dr. h. westley clark, u.s. department of health and human services, substance abuse and mental health services administration, center for substance abuse treatment. dr. jane maxwell, senior research professor, university of texas at austin, golf coast addiction technology transfer center; lisa mojer-torres, esquire, consumer advocate, faces & voices of recovery; mark parrino, founder and president, american association for the treatment of opiod dependence (aatod). dr. clark, let's talk a little bit about medication-assisted therapies and how they're used. well there are a number of medications that are used to help facilitate recovery from substance use disorders. the most popular and most prominent would be buprenorphine and methadone. but there are also medications used for the treatment of alcohol. examples of that would be naltrexone and the camprosate or disulfiram. what they're used to do is to either facilitate the recovery of persons through maintenance, as with methadone or buprenorphine, to facilitate

dr. h. westley clark, director, center for substance abuse treatment, substance abuse and mental health services administration, u.s. department of health and human services, rockville, maryland; dr. timothy condon, deputy director, national institute on drug abuse, national institutes of health, u.s. department of health and human services, rockville, maryland; dr. barbara krantz, chief executive officer

dr. h. westley clark, director, center for substance abuse treatment, substance abuse and mental health services administration, u.s. department of health and human services, rockville, maryland; dr. timothy condon, deputy director, national institute on drug abuse, national institutes of health, u.s. department of health and human services, rockville, maryland; dr. barbara krantz, chief executive officer and medical director, hanley center, west palm beach, florida; beverly gmerek, prescription drug abuse prevention program coordinator, peer assistance services inc., denver, colorado. dr. clark, how prevalent is prescription drug misuse in the united states? well, we estimate that there are approximately 15 million people who misuse prescription drugs in the united states, and that gives us an estimated 2.5 million new initiates per year, or, if you think about it, that's about 7,000 new initiates a day. and within that, do one age group uses it more than others? what is the distribution among the age groups? well, i think the most important thing to keep in mind is that prescription drug abuse

dr. h. westley clark, director, center for substance abuse treatment, substance abuse and mental health services administration, u.s. department of health and human services, rockville, maryland. marco e. jacome, chief executive officer, healthcare alternative systems incorporated, chicago, illinois. john de miranda, president and ceo, stepping stone, san diego, california. william lossiah-bratt, board of directors, southeastern regional representative, faces and voices of recovery, cherokee, north carolina. dr. clark, why should we be concerned about ethnic and racial differences within the addiction and recovery field, as well as other differences? well, one of the things that we want to make sure is that people who have substance use problems are able to recover and that materials that we use can assist them in that process. and so, you know, there are differences associated with cultural values and beliefs, starting from how one physiologically responds to a particular substance misuse to how certain substances are used in a cultural context. so if we're going to facilitate recovery, we need

dr. h. westley clark, director, center for substance abuse treatment, substance abuse and mental health servicestration, u.s. department of health and human services, rockville, maryland. richard cho, director of innovations and research, corporation for supportive housing, new haven, connecticut. robert kershaw, business owner and outreach worker, oxford house, incorporated, silver spring, maryland. dr. jesse b. milby, director, medical psychology, substance abuse and homeless research program, department of psychology, university of alabama at birmingham, birmingham, alabama. dr. clark, when is a person categorized as homeless? well, the most important thing is to recognize that when a person lacks a permanent, fixed residence, they meet the category of homeless. now, there are a number of temporary arrangements that people have; for instance, it's estimated that roughly 1.6 million people are living in transitional or shelters, and they also meet the definition of homeless. so it's-we're looking for people who have permanent, fixed residence, and if you don't have that, then you're defined as

dr. h. westley clark, director, center for substance abuse treatment, substance abuse and mental health services administration, u.s. department of health and human services; josh koerner, executive director, consumers helping others in a caring environment (choice); katherine high, duel diagnosis program coordinator, community psychiatry, university of maryland medical systems; mark segal, clinical director of co-occurring services, second genesis. dr. clark, about 33 million people in the u.s. live with a mental illness and a substance-use condition. what are co-occurring conditions? co-occurring conditions are conditions that occur in people who have several things going on. they may have a substance-use disorder and they may have an independent psychological problem such as anxiety or depression, or more serious problems like bi-polar affected disorder or schizophrenia. and, kathy, what are the current barriers of care for individuals with co-occurring conditions? well, there's probably many barriers. one is, you know, accessibility of treatment - availability of treatment programs. you know