Advances in Addiction & Recovery (Spring 2016)

SPRING 2016 Vol. 4, No. 1

E-Cigarettes: Cause for Optimism or Pessimism?

By Jack Stein, PhD, MSW

National Institute on Drug Abuse (NIDA)

2016 NAADAC Elections SALIS: A Trusted Source of Information in Addiction Science

NCAC I & II, MAC Grandfather Credential Offer This one-time offer for a NCAC I, NCAC II, or MAC national credential is only available for a limited time!

NCAC I & II Deadline: April 30, 2016 • MAC Deadline: May 31, 2016 The NCC AP announces an opportunity for all currently state credentialed/licensed addiction professionals to apply for the National Certified Addiction Counselor Level I or Level II, or Masters Addiction Counselor credentials based on their already demonstrated competence, skill, training, and experience.

No testing necessary!

MATT ANTONINO| PHOTOSPIN.COM

For more information about the NCC AP and its substance use disorder counselor certification and specialty endorsement opportunities at the national and international level, visit www.naadac.org/certification.

For details, including requirements for credentialing, recredentialing and exam schedule and fees, go to

www.naadac.org/certification

NAADAC is excited to announce the following speakers at its 2016 Annual Conference, Embracing Today, Empowering Tomorrow, in Minneapolis, MN, from October 7–11!

Sheila Raye Charles

daughter of legendary Ray Charles and The Ray of Hope Crusade for Recovery

Rokelle Lerner, MA

Senior Clinical Advisor for Crossroads Centre in Antigua

Mark Mishek, JD

President and CEO of the Hazelden Betty Ford Foundation

William C. Moyers

Hazelden Betty Ford Foundation’s V.P. of Public Affairs & Community Relations

w Open!

Registration No ailable!

Av s hip rs Sponso exhibits 2014 & 2015 be left sold out – don’t !

16 20 for t ou

Don’t miss out on learning from these wonderful speakers! www.naadac.org/2016annualconference

CONTENTS SPRING 2016 Vol. 4 No. 1 Advances in Addiction & Recovery, the official publication of NAADAC, is focused on providing useful, innovative, and timely information on trends and best practices in the addiction profession that are beneficial for practitioners.

NAADAC, the Association for Addiction Professionals, represents the professional interests of more than 85,000 addiction coun­selors, educators, and other addictionfocused health care pro­fessionals in the United States, Canada, and abroad. NAADAC’s members are addic tion counselors, educators, and other addic tionfocused health care professionals, who specialize in addiction prevention, treatment, recovery support, and education.

Mailing Address Telephone Email Fax

44 Canal Center Plaza, Suite 301 Alexandria, VA 22314 800.548.0497 naadac@naadac.org 703.741.7698

Managing Editor

Jessica Gleason, JD

Graphic Designer

Elsie Smith, Design Solutions Plus

Editorial Advisory Committee

Kirk Bowden, PhD, MAC, LISAC, NCC Rio Salado College Alan K. Davis, MA, LCDC III Bowling Green State University

■ F EAT UR ES

Carlo DiClemente, PhD, ABPP University of Maryland, Baltimore County

18 E-Cigarettes: Cause for Optimism or Pessimism? By Jack B. Stein, PhD, MSW, National

Rokelle Lerner, MA Cottonwood de Tucson

20 Understanding Addiction: An Interview with Dr. Darryl S. Inaba, PharmD, CADC-V,

Cynthia Moreno Tuohy, NCAC II, CDC III, SAP NAADAC, the Association for Addiction Professionals

Institute on Drug Abuse (NIDA) CADC III By Ashley Johnson

Robert Perkinson, MD Keystone Treatment Center

22 The Cost of Three Years of Marijuana Legalization in Colorado and Washington State

By Kevin Sabat, PhD and Jeffrey Zinsmeister, Smart Approaches to Marijuana

Robert C. Richards, MA, NCAC II, CADC III Willamette Family Inc.

24 SALIS: A Trusted Source of Information in Addiction Science By Judit Ward, PhD, MLIS

William L. White, MA Chestnut Health Systems

and William Bejarano, MA, MLIS ‘15 (Rutgers Center of Alcohol Studies), and Deann Jepson, MS (Advocates for Human Potential, Inc.)

27 The High Cost of Varying Standards for Certification and Licensure of Addiction Counselors in the United States By John Korkow, PhD, LAC, SAP

■ DEPA R TME N TS 4

President’s Corner: Learning About the National Addiction Studies Accreditation Commission (NASAC) By Kirk Bowden, PhD, MAC, NCC, LPC, NAADAC President

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From The Executive Director: Consider Being a Leader and Vote for One!

By Cynthia Moreno Tuohy, NCAC II, CDC III, SAP, NAADAC Executive Director

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Letter to the Editor: From Trish Hernandez, PsyD

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Membership: NAADAC Annual Awards and Nomination Process By Jessica Gleason, Communication Consultant

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Membership: Remembering Thomas E. Van Wagner By Cynthia Moreno Tuohy, NCAC II, CDC III, SAP, NAADAC Executive Director

10 Elections: Meet the 2016 Candidates for NAADAC Executive Leadership Positions

By Charles Jordan, NAADAC Contributing Writer

15 Certification: Field Advocacy Through Certification and Licensure By Thaddeus Labhart,

Article Submission Guidelines We are interested in accepting any interesting and topical articles that address issues of interest to addiction-focused professionals. Please submit story ideas and/or articles to Jessica Gleason at jgleason@naadac.org.

For more information on submitting articles for inclusion in Advances in Addiction & Recovery, please visit www.naadac.org/advancesinaddictionrecovery# Publication_Guidelines Disclaimer It is expressly understood that articles published in Advances in Addiction & Recovery do not necessarily represent the view of NAADAC. The views expressed and the accuracy of the information on which they are based are the responsibility of the author(s) and represent the wide diversity of thought and opinion within the addiction profession.

Advertise With Us For more information on advertising, please contact Elsie Smith, Ad Sales Manager at esmith@naadac.org.

Advances in Addiction & Recovery The Official Publication of NAADAC, the Association for Addiction Professionals ISBN: 978-0-9885247-0-5 This publication was prepared by NAADAC, the Association for Addiction Pro­fes­sionals.

Reproduction without written permission is prohibited. For more in­formation on obtaining additional copies of this publication, call 1.800.548.0497 or visit www. naadac.org.

Printed April 2016

MA, LPC, MAC, NCC AP Commissioner

17 Ethics: You Can Do What??? That’s Not in Your Scope of Practice! By Mita M. Johnson,

STAY CONNECTED

EdD, LAC, MAC, SAP, NAADAC Ethic Committee Chair

29 NAADAC CE Quiz 31 NAADAC Leadership

ALL IMAGES FROM SHUTTERSTOCK UNLESS OTHERWISE NOTED

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■ PR ES ID ENT ’S CORN E R

Learning About the National Addiction Studies Accreditation Commission (NASAC)

By Kirk Bowden, PhD, MAC, NCC, LPC, NAADAC President In my current roles as NAADAC President and college addiction counselor educator, I am frequently questioned about the National Addiction Studies Accreditation Commission (NASAC) of which I am a Com­missioner. As such, I have compiled some basic FAQs to share in the hopes of clarifying what NASAC is, what it does, and why NASAC accreditation is important for college and university addiction studies programs.

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What is NASAC? The National Addiction Accreditation Studies Commission (NASAC) is an academic accreditation organization for higher education addiction studies programs. It is the only accrediting body that represents addiction-focused educators and practitioners. It is also the only discipline-specific accrediting body that accredits all levels of higher education addiction studies programs, from Associate Degree program to Doctoral Degree programs.

What is the history of NASAC? In 2010, the Substance Abuse and Mental Health Services Ad­min­is­ tra­tion (SAMSHA) and its Center for Substance Abuse Treatment (CSAT) held a panel summit of expert stakeholders tasked with developing national educational standards for college and university addiction studies education programs. The standards were to be based on SAMHSA’s Technical Assistance Publication (TAP) 21, Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice.

At the conclusion of the summit, SAMSHA/CSAT encouraged the two primary groups representing academic educators and counselors, the International Coalition for Addiction Studies Education (INCASE) and NAADAC, the Association for Addiction Professionals, to jointly develop and implement a single accreditation body to assess and accredit addiction studies programs at regionally-accredited colleges and universities nationally.

What levels of addiction education does NASAC accredit?

NASAC accredits Associate, Bachelor’s, Master’s, and Doctoral Degrees addiction studies programs at regionally-accredited colleges and universities. NASAC also accredits Associate, Bachelor’s, Master’s, and Doctoral level certificate programs at regionally-accredited colleges and universities.

Why is NASAC accreditation important?

• To meet the challenges facing the addiction profession, a major focus toward developing the addictions workforce is to improve the competencies of those entering and serving in the profession. NASAC 4

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ac­creditation assures key stakeholders (students, legislators, future employers, and others) that a college or university’s addiction studies program meets or exceeds all NASAC standards and TAP 21 curriculum competencies and its faculty members are experienced and appropriately credentialed.

Some state licensing boards including the board in my home state of Arizona accept NASAC-accredited degrees as meeting academic requirements for licensing. Non-NASAC-accredited degrees must have each individual course reviewed and approved by the board. This is a distinct advantage for students.

Potential employers can be assured that a graduate of a NASACaccredited program has completed a high quality program that meets or exceeds national established standards.

NASAC accreditation requires a college or university to provide their students with a nationally standardized curriculum that includes all of SAMHSA’s TAP 21, Addiction Counseling Com­peten­cies. Competencies are the professional standards guiding addiction professionals and TAP 21 provides a comprehensive list of 123 competencies that all addiction counselors should master to do their work effectively.

Nationwide standardization of addiction studies curriculum is vitally important to the future health of our profession. Currently addiction studies educational standards and counselor credentialing varies greatly from state to state and from university and university. Some states require as little education as a GED and 300 clock hours of seminar-type training for an independent level certification, while other states require as much as an addiction counseling specific master’s degree to obtain an independent level license. NASAC has established a single set of academic expectations that meet national standards set by SAMHSA. NASAC accreditation standards can be used as guidance when developing or evaluating an addiction studies program at a college or university to make sure the program meets national standards. Its self-assessment allows colleges and universities to evaluate their program’s goals, curriculum, strengths, and weaknesses.

NASAC accreditation requires an institution of higher learning to commit to continuous quality improvement.

What are the steps to NASAC accreditation?

Step 1: Review NASAC Manual Download the NASAC Manual from the NASAC website (www.nasac accredititation.org) and review all aspects of the NASAC accreditation process.

Step 2: Complete and Return Application and Self-Study Obtain a NASAC application and instructions from the NASAC website. The application requests verification of the college or university’s regional accreditation information and information on the college or President’s Corner, continued on page 6 ☛

■ F R O M T H E E X E C U T I VE DI RE C TOR

Consider Being a Leader and Vote for One!

By Cynthia Moreno Tuohy, NCAC II, CDC III, SAP, NAADAC Executive Director

The election is almost upon us! The 2016 NAADAC Executive Leadership election, that is. In this year’s election, the NAADAC membership will elect the President-Elect, the Secretary, the Treasurer, and Regional Vice Presidents for the Mid-Atlantic, the MidSouth, the Northeast, and the Northwest for the 2016–2018 term.

The President-Elect requires the biggest commitment. He or she will serve a two-year term as PresidentElect and be mentored during that time by the current President. After those two years, the President-Elect is promoted to President, and the sitting President is promoted to the position of the Immediate Past-President for two years. A full six year commitment! All of the other officers and regional vice presidents serve two year terms, and are eligible to serve two such terms.

When you review the nominees profiled in this issue and read about their history of service, philosophies, and vision for NAADAC, please consider what qualities you would like to see in NAADAC leadership and what direction you would like NAADAC to go in the future. Please also consider becoming a leader yourself in your local NAADAC State Affiliate, or on a NAADAC National Committee. Many of our national leaders got their start at the affiliate level, where they were able to learn and be mentored by fellow leaders.

So, what qualities does it take to be a leader?

Honesty and Transparency Serving in an Affiliate or National office is not always smooth sailing— there are conflicts, differences of opinion, and conflicting priorities. It is important to understand the NAADAC Code of Ethics and to be firmly rooted in your own values. Being transparent about your values and holding yourself accountable is vital. In any position of leadership, modeling transparency and ethical responsibility will prompt constituents to follow down the same path.

Ability to Delegate and Share Trust your colleagues to work toward the common vision and mission.

Agree to share and delegate the work, and hold each other accountable for the work that you have each performed. Keep in mind that people have different strengths and weaknesses, and be open to re-adjusting

workload and task delegation to best utilize your team members.

Communication, Communication, and did I say, Communication We often feel we have communicated a message, an idea, or a process when in fact, the other person came away with an entirely different understanding. Staying in the conversation until you know that the other team members have understood your message is key.

Healthy communication is straight-to-straight communication, not communicating through triangulation, inference, or guessing. Avoidance of communication only digs the hole deeper and it becomes more difficult to pull yourself out! Talk issues through with mutual respect, and look for mutual understanding and mutual benefits. Keep in mind that each person has a unique perspective and set of experiences, and, as a result, has a unique sensitivity to how he or she feels and want to be treated. Be thoughtful about how to communicate the most effectively with each person.

Shining Your Positive Light It’s difficult to guide others when your own light is not shining! Sure, you are going to have tough days and times when you wonder why you showed up for this position—that is normal! We are dealing with other humans here—go ahead and shine your light! Be positive in the thick of the negative wave that is coming at you! High morale means high productivity and better decision-making. Avoid complaining about the negative and instead focus on finding a solution. A sense of humor in it all also helps! We all make mistakes, don’t see the train coming, and are in the dark at times. So what! It only means you are in a place with millions of others. Clear the brain and begin again! Have fun in the midst of the chaos—it will change!

Confidence with a Calmness There is confidence that comes from the ego and there is confidence that is calm and consistent. The ego-bound confidence may be flashy, but it is not usually what will last in the midst of a storm. Calmness, consistency, From the Executive Director, continued on page 6 ☛

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President’s Corner, continued from page 4

From the Executive Director, continued from page 5

university’s eligible degree program(s). For each program, the requested information includes: an overview; its mission and goals; a program self-assessment; a detailed review of its curriculum, including course descriptions, outlines, syllabi, and a TAP 21 course crosswalk; its educational modalities; and documentation of any practicum, internship, fieldwork, or field experience required. Programs are welcome to contact NASAC at any time with questions or for help with the application process. Once all of this material is complete, the application and supporting documents can be submitted by email, along with payment of the application fee.

Step 3: Peer Evaluation Upon receipt of the completed application and fee, NASAC will select an evaluation team made up of three peers matched for expertise and relevant field experience from similar NASAC-accredited programs to review the application and self-study. The team may consult with the program’s leadership, faculty, and/or staff and, if necessary, recommend an on-site evaluation. Upon completion, the evaluation team will make its recommendations to the NASAC Board of Commissioners.

Step 4: Decision by NASAC Board of Commissioners Upon reviewing the evaluation team’s written report and documentation, the NASAC Board of Commissioners will render one of the four accreditation decisions below and notify the institution by written notice: • Full Accreditation for a period of seven years; • Conditional Accreditation, requiring the program to submit a plan and timeline for specific program modifications, the submission of additional documentations, additional policies/procedures to be developed, or other relevant information, within three years; • Denial of Accreditation; or • The tabling of the application to allow for further development of the program, or submission of further documentation where indicated.

Institutions will have the opportunity to appeal any decision if there is disagreement with the Board’s decision.

and reliability are what grow confidence in a team. Having confidence does not mean having the lowest voice; instead, it means being calm enough not to have to raise your energy to that level of frenzy. There are going to be days that are tough; those are the days one needs to look for the person on their team who can build others up and motivate them to tackle the task at hand. You are that person as the leader of the team!

Remember, your confidence can dwindle as well, so make sure you have folks to go to who will build you up and keep your morale at a high enough level to be able to support others. You are modeling to your team and they will take cues from you. Check yourself—if you are low on positive energy, seek support and re-fill.

How do I get more information on NASAC? For more information on NASAC, including full guidelines, accreditation details, benefits, student membership and more, please visit http://nasacaccreditation.org.

How do I contact NASAC? If you have any questions, comments, or concerns regarding NASAC, please email info@nasacaccreditation.org.

In addition to serving as NAADAC’s President, Kirk Bowden, PhD, MAC, NCC, LPC, serves on the Editorial Advisory Committee for Advances in Addic­tion & Recovery. While serving in many capacities for NAADAC through the years, Bowden also serves as Chair of the Addiction and Substance Use Disorder Program at Rio Salado College, consultant and subject matter expert for Ottawa University, a past-president of the International Coalition for Addic­tion Studies Education (INCASE), and as a steering committee member for SAMHSA’s Center for Substance Abuse Treatment (CSAT), Part­ners for Recovery, and the Higher Education Accreditation and Competencies expert panel for SAMHSA/CSAT. Bowden was recognized by the Arizona Association for Alcoholism and Drug Abuse Counselors as Advocate of the Year for 2010, and by the American Counseling Asso­ciation for the Counselor Educator Advocacy Award in 2013, the Fellow Award in 2014, Outstanding Addiction/Offender Professional Award in 2015, and most recently the California Association for Alcohol/Drug Educators’ Lifetime Achievement Award in 2015.

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Commitment and Consistency Are you a person who does what you say you will do, when you say you will do it? Great leaders make commitments and then work to fulfill them! Great leaders motivate others through example by producing consistently high-quality work and encouraging others to do the same.

Consistency, day in and day out, is a visual verification of the commitment you exhibit as a leader. If you promise something, or agree to something, keep your word. People will follow you if they know they can count on you.

Creativity and Quick Thinking There are many times when a leader is faced with a decision that has to be made before all the information has been received. Being able to be creative and to draw upon on your life and work experiences to help form a decision is vital. Being a leader means taking the risk to do this and trust that the outcome will be positive, or if the outcome is not, to be able to reverse the decision and find a new creative solution.

Intuition There is not always a road map to follow as a leader. Years of experience and mentoring helped to build your intuition—trust yourself to make good intuitive decisions. If you don’t trust yourself—neither will others!

Ability to Inspire When you are clear with your vision and your passion, others will be inspired to invest in your vision. People need to feel inspired to keep moving forward and working toward a goal, especially in the addiction and helping worlds! You inspire by setting goals and working towards them.

Being a leader is not accidental—it is a calculated decision that requires thought, planning, and patience. Take the time to read each nomination and ask yourself, is this the person who I want to lead me and my colleagues for the next few years…and if not, why not you?

Cynthia Moreno Tuohy, NCAC II, CDC III, SAP, is the Executive Director of NAADAC, the Association for Addiction Pro­fes­sionals, and has worked as an addiction professional for over 35 years. She has been a trainer in Domestic Violence/Anger Man­age­ment and Conflict Res­olu­tion for over 25 years, as well as an international, national and state trainer in a variety of topics. Moreno Tuohy is also a curriculum writer in addiction screening and evaluation, counseling methods, conflict resolution, co-occurring disorders and medicated assisted treatment and recovery, and has written articles published in national and other trade magazines. She holds a Bachelor’s Degree in Social Work and is certified both nationally and in Washington State.

■ Le t te r to t he Ed ito r Dear NAADAC, I am the Lead Faculty and Program Director for Counseling at Ottawa University and am writing to share why Ottawa’s addictions counseling programs choose to pursue National Addiction Studies Accreditation Commission (NASAC) accreditation.

In 1999, I worked as a lead therapist for an intensive outpatient substance use disorder program for adolescents. My employer persuaded me to apply for certification as a substance use disorder counselor by offering to pay for the application and exam. Back then, my Master’s Degree in clinical psychology satisfied the educational requirements and my practicum at the Intensive Outpatient Treatment satisfied the experiential com­ponent. Without formal education in addictions, I applied for and was granted certification. Times have changed.

Today, many states have licensure for an addictions category and others have certification. This is evidence of our growth as a profession; the realization of our own professional identity. This is just in time as the United States Department of Labor, Bureau of Labor Statistics, projects that the need for substance abuse counselors will increase by 22% by 2020 (Bureau of Labor Statistics, 2016).

In an effort to meet the need for highly qualified addiction professionals in the United States, Ottawa University offers top tier, programmatic accredited, undergraduate and graduate programs in addictions counseling. Ottawa is a regionally accredited, non-profit, Christian university with a rich heritage spanning over 150 years. While our residential campus is

2016 Nebraska Annual Behavioral Health Conference

May 31–June 2 • Lincoln, NE This conference will examine the evolving landscape by turning to those with first-hand experience, redefining the behavioral healthcare field.

The Lincoln Marriott Cornhusker Hotel 333 S. 13th St. Lincoln, NE 68508 Earn up to 16

CEs Registration $55

Presenters at this conference will include some of the nation’s leading consultants and trainers who have synthesized stories of hope and creative inspiration to successfully cultivate innovation and translate it into Success, Resiliency, and Recovery.

Attendees will learn from the presenters’ experiences to integrate new ideas, to leverage change and will receive critical new tools for Success, Resiliency, and Recovery.

Who Should Attend?

Adult peer support specialists, family peer support specialists, providers, clinicians, care managers, health and behavioral health managed care organizations, ■ Adults, family members, youth, and young adults who utilize behavioral health services, ■ Individuals from child and adult-serving agencies, such as substance use and mental health, child welfare, justice, education, primary care, early care and education, and systems for transition-age youth and young adults, ■ Federal, State, tribal, territorial, and local policy makers, administrators, planners, leaders, and advocates, ■ Educators, technical assistance providers, and evaluators, and ■ Medical and legal professionals.

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located in Ottawa, Kansas, we also have campuses in Arizona, Indiana, Wisconsin, and online. Our addiction programs are accredited by NASAC. Why NASAC? Simple—community, consistency, and professional identity. NASAC’s educational standards incorporate academics and professional practice. NASAC outlines standards for all levels of our profession and educational programming. Lastly, NASAC standards reinforce professional identity, allowing for a common language from the classroom to the field.

I am exceptionally proud of our NASAC accredited addictions programs and have been privileged to witness the quality of our students as a clinical supervisor. Ottawa University is helping to meet the need for addictions professionals by producing high quality graduates ready for licensure or certification and ready to help those suffering from addictions.

With NASAC’s help, we are readying for tomorrow!

Sincerely, Trish Hernandez, PsyD Director of Graduate Programs in Counseling Ottawa University REFERENCES Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2016–17 Edition, Substance Abuse and Behavioral Disorder Counselors. Retrieved from http://www.bls.gov/ooh/community-and-social-service/substance-abuse-and-behavioraldisorder-counselors.htm (visited January 18, 2016).

NAADAC is now accepting submissions for the

William L. White Student

Scholarship Award This award was created to promote student addiction studies research and develop the importance of student research projects in NASAC accredited programs, NAADAC approved programs in higher education, or an accredited addiction studies higher education program acknowledged by the Higher Learning Commission (HLC) that provides research or education to the addiction profession. It is awarded annually to one graduate NAADAC Student Member and one undergraduate NAADAC Student member with the best student addiction research paper on the assigned yearly topic.

Award benefits: one undergraduate student will receive $1,000; one graduate student will receive $2,000 (award monies are submitted in the students’ names to their educational debtor), and each will be recognition at the 2016 NAADAC Annual Conference, October 7–11 in Minneapolis, MN. Application submission: The completed application form, academic transcript, letters of reference, and the research paper must be submitted together electronically to NAADAC at naadac@ naadac.org, Attention: William L. White Student Scholarship.

Submission Deadline: May 31, 2016 To register and for information about support or exhibit opportunities, please visit www.naadac.org/2016NEBehavioralHealthConference

For complete information, including the 2016 research paper topic, eligibility and application requirements, please visit:

www.naadac.org/white-scholarship-award

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■ M EM B ER S H I P

NAADAC Annual Awards and Nomination Process

By Jessica Gleason, Communication Consultant Each year NAADAC and its members celebrate and honor people and ­organizations that have achieved excellence in the treatment, recovery, ­prevention, medical and educational sectors of our addiction profession over the past year. Awards are given in seven categories and will be presented during NAADAC’s Annual Conference in Minneapolis, MN at the President’s Awards Luncheon. It is important to recognize and honor the distinguished services, accomplishments, and contributions of individuals and organizations to continue to elevate and motivate the profession. Make sure to get your nominations in by May 31st!

Award Categories The Addiction Educator of the Year Award recognizes an adjunct or full-time college/university professor who has contributed through academia to the addiction profession through mentoring students/student chapters, colleagues or addiction professionals and/or by providing on­ going research or other contributions that grow, enhance, advocate and educate for the addiction profession.

The Lifetime Honorary Membership Award recognizes an individual or entity who/that has worked in the addiction profession for at least 25 years, has established through research, publications, presentations or by other means the significance of the addiction profession and its professionals, had demonstrated leadership, service, and contributions to addiction profession, and has supported NAADAC’s mission, vision and Code of Ethics.

The Lora Roe Memorial Alcoholism and Drug Abuse Counselor of the Year recognizes a counselor who has made an outstanding contribution to the profession of addiction counseling.

To be eligible for this award, nominees must: be currently employed as an addiction counseling professional, and actively working as a counselor for not less than three years prior to receiving the award; be an active NAADAC member in good standing (the individual must be a voting member as opposed to an honorary or nonvoting member); have worked with clients (patients) for a sustained period with individual or group contact that fosters recovery from addiction disorders; preferably, be certified, registered or licensed as an addiction professional, although these qualifications are not mandatory; and have demonstrated to the satis­faction of one’s peers full compliance and support of NAADAC’s Code of Ethics.

The Medical Professional of the Year recognizes medical professional who has made an 8

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outstanding contribution to the addiction profession. To be eligible for this award, nominees must: be currently employed in the addiction profession and actively working as such for a minimum of three years prior to receiving this award; hold ­licensure as a Medical Doctor, Registered Nurse, Licensed Practical/Vocational Nurse in their respective state; be an active NAADAC member in good standing (i.e., the individual must be a voting member as opposed to an honorary member or nonvoting member); be working with clients/patients for a sustained period with individual or group contact that fosters recovery from addiction disorders; and have demonstrated to the satisfaction of one’s peers full compliance and support of NAADAC’s Code of Ethics.

The Mel Schulstad Professional of the Year Award recognizes an individual who has made outstanding and sustained contributions to the advancement of the addiction counseling profession.

The Organizational Achievement Award recognizes an organization that has demonstrated a strong commitment to the addiction profession and particularly strong support for the individual addiction professional.

To be eligible for this award, nominees must have been in existence for at least five years and cannot be affiliated with any other organization or company that sells, distributes or supports the consumption of alcoholic spirits or illicit substances.

The William F. “Bill” Callahan Award recognizes sustained and mer­i­torious service at the national level to the profession of addiction counseling.

To be eligible for this award, nom­ inees must have a minimum of 15 years in the addiction counseling profession or related ad­min­istration, and possess a strong dedication to the addiction profession as demonstrated by involvement in and commitment to a vari­ ety of key organizations.

Nominating Information Any NAADAC member in good standing may nominate any eligible individual NAADAC member for any of the above individual awards. Current members of the NAADAC Executive Committee are ineligible for all awards. To nominate an eligible addiction professional for a NAADAC award, please submit (1) a letter of recommendation stating how the nominee fulfills the award criteria; (2) at least three letters of support from three different sources (individuals, organizations, or agencies); (3) the nominee’s resume; and (4) a completed NAADAC Recognition and Awards Nomination Ac­knowl­edgement Form.

To nominate an eligible organization for the NAADAC Organizational Achievement Award, please submit (1) a letter of recommendation in­cluding a detailed description of the nominated organization and how the organization has supported the addiction profession; (2) at least three letters of support from three different sources (individuals, organizations, or agencies); and (3) a completed NAADAC Recognition and Awards Nomination Acknowledgement Form.

The NAADAC Recognition and Awards Nomi­nation Acknolwedgment Form requires the nominee to sign a statement acknowledging that he/she meets all of the eligibility criteria for the particular award and has “demonstrated to the satisfaction of one’s peers full compliance and support of NAADAC’s Code of Ethics throughout [his/her] professional career.” For access to the NAADAC Recognition and Awards Nomination Acknowl­e dgement Form and the specific eligibility criteria for each award, visit: www.naadac.org/recognitionand-awards.

All award nomination packets must be received by May 31, 2016 for con­sideration by the NAADAC Awards Committee.

To nominate an individual or organization, please send the required documentation to: NAADAC, the Association for Addiction Professionals Attn: Awards Committee Chair 44 Canal Center Plaza, Suite 301 Alexandria, VA 22314 Materials may also be faxed to the NAADAC Awards Committee (Attn: Director of Operations) at 800.377.1136 or sent by e-mail to naadac2@naadac.org (please put “NAADAC Awards” in the subject line). NAADAC does not pay for travel to the venue of acceptance. If the award winner cannot attend the presentation, the award will be sent to the recipient.

Questions?

For more information, please visit www. naadac.org/recognition-and-awards. For further questions, email NAADAC at naadac2@ naadac.org or call 800.548.0497.

Jessica Gleason is the Communications Consultant for NAADAC, the Association for Addiction Professionals. Her consulting projects include NAADAC communications, marketing, public relations, and digital media, including the NAADAC website, ePublications, and social media. She also continues on as Managing Editor for NAADAC's official publication, Advances in Addiction & Recovery magazine. Gleason holds a Juris Doctorate from Northeastern University School of Law in Boston, MA and a Bachelor of Arts Degree in Political Science from the University of Massachusetts at Amherst in Amherst, MA.

■ ME MBE R S H IP

Remembering Thomas E. Van Wagner

By Cynthia Moreno Tuohy, NCAC II, CDC III, SAP, NAADAC Executive Director In September of this past year, when many of us were celebrating National Recover y Month, NAADAC lost a dear friend and suppor ter, Thomas E. Van Wagner. He died at the age of 90, after serving the alcohol and drug addiction community for over 40 years and spending the last 47 years of his life in recovery.

While Tom ser ved on the boards of the the New York State Council on Alcoholism, the Long Island Council on Alcoholism, and the National Council on Alcohol and Drug Dependency, and taught at the Institute of Alcohol Studies at South Oaks Hospital in New York, he was most fondly known to many NAADAC members as the “In­ sur­a nce Man” after he made malpractice insurance available to alcohol and drug counselors through NAADAC and his Van Wagner Insurance Company in 1994. Being able to purchase individualized insurance for alcohol and drug counselors was groundbreaking at the time, and thousands of NAADAC members signed up and received the benefits of this protection.

After Tom sold the Van Wagner Insurance Company and moved toward retirement in 2005, he became the co-chair of the NAADAC Building Endowment Fund along with the first President of NAADAC, Mel Schulstad. Together, they brought the spotlight to raising funds to secure a more prominent site for NAADAC’s headquarters. Tom worked tirelessly to support NAADAC and its leadership over the many years we worked together.

We are happy to say that Tom has left a legacy at NAADAC and on the addiction profession.

A few weeks before he passed away, we let Tom know that NAADAC initiated a new insurance plan with his long-time colleague and friend, Pamela Van Cott, who worked with NAADAC for many years and now works for the American Professional Agency, Inc. We lost Tom, but his memory lives on daily in the work and service that we do at NAADAC. It was an absolute pleasure to know and work with Tom through the years. He is a giant who will be truly missed.

Cynthia Moreno Tuohy, NCAC II, CDC III, SAP, is the Executive Director of NAADAC, the Association for Addiction Pro­fes­sionals, and has worked as an addiction professional for over 35 years. She has been a trainer in Domestic Violence/Anger Man­age­ment and Conflict Res­olu­tion for over 25 years, as well as an international, national and state trainer in a variety of topics. Moreno Tuohy is also a curriculum writer in addiction screening and evaluation, counseling methods, conflict resolution, co-occurring disorders and medicated assisted treatment and recovery, and has written articles published in national and other trade magazines.

She holds a Bachelor’s Degree in Social Work and is certified both nationally and in Washington State.

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■ ELEC T IO NS

Meet the 2016 Candidates for NAADAC Executive Leadership Positions

By Charles Jordan, NAADAC Contributing Writer Help choose the future leaders of NAADAC! It’s election time again, and we are seeking new leadership to help us determine the direction of the Association. NAADAC holds elections every two years to select its Officers and four Regional Vice-Presidents (the other four Regional Representatives are selected on alternate years). This year, 10 well-qualified addiction-focused professionals have been nominated as candidates for NAADAC Executive Leadership. All 2016–2018 terms will begin on October 12, immediately after the 2016 NAADAC Annual Conference in Minneapolis, MN.

Voting starts on April 30, 2016 and ends May 30, 2016. All NAADAC members are eligible and encouraged to vote. Eligible members will receive email instructions for voting. Voting can be done online by logging into your naadac.org account or by mail.

Please read the following statements by and for the candidates in order to help inform your vote this spring.

Candidates for President-Elect President-Elect Candidate: Sherri Layton, MBA, LCDC, CCS Bourne, TX slayton@lahacienda.com Summarize the nominee’s NAADAC activities: Sherri was elected Mid-South Regional VP in 2012 and is currently ser ving her second term. She joined NAADAC’s Public Policy Committee in 2008 and serves alongside Michael Kemp as Co-Chair. Sherri worked on the Recovery to Practice Advisory Board for NAADAC, assisting with both the Situational Analysis and curriculum development, and co-presented one webinar. She has been actively involved with the National Conference and Advocacy in Action Conference for a number of years. As Mid-South RVP, Sherri has reached out to addiction professionals in Louisiana, Oklahoma and Arkansas, working to establish affiliates in those states; a goal not yet fully accomplished. On behalf of NAADAC she has made connections with the South Southwest ATTC and SAMHSA’s Regional Representative. Her membership in NAADAC, and its Texas affiliate, TAAP, dates back to the mid 1980s. Her involvement over the decades has been an important and meaningful part of her career. She served on the Texas Board of Directors as well as the Texas Certification Board in the past. She is active in TAAP’s Legislative Committee and frequently presents on advocacy, as well as other topics. She also chairs the golf tournament for TAAP’s Annual State Conference.

Philosophy statement of the nominee on the future of NAADAC: I believe the future of NAADAC holds great promise. We will grow our Layton, continued on page 11 ☛

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President-Elect Candidate: Diane Sevening, EdD, LAC Vermillion, SD diane.sevening@usd.edu Summarize the nominee’s NAADAC activities: Diane has been the RVP for the North Central Region for several years, and to say she has done an outstanding job is an understatement. She was president of SDAAPP for several years, and brought SDAAPP into the NAADAC family single handedly. Dr. Sevening was the driving force behind licensure in South Dakota, and worked extensively with NAADAC to see that massive project through to the end.

Philosophy statement of the nominee on the future of NAADAC: Dr. Diane Sevening believes in the NAADAC mission to lead, unify and empower addiction focused professionals to achieve excellence through education, advocacy, and knowledge, standards of practice, ethics, professional development and research. Further she is a strong advocate for addiction studies’ students. She is also dedicated to recruiting students to join NAADAC. These students will enhance the health and recovery of individuals, families, and communities and help strengthen NAADAC by emerging as future leaders.

Other qualifications of the nominee for this office: Dr Diane Sevening is an Assistant Professor, in the Department of Addiction Studies, at the University of South Dakota. She serves on the Board of Directors of INCASE a professional association of college\university professors specializing in addiction studies counselor education. She has also served as an addiction family therapist at St. Luke’s Addiction Center and as an Sevening, continued on page 11 ☛

Layton, continued from page 10

established position as an important contributor to the national conversation concerning addiction prevention, treatment and recovery, allowing us to influence legislation and policy. We will continue to support state affiliates pursuing licensure; assure addiction counseling is recognized as an important and unique skill set; increase opportunities for education assistance; advocate for addiction professionals in thirdparty reimbursement; insure healthcare integration does not mean absorption (and loss) of ad­diction related services. And support the growth of recovery support services and further emphasize a chronic care model. Our members and state affiliates are the life blood of NAADAC. Looking to the future we will continue to increase services to members and affiliates, adding valuable products and services that make membership so valuable. We will add to our excellent education offerings. Lastly, we will expand our partnerships with other organizations working on behalf of addiction, prevention, treatment,

and recovery. In combing our voicing our impact will be even greater.

Other qualifications of the nominee for this office: Sherri began her career in addiction treatment working as an evening tech in 1977.

She was first certified as an Alcohol and Drug Abuse Counselor in 1983. She has worked in outpatient and residential setting with adolescents, adults and families, in privately funded non-for-profit and for-profit organizations. She has been closely involved with training new counselors since early in her career. Sherri is currently the Outpatient Services Administrator for La Hacienda Treatment Center and has been with them for 23 years. She oversees intensive outpatient programs, continuing care, and alumni services. Sherri is part of the Executive Leadership Team and represents the organization in regulatory, legislative, and policy activities at the local, state and national level.

Although her roots are in counseling, Sherri found herself more and more in administrative

and leadership roles, prompting her to complete an MBA with an emphasis in leadership in 2009.

Day to day Sherri’s primary focus is to ensure the counselors she works with have the resources and support needed to provide the best service possible to their patients. She sees the role of NAADAC Present Elect much like that—doing all she can to support NAADAC’s addiction professionals in their important work.

Sevening, continued from page 10

alcohol and drug counselor at the University of South Dakota student health services.

Dr. Seven­ing presented at the 2011–2015 NAADAC conferences, the 2010 National Con­ ference on Addiction Disorders (NCAD), the 2007 Advocacy in Action Conference and the 2006 Work­force Development Summit. As NAADAC student committee chair, she was vital in the implementation of the NAADAC William L. White student scholarship award in 2015.

Candidate for Secretary-Elect Secretary Candidate: John Lisy, LICDC-CS, OCPS II, LISW-S, LPCC-S Cleveland Heights, OH jlisy@msn.com Summarize the nominee’s NAADAC activities: John currently is serving in his second term as NAADAC Treasurer. In that capacity he has worked with NAADAC staff to improve fiscal planning, reporting and accountability. Currently the Treasurer, Executive Committee and Management Staff have focus on developing a plan for long term fiscal stability. NAADAC is currently in the process of implementing that plan. John currently serves on the NAADAC Executive, Finance and Personnel committees and represents NAADAC on the National Addiction Studied Accreditation Committee.

John has completed two terms as the Mid-Central Regional Vice Presi­ dent. He has served on the Mentoring Committee and the NAADAC Public Policy Committee. John was awarded the NAADAC Advocate of the Year for 2005 at the Leadership Conference in Washington, DC. John helped to secure national funding for workforce development for NAADAC and the State of Ohio. He chaired the Workforce Development Committee, a statewide coalition representing all segments of the Ad­dic­ tions Prevention and Treatment Community. The committee assembled a comprehensive team that developed and implemented a strategic plan for the addictions workforce. On the state level, John was President of OAADAC from 2001 to 2003. He has served as State Legislative Chair.

John received the OAADAC August Meuli Humanitarian Award.

Philosophy statement of the nominee on the future of NAADAC: I believe the future of NAADAC is dependent on both strong fiscal management and a vision for the Addictions profession that will enable all of our members to continue to provide excellent services to their clients. The Board and Staff have taken significant steps to insure that NAADAC is financially secure. As Treasurer I worked with the staff to be good stewards of our current resources and expand our ability to bring in grants and

contracts that are in harmony with our core mission. I would like to continue to serve on the Executive Committee to help us take that next step in service to our members. NAADAC is the premier organization for addictions professionals. We as addiction professionals have an obligation to the individuals we serve to advocate for a system of care that has the capacity to provide them the help they need. Capacity includes both “treat­ment on demand” and a workforce that is empowered by the most current scientific advancements of our field. These principals should guide us as we seek new resources to maintain a combination of strong advocacy and leadership in Addiction Workforce Development.

Other qualifications of the nominee for this office: Education/ Licenses – John’s education includes a Masters in Social Work from Case Western Reserve University. He is also a Licensed Independent Chemical Dependency Counselor – Clinical Supervisor, an Ohio Certified Prevention Specialist II, a Licensed Independent Social Worker- Supervisor and a Licensed Professional Clinical Counselor- Supervisor. Current work experience – John Lisy is the Executive Director of the Shaker Heights Youth Center. While serving in this position since 1996, he has been responsible for a 350% increase in funding and a 450% increase in services.

More important than the increase in services is the excellent quality of services the Center provides to its consumers. The Center received the Exemplary Prevention Award from the Ohio Department of Alcohol and Drug Addiction Services three times: for the Mentoring Program, 1999, the Intensive Prevention Program, 2001 and the Academic Success Aid Program, 2004. The Center received the Matthew Dunlop Prevention Services Award and John received the Calvin Thomas Community Leadership Award from the Alcohol and Drug Addiction Services Board of Cuyahoga County. Licensure – John worked to build the Ohio Coalition for Chemical Dependency Licensure. He very actively served on the Coalition for seven years from its inception through the passage of the licensure bill.

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Candidate for Treasurer Treasurer Candidate: Mita M. Johnson, EdD, LPC, LMFT, ACS, LAC, MAC, SAP Evergreen, CO mitamjohnson@comcast.net Summarize the nominee’s NAADAC activities: Ad­vocating for the addictions workforce and engaging in activities specific to recruitment and retention are important to Dr. Mita Johnson. It has been a privilege and honor for Mita to be associated with NAADAC. For over 8 years, Mita has been actively participating at NAADAC and the Colorado state affiliate (CAAP). Mita is a NAADAC member and served as a Board Member for 2 years, has been the South­ west Regional Vice President for 3 years, served on the Executive Com­ mit­tee for 3 years, and been the Ethics Chair for 1 year. Mita had the opportunity on behalf of NAADAC, to teach pharmacology and other topics to clinicians working in Hong Kong. At the Colorado state affiliate level, Mita has served as Treasurer, President, Past-President, Events Chair, and committee member. Mita is currently mentoring 3 NAADAC mem­ bers including an awardee of the NAADAC Minority Fellowship Grant Philosophy statement of the nominee on the future of NAADAC: I believe that the future of NAADAC rests squarely on how well NAADAC represents and serves its members. Now more than ever before the addic­ tions treatment workforce needs to strengthen its professional identity.

Pressing issues that require NAADAC’s and our attention include insuf­ ficient workforce capacity to meet demand: lack of national credentialing and portability of credentials; unenforced parity laws; inadequate com­ pensation; changing profile of those needing services; and societal and organization stigmatization and judgment. Insurance payors and govern­ mental programs (VA, Medicare, Medicaid, etc.) have been slow to accept

addiction credentials as genuine mental health/behavioral health cre­ dentials on the same par as other mental health credentials. There is profound need for workforce recruitment, development, and retention.

The future of the addictions treatment workforce would be time-limited if it were not for the efforts for NAADAC and its state affiliates. The future of NAADAC will lie in its ability to build up the next generation of profes­ sionals. I believe that the future of the addiction treatment profession will require NAADAC to initiate and engage in opportunities to network, edu­ca­te, train, empower, mentor, unify, develop, collaborate, and advocate.

Other qualifications of the nominee for this office: Currently, Mita has over 25 years of experience in the world of addictions, having worked in outpatient clinics and private practice settings. Mita is core faculty at Walden University in the Masters in Clinical Counseling Program and has taught addiction-specific courses for Walden. Mita provides online train­ ings for Seven Cedars Live and Online Trainings, and trains all over her state and nationally. Mita has been involved with her regional ATTC, and sits on a committee at the state SSA. Advocacy is important; Mita serves on 2 governor-appointed councils specific to behavioral health integration as well as being a member of several addiction-focused committees. Mita is a consultant to the state regulatory body regarding addictions and mar­ riage and family issues. Mita actively supervises the next generation coming into our profession. She speaks whenever she can on issues related to excel­ lence in clinical care, culturally-sensitive care, ethics, boundaries, and pharmacology/neurology. Mita served as Treasurer of the Colorado Association of Addiction Professionals; a faith-based community nonprofit; and the local Boy Scout troop. Mita is very detail oriented and committed to an ethical work ethic.

Candidates for Mid-Atlantic Regional Vice President Mid-Atlantic RVP Candidate:

Mid-Atlantic RVP Candidate:

Susan Coyer, MA, AADC-S, MAC, SAP, CCJP Huntington, WV susancoyer@outlook.com Summary of NAADAC activities: Susan has been a member of NAADAC for over 20 years. She has served as Mid-Atlantic Regional Vice President since the fall of 2014. During this time, she served on the annual conference, membership and ethics committees. Prior to taking office as RVP, Susan served on the NCC AP as secretary and ethics committee chair. In addition, she also chaired the NCC AP policies and procedures and co-chaired strategic planning/marketing committees. Susan previously served on the NAADAC membership, annual conference, bylaws and public policy committees. As affiliate president, Susan represented the West Virginia Association of Alcohol and Drug Abuse Counselor on the NAADAC Board of Directors for four years. Prior to becoming President of WVAADC she was the affiliate secretary and chaired the affiliate confer­ ence, regional training seminar, membership, nominations and awards committees.

Philosophy statement on the future of NAADAC: I believe that the future of NAADAC lies in the strength of membership and advocacy.

NAADAC members are challenged by reductions in revenue streams, increased workloads and lower salaries than other healthcare professions.

Qualified professionals are needed to meet the demand for treatment.

Ron Pritchard, BS, CSAC, CAC Virginia Beach, VA ronpritchard@verizon.net Summary of NAADAC activities: Has been person­ ally active in a wide spectrum of NAADAC activities that include advocacy at the White House, Federal and State Pub­lic Comment sessions, local General Assembly and Virginia Board of Coun­seling. Past Mid-Atlantic RVP. Current Mil/Vet Affairs Chairperson.

Cur­rent State Affiliate Chair with 30% membership growth in one year.

Volunteer at NAADAC Annual Conferences. Active in Forging NAADAC role in Dept of Defense SA Education and Certification programs.

Provides yearly SA training at Uniform Services College, Bethesda Grad­ u­ate Psychiatric Nursing Program. Provides state-wide training, education and Town Hall Sessions. Serves on Governor’s Boards of Beh Health, Council for SA Services, and SA Public Policy Committees Participating in funding, policy and strategic planning for state’s SA/MH service delivery.

Philosophy statement on the future of NAADAC: I believe that the future of NAADAC will be determined by the strength and vision of our leadership. NAADAC leaders must be alert and active to ensure that the policies of our federal and state governments do not relegate the roles of qualified Addiction Professionals to para-professional status. The RVP position requires active leadership with responsiveness to the needs and

Coyer, continued on page 13 ☛

Pritchard, continued on page 13 ☛

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Coyer, continued from page 12­

Workforce development, including a national credential, is needed to attract and maintain a professional, well-trained workforce. Competitive salaries and solid benefits including tuition reimbursement are vital to in­creasing the number of practicing addiction professionals. Advocacy efforts at the state and national level are crucial to support our workforce and continue to decrease stigma associated with addictive disorders.

Advocacy is essential in ensuring quality addiction prevention, treatment and recovery support services as well as improving treatment access. Ad­ vanc­ing legislation at the national and state levels is imperative to continue to support and enhance addiction services. Established partnerships with stakeholders allows NAADAC to have a meaningful impact on these areas and lead our members through these exciting times. Affiliates, needed in all states in our region, play a key role in these efforts. NAADAC remains the premiere organization dedicated to individuals working in addiction services and will continue to serve as the most relevant voice for the addic­ tions field.

Other qualifications for RVP-Mid-Atlantic: Susan has over 27 years of experience in the addictions field in direct practice, clinical and administrative management of outpatient and residential addiction treatment programs. She has been active with NAADAC and WVAADC for over 20 years. She has participated in a number of ATTC Training of Trainers events including the Buprenorphine blending products and Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency (MIA:STEP) providing training across the region. She was a mentor in the ATTC Leadership Institute in West Virginia. In 2001, Susan was the recipient of the West Virginia Certification Board for Addiction and Prevention professionals Lisa Grossi Award for inspiring dedication in the field of addiction prevention and treatment. She is a former surveyor with CARF (Behavioral Health Division) and is currently serving on a number of committees and task forces.

Pritchard, continued from page 12

concerns of all the regional membership. RVP communication and interaction with the NAADAC board must be achieved in such a way that information and services pertaining to the membership is fast, accurate and effective. As a member of the NAADAC Board of Directors, the RVP must take an active role in ensuring NAADAC and state affiliate Boards do more than meet to plan conferences. Our future is NAADAC leadership’s responsiveness to our membership and its ability to recognize and carry out effective advocacy strategies. NAADAC must continue to have a respected seat at the decision table regarding addiction strategies at the state and federal level.

Other qualifications for RVP-Mid-Atlantic: Ron Pritchard has experience. He has participated as founder, or co-founder of a number of

successful non-profit organizations with focus on education, prevention, treatment, and recovery in the MH/SUD population. Retired from the US Navy and past Head of Addiction Medicine Services at Portsmouth Naval Hospital, he continues to be active in lecturing and training in Department of Defense and other audiences of Behavior Care providers.

Self-employed, Ron is the owner/manager of Addictions Program Consulting and provides guidance and strategic planning for program development. Ron serves on a variety of boards and councils and constantly advocates for the inclusion and growth of the addiction counseling field. Ron continues to participate in, or coach interventions with substance abusing clients and their families.

Candidate for Northeast Regional Vice President Northeast RVP Candidate: William A. Keithcart, MA, LADC, SAP Essex Junction, VT william.keithcart@uvmhealth.org Summary of NAADAC activities: I have actively been involved with the Vermont State Affiliate and been President for the past five years.

Philosophy statement on the future of NAADAC: I believe the future of NAADAC is to enhance our professional colleagues by providing them with national level guidance, support and training to further their clinical skills. Membership within this organization allows for professional networking and advocacy. I believe that my fifteen years as a substance use disorder clinician has enabled me to see where the profession has been and where we need to proceed.

Other qualifications for RVP-Northeast: Licensed Alcohol and Drug Abuse Counselor – Vermont Substance Abuse Professional Board Certified Clinical Psychotherapist EMDR Part II Training

1978 Master of Arts in Psychology – University of West Georgia, Carrollton, Georgia 1975 Bachelor of Arts in Psychology/Sociology – Mercer University, Macon, Georgia President – Vermont Addiction Professionals’ Association (VAPA) Board Member – Vermont Association for Mental Health & Addiction Recovery Vermont Department of Health, Agency of Drug and Alcohol Programs – Treatment Engagement Work group member Life member – Appalachian Trail Conservancy Life member – National Eagle Scout Association Member – Burlington Partnership for a Healthy Community Member – Green Mountain Club Member – Vermont Addiction Association of Treatment Providers (VAATP) Involvement with University of Vermont Collegiate Recovery Community Collaboration with Turning Point Center of Chittenden County

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Candidate for Mid-South Regional Vice President Mid-South RVP Candidate: Matt Feehery, LCDC Houston, TX matt.feehery@nemorialhermann.org Summary of NAADAC activities: Matt has been a member of TAAP and NAADAC for over 30 years. He has served as interim Region Vice President for NAADAC prior to Sherri Layton’s election 4 years ago. He was legislative representative to NAADAC in the 1990’s in addition to all his service to the Texas affiliate. He has been TAAP President, TAAP Finance Committee Chair­ man, TAAP Education Committee Chairman and also held numerous leader­ship roles with the TAAP Houston chapter, including President and num­erous times as TAAP Spectrum Conference Chair. Matt has been active on the local, state and national legislative levels and a long time advo­cate the addiction professional. He has actively supported the edu­ cation and training of licensed counselors in Texas and beyond. The treatment organization that Matt is employed with has been a leader in preparing counselor interns and providing practicum opportunities for students. They also have an accredited ABAM addiction medicine fellowship for physicians.

Philosophy statement on the future of NAADAC: First and foremost, I believe NAADAC’S role is to protect, promote and enhance the addiction profession, including its related credentials. As an advocate for public policy and legislation that advances the educational and treatment options for Americans, NAADAC must continue to provide an important voice of influence and unite addiction professionals. Collaboration with government agencies, research and educational institutions, addiction industry treatment and support organizations and other credentialing representatives is vital for maintaining credibility and significance in an ever-changing healthcare environment. The future of NAADAC and the recognition of our licenses and credentials requires that addiction professionals from all states come together to advance the profession through attraction and activism. As Regional VP, I will continue the work to reach out and support the states in the Mid-South Region, inviting the nonmember and less active states to participate more fully in NAADAC for both their input and benefit.

Other qualifications for RVP-Mid-South: Matt has served NAADAC and its Texas affiliate well over the years. His business perspective, commitment to the addiction profession and leadership will help the region achieve its objectives to engage the regional membership and grow participation in NAADAC.

Candidates for Northwest Regional Vice President Northwest RVP Candidate: Malcolm Horn, LCSW, MAC Billings, MT mhorn@rimrock.org Summary of NAADAC activities: MAC since 2010 President Elect of Montana Chapter 2012–2014 President of Montana Chapter 2014–current As current President, is a strong advocate for utilizing technology to expand practice and education for practitioners Provides Clinical Supervision for Addiction Counselors since 2010: focusing on evidence-based practices, rural practice, ASAM practices and philosophy.

Currently provides supervision for 13 practitioners.

Has been counseling chemical dependency and process addictions for over 10 years.

Philosophy statement on the future of NAADAC: I believe that the future of NAADAC exists in our ability to be advocates for and effect social change. The disease of addiction requires specialized treatment and unique skills: as a practitioner and teacher I believe that effecting change happens by not only improving counseling skills of practitioner, but also societal understanding of the disease of addiction. Society is at a place where pivotal choices are being made in terms of health care and mental health services: addiction is one of leading co-morbid conditions that affects people across all economic and cultural lines. As the leader in the country, I believe that NAADAC is obligated to ensure that practitioners and clients have 1) access to resources including education, supervision, and evidence-based practices, and 2) we are advocating on a political level to change the stigma of addiction and mental health on a legislative platform in 50 states. I believe that, as the president of NAADAC, and the principle addiction practitioner for Montana’s ECHO, I am uniquely positioned to fulfill these goals.

Other qualifications for RVP-Northwest: Currently all but Horn, continued on page 28 ☛

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Northwest RVP Candidate: Arturo P. Zamudio, CADCII Springfield, OR artz@wfts.org Summary of NAADAC activities: Art has been on the Oregon Board (AADACO) for the last 6 years. Within that time Art has held the positions of Secretary, Treasurer, Vice President and is the current President of Oregon. Each position he has successfully shown up and followed through with the responsibilities that came with these positions. Art has shown integrity and perseverance while on the board as it has gone through many challenges. He also sought help and direction from the Regional Vice President, President of NAADAC and Executive Director of NAADAC in times of need to ensure NAADAC’s code of ethics and bylaws were followed. Art has participated in State and National trainings and has always lended a hand when needed.

Philosophy statement on the future of NAADAC: I believe that the Country is finally realizing the importance of Alcohol and Drug treatment. I also believe that NAADAC should be the light to show both our government officials and our Alcohol and Drug professionals the way.

Through advocation and training we can help steer the ship of recovery to all those that need it and/or provide it. As you can see from some of my other answers I get involved to be part of a solution rather than be a by­stander that points out the problems. I believe NAADAC provides solutions and I wish to be part of it in any way I am allowed. My hope is to share NAADAC’s message which “is to lead, unify, and empower addiction focused professionals to achieve excellence through education, advocacy, knowl­edge, standards of practice, ethics professional development and research.”

Other qualifications for RVP-Northwest: Art has held several positions within his community to further support the Alcohol and Drug pro­fession. Other than being the current President of Oregon Zamudio, continued on page 28 ☛

■ CER T IF IC AT I O N

Field Advocacy Through Certification and Licensure

By Thaddeus Labhart, MA, LPC, MAC, NCC AP Commissioner As addiction treatment professionals, most of us know the domestic treatment environment is rapidly changing. In the United States, ap­ prox­imately 22 million people age 12 or older have substance use conditions.1 Unfortunately, nation-wide, only around 11% of those with addiction disorders receive treatment.2 As part of the relatively recent implementation of the Affordable Care Act, approximately eight million people have signed up for exchange insurance policies and an additional 7.2 million have signed up for Medicaid, since 2013.3 This tremendous influx of covered individuals with substance use disorders has led to an increased need for addiction treatment professionals as well. The U.S. Bureau of Labor Statistics projected a 22% increase in the number of jobs for counselors specializing in substance abuse and behavioral health disorders between 2014 and 2024. Clinical supervisors and managers across the nation report difficulty finding qualified addiction candidates. Fur­ther­more, many states and organizations are integrating addiction care with behavioral health and primary care. With all of these rapid changes taking place, how can one help preserve and grow the addiction treatment field?

One way is through membership. If you aren’t a member already, you or your organization can join NAADAC, the Association for Addiction Professionals. NAADAC’s core mem­ ber­ship benefits are centered around education, professional identity promotion, advocacy, and professional services. Education services include free CEs, a free subscription to Advances in Ad­ dic­tion & Recovery, and reduced rates for many conferences, periodicals and continuing education opportunities. Professional identity services include substantial networking opportunities, a strong code of ethics and connection opportunities with your state affiliate. Advocacy occurs at the federal level which greatly impacts funding and policy at the state level. Professional services include access to NAADAC’s career center, reduced rates for malpractice and liability insurance, and substantially reduced rates for national certification fees.

A less traditional but powerful way to advocate for the addiction field is though advocating

for national standards and obtaining cer­tificafi­cation/licensure. The addiction field must re­ tain its identity and specialty if it is to survive in this new age of healthcare integration. Ensuring strong certification standards are in place is one way to ensure the addiction field survives. A re­view of publicly available state credentialing/ licensing requirements shows significant variance in requirements for state addiction credentials. Some states do not require a degree while others do. Some states have certification while others have licensure. Others require limited education, with a diploma or GED, and no certi­ fi­cation or licensure. The National Certification Com­mission for Addiction Professionals (NCC AP), under NAADAC, offers numerous national addiction certifications. All but the peer cre­ dential require the national applicant to be certified or licensed in their state. In addition, NCC AP cre­dentials and endorsements have minimum edu­c ation, training and experience requirements.

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While dozens of studies show the positive impact of organizational accreditation (JCAHO, CARF, etc.) in improving healthcare client outcomes4, safety, and satisfaction, ironically few studies have been conducted to find out if certification or licensing of counselors improves client outcomes. Furthermore, there is little evidence in the literature to support client outcomes are better with degreed versus non-degreed counselors.

The often referenced Columbia University study from 2012, Addiction Medicine: Closing the Gap between Science and Practice, suggests that gap is complex and has many contributing factors including a lack of training and utilization of evidence-based practices (EBP’s) amongst many other factors such as, but not limited to: • poor quality assurance practices; • inadequate insurance coverage of patients; • limited use of pharmacological interventions; and/or • poor outcome tracking, and no existing overarching body for addiction science and treatment.

The study goes on to recommend a number of strategies including, but not limited to, enhanced screenings, enhanced training for addiction staff, national standards and licensing for addiction facilities, instituting the National Institutes of Health’s recommendation to create a single institute addressing substance use and addiction, and expanding the addiction counselor workforce. With so many concerns and recommendations, how does one wade through it all when promoting minimum requirements?

Minimum requirements need to be based in research and science.

Studies show some correlation between outcomes and the use of evidencebased practices.5 A large survey of MSW graduates showed social workers should be trained in substance use disorder content.6 Other studies show Up to 15 CEs available

N AADAC & AAPA

ANNUAL TRAINING INSTITUTE MAY 2–3, 2016 | ANCHORAGE, ALASKA

NAADAC, the Association for Addiction Professionals and AAPA, the Alaska Addiction Professionals Association are pleased to announce the Annual Training Institute, May 2–3, 2016 in Anchorage.

Two-day Intensive Sessions with National Trainers Sheila Raye Charles, daughter of legenday Ray Charles,

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and The Ray of Hope Crusade for Recovery

Dr. Darryl Inaba, author of Upper, Downers, All-Arounders ■ David Dickinson, SAMHSA Region 10 Representative ■ Don Coyhis, president of White Bison Greg Bennett, presenting “Improving Professional Knowledge,

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Skills, Attitudes and Abilities for Adolescents” ■

Tom Durham, presenting “Motivational Interviewing with the Crimeagenic and Addiction Population” ■

Cynthia Moreno Tuohy, author of Rein in Your Brain

Sponsorships and Exhibits Available! Contact HeidiAnne at 703.741.7686 ext. 101

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patient outcomes are most correlated to patient-therapist relationships.7 As with the Columbia University study, the NCC AP considers these types of studies when setting minimum education and content requirements.

Research and policy from the Substance Abuse and Mental Health Services Administration (SAMHA) as well as the Centers for Medicare and Medi­ caid Services (CMS) are also strongly considered. When drafting test ques­tions for our certification exams, NCC AP takes the time to utilize and cite reputable literature. At the NCC AP, we are often asked why does one have to have a college degree for many of our certifications? The answer, while simple, is not always easy to digest. As most of us know, it has to do with payer (CMS-varies by state, commercial insurance, etc.) requirements. That is not likely to change any time soon. And thus we incorporate minimum degree requirements as applicable. The NCC AP believes non-degreed addiction professionals need an avenue for certification and practice as well. Two of our national credentials recognize this: the National Certified Addiction Counselor Level I (NCAC I) and the National Certified Peer Recovery Support Specialist (NCPRSS) credentials.

One of the biggest reasons to promote certification and licensure is accountability. Certification and licensure carry minimum requirements.

At the national level and typically at the state level, these requirements include minimum education, code of ethics adherence, supervised experience, and passing of a standardized exam. This assures the certified/ licensed practitioner has a minimum skill set, ongoing education requirements, and accountability to a body for any patient or public concerns and complaints. These types of standards are common among many flourishing fields such as social work and primary care. The NCC AP strives to base its certification requirements around ongoing research, national policy and payer requirements.

The NCC AP encourages all addiction practitioners to obtain addiction specific certification/licensure in their respective states. We also encourage addiction practitioners to obtain national certification through the NCC AP. Possessing the national credential signifies one has met national standards. It also helps promote a set of national standards which is necessary to strengthen our identity as a profession. For ways you can become nationally certified or promote standards within your own state, please visit www.naadac.org/ncc-ap.

Thad Labhart, LPC, MAC, serves as the Clinical Director for Community Counseling Solutions which provides behavioral health and addiction services in numerous counties throughout Oregon. Labhart is a long-standing board member of the Addiction Counselor Certification Board of Oregon and currently serves as treasurer for the National Certification Commission for Addiction Professionals. He is a current NAADAC member and has been working in the addiction field for 18 years.

FOOTNOTES Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Results from the 2010 National Survey on Drug Use and Health: summary of national findings. Rockville (MD): SAMHSA; 2011.

2 Office of National Drug Control Policy. 2013 national drug control strategy [Internet].

Washington (DC): White House; 2013 [cited 2013 Sep. 13]. Available from: http://www. whitehouse.gov/ondcp/2013-national-drug-control-strategy 3 Kasier Family Foundation Medicaid enrollment survey conducted by Health Management Associates, October 2015. Courtesy of the Pew Charitable Trusts, 2015.

4 Alkhenizan, A., Shaw, C. Impact of Accreditation on the Quality of Healthcare Services: a Systematic Review of the Literature. Annals of Saudi Medicine. 2011;31(4):407-416. doi:10.4103/0256-4947.83204.

5 Martino, S. Strategies for Training Counselors in Evidence-Based Treatments. Addiction Science & Clinical Practice. 2010;5(2):30–39.

6 Bina et al. Survey of MSW graduates. Journal of Social Work Education. Fall 2008: 44(3).

7 Luborsky, McLellan, Woody, O’Brien, Auerbach. Therapist Success and Its Determinants.

Arch Gen Psychiatry. 1985;42(6):602–611.

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You Can Do What??? That’s Not in Your Scope of Practice!

By Mita M. Johnson, EdD, LAC, MAC, SAP, NAADAC Ethics Committee Chair Over the last several years there has been renewed and oftentimes heated discussion regarding “scope of practice” within the healthcare disciplines including addictions counseling, and amongst professional and legal regulatory bodies. Scope of practice and standards of practice can be viewed as two sides of the same coin.

Scope of practice is defined here as those activities a clinician can ethically and legally engage in as a result of education, training, skills development, and supervised experience. Standards of practice is defined here as those activities that are considered to be evidence-based, outcomedriven treatment modalities specific to co-occurring mental health and substance use disorders.

Scope of practice wasn’t meant to create a turf war; scope of practice was meant to protect both the client and the clinician.

While it is important to maintain the specialized identities of our numerous disciplines, scope of practice is meant to protect our clients first—not us. It is important to keep sight of this fact: our clients deserve to be and expect to be protected from fraudulent, incompetent, and unethical practitioners. Since we claim to be professionals, their expectation is that there are ways to monitor and regulate clinicians when they are not offering competent, safe, and effective services. The public also expects that clinicians who claim to be professionals have standards, guidelines, and rules that they adhere to.

The scope of practice of credentialed and licensed healthcare professionals is defined in each state’s laws in their practice act, by profession.

To adopt or modify the scope of practice of any healthcare profession requires the actions of the state’s legislature, which ultimately has the authority to make such changes. The paradigm shifts around healthcare delivery are noteworthy; the underlying assumptions around who can deliver what services are changing in evolutionary ways. We have more baby boomers who are aging in our systems. We are treating the first generation of HIV patients who are identifying themselves as older adults. Daily, there are advances in technology that allow us to reach out further and deeper. Advances in evidence-based

and outcome-driven treatment are occurring on a continual basis. Clinicians are being asked to deliver quality services with fewer dollars.

Healthcare practices must evolve as healthcare demands and capabilities change.

The Affordable Care Act and other healthcare reforms are invested in collaborative, integrated care teams with numerous credentials at the table. The collaborative care team is charged with tearing down barriers to treatment, promoting improved and targeted care by competent providers, and developing flexibility across disciplines as each discipline maneuvers overlapping scopes of practice. It is important for us to acknowledge that professions don’t own a skill or activity and many professions utilize the same skill or activity; a profession is not defined by any one activity. Each healthcare discipline is unique because of the entire scope of activities that work together under its purview. That is true in the world of co-occurring mental health and substance use disorders as well.

While many mental health disciplines can claim to have addictions treatment within their scope of practice, not every clinician has developed the skills or knowledge necessary to provide addiction-specific services. Practice acts are the logical vehicle to require licensees to demonstrate that they have the requisite training and competence to provide a service; scope of practice is demonstrated through specialized education, training, skills development, and supervised experience. Scope of practice changes occur when there is an established history of a practice being utilized by the profession, advanced education and training with supportive

evidence, and appropriate regulatory frameworks. Working with addictions requires an understanding of the science of addiction, including pharmacology of drugs of addiction and brain science, in order to provide competent and safe services to clients. A new professional comes into the field with entry-level skills and techniques—not advanced techniques. With supervised experience comes advanced tools and broader scope of practice.

Working with addictions is a specialization that is much needed in today’s healthcare environment. Having addictions within one’s scope of practice means that the clinician has education, training, skills, and supervised experience that offers clients access to quality healthcare based on the best available clinical evidence, expertise, and research. NAADAC and NCC AP have been at the forefront encouraging clinicians, regardless of discipline, to make sure they have evidence that supports their claims as a substance use and addictive behavior disorders clinical provider. Collaborative care practitioners who consider addiction services to be within their scope of practice have an ethical and legal obligation to make sure that their scope of practice competencies are valid, targeted, evidencebased, and client-focused.

Mita M. Johnson, EdD, LAC, MAC, SAP, has a doctorate in Counselor Education and Supervision, an MA in Counseling, and a BA in Biology. She is a licensed professional counselor, licensed marriage and family therapist, and licensed addiction counselor, along with earning the national Master Addiction Counselor (MAC) and Department of Transportation Substance Abuse Pro­fes­sional (SAP) certifications. Johnson has two supervisory credentials (ACS and AAMFT) and am a NCC. In addition to being a core faculty member at Walden University, she maintains a private practice where she sees clients and supervisees who are working on credentialing. Johnson is the Past-President of the Colorado Association of Addiction Professionals (CAAP) and am the Ethics Chair and Southwest Regional VP for NAADAC. She speaks and trains regionally and nationally on topics specific to counseling skills, ethics, supervision, and addiction-specific services. She has been appointed by the Governor of Colorado to two committees working on behavioral health integration and transformation, is a consultant to the state regulatory agency that regulates our professions, and is a consultant and committee member at the state Office of Behavioral Health.

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E-Cigarettes: Cause for Optimism or Pessimism?

By Jack B. Stein, PhD, MSW, National Institute on Drug Abuse (NIDA)

C

igarette smoking, which leads to more than 400,000 deaths in the United States annually, remains the number-one preventable cause of sickness and mortality. Thus it is no wonder that there is so much interest in, as well as controversy over, e-cigarettes, which simulate the cigarette smoking experience but without producing tar and other combustion products in tobacco smoke. The promise—and the implication of much of the marketing of these increasingly popular devices—is that they could be a safer, less toxic alternative to conventional cigarettes and even could work as cessation aids for people who are trying to quit smoking.

E-cigarettes produce a flavored aerosol that looks and feels somewhat like tobacco smoke and, in many cases, delivers rewarding nicotine.

Unfortunately the evidence for e-cigarettes’ possible benefits as well as their safety remains very limited at this point, creating a challenge for policymakers, addiction counselors, and others in healthcare who are in a position to influence the health of Americans. We just don’t know yet how enthusiastic versus cautious to be about vaping, particularly when it involves a substance as addictive as nicotine.

The uncertainty is reflected at the level of world public health authorities, whose reactions to the new devices are widely varied. An executive agency of the UK’s Department of Health, Public Health England, asserted last August that e-cigarettes were “95% safer” than cigarettes and recommended maximizing the public health opportunities they present.1 However, their report was strongly criticized in The Lancet for a lack of evidence base on which to make such an optimistic claim.2 American authorities have been much more cautious, with the U.S. Centers for Disease Control and Prevention sounding alarms over e-cigarettes and their advertising.3 One concern is the safety of the fluids and flavorings used in e-cigarettes. Testing of some e-fluids has found known carcinogens and toxic chemicals (such as formaldehyde and acetaldehyde) in the vapor, as well as metals.4 Whether there will be long-term health consequences as a result of repeated exposure to these chemicals is unknown. At the time of this writing, the U.S. Food and Drug Administration is proposing extending regulatory requirements for tobacco products to e-cigarettes and the fluids used in them, meaning that products would need to be safety tested and approved.

An even more pressing question is the relationship between e-cigarette use and traditional cigarette smoking. Much of the optimism of the Public Health England report is based on the idea that e-cigarettes may be a substitute for more harmful options. If this were true, then given the known health risks of cigarettes it might be reasonable to be optimistic about the new devices, even given the unknowns about the safety of vaping. However, increasingly there is evidence—albeit preliminary—that e-cigarettes are supplementing tobacco products without necessarily reducing the use of the latter. They may even be opening the door to cigarette use among individuals who might not otherwise smoke.

That this could happen among teen users is particularly worrying. Since their emergence on the market, e-cigarettes have skyrocketed in popularity among U.S. adolescents. According to the 2015 Monitoring the Future Survey of drug use and attitudes among middle- and high-school students, 18

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9.5% of 8th graders, 14.0% of 10th graders, and 16.2% of 12th graders used e-cigarettes—more than use traditional cigarettes.5 Cigarette smoking by teens is currently at an all-time low, after declining steadily since the 1990s. A recent NIDA-funded study found that teen e-cigarette users may be more likely to graduate to conventional tobacco products than non-users: In a sizeable, demographically diverse cohort of California 14-year-olds, e-cigarette use at baseline was associated with a greater likelihood of cigarette use over the subsequent year than no e-cigarette use.6 E-cigarettes are similarly popular among U.K. teens. Nearly one fifth of over 16,000 14- to 17-year-old school students surveyed in North West England in 2013 reported trying or purchasing e-cigarettes.7 This study was interesting because it suggested British teens view e-cigarettes as a new type of recreational drug rather than as a replacement for cigarettes: E-cigarette use was linked to other risky substance-related behaviors such as drinking to get drunk, binge drinking, avoiding age restrictions to obtain alcohol, and cigarette smoking. Only 15.8% of e-cigarette users had never smoked conventional cigarettes.

Many, though not all, e-cigarettes deliver nicotine to the user, and this is a particular concern for adolescents, who are more susceptible to developing nicotine addiction. Early nicotine exposure produces lasting sensitization to nicotine and appears to alter synaptic connectivity.8 Younger age at smoking initiation increases risk of later heavy smoking.9 Nicotine exposure has also been found to sensitize mice to the rewarding effects of cocaine, via an epigenetic pathway (changes in gene expression), and thus nicotine may act as a “gateway drug.”10

It is still unclear how teen use of e-cigarettes translates to nicotine exposure. Students in the 2015 MTF survey were asked for the first time about what was in the fluid they vaporized on the most recent occasion they used an e-cigarette, and over 60% across all grades reported vaporizing “just flavoring.” Since products are currently unregulated and their labeling often suspect, there is no way to know how accurately teens can assess what they are really consuming.

Also it is possible that enjoyment of flavorings alone could lead to using nicotine fluids and/or flavored tobacco products. Most teens who ever have used tobacco started with a flavored product—63% started with flavored e-cigarettes.11 Concerns over teen e-cigarette use and possible smoking initiation must be weighed against any potential benefits of existing smokers switching to e-cigarettes—the harm-reduction potential on which the U.K. public health recommendations rest. Here again, the data are preliminary, and as yet, no head-to-head comparisons between the efficacy of e-cigarettes and FDAapproved smoking-cessation aids such as nicotine patches have been conducted. But there is some evidence that e-cigarettes may not be the smoking-cessation aids the makers and consumers had hoped. A recent review and meta-analysis

of 38 previous studies of e-cigarette use and smoking cessation funded by the National Cancer Institute found that adult smokers who had used e-cigarettes had 28% lower odds of quitting compared to smokers who had not used these devices.12 Limiting the analysis to studies of smokers with an intent to quit did not alter the results.

Public health campaigns and legislation restricting smoking in public places have successfully stigmatized smoking over the past decades, which is expected to lower the burden of disease and mortality from cigarettes. It would be tragic if, by newly glamorizing a smoking-like behavior, e-cigarettes and vaping led to a reversal of the current trends by increasing cigarette use in teens or actually prolonging cigarette use in smokers trying to quit. But more research is needed to know how much weight to place on these fears. Are teens using e-cigarettes the ones who are more likely to use tobacco products anyway? Are smokers who experiment with ecigarettes already less likely to quit? Finding some answers to these and other questions is an urgent priority, and thus NIH is supporting wide research in this area. We hope and expect to know much more in coming years.

Dr. Jack Stein joined NIDA in August 2012 as the Director of the Office of Science Policy and Communications (OSPC). He has over two decades of professional experience in leading national drug and HIV-related research, practice, and policy initiatives for NIDA, the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of National Drug Control Policy (ONDCP) where, before coming back to NIDA, he served as the Chief of the Prevention Branch.

FOOTNOTES McNeill, A. et al. E-cigarettes: an evidence update. A report commissioned by Public Health England. (Public Health England, 2015).

2 The Lancet. E-cigarettes: Public Health England’s evidence-based confusion. The Lancet 386, 829 (2015).

3 E-cigarette ads reach nearly 7 in 10 middle and highschool students. at http://www.cdc.gov/media/ releases/2016/p0105-e-cigarettes.html 4 Grana, R., Benowitz, N. & Glantz, S. A. E-Cigarettes:A Scientific Review. Circulation 129, 1972–1986 (2014).

5 Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G. & Schulenberg, J. E. Monitoring the Future national survey results on drug use , 1975-–2015: Overview, key findings on adolescent drug use. (Institute for Social Research, The University of Michigan, 2016).

6 Leventhal, A. M. et al. Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence. JAMA 314, 700 (2015).

7 Hughes, K. et al. Associations between e-cigarette access and smoking and drinking behaviours in teenagers. BMC Public Health 15, 244 (2015).

8 Smith, R. F., McDonald, C. G., Bergstrom, H. C., Ehlinger, D. G. & Brielmaier, J. M. Adolescent nicotine induces persisting changes in development of neural connectivity.

Neurosci. Biobehav. Rev. 55, 432–443 (2015).

9 National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. (Centers for Disease Control and Prevention (US), 2012). at http://www.ncbi.nlm.nih.gov/ books/NBK99237 10 Levine, A. et al. Molecular Mechanism for a Gateway Drug: Epigenetic Changes Initiated by Nicotine Prime Gene Expression by Cocaine. Sci. Transl. Med. 3, 107ra109– 107ra109 (2011).

11 Ambrose, B. K. et al. Flavored Tobacco Product Use Among US Youth Aged 12–17 Years, 2013-2014. JAMA 314, 1871 (2015).

12 Kalkhoran, S. & Glantz, S. A. E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. Lancet Respir. Med. 4, 116–128 (2016).

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Understanding Addiction

An Interview with Dr. Darryl S. Inaba, PharmD, CADC-V, CADC III Interview by Ashley Johnson

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his article’s questions on the nature of substancerelated and addictive disorders and the future of the ­evolving field of addiction medicine were posed by Ms. Ashley Johnson, a journalism major at University of Winchester in England. Submit your questions for Dr. Inaba to jgleason@naadac.org.

Ms. Johnson: How is it that one person becomes addicted and another doesn’s? Is the brain chemistry different?

DR. INABA: Addiction is due to a combination of genetics, environment and pharmacology. Most researchers feel that genetics contribute about 40% to 60% of the vulnerability to addiction. (Schuckit, Marc M. A., 1986; Goodwin, D. W., 1976; Blum, K. et al., 1990, Gold­man, O., 2005; Hiroi, A., 2005.). Some 89 different genes have been linked to addiction vulnerability with 900 other suspected genes. (Li, M. D. &

Burmeister, M., 2009; Agrawal A., et al., 2012.) Some are born prone to be addicted to either a specific drug/behavior or to a multitude of drugs/ behaviors while others may not. This and other factors cause anomalies in brain cells, brain chemistry and even communication pathways between brain cells that make certain individuals more vulnerable to addictive disorders. Current U.S. estimates project that about 15% of those who drink alcohol, 17% of cocaine and methamphetamine users, 24% of opiate/ opioid users, 9% of marijuana users and 5% of gamblers will develop addiction to that substance or behavior. Note that about 34% of those who try a tobacco product will become addicted to nicotine making it the most addictive substance. (American Psychiatric Association, 2000.)

Ms. Johnson: Are persons with addictive disorders just born that way or can it develop from other causes?

DR. INABA: Even though one might be born with all the genes to develop addictive disorders; they will not manifest that vulnerability unless they are exposed to what they are genetically prone to be addicted to. So if you have all the genes to be, say an alcoholic but never drink alcohol you will not develop alcoholism. On the other hand, if you even just experiment a little with drinking alcohol and have all the genetics for it you will likely manifest that addiction.

In addition to genetics, environment and pharmacology or toxicology also affects the brain’s neurons, chemistry and communication networks to make one more or less vulnerable to developing addiction. En­vi­ron­ mental influences like stress, trauma, nutrition, injury, illness, toxins, pesticides, et al. all alter brain neurons (cells), neurotansmitters (brain chemicals) and brain communication networks to make one more or less vulnerable to addiction. Drugs and even behaviors like gambling, internet, sex, relationships, eating disorders, arson, et.al. also alter the brain to make one more or less vulnerable to addiction. Each involves the brain’s natural balance of chemicals and activity and can be altered by artificial external chemical or inappropriate involvement in addictive behaviors. So, one can be born with a very low genetic vulnerability to addiction but be in a very traumatic and stressful environment, drink excessively to cope with that environment and develop alcoholism. On the other hand, one can be born with a high genetic vulnerability but have a wonderfully supportive environment and drink for social reasons and wind up an addict.

The combination of genetics, environmental influences and pharmacological effects of addictive drugs or behaviors on the development of substance related or addictive disorders is known as the Diathesis-Stress Theory of Addiction (Inaba and Cohen, 2014).

Ms. Johnson: In layman terms, can you describe the process that occurs in the brain when an addict uses and is unable to stop?

DR. INABA: There are specific parts of the brain involved with addiction that I call the brain’s addiction pathway. This pathway consists of two main brain circuits: the survival-reinforcement and the control circuits.

The survival-reinforcement circuit is also known as the reward circuit in scientific literature. It has a small cluster of cells, the Nucleus Accumbens Septi that I call the “go switch.” When activated, the “go switch” results

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in a strong need or compulsion to be activated again linking it to our primitive survival instincts. (Inaba and Cohen, 2014; Schmidt, H. D., Vassoler, F. M., and Pierce, R. C., 2011; Olds, J. and Milner, P., 1954.)

The second part of the addiction pathway, the control circuit located in the orbital frontal cortex of the brain acts like a sort of “stop switch” that turns off the “go switch” when it determines that the survival need is satisfied. (Denton, D., Shade, R., Zamarippa, F., et al., 1999.) Persons with addictive disorder have an overactive go and an under-active or disconnected stop switch in response to the drug or behavior that they are vulnerable to. (Hyman, S. E., 1996; Courtney, K. E., Ghahremani, D. G. and Ray, L. A., 2013.) This makes them obsessed with continued drug use or participating in destructive behaviors once addiction has occurred. Then, other parts of the brain also conspire to keep the person with addictive disorder using.

Major decision areas in the thinking part of the brain, the neo-cortex, turn off and make it difficult to enforce any decision not to use. (Paulus, M. P., Tapert, S. F., and Schuckit, M. A., 2005; Bando, K., et al., 2011).

The “go switch” becomes dysfunctional with continued use and this creates a strong urge to use drugs. Powerful emotional memories of using that emphasize the benefits of use and downplay the negatives are activated by any stimulus: sight, smell, place, using partner, an emotional event, etc. also activate the addiction pathway to get a person with addictive disorder to start using again. (Kasai, H., Fukuda, M., Watanabe, S., et al., 2010; Luo, A. H., 2011, Inaba and Cohen, 2014.)

Additionally, the human hormonal stress cycle is interrupted by addiction creating uncomfortable feelings from any stress (relationship, money, life problems). The addicted body is unable to regulate stress to turn off the discomfort caused by stress in its normal way with its own regulatory hormone (cortisol) thus keeping the person with addictive disorder in a stressed out state. (Kreek, M. J. and Koob, G. F., 1998; Kreek, M. J., et al., 1984; Heilig, M. and Koob, G. F., 2007; Lowery, E. G., 2008.)

All this makes it difficult to stop using once a person with addictive disorder starts and those in early recovery continue to crave that often results in relapse.

Ms. Johnson: What is your response to people who say that addiction is a choice?

DR. INABA: Addiction is a biologic process that hijacks the ability of an addict to make healthy choices about their life since it disrupts the unconscious survival mechanisms of the brain. The brain’s normal function is to seek out and continue exposure to things that benefit one's life.

Addiction hijacks that process to make one seek out and continue exposure to things that bring catastrophic consequences to their life. (Inaba and Cohen, 2014.) Note that nicotine is the most addictive substance to humans (American Psychiatric Association, 2000) and I don’t know of any nicotine addict who really continues smoking because it provides them with any life or health benefits yet they cannot stop (without help) when they so desperately want to stop. If one cannot stop if they really desire to do so, how can addiction be a choice?

Dr. Gene Heyman has argued that addiction is a disorder of choice.

(Heyman, G. M., 2009.) Dr. Kevin McCauley provided the essential components of Dr. Heyman’s concept in his wonderful film, Pleasure Un­woven: A personal journey about addiction (McCauley, K., 2009) as con­sisting of: 1. Genetic Vulnerability (Schuckit, M. A., 2000) 2. Incentive-sensitization of Reward (Robinson, T. E. and Berridge, K. C., 2008)

3. Pathology of Learning & Memory (Hyman, S. E., 2005; Everitt, B.J., Robbins, T. W., 2005) 4. Stress and Allostasis (Koob, G. F. and LeMoal, M., 2001) 5. Pathology of Motivation and Choice (Kalivas, P. and Volkow, N., 2005) More succinctly, addiction is biological process that impairs a person with that vulnerability from making a choice about using a substance or participating in a behavior that will result in catastrophic health, emotional and spiritual consequences in their lives.

Dr. Darryl Inaba is Director of Clinical and Behavioral Health Services for the Addictions Recovery Center and Director of Research and Education of CNS Productions in Medford, OR. He is an Associate Clinical Professor at the University of California in San Francisco, CA, Special Consultant, Instructor, at the University of Utah School on Alcohol and Other Drug Dependencies in Salt Lake City, UT, and a Lifetime Fellow at Haight Ashbury Free Clinics, Inc., in San Francisco, CA. Dr. Inaba has authored several papers, award-winning educational films and is co-author of Uppers, Downers, All Arounders, a text on addiction and related disorders that is used in more than 400 colleges and universities and is now in its 8th edition. He has been honored with over 90 individual awards for his work in the areas of prevention and treatment of substance abuse problems.

REFERENCES Agrawal, A., Verweij, K. J. H., Gillespie, N. A., Heath, A. C., Lessov-Schlaggar, C. N., Martin, N. G., Nelson, E. C., Slutske, W. S., Whitfield, J. B. and Lynskey, M.T., (2012). The genetics of addiction—a translational perspective, Translational Psychiatry, 2:e140 (published on-line http://www.nature.com/tp/journal/v2/n7/full/tp201254a.html accessed 11/15/12di).

American Psychiatric Association, (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Text Revision, DSM-IV-TR. Bando, K., Hong, K.-I. K., Bhagwager, Z., Li, C.-S. R., Bergquist, K., Guarnaccia, J. and Sinha, R., (2011). Association of Frontal and Posterior Cortical Gray Matter Volume with Time to Alcohol Relapse: A Prospective Study, The Am. J. of Psychiatry, 168(2):183–192.

Blum, K., Noble, E. P., Sheridan, P. J., Montgomery, A., Ritchie, T., Jagadeeswaran, P., Nogami, H., Briggs, A.H. and Cohn, J. B., (1990). Allelic Association of Human Dopamine D2 Receptor Gene in Alcoholism, JAMA, 263(15):2055–2060.

Courtney, K. E., Ghahremani, D. G., and Ray, L. A., (2013). Fronto-striatal functional connectivity during response inhibition in alcohol dependence, Addict Biol.18(3):593–604.

Denton, D., Shade, R., Zamarippa, F., et al., (1999). Neuroimaging of genesis and satiation of thirst and an interceptor-driven theory of origins of primary consciousness, Proceedings of the National Academy of Sciences, 96(9), 5304–9.

Everitt, B. J., Robbins, T. W., (2005). Neural systems of reinforcement for drug addiction: from actions to habits to compulsion, Nat Neurosci. 8(11):1481–1489.

Goldman, O. G., Ducci, F., (2005). The genetics of addictions: uncovering the genes, Nat Rev Genet. 6 (7):521–532.

Goodwin, D. W., (1976). Is Alcoholism Hereditary. Oxford University Press, New York.

Heilig, M. and Koob, G. F. (2007). A key role for corticotrophin-releasing factor in alcohol dependence, Trends Neurosci., 30(8):399–406.

Heyman, G. M. (2009). Addiction: A disorder of choice. Cambridge, MA: Harvard University Press; 2009.

Hiroi, A., (2005). Genetic susceptibility to substance dependence, Mol Psychiatry 10 (4):336–44.

Hyman, S. E., (1996). Shaking out the cause of addiction. Science, 273(5275), 611–12.

Hyman, S. E. (2005). Addiction: a disease of learning and memory, Am J Psychiatry 162(8):1414–1422.

Inaba, D. S., and Cohen, W. E., (2014). Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs (8th Edition). Medford, OR: CNS Productions, Inc. Kaliva, P. and Volkow, N., (2005). The neural basis of addiction: a pathology of motivation and choice, Am. J. Psychiatry 162:1403–13.

Kasai, H., Fukuda, M., Watanabe, S., et al. (2010). Structural dynamics of dendritic spines in memory and cognition, Trends in Neurosciences, 33(3), 121–29.

Kreek, M. J. and Koob, G. F. (1998). Stress and dysregulation of brain reward pathway, Drug and Alcohol Dependence, 51:23–47.

Kreek, M. J., Ragunath, J., Plevy, S., Hamer, D., Schneider, B., Hartman, N., (1984). ACTH, cortisol, and b-endorphin response to metyrapone testing during chronic methadone maintenance treatment in humans, Neuropeptides, 5(1-3):277–278.

Koob, G. F. and Le Moal, M. (2001). Drug addiction, dysregulation of reward, and allostasis, Neuropsychopharmacology 24(2):97–129.

Li, M. D. and Burmeister, M., (2009). New insights into the genetics of addiction, Nature Reviews Genetics, 10(4):225–231.

Lowery, E. G., Sparrow, A. M., Breese, G. R., Knapp, D. J. and Thiele, T. E. (2008). The CRF-1 receptor antagonist, CP-154,526, attenuates stress-induced increases in ethanol consumption by BALB/cJ mice, Alchol Clin Cep Res, 32(2):240–248.

Inaba Interview, continued on page 28 ☛

S P R I N G 2 016 | A d va n ce s i n A d d i c t i o n & R e c o v e r y 21

The Cost of Three Years of Marijuana Legalization in Colorado and Washington State

By Dr. Kevin Sabet and Jeffrey Zinsmeister, Smart Approaches to Marijuana

I

n the wake of multimillion-dollar political campaigns funded with out-of-state money, Colorado and Washington voted to legalize marijuana in November 2012. Though it would take more than a year to set up retail stores, personal use (in Colorado and Washington), and home cultivation/giving away plants (in Colorado) were almost immediately legalized after the vote. And as retail sales began, a brand-new marijuana industry selling candies, waxes, sodas, and other marijuana items exploded, and with it a lobby to fight regulation.

These “experiments” in legalization and commercialization, have not succeeded, and the toll to the citizens of those states has been as serious as many of us had feared. The most obvious indicator of this impact is a surge in regular marijuana use by minors. Unsurprisingly, Colorado now leads the country in past-month marijuana use among 12- to 17-year-olds, with Washington in 6th place.1 Moreover, use overall and among minors in both states has, on average, grown faster than the national rate since legalization began in 2012.2 The chart below indicates this clearly—not only do the bars for Colorado and Washington tower over those for the United States as a whole, but they have increased far more rapidly than the national average since before legalization began.3

decrease consumption. Common sense alone tells us that this would not hold true, but the data vindicates this concern.

Moreover, it is hardly surprising that more children would use marijuana in states where edible pot products, including chocolates, gummi bears, and lollipops, dominate the market. In Colorado, some estimates indicate that these products now accounted for almost 50% of the total marijuana market by early 2014.5 One look at these edibles reveals the connection between edibles and marijuana use by children—their bright colors and kid-friendly packaging are close cousins of the candy cigarettes and other products Big Tobacco used to hook kids on their products.

Sadly, the dangers of these edibles do not stop with increased use. They also correlate with a tremendous surge in marijuana poisonings. Marijuana poisonings jumped 148% and 52% between 2012 and 2014 in Colorado and Washington State, respectively.6 Even more concerning is the rise in poisonings among children between zero and five years old, increasing 153% in Colorado between 2012 and 2014.7 Poisonings represent just the tip of a larger iceberg of health and safety problems triggered by legalization. Hospitalizations (graph below) in Colorado related to marijuana use grew 70% from 2012 (pre-legalization) to 2014, reflecting a public health problem far greater than poisonings alone.8

This same dynamic has pushed more and more Colorado teenagers into treatment for marijuana use. Although the state of Colorado itself has declined to gather data for this, a major network of treatment providers there, Arapahoe House, reported that teen admissions for marijuana rose 66% from 2011 to 2014.4 This spike in use and treatment belies the constant refrain from marijuana legalization activists that normalizing and sanctioning use would not encourage children to use the drug or in some cases, would even

The health effects don’t end at the hospital door, either. Similarly—and predictably—marijuana intoxication plays an ever-greater role in DUI cases and traffic fatalities in the two states. As of June 2015, a full third of DUI cases in Washington State tested positive for THC.9 And in Colorado, a driver in almost one in every five traffic fatalities tested positive as of 2014.10 Another common refrain from Colorado’s legalization activists—that legalization will reduce the black market and crime, appear to contradict data from that state. In the city and county of Denver, overall crime was up 3.9% in 2015, compared to the prior year.11 Most saliently, drug and narcotics crime rose 12.5% and homicides were up a staggering 81%, belying rampant media reports of “legalization linked with a drop in crime.”12 Additionally, Colorado officials themselves admit that legalization has not impacted the black market in a meaningful way. In February 2015, Colorado Attorney General Cynthia Coffman told reporters, “The criminals are still selling on the black market. ...We have plenty of cartel activity in Colorado (and) plenty of illegal activity that has not decreased at all.”13 And Lt. Mark Comte of the Colorado Springs Police Vice and Narcotics Unit similarly commented that “[legalization] has done nothing more

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than enhance the opportunity for the black market.” Indeed, a federal law enforcement official characterized Colorado as “the black market for the rest of the country.”14 Denver also represents another concerning but predictable trend: the marijuana industry’s disparate impact on minority and disadvantaged communities. A 2016 investigation by the Denver Post revealed that a “disproportionate share” of marijuana businesses are now located in lower-income and minority communities in Denver, communities that often suffer disparate impacts of drug use.15 One such neighborhood had one marijuana business license for every 47 residents.16 This dynamic is similar to a Johns Hopkins study that showed that predominantly black, low-income neighborhoods in Baltimore were eight times more likely to have carr y-out liquor stores than white or racially integrated neighborhoods.17 Finally, and perhaps most importantly, the federal and state governments involved have shown little interest in tracking this data and monitoring the effects of marijuana legalization. The state legalization “experiments” were based on the Department of Justice’s “wait-and-see” strategy of tracking the consequences of legalization, such as the distribution of marijuana to minors and preventing drugged driving and other adverse public health consequences.18 This information would ostensibly allow the government to determine appropriate action later.19 So far, however, neither the federal nor state authorities have implemented a robust public tracking system. This failure led the U.S. Government Accountability Office (GAO) to criticize DOJ in 2016 for not appropriately monitoring and documenting outcomes.20 Proving true the adage that “you can’t manage what you don’t measure,” the report states that DOJ has not “documented their monitoring process or provided specificity about key aspects of it[.]”21 This lack of specificity includes missing information about “potential limitations of the data [DOJ officials] report using and how they will use the data to identify states that are not effectively protecting federal enforcement priorities.”22 The report also highlighted unusual attitudes and behavior by DOJ officials concerning monitoring of the agency’s own priorities concerning marijuana, including that: • “[O]fficials reported that they did not see a benefit in DOJ documenting how it would monitor the effects of state marijuana legalization relative to the August 2013 [Office of the Deputy Attorney General] guidance,” • DOJ field offices “do not consistently enter information” in a “key source of information for monitoring,” thus ensuring that the database “would not provide reliable information regarding the extent of marijuana-related cases,” and • DEA and DOJ officials from California, Colorado, Oregon, and Washington reported that they had not sent warning letters to owners and lien holders of medical marijuana dispensaries since DOJ issued August 2013 guidance on marijuana.23 In other words, the federal government has effectively abdicated its promise to track the effects of its own policies. This turns its stated strategy of “wait-and-see” strategy into just “wait”—if you aren’t “seeing” the consequences, it is hard to take any effective action. This has also effectively delegated the job of tracking results to civil society groups, many of whom risk losing federal funding for raising inconvenient truths about the impact of legalized marijuana.

If we as a nation are to make informed decisions about marijuana use, at a minimum our government must shoulder the burden of tracking the

consequences of its own policies. If our elected representatives fail to shape policy, the multi-billion-dollar marijuana industry will—in a way that best serves their bottom line instead of our public health and safety.

Kevin Sabet, PhD, was a senior advisor in the Obama Administration and is the author of Reefer Sanity: Seven Great Myths About Marijuana. He also served in the Bush and Clinton Administrations, and has a PhD in social policy from Oxford University. In 2013, he founded SAM (Smart Approaches to Marijuana), with former Congressman Patrick J. Kennedy. Sabet has appeared on front page of the New York Times, and has had op-ed pieces published in most major U.S. newspapers. He regularly advises the United Nations on drug issues and speaks regularly to parent groups, students, business owners, and other community members about drugs. www.kevinsabet.com and www.learnaboutsam.org.

Jeffrey Zinsmeister is Executive Vice President of SAM and a Senior Fellow at the University of Florida’s Drug Policy Institute. Previously, he worked as a management consultant with Bain & Company, and served as a Foreign Service Officer with the U.S. State Department, where he spent two years at the U.S. Embassy in Mexico City overseeing a $55 million drug demand reduction and anti-corruption foreign assistance program. Zinsmeister received his AB from Harvard College, and his JD from the UC Berkeley School of Law (Boalt Hall).

He is fluent in Portuguese and Spanish.

FOOTNOTES SAMHSA (Dec. 17, 2014). 2011–2012 vs. 2012–2013 NSDUH State Estimates. Retrieved from http://www.samhsa.gov/data/sites/default/files/NSDUHStateEst2012-2013-p1/ ChangeTabs/NSDUHsaeShortTermCHG2013.htm; SAMHSA (Dec. 16, 2015). 2013–2014 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia). Retrieved from http://www.samhsa.gov/data/sites/default/files/ NSDUHsaePercents2014.pdf.

2 Id. 3 Id. 4 Arapahoe House (Sep. 18, 2014). Back by Popular Demand, Dr. Drew Champions the Mission of Arapahoe House and Helps Raise More than $230,000. Retrieved from https://www. arapahoehouse.org/back-popular-demand-dr-drew-champions-mission-arapahoe-houseand-helps-raise-more-230000.

5 Hughes, T. (Feb. 3, 2014). The food in Colorado is going to pot. USA Today. Retrieved from http://www.usatoday.com/story/news/nation/2014/02/03/pot-marijuana-ediblecolorado/5043843/.

6 Rocky Mountain High Intensity Drug Trafficking Area (Sep. 2015). The Legalization of Marijuana in Colorado: The Impact, Volume 3. Retrieved from http://www.rmhidta.org/ html/2015%20FINAL%20LEGALIZATION%20OF%20MARIJUANA%20IN%20 COLORADO%20THE%20IMPACT.pdf; Washington Poison Center (Jan. 22, 2015) Toxic Trends Report* Cannabis. Retrieved from http://www.wapc.org/toxic-trends-report-cannabisjanuary-22nd-2015/.

7 Rocky Mountain High Intensity Drug Trafficking Area (Sep. 2015). The Legalization of Marijuana in Colorado: The Impact, Volume 3. Retrieved from http://www.rmhidta.org/ html/2015%20FINAL%20LEGALIZATION%20OF%20MARIJUANA%20IN%20 COLORADO%20THE%20IMPACT.pdf.

8 Rocky Mountain High Intensity Drug Trafficking Area (Sep. 2015). The Legalization of Marijuana in Colorado: The Impact, Volume 3. Retrieved from http://www.rmhidta.org/ html/2015%20FINAL%20LEGALIZATION%20OF%20MARIJUANA%20IN%20 COLORADO%20THE%20IMPACT.pdf.

9 Washington Traffic Safety Commission (Feb. 2016.) Driver Toxicology Testing and the Involvement of Marijuana in Fatal Crashes, 2010-2014. Retrieved from http://wtsc.wa.gov/ wp-content/uploads/dlm_uploads/2015/10/Driver-Toxicology-Testing-and-theInvolvement-of-Marijuana-in-Fatal-Crashes_REVFeb2016.pdf.

10 Rocky Mountain High Intensity Drug Trafficking Area (Sep. 2015). The Legalization of Marijuana in Colorado: The Impact, Volume 3. Retrieved from http://www.rmhidta.org/ html/2015%20FINAL%20LEGALIZATION%20OF%20MARIJUANA%20IN%20 COLORADO%20THE%20IMPACT.pdf.

11 Denver Police Department (Jan. 2016). Monthly Citywide Data. Retrieved from https:// www.denvergov.org/content/dam/denvergov/Portals/720/documents/statistics/2015/ Xcitywide_Reported_Offenses_2015.pdf.

12 Id. 13 The Colorado Springs Gazette editorial board (2015, March 23). Special report, ‘Clearing the Haze:’ Black market is thriving in Colorado. The Colorado Springs Gazette. Retrieved from http://gazette.com/special-report-clearing-the-haze-black-market-is-thriving-incolorado/article/1548305.

14 Associated Press (2014, April 4). Legal pot hasn’t stopped Colo. black market. USA Today.

Retrieved from http://www.usatoday.com/story/news/nation/2014/04/04/colo-pot-blackmarket/7292263/.

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S P R I N G 2 016 | A d va n ce s i n A d d i c t i o n & R e c o v e r y 2 3

SALIS: A Trusted Source of Information in Addiction Science

By Judit Ward, PhD, MLIS, and William Bejarano, MA, MLIS ’15 (Rutgers Center of Alcohol Studies), and Deann Jepson, MS (Advocates for Human Potential, Inc.)

H

ow often do you turn to Google as a professional?

How do you know whether or not you can trust the sources that you have found? How do you separate authoritative and reliable information from sales pitches? How about asking a librarian?

The library of the 21st century is not the one you remember from grade school. Often thought of as outdated book repositories, libraries and information centers are presently in the unique position to follow trends involving the ever-changing needs of their users.

Librarians and information specialists with expertise in the field of substance use and mental health disorders can serve as a bridge to scholarly resources, popular material, government publications, grey literature, and more. Information professionals can help navigate through the overwhelming amount of resources available in the public domain and subscription databases. An entire network of these experts, called the Substance Abuse Librarians and Information Specialists (SALIS), is involved in the dissemination of information and linking research to practice in the behavioral health field by means of using both old-fashioned and cutting-edge methods of library and information science.

Why a librarian?

Librarians and information specialists1 have been trained to retrieve and organize information on specific topics from reliable sources as well as follow and monitor trends in the field of their subject expertise and information science. Librarians can provide guidance while navigating the

maze of hard-to-find and/or potentially contradictory information.

Librarians who, behind the scenes, are negotiating and licensing online subscriptions to journals and databases and integrating free and licensed resources have developed valuable subject expertise and experience in finding information efficiently (Mitchell, Lacroix, Weiner, Imholtz, & Goodair, 2012). Librarians can help passive recipients of unfiltered information transform into practitioners actively seeking and finding the right information at the right time (Wheeler & Goodman, 2007). Librarians can assist practitioners to improve their skills in information retrieval and evaluation in order to find quality information in a timely manner and better bridge the gap between theory and practice.

What gap?

The gap between the work of researchers and the application of evidence-based practice is a topic of many conversations. Scholars who work in academic institutions do not necessarily call on practitioners to critically examine evidence-based practice models. Similarly, the current education and practice framework does not encourage addiction practitioners to work closely with researchers. Professionals who are expected to carry out empirically supported practices without being involved in research can be supported by librarians and information specialists, who are well versed in the current practices of information literacy, and can help them find and translate evidence-based research into day-to-day practice (Wheeler & Goodman, 2007).

From this point forward, the term “librarian” will act as shorthand for all information professionals.

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What is Information Literacy?

Information literacy refers to a set of skills and competencies required to retrieve, analyze, and use information in the era of information overload (Pinto, Pulgarín, & Escalona, 2014). The significance of information literacy for practitioners has been well-documented (e. g., Cullen, Clark, & Esson, 2011; Schardt, 2011). Information literacy is exceptionally crucial in the behavioral health field, since easily accessible information may introduce bias into the practice of evidence-based medicine (Pittler et al., 2011). There is a strong correlation between the information literacy competency standards in libraries and the principles of evidence-based medicine (Nail-Chiwetalu & Bernstein Ratner, 2007). As an example, information literacy and critical thinking were suggested as crucial components of social worker education (Mirabito, 2012). Case studies prove the importance of discipline-based information literacy integration (Gordon & Bartoli, 2012; Lampert, 2005; Marshall, 2014; Pendell & Armstrong, 2014).

provided by the Internet Archive on ATOD topics called The SALIS Col­ lec­tion: Alcohol, Tobacco, and Other Drugs.

What can SALIS do for NAADAC members?

SALIS has been offering information services for NAADAC members since its inception. The resources section of the SALIS website (Fig. 2) is a treasure trove of information, including: • a serials database with more than 350 journals, newsletters, and monograph series in addictions; • a new books section compiled from extensive web searching, publisher catalogs, book reviews, advertising, and “insider” information; • selected web links presented in both categorical and alphabetical order; • a curated list of 80 bibliographic, statistical, and related ATOD databases; and • other member-developed resources.

What is SALIS? Librarians add their unique approach based on their own settings and circumstances to provide quality information by linking research to practice (Marshall, 2014). Founded in 1979, SALIS is an international association of individuals and organizations with special interests in the exchange and dissemination of alcohol, tobacco, and other drug (ATOD) information. A diverse group spanning from academic librarians to information and other professionals in various organizations, SALIS is represented all over the United States and beyond in institutions such as academic and research centers, universities and colleges, prevention centers, government agencies, and non-profit organizations. To locate the nearest SALIS member, you can consult the SALIS members list, located on the organization’s website at www.salis.org. The key aim of SALIS is to promote and improve the communication, dissemination, and use of objective, accurate, and timely information about ATOD.

What is SALIS doing?

Fig. 2. ATOD resources on the SALIS website

SALIS provides a network for information professionals in the ATOD field. The organization encourages collaboration and connections among its members and serves as an advocate on matters of common interest.

One of its main activities is supporting professional development programs, culminating in an annual conference on topics relevant to information, research and documentation (Ward, Bejarano, & Geary, 2014).

A major source of information exchange, the SALIS listserv, helps daily communication. The members-only newsletter, published quarterly, also includes a list of “new books,” handpicked by an experienced librarian, from the latest publications in the field. You can find a sample of the newsletter on the SALIS homepage.

SALIS has made substantial contributions to the entire field. For example, the organization was instrumental in Fig. 1. An early SALIS publication dev­eloping guidelines (Fig. 1) on how to organize and operate ATOD information centers to be used by researchers, practitioners, and librarians (Rolett, V. & Kinney, J., 1990; Rolett, V. & Kinney, J., 1995). Cur­rently SALIS is spearheading a project that involves major preservation and digitization endeavors, the latest of which is a significant contribution to the downloadable e-book collection

From the SALIS page, NAADAC members can also navigate to an abundance of valuable resources on the respective websites of the member libraries and information centers. This can provide an opportunity to build virtual and face-to-face relationships with SALIS members with common interests. In addition, NAADAC members can benefit from the pro­ fessional development activities of the host institutions of SALIS members.

What more?

As a specific example of what our collective expertise can bring to NAADAC members, consider the emerging field of alternative metrics.

With the changing landscape of the publishing field in the past few years, open science has considerably transformed information evaluation (Rinaldi, 2014; Weller, 2015). Alternative ways of sharing science resulted in the acceptance of unorthodox forms of scholarly communication (Giglia, 2011; Mendez et al., 2009), such as the scholarly social media platforms of ResearchGate and Academia.edu (Thelwall & Kousha, 2014a; Thel­wall & Kousha, 2014b), as well as blogs and more (Bik & Goldstein, 2013).

Open access journals, previously viewed as products of predatory publishers lacking academic credentials, have developed into an accepted venue of publication. Traditional metrics are no longer the sole providers of guidance in the quality of scholarly information, and a new field has emerged called altmetrics (Bornmann, 2014; Piwowar, 2013; Priem et S P R I N G 2 016 | A d va n ce s i n A d d i c t i o n & R e c o v e r y 2 5

al., 2012; Priem, Piwowar et al., 2012). SALIS has members who are pro­fici­ent in alternative metrics and can help evaluate and interpret these resources.

Where is your proof?

A prime example of bringing evidence-based practice (EBP) to the field of substance use and mental health disorders by libraries is an Au­stral­ ian project, which assisted particular members of the ATOD sector to improve quality and the transfer of research into practice, through information literacy training using the evidencebased practice process (Shelling, 2009).

SALIS members had the privilege of conducting several information literacy sessions with practitioners and addiction researchers for their affiliated institutions. These included information sessions and workshops relating to searching the scholarly literature, evaluating information, navigating academic social media, and fulfilling the brand-new requirements of the National Institutes of Health (NIH) grant submission process. The instructional endeavors on these topics indicate a potential role for SALIS librarians and information specialists to step up and connect practitioners with the needed information.

What is the takeaway?

Providing a network diverse in geography and expertise, SALIS is uniquely positioned to serve as a link between research and practice.

More specifically, SALIS members can help clinicians identify and translate evidence-based research into day-to-day best practice, and ATOD librarians and information specialists are well suited for this work. With this goal in mind, SALIS looks forward to a continuing relationship with NAADAC members and building a strong network with the common goal of improving the quality of behavioral healthcare. The members of SALIS are available and happy to share the benefits of their network to providers.

For more information, visit www.salis.org.

William Bejarano, MLIS, MLER, is the Senior Information Specialist at the Rutgers Center of Alcohol Studies (CAS). He has been working in academic libraries for the past 15 years. In his current role at CAS, his work entails instruction and research support on topics in addiction and information science. His current focus is to build and maintain a critical framework of information literacy in addiction science. Related is his research on scholarly communication, including academic social media and emerging assessment and evaluation techniques. Bejarano also devotes time to the preserving, digitizing, archiving, and displaying of material related to alcohol and addiction history. He is currently serving on the executive board of the Substance Abuse Librarians and Information Specialists (SALIS).

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Deann Jepson, MS, is a Program Associate at Advocates for Human Potential, Inc. (AHP). Since 1998, she has responded to the needs of the behavioral healthcare field and led many initiatives to improve the knowledge and skills of the workforce. She currently leads multiple teams in simultaneous product development on SAMHSA’s Homeless and Housing Resource Network (HHRN) contract. Jepson has a distinctive portfolio derived from a diverse background working with nonprofit, corporate, media, government, and educational organizations. Prior to AHP, she served as Program Manager and Workforce Development Specialist for the Addiction Technology Transfer Center (ATTC) National Office. Jepson received a MS in Health Communication from Boston University and a BS in Business Administration from San Jose State University. She is Chair of SALIS. Judit H. Ward, PhD, MLIS, MA, is Director of Information Services at Rutgers Center of Alcohol Studies. Her current focus is on conceptualizing and developing a critical framework of information literacy in addiction science. Her current research interests include digital libraries, instructional technology and the evaluation of information in the electronic environment, human information behavior, and cross-cultural research methods.

During her 30+ years in academia, Dr. Ward has presented and published extensively, including keynotes at international conferences, and scholarly articles on emerging topics. She serves as Field Editor of the Journal of Studies on Alcohol and Drugs, is Adjunct Faculty at the School of Communication and Information at Rutgers, and is past-chair of the Substance Abuse Librarians and Information Specialists (SALIS).

REFERENCES Bik, H. M., & Goldstein, M. C. (2013). An introduction to social media for scientists. PLoS Biology, 11(4), e1001535.

Bornmann, L. (2014). Measuring the broader impact of research: The potential of altmetrics. ArXiv Preprint arXiv:1406.7091.

Cullen, R., Clark, M., & Esson, R. (2011). Evidence‐based information‐seeking skills of junior doctors entering the workforce: An evaluation of the impact of information literacy training during pre‐clinical years. Health Information & Libraries Journal, 28(2), 119–129.

Giglia, E. (2011). Academic social networks: It’s time to change the way we do research. European Journal of Physical and Rehabilitation Medicine, 47(2), 345–349.

Gordon, L., & Bartoli, E. (2012). Using discipline-based professional association standards for information literacy integration: A review and case study. Behavioral & Social Sciences Librarian, 21(1), 23-38. doi:10.1080/01639269.201 2.657518 Lampert, L. (2005). “Getting psyched” about information literacy: A successful faculty-­librarian collaboration for educational psychology and counseling. The Reference Librarian, 43(89-90), 5–23.

Marshall, J. G. (2014). Linking research to practice: The rise of evidence-based health sciences librarianship. Journal of the Medical Library Association: JMLA, 102(1), 14.

Mendez, J. P., Curry, J., Mwavita, M., Kennedy, K., Weinland, K., & Bainbridge, K. (2009). To friend or not to friend: Academic interaction on Facebook. International Journal of Instructional Technology & Distance Learning, 6(9), 33–47.

Mirabito, D. M. (2012). Educating a new generation of social workers: Challenges and skills needed for contemporary agency-based practice. Clinical Social Work Journal, 40(2), 245–254.

Mitchell, A. L., Lacroix, S., Weiner, B. S., Imholtz, C., & Goodair, C. (2012). Collective amnesia: Reversing the global epidemic of addiction library closures. Addiction, 107(8), 1367–1368.

Nail-Chiwetalu, B., & Bernstein Ratner, N. (2007). An assessment of the information-seeking abilities and needs of practicing speech-language pathologists. Journal of the Medical Library Association : JMLA, 95(2), 18–8, e56-7. doi:10.3163/1536-5050.95.2.182 [doi]

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The High Cost of Varying Standards for Certification and Licensure of Addiction Counselors in the United States

T

By John Korkow, PhD, LAC, SAP

he complex and inconsistent licensure of addiction professionals has become a much discussed topic, and licensure guidelines are only getting more confusing.

Currently, the country is split: 27 states and the District of Columbia have addition-specific licensure, and the remaining 23 states do not. The American Counseling Association (ACA) is working to have all of 23 states currently without addiction-specific liensure under their licensure umbrella by 2020.

However, the ACA plan’s guidelines require a degree from a master’s program accredited by the Council for Accreditation of Counseling & Related Educational Programs (CACREP). This means that counselors practicing in almost half of the states in the country will not be eligible for an addiction professional license unless they hold a master’s degree from a CACREP accredited master’s program.

An exhaustive review of the addiction counselor licensure and certification standards on a state-by-state basis reveals a crazy quilt of different titles, different standards, different levels, different educational requirements, and differentexperienceial requirements. There is, surprisingly, not even a common thread running through all programs. This state of affairs places states lacking addiction-specific licensure in a position that will readily allow outside groups to seize the profession out of addictionspecific stakeholders’ grasps and remake it into something new and different. I cannot overstate the damage this will do, not only to addiction counselors, but to the addiction profession and our clients.

Only California, Mississippi and Ohio have implemented the SAMHSA career ladder, though some other states have partially done so. The SAMHSA career ladder provides addiction counselors at all educational levels a method to enter and remain in the profession, along with the ability to move to higher levels of the ladder should the counselor wish to gain additional education.1 This is where the National Addiction Studies Accreditation Commission (NASAC) standards for accreditation intersect with existing certification and licensure standards. A primary first step for states wishing to move toward licensure is a joint incorporation of the NASAC standards within the SAMHSA Career Ladder. The NASAC accreditation model adopts the Practice Dimensions from SAMHSA pub­ li­cation TAP 21, Addiction Counseling Competencies. The Knowledge, Skills, and Attitudes of Professional Practice.

These dimensions include: clinical

evaluation, treatment planning, referral, service coordination, counseling, client-family-community education, documentation, and professionalethical responsibilities.2 With the exception of Category 5, Independent Skills Supervisor (covered in TAP 21-A), these competencies very neatly dovetail with the existing educational standards for licensure and certification in ALL states.3 Even states which specify certain addiction courses could easily incorporate the Practice Dimension into their existing requirements without sacrificing the education the state has deemed appropriate. The true basis of a national licensure standard, which allows state-by-state flexibility, and simplifies reciprocity, lies within the Practice Dimensions, as utilized in the NASAC accreditation standards. These standards were developed by INCASE over many years, and as we reviewed TAP 21, it became apparent that we now had a universal standard that could apply to a wide range of programs in many states with differing requirements for licensure and certification.

The lack of a flexible and accommodating national standard has left 23 states in a position that opens the addiction profession to an aggressive takeover by other professions. While we, as addiction professionals, are very open to working with outside professions, we should not be open to working for these other professionals who do not fully understand our ethics, standards, competencies, diagnoses, skills, business, and, most importantly, our clients. In one particular state that has achieved licensure within the last five years, there are four levels of the SAMHSA ladder in place. The categories, which I have renamed so as to avoid identifying the state, are as follows: (1) Entry Category: Addiction Technician, which requires a high school diploma and 60 hours of education including ethics, HIV, education and recovery support; (2) Category 1: Certified Addiction Counselor, which requires a bachelor’s degree or master’s degree with 270 hours of education covering the 12 core functions and ethics along with HIV and domestic violence classes; (3) Category 2: Licensed Addiction Counselor, which requires 180 education hours in addiction (again, very similar to the 12 core functions) with a master’s degree or PhD; and (4) Category 3: Licensed Clinical Addiction Counselor, which requires 180 hours of addiction education, and the ability to do mental health diagnosis. The Practice Dimensions neatly cover this state’s standards, and when placed within the career ladder, allow for the addition of Category 4, Administrator with a master’s degree, and Category 5, Supervisor.

Currently, there is little to no consistency amoung the states. Several states have a lengthy list of required trainings, several states have a listing of required college coursework, and several merely state a required number of hours in addiction counseling workshops. Regardless, the Tap 21 S P R I N G 2 016 | A d va n ce s i n A d d i c t i o n & R e c o v e r y 27

Compentencies would fit as an umbrella over all states. Utilizing this simple and comprehensive eight competency listing is the key to a uni­ versal standard that fits all existing models in all states, and meets the high level of accreditation standards set by NASAC. Universal, and understandable competency standards that are the foundation of our profession, leading us into a position of safe leadership via national licensure with regional flexibility, or a patchwork quilt of 23 states at high risk of takeover by external professionals who truly do not understand our profession: the choice is before us.

John Korkow, PhD, LAC, SAP, received his PhD in Educational Psychology from the University of South Dakota in 2008. He completed an MA in Community Agency Counseling, and a BS in Addiction Studies, and has worked as an addiction counselor since 1999. He is a board member and conference committee planning chair of SDAAPP, member of NAADAC, President of INCASE, and board member of NASAC. He is currently an assistant professor in Addiction Studies at the University of South Dakota REFERENCES 1SAMHSA Career Ladder, http://store.samhsa.gov/product/Scopes-of-Practice-andCareer-Ladder-for-Substance-Use-Disorders-Counseling/PEP11-SCOPES 2SAMHSA TAP 21, http://store.samhsa.gov/product/TAP-21-Addiction-CounselingCompetencies/SMA15-4171 3SAMHSA TAP 21-A, http://store.samhsa.gov/product/TAP-21-A-Competencies-forSubstance-Abuse-Treatment-Clinical-Supervisors/SMA13-4243

Inaba Interview, continued from page 21 Luo, A. H., Tahsili-Fahadan, P., Wise, R. A., Lupica, C. R. and Aston-Jones, G., (2011). Linking Context with Reward: A Functional Circuit from Hippocampal CA3 to Ventral Tegmental Area, Science, 333 (6040):353–357.

McCauley, K., (2009). Pleasure Unwoven: A personal journey about addiction. Salt Lake City, Utah: The Institute for Addiction Studies.

Olds, J. and Milner, P., (1954). Positive reinforcement produced by electrical stimulation of septal area and other regions of rat brain, Journal of Comparative and Physiological Psychology, 47(6), 419–27.

Paulus, M. P., Tapert, S. F., and Schuckit, M. A., (2005). Neural activation patterns of methamphetamine-dependent subjects during decision making predict relapse, Archives of General Psychiatry 62(7):761–768.

Robinson, T. E. and Berridge, K.C., (2008). The incentive sensitization theory of addiction: some current issues, Philosphical Transactions of the Royal Society B, 363:3137–3146.

Schmidt, H. D., Vassoler, F. M. and Pierce, R. C., (2011). Neurobiological factors of drug dependence and addiction. In P. Ruiz and E. C. Strain, eds. Lowinson and Ruiz’s Substance Abuse: A Comprehensive Textbook (5th ed., pp. 55–78), Philadelphia: Wolters Kluwer.

Schuckit, M. A., (1986). Genetic and clinical implications of alcoholism and affective disorder, The American Journal of Psychiatry, 143(2):140–147.

Schuckit, M. A., (2000). Genetics of the Risk for Alcoholism, The American Journal on Addictions, 9(2):103–112, Spring 2000.

Marijuana Legalization, continued from page 23 Migoya, D. & Baca, R. (2016, Jan. 4). Denver’s pot businesses mostly in low-income, minority neighborhoods. The Denver Post. Retrieved from http://www.denverpost.com/ marijuana/ci_29336993/denvers-pot-businesses-mostly-low-income-minorityneighborhoods.

16 Id. 17 Johns Hopkins Bloomberg School of Public Health (Jun. 6, 2000). Off-Premises Liquor Stores Targeted to Poor Urban Blacks. Retrieved from http://www.jhsph.edu/news/ news-releases/2000/alcohol-off-premises.html.

18 Department of Justice (Aug. 29, 2013). Guidance Regarding Marijuana Enforcement.

Retrieved from http://www.justice.gov/iso/opa/resources/3052013829132756857467. pdf.

19 Id. 20 U.S. Government Accountability Office (Dec. 2015). DOJ Should Document Its Approach to Monitoring the Effects of Legalization. Retrieved from http://gao.gov/assets/680/ 674464.pdf.

21 Id. 22 Id. 23 Id. 15

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Horn, continued from page 14

Dissertation on PhD in Psychology with a Teaching Emphasis Active in clinical practice and supervision Currently is Adjunct professor at Montana State University – Billings teaching Gambling Assessment and Pharmacology for Addiction Counselors Currently one of the specialists in the Billings Clinic Project ECHO: a revolutionary program that is in collaboration with University of New Mexico to provide education and clinical mentoring via telehealth to rural residents.

Zamudio, continued from page 14

“AADACO” he is a Board Member of the Juvenile Public Safety Co­or­ dination Counsel of Lane County, Co-Chair/Treasurer of the Alcohol and Drug Professionals of Lane County, Advisory Committee Board Member of Centro Latino Americano and speaker for the Substance Abuse Prevention Program at the University of Oregon. Art is also one of the first to become a Certified Recovery Mentor in the State of Oregon and is a CADC II. Through his career path he has been an Anger Management trainer/facilitator, Parent Educator, Ex-Offender Employment Specialist, Housing Specialist, along with several positions in A&D Treatment. He has worked as a Corporation Compliance Officer for a Methadone Program, has worked in inpatient and outpatient treatment settings. He is currently the Program Manager for a Detox facility.

Chuck Jordan is a contributing writer with NAADAC, the Association for Addiction Professionals. Jordan has worked as an assistant managing editor for a Capitol Hill publication. He has covered policy issues at the state level for the publication and did freelance writing. Jordan received a Bachelor of Arts in Political Science from Coe College in Cedar Rapids, Iowa.

SALIS, continued from page 26 Pendell, K., & Armstrong, A. (2014). Psychology guides and information literacy: The current landscape and a proposed framework for standards-based development. Reference Services Review, 42(2), 293–304. doi:10.1108/RSR-10-2013-0052 Pinto, M., Pulgarín, A., & Escalona, M. I. (2014). Viewing information literacy concepts: A comparison of two branches of knowledge. Scientometrics, 98(3), 2311–2329.

Pittler, M., Mavergames, C., Ernst, E., & Antes, G. (2011). Evidence-based medicine and web 2.0: Friend or foe? The British Journal of General Practice : The Journal of the Royal College of General Practitioners, 61(585), 302–303. doi:10.3399/bjgp11X567342 [doi] Piwowar, H. (2013). Altmetrics: Value all research products. Nature, 493(7431), 159–159.

Priem, J., Groth, P., & Taraborelli, D. (2012). The altmetrics collection. PloS One, 7(11), e48753.

Priem, J., Piwowar, H. A., & Hemminger, B. M. (2012). Altmetrics in the wild: Using social media to explore scholarly impact. ArXiv Preprint arXiv:1203.4745.

Rinaldi, A. (2014). Spinning the web of open science: Social networks for scientists and data sharing, together with open access, promise to change the way research is conducted and communicated. EMBO Reports, 15(4), 342–346. doi:10.1002/embr.201438659 [doi] Rolett, V. & Kinney, J. (1990). How to start and run an alcohol and other drug information centre: A guide. Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, Office for Substance Abuse Prevention.

Rolett, V. & Kinney, J. (1995). How to organize and operate an information center on alcohol, tobacco, and other drugs: A guide CCSA, CSAP, SALIS. Schardt, C. (2011). Health information literacy meets evidence-based practice. Journal of the Medical Library Association: JMLA, 99(1), 1–2. doi:10.3163/1536-5050.99.1.001 [doi] Shelling, J. (2009). Bringing the evidence base to the alcohol and other drugs sector. The Australian Library Journal, 58(1), 39–46.

Thelwall, M., & Kousha, K. (2014a). Academia. edu: Social network or academic network?

Journal of the Association for Information Science and Technology, 65(4), 721–731.

Thelwall, M., & Kousha, K. (2014b). ResearchGate: Disseminating, communicating, and measuring scholarship? Journal of the Association for Information Science and Technology.

Ward, J., Bejarano, W., & Geary, D. (2014). Making a difference: Past SALIS conferences from 1978 to present. Substance Abuse Library and Information Studies, 1, 138–141.

Weller, K. (2015). Social media and altmetrics: An overview of current alternative approaches to measuring scholarly impact. In Incentives and performance (pp. 261–276) Springer.

Wheeler, D. P., & Goodman, H. (2007). Health and mental health social workers need information literacy skills. Health and Social Work, 32(3), 235.

Earn 1 CE by Taking an Online Multiple Choice Quiz

Earn One Continuing education credit by taking a multiple choice quiz on this article now at www.naadac.org/magazineces. $15 for NAADAC members and non-members.

1. In a 2013 research study, it was determined that In the United States, approximately twenty-two million people age twelve or older have substance use conditions. Of this number, what percentage, nationwide, received treatment at the time of this study: a. 7% b. 11% c. 28% d. 45% 2. According to Thaddeus Labhart, which of the following is accurate regarding evidence found through research: a. Studies have shown that correlation exists between outcomes and the use of evidence-based practices. b. A large survey of MSW graduates showed social workers do well in treating SUDs without being trained in substance use disorder content. c. Studies have shown that patient outcomes are rarely correlated to patient-therapist relationships. d. Empirical evidence has long demonstrated that the counselor’s own experience in recovery is the best role model.

3. Mita Johnson discussed the importance of a “scope of practice” for addiction counselors. Which of the following is correct with regards to a scope of practice: a. Scope of practice does not include activities that are evidencebased or outcome-driven. b. Scope of practice has created a turf war among behavioral healthcare disciplines. c. Scope of practice includes activities a clinician can ethically and legally engage in. d. Scope of practice was meant to protect only the client.

4. In Mita Johnson’s article on scope of practice, she noted that in order to adopt or modify the scope of practice of any healthcare profession: a. It requires a policy change at the federal level. b. It requires approval by the National Certification Commission. c. It requires the actions of the state’s legislature, which ultimately has the authority to make such changes. d. All of the above.

5. In Jack Stein’s article about e-cigarettes, which of the following was indicated as fact: a. There is ample evidence of the possible benefits of using e-cigarettes. b. Testing of some e-fluids has found no carcinogens or toxic chemicals in the vapor. c. Adding flavorings to e-fluids prevent usage of tobacco products. d. Adult smokers who had used e-cigarettes had 28 percent lower odds of quitting compared to smokers who had not used these devices.

6. Regarding international views on e-cigarettes, which of the following is most accurate: a. U.K.’s Department of Health’s assertion that e-cigarettes were “95% safer” than cigarettes has been accepted as an evidence based claim. b. In the U.S., the Centers for Disease Control and Prevention have been “sounding alarms” over e-cigarettes and their advertising. c. E-cigarettes have been shown not be a risk factor in opening the door to cigarette use among individuals who might not otherwise smoke. d. U.S. Food and Drug Administration has approved the fluids used in e-cigarettes, demonstrating the they were safety tested and approved.

7. In the interview with Dr. Inaba, he stated that most researchers feel that genetics contribute: a. Very little to addiction, since it is environmentally caused. b. About 40% to 60% of the vulnerability to addiction. c. About 90% to 95% of the vulnerability to addiction. d. Totally to addiction, since it is a genetically-based disease.

8. Dr. Inaba noted that each person has a control circuit located in the orbital frontal cortex of the brain that acts like a "stop switch" that turns off the "go switch" when it determines that the survival need is satisfied.

For the addict, which of the following best describes how this mechanism works: a. Persons with addictive disorder have an overactive “stop switch” and an under-active or disconnected “go switch” in response to their drug use. b. Persons with addictive disorder do not have a “stop switch” so they continue using and lose control of their drug use. c. Persons with addictive disorder have lost control of both their “stop switch” and “go Switch” such that they don’t know the difference between them. d. Persons with addictive disorder have an overactive “go switch” and an under-active or disconnected “stop switch” in response to their drug use.

9. Which of the following describes SALIS? a. An international association of individuals and organizations with special interests in the exchange and dissemination of alcohol, tobacco, and other drug information. b. The dissemination of information and linking research to ­practice in the behavioral health field. c. Substance Abuse Librarians and Information Specialists that uses both old-fashioned and cutting-edge methods of library and information science. d. All of the above.

10. In the article by John Korkow, which of the following is an accurate statement about NASAC accreditation? a. NASAC provides a national set of standards for addiction counselor credentialing. b. NASAC provides accreditation of academic programs that demonstrate compliance with a set of 8 primary addiction professional competencies. c. NASAC standards are those adopted by the federal government for the SAMHSA Career Ladder. d. NASAC standards became the basis upon which TAP 21 was developed.

S P R I N G 2 016 | A d va n ce s i n A d d i c t i o n & R e c o v e r y 2 9

■ N A A DAC L E ADE RS HI P NAADAC OFFICERS Updated 03/11/2016

President Kirk Bowden, PhD, MAC, LISAC, NCC, LPC President Elect Gerry Schmidt, MA, LPC, MAC Secretary Thurston S. Smith, CCS, NCAC I, ICADC Treasurer John Lisy, LICDC, OCPS II, LISW-S, LPCC-S Immediate Past President Robert C. Richards, MA, NCAC II, CADC III National Certification Commission for Addiction Professionals (NCC AP) Chair Kathryn B. Benson, LADC, NCAC II, QSAP, QSC Executive Director Cynthia Moreno Tuohy, NCAC II, CDC III, SAP REGIONAL VICE-PRESIDENTS

NAADAC BOARD OF DIRECTORS Mid-Atlantic

PAST PRESIDENTS

(Represents Delaware, the District of Columbia, Maryland, New Jersey, Pennsylvania, Virginia and West Virginia)

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(Represents Kentucky, Illinois, Indiana, Michigan, Ohio and Wisconsin)

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(Represents Arkansas, Louisiana, Oklahoma and Texas)

Sherri Layton, MBA, LCDC, CCS North Central

(Represents Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota)

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(Represents Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island and Vermont)

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1974-1977 Robert Dorris 1977-1979 Col. Mel Schulstad, CCDC, NCAC II (ret’d) 1979-1981 Jack Hamlin 1981-1982 John Brumbaugh, MA, LSW, CADAC IV, NCAC II 1982-1986 Tom Claunch, CAC 1986-1988 Franklin D. Lisnow, MEd, CAC, MAC 1988-1990 Paul Lubben, NCAC II 1990-1992 Kay Mattingly-Langlois, MA, NCAC II, MAC 1992-1994 Larry Osmonson, CAP, CTRT, NCAC II 1994-1996 Cynthia Moreno NCAC I, CCDC II 1996-1998 Roxanne Kibben, MA, NCAC II 1998-2000 T. Mark Gallagher, NCAC II 2000-2002 Bill B. Burnett, LPC, MAC 2002-2004 Roger A. Curtiss, LAC, NCAC II 2004-2006 Mary Ryan Woods, RNC, LADC, MSHS 2006-2007 Sharon Morgillo Freeman, PhD, APRN-CS, MAC 2007-2010 Patricia M. Greer, BA, LCDC, AAC 2010-2012 Donald P. Osborn, PhD (c), LCAC 2012-2014 Robert C. Richards, MA, NCAC II, CADC III

NERF Committee Chair Nancy Deming, MSW, LCSW, CCAC-S Nominations and Elections Chair Robert C. Richards, MA, NCAC II, CADC III Personnel Committee Chair Kirk Bowden, PhD, MAC, LISAC, NCC, LPC Public Policy Committee Co-Chairs Michael Kemp, ICS, CSAC, CSW Sherri Layton, MBA, LCDC, CCS

Adolescent Specialty Committee Chair Christopher Bowers, MDiv, CSAC, ASE International Committee Chair Paul Le, BA Leadership Committee Chair Robert C. Richards, MA, NCAC II, CADC III

Greg Bennett, MA, LAT

STANDING COMMITTEE CHAIRS

Southeast

Bylaws Committee Chair Ronald A. Chupp, LCSW, LCAC, NCAC II, ICAC II

Professional Practices and Standards Committee Chair Donald P. Osborn, PhD, LCAC

Clinical Issues Committee Chair Frances Patterson, PhD, MAC

Tobacco Committee Chair Diane Sevening, EdD, LAC

(Represents Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina and Tennessee)

Angela Maxwell, MS, CSAPC Southwest

(Represents Arizona, California, Colorado, Hawaii, Nevada, New Mexico and Utah)

Mita Johnson, EdD, LPC, LAC, MAC, SAP

Steven Durkee, NCAAC Secretary Kentucky

Awards Committee Chair Jamie Durham

Product Review Committee Chair Matt Feehery, MBA, LCDC, IAADC

Kathryn B. Benson, NCAC II, LADC, QSAP, QSC NCC AP Chair Tennessee James “Kansas” Cafferty, NCAAC California

AD HOC COMMITTEE CHAIRS

Membership Committee Co-Chairs Diane Sevening, EdD, LAC Margaret Smith, EdD, LADC

NATIONAL CERTIFICATION COMMISSION FOR ADDICTION PROFESSIONALS (NCC AP)

Tay Bian How, NCAC II Sri Lanka Thaddeus Labhart, MAC, LPC Treasurer Oregon Rose Maire, MAC, LCADC, CCS New Jersey Sandra Street, MAC, SAP West Virginia Loretta Tillery, MPA, CPM Public Member Maryland Kirk Bowden, PhD, MAC, LISAC, NCC, LPC (ex-officio) Arizona

Ethics Committee Chair Mita Johnson, EdD, LPC, LPC, MAC, SAP Finance & Audit Committee Chair John Lisy, LICDC, OCPS II, LISW-S, LPCC-S

Organizational Member Delegate Matt Feehery, MBA, LCDC, IAADC

NAADAC REGIONAL BOARD REPRESENTATIVES

NORTHEAST NORTH CENTRAL

MID-CENTRAL

Gloria Nepote, LAC, NCAC II, CCDP, BRI II, Kansas-Missouri Ted Tessier, MA, LAMFT, LADC, Minnesota Tiffany Gormley, Nebraska John Wieglenda, LAC, North Dakota Linda Pratt, LAC, South Dakota

Mark Sanders, LCSW, CADC, Illinois Angela Hayes, MS, LMHC, LCAC, Indiana Michael Townsend, MSSW, Kentucky Terrance Lee Newton, BAS, CADC, Michigan Jim Joyner, LICDCCS, ICCS, Ohio Daniel Scoville, MSW, ICS, CSAC, Wisconsin

Susan Campion, LADC, LMFT, Connecticut Ruth A. Johnson, LADC, SAP, CCS, Maine Gary Blanchard, MA, LADC, Massachusetts Lori Ford-Magoon, MLADC, New Hampshire Christopher Taylor, CASAC, LMHC, MAC, DOT SAP, New York William Keithcart, MA, LADC, Vermont

NORTHWEST Diane C. Ogilvie, MAEd, Alaska Malcolm Horn, LCSW, MAC, SAP, NCIP, Montana Arturo Zamudio, Oregon Greg Bauer, CDP, NCAC I, Washington SueAnne Tavener, MS, LPC, LAT, Wyoming

SOUTHWEST

MID-ATLANTIC

Carolyn Nessinger, MS, NCC, BHT, Arizona Thomas Gorham, MA, CADC II, California Thea Wessel, LPC, LAC, MAC, Colorado Kimberly Landero, MA, Nevada J.J. Azua, LADAC, CPSW, New Mexico Michael Odom, LSAC, Utah

Jevon Hicks Sr., BS, ICADC, Delaware Johnny Allem, MA, District of Columbia Ron Pritchard, CSAC, CAS, Virginia Patrice Pooler, MA, ADC, West Virginia

SOUTHEAST MID-SOUTH Suzanne Lofton, LCDC, ADC, SAP, Texas

Sam Long IV, NCAC I, Alabama Bobbie Hayes, LMHC, CAP, Florida David A. Burris, CAC II, NCAC II, CCS, Georgia Tony Beatty, MA, LCAS, CCS, North Carolina Charles Stinson, MS, South Carolina Lori McCarter, LADAC, QCS, Tennessee

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