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Treating Alcohol and Other Drug Abusers in Rural and Frontier Areas

1994 Award for Excellence Papers

Technical Assistance Publication Series

17

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment

Rockwall II, 5600 Fishers Lane
Rockville, MD 20857

This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. All material appearing in this volume except quoted passages from copyrighted sources is in the public domain and may be reproduced or copied without permission from the Center for Substance Abuse Treatment (CSAT) or the authors. Citation of the source is appreciated.

This publication was prepared for publication under contract number 270-93-0004 from the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration (SAMHSA). Richard Bast of CSAT served as the Government project officer.

The opinions expressed herein are the views of the authors and do not necessarily reflect the official position of CSAT or any other part of the U.S. Department of Health and Human Services (DHHS).

Foreword

The Center for Substance Abuse Treatment (CSAT) and the National Rural Institute on Alcohol and Drug Abuse (NRIADA) are pleased to jointly sponsor this publication, which is a compilation of papers submitted to the 1994 Award for Excellence contest. The Award for Excellence called for papers addressing the special challenges of providing quality treatment services to substance abusers in rural and frontier areas.

Papers were particularly solicited in the following areas:

• Experiences, ideas, practical measures, and recommended actions for implementing health care reform initiatives in rural areas (such as regional cross-State provider arrangements)

• Innovative strategies, policies, and programs for improving the delivery of substance abuse, health, and public health services in rural and frontier areas

• Proposals for political and economic solutions that would expand the development of services in rural/frontier areas

• Strategies for building rural coalitions and networks

• Approaches for special issues related to substance abuse, such as rural crime, gangs, and violence, including family violence

• Research studies and needs assessment data showing the prevalence of AOD abuse problems in rural and/or frontier settings, as well as their effects on rural crime, family life, and social, cultural, and economic conditions

• Cost-benefit analyses showing the impact at the Federal and State levels from resolving substance abuse and public health needs of rural and frontier communities

The papers presented here are a remarkable portrait not only of the daunting AOD problems that face rural and frontier America but, more importantly, of the viable approaches to those problems that are being created in rural and frontier areas.

The top three winners of this contest illustrate three successful approaches to helping substance abusers in rural and frontier areas deal with their problems. Riedel, Hebert, and Byrd describe an innovative program in their paper, "Inhalant Abuse: Confronting the Growing Challenge." Our Home, Inc., in Huron, South Dakota, has unlocked the doors of treatment to rural, inhalant-abusing youths—mostly American Indian youths—who did not before have access to treatment. This comprehensive residential treatment program provides a length of stay between 90 and 120 days. The treatment gives these young inhalant abusers, who are an average of 13 years old, the opportunity to detoxify, reduce impairment in neurocognitive functions, improve academic performance, and stabilize emotionally and behaviorally.

Tanya Tatum describes two substance abuse programs designed to address the needs of Appalachian women in Ohio. "Rural Women's Recovery Program and Women's

Outreach . . . Serving Rural Appalachian Women and Families in Ohio" is designed to take advantage of the strengths of these women, as well as their wealth of culture and spirit of perseverance. Appalachian women have specific cultural barriers, which include "a mistrust of outsiders, fear of the 'system,' the conscious exclusion of specific groups in a bureaucracy, a tradition of self-sufficiency and taking care of one's own, and geographic and social isolation." Tatum's group found that the key to delivering effective programs was to gain acceptance from the community and client population. They built on the personal and collective strengths of individuals and of the communities to be served.

A successful rural coalition in Northwest New Mexico is the subject of a paper by Raymond Daw and Herb Mosher. "The Bridges of McKinley County" describes a county that had the highest composite rate of alcohol-related problems of all counties in the United States from 1975 to 1985. The rural coalition that Daw and Mosher describe initiated The March of Hope, a journey made by a group of citizens who walked 200 miles in 10 days from Gallup to the State Legislature in Santa Fe. This rural coalition has been the catalyst to a regional response that has closed drive-up liquor windows, built a detoxification and assessment center, reformed State driving-while-intoxicated laws, and offered new prevention and treatment services.

Successful strategies and insights into the AOD problems facing rural and frontier Americans are mirrored in the other papers submitted to the Award for Excellence. These papers illustrate the difference that can be made for people suffering from alcohol and other drug problems in rural and frontier America.

Award for Excellence Review Panel

Barbara Groves, M.M.
Regional Coordinator
Oregon Office of Alcohol and Drug Abuse Programs
Salem, Oregon

Vicki L. Lentz
Green County Mental Health Services, Inc.
Muskogee, Oklahoma

Larry W. Monson, ACSW
Coordinator
National Rural Institute on Alcohol and Drug Abuse
Tony, Wisconsin

Leon PoVey
Director
Utah Division of Substance Abuse
Salt Lake City, Utah

Peggi White, R.N., C.S.
Family Nurse Practitioner
New Choice Drug and Alcohol Recovery
Champaign, Illinois

Last Updated 11-7-02