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Designing for Addiction Prevention and Recovery
Presentation by
Mary Beth Schoening, Co-founder, Behavioral Health Innovat...
Behavioral Health Innovators
“Combining the power of human compassion with
technology, advanced research and best practice...
Addiction & Co-Occuring Disorders: Cause or Effect?
75% Co-occuring
7%= TX for both
Addiction
Mental
Health
?
MIDDLE/ HIGH SCHOOL
INTERVENTION
EARLY WARNING
CRIMINAL
JUSTICE/
POLICE
• Alcohol violation
• Course drops – there is no t...
2/3
46.6%
“THE WAR WITHIN”
DEATHS PER YR.
Vietnam = 47k
WWI = 53k
Vs.
Drugs = 46k
Alcohol = 47k
WE’RE LOSING THE
WAR…AND EACH
OTHER
-Problem Drinkers, Users
-Early Intervention
Addiction Stage 4 =
Revolving Door
• Younger in age
• Better prognosis
• Easi...
https://www.nlm.nih.gov/medlineplus/SAMHS
A
magazine/issues/spring07/images/addiction04
_large.jpg
Prevalence
MIDDLE/ HIGH SCHOOL
INTERVENTION
EARLY WARNING
CRIMINAL
JUSTICE/
POLICE
• Alcohol violation
• Course drops – there is no t...
RAMP RAMP
Risk Addiction Mapping Progression
Peer Model – Solution Co-development & Delivery of Messages w/ Their Voice
• ...
THE RAMP™
My mind was always
going crazy, I could
never think straight
Personas: Different Approaches Work
for Different Personas
Family Unit Personas
• Family is aware and addict is resistant
...
Industry Snapshot: How Technology Can Help
• Most Go Undetected – as Many as 9/10
• Behavioral Health and Primary Care Cha...
Please come talk to us!
Lived experience, developers, researchers, film/content, clinicians, donors
MaryBeth@bhinnov.com
@...
• Stephanie Briody
• John Cabral
• Louise Griffin
• Cory Gys
• Lauren Stahl
Lived Experience Panel
John and his son Eric
Louise and her son Zack
Cory and his cousin
Zack, Louise’s son
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.
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HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.

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This panel is comprised of parents who’ve lost their children to addiction, a parent whose son is in recovery, and individuals themselves in long-term recovery. We will hear directly from them about their struggles, the impact on individuals and families dealing with addiction, as well as their opinions on where the system could benefit from solutions. The addiction issue is complex and would benefit from solutions in many areas. We invite you to join us to hear first hand.

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HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavioral Health Innovators, Inc.

  1. 1. Designing for Addiction Prevention and Recovery Presentation by Mary Beth Schoening, Co-founder, Behavioral Health Innovators Lauren Stahl, Founder, SPARKITE • Stephanie Briody • John Cabral • Louise Griffin • Cory Gys • Lauren Stahl “Lived Experience” Panel
  2. 2. Behavioral Health Innovators “Combining the power of human compassion with technology, advanced research and best practices from industry to create innovative solutions to some of the biggest problems in behavioral health – starting with Substance Use Disorder/Addiction”
  3. 3. Addiction & Co-Occuring Disorders: Cause or Effect? 75% Co-occuring 7%= TX for both Addiction Mental Health ?
  4. 4. MIDDLE/ HIGH SCHOOL INTERVENTION EARLY WARNING CRIMINAL JUSTICE/ POLICE • Alcohol violation • Course drops – there is no tracking here, no interventional assessment • Grades going down – look at trends • Attendance rates • Dorm RA, friends recognize issues • Health services screening • All opptys for intervention • FERPA allows parental involvement in discipline cases COLLEGE ER/HOSPITALS SCHOOL NURSES • Flooded w/ anxiety, SUD, eating disorders, LGBT • No standards screening, intervention, referral • Desperate for help • Social worker needs to be involved w/ this • Many friends know when someone “has an issue” • Don’t feel empowered to do anything about it • If they do, they try to reason with addict directly • After an intervention some can show lots of support and will admit to knowing about the problem • Some friends are part of the addicts enablement environment = companions in abuse • Many times girls intervene on behalf of their boyfriends • People in recovery maybe able to direct message friends they are concerned about – need helpntact me at any time – I’m doing very well now. I FRIENDS << INTERVENTION • Disciplinary cases • Attendance record • Teachers, coaches observations • Nurse, social worker, psychologist • Administrators • Intervention opptys • Need curriculum • Need tools for parents PARENTS/FAMILY • Drug Overdose • Injury/Accident • Alcohol poisoning • Sexual assault • Need programs here • Need chronic disease care model • Assessment, transfer to treatment • Oppty for Intervention – Angels, Treatment interventionists • Crime • Addiction is an illness; criminal reform/treatment is needed • Injury/Accident • Overdose • Blackout • Protective custody process broken, 24 hour warrants issued in a.m. but beds don’t open till p.m. • Judges order to treatment but insurance doesn’t cover • Addicts can sweet talk judges in sober moments • Diversion, Amnesty Programs, Drug Courts • Recognize first sometimes • Suffer in silence for months/years • They might be more willing to acknowledge issue than the addicted • Don’t know where to turn or how to get addict help • Reluctant to “pull the trigger” • Will act during narrow window of crises • Need 24x7 support • Need intervention guidance • Navigation of system & insurance PRIMARY CARE/PEDS/B EHAVIORAL HEALTH SPECIALISTS • Anxiety, Depression,SUD not picked up • Lack of integration w/ PCP and BH • PCP not screening or trained in treatment • Industry push to integrate but lots of help needed • SUD and MH is component of many other diseases • Intervention oppty Mapping the Addiction Chain From Early Warning Through Sustained Recovery to Discover Gaps DETOX FACILITY • Short term solution 3-5 days • Revolving door • Must transition to long term care w/ transport • Relapse & OD high risk here HOMELESS SHELTERS IN PATIENT TREATMENT CENTERS • 15 day discharge common due to insurance limits- not enough • 14-21 days after detox is when individual has acceptance vs. denial • Sleep, brain function start but need more time to work on recovery • Re-evaluate every 15 days • Have addict sign promisory notes while “impaired” • Need tight continuum and insurance coverage EMPLOYERS • Employer assistance programs • Company insurer aware of issues, case mgmt oppty • Privacy ensured – employer doesn’t know • Companies can provide EAP support & education IOP/STEP DOWN • Intensive outpatient program • Sometimes combined with sober living • Lack of insurance an issue • 6 weeks ideal, but rarely get enough time SOBER HOUSING • Ideally 5 months + • Medication management • Life skills support • Peer support • Matchmaking is needed • Reportedly depressing places SUSTAINED RECOVERY, WELLNESS PROGRAMS • Ongoing 12 Step or SMART programs, Yoga • Need more sustained recovery modalities • Mix of in-person and virtual TREATMENT>> © Copyright 2016, Please Use w/ Attribution Mary Beth Schoening Stephanie Briody THERAPISTS • Many people in recovery don’t go into residential treatment programs and use traditional therapy • Mental health and substance use treatment are separated in many cases • Integrated treametne needed • Insurance reimbursement lacking INSURANCE COMPANIES • Provide intervention services based on health algorithms • Confidential, employer not informed • Working on prevention strategies and programs for future=ACO model PHARMACY • Need to address overprescribing • 70% opioid start w/ prescription • 90% OD get another script • MD doesn’t know about OD • Clinical, parental, & onsumer education needed • Prescription take back • Dentists included TREATMENT APPROACHES • Medicated assissted treatmentvs. abstinence • MAT outcomes better • Many feel suboxone, bupenorphene subs one drug for another • AA vs. SMART • Faith based recovery strong for some • Anonymity of AA questioned • Need more to speak up to remove stigma Behavioral Health Innovators, Inc. www.bhinnov.com marybeth@bhinnov.com @mbschoening Thank you to the individuals in recovery and their families for contributing to this document 1/3
  5. 5. 2/3
  6. 6. 46.6%
  7. 7. “THE WAR WITHIN” DEATHS PER YR. Vietnam = 47k WWI = 53k Vs. Drugs = 46k Alcohol = 47k WE’RE LOSING THE WAR…AND EACH OTHER
  8. 8. -Problem Drinkers, Users -Early Intervention Addiction Stage 4 = Revolving Door • Younger in age • Better prognosis • Easier to recover • Have lost jobs, families, homes • Further into addiction • Criminal activity • Harder to treat • Lower recovery rates End stage 2.5M Early Intervention w/ problem drinkers 60 M
  9. 9. https://www.nlm.nih.gov/medlineplus/SAMHS A magazine/issues/spring07/images/addiction04 _large.jpg Prevalence
  10. 10. MIDDLE/ HIGH SCHOOL INTERVENTION EARLY WARNING CRIMINAL JUSTICE/ POLICE • Alcohol violation • Course drops – there is no tracking here, no interventional assessment • Grades going down – look at trends • Attendance rates • Dorm RA, friends recognize issues • Health services screening • All opptys for intervention • FERPA allows parental involvement in discipline cases COLLEGE ER/HOSPITALS SCHOOL NURSES • Flooded w/ anxiety, SUD, eating disorders, LGBT • No standards screening, intervention, referral • Desperate for help • Social worker needs to be involved w/ this • Many friends know when someone “has an issue” • Don’t feel empowered to do anything about it • If they do, they try to reason with addict directly • After an intervention some can show lots of support and will admit to knowing about the problem • Some friends are part of the addicts enablement environment = companions in abuse • Many times girls intervene on behalf of their boyfriends • People in recovery maybe able to direct message friends they are concerned about – need helpntact me at any time – I’m doing very well now. I FRIENDS << INTERVENTION • Disciplinary cases • Attendance record • Teachers, coaches observations • Nurse, social worker, psychologist • Administrators • Intervention opptys • Need curriculum • Need tools for parents PARENTS/FAMILY • Drug Overdose • Injury/Accident • Alcohol poisoning • Sexual assault • Need programs here • Need chronic disease care model • Assessment, transfer to treatment • Oppty for Intervention – Angels, Treatment interventionists • Crime • Addiction is an illness; criminal reform/ treatment is needed • Injury/Accident • Overdose • Blackout • Protective custody process broken, 24 hour warrants issued in a.m. but beds don’t open till p.m. • Judges order to treatment but insurance doesn’t cover • Addicts can sweet talk judges in sober moments • Diversion, Amnesty Programs, Drug Courts • Recognize first sometimes • Suffer in silence for months/years • They might be more willing to acknowledge issue than the addicted • Don’t know where to turn or how to get addict help • Reluctant to “pull the trigger” • Will act during narrow window of crises • Need 24x7 support • Need intervention guidance • Navigation of system & insurance PRIMARY CARE/PEDS/ BEHAVIORAL HEALTH SPECIALISTS • Anxiety, Depression,SUD not picked up • Lack of integration w/ PCP and BH • PCP not screening or trained in treatment • Industry push to integrate but lots of help needed • SUD and MH is component of many other diseases • Intervention oppty Mapping the Addic on Chain From Early Warning Through Sustained Recovery to Discover Gaps DETOX FACILITY • Short term solution 3-5 days • Revolving door • Must transition to long term care w/ transport • Relapse & OD high risk here HOMELESS SHELTERS IN PATIENT TREATMENT CENTERS • 15 day discharge common due to insurance limits- not enough • 14-21 days after detox is when individual has acceptance vs. denial • Sleep, brain function start but need more time to work on recovery • Re-evaluate every 15 days • Have addict sign promisory notes while “impaired” • Need tight continuum and insurance coverage EMPLOYERS • Employer assistance programs • Company insurer aware of issues, case mgmt oppty • Privacy ensured – employer doesn’t know • Companies can provide EAP support & education IOP/STEP DOWN • Intensive outpatient program • Sometimes combined with sober living • Lack of insurance an issue • 6 weeks ideal, but rarely get enough time SOBER HOUSING • Ideally 5 months + • Medication management • Life skills support • Peer support • Matchmaking is needed • Reportedly depressing places SUSTAINED RECOVERY, WELLNESS PROGRAMS • Ongoing 12 Step or SMART programs, Yoga • Need more sustained recovery modalities • Mix of in-person and virtual TREATMENT>> © Copyright 2016, Please Use w/ Attribution Mary Beth Schoening Stephanie Briody THERAPISTS • Many people in recovery don’t go into residential treatment programs and use traditional therapy • Mental health and substance use treatment are separated in many cases • Integrated treametne needed • Insurance reimbursement lacking INSURANCE COMPANIES • Provide intervention services based on health algorithms • Confidential, employer not informed • Working on prevention strategies and programs for future=ACO model PHARMACY • Need to address overprescribing • 70% opioid start w/ prescription • 90% OD get another script • MD doesn’t know about OD • Clinical, parental, & onsumer education needed • Prescription take back • Dentists included TREATMENT APPROACHES • Medicated assissted treatment vs. abs nence • MAT outcomes be er • Many feel suboxone, bupenorphene subs one drug for another • AA vs. SMART • Faith based recovery strong for some • Anonymity of AA ques oned • Need more to speak up to remove s gma Behavioral Health Innovators, Inc. www.bhinnov.com marybeth@bhinnov.com @mbschoening Thank you to the individuals in recovery and their families for contributing to this document
  11. 11. RAMP RAMP Risk Addiction Mapping Progression Peer Model – Solution Co-development & Delivery of Messages w/ Their Voice • Typical Everyday Behaviors – Can Relate To • Their Language • Understanding of Progression • Where They Are on Ramp • How to Get Off
  12. 12. THE RAMP™
  13. 13. My mind was always going crazy, I could never think straight
  14. 14. Personas: Different Approaches Work for Different Personas Family Unit Personas • Family is aware and addict is resistant • Family and addict are both in denial • Family and addict are both open to help • Addict is open to help and family is in denial
  15. 15. Industry Snapshot: How Technology Can Help • Most Go Undetected – as Many as 9/10 • Behavioral Health and Primary Care Chasm and SUD TX • Severe Shortage of Clinicians and Beds • Broken Care Continuum, Patient Centered Planning • Lack of Standard Treatment Protocols • Stigma –We’re Working On It, But Still There • Lack of Understanding of Addiction as a Disease • No Black and White Diagnosis – Life Disruption • Denial is So Strong
  16. 16. Please come talk to us! Lived experience, developers, researchers, film/content, clinicians, donors MaryBeth@bhinnov.com @mbschoening Stephanie@bhinnov.com @sjbriody Next up: Lauren Stahl
  17. 17. • Stephanie Briody • John Cabral • Louise Griffin • Cory Gys • Lauren Stahl Lived Experience Panel
  18. 18. John and his son Eric
  19. 19. Louise and her son Zack
  20. 20. Cory and his cousin Zack, Louise’s son

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