This online discussion that will explore the activities and resources that sustain individual and community substance abuse recovery efforts. The online chat will explore what individuals, groups, organizations, schools, the criminal justice system and others can do to help those who need substance abuse treatment.

Janice Ford Griffin, Deputy Director at Join Together, leads the Demand Treatment! Initiative, a nationwide movement to increase the demand for screenings, intervention, and quality treatment for substance abuse. Demand Treatment! supports strategic efforts to increase the demand for treatment across the nation with information and interactive discussion on the world wide web at www.jointogether.org; and with intensive technical assistance to 15 communities that participate as Demand Treatment Partners. She has led the Join Together team on innovation and direct contact with communities, including supervision of the Robert Wood Johnson Fighting Back project - a grant funded project to 14 cities to measurably reduce their most serious substance abuse problems.

Griffin served as the Drug Policy Advisor to former Mayors Bob Lanier and Kathy Whitmire of Houston, which included directing the Houston Crackdown county-wide, public-private effort to develop solutions to problems associated with substance abuse. She also served as a regional coordinator for Texans' War on Drugs, a statewide drug prevention program, focusing on drug prevention and education programs for schools, civic and community organizations, and businesses.

Ms. Griffin has been active in many health-related organizations, and currently holds membership on CSAP's External Work Group for the National Prevention Plan, the Implementation Team for the Center for Substance Abuse Treatment (CSAT) National Treatment Plan; the National Advisory Council of the Centers for the Application of Prevention Technology for the Center for Substance Abuse Prevention (CSAP); and the Board of Directors of Education & Testing Programs, Inc. (ETP). She is a consultant to the Johnson Foundation Urban Health Initiative, and has served as a consultant to the World Health Organization's Committee on Primary Health Care for the European Region. She has been a member of the review committees for the CSAP Exemplary Programs, and the US Department of Education Drug Free Schools Exemplary Programs, and has served on the boards of directors of several national organizations addressing substance abuse. Ms. Griffin has also served as a consultant to several federal agencies, and been a member of the USDHHS Healthy People 2000 mid-course review team. She has conducted workshops and presentations at numerous state and national conferences. Griffin is a graduate of Fisk University in Nashville, TN.

MODERATOR: Janice Ford Griffin, Deputy Director at Join Together, leads the Demand Treatment! Initiative, a nationwide movement to increase the demand for screenings, intervention, and quality treatment for substance abuse. Demand Treatment! supports strategic efforts to increase the demand for treatment across the nation with information and interactive discussion on the world wide web at www.jointogether.org

MODERATOR: Welcome to the Recovery Month 2002 Web chat. Our host today is Janice Ford-Griffin, Deputy Director of Join Together. Our topic today is "Calling Community-Based Voices to Action". This online discussion will explore the activities and resources that sustain individual and community substance abuse recovery efforts. The online chat will explore what individuals, groups, organizations, schools, the criminal justice system, and others can do to help those who need substance abuse treatment. Please note that the views and opinions expressed by non-CSAT staff members in the Web chats and Web casts should not be interpreted as official CSAT policy, but as the views and opinions of the individuals participating in these events. We have a problem in Connecticut and in most other States when it comes to providing methadone as a withdrawal agent in a jail or prison system. In Connecticut, women do get treated in the women's prison and, if pregnant, are maintained for the course of the pregnancy. There are reports of two deaths in Orlando, FL, one of which was settled by Orlando for $3 million. Another State that is doing good work is Rhode Island. How can we best address this suffering for opiate addicts and Maintenance Patients?

SPEAKER_Janice Ford-Griffin: I think generalizations are terribly difficult to make with any health question. And certainly substance abuse disorders are no different. To ask what will work for the entire country is a question that should be put to Solomon. NIDA has produced the principles of affective treatment which strongly encourage a variety of treatment options and therapies according to an individual's problems. The guidelines offered by CSAT's improvement protocol are another body of work that should be consulted when considering treatment options. The caller identifies a significant problem but the information they provide is inadequate to be able to respond in the most accurate manner.

MODERATOR: How common is it for school-aged children to develop substance abuse problems? Taking into account that many kids are intimidated by those of their peers who may be experimenting with drugs or alcohol, how would you suggest kids steer their peers towards help?

SPEAKER_Janice Ford-Griffin: There is a much stronger correlation between drug and alcohol use by adolescents and children with their parents drug and alcohol use. Much of the attention that is paid to peer influence is done so without regard to family and home environmental factors. It is also done without regard to understanding the general health status of children and adolescents. There is very little discussion amongst the public about the link between children who self-medicate untreated and undiagnosed medical problems, learning disabilities, and other problems for which they may seek relief through alcohol and other drugs.

Farra: It seems like most people would rather send drug users to jail then spend money on treatment and rehabilitation. How can communities rally to change this?

SPEAKER_Janice Ford-Griffin: Communities need to become much more aware of their citizen's overall health status. We must pay more attention to the prevalence and incidence of infectious disease and other health issues associated with alcohol and other drug use. When we begin to recognize and address those problems as they occur throughout the population, we will really have a better understanding of the true extent of substance use disorders and consequently be able to encourage the broader health approach, which goes far beyond the criminal justice system and can hopefully aid in reframing the issue as a health issue.

MODERATOR: If an alcoholic is unwilling to seek help, is there any way to get him/her into treatment?

SPEAKER_Janice Ford-Griffin: There are many leverage points that individuals, families, employers, and others have used to "coerce" the person into treatment. The coersion can come from an employer. It can come from a spouse who may threaten to leave. It can come from a sense of jeopardy that the person may experience from many different sources. The successful coersive factor is different for different individuals.

Herbert Mann: How can community-based organizations support the recovery process?

SPEAKER_Janice Ford-Griffin: All persons in recovery recover in a community context as well as a family context. I think communities can be most helpful when they make a comprehensive effort to attend to the basic health needs of persons in recovery as well as the entire citizenry. There are many persons in recovery who complete a treatment program that has never attended to the individuals physical health problems. Left unattended, those physical problems almost assure relapse.

SKEETER531: How can our family and children services tell MMT patients they must get off methadone or lose children? Is this legal?

SPEAKER_Janice Ford-Griffin: There are 50 different States with 50 different alcohol and drug agencies and 50 different sets of alcohol and drug policies and criminal justice policies. A big feature of welfare reform provided States with complete autonomy in administering their welfare programs. There is precious little uniformity among the States, and a one-size answer will not fit all. What is legal in one State may not be legal in another.

SKIPPY: Are residential treament plans more effective than the traditional treatment plans? If so, how do we bridge the economic gap to allow the underpriviledged addicts access to these plans?

SPEAKER_Janice Ford-Griffin: Different treatment methodologies and approaches are appropriate and are prescribed based on an individual's addictions, health status, and other issues. So some underprivileged addicts may fair just as well in outpatient, intensive outpatient, or some other theraputic approach. What is most important is that the sufferer, whether underprivileged or not, has access to the comprehensive array of health services, whether inpatients or outpatients.

SUPAHFR33K!: Lots of TV and rock stars seem to glorify alcohol use. How can we change this so our kids aren't growing up to be like Ozzy Osbourne?

SPEAKER_Janice Ford-Griffin: Children's most significant role models are their parents and immediate caring adults.

SPEAKER_Janice Ford-Griffin: Media images often leave the impression of a problem being more widespread than in reality. Many young people who use alcohol and other drugs are more likely to be imitating the behavior of their parents or other older family members. The assumption of the influence of rock stars, athletes, and other celebrities is often overblown.

GUEST1: Can you recommend effective methods for teachers to communicate thier concern/observations about a child's possible use of drugs?

SPEAKER_Janice Ford-Griffin: Schools should be much more active in conversations about the overall health status of their students. To place such an emphasis on students' alcohol and drug use and ignore other health issues such as juvenile diabetes, obesity, sexually transmitted disease, bad dental health, and other such problems is misguided.

GUEST1: How can we persuade our legislators to address the drug problem by stressing treatment and prevention over the seemingly disproportiante level of funding which interdiction receives?

SPEAKER_Janice Ford-Griffin: We must emphasize to our legislators the prevalence of infectious diseases related to alcohol and drug abuse to get them to understand the true extent of the problem. The prevalence of these diseases, which are much more accurate indicators of substance use disorders, goes far beyond the walls of correctional facilities and the criminal justice system. When legislators truly understand this, we will be able to motivate them to support new solutions that actually get at these health problems. Once addressed and alleviated, there will definitely be less social strife and community disorder.

ANGEL: It appears that there are more liquor stores being built by the day. Is this true? Are there any laws being put in place to control the growth of this industry?

SPEAKER_Janice Ford-Griffin: Zoning is a local issue. Communities use this tactic along with public hearings and other protests to successfully limit the siting of liquor stores and other businesses and institutions through activism around the "Not In My Back Yard (NIMBY)" approach. Since September 11th, there has been a dramatic increase in the consumption of alcohol, particularly in Manhattan, though not necessarily related to the proliferation of liquor stores. Stress, post-traumatic stress syndrome, and other problems as well as personal taste, compel persons to seek alcohol. There are many cases of persons who drive or travel across State lines and other distances or go to other neighborhoods for the purpose of obtaining alcohol. So site restrictions are an important tactic that do not always correlate with restrictions of the growth of the industry or the sale of the product.

MS FOG: Are employers in the transportation industry held to higher drug abuse scrutiny than other industries? Could other professions benefit from the lessons they've learned?

SPEAKER_Janice Ford-Griffin: Absolutely. The Department of Transporation regulations for treatment as well as monitoring and testing, are perhaps the most stringent in the nation. Because those requirements apply to persons who are employed within that industry, as employees, they are very likely to be covered by good health insurance benefits and thus are able to access quality services from well qualified and credentialed professionals and other supports. Their access to these services in the private sector does not have to be reported to the Federal Government. As a result, there are many successes among these persons in the private sector that are not part of our discussion about statistics of successful recovery. The model that they offer for the services is "one that should be more widely known."

Daniel Quinn: How can we convince employers to better support Employee Assistance Programs since the workplace (A) has a vested interest in the health/productivity of their employees and (B) the workplace is a core institution through which those in need of treatment can be reached. Are EAP programs actually effective to be worth increased consideration?

SPEAKER_Janice Ford-Griffin: Persons with substance abuse disorders suffer from more health problems than other persons. The more successful we are in demonstrating this or in sharing these data with employers, the greater the likelihood we can pursuade employers that treating substance abuse will provide for lower healthcare costs for other problems. In as much as any employee health benefit program also includes dependence by extension, addressing substance abuse problems wherever they occur by their employees and dependents will result in lower health costs overall. A spouse of an employee who delivers a drug-infected infant can encounter healthcare costs of as much as $250,000 by the time you add the cost for delivery and infant care. It makes much more sense to provide benefits and have a person undergo a course of therapy to assure a sober delivery than to withhold treatment and thereby assure delivery of a drug-exposed infant. Healthcare costs which are intimately associated with the costs of production are the road to opening new discussions with employers.

SKIPPY: There are many instances where people who are arrested for DUI/DWIs are arrested again for the same offense. Should there be harsher penalties levied for such offenses? Should treatment be mandatory for the offenders?

SPEAKER_Janice Ford-Griffin: There are only 11 states that have mandatory assessments for persons arrested for driving under the influence. It certainly makes good sense to require an assessment and appropriate treatment for anyone convicted of driving under the influence.

Captain Wuzzles: If a child can refrain from drinking alcohol at the high school age, are they less likely to have a drinking problem later in life?

SPEAKER_Janice Ford-Griffin: There are contradicting studies in this area. In community after community, we have found that the majority of drug and alcohol abuse is occurring in young adults between the ages of 20-35. In fact, many of those are persons who did not use alcohol or other drugs before young adulthood participated in one or more prevention programs. There is no one inocculation that lasts a lifetime. Health factors change, environmental factors change, and associates change. Prevention efforts are certainly worthwhile, as is any effort to develop and assure good basic health practices including alleviating other health disorders that may be precursors to substance abuse.

MODERATOR: This question was submitted earlier...What role can businesses play in supporting recovery at the community level?

SPEAKER_Janice Ford-Griffin: I think comprehensive wellness and health programs are important factors that businesses and employers can support that can have an impact on reducing substance abuse.

SKIPPY:Are there plans in place to allow equal access to all treament plans? It would seem as though a person with health insurance would have more access to treatment plans than ones without. Also, is there some sort of outreach for homeless addicts?

SPEAKER_Janice Ford-Griffin: Many communities have various strategies and outreach efforts to the homeless. They vary from city to city. Many treatment benefits are negotiated by labor unions and other health consumer groups with employers. That is the kind of activity that must include considerations for substance abuse treatment in the job market.

MODERATOR: This question was submitted earlier...How is your organization supporting substance abuse prevention and addiction recovery through communities?

SPEAKER_Janice Ford-Griffin: Join Together supports a national initiative, Demand Treatment. In the United States, goods and services are provided in direct response to the public demand. If we continue to use substance abuse as something persons must hide and therefore not demand quality services, we will never get them. Demand Treatment is about increasing the demand and access for high quality services for brief interventions, screenings, and referrals to appropriate treatment. In order to achieve this, communities must integrate these services into the overall healthcare system and like other health services, make sure the public is aware of what they can expect as well as what they should demand when seeking those services. Join Together has a Web site, www.jointogether.org, that provides information about quality services and community strategies available around the Nation by people who are working on this issue.

MODERATOR: This question was submitted earlier...How do you handle children experimenting with alcohol if one or both parents is a recovering alcoholic?

SPEAKER_Janice Ford-Griffin: I think the most important thing is for that child to have a thorough physical examination to first rule out any complicating health issues that might be masked by the alcohol use.

Leslie: How do we serve people who demand treatment and it isn't available?

SPEAKER_Janice Ford-Griffin: If only we had that problem. It's so hard to believe there is unused treatment capacity in the Nation. For the most part, the unused capacity is in the outpatient setting. Our ability to increase expansion of treatment so that persons could get it throughout the healthcare delivery system is directly related to the activism and the demand and the expectation on the part ofevery person who enters the healthcare system.

MODERATOR: Our hour has concluded. For more information, visit Join Together at http://www.jointogether.org, and CSAT's Recovery Month Web site at http://www.recoverymonth.gov/2002. We would like to thank our host, Janice Ford-Griffin from Join Together, for her participation in this online event, and thank our participants for their questions. This transcript will be available shortly so that others may benefit from the dialogue. The chat has now officially ended.

MODERATOR: The chat has now officially ended.