A New York State Initiative to Address Tobacco in Alcohol and Drug Treatment

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A New York State Initiative to Address Tobacco in
Alcohol and Drug Treatment

• National Conference on Tobacco or Health
• Chicago, IL
• May 5, 2005
• William J. Panepinto, LMSW, Columbia Memorial
  Hospital
• Patricia Bax, CASAC, MS, RN, Roswell Park Cancer
  Institute
• Anthony Klein, BS, CASAC, Unity Health System
• Brian Sands, MD, New York City Health and
  Hospitals Corporation
• Michael Seserman, MPH, American Cancer Society,
  Eastern Division

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Seeds of a Tobacco Control-Addiction Services
Partnership
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Passage of the NYS Clean Indoor Air Act was a win
for Tobacco Control advocates, but

• New Yorkers still had limited tobacco dependence
  treatment options
• Medicaid coverage for bupropion and NRT
• Telephone counseling through the NYS Smokers
  Quitline
• Cessation services from various providers across
  NYS
• Tobacco dependence continued to exact a
  devastating toll on the addictions treatment and
  recovery community.

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Passage of the NYS Clean Indoor Air Act was a win
for Tobacco Control advocates, but

• If tobacco dependence is drug addiction,
  shouldnt it be treated by addiction
  professionals?
• If New Jersey can do it, why cant we?

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Potential Benefits of Successful Integration

• Providing chemical dependency treatment for
  tobacco dependence further de-normalizes tobacco
  use.
• People whose tobacco dependence does not respond
  to minimal counseling and pharmacotherapy will
  get the treatment they need.

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Potential Benefits of Successful Integration

• Chemical dependency providers can make a
  significant contribution to public health by
  preventing tobacco-related illnesses and deaths.
• Tobacco dependence treatment can be recognized as
  a medically-valuable service by physicians,
  insurers, and politicians.

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Champions for Tobacco Dependence Treatment
Prevention

• NYS Tobacco Control Program (TCP)
• New York State Smokers Quitline
• Cessation Centers
• American Cancer Society, Eastern Division (ACS)
• Center for a Tobacco-Free New York
• Healthcare Tobacco Initiative

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Champions for Tobacco Dependence Treatment
Prevention

• NYS Office of Alcoholism and Substance Abuse
  Services (OASAS)
• Nicotine Work Group
• Alcoholism and Substance Abuse Providers of NYS
  (ASAP)

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From a Conversation to a Plan

• June 2003
• ACS and ASAP first discuss collaboration to
  address tobacco in the addiction field.
• OASAS Nicotine Work Group convenes
• July-December 2003
• ACS-ASAP and OASAS develop draft plans to
  integrate tobacco dependence services into
  addictions treatment and prevention.

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From a Conversation to a Plan

• January 2004
• ACS, ASAP and OASAS meet, consolidate their draft
  plan, and establish a Partnership.
• TCP and provider agencies join the Partnership.
• March 2004
• Tobacco Dependence Program shares the New Jersey
  experience with the Partnership, inspiring
  Partners to promote full parity of tobacco with
  other drugs of abuse.

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NYS Partnership for the Treatment and Prevention
of Tobacco Dependence

• Alcoholism and Substance Abuse Providers of New
  York State
• American Cancer Society, Eastern Division
• Columbia Memorial Hospital
• New York City Health and Hospitals Corporation
• New York State Office of Alcoholism and Substance
  Abuse Services
• New York State Tobacco Control Program
• Roswell Park Cancer Institute
• Unity Health System

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The Partnerships Mission

• The New York State Partnership for the Treatment
  and Prevention of Tobacco Dependence is dedicated
  to the belief that all tobacco dependent people
  deserve access to the support and evidence-based
  treatment and prevention necessary to overcome
  their tobacco addiction. Using education,
  advocacy, and the strengthening of linkages among
  organizations, the Partnership works to develop
  high quality, well-coordinated tobacco dependence
  treatment throughout the state.
• (Panepinto, 2004)

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The Partnerships Goal is to

• establish a model for reducing the incidence of
  tobacco use, tobacco dependence, and
  tobacco-related disease among adults in chemical
  dependency treatment by fully integrating tobacco
  dependence services into New York States
  chemical dependency services infrastructure
  from provider education and service delivery
  evaluation to regulation and funding.
• (Panepinto, 2004)

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Partnership Activities
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Partnership Activities, January 2004 April 2005

• Coalition-building
• Public statements of support for tobacco-free
  chemical dependency programming
• Provider education and consciousness-raising

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Partnership Activities, January 2004 April 2005

• Surveillance on provider knowledge, attitudes,
  and experiences related to tobacco
• Development of recommendations for OASAS
  regulations and guidance for OASAS-licensed
  programs

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Building Provider Coalitions

• Recruited several provider agencies as
  Partnership members
• Facilitated the founding of a regional coalition
  of tobacco control and addictions professionals
  to integrate tobacco dependence treatment and
  tobacco control policies into chemical dependency
  treatment programs in a coordinated manner

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Public Statements of Support for Tobacco-Free
Programming

• Letter from OASAS Commissioner to all 1400
  licensed chemical dependency treatment programs
  and 600 chemical dependency prevention provider
  agencies publicizes Partnership and urges
  providers to begin to address tobacco dependence
  in their programs

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Public Statements of Support for Tobacco-Free
Programming

• Letter from NYS Department of Health Commissioner
  follows up OASAS Commissioner letter supporting
  Partnership and Tobacco Control Program efforts
  to help chemical dependency providers to address
  tobacco dependence

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Provider Education and Consciousness-Raising

• Sponsored 3 workshops by Terry Rustin on
  integrating tobacco dependence into chemical
  dependency programs at January 2004 ASAP Annual
  Meeting in NYC
• Delivered regional educations and focus groups
  for providers in five regions across NYS, October
  2004 January 2005

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Provider Education and Consciousness-Raising

• Sponsored Regional Coalitions Tobacco Dependence
  Conference in Albany, March 2005
• Developed, sponsored, and delivered a Tobacco
  Dependence Institute at April 2005 ASAP Annual
  Meeting in Rochester, NY

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Surveillance on provider knowledge, attitudes,
and experiences

• Regional focus groups for providers in five
  regions across NYS, October 2004 January 2005
  captured perceptions of barriers, benefits, and
  recommended strategies for implementing
  tobacco-free chemical dependency programming

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Surveillance on provider knowledge, attitudes,
and experiences

• Key informant survey administered by TCP and
  Research Triangle Institute captured program
  administrator knowledge, attitudes, and
  experiences in addressing tobacco dependence in
  their OASAS-licensed chemical dependency
  treatment programs

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Recommendations for Chemical Dependency Programs

• Adapted New Jersey Licensure Standards to develop
  recommendations for integrating requirements for
  tobacco dependence training for Credentialed
  Alcoholism and Substance Abuse Counselors and
  tobacco-free environment and tobacco dependence
  treatment policies into OASAS program licensure
  standards

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Recommendations for Chemical Dependency Programs

• Adapted Tobacco Dependence Program (Hoffman and
  Slade)s 12 Steps for Addressing Tobacco in
  Addictions to Develop guidance for training,
  policy development, and service delivery for
  OASAS-licensed chemical dependency treatment
  programs

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Next Steps
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Future Partnership Activities

• Secure funding to support the Partnerships
  educational, advocacy, and coalition-building
  activities
• Building regional tobacco dependence coalitions
  from regional chemical dependency provider
  coalitions to coordinate ongoing educational and
  advocacy activities

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Future Partnership Activities

• Building OASAS capacity to monitor tobacco
  dependence prevalence and treatment delivery
• Development of a website to deliver educational
  materials and coordinate statewide and regional
  educational and advocacy activities

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Any Questions?
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For more information, please contact

• William J. Panepinto, LMSW
• billpanepinto_at_msn.com
• 518.275.2793