Strengthening the Treatment System
Research shows that the sooner substance abusers get into treatment and the longer they stay, the better their chance of recovery. However, current treatment resources are not meeting demand and the system itself often pre-sents barriers to those seeking treatment.

In response to this supply and demand challenge, the Foundation awarded $1.7 million in grants in 2002 as part of the $9.5-million Paths to Recovery: Changing the Process of Care for Substance Abuse initiative. The program is designed to strengthen the substance abuse treatment system by re-engineering business systems and processes in nonprofit and public treatment facilities to get more people into treatment sooner and keep them there longer.

The barriers to changing the substance abuse treatment and recovery systems are legion. Too few beds, staffing shortages, financial issues or administrative bureaucracy result in long backlogs, with those seeking help often having to wait months for admission. Such delays represent a lost opportunity to treat millions of substance abusers.

While Paths to Recovery focuses on the point of delivery for treatment services, Resources for Recovery: State Practices That Expand Treatment Opportunities takes a broader view. This new $3-million initiative encourages states to identify and implement strategies to expand treatment resources and eligible populations by using current funding levels more efficiently and effectively. Up to 20 states will participate in a two-year policy forum to identify strategies to expand resources; up to five will then be awarded implementation grants to carry out selected strategies. Under this program, for example, states might divert consumers from high-cost inpatient facilities to lower-cost outpatient settings and coordinate purchasing between Medicaid and federal block grant dollars.

Building Depth and Momentum in Adolescent Services
To catch problems early, much of the Foundation’s work centers on strategies that have been shown to reduce substance use among young people—from supporting public education about the link between tobacco tax increases and reductions in smoking to structuring research-based prevention programs.

All too often, the treatment of substance abuse is isolated from the settings in which the sufferers from addiction interact—the justice system, the health care system and the welfare system. Children who abuse alcohol and drugs are more likely to behave violently, break the law or end up in court. Yet up to two-thirds of young people in juvenile justice facilities are not receiving treatment for substance abuse. The Foundation’s $21-million initiative, Reclaiming Futures^®: Communities Helping Teens Overcome Drugs, Alcohol & Crime, addresses that disconnect by supporting research and programs that integrate substance abuse treatment into the juvenile justice system.

Eleven communities received grants under Reclaiming Futures in 2002 to develop model programs. In Dayton, Ohio, for example, where six out of 10 young people who go through the county's juvenile court system have substance abuse problems, the RWJF-funded Mobilizing Natural Helpers project will work to redefine three major components of the system:

• How youths are assessed when they enter the system, focusing on their assets and abilities rather than their problems.
• How members of the youths’ communities (family, friends, religious congregations—called “natural helpers”) can assist in their rehabilitation.
• How restorative justice practices, such as activities that give back to the community, can be employed.