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February 2014

In This IssueCurrent FundingOpportunities

Signature Theme: Addictionand Counseling

Best Practices Principles ofEffective AddictionTreatment

Addiction and CounselingFunding Opportunities

Resources for AddressingAddiction and Counseling

Upcoming NewsletterThemes

About NCMUSA/CanadaNazarene CompassionateMinistries seeks to live and actcompassionately in the worldfollowing Christ's own life andministry. We seek to beincarnations of the samegospel that Christ lived andpreached and to be witnessesto the same love andcompassion God has for ourworld.In the United States andCanada, NCM works closelywith Compassionate MinistryCenters (CMCs) to bringcompassion and healing tocommunities that need thelove and presence of Christ. MissionNazarene CompassionateMinistries USA/Canadapartners with Nazareneinterests to facilitate ministrieswhich address the temporalas well as the spiritual needsof the economicallydisadvantaged.

My Fellow Leaders, As you read through this resource newsletter,you will see what some have called, "thehidden scourge." Substance abuse is highlyprevalent in our culture, knowing no incomelevel, zip code, age, or gender. Actually, moreindividuals die in America from prescriptiondrug abuse than illegal drugs. The church must respond. We must be the hope and light tothose who are hurting and struggling under the stronghold ofaddiction.

We hope this eNews will provide your compassionate ministrycenter and church with the resources needed to help those in yourcommunity.

Serving together,

Jay Height jheight@nazarene.org Coordinator, Nazarene Compassionate Ministries USA/Canada

Current Funding Opportunities CMC Multi­Site Application Opportunity "In the world today, youth WILL be mentored. The question is, by whom?" NCM is gearing up to prepare a group application for youth mentoring and would like toidentify and learn more about Compassionate Ministries Centers currently engaged inyouth development activities. If you would like to learn more about this groupapplication and share how you are working with youth in your community, pleaseemail hginese@ncmi.org to request a preliminary survey by Friday, February 14,

ChurchesLocal churches are theprimary avenue for Nazarenesto reach out to those in theircommunities. NazareneCompassionate Ministriesseeks to support churches instarting and maintainingministry to the under­servedand marginalized. We believeevery church, no matter sizeor budget, can find ways tomeet needs in theircommunity with compassion,creative, and the firmfoundation and life­changingpower of the Gospel message. CMCs­ CompassionateMinistry CentersA Compassionate MinistryCenter is a non­profitorganization dedicated tomeeting the needs of theunder­resourced in thecommunity. While theseorganizations are oftenaffiliated with a specific localchurch, they are in a strategicposition to unite others in theircommunity around a high­needs cause. NDR­ Nazarene DisasterResponseNazarene DisasterResponse is Nazarenesmobilizing for disaster throughReadiness, Response, andRecovery. Local Nazarenesare in a unique position tounderstand, serve, andremain with disaster victims intheir own neighborhoods. Inlarge­scale events thedenomination can comealongside local efforts with thesupport of volunteers anddonors from across thecountry and through ourstrong partnerships with otherdisaster relief agencies.NDR serves victimsregardless of race, creed, oreconomic status byconcentrating on assistance tothe poor, elderly, andhandicapped. W&W­ Work & WitnessWork & Witness providesopportunities for Nazarenes toserve together in support ofexisting ministries such aschurches, CMCs, andNazarene Disaster Response.Work & Witness can be any

email hginese@ncmi.org to request a preliminary survey by Friday, February 14,2014.

Ben & Jerry's Foundation seeks proposals for social and environmental justiceprojects from nonprofit, grassroots community­organizing groups with annual budgetsunder $500,000. Review eligibility and application guidelines Deadline: March 14, 2014 Funding Amount: $20,000 Singing for Change is accepting letters of interest for social and environmentalprojects that include community members in planning and collaborate to find innovativesolutions. Apply Deadline: Ongoing Funding Amount: $1,000 ­ 10,000 Ruddie Memorial Youth Foundation seeks applications for innovative youthprograms in Baltimore, Boston, Los Angeles, Madison, Philadelphia, San Francisco,and Washington, DC. Program guidelines Deadline: April 30, 2014 Funding Amount: $25,000 Mutual of America Foundation is accepting nominations for 2014 CommunityPartnership Awards that recognize outstanding nonprofit organizations that haveformed strong partnerships with public, private, and social sectors. Applicationinstructions Deadline: April 1, 2014 Award Amount: $25,000 plus documentary awareness video Lawrence Foundation awards grants to organizations working in the areas ofeducation, human service and disaster relief. Learn more Application Deadline: April 30, 2014

Signature Theme: Addiction and Counseling

Best Practices, Innovations, Resources, Funding Opportunities Addictionis compulsive drug use despite harmful consequences that is characterized by theinability to stop using drugs, failure to meet work, social, or family obligations, and,sometimes, tolerance and withdrawal. Physical dependence is the adaptation of the body to a drug, requiring more of it toachieve a certain effect (tolerance) and eliciting drug­specific physical or mentalsymptoms if drug use is abruptly ceased (withdrawal).

Addictionhas also been defined as a systematic deconstruction of the personality, characterizedby a loss of interest in life, feelings of guilt and self­resentment, and anger toward self,others, and God.

Addiction StatisticsDependence on alcohol and drugs is the mostubiquitous national public health problem,affecting individuals and their families regardless

Work & Witness can be anytype of project, fromconstruction to evangelism tocompassionate outreach.

ContactToll Free Number: 1­800­306­9950Fax: (913) 577­0893General Email:ncmusacan@nazarene.org Coordinator: Jay HeightDirect Line: (317) 281­6768E­Mail:jheight@nazarene.org

affecting individuals and their families regardlessof ethnicity, region, or economicstatus.Approximately 23.9 million Americansaged 12 and older are current illicit drug users,and 20.3 million of the 22.2 million individuals inneed of treatment to overcome addiction to illicitdrugs or alcohol do not receive it.[1] Family

history of substance abuse and earlier age at first use both place individuals at higherrisk of developing an addiction to drugs or alcohol. Characteristics of AddictionAddiction affects the brain's control of reward and motivation, learning and memory, andbehavioral control and inhibition. A combination of factors including genetic makeup,age of exposure to drugs, and environmental influences initially leads a person tochoose to take drugs. However, after prolonged drug exposure weakens brain function,the individual's ability to choose and exercise willpower is impaired. Seeking andconsuming the drug becomes compulsive, and psychological stresses, physical pain,social cues, or environmental cues can trigger intense cravings without the individualrealizing it. Consequences of InactionDrug abuse and addiction lead to other mental illnesses and physical risks includinginjury, infectious diseases such as HIV/AIDS and hepatitis, weakened immune system,heart disease and stroke among others. Other consequences include dysfunctionalbehaviors that disrupt family and social relationships and can lead to legal problems. Substance abuse costs the U.S. over $600 billion annually in related crime, criminaljustice, theft, and healthcare costs.[2] Every dollar invested in addiction treatmentsaves $12 in drug­ related costs. Individuals and society save even more throughreduction in interpersonal conflicts, increased work productivity, and fewer drug­relatedaccidents, including overdose and deaths. Despite the clear need and cost effectiveness, nearly 90% of those with illicit drug oralcohol problems do not receive the treatment that they need to recover. Reducingstigma, raising awareness about the effectiveness of treatment, and increasingtreatment availability and access are essential to reduce this treatment gap. Treatment Effectiveness Most people who receive treatment stop using drugs, decrease criminal activity, andimprove their occupational, social, and psychological functioning. Although relapseoccurs, it is not a sign of treatment failure. Patients often require long­term or repeatedepisodes of treatment to achieve sustained abstinence and recovery of their lives. Many factors affect an individual's level of engagement and retention in treatment:motivation to change drug­using behavior; support from family and friends; pressurefrom criminal justice system, child protective services, employers, and family; clinicianability to establish positive, therapeutic relationships with their patients. Predictors ofpositive treatment outcomes include being married, employed, high social class,financially secure, socially active, and well­adjusted with little history of arrest and lowseverity of psychiatric symptoms. Factors limiting treatment outcomes includeaggression, attempted suicide, organic brain syndrome, sociopathic personality, anddual diagnosis.[3] What the faith community can do to help Churches and compassionate ministries centers are well positioned to help prevent andsupport recovery from substance abuse because they offer spiritual support toindividuals and communities. Just being associated with the activities of a faith

community can protect children living in high risk environments from initiatingsubstance use. Additionally, churches are communities of support that can helpindividuals reintegrate themselves and succeed in recovery. Despite the greatopportunity for churches and faith­based organizations to help people recovering fromaddiction, a "wall of silence" still stands between the faith community and people withalcohol and drug dependence, driving away addicts and their families from needed

alcohol and drug dependence, driving away addicts and their families from neededsupport and comfort with messages that perpetuate societal stigma and judgment.Properly equipped pastors and church leaders can explain in spiritual terms howaddiction is a barrier to spirituality to help reduce stigma and encourage theircongregations to welcome and support individuals and families affected by substancedependence. SAMHSA has developed core competencies[4] aimed to equip clergy and other pastoralministers to break through the wall of silence that surrounds alcohol and drugdependence, and to become involved actively in efforts to combat substance abuse andmitigate its damaging effects on families and children by (a) being alert to windows ofopportunity for contact, assessment, intervention, and treatment; (b) being internallyprepared with necessary information, resources, and teaching tools; (c) establishingeffective healing relationships with those affected by addiction; (d) forming therapeuticalliances with professionals, congregational caregivers, and affected individuals andtheir families; and (e) knowing when to leave.

Core Competencies for Clergy and Other Pastoral Ministers inAddressing Alcohol and Drug Dependence and the Impact onFamily Members

1. Be aware of the definition and societal stigma attached to alcoholand drug dependence.

2. Be knowledgeable about the signs of alcohol and drugdependence, characteristics of withdrawal, effects on theindividual and the family, and stages of recovery.

3. Be aware that possible indicators of the disease may includemarital conflict, family violence, suicide, hospitalization, orencounters with the criminal justice system.

4. Understand that addiction erodes and blocks religious andspiritual development, and be able to effectively communicate theimportance of spirituality and the practice of religions in recovery,using the scripture, traditions, and rituals of the faith community.

5. Be aware of the benefits of early intervention to the addictedperson and affected family.

6. Be aware of appropriate pastoral interactions with the addictedperson and affected family.

7. Be able to communicate and sustain concern and messages ofhope and caring.

8. Be familiar with and utilize available community resources toensure a continuum of care for the addicted person, familysystem, and affected children.

9. Have general knowledge of and exposure to 12­step programs(AA, NA, Al­Anon, etc.)

10. Be able to acknowledge and address values, issues, andattitudes regarding alcohol and drug use and dependence inoneself and one's own family.

11. Be able to shape, form, and educate a caring congregation thatwelcomes and supports persons and families affected by alcoholand drug dependence.

12. Be aware of how prevention strategies can benefit the largercommunity.

Program Models for Substance Abuse TreatmentMost substance abuse treatment begins with detoxification and medically managed

Most substance abuse treatment begins with detoxification and medically managedwithdrawal as the first stage, followed by a formal assessment and development of adrug addiction treatment plan. The core components of a comprehensive treatmentprogram[5] include:

Group/individual counselingPharmacotherapySelf­Help (AA/NA)Urine monitoringCase managementContinuing careSupports as needed: financial, medical, mental health, vocational, educational,legal, HIV/AIDS, family, child care, housing and transportation

Types of Treatment ProgramsLong­term residential treatment provides 24­hour care for 6­12 months and utilizes atherapeutic community to "resocialize" individuals. Highly structured treatment focuseson developing personal accountability and responsibility as well as socially productivelives. Activities help residents examinedamaged beliefs, self­concepts, anddestructive patterns of behavior and adopta new, more harmonious and constructiveway to interact with others. Short­term residential treatment providesintensive three­ to six­week hospital­basedinpatient phase followed by extendedoutpatient therapy and participation in a 12­step self­help group. Outpatient treatment costs less than residential or inpatient treatment and is moresuited for people with jobs and extensive social networks, but is much less intensive. Individualized drug counseling focuses on stopping substance use and addressesrelated impaired function such as employment status, illegal activity, and family/socialrelations by emphasizing short­term behavioral goals to develop coping strategies andtools to abstain from drug use and maintain abstinence. The addiction counselorencourages 12­step participation one or two times per week and refers for medical,psychiatric, and employment services. Group counselingfocused on social reinforcement through peer discussion and uses principles ofcognitive­behavioral or contingency management strategies. The main aim of treating substance dependence is to develop apersonally meaningful lifestyle that involves productivefunctioning in the family, workplace, and society through[3] :

Abstinence from alcohol and other mind altering drugsStructured recovery program centered around sober andresponsible activitiesRepair of physical, psychological, and social damage caused by

the substance use disorderTreatment of coexisting mental and personality disorders thatinterfere with abstinence and responsible livingPositive personality and lifestyle changes that support continuedabstinence

Pharmacotherapies[2]Prevent withdrawal symptoms, reduce cravings, and block desired effects of drugs and

Prevent withdrawal symptoms, reduce cravings, and block desired effects of drugs andalcohol, or generate undesirable symptoms when combined with drugs or alcohol todiscourage relapse. Allows patients to hold jobs, avoid crime and violence, reduceexposure to HIV, and engage more readily in counseling and behavioral interventionsessential to recovery. Methadone Opioid prevent withdrawal; reduce cravings; block

effectsBuprenorphine Opioid does not produce euphoria/sedation; reduce

withdrawalNaltrexone Opioid prevents euphoria to diminish cravings and

addictionNicotine

replacementTobacco prevent withdrawal symptoms; maintain

motivation to quitBupropion Tobacco suppress craving; quit without gaining weightVarenicline Tobacco blocks ability of nicotine to activate dopamineNaltrexone Alcohol blocks receptors for rewarding effects and

cravingAcamprosate Alcohol reduces symptoms of protracted withdrawalDisulfiram Alcohol interferes with degradation of alcohol, which

causes flushing, nausea, and palpitations ifalcohol is consumed

Behavior Therapies[2] Engage people in drug abuse treatment, provide incentives to remain abstinent, modifyattitudes and behaviors, and increase skill to handle stress and environmental cues.

CognitiveBehavioralTherapy

Individuals learn to anticipate problems and developcoping strategies.

Exploring positive and negative consequencesof continued drug useSelf­monitoring to recognize cravings early andidentify high risk situationsDeveloping strategies for coping with cravingsand high risk situations.

ContingencyManagement/MotivationalIncentives

To reinforce positive behaviors (abstinence andattendance), patients receive monetary vouchers(Voucher­Based Reinforcement) or chances to draw acash prize (Prize Incentives) as a reward for supplyingdrug­free urine samples or attending counselingsessions. Voucher value and chances to drawincrease with consecutive negative urine samples, butreset with drug­positive urine.

Community

ReinforcementPlus Vouchers

Intensive 24­week outpatient therapy usingrecreational, familial, social, and vocational reinforcersand material incentives to make a non­drug­usinglifestyle more rewarding than substance abuse.

Weekly individual counseling sessions focus onfamily relations, new skills, vocationalcounseling, and new recreational activities and

counseling, and new recreational activities andsocial networksVouchers for negative urine samples two or threetimes each week

MotivationalEnhancement

Therapy

Evokes internal change in client attitude towardtreatment and abstinence.

Initial assessment session followed by 2­4individual treatment sessions.Feedback on the assessment stimulatesdiscussion and self­motivation.Build a plan that includes coping strategies forhigh risk situations.

Matrix Model

Therapist fosters a positive, encouraging relationshipwith the patient to reinforce positive behavior changeand teach patients about addiction relapse and self­help programs. Drug use is monitored and treatmentmanuals followed for individual sessions. Othercomponents include family education groups, earlyrecovery skills groups, relapse prevention groups,combined sessions, 12­step programs, relapseanalysis, and social support groups.

12­StepFacilitationTherapy

Encourage active involvement in 12­step self­helpgroups.

Accept that drug addiction is a chronic diseasethat willpower alone is insufficient to overcomeand abstinence is the only alternativeSurrender to a higher power, accept fellowship,follow 12­step recoveryActive involvement in 12­step meetings andactivities

[1] SAMHSA 2012 National Survey on Drug Use and Health [2] Principles of Drug Addiction Treatment: A Research­Based Guide. National Institute on DrugAbuse. [3] Research­Based Best Practice Principles in Treating Addiction. Wisconsin Defender. [4] Core Competencies for Clergy and Other Pastoral Ministers in Addressing Alcohol and DrugDependence and the Impact on Family Members [5] Introduction to Evidence­Based Practices in Addiction Treatment (Power Point Presentation).Addiction Technology Transfer Center Network

Best Practices Principles of Effective Addiction Treatment[6]

Addiction is a complex but treatable disease that affects brain function andbehavior.All substance abusers should be treated with dignity at all stages of the recoveryprocess.

process.No single treatment is appropriate for everyone. Treatment should be matched toeach individual's specific needs.Treatment needs to be readily available so that drug­addicted individuals cantake advantage of available services as soon as they are ready for treatment.Effective treatment addresses the multiple needs of the individual, not just drugabuse.Treatment plans must be assessed and modified continually to meet changingneeds. At least three months of treatment arerequired to significantly reduce or stop druguse, and the best outcomes occur withlonger durations of treatment.Counseling and behavioral therapies arecentral to effective treatment because theyaddress the client's motivation to change,provide incentives for abstinence, build skillsto resist drug use, replace drug­usingactivities with constructive and rewardingactivities, improve problem­solving skills, and facilitate better interpersonalrelationships.Medications are one important component of comprehensive treatment for manypatients.Co­existing disorders should be treated in an integrated way.Medical detox is only the first stage of treatment and by itself does little tochange long­term drug abuse without continued motivational enhancement andincentive strategies.Treatment does not need to be voluntary to be effective. Although strongmotivation facilitates treatment and recovery, initial approaches can createmotivation for clients who are initially resistant to treatment.Possible drug use during treatment must be monitored continuously asmotivation for patients to resist urges to use drugs and as an early indicator ofreturn to drug use.Treatment manuals that assign reading, journaling, and self­assessment helpfacilitate productive group and individual therapy sessions.Assess for infectious diseases and help clients modify at­risk behaviors.Recovery can be a long­term process and require multiple episodes of treatment.Relapse does not indicate treatment failure, but shows that treatment plans needto be adjusted.

[6] Introduction to Evidence­Based Practices in Addiction Treatment (Power Point Presentation).Addiction Technology Transfer Center Network

Addiction and Counseling Funding

OpportunitiesSubstance Abuse and Mental Health Services Administration (SAMHSA) funds drugabuse prevention, treatment, and recovery interventions through several grantprograms. Review 2013 grants awards Monitor for upcoming opportunities Sprint Foundation supports youth development programs including those that focus onsubstance abuse prevention. More Information Daniels Fund grants to nonprofits that assist youth and adults in CO, NM, UT, and WYwith alcohol and substance abuse challenges in achieving stability through outreach andeducation, information and resources, early identification and intervention, outpatientand residential services, and recovery support services. More information and

and residential services, and recovery support services. More information andApplication Armstrong Foundation supports programs seeking to improve quality of life within

communities where their employees live byaddressing health, substance abuse, and hunger. Eligible communities Online Application BNSF Railway Foundation funds chemicaldependency treatment and prevention forcommunities along main BNSF lines Apply Otto Bremer Foundation supports activities that

transform communities into places where basic needs are met, mutual regard is prized,and opportunity for economic, civic and social participation is within everyone's reach. Eligible communities How to Apply Freeport­McMoRan Copper & Gold Foundation grants to organizations that providedirect services including substance abuse prevention and treatment to communitieswhere the company has an operational presence. To obtain an application, complete theEligibility Quiz

TJX Foundation contributes to programs that provide basic­need services todisadvantaged children, women, and families in communities where the company doesbusiness. Focus areas include domestic violence prevention, mentoring and tutoring,prenatal care and healthy­baby education, and social services to strengthen the familyunit. More information

Resources for Addiction and Counseling Substance Abuse and Mental Health Services Administration (SAMHSA) directoryof residential, outpatient, and hospital inpatient treatment programs throughout thecountry. Find Treatment Locations

American Society of Addiction Medicine nationwide directory of addiction medicineprofessionals Addiction Severity Index is a structured clinical interview designed to collectinformation about substance use and functioning in life areas from adult clients seekingdrug abuse treatment. Download Instruments and Manuals SAMHSA's Faith­based and CommunityInitiatives page provides technical assistanceand information resources. Evidence­based Interventions for Drugs andSubstance Abuse: ­ National Institute of Justice CrimeSolutions More Info ­ Institute for Research, Education, andTraining in Addictions View Site ­ Substance Abuse and Mental HealthServices Administration (SAMHSA) Learn More National Institute on Alcohol Abuse and Alcoholism professional educationmaterials

Upcoming Newsletter Themes If you would like to submit a story about innovative work you are doing or adescription of successes you have had within these thematic areas forinclusion in an upcoming newsletter, please send it tojheight@nazarene.org by the stated deadline.

March 2014 Volunteerism andService Learning

Submit by:February 14, 2014

Nazarene Compassionate MinistriesUSA/Canada Region

17001 Prairie Star Parkway Lenexa, KS 66220, USA

Phone: 1.800.310.6362 * Email: JHeight@nazarene.org

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