the first phase, orientation. second phase, awareness. third phase, enhancement. fourth phase, enlightenment. and fifth phase, empowerment. god, grant me the serenity to accept the things i cannot change. we do a weekly group, a session with the clients and the staff, and we talk about their initial stay here at the shelter. we discuss what they're doing well and where they can work on. it is told to the client so the client can actually work on that as well. besides the group counseling and the individual sessions, we have drug and alcohol seminars. we have anger management, and we have self-esteem. and we also have recreation activities such as ping-pong, physical activities, and also do walking and running. so that's one of the good, big components to beef stew. so go on and bring that back to a boil, and it's lunch. one of the things they do as part of their life skills

is to cook their own meals. and staff are here to help them learn how to set up a nutritious meal, how to set up the menu. so the resident here would be helping and cooking until they're able to learn how to do that on their own. the transitional living program is an independent living program, and it's for young people 16 ½ and older, and they may stay with us for 18 months to three years. and that includes an agriculture farm, where they grow tilapia and they market it themselves and the money goes to them. and we have an organic farming project as well, where they can farm produce that they can later sell to the markets. my life before was terrible. it wasn't good. i was doing into troubles a lot. i was facing the courthouse, had many charges,

and it wasn't helpful. the best thing about sanctuary is you learn new things, you learn how to communicate with your peers, your adults, your staffs, and helps you stay out of trouble. being able to recover and be able to find a means to help them through their treatment, some of these kids don't have that opportunity, and guam sanctuary, this is the only place they have. here on guam, you will often hear [speaks in chamorro]. and [speaks in chamorro], is a word that is used to celebrate or elevate a particular group or cause. and so here at sanctuary, because we celebrate and we elevate young people and their families, we say [speaks in chamorro],

we celebrate young people and their families. george, let's go back to you and your program. tell us, how does that fit in into a continuum of care? yes, ok, thank you. illinois tasc, we see about 30,000 clients a year through various systems and particularly, our criminal justice systems. we go in and advocate at the county level to ask for an exception to probation services and then he or she receives the probation services. and then, we go out and we negotiate the relationships with the external systems, housing, workforce development, and so forth. but the critical component in that is working with the judges. the judges, the probation systems, the state's attorney systems and so forth, to have them to have buy-in to allowing this option for these individuals. other than that, they go to prison. so they get a treatment option, they come back to their respective communities, and then begin to come out with what i like to call a attitude of gratitude versus just having a attitude, that they make this commitment.

and then, the systems see themselves involved because they come out. and years ago, you had to come out and you had to hide out with that situation. now, they come back as george the citizen, trying to take his rightful place in those suspected places. so you're working with ex-offenders once they get ready to be released. absolutely, correct. is that at the point where you come in and then work with the judge? so they're not drug courts. right. no, no. we work before. we go in and do the initial assessment for the court system, for the judge, and we advocate for treatment services initially, up front. and then, at the end, when he or she completes the probation piece of it, we then make sure that they are in a continuum of care that help them to be successful. what has happened is that we have 2.1 million folks in jails and prisons today, and as many as 80 percent have an alcohol or drug problem.

and if you go to jail because you got caught knocking off a 7-eleven in order to buy some drugs. you get out of prison. if you go back where you came from, the only guys who welcome you back in the neighborhood is your old drug dealer. and so this is where systems like attc have working on, connecticut's working on, are so important to take into account that you need to do other things. a part of that system that george mentioned, he deals with people after they're in prison, but the country has come a long way in setting up drug courts to try to send alcoholics and drug addicts off to treatment before they go to prison. dr. kirk, what is it that needs to occur? in particular, i know that paul just mentioned the whole notion of co-occurring conditions. what needs to occur for someone who has the complicated scenario of having both an addiction and a mental illness?

what should the approach be within this continuum of care? a couple of different things. one of them is that our provider system should be set up in such a way that there's no wrong door. we hear, you go to a mental health clinic, but we don't do that in our agency. so helping, and i'm sure lonnetta can talk about this, trying to provide the proper training so that wherever it is i go, i present the care there's a person that can properly assess and then follow up care with that. i think the other aspect is that frankly, there's some stigma between the mental health and addiction systems. and we as people, stakeholders, have to work on trying to offset that. what i try to pay attention to is every week, part of my job, what comes across my desk are what are called critical incidents. a person that died, one of the people in our system had died. somebody got arrested for some major crime, some other kind of thing.

good eight out of every 10 of those is a person with some degree of some co-occurring conditions. so if we're truly going to view this as a life change, as if we can truly see this as a healthcare condition, let's get over these, if you will, artificial beliefs that we have that well, it's one versus the other, and move on. i don't want to over-mental health-ize the addiction system or vice versa but i think that's one of the areas that for a certain percentage of people, that's a proper response. well, to give you some idea of the co-occurring effect, depaul university just published a paper this summer in the journal of community psychology, which was funded by the national institutes of health, and they looked at 890 people in oxford houses out of this group of 10,000 and administered tests to their 890 folks that measure the degree of severity of mental illness.

fifty-eight percent of the folks had mental illness in addition to the alcoholism and drug addiction. and i think there's probably a good reason for that, and that is that if you had a mental illness, manic depression, schizophrenia, acute depression, the street gives you an easy way to treat it. you'll feel differently if you take cocaine or crack or booze. and because you want to feel differently, you do that. and so then, do you need more than simply saying i'm going to stop using alcohol - (inaudible) - and drug and you don't really know that until you stop using for six months. if you still got a problem, you probably got an underlying mental illness problem. absolutely. but again, you need a safe place to live, you need support, you need this continuum of care, which professionals now begin to talk about and didn't talk about very much 20 years ago. lonnetta. yes. talk to us.

dr. kirk mentioned related to offering services, how we prepare our workforce in order to be able to not only assess, but treat individuals with a co-occurring condition. how are you involved in efforts to do that? the attc's technology transfer, i think, is where i'd like to go with this is as a larger framework for preparing the workforce, working with systems, training as a part of technology transfer. and as i listen to the discussion, our first job is raising awareness and what is it that we're talking about in helping our constituents, whether it's the states, the systems, the line staff, the supervisors? what is it that we're talking about? what is recovery? the first question you asked me when we started, what's the recovery-oriented system of care? what's the delivery system? so that's one of the first things that we do in our

workshops and different venues is the what. are we talking mild to moderate type of a situation that's handled, say, by the sbirt programs with primary healthcare and brief intervention? are we talking moderate to severe, which is where recovery support services? when we look at the what and can get a good description of what our delivery system looks like and we engage everybody in that process, so that collaboration piece even at the systems level is important. we have a 45-member advisory board. leaders from across our four-state region with the state directors, co-occurring institutes, treatments, certification. tasc is responsible for our special services for criminal justice, professionals and populations all coming together to sort of guide

and lead the discussion on what the workforce development issues are, how do we integrate evidence-based practices, which evidence-based practices are appropriate? so that whole collaboration piece and getting our service delivery system described, i think this recovery-oriented system of care has a great benefit and an opportunity, i think, for us to really build on the research from addiction treatment. dr. kirk talked about it with the recovery zone and how do we look at what the recovery measures? people who have been in recovery such as george and paul, here, what is that about? so recovery measures, that's some of the recent studies that are being looked at and some of the questions that we're asking. and i'm happy that the research community is joining us in this to try and -

yeah. and once you get these recovery outcomes and once you begin to get the evidence, and once you be able to figure out what works and what doesn't work, it is so important that lonnetta's operation, attc, transfers that information. and we're really lucky today, as compared to say, bill wilson and dr. bob when aa was starting in 1935, in that we have instant communication. all this internet stuff. all the tom is addicted to a blackberry for example. if bill wilson and dr. bob had that, they probably would have had us all sobered up by now. i think it's more than dr. kirk that's addicted to the blackberry. (laughter) but we will be coming back to actually talk about how is it, indeed, beyond what the attcs are doing that we can further explore ways of getting other states and getting other individuals to really look at the individual that needs the services

and tailor a service delivery system around that person that needs the assistance. we'll be right back. if someone you love has a problem with drugs and alcohol - he's not expecting this. yeah, but it's the right thing. - there is something you can do. you think he'll be ok with this? shhh, here he comes. congratulations. (clapping) you can celebrate his recovery every chance you get. for drug and alcohol treatment referral for you or someone you know, call 1-800-662-help. (music) mornings used to be the toughest. before i got treatment for my addiction, it was the little things that were hardest to bear. but now that i'm free of drugs and alcohol, it's the little things that give me the most joy. recovery, it gave me back my life. now, i can give back.

for drug and alcohol treatment referral for you or someone you know, call 1-800-662-help. (music) for 24-hour drug information and treatment referral, access help online with the substance abuse treatment facility locator at recoverymonth.gov. or call the toll-free treatment line at 1-800-662-help. thank you. have a great day. (music) well, i think that other states might benefit from a recovery-oriented focus because when all is said and done, we all have the same goal, and that is to

provide appropriate care to people to help them to recover and reclaim their lives. i don't think it's any different from south dakota than it is in connecticut or new york. that's our common goal, that's our common objective. and because it is an individual path to recovery, we have to remember what it is we're supposed to be about, helping people to recover their lives. and i think as long as we do that, then it doesn't make a difference where you live or what the system is. (music) odyssey house louisiana, we began 37 years ago as a drug treatment program. we operate on a therapeutic community model. we see that drug addiction is only one part of the individual's problems. we focus on treating everything from mental health issues, family issues, behavioral issues, job and job readiness issues.

so we're sort of taking a holistic approach. for example, our furniture rehab program, where we actually take furniture that people don't want, we redo it, and we sell it at an upscale store over on magazine street, here in new orleans. magazine street is more of the upscale area where people do a lot of their shopping. i'm going to take this point. make sure you flush it's perfect center and you want to go down just deep enough to this line, that's your line. your at that mark, ok? all right. the furniture rehab shop here is like a job. they have to report here every day at nine o'clock. they have responsibilities. they're trained. a lot of the clients that are here haven't worked in years, and this gives them the skills that they're going to need when they get out of here. it's helped me to learn how to stick to something because i start on a project and i know i can't just leave that project and walk off and let it sit there. and that's something that definitely has taught me

how to follow through on whatever it is, projects, jobs, just with life situations. i got to build this chair. it was like a throne type of chair, i just came up with it on my own. and it ended up being in art for arts' sake. and i sold it to a lady that is going to be at a mardi gras parade. and she's going to be sitting as the queen of the mardi gras parade. and so that was a good experience for me. pies for dinner, yes. we're doing apple? apple pies, yeah. second helping catering is a culinary arts program that we have. we have a full-time chef who works on teaching our clients basic culinary art skills that they prepare all of the foods in the house. and they also provide all of the basic catering for our catering company, second helpings catering. i see a lot of change as far as some people come in

not really having a history of work and we, by us doing catering, we need to maintain timelines and everything. so it teach people how to be more timely and work ethic and i think it changes people in that way. the best thing about working in here is you acquire people skills, you have to learn how to deal with all different types of people and to be able to manage it on a day-to-day basis. personally, it's taught me how to be able to function without being on different types of drugs. from where i was to where i am now, i've managed to be able to do a lot more throughout my day-to-day functions. i think that they gain valuable on-the-job training. the clients, when they come in, some people have experience and some people don't. but the attitude, the change in the attitude from when they come in and they leave, i think that's probably the best thing i see about the program.

the key component around this is helping our clients to develop a work ethic. a lot of our clients come to us without any basic idea around how to work or how they should be able to operate within a work environment. we teach them how to take directions from a supervisor, how to work within a certain framework of time, how to follow through with directions. and we hold them accountable about the things that they're supposed to be doing and how this is going to transition to get them into jobs and job readiness here in the future. tom, we started talking a little bit about the strains on the state systems due to the economic conditions. and let's pair that up with why it would be in the best interest of states to consider a system such as the one connecticut and other states currently have in terms of continuum of care and recovery-oriented systems. two points. one of them is that the larger public legislators and others now clearly understand the major issue

with the financial problems relates to healthcare. how do we provide healthcare? secondly, that when all is said and done, we're part of the solution to those issues. it gives us a great opportunity. let me just give you one example. those persons that i mentioned where we're spending 80 percent of our resource on 20 percent of our persons, the legislature, my governor, is interest in controlling the rate and growth of cost. and so these heavy-duty expensive services, the more i can show decreasing those and reinvest them in what we call a innovation savings reinvestment type of option, improving care, that gets their attention. so my state, as a state agency, i'm the safety net. so people who may not have private insurance, i'm the safety net. the more people we can effectively treat and lower cost per person, that makes us part of the solution. and one of the great things as you hit hard economic times,

a good example is the state of washington. there are 229 oxford houses in washington, 1,800 people at any given time. roughly 6,000 people go through those oxford houses. the average cost per bed for the state because they pay outreach workers to monitor the houses is 43 cents a day. now, for that 43 cents a day, the taxpayers of washington state get 83 percent of the people in those houses have been clean and sober for two years. we tracked them for two years. 83 percent. normally, you're lucky. dr. valiant, who did his study, the framingham, mass. group, he says about 20 percent is his success rate. well, here, all of a sudden, 80 percent. what is it different about an oxford house environment that gets people to stay sober? it makes it a little easier for the people in sobriety

because of the common bond that everybody has in recovery, but it's not unique to oxford house. what is unique is that people are focusing on recovery. it makes it easier if everybody's living together, but as tom mentioned, having people call once a week or once a day and remind you, that builds that family, that network. and i'll tell you the secret of recovery. if you stay clean and sober long enough, you're probably going to stay clean and sober forever. people ask me, why does oxford house work? and i say, this damn sobriety stuff is habit forming. i've heard someone say that recovery is contagious. and so i think that point's well taken. i think when dr. kirk talks about when people leave treatment, your recovery community services programs are much the same. not an oxford house, but certainly there are peers

that are providing services. when you talk about cost and what keeps a person in recovery and the cost savings in the recovery support services end of that continuum. i think there is a lot of opportunities there with those recovery organizations and the use of peers. the good news for us, by the way, is we've got 1,300 oxford houses today across the country. that's the good news. bad news is there needs to be 70,000. i'm sure there's lots of need out there. the good news is the bad economy means housing is cheap. it's possible to do it. it's the best time in the world for oxford house formation because you can get folks to buy houses at reasonable prices and rent them to the group to become an oxford house. absolutely. george, i want to go back to you. in terms of the population from the criminal justice system, how does one sustain, what is the best approach to sustain the recovery among that population?

thank you. we have a constellation of what we call winner's circles that we have developed throughout the state. and these are groups that men and women can come to and talk about their journey, their recovery, and their stages of recovery. and they can talk about their criminal justice background, they could talk about the drug piece and so forth. they can talk about their successes in the work world and as they try to enter the work world. and we see these as real citizen circles in how they come together and have those kinds of conversations and that dialogue and celebrate the spirit of gratitude versus having the attitude about their journey. and we have a lot of activities where we have social events where they can talk about and have those kinds of experiences without drinking and drugging and so forth. bring family, bring community. we have locations in community at churches,

at little, small businesses and so forth and so on, where we can have these kinds of experiences and they can have that kind of support ongoing, outside of that criminal justice system environment. and that's a point that we really haven't touched on, is really the family. certainly, paul talked about the concept of family within the oxford house, that they create a real bonding of almost a family type of support system. and certainly, within the justice system, the family, certainly, the acceptance of the individual. and not only in the criminal justice system but in all systems. right. the acceptance and sometimes, the forgiveness as well because sometimes when you involve yourself in criminal behavior, you bring on a heavy burden to family. you sometimes have violated the family, and sometimes from the things that you've done out in community, the family have to carry that weight as you are away to some extent. they have to live in guilt and shame and denial and so forth. and so we get them engaged and let them talk about

and let them begin to debrief from their own personal feelings and shame and guilt and so forth. and then, they come back very differently. this way here, the person coming out of the system don't have to sneak back no more, they can come back. sometimes, in days old, you had to sneak back and they hide you in a room. you, just go on back there, don't say nothing. but now, it's no longer having to sneak back, they now come back as a family member. and one of the nice things about alcoholism and drug addiction, we haven't mentioned many of the nice things. but one of the nice things about alcoholism and drug addiction is it's an egalitarian disease. it gets lawyers like me, doctors, indian chiefs, garbage collectors, street sweepers, homeless people. we all have this common bond. it's funny that you all have the common bond but not everyone looks at it with the eyes of acceptance, and that is why we have a lot of discrimination still, tom, and a lot of issues related to the public opinion

about those individuals that face this problem. is that true? yes. let me mention. what the recovery focus gives us as a system, if you will, a larger system, the opportunity to widen the choir. and i grew up in a family where i'm sure you, maybe, have the same circumstances. when someone went into the hospital or someone had these kind of, my mother would prepare a casserole. and i say, when it get to the point where a person who goes into treatment for alcohol, drug abuse and the neighbors go ahead and send a casserole to that family, then we've died and gone to heaven. that's where the message has gotten across. and so we need to speak in different dialects. some legislators, they think about it from the dollar point of view. another one thinks about it from a healthcare point of view. someone else, criminal justice, education. try and understand how we change the message so that these different dialects make our choir bigger, and people such as us, we don't have to do what we're doing. and that is where we really do need to be, tom,

in terms of really taking a look at the opportunities to be able to tell that broader community how to join the voices for recovery. and there's nothing better than national alcohol and drug addiction recovery month each year, where we can lead up to september with a great event and join the voices for recovery. and we hope that our audience has enjoyed this program, and we hope that in the future, they will in fact join their community in celebrating recovery month. thank you for being here. it was a great show. thank you. (music) every september, national alcohol and drug addiction recovery month provides an opportunity for communities like yours to raise awareness of alcohol and drug use disorders and highlight the effectiveness of treatment. 2009 will mark the 20th anniversary of this annual celebration of addiction treatment and recovery.

in order to help your organization plan events and activities in commemoration of this year's recovery month observance, the free recovery month kit offers ideas, materials, and tools for planning, organizing, and realizing an event or outreach campaign that matches your goals and resources. to obtain your copy of this year's recovery month kit and gain access to other free publications and materials related to addiction treatment and recovery issues, visit the recovery month web site at www.recoverymonth.gov or call 1-800-662-help. it's important that everyone become involved because addiction is our nation's number one health problem and treatment is our best tool to address it. for a copy of this program or other programs