RD64 - 2011 Biennial Report on Substance Abuse Services


Executive Summary:
Overview

Title 37.2 of the Code of Virginia establishes the Virginia Department Behavioral Health and Developmental Services (DBHDS) as the state authority for alcoholism and drug abuse services. DBHDS works to make efficient, accountable and effective services available for citizens with substance use disorders. The department is responsible for the administration, planning and regulation of services for substance use disorders in the Commonwealth.

This report provides epidemiological information about the extent to which substance use disorders affect the residents of the commonwealth and reports on major activities of the department on their behalf.

Nature, Scope and Degree of Substance Abuse in Virginia

Epidemiological information about the numbers of residents using, abusing and dependent on alcohol and other drugs in Virginia is derived from the National Survey on Drug Use and Health (NSDUH), conducted annually under the auspices of the federal Substance Abuse and Mental Health Services Administration (SAMHSA). NSDUH data, collected from individuals age 12 and older, can be analyzed regionally and by age groups. Another source of information is the Office of the Chief Medical Examiner at the Virginia Department of Health which reports drug caused deaths on an annual basis.

Over half (52.37%) of Virginians drink alcohol, and nearly half of these (22.9% of all Virginians) engaged in binge drinking (drinking five or more drinks in one occasion) in the month prior to the survey. This proportion increases to 42.98% for those 18-25. Almost 8% of Virginians meet the criteria for abuse or dependence on alcohol (see Appendix C for definitions), and this rises to 19.45% for those 18-25. The proportion needing but not receiving treatment for alcohol use is 7.23% for the general population, rising to 18.44% in the 18-25 age group.

Illicit drugs include legal drugs that are used illicitly as well as drugs that are illegal. While fewer than 8% (7.56%) of Virginians age 12 and older used illegal drugs in the month prior to the survey, the proportion was about one-fourth (25.79%) for those between the ages of 12-25. In the past year, 9.84% Virginians used marijuana but, following the same pattern, 13.77% of those between 12-17 and 26.94% of those between 18-25 used this drug. The proportion of Virginians 12 and older using cocaine, including “crack”, was only 2.37%, but that is slightly higher than the national rate of 2.32%. The rate of use nonmedical use of pain relievers in the past year is 4.89% for the commonwealth as a whole, slightly lower than the national rate of 5%, but the rate in the southwestern region of the state is 5.62%. Age data indicate that this is a significant problem among youth in Virginia, with 6.91% of those 12-17 and 11.15% of those 18-25 reporting nonmedical use of pain relievers in the past year. The proportion of Virginians needing but not receiving treatment for illegal drug use is slightly less, at 2.45%, than the national rate of 2.53%, but the rate among youth is 4.07%, climbing to 6.99% for young adults ages 18-25.

The Office of the Chief Medical Examiner reports that drug caused deaths have increased 85.7% since 1999. In 2009, 713 individuals died due to this cause, with 38% of these deaths attributed to narcotics. Rates in the western part of the state (which includes the southwestern region discussed above) are considerably higher than other parts of the state, but the problem is clearly spreading.

Major Activities

"Creating Opportunities for People in Need of Substance Abuse Services: An Interagency Approach to Strategic Resource Development." At the request of the Governor, DBHDS prepared a strategic plan for substance abuse services and placed the plan on its website on November 21, 2011. This plan was the result of a two-stage, two-year process, involving advocates and consumers, providers, and other key state agencies. The resulting plan, "Creating Opportunities for People in Need of Substance Abuse Services: An Interagency Approach to Strategic Resource Development" ( http://www.dbhds.virginia.gov/documents/omh-sa-InteragencySAReport.pdf) , indicates that nearly $54 million is needed to improve access to services, address gaps in the array of services and provide adequate support services to those in need of substance abuse treatment.

"Senate Joint Resolution 73: The Study of Strategies and Models for Substance Abuse Prevention and Treatment." Chaired by Senator Emmett W. Hanger, Jr., this was the third and final year of a joint subcommittee that heard extensive testimony about a variety of programs and services in the commonwealth. These include regional approaches currently in place to address the problem of prescription drug abuse; the importance of prevention and other community coalitions; federal initiatives, including the Wellstone-Domenici Act and the Affordable Care Act; Recovery-Oriented Systems of Care models of service provision; homelessness and addiction; medication-assisted treatment; and the state’s Prescription Monitoring Program.

"Project REMOTE (Rural Enhanced Model for Opioid Treatment Expansion)." Project REMOTE was funded by a federal grant of $500,000 annually from SAMHSA for three years, starting in the fall of 2006. It concluded its federal funding in November, 2009. Project REMOTE provided treatment to 229 persons addicted to opiates, often through abuse of prescription pain medication. Evaluation data indicated that project participants were less likely to use drugs by injection, more likely to be abstinent from drug or alcohol use, and more likely to be employed or engaged in education than they were before receiving treatment through the project. DBHDS received funding from the Virginia Office of the Attorney General to continue to project for an additional year.

"Strengthening Families Prevention Grants." DBHDS used funds from the federal Substance Abuse Prevention and Treatment block grant to support Strengthening Families in 16 communities. These projects provided a weekly family meal and facilitation to “at-risk” families to improve communication.

"Interagency Prevention Grant." As a member of the Governor’s Office for Substance Abuse Prevention Collaborative, DBHDS partnered in the commonwealth’s application to SAMHSA for funds to develop a major statewide prevention initiative. Virginia was awarded $2,135,724 annually through 2015 and is targeting underage alcohol use. DBHDS is the administrator of the grant and is partnering with the Virginia Commonwealth University Center for School and Community Collaboration.

"Preventing Youth Tobacco Use." DBHDS worked with CSBs and the Virginia Foundation for a Healthy Youth to strengthen prevention activities aimed at reducing tobacco use by youth. Funded by the foundation and federal funds from the Substance Abuse Prevention and Treatment block grant, the programs reached over 35,000 individuals.

"Training in Clinical Supervision for CSBs and Other State Agencies." DBHDS provided skill and knowledge training to over 200 clinical supervisors from CSBs, state mental health facilities and the Department of Juvenile Justice Services to improve the quality of treatment services. The training also provided necessary training hours to qualify these professionals to provide supervision to those seeking licensing as clinical social workers or professional counselors, per regulations promulgated by the Department of Health Professions. Provided in nine sites over multiple days, these events were funded by the Substance Abuse Prevention and Treatment block grant.

"2010 Annual Meeting of the National Association of State Alcohol and Drug Abuse Directors, Inc. (NASADAD)." The Virginia Department of Behavioral Health and Developmental Services hosted the 2010 annual meeting of the National Association of State Alcohol and Drug Abuse Directors, Inc. (NASADAD) in Norfolk, Virginia. Approximately 250 individuals representing other states and national programs participated in the meeting.

"Virginia Summer Institute for Addiction Studies (VSIAS)." DBHDS provided staff and financial support from the Substance Abuse Prevention and Treatment block grant for the 2009 and 2010 VSIAS events held in Williamsburg. VSIAS provides an opportunity for Virginia substance abuse professionals to learn from national experts through lectures and participatory workshops in an intensive learning environment. In 2009, 339 persons participated and 304 participated in 2010.

"Virginia Association of Medication Assisted Recovery Programs (VAMARP)." This annual training event provides current information to professionals working with opiate-dependent individuals. DBHDS provides staff support and funding from the Substance Abuse Prevention and Treatment block grant. More than 250 persons attended each of the conferences offered in 2009 and 2010.

"Statewide Peer Services Conference." DBHDS collaborated with SAARA of Virginia and the Central Virginia Evidence-Based Practice Implementation Network in the planning and executing of the second conference focused on services for persons with substance use disorders and/or mental illness that are provided by people in recovery from these illnesses. Funded with federal Substance Abuse Prevention and Treatment and Community Mental Health Services block grant funds, the conference was attended by over 225 participants who represented a broad range of stakeholders.

"Regional Professional Development Conferences." To improve the quality of services offered in the community, DBHDS offered a variety of knowledge and skill building workshops on a regional level. These events were funded by the federal Substance Abuse Prevention and Treatment block grant.