|Jurisdiction||Federal government of the United States|
|Headquarters||North Bethesda, Maryland (Rockville mailing address)|
|Parent department||Department of Health and Human Services|
The Substance Abuse and Mental Health Services Administration (SAMHSA; pronounced // ) is a branch of the U.S. Department of Health and Human Services. It is charged with improving the quality and availability of treatment and rehabilitative services in order to reduce illness, death, disability, and the cost to society resulting from substance abuse and mental illnesses. The Administrator of SAMHSA reports directly to the Secretary of the U.S. Department of Health and Human Services. SAMHSA's headquarters building is located outside of Rockville, Maryland.
Substance abuse, also known as drug abuse, is a patterned use of a drug in which the user consumes the substance in amounts or with methods which are harmful to themselves or others, and is a form of substance-related disorder. Widely differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases criminal or anti-social behaviour occurs when the person is under the influence of a drug, and long term personality changes in individuals may occur as well. In addition to possible physical, social, and psychological harm, use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.
The United States Secretary of Health and Human Services is the head of the United States Department of Health and Human Services, concerned with health matters. The Secretary is a member of the President's Cabinet. The office was formerly Secretary of Health, Education, and Welfare.
SAMHSA was established in 1992 by Congress as part of a reorganization of the Federal administration of mental health services; the new law renamed the former Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA). ADAMHA had passed through a series of name changes and organizational arrangements throughout its history:
The National Institute of Mental Health (NIMH) is one of 27 institutes and centers that make up the National Institutes of Health (NIH). The NIH, in turn, is an agency of the United States Department of Health and Human Services and is the primary agency of the United States government responsible for biomedical and health-related research.
The National Institutes of Health (NIH) is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late 1870s, and is now part of the United States Department of Health and Human Services. The majority of NIH facilities are located in Bethesda, Maryland. The NIH conducts its own scientific research through its Intramural Research Program (IRP) and provides major biomedical research funding to non-NIH research facilities through its Extramural Research Program.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), as part of the U.S. National Institutes of Health, supports and conducts biomedical and behavioural research on the causes, consequences, treatment, and prevention of alcoholism and alcohol-related problems. The NIAAA functions both as a funding agency that supports research by external research institutions and as a research institution itself, where alcohol research is carried out in‐house. It funds approximately 90% of all such research in the United States. The NIAAA publishes the academic journal Alcohol Research: Current Reviews.
The 1992 ADAMHA Reorganization Act consolidated the treatment functions that were previously scattered amongst the NIMH, NIAAA, and NIDA into SAMHSA, established as an agency of the Public Health Service (PHS). NIMH, NIAAA, and NIDA continued with their research functions as agencies within the National Institutes of Health.
Congress directed SAMHSA to target effectively substance abuse and mental health services to the people most in need and to translate research in these areas more effectively and rapidly into the general health care system.
Charles Curie was SAMHSA's Director until his resignation in May 2006. In December 2006 Terry Cline was appointed as SAMHSA's Director. Dr. Cline served through August 2008. Rear Admiral Eric Broderick served as the Acting Director upon Dr. Cline's departure,until the arrival of the succeeding Administrator, Pamela S. Hyde, J.D. in November 2009. She resigned in August 2015 and Kana Enomoto, M.A. served as Acting Director of SAMHSA until Dr. Elinore F. McCance-Katz was appointed as the inaugural Assistant Secretary for Mental Health and Substance Abuse. The title was changed by Section 6001 of the 21st Century Cures Act.
Terry L. Cline is an American psychologist and public health policy specialist from Oklahoma. Cline resigned on October 30, 2017 from the Oklahoma State Department of Health. He has served in various positions under Governors of Oklahoma Frank Keating (R), Brad Henry (D), and Mary Fallin (R). Cline resigned his position after financial mismanagement was discovered within the Oklahoma State Department of Health.
Elinore F. McCance-Katz is an American physician, academic, and government official who currently serves as Assistant Secretary of Health and Human Services for Mental Health and Substance Use. Prior to assuming her current role, she was the chief medical officer for the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals and a professor at the Alpert Medical School at Brown University. Her nomination was supported by the American Psychiatric Association, which released a statement saying "Dr. McCance-Katz has a wealth of experience in academic and public sector settings in addressing mental health and substance use disorders."
The 21st Century Cures Act is a United States law enacted by the 114th United States Congress in December 2016. It authorized $6.3 billion in funding, mostly for the National Institutes of Health. The act was supported especially by large pharmaceutical manufacturers and was opposed especially by consumer organizations.
SAMHSA's mission is to reduce the impact of substance abuse and mental illness on American's communities.
Four SAMHSA offices, called Centers, administer competitive, formula, and block grant programs and data collection activities:
The Centers give grant and contracts to U.S. states, territories, tribes, communities, and local organizations.They support the provision of quality behavioral-health services such as addiction-prevention, treatment, and recovery-support services through competitive Programs of Regional and National Significance grants. Several staff offices support the Centers:
The Center for Mental Health Services (CMHS) is a unit of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services. This U.S. government agency describes its role as:
The Center for Mental Health Services leads federal efforts to promote the prevention and treatment of mental disorders. Congress created CMHS to bring new hope to adults who have serious mental illness and children with emotional disorders.
As of March 2016 [update] , the director of CMHS is Paolo del Vecchio.
CMHS is the driving force behind the largest US children's mental health initiative to date, which is focused on creating and sustaining systems of care. This initiative provides grants (now cooperative agreements) to States, political subdivisions of States, territories, Indian Tribes and tribal organizations to improve and expand their Systems Of Care to meet the needs of the focus population—children and adolescents with serious emotional, behavioral, or mental disorders. The Children's Mental Health Initiative is the largest Federal commitment to children’s mental health to date, and through FY 2006, it has provided over $950 million to support SOC development in 126 communities.[ citation needed ]
The Center for Substance Abuse Prevention (CSAP) aims to reduce the use of illegal substances and the abuse of legal ones.
CSAP promotes self-esteem and cultural pride as a way to reduce the attractiveness of drugs, advocates raising taxes as a way to discourage drinking alcohol by young people, develops alcohol and drug curricula, and funds research on alcohol and drug abuse prevention. CSAP encourages the use of "evidence-based programs" for drug and alcohol prevention. Evidence-based programs are programs that have been rigorously and scientifically evaluated to show effectiveness in reducing or preventing drug use.
The current director of CSAP is Frances Harding.
CSAP was established in 1992 from the previous Office of Substance Abuse Prevention by the law called the ADAMHA Reorganization Act.Defining regulations include those of Title 42.
The Center for Substance Abuse Treatment (CSAT) was established in October 1992 with a Congressional mandate to expand the availability of effective treatment and recovery services for alcohol and drug problems. CSAT supports a variety of activities aimed at fulfilling its mission:
CSAT works with States and community-based groups to improve and expand existing substance abuse treatment services under the Substance Abuse Prevention and Treatment Block Grant Program. CSAT also supports SAMHSA’s free treatment referral service to link people with the community-based substance abuse services they need. Because no single treatment approach is effective for all persons, CSAT supports the nation's effort to provide multiple treatment modalities, evaluate treatment effectiveness, and use evaluation results to enhance treatment and recovery approaches.
The current director of CSAT is Louis A. Trevisan, MD
The Center for Behavioral Health Statistics and Quality (CBHSQ) conducts data collection and research on "behavioral health statistics" relating to mental health, addiction, substance use, and related epidemiology. CBHSQ is headed by a Director. Subunits of CBHSQ include:
The Center's headquarters are outside of Rockville, Maryland.
CMS has its headquarters outside of Rockville, Marylandwith 10 regional offices located throughout the United States:
In 2010, SAMHSA identified 8 Strategic Initiatives to focus the Agency's work. Below are the 8 areas and goals associated with each category:
Their budget for the Fiscal Year 2010 was about $3.6 billion. It was re-authorized for FY2011. Most recently, the FY 2016 Budget requests $3.7 billion for SAMHSA, an increase of $45 million above FY 2015.[ citation needed ]
In February 2004, the administration was accused of requiring the name change of an Oregon mental health conference from "Suicide Prevention Among Gay/Lesbian/Bisexual/Transgender Individuals" to "Suicide Prevention in Vulnerable Populations."
In 2002, then-President George W. Bush established the New Freedom Commission on Mental Health. The resulting report was intended to provide the foundation for the federal government's Mental Health Services programs. However, many experts and advocates were highly critical of its report, Achieving the Promise: Transforming Mental Health Care in America.
Drug rehabilitation is the process of medical or psychotherapeutic treatment for dependency on psychoactive substances such as alcohol, prescription drugs, and street drugs such as cannabis, cocaine, heroin or amphetamines. The general intent is to enable the patient to confront substance dependence, if present, and cease substance abuse to avoid the psychological, legal, financial, social, and physical consequences that can be caused, especially by extreme abuse.
Substance dependence, also known as drug dependence, is an adaptive state that develops from repeated drug administration, and which results in withdrawal upon cessation of drug use. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.
The Alcohol, Drug Abuse, and Mental Health Services Block Grant was a federal assistance block grant given by the United States Department of Health and Human Services. This block grant has been replaced by two separate block grants which cover essentially the same set of services once combined in the ADMS. These are the Substance Abuse Prevention and Treatment Block Grant and the Community Mental Health Services Block Grant.
The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) is an agency of the Government of Oklahoma responsible for providing public health services relating to mental illness and substance abuse.
Edna Foa is an Israeli professor of clinical psychology at the University of Pennsylvania, where she serves as the Director of the Center for the Treatment and Study of Anxiety. Foa is an internationally renowned authority on the psychopathology and treatment of anxiety. She approaches the understanding and treatment of mental disorders from a cognitive-behavioral perspective.
Treatment Improvement Protocols (TIPs) are a series of best-practice manuals for the treatment of substance use and other related disorders. The TIP series is published by the Substance Abuse and Mental Health Services Administration, an operational division of the U.S. Department of Health and Human Services.
Dual diagnosis is the condition of suffering from a mental illness and a comorbid substance abuse problem. There is considerable debate surrounding the appropriateness of using a single category for a heterogeneous group of individuals with complex needs and a varied range of problems. The concept can be used broadly, for example depression and alcoholism, or it can be restricted to specify severe mental illness and substance misuse disorder, or a person who has a milder mental illness and a drug dependency, such as panic disorder or generalized anxiety disorder and is dependent on opioids. Diagnosing a primary psychiatric illness in substance abusers is challenging as drug abuse itself often induces psychiatric symptoms, thus making it necessary to differentiate between substance induced and pre-existing mental illness.
Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.
Substance Abuse Prevention, also known as drug abuse prevention, is a process that attempts to prevent the onset of substance use or limit the development of problems associated with using psychoactive's substances. Prevention efforts may focus on the individual or their surroundings. A concept known as "environmental prevention" focuses on changing community conditions or policies so that the availability of substances is reduced as well as the demand.
An opioid overdose is toxicity due to excessive opioids. Examples of opioids include morphine, heroin, fentanyl, tramadol, and methadone. Symptoms include insufficient breathing, small pupils, and unconsciousness. Onset of symptoms depends in part on the route opioids are taken. Among those who initially survive, complications can include rhabdomyolysis, pulmonary edema, compartment syndrome, and permanent brain damage.
The California Department of Alcohol and Drug Programs (ADP) was a California state agency concerned with substance abuse prevention and treatment. Created by the California Legislature in 1978, ADP brought together the Governor's Office of Alcoholism and the California Department of Health's Division of Substance Abuse to form the single state authority for substance abuse prevention and treatment, and is currently within the auspices of the California Health and Human Services Agency. In this capacity, ADP provided leadership and policy coordination for the planning, development, implementation, and evaluation of a comprehensive statewide system of alcohol and other drug (AOD) prevention, treatment and recovery services. As of July 1, 2013, functions of ADP were transferred to the Department of Health Care Services.
Henry Lozano is a non-profit executive and grassroots organizer. His years of public service culminated in his post at the White House as Deputy Assistant to the President and Director of USA Freedom Corps. On August 10, 2011, he was appointed to serve as the Director of Los Angeles County Teen Challenge and Urban Ministries Initiatives.
The adolescent community reinforcement approach (A-CRA) is a behavioral treatment for alcohol and other substance use disorders that helps youth, young adults, and families improve access to interpersonal and environmental reinforcers to reduce or stop substance use.
The National Registry of Evidence-based Programs and Practices (NREPP) is an online, searchable database of interventions designed to promote mental health or to prevent or treat substance abuse and mental disorders. The registry is funded and administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services. The goal of the Registry is to encourage wider adoption of evidence-based interventions and to help those interested in implementing an evidence-based intervention to select one that best meets their needs.
Mary Jane Rotheram-Borus is a licensed clinical psychologist and professor with the University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences. Rotheram is the professor-in-residence in the Semel Institute for Neuroscience and Human Behavior. She is the Director of the Global Center for Children and Families at UCLA and the former director of the Center for HIV Identification, Prevention, and Treatment Services.
The National Survey on Drug Use and Health, often abbreviated NSDUH, is an annual nationwide survey on the use of legal and illegal drugs, as well as mental disorders, that has been conducted by the United States federal government since 1971. It is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), and is supervised by the SAMHSA's Center for Behavioral Health Statistics and Quality. The survey interviews about 70,000 Americans aged 12 and older, through face-to-face interviews conducted where the respondent lives. In 1988, RTI International started conducting the survey, and they have been contracted by SAMHSA to continue doing so through 2017. It was originally called the National Household Survey on Drug Abuse, but was renamed in 2002 to its current name. The NSDUH, along with the Monitoring the Future, is one of the two main ways the National Institute on Drug Abuse measures drug use in the United States.
The Comprehensive Addiction and Recovery Act (CARA) was signed into law by President Obama on July 22, 2016. The bill was introduced by Senator Sheldon Whitehouse and Representative Jim Sensenbrenner as the first major federal addiction act in 40 years.
Screening, Brief Intervention and Referral to Treatment (SBIRT) is a model that encourages mental health and substance abuse screenings as a routine preventive service in healthcare.