Community Perspectives on Addiction Treatment

Transcription

1 Community Perspectives on Addiction Treatment Alan Mlinarchik, Co-Chair CBP SMSA Task Force Thursday, 15 Jan 2015 Presentation Overview: Saturation of Social Service Agencies: One Neighborhood 1. Defining the Issue: Saturation / Over Saturation 2. Focus on the Issue in Central Baltimore, and Citywide 3.History and Work of the SMSA Task Force 4.A Community Wishlist 1

2 Defining the Issue: Concentration of substance abuse treatment centers and other social service providers (mental health, recovery housing, food assistance, others) creates unique challenges for the Community Put the big rocks in first: Greatest concern is illicit activity on the street, surrounding and related to large outpatient opioid treatment facilities, specifically MMTs Treatment slots in several neighborhoods across the City (including Central Baltimore) far exceed local demand, while treatment deserts exist in other areas The issue is not the existence of treatment; it is the uneven distribution of treatment Citywide, and the problems inherent in concentration Defining the Issue: Saturation Red: Substance Use Disorder Magenta: Recovery Housing Yellow: Mental Health Teal: Counseling Blue: Other Social Services *Map & data compiled by the Old Goucher Community Association & the SMSA Task Force 2

3 Problems: Unhealthy ecosystem (the moat) of drug sales, drug use, and predation surrounding the clinics; open-air drug market Unhealthy for the patients 82% of clinic patients in travel from other zip codes Accessing treatment means crossing the moat; environmental queues make it difficult to avoid relapse Police reports: Common complaint: Theft of methadone on the street 80% of arrests: Sale of benzodiazepines 70% of CDS arrests: From other areas of the City Unhealthy for the saturated community Investment and development is stunted by fears of crime Residents avoid street life; illicit activity fills the void Derelict buildings contribute to downward spiral Disorder breeds disorder 3

4 History of the Saturation of Metropolitan Service Agencies (SMSA) Task Force 1. organized and supports the Task Force efforts 2. 3 representatives from Central Baltimore neighborhoods + Councilman Stokes co-chair the Task Force 3. A public brainstorming session was held in late October Two subcommittees were formed: Best Practices & Understanding the Regulatory Environment 5. Our areas of focus: Community and Patient Safety, Improved Treatment Outcomes, Access to Care Citywide Goals: SMSA Task Force Goals & Objectives: Prevent further saturation Mitigate the impacts of the existing concentration of treatment centers Ensure access to treatment in all areas of the City and State Objectives: Improve existing conditions on the street Legislation to make saturation a consideration when licensing a new clinic; it is in the interests of the patients, existing clinics, and the community Engage clinics, local and State agencies, community, and public safety agencies in a partnership to address areas of concern 4

5 Best Practices Subcommittee This subcommittee is seeking to develop a partnership with providers, public safety, and the Community to address issues in the areas around OTP facilities Researched best practices for MMT programs Identified SAMHSA s Tips as a solid foundation for Good Neighbor Agreements between the Community and OTPs Worked with providers to draft Good Neighbor Agreements Regulatory Environment Subcommittee The Regulatory Environment subcommittee specifically identified MMTP s as those drawing the biggest crowds and focused their efforts on researching Local, State & Federal Regulatory bodies in order to understand the licensing, regulation and oversight procedures This subcommittee is seeking to: ensure that saturation is a consideration when the state is licensing new clinics or expanding existing facilities, and that local agencies such as BHSB have increased input into the process incorporate the SAMHSA guidelines for OTPs (community relations) in the State licensing and oversight as requirements, rather than simply best practices 5

6 What s Needed: One Community s Perspective The recognition by all communities across the State that opioid addiction is everywhere, and that treatment needs to be everywhere as well. Discussions at both the City and State levels on where the unmet demand is for treatment, and how to best meet it without overloading specific communities or jurisdictions Frank discussions about the impacts of large outpatient OTPs on communities and patients, and how best to mitigate these impacts Legislation that authorizes and requires the OHCQ to assess the need for additional treatment in a given area, as part of its OTP licensing process, and to identify overserved or underserved areas, in an effort to better distribute treatment programs. A strengthening of requirements for OTP engagement with communities, and for the adoption of best practices. Questions & Answers 6