Making a Difference through Prevention and Treatment

194 Presentation MAKING A DIFFERENCE THROUGH PREVENTION AND TREATMENT ROBBIE M. JACKMAN, M.S.S.W. Assistant Commissioner Bureau of Alcohol and Drug Abuse Service State of Tennessee Department of Public Health The Cordell Hull Building Nashville, TN 37247 IHAVE been IN the FIELD of alcohol and drug abuse for over 20 years. Most of my experience has been in treatment. However, during the last year, as Assistant Commissioner, my appreciation of the needs of people and the services that they need has grown, and I now have a clearer understanding that prevention and treatment go hand in hand. As we look at the components of innovative systems of treatment, it is important for me to speak in light of our mission, which is to reduce the incidence and prevalence of alcohol and drug abuse and to completely change society's attitude and tolerance for drugs and alcohol abuse. It is very difficult to discuss the treatment system without incorporating prevention and intervention activities as an integral part of the delivery of services for substance abuse, particularly for poor and underserved populations . Prevention includes information, education, communication, alternatives , and intervention. In these areas, we focus on outreach, culturally specific needs, and community-based needs. Especially with our youth, we strive to increase the opportunity for fun and learning through community- and schoolbased activities. Other examples of prevention projects utilized in our bureau are the early intervention programs, the Tennessee Teen Institute, inner-city outreach programs, parent groups, and Clown Around. Each of these programs , in coordination with treatment, represent an ideal service delivery system. We know that our society is made up of families and communities. Particularly for the African-American community, the experiences of the past Journal of Health Care for the Poor and Underserved, Vol. 3, No. 1, Summer 1992 ____________________________Jackman_________________________195 can help us as professionals to look at the mores and cultural make-up of our communities. The negative impact of slavery on our people and the results of the sit-ins during the 1950s let us know that until we can come together to change systems, we are at risk of losing our communities to crime, alcohol and drug abuse, homelessness, and despair. Before we take an in-depth look at elements of state-of-the-art treatment modalities and approaches nationwide, we as government workers, physicians, researchers, teachers, counselors, and community leaders must first examine our responsibility to those we serve. Every aspect of society must be involved in the prevention and treatment of alcohol and drug abuse in this country. This includes people in law enforcement, education, policymaking, and criminal justice, as well as families and communities. It is our belief that though many of these components of society are critical to the delivery of alcohol and drug abuse services, the greatest impact on the delivery of services and the prevention of substance abuse takes place at the community level. Communities and leaders must begin to accept the responsibility to help people realize their dreams. We need more movement in our communities. Often, we fail to realize that a sense of power, determination , and pride is derived from deciding priorities for the neighborhood. There are those who say the system needs to be changed. We realize that there are gaps in services and barriers to service delivery. However, a systems change alone cannot make a difference in the lives of the people we serve without a commitment on the part of local communities, businesses, health care institutions, mental health organizations, and concerned citizens. Ideally, when we look at a systems change we not only focus on treatment, but we want the system to use model intervention activities and to advocate self-respect and respect for the community. The continuum of care includes prevention, intervention, and treatment. Preventing alcohol and drug abuse involves building positive attitudes, values, behaviors, and skills. In this state and across this nation, alcohol and drug abuse is in a major way destroying our families, relatives, friends, and our communities . We know that it is causing untold human suffering, and hurting AfricanAmericans ' ability to realize their dreams. Realizing that treatment is usually the avenue available for substance abusers to break deeply...