Building Ohio s Youth Recovery Continuum of Care. Sarah Nerad, MPA

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1 Building Ohio s Youth Recovery Continuum of Care Sarah Nerad, MPA

2 Table of Contents My Story Recovery Oriented System of Care Collegiate Recovery Overview Recovery High Schools Alternative Peer Groups Parent & Family Support Q&A 2

3 Learning Objectives Participants will be able to: 1. Describe what the youth recovery continuum of care is 2. Understand the needs and challenges of being a young person in recovery 3. Summarize ways to get involved with youth recovery initiatives 3

4 My Story & Missed Opportunities 4

5 My Story & Missed Opportunities 5

6 My Story & Missed Opportunities Student Government Orchestra Swim Team Honors Classes Part-time Job 6

7 My Story & Missed Opportunities Alcohol Marijuana Cocaine Ecstasy Adderall Codeine Hydrocodone Heroin PCP Soma 7

8 The Good News I Entered Recovery! What it Took: Crisis stabilization & detox at psych hospital Inpatient treatment at age 16 and 17 IOP counselor who understood youth recovery Non-traditional school of choice Alternative peer group Youth friendly mutual support groups Collegiate recovery program 8

9 My Story & What Helped: SAMHSA s Four Pillars of Recovery Health Home Purpose Community Adolescent detox Family Support School Mutual Support Group Supportive medical professionals always disclosed Transportation Employment Young people s meetings Women & Girls Adolescent Inpatient Safe and drug free living environment Service work/learning Supportive nonrecovering friends Adolescent IOP Environmental change Mentorship Leadership development 9

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11 Recovery Oriented System of Care Youth Recovery Oriented System of Care 11

12 Typical Addiction Career Age first drink Age first drug Age first trx Stable recovery? Addiction related consequences 31.1 Relapse/ recovery cycle +/- 10 years 41 Loss to the individual = 16 years of active use + about a decade of cycling 12 Laudet, 2014

13 CRC Student Addiction Career Age first drink Age first drug Age first trx Stable recovery/ college Addiction related consequences 21 Relapse/ recovery cycle +/- 5 years 26 CRC reduce recovery & relapse cycling by 15 years plus produce educated citizens Laudet,

14 Addiction is like other chronic diseases Young people need ongoing monitoring and support Sustaining Recovery 1 yr of abstinence ~5 yrs of abstinence Remission Risk of relapse drops below 15% Surgeon General s Report,

15 It s All About Social Connection & The Peer Group More abstinent friends = few relapses Predictor of relapse = hanging with old friends Develop sense of belonging = critical to identity development Wiebe, Cleveland & Harris, DePue & Hagedorn Watson Perron et al.,

16 Lasting Recovery Personal Identity Social Identity Lasting Recovery Sense of Belonging & Social Support New recovery friends & disengage from old friends Watson, DePue & Hagedorn, Wiebe, Cleveland & Harris,

17 Developmental stage of early adulthood provides highest risk for developing SUD College students are at particular risk due to binge drinking, exposure to drug experimentation and peer pressure. One of the heaviest drinking groups in society 1 in year olds has a SUD Addiction Among Young People The earlier someone starts using, the more likely they are to develop a SUD DePue & Hagedorn, NSDUH, Clapp,

18 Recovery Oriented System of Care A coordinated network of community-based services and supports that is person-centered and builds on strengths and resilience of individuals, families and communities to achieve abstinence and improved health, wellness and quality of life for those at risk for drug and alcohol misuse. William White 18

19 Recovery Oriented System of Care (ROSC) What helps our recovery? Jobs and schooling Recovery schools School based and student assistance services Collegiate recovery programs Drug courts Recovery housing Family support Peer to peer support and fellowship Mutual support groups Recovery coaches Spiritual side of recovery SAMHSA background paper,

20 Youth Recovery Supports As We Have Experienced It Major Challenges We Have Experienced For Moving Youth Recovery Support Forward: Under-Studied / Under-Funded Fragmented Systems (Mental Health and Addictions) Between Children and Adult (Health Care and Enforcement) Advocacy Issue Is Different For Youth Versus Adults (Stigma Issues) What We See Is Working for Young People (13-25) In Sustained Recovery: Youth Peer-to-Peer Support Early Intervention Family Involvement and Support Environmental Solutions and Recovery Support Services: Housing, Social Supports, Employment, Education, etc. Youth and Their Families With Lived Experience are an Under-Utilized Resource In Our Systems 20

21 Recovery-Oriented Activities Examples of Recovery Oriented Activities Prevention Intervention Treatment Post- Treatment Early screening before onset Collaborate between community agencies & school Stigma reduction activities Refer to intervention services Screening Early intervention Pre-treatment Recovery support services Outreach services Menu of treatment services Recovery Support services Alternative services and therapies Continuing care Recovery support services Check-ups Selfmonitoring 21

22 Youth Continuum of Care Prevention Early Intervention Treatment Recovery Evidence based SBIRT Developmentally appropriate Collegiate Recovery Recovery high school Early & often Involves family Involves family Alternative peer group Recovery housing Includes family Resiliency & protective factors Strong aftercare planning Includes family 22

23 Collegiate Recovery Overview 23

24 Yet, amid all the activities to prevent alcohol abuse or reduce alcohol-related harm, there has been relatively little attention directed to those students who are recovering from severe alcohol [and other drug] abuse or dependence Donald Misch,

25 Collegiate Recovery Programs A supportive environment within the campus culture that reinforces the decision to disengage from addictive behavior. It is designed to provide an educational opportunity alongside recovery support to ensure that students do not have to sacrifice one for the other. Association of Recovery in Higher Education 25

26 Collegiate Recovery Program Institutionally sanctioned and supported program for students in recovery from SUD seeking a degree in higher education CRPs seem consistent with continuing care paradigm within a recovery management system (ROSC) that experts recommend While sharing the goals of providing support, preventing relapse, and promoting academic performance, individual CRPs likely vary greatly on key dimensions Association of Recovery in Higher Education,

27 Scope of the Problem Campus is an abstinence hostile environment Acute care model doesn t work Underdeveloped continuum of care for youth and young adults Opioid epidemic Average age of onset for a SUD is 19 (Crum, 2011) 1 out of 5 young adults has a SUD (ONDCP, 2014) 27

28 Need for Recovery Supports New freedoms Less structure & supervision High rates of substance use Leaving behind established support system Hard to develop new peer group Balancing recovery & school Isolation & yielding to peer pressure Laudet et al

29 Scope of the Solution Almost 200 CRPs across the country Multiple conferences dedicated to CRPs Research is being funded & published Recognition from federal agencies System-wide expansion Foundation/nonprofits devoted to it 29

30 Benefits of CRPs Extends the continuum of care Parents can worry a little bit less Increases access to higher education Retention and graduation Change campus culture Students that embody what the university is trying to instill 30

31 CRP Movement Transforming Youth Recovery,

32 Timeline 1977 Brown University 1983 Rutgers University 1986 Texas Tech 1997 Augsburg 2005 SAMHSA/TTU Replication Grant 2013 TYR Seed Grants 32

33 Data Supporting Collegiate Recovery 33

34 Student Data 26 years average age 50% over the age of months average length of recovery 32% freshmen 35% transfer student 12% Veterans 8% relapse rate Laudet, 2013, 2014 &

35 Student Data 1/3 of students would not be in school right now if it weren t for the CRP Very high addiction severity, high treatment utilization and related consequences 59% charged with a crime 33% experienced homelessness 82% received addiction treatment 66% currently being treated for mental health Laudet,

36 Graduation and Retention CRP Average Graduation Rate 89% Average Institution Graduation Rate 60.5% CRP Average Retention Rate 91.8% Average Institution Retention Rate % Average GPA = 3.22 Laudet,

37 How You Can Support Your Local CRC Connect students & prospective students Help advertise the CRC Ask them to speak at your staff meetings, classes, committees, etc. Bring some colleagues/students/friends and tour the CRC Attend their events Scarlet, Gray & Sober tailgates in the fall! 37

38 Collegiate Recovery Community Ohio State s Collegiate Recovery Community 38

Ohio State s CRC Started March 2013 54 official members since inception Over 220 current and

39 Ohio State s CRC Started March official members since inception Over 220 current and prospective students serviced years old Mix of undergrads, graduate and professional students 39

40 Current Programming and Support Collegiate Recovery Community Two Dedicated Recovery Staff Members Dedicated Space Recovery Scholarships Peer to Peer Support Recovery House Social Events Professional and Leadership Development On Campus Recovery Meetings 40

41 Member vs. Participant Member Priority registration Option to live in recovery house 24/7 Access to lounge Social events (sponsored) Eligible for recovery scholarships Small groups Fill out application Participant Social events Access to lounge during business hours Peer-to-peer support Don t have to fill out application 41

42 CRC Dedicated Recovery Staff Sarah Nerad Program Manager In long-term recovery Ahmed Hosni Program Coordinator In long-term recovery 42

43 Current Dedicated CRP Space 1230 Lincoln Tower Amenities include: Coffee station Computers Prayer/meditation room Lounge area Media room Kitchenette Group project space Lockers Access to staff Arts & craft room 43

44 Recovery House at Penn Place Fall 2014 Can hold 28 students Accountability and Support Residence hall experience Recovery CA 44

45 CRP Signature Events Annual CRC Orientation 45

46 CRP Signature Events Annual CRC Graduation Dinner 46

47 CRP Signature Events Scarlet, Gray and Sober Tailgates 47

48 CRP Signature Events Party at the Park 48

49 CRP Programming Peer to Peer Support On-Campus Support Group Meetings Monthly Social Events Monthly Community Lunch 49

50 CRP Programming Leadership and Professional Development CRC Student Leadership Board Clean and Sober Fellowship 50

51 CRP Programming Recovery Tracks Individualized Recovery Plan Monthly Wellness Workshops Advocacy, Information and Referrals 51

52 CRP Programming Sober Spring Break Trip Service Opportunities Ohio State Alumni in Recovery Mentor Program 52

53 Recovery High Schools 53

54 Four criteria must be met: Mission is to educate students in recovery Award state recognized diploma Students must be in recovery and working a program of recovery Be available to any student in recovery who meets state/district eligibility requirements 38 currently operating across the country Recovery High School Association of Recovery Schools (2015) 54

55 Recovery High Schools Across the Country 55

56 Why Do We Need Them? 65-75% of teens relapse after leaving treatment Two biggest triggers for relapse among teens School stress Socialization process The earlier someone starts using the more more likely they are to develop a SUD Best time to intervene is at the onset of a SUD 56

57 RHS Favorability Map 57

58 Resources To Learn More Association of Recovery Schools (ARS) recoveryschools.org Can assist with needs assessment Free toolkit on their website Transforming Youth Recovery transformingyouthrecovery.org 58

59 Recovery High Schools What recovery supports currently exist in the schools? Do we screen for SUD in the schools? Where are our students going when they need treatment? What happens when they come home? 59

60 Collegiate Recovery Community Alternative Peer Groups 60

61 Alternative Peer Group (APG) Model Created in Houston over 40 years ago APG Model integrates peer connections with clinical practice through intervention, support, education and parent involvement Created to address the emotional, psychological, spiritual and social needs of young people Foundation of the model peer relationships (just like the ones that support addiction) are necessary for recovery Negative peer pressure to positive peer pressure Morrison, C. & Bailey, C,

62 62

63 Alternative Peer Group (APG Model) Key factors inherent in the model: Fun still get to be a kid Develop healthy decision making through fun and challenging activities Weekday and weekend social activities Healthy balance of love and limits Accountability and enforcing consequences Parents work a program of recovery Intensive out patient, individual therapy, weekly group meeting Morrison, C. & Bailey, C,

64 Alternative Peer Group (APG) Model Things to be cautious of: Group think Not learning how to function outside of APG/RHS/CRC Education and job skills need to be a focus Focusing too much on being a kid and not learning how to grow up Not properly phased out prior to graduation Morrison, C. & Bailey, C,

65 History of APGs Palmer Drug Abuse Program 1971 Lifeway International 1985 Started Three Oaks Academy Cornerstone Recovery 1999 Teen and Family Services 2002 APG Inc Hope for Today 2010 Morrison, C. & Bailey, C,

66 History of APGs Differ in format, location and cost Traditionally focused on adolescents Outcomes: Some began to fill the continuum of care and allow young adults to participate National relapse rate for teens is 50-90% Houston teens in an APG had a relapse rate of 8-11% Overall, their recovery rate is greater than 85% Morrison, C. & Bailey, C,

67 Alternative Peer Groups What substance free fun & activities do we have in the community? What recovery supports do we have in the community post-treatment? Where do the young people in recovery go for fun and fellowship? What recovery housing do we have for young people? 67

68 Collegiate Recovery Community Family Recovery Support 68

69 Parents & Youth Recovery Trust doesn t return immediately Dropping child off at a 12-step meeting Who is this sponsor person? Sober behavior sometimes looks like using behavior Anonymous friends Hanging out late Erratic emotions Drastic changes in people, places and things What happens when child tells parent something bad about their recovery group/meeting/peers? 69

70 Parents & Youth Recovery Talk about your family history Family must recovery together Parents and families need support too More shame here than with individual receiving treatment sometimes Resources need to be developed Treatment how to guide Support groups Peer to peer support 70

71 Resources for the Family Treatment Research Institute Parent Translational Research Center Questions to Ask Treatment Providers Continuing Care: A Parent s Guide to Your Teen s Recovery Partnership for Drug Dree Kids Parent Support Network hotline, peer to peer coaching, online resources, etc. 71

72 Parents & Youth Recovery What support for parents and families currently exist in central Ohio? What needs to be developed? 72

73 Thank you! Sarah Nerad go.osu.edu/recovery 73

Recovery 4/12/2018. Collegiate Recovery Programs: Extending the Continuum of Care for SUD Through Higher Education. Ahmed Hosni

Recovery 4/12/2018. Collegiate Recovery Programs: Extending the Continuum of Care for SUD Through Higher Education. Ahmed Hosni Collegiate Programs: Extending the Continuum of Care for SUD Through Higher Education Ahmed Hosni Learning Objectives Participants will be able to: 1. Understand the needs and challenges of being a young