ADSAC

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ADSAC

• Standardized treatment options for license
  reinstatement
• February 2012

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ADSAC

• Commonly reported causes of automobile accidents

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ADSAC
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ADSAC
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ADSAC
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ADSAC
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ADSAC

• Ray Caesar LPC, LADC
• Director of Addiction Specialty Programs
• Oklahoma Department of Mental Health and
  Substance Abuse Services
• P.O. Box 53277
• Oklahoma City, OK 73152-3277
• rcaesar_at_odmhsas.org
• 405-522-3870
• 405-522-4470 fax

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ADSAC

• CONTACT INFORMATION
• Ray Caesar 405-522-3870
• rcaesar_at_odmhsas.org
• Patty Patterson 405-522-8537
• ppatterson_at_odmhsas.org
• John Bureman 405-522-8024
• jbureman_at_odmhsas.org
• Linda Clark 405-522-5837
• lclark_at_odmhsas.org

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COSTS

• Alcohol and other drug abuse is the number one
  public health problem in Oklahoma and the nation.
• The economic cost is estimated at approximately
  7 billion a year for Oklahoma and 414 billion
  nationally.

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COSTS

• Cost of impaired driving for Oklahoma
• 1.4 billion in crash related costs
• .6 billion in direct monetary costs
• .8 billion in quality of life costs
• The average cost to the injured person in an
  alcohol related crash is 90,000.00

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COSTS
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ADSAC

• TITLE 450
• Chapter 21
• Certification of Alcohol and Drug Substance
• Abuse Courses (ADSAC),
• Organizations And Facilitators
• Effective July I, 2009

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ADSACNew Facilitator Training

• Course Costs
• Twenty-four hour course 360.00
• Ten hour course 150.00
• Course costs equal fifteen dollars an hour

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ADSAC

• ADSAC courses are considered covered entities
  and therefore protected by 42 CFR Part 2
• Participant records must be kept in a specific
  manner

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ADSAC

• 203
• Certified ADSAC Facilitators
• 60
• Certified ADSAC Course Organizations
• with 90 satellites
• 2012

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HISTORY

• The Oklahoma DUI School system was comprised of
  independently certified agencies. Each agency
  was responsible for curricula development.
• ODMHSAS approved the curriculum verifying all
  areas required by statute were present.

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HISTORY

• Many schools were appropriate and well run with
  competent, professional staff
• A few schools were run in a less than
  professional manner.
• A small number or inappropriate schools created a
  negative public perception

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ADSAC

• Each DUI school created a curriculum for that
  school.
• There were no standards for use of video.
• Most DUI schools were lecture only.

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SOLUTION

• Utilize evidence based, best practices.
• Most current, science based information.
• Highest quality exercises.
• Highest quality materials.
• Transtheoretical Model of Change.
• Require Participant interaction.

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TRANSTHEORETICAL MODELOF CHANGE

• STAGES OF CHANGE
• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance/Termination

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SOLUTION

• Through the provision of multiple interventions
  separate offenders by relative severity of
  problem.
• 10 hour ADSAC
• 24 hour ADSAC

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ADSAC

• Alcohol Drug, Substance Abuse Course
• 10 hour ADSAC
• Three sessions, held on three separate days,
  with no session lasting over three and one-half
  hours

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ADSAC

• 10 hour ADSAC Table of Contents
• Introduction
• Laws and Consequences
• Alcohol/Other Drugs and Effects
• Use, Abuse and Addiction
• Looking Ahead

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ADSAC

• Alcohol Drug, Substance Abuse Course
• 24 hour ADSAC
• Twelve sessions, held two nights per week for
  six weeks, with each session two hours in length.

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ADSAC

• 24 hour ADSAC Table of Contents
• Introduction
• Laws and Consequences
• Alcohol/Other Drugs and Effects
• Use, Abuse and Addiction
• Substance Use and the Family
• Self-Evaluation
• Strategies for Positive Change
• Looking Ahead

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SOLUTION

• Instructor
• Facilitator
• Counselor
• Therapist

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ADSAC

• November 1, 1985 10 hour DUI school
• Testing suspensions
• July 1, 1991 10 hour DUI school
• All alcohol related suspensions
• May 26, 1993 10 hour DUI school
• Drug convictions
• September 1, 1993 Assessment required
• November 1, 1996 24 hour DUI school
• July 1, 2003 Assessment driven Evidence based
• July 1, 2008 Recommendations in code
• November 1, 2008 Change in assessment fee
  collection

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ADSAC

• ADSAC is an acronym for
• ALCOHOL AND DRUG, SUBSTANCE ABUSE COURSE
• This phrase is found in Title 47 Motor Vehicle
  Code and originally referred to the entire
  process of assessment, education and treatment.
• Authority for the ADSAC process comes from Titles
• 43A Mental Health Law
• 47 Motor Vehicle Code
• 22 Criminal Code

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ADSAC

• THEORY APPLICATION

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ADSAC

• Question
• Who is a candidate for the ADSAC process?

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ADSAC

• Answer
• Almost everyone.

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ADSAC

• Access to ADSAC services may be required of
  almost the entire population of Oklahoma
• Only a very small percentage of the population
  will not be possible candidates for ADSAC
  services. Those who never drink or use mood
  altering drugs and who never associate with those
  who do.

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ADSAC

• 25 to 40 of 30 of the population the
  population consume 90 of never drink the
  alcohol
• Of this group only 30 or (10 of the
  total population) are physically dependent
• National Institute of Health

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ADSAC

• ADSAC PROHIBITION
• Excessive drinking rather than alcoholism creates
  the majority of alcohol related problems.
• The prevalence of alcohol dependence among
  excessive drinkers in New Mexico, Alcoholism
  Clinical Experimental Research, Jan. 2007

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ADSAC

• Institute of Medicine
• Intervention Spectrum

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ADSAC

• How does ADSAC become a requirement?

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ADSAC

• Alcohol or other drug related driving
  offenses (license revoked on arrest)
• DUI
• DUI D
• DWI
• APC
• Drug offenses (license revoked on conviction)
• Possession
• Transportation
• Distribution
• Paraphernalia

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ADSAC
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ADSAC

• Intervention Categories
• Recommendations
• from the Assessment

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ADSAC

• American Society of Addiction Medicine
• Patient Placement Criteria
• Second Edition - Revised

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ADSAC

• Intervention Category I 0 39 Low Risk
• Intervention Category II 0 39 Low Risk
• (Second offense)
• Intervention Cat III 40 69
• Moderate Risk
• Intervention Category IIIB
• Override from (IV or V)
• Intervention Category IV 70 89 Problem
• Intervention Category V 90 100 Severe

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ADSAC

• Intervention Cat I 10 hour VIP
• Intervention Cat II 24 hour VIP
• (Second offense)
• Intervention Cat III 6 wks grp 24 hr VIP
• Intervention Cat IIIB 12 wk grp 12 wk MSG
• Intervention Cat IV Intensive Outpatient
• Intervention Cat V Residential Treatment

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ADSAC

• Multiple interventions allow the separation of
  offenders by identified severity of problem

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ADSAC

• Intervention Category I
• 10 hour VIP

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ADSAC

• Intervention Category II
• 24 hour VIP
• (Second offense)

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ADSAC

• Intervention Category III
• 6 weeks of group 24 hr VIP

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ADSAC

• Intervention Category IIIB
• 12 weeks of group 12 weeks Mutual Support Group

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ADSAC

• Intervention Category IV
• Intensive Outpatient

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ADSAC

• Intervention Category V
• Residential Treatment

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ADSAC

• The ADSAC Course

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ADSAC

• Both the Ten and Twenty-four hour ADSAC journals
  were originally created with the assistance of
  Oklahoma ADSAC facilitators and course
  administrators
• The journals are interactive, requiring the
  participation of the offender

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ADSAC

• Standardization of curricula
• Allows the best possible product to be
  delivered
• Allows individual facilitator competencies
  to be evaluated
• Allows for the identification of unique
  participant characteristics

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ADSAC

• The ADSAC Course
• The ADSAC course is often the first
  therapeutically styled intervention
• The ADSAC course may be the only intervention the
  offender receives
• The ADSAC course should provide the information
  needed for the offender to make a quality life
  decision
• The ADSAC course requires the creation of a
  personal plan of action

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ADSAC

• Utilizing evidence based, best practices allows
  for inclusion of
• the most current materials
• the most current and effective exercises
• the highest quality materials
• required participant interaction

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ADSAC

• Alcohol Drug,
• Substance Abuse Course
• 10 hour ADSAC Course
• Three sessions,
• held on three separate days,
• with no session lasting over 3.5 hrs.

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ADSAC

• 10 hour ADSAC Course Table of Contents
• Introduction
• Laws and Consequences
• Alcohol/Other Drugs and Effects
• Use, Abuse and Addiction
• Looking Ahead

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ADSAC

• Alcohol Drug
• Substance Abuse Course
• 24 hour ADSAC Course
• Twelve sessions,
• held two nights per week for six weeks,
• with each session two hours in length.

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ADSAC

• 24 hour ADSAC Table of Contents
• Introduction
• Laws and Consequences
• Alcohol/Other Drugs and Effects
• Use, Abuse and Addiction
• Substance Use and the Family
• Self-Evaluation
• Strategies for Positive Change
• Looking Ahead

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ADSAC

• Interactive Journaling

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ADSAC

• I hear and I forget
• I see and I remember
• I do and I understand
• Confucius

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ADSAC

• INSTRUCTION
• FACILITATION
• COUNSELING
• THERAPY

FACILITATION
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ADSAC

• KNOWLEDGE RETENTION
• Reading 10
• Lecture 20
• Observation 30
• Observation Lecture 50
• Verbal restatement 70
• Learning through doing 90

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ADSAC

• Common Problems Issues with ADSAC

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ADSAC

• Sixty million Americans are functionally
  illiterate
• or illiterate.

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ADSAC

• According to the U.S. Census of 2000
• 20 of Oklahoma residents are illiterate
• 40 of the residents in some Oklahoma Counties
  have less than a twelfth grade education.

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ADSAC

• PERCEPTIONS

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ADSAC

• How the participants may appear to the facilitator

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ADSAC

• How you may appear to the paticipant

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• What the self image of the participant may be

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ADSAC

• LEARNING STYLES
• Kinesthetic 45
• Visual 30
• Auditory 25

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ADSAC

• Thinking Strategies
• Convergent thinkers
• Divergent thinkers

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ADSAC

• Methamphetamine dependent subjects tested scored
  somewhat below average in
• Motor function
• Abstraction
• Information processing
• Attention
• Verbal Fluency
• These areas tended to improve with abstinence
• ALCOHOL AND DRUG ABUSE INSTTUTE, UNIVERSITY OF
  WASHINGTON

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ADSAC

• Methamphetamine dependent subjects tested scored
  in the impaired range in
• Visual memory
• Verbal memory
• These areas tended to improve with abstinence
• ALCOHOL AND DRUG ABUSE INSTTUTE, UNIVERSITY OF
  WASHINGTON

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ADSAC
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ADSAC

• Neurological Deficits in Affective Prosody
  Comprehension Among Alcoholics and Fetal
  AlcoholExposed Adults
• Affective prosody is a nonlinguistic aspect of
  language that conveys emotions and attitudes
  during verbal communication.
• Alcoholic and Fetal Alcohol-Exposed adults were
  significantly less accurate in affective prosody
  comprehension. This specific impairment may be a
  consequence of callosal and right cortical
  dysfunction or damage.
• University of Oklahoma Health Sciences Center,
  Department of Neurology,

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ADSAC

• Leveling
• Modeling
• Framing Reframing
• Pacing Leading

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ADSAC

• Ray Caesar LPC, LADC
• Director of Addiction Specialty Programs
• Oklahoma Department of Mental Health and
  Substance Abuse Services
• P.O. Box 53277
• Oklahoma City, OK 73152-3277
• rcaesar_at_odmhsas.org
• 405-522-3870
• 405-522-4470 fax

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ADSAC

• CONTACT INFORMATION
• Ray Caesar 405-522-3870
• rcaesar_at_odmhsas.org
• Patty Patterson 405-522-8537
• ppatterson_at_odmhsas.org
• John Bureman 405-522-8024
• jbureman_at_odmhsas.org
• Linda Clark 405-522-5837
• lclark_at_odmhsas.org