Outpatient Services (n = 590)

Clinical Services - Continued

Crisis Evaluations at Hospital Emergency Rooms (Master’s Prepared > Clinicians)

Counseling Services: Community Mental Health Centers Alcohol and Other Drug Treatment Programs Master Prepared > Independent Practitioners

Board of Mental Health Practice Board of Alcohol and Drug Abuse Professionals

Program Development /Provision of Services

Community Level Prevention Services

Media / Social Marketing Clinical Services Program Development Training / Certification Administration Program Evaluation

BDAS Org Chart with Gaming

BudgetSFY-11 SFY-12

Community Level Prevention Services (reg. Networks) 250,000$ 250,000$

Media / Social Marketing 665,000$ 380,000$

Clinical Services # Served Crisis Evaluation 236 118,813$ 118,813$ Out Patient 5,310 4,141,660$ 4,141,660$ Intensive Outpatient 590 1,061,964$ 1,061,964$ Total Clinical Services 6,136 5,322,436$ 5,322,436$

Training/Program Development 20,648$ 13,148$

Program Evaluation 65,000$ 32,500$

Administration 382,393$ 339,664$

Total 6,705,477$ 6,337,748$