Annual Report on Substance Abuse
Treatment Programs

Submitted Pursuant to ARS 36-2023

Arizona Department of Health Services
Division of Behavioral Health Services

December 31, 2008

Table of Contents
Executive summary
A. Name and Location of Each Program
B. Amount and Sources of Funding
C. Number of Clients Who Received Services during the Preceding Fiscal Year
D. Demographic Characteristics of the Client Population Served
E. Client Problems Addressed by the Programs Including the Types of Substances
Abused
F. Summary of the Numbers and Types of Services Available
G. Evaluation of the Results Achieved by the Programs
H. Substance Abuse Treatment and Best Practices Goals for SFY 2009
I. System Enhancement Goals for SFY 2009

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Tables
Table 1: Service Delivery System SFY 2008
Table 2: Substance Abuse Treatment Funding Summary: SFY 2008 (Actual)
Table 3: Treatment Costs in 2008 by Treatment Setting

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Figures
(Please note that percentages may not total 100% due to rounding.)

Figure 1:
Figure 2:
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Figure 5:
Figure 6:
Figure 7:
Figure 8:
Figure 9:
Figure 10:
Figure 11:
Figure 12:
Figure 13:
Figure 14:
Figure 15:
Figure 16:
Figure 17:
Figure 18:

Trends in Statewide Substance Abuse Treatment Enrollment SFY 2005
– SFY 2008
Trends in TXIX/TXXI Substance Abuse Treatment Enrollment SFY
2005 – SFY 2008
Substance Abuse Treatment Enrollees by T/RBHA
Enrolled Children in Substance Abuse Treatment by T/RBHA
Enrolled Adults in Substance Abuse Treatment by T/RBHA
Expenditures for Substance Abuse Treatment Services
Substance Abuse Treatment by Age Group
Substance Abuse Treatment by Gender
Substance Abuse Treatment Participants by Race
Substance Abuse Treatment Participants by Ethnicity
Referrals for Substance Abuse Treatment Services
Involuntary Substance Abuse Treatment Participants Served by
T/RBHA
Primary Residence in the Past 30 Days
Primary Substance Abused SFY 2006 – SFY 2008
Primary Substance Abused by Children/Adolescents SFY 2006 – SFY
2008
Primary Substance Abused by Adults with SMI SFY 2006 – SFY 2008
Pregnant Women or Women with Dependent Children Receiving
Substance Abuse Treatment
Employment and Abstinence at Admission and Discharge

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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Executive Summary
ARS 36-2023 establishes a requirement for an annual report on substance abuse treatment programs that
receive funds from the Arizona Department of Health Services (ADHS). This report contains information
regarding substance abuse treatment pertaining to enrolled children and adults during SFY 2008,
including funding sources and costs of treatment services, services according to geographic area,
treatments setting and types, demographic data, and substance abuse issues faced by recipients. Finally,
an evaluation of services is presented along with proposed goals for the current fiscal year.
During SFY 2008, more than $121 million was spent on substance abuse treatment for more than 63,000
eligible enrollees. The majority of the recipients (65%) were in the state’s two major metropolitan areas,
Phoenix and Tucson. Half of those served were between the ages of 25 and 45 with an additional 27%
between the ages of 45 and 65.
The majority of those receiving services did so on an outpatient basis, which provided support and
medical assistance. Most recipients (45%) were either self-referred or sought treatment at the urging of
family and/or friends. Another 22.5% were court ordered to treatment. Of those receiving treatment, 56%
were male. The primary substance of choice of adults receiving services was alcohol, while the substance
of choice for those under the age of 18 was marijuana.
Available services include three methamphetamine Centers of Excellence, services for recovering women
and children, re-entry programs for those released from the Arizona Department of Corrections, HIV
Early Intervention Services that target persons with substance abuse issues, and the use of peer and family
support in the treatment process. In addition, special adolescent alcohol/drug treatment services are
available for families involved with Child Protective Services.

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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A. Name and Location of Each Program
In SFY 2008, the Arizona Department of Health Services, Division of Behavioral Health Services
(ADHS/DBHS) contracted with four Regional Behavioral Health Authorities and three Tribal Regional
Behavioral Health Authorities (T/RBHAs). T/RBHAs are responsible for developing and managing
networks of community agencies to deliver substance abuse services for persons eligible under the federal
Title XIX/XXI programs and for Non-Title XIX/XXI eligible individuals and families in Arizona. In
addition, ADHS/DBHS contracted with five tribal nations for delivery of substance abuse treatment
services to reservation residents.

Table 1: Service Delivery System (SFY 2008)
Area
GSA 1
GSA 2

Counties
Apache, Navajo, Coconino,
Mohave, Yavapai
La Paz, Yuma

GSA 3

Cochise, Graham, Greenlee,
Santa Cruz
GSA 4
Pinal, Gila
GSA 5
Pima
GSA 6
Maricopa
Tribal
Pascua Yaqui Tribe
Authorities/ Gila River Indian Community
Contractors White Mountain Apache
Tribe of Arizona
Navajo Nation
Colorado River Indian Tribes

*

T/RBHA
Northern Arizona Regional Behavioral Health
Authority (NARBHA)
Cenpatico Behavioral Health of Arizona
(CBHS) - 2
Community Partnership of Southern Arizona
(CPSA) – 3
CBHS – 4
CPSA – 5
Magellan of Arizona *
Tribal Regional Behavioral Health
Authorities: Pascua Yaqui Tribe, Gila River
Indian Community and White Mountain
Apache of Arizona
Tribal Contractors: Navajo Nation and
Colorado River Indian Tribes

Magellan of Arizona replaced ValueOptions as the RBHA on September 1, 2007. ValueOptions was the RBHA
during the July 1-August 31, 2007 period.
Arizona Department of Health Services / Division of Behavioral Health Services
2
Annual Report on Substance Abuse Treatment Programs (2008)

B. Amount and Sources of Funding
During SFY 2008, ADHS/DBHS expended $121,191,579 in service funding for individuals and families
with substance abuse disorders. The Title XIX program for persons eligible under the Arizona Health
Care Cost Containment System (AHCCCS) program comprised the single largest source of substance
abuse treatment funding during the fiscal year (62.66%), followed by the Substance Abuse Prevention and
Treatment Block Grant (19.43%). Funding for substance abuse treatment also included state appropriated
monies from the Arizona State Legislature, funds from Maricopa County for local detoxification services,
and funds from the Arizona Department of Corrections for prison re-entry services.

Table 2: Substance Abuse Treatment Funding Summary: SFY 2008 (Actual)
Fund Source

Dollar Amount

Percentage

Title XIX/XXI Funding

$75,941,357

62.66%

Federal Block Grant for Substance Abuse Prevention and
Treatment

$23,545,206

19.43%

State Appropriated

$16,518,610

13.63%

$5,141,081

4.24%

$45,325

0.04%

$121,191,579

100%

Maricopa County, City of Phoenix, Arizona Department of
Corrections Correctional Officer/Offender Liaison
(COOL), Intergovernmental Agreements (IGA) and
Interagency Service Agreements (ISA).
Liquor Fees
TOTAL:

C. Number of Clients Who Received Services during the Preceding Fiscal Year
Individuals and families eligible under Arizona’s Title XIX and Title XXI programs receive all medically
necessary covered behavioral health services for substance abuse and mental health treatment through the
T/RBHA. Covered behavioral health services for Non-Title XIX/XXI eligible Arizonans, also delivered
by T/RBHA providers, are based on available funding and special population designations in the
Substance Abuse Block Grant and other fund sources such as the Correctional Office/Offender Liaison
program.
Statewide, 63,571 adults and children were enrolled in ADHS/DBHS treatment for substance abuse or
dependence during SFY 2008.
3,929 (6.2%) of individuals enrolled in substance abuse treatment were children or adolescents, 49,571
(78.0%) were adults with substance abuse disorders and 10,071 (15.8%) were adults with Serious Mental
Illness (SMI) and a co-occurring substance abuse disorder.

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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Figure 1: Trends in Statewide Substance Abuse Treatment Enrollment SFY 2005 – SFY
2008
6 5 ,6 9 6
66,000
65,000
64,000

6 3 ,5 7 1

63,000
62,000
61,000
60,000

6 0 ,1 0 5
5 9 ,6 6 1

59,000
58,000
57,000
56,000
2005

2006

2007

2008

E n ro llm e n t b y Y e ar

Figure 1 indicates the number of Arizonans enrolled in substance abuse treatment services in the
behavioral health system during the years 2005 to 2008. The number of enrolled members decreased by
3.2% between 2007 and 2008.

Figure 2: Trends in TXIX/TXXI Substance Abuse Treatment Enrollment SFY 2005- SFY
2008
76%
74%

76%
74%
70%

72%
70%
68%

66%

66%
64%
62%
60%
2005

2006

2007

2008

E nro llm e nt by Ye ar

Figure 2 shows the proportion of individuals enrolled in substance abuse treatment who were AHCCCSeligible. For SFY 2008, 74% of individuals enrolled in substance abuse treatment services were eligible
for Title XIX/XXI programs (47,096 individuals) and 26% were Non-Title XIX/XXI (16,475
individuals).

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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Figure 3: Substance Abuse Treatment Enrollees by T/RBHA

4 .9 %

CBHS -2

6.6 %

CBHS -4

5 .8 %

C P S A-3

26 .3 %

C P S A-5
0 .7%

G ila R iv er

38 .0 %

M ag ellan / ValueO ption s
1 4.8%

N AR BHA
2 .2 %

N avajo
P as c ua- Yaq ui

0.4%

W hite M tn Apac h e

0.4%

0%

5%

1 0%

15 %

20 %

25 %

30 %

35 %

40 %

Pe rc e n ta g e

Figure 3 illustrates that Maricopa County accounted for the largest number of individuals receiving
substance abuse treatment in SFY 2008. Magellan/ValueOptions served 38%, followed by Community
Partnership of Southern Arizona (CPSA-5, 26.3%) and Northern Arizona Behavioral Health Authority
(14.8%). The remaining service areas totaled 21% of all persons treated during the SFY.

Figure 4: Enrolled Children in Substance Abuse Treatment by T/RBHA
C B H S-2

5.2%
5.8 %

C B H S-4

6 .9 %

C P SA -3
C P SA -5

30 .0 %
3 .6 %

G ila R iver

2 6.3%

M agellan / ValueO p t io ns
1 5.2 %

N A RBH A
4 .5 %

N avajo
P as cua- Yaqu i
W h it e M t n A p ache
0%

0.5 %
2 .0 %
5%

10 %

1 5%

2 0%

2 5%

3 0%

Pe rc e n ta g e

The majority of children who received treatment were served through Community Partnership of
Southern Arizona GSA 5 (30.0%), followed by Magellan/ValueOptions (26.3%), and Northern Arizona
Regional Behavioral Health Authority (15.2%).

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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Figure 5: Enrolled Adults in Substance Abuse Treatment by T/RBHA
4 .9 %

CBH S-2

6 .6 %

CBH S-4
CP SA -3

5 .7 %
2 6 .0 %

CP SA -5
Gila Riv e r

0 .5 %

M a g e lla n / Va lu e O p tio n s

3 8 .8 %
1 4 .8 %

N A RBH A
2 .0 %

N a v a jo
P a s c u a - Ya q u i

0 .4 %

W h ite M tn A p a c h e

0 .3 %
0%

5%

10%

15%

20%

25%

30%

35%

40%

P e rc e nta ge

Over 90% of all individuals receiving substance abuse treatment services in SFY 2008 were adults.
Magellan/ValueOptions served the majority of the adult population (38.8%), followed by Community
Partnership of Arizona (CPSA-5, 26.0%), and Northern Arizona Regional Behavioral Health Authority
(14.8%).
Table 3 lists the array of treatment options offered by the behavioral health system and outlines the mean
cost of each service. The majority of individuals received outpatient treatment which is significantly less
costly than inpatient services. Figure 6 illustrates the percentages of the total outlay by service.

Table 3: Treatment Costs in 2008 by Treatment Setting

Treatment Type

Average Cost of
Services per
Person

Persons
Served

Hospital Treatment

3,418

$9,338

Brief Residential Treatment

5,112

$4,992

Hospital Detoxification

189

$2,937

Long Term Residential Treatment

646

$2,863

1,672

$2,332

53,334

$1,649

2,833

$1,211

Residential Detoxification
Outpatient Treatment
Intensive Outpatient Treatment

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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Figure 6: Expenditures for Substance Abuse Treatment Services
30%
25.6%
25%
19.6%

20%

18.0%
14.4%

15%

13.3%

10%
4.3%

5%

3.4%
1.4%

tS
er
Re
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S

Ph
ar
m

an
d
ica
l

M
ed

Su
pp
or
tS

er
vi
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s

0%

D. Demographic Characteristics of the Client Population Served
Figure 7: Substance Abuse Treatment by Age Group
50.0%
50%
45%
40%
35%
26.8%

30%
25%
20%
10.5%

15%
6.0%

10%
5%

5.7%

0.1%

1.0%

0%
0-11

12-17

18-20

21-24

25-44

45-64

65+

Figure 7 shows that most individuals entering substance abuse treatment in Arizona during 2008 were
adults. Individuals age 25-44 years old represented half (50%) of all persons who received substance
abuse treatment. Together, persons aged 25-64 accounted for almost 77% of service recipients.

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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Young adults age 21-24 years represented 10.5% of persons enrolled in substance abuse treatment
services which is similar to previous years. 6.0% of persons receiving treatment for substance abuse
disorders were under the age of 18.

Figure 8: Substance Abuse Treatment by Gender
Male

Female

42.8%
45%
40%

33.3%

35%
30%
25%
20%
9.5%

15%
10%

8.4%

3.8%
2.2%

5%
0%

Children

GMH/SA

SMI

Behavioral Health Category

Figure 8 illustrates that more males 56.2% (30,927 males) receive substance abuse treatment in Arizona
than females 43.8% (24,122).

Figure 9 * : Substance Abuse Treatment Participants by Race
85.8%

90%
80%
70%
60%
50%
40%
30%
20%
10%

1.0%

6.9%

4.9%

1.4%

0%

Asian or
Pacific Islander

African
American

Native
American

White

Multi-racial

As Figure 9 shows, the majority of persons who received substance abuse treatment services in 2008 were
White (85.8%). Approximately 7% of persons served were African Americans and 5% were Native
American. Overall, 26% of participants identified themselves as Hispanic/Latino, which is the same as
2007.

*

Value of Unknown was less than 1%, therefore it was removed.
Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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Figure 10 * : Substance Abuse Treatment Participants by Ethnicity
74%
80%
60%
26%
40%
20%
0%
Hispanic/Latino

Not Hispanic/Latino

Figure 11: Referrals for Substance Abuse Treatment Services
44 .7 %

Se lf/fa m ily/frie nd
C rim ina l justic e or C orre c tiona l

22 .5 %
10.4%

B e ha viora l H e a lth P rovide r

9.8%

O the r or U nknow n
D E S (N on-C P S)

3.7%

H e a lth P la n or P C P

3 .0 %

N on B e ha viora l H e a lth C om m unity A ge nc y

2.7%
1.4%

Fe de ra l a ge nc y (V A , IH S, fe de ra l prison, e tc .)
A rizona D e pa rtm e nt of E duc a tion

1.0 %

C hild P rote c tive Se rvic e s

0.8%
0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Self referral or referral by a family member or friend was reported most frequently (44.7%) as the source
of referral for person admitted to substance abuse services in SFY 2008, while 22.5% of individuals
reported they entered substance abuse treatment due to court order or a referral by a criminal justice
agency.

*

Value of Unknown was less than 1%, therefore it was removed.
Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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50%

Figure 12: Involuntary Substance Abuse Participants by T/RBHA

9 .6 %

C B H S-2

1 2 .2 %

C B H S-4

1 1 .5 %

C P SA -3

2 0 .3 %

C P SA -5

2 7 .6 %

M a ge llan / V alue O ptions
1 8 .8 %

NARBHA
0%

5%

10%

15%

20%

25%

30%

A total of 11,282 individuals received court ordered substance abuse treatment. Figure 12 indicates that
the majority of involuntary substance abuse treatment participants resided in Maricopa County (27.6%),
followed by Community Partnership of Arizona GSA 5 (20.3%) and then Northern Arizona Regional
Behavioral Health Authority (18.8%).

Figure 13: Primary Residence in the Past 30 Days
45%

39.6%

42.2%

40%
35%
30%
25%
20%
15%
10%

3.2%

4.3%

4.7%

6.1%

5%
0%
Transitional
Housing

Institution

Other or
Unknown

Homeless

Home with Independent
Family
Living

Primary Residence in the Past 30 Days

Figure 13 shows that 42.2% of persons enrolled in substance abuse treatment services in SFY 2008
resided in an independent living environment in the 30 days prior to entering treatment. This was
followed by 39.6% reported living at home with their family. The data is consistent with 2007 data.

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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E. Client Problems Addressed by the Programs Including the Types of Substances Abused
Figure 14 illustrates that the abuse of alcohol and stimulants decreased between SFY 2006 and SFY 2008.
During the same time period, the abuse of marijuana and narcotics increased.

Figure 14 * : Primary Substance Abused SFY 2006 – SFY 2008
45%
40%

44%
2006

2007

2008

38%
37%

35%

31%

30%

27%

26%

25%

24%
21%
19%

20%
15%

9%
10%

11%

7%
3% 2% 2%

5%
0%
Alcohol

Stimulants

Marijuana

Narcotics

Other Drugs

Figure 15*: Primary Substance Abused by Children/Adolescents SFY 2006 – SFY 2008
70%
70%

64%
59%

2006

2007

2008

60%
50%
40%
27%

30%

23%
20%

20%

11% 9%
6%

10%

2% 2% 2%

0% 1% 1%

0%
Marijuana

Alcohol

Stimulants

Other Drugs

Narcotics

Patterns in substance abuse differ significantly between children and adults. Figure 15 shows that children
and adolescents receiving treatment overwhelmingly report marijuana as their primary drug problem
(70%), followed by alcohol (20%). The proportion of children and adolescents reporting a primary
marijuana problem has increased approximately 11% from 59% in 2005 to 70% in 2008, while alcohol
abuse has decreased from 27% in 2006 to 20% in 2008. Stimulants (6%) remain a distant third as a
primary problem reported by children and adolescents.
*

The Stimulant category includes methamphetamine, cocaine/crack and other stimulants. The Narcotics category
includes heroin and non-medical abuse of prescription painkillers.

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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Figure 16: Primary Substance Abused by Adults with SMI SFY 2006 – SFY 2008
60%
51%

2006

2007

2008

50%
39% 40%

40%
28%
27%

30%
23%

22%

24%

17%

20%

10%
4%

5% 5%

6% 5%

4%

0%
Alcohol

Stimulants

Marijuana

Narcotics

Other Drugs

In contrast, Figure 16 shows that alcohol was the leading substance abused by adults with serious mental
illness (40%). Stimulants continued as the second most commonly abused substance (27%), while
marijuana remained the third most commonly abused substance (24%). Narcotics and other drugs
accounted for less than 10% of persons served.
Further complicating substance abuse treatment is the fact that co-occurring mental health issues such as
depression, anxiety and psychotic disorders are commonly noted with substance abuse.

F. Summary of the Numbers and Types of Services Available
Methamphetamine Centers of Excellence (COE)
The COEs were initiated in 2005 and designed to serve individuals with a primary diagnosis of
methamphetamine abuse or dependence. ADHS/DBHS continues to support three centers: Gila River
Tribal Behavioral Health Authority in Sacaton, La Frontera and Compass Healthcare in Tucson, and
Community Bridges in Phoenix.
All three centers adhere to evidence-based treatment approaches including cognitive behavioral therapy,
motivational interviewing, peer support, aftercare support, family education, therapeutic urinalysis, a
community reinforcement approach and contingency management.

Services for Recovering Women and Children
ADHS/DBHS continues to support priority access to treatment for pregnant women and women with
dependent children as mandated by the Federal Substance Abuse Prevention and Treatment Block Grant.
During 2008, ADHS/DBHS contracted with Health Services Advisory Group to conduct a study
involving a case file review and client interviews at nine residential women’s treatment facilities. The
objective of the study was to gather baseline data regarding women’s substance abuse residential
treatment programs throughout the state of Arizona. A total of 1,139 pregnant women and 6,238 women
with children were served.
Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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Figure 17: Pregnant Women or Women with Dependent Children Receiving Substance
Abuse Treatment
50%

C BHS - 2

44.2%

45%
40%

C BHS - 4

34.5%

35%

31.1%

30%

C P S A- 3

25%

C P S A- 5

16.7%

15%
9.5%

10%
5%

M a ge lla n /
0%
V a lue O ptions

N ARBHA

21.5%

19.6%

20%

3.1%

8.6%

6.9%

3.1%
1.3%

P regnant W om en

W om en w ith D ependant Children*

Pre g nant W o m e n Ve rs us W o m e n with D e pe nde nt C hildre n

Figure 17 illustrates that the majority of pregnant women (44.2%) and women with dependent children
(34.5%) were in Maricopa County (Magellan/ValueOptions), followed by Community Partnership of
Southern Arizona-5 (pregnant women 19.6% and women with dependent children 31.1%). In addition,
the following numbers of adolescent females were served: 24 who were pregnant and 22 with dependent
children.

Addiction Reduction and Recovery Fund
The Addiction Reduction and Recovery Fund (HB2554) was passed in the 2006 Legislative General
Session. The goals of this initiative were:
 to improve access to care for individuals who reside in rural or tribal areas with addiction
disorders,
 to provide culturally appropriate services with local linkage for ongoing support, and
 to assist communities in reducing crime, lower health care costs, decrease dependence on welfare,
and minimize the use of scarce public resources.
Funds were awarded for projects in Globe, Gila River Indian Community, Holbrook, Payson, Winslow,
and Yuma.
Five Level IV stabilization units (Globe, Payson, Holbrook, Winslow, and Yuma) obtained their license
from the Office of Behavioral Health Licensure and began serving individuals during the fall of 2008.
Gila River Indian Community utilized their money to support the Thwajic Ke (adult residential
detoxification facility) which opened in March 2008. Recently, ADHS/DBHS has started to collect
demographic utilization data for all Level IV facilities throughout Arizona.

Re-Entry Services (COOL Program)
The Correctional Officer/Offender Liaison (COOL) Program was established in 1998 to better serve the
substance abuse and behavioral health needs of high-risk offenders on parole. Funding is provided
through an Agreement between the Arizona Department of Corrections (ADOC) and ADHS/DBHS. The
Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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program ensures rapid access to treatment and increased coordination for consumers transitioning from
prison to the community. The COOL program also provides re-entry services for persons on parole.
The COOL Program supports staff liaisons at each of the four RBHAs contracted with ADHS/DBHS.
The program provides covered behavioral health services to address substance abuse issues among
persons on community supervision. During SFY 2008, parole officers referred 6,220 persons leaving
prison to COOL program providers funded through the RBHAs. Approximately three out of four of those
persons referred (4,514 people or 73%) were subsequently enrolled in substance abuse treatment. For
SFY 2008, the COOL program delivered $3,372,822.83 worth of services funded by a combination of
Title XIX, COOL and state funding. Funding for this program for SFY 2009 has been reduced by
$500,000 by the Arizona Department of Corrections.

HIV Early Intervention Services Targeting Persons with Substance Abuse Disorders
In SFY 2008, ADHS/DBHS provided HIV Early Intervention services, including testing and education, to
persons with substance abuse disorders. Activities specifically targeted persons enrolled in substance
abuse treatment with ADHS/DBHS, homeless populations and intravenous drug users. Approximately
19,000 people with substance abuse disorders received HIV prevention education. Of those 19,000
people, 4,033 were tested for HIV. Of the persons tested, 24 (0.6%) were found to have HIV, each of
whom received confirmatory testing and counseling related to their diagnosis.

Enhancing Treatment Effectiveness through Peer Support and Family Support
The development and growth of peer and family support services within Arizona’s system of care for
substance abuse evolved out of the State’s recognition of the value that peers and family members bring
to the clinical environment. The peer and family support worker project enhanced the effectiveness of
substance abuse treatment and provided a more efficient use of public service funding by matching people
in recovery as mentors and recovery coaches with individuals receiving services. Recovery Innovations of
Arizona (RIAz) has contracted with the State to provide peer support specialist training to individuals
with substance abuse disorders. This year, RIAz has provided training to individuals throughout the State
to work as Peer Support Specialists, Recovery Coaches and mentors for young adults 18 to 24 years old
who have substance abuse issues. In 2009, their focus will be on peers working with older adults with
substance abuse issues.

Adolescent Alcohol/Drug Treatment Projects
ADHS/DBHS manages two Substance Abuse and Mental Health Services Administration (SAMHSA)
grants, the Child and Adolescent State Infrastructure (CA-SIG) and the Substance Abuse Coordination
grant (SAC). Grant funds are targeted to address infrastructure development in addressing adolescent
substance abuse, including:
 creating and sustaining trusting partnerships with families and other child serving systems;
 workforce development through expanded training and coaching;
 community infrastructure development for child and family serving agencies including barrier
identification and resolution;
 improvements to the overall quality management to ensure sustainability of the statewide system
reform; and
 expanding the continuum of substance abuse prevention and treatment services in order to
enhance the system of service delivery to children and adolescents.
These two federal grants also focus on implementing evidence-based treatment approaches through
training and ongoing coaching and mentoring, and building and sustaining family and youth-driven
support services.

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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Federal grant funding supported a variety of projects to improve infrastructure around adolescent
substance abuse treatment such as:










White Bison training on The Medicine Wheel and 12 Steps for Youth Programs
Summit on Family Involvement in Adolescent Substance Abuse Treatment
Adolescent Community Reinforcement Approach (A-CRA) training
Motivational Enhancement Therapy/Cognitive Behavioral Therapy (MET/CBT5) training
Motivational Interviewing (MI) training
Matrix model training
The American Society of Addiction Medicine (ASAM) conference
Arizona’s 2008 Adolescent Substance Abuse Conference: “Confronting Social Barriers in
Adolescence”
Development of an evaluation tool to assess substance abuse programs that treat adolescents..

Services for Families Involved with Child Protective Services
Through legislation passed in 2000, ADHS/DBHS collaborates with the Arizona Department of
Economic Security (ADES)/Division of Children, Youth and Families (DCYF), community agencies and
faith-based organizations to provide a continuum of family-centered services through the Arizona
Families F.I.R.S.T. (Families in Recovery Succeeding Together) program (AFF). The collaboration has
provided services to more than 26,400 families since its inception in 2001. During SFY 2008, Child
Protective Services (CPS) workers referred nearly 4,700 individuals across the state for services. Persons
referred to the AFF program are screened for TXIX eligibility and, if eligible, are referred to the RBHA
system. Over 2,600 individuals received services through the RBHA system. Those who are not TXIXeligible can be served by the RBHA system when non-TXIX funding is available (e.g. SAPT Block Grant
funds). Priority is given to pregnant women who are in need of substance abuse treatment.
The Governor’s Executive Order 2008-01 “Enhanced Availability of Substance Abuse Treatment Services
for Families Involved with Child Protective Services” increased the collaboration between DBHS and
DCYF around improving access to quality substance abuse services for individuals involved with CPS. In
response to the Governor’s Executive Order, ADHS/DBHS has focused on maximizing SAPT funding for
women involved with CPS.
Individuals engaged in the AFF program received help in reducing or abstaining from abuse of illicit
substances and/or alcohol abuse. Almost 70% of clients who either completed their AFF treatment
services or voluntarily terminated services demonstrated no drug use at all during their participation in the
AFF program, as verified by drug screening tests. These findings are consistent with outcomes from other
successful model treatment programs that use random drug testing as a program component.
ADHS/DBHS and DCYF have conducted coaching sessions at eight treatment provider sites in SFY
2008. These coaching sessions represent an opportunity for the two agencies to have a dialogue with
providers and stakeholders about clinical practice and cross-agency coordination. These sessions focus on
assessment, interim service plan/service plans, collaboration with others, treatment/support services,
connection to natural supports, clinical record documentation and family-centered services. The goal is to
improve substance abuse treatment services for families involved in the child welfare system.

G. Evaluation of the Results Achieved by the Programs
ADHS/DBHS evaluates the effectiveness of substance abuse treatment by comparing outcome indicators
from admission into treatment to discharge from treatment including abstinence from alcohol and drug
use and employment status. ADHS/DBHS can demonstrate positive outcomes for persons receiving
Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

15

substance abuse treatment through the state funded behavioral health system. Figure 18 shows the change
from admission to discharge in employment status as well as abstinence from alcohol and drugs.

Figure 18: Employment and Abstinence at Admission and Discharge
Admis sion

Discharge

40%
35%
30%

34.6%
5752

37.5%
6602
28.5%
1748

25%

33.7%
1861

29.4%
2583

34.4%
2796

20%
15%
10%
5%
0%
Employment

Abstinence from
Alcohol

Abstinence from
Drugs

H. Substance Abuse Treatment and Best Practices Goals for SFY 2009
ADHS/DBHS is committed to promoting the recovery and resiliency of Arizonans through provision of
high quality prevention, support, rehabilitation and treatment services. ADHS/DBHS will continue to
align substance abuse prevention and treatment initiatives with state and national priorities as well as best
practices.
The SFY 2009 strategic plan of the Arizona Substance Abuse Partnership (ASAP) identified reduction of
underage drinking and prescription drug abuse as priorities. ADHS/DBHS, an active participant in ASAP,
has also adopted these issues as priorities for 2009 and is in the process of developing a strategic plan to
address underage drinking in collaboration with the statewide Underage Drinking Prevention Committee
of the ASAP. The plan involves strategies that include improving treatment quality, reducing access to
alcohol and increasing the perception that alcohol consumption is harmful to the neurological
development of youths. In SFY 2009, ADHS/DBHS will begin to identify effective prevention and
treatment interventions that can be used to decrease abuse of prescription drugs.
Methamphetamine continues to be a significant threat to the health and safety of Arizona. To improve the
effectiveness of methamphetamine treatment, ADHS/DBHS has adopted best-practice approaches such as
Centers of Excellence for methamphetamine addiction, increased access to detoxification facilities and
improved medical interventions. ADHS/DBHS will continue current activities while striving to
continually improve quality through provision of technical assistance, training, and monitoring of
providers.

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

16

I. System Enhancement Goals for SFY 2009
1. Use data to monitor the effectiveness of current treatment and prevention services and to develop
strategies for improvement.
2. Increase the capacity of T/RBHAs and providers to apply research-based, cost effective and culturally
specific practices to prevent and treat substance abuse disorders.
3. Develop clinical guidance documents that describe expectations for T/RBHAs and providers related
to opioid treatment interventions for adults and adolescents.
4. Support the implementation of the statewide Underage Drinking Prevention strategic plan and
coordination of the statewide Underage Drinking Prevention Committee.
In Summary, ADHS/DBHS will explore further prevention and treatment strategies around underage
drinking, treatment for children and adolescents, prescription drugs, methamphetamine, and opioid
addiction with the present level of funding and resources in SFY 2009. ADHS/DBHS believes the
continued focus on these key areas will support a healthier Arizona.

Arizona Department of Health Services / Division of Behavioral Health Services
Annual Report on Substance Abuse Treatment Programs (2008)

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