NASW Alaska | The Alaska Chapter of the National Association of Social Workers

In 2004, almost 38,000 Alaskans age 12 and over either abused or were dependent on alcohol. In 2005, 18% of all adults and 21% of those ages18-24 reported binge drinking. At the same time, over 13,000 Alaskans availed themselves of publicly funded mental health services. In Alaska, 79% of newly incarcerated inmates were actively abusing or dependent on alcohol or other substances in the year before their incarceration. Over one-third of Alaskans in jail have some type of mental health disorder or substance abuse problem. Children in alcohol-abusing families are almost four times more likely to be maltreated and 10 times more likely to be neglected; 81% of all reports of harm against Alaska children involve substance abuse.

In 2003, the cost of alcohol and drug abuse to Alaska’s economy was estimated to be $738 million in lost productivity, accidents, health care, criminal justice and public assistance. Yet, between FY 2002 and FY 2007, state funding for substance abuse treatment dropped by 56.2% or $18.6 million. In 2004, over 35,000 Alaskans who needed treatment for alcohol abuse could not receive it. Medicaid does not cover most substance abuse treatment.

Alcohol and Other Drug Treatment and Prevention Fund

Millions of dollars earmarked for substance abuse prevention and treatment are not being used for their intended purpose by the Legislature. In 2002, the 22nd Alaska Legislature passed HB 225 that increased the excise tax on alcoholic beverages by 7.5 cents per drink. The legislation, sponsored by Representative Lisa Murkowski, also created the Alcohol and Other Drug Treatment and Prevention Fund (ADTP) into which 50% of all alcohol taxes are now deposited. Each year, approximately $17 million in alcohol taxes are deposited in the ADTP. With “carry over” from previous years, the fund is expected to hold over $20 million in FY 07. In her sponsor statement, Representative Murkowski wrote that the fund “would help provide revenue needed for the expanded treatment, therapeutic courts, diversion programs and other initiatives now under consideration in the Legislature.” But the Legislature has not expanded prevention and treatment services by adding ADTP dollars to General Fund/Mental Health dollars (GF/MH). Instead they took away GF/MH and replaced it with ADTP. In 2005, 18% of all adults and 21% of those 18-24 reported binge drinking. If the ADTP fund was used as intended to supplement and not supplant GF/MH spending in FY 07, the State of Alaska would have an additional $20 million for treatment and prevention of alcoholism and substance abuse. NASW Alaska Chapter supports the full funding of substance abuse prevention and treatment through the appropriate use of the Alcohol and Other Drug Treatment and Prevention Fund.

Co-Occurring Disorders

The chronic conditions of mental illness and chemical dependency can, with supports, be maintained in such a way as to foster long periods of mental health and substance health, with occasional relapses. This is true even in cases with combined elements of mental illness, chemical dependency, traumatic brain injury, personality disorders, and other similar conditions, although more supports would likely be needed. The State of Alaska can succeed in providing supports that lead to sustained periods of mental health, substance health, and successful functioning in the community for individuals with behavioral health challenges. The State of Alaska has a vested interest in providing these supports, as they are critical for the health and functioning of individuals with behavior health challenges, as well as for the health and functioning of their families and communities. NASW Alaska Chapter supports the full funding of behavioral health services through General Funds as well as through Medicaid.

Consumer-Operated Services

Consumer-operated services are services that are planned, operated and evaluated by consumers.[1] Though control is ultimately in the hands of consumer operators, consumer-operated services do not prohibit non-consumers or professionals from being involved. Some programs may seek or employ professionals to assist with specific responsibilities, but that involvement is decided by consumer operators. There are often varying degrees of organizational structure, but most often consumer-run programs are separate legal entities.[2] The Consumer movement in Alaska has developed over the last thirty years out of the discovery of the usefulness of peers supporting each other in self-help groups and from thousands of psychiatric patients who were discharged from psychiatric hospitals to communities where they found themselves isolated, lonely, and lacking meaningful relationships.[3] Current research has demonstrated that consumer services can reduce hospital stays[4] and can be cost effective. NASW Alaska Chapter advocates for Consumers of any population in need to be involved in the planning, development, implementation, and evaluation of any services intended to help aide in recovery and support.

A National Perspective

NASW will work to promote full parity for mental health and substance abuse prevention and treatment within the health care system.

Alerts / Letters: http://www.socialworkers.org/advocacy/issues/mental_health.asp

Alcohol, tobacco, and other drug (ATOD) problems affect millions of individuals and families. Although there are no conclusions about the causes of these problems, evidence indicates that some treatment and prevention approaches can be helpful. Many affected by ATOD problems do not receive appropriate services because of the stigma attached, the lack of appropriate available treatment, and the inability to pay for services. Private and public health plans should cover ATOD treatment in parity with other health problems, and everyone should have access to ATOD treatment. Drug offenders should be diverted to treatment whenever it is a prudent alternative to incarceration. Inequities in criminal penalties for drug crimes should be eliminated. ATOD policy and practice should be grounded in evidence about effective prevention and treatment approaches. Social workers are obligated to address ATOD problems to improve the quality of life for all affected and to advocate for ATOD policies that will increase social and economic justice.

[1] Substance Abuse and Mental Health Services Administration [SAMHSA] (1998). GFA No. SM 98-004. Cooperative agreement to evaluate consumer-operated human service programs for persons with serious mental illness, Rockville, MD

[2] Stroul, B. (1993). Rehabilitation in community support systems. In R. W. Flexner & P.L. Solomon (Eds.) Psychiatric rehabilitation in practice, 45-61, Boston: Andover Medical Publishers.

[3] Clay, S., Schell, B., Corrigan, P., and Ralph, R., (2005), On Our Own Together: Peer Programs for People with Mental Illness. Vanderbilt University Press: Nashville, Tennessee

[4] Rosenthal, H., Testimony Regarding the Results of the Research Study of the New York City Involuntary Outpatient Commitment Pilot Program, December 16, 1998