Tackling Drug Addiction

Guidelines  |  Grantee List

Priority 1

To make available drug treatment that integrates services targeting poverty-related barriers to self-sufficiency.

The integration of services targeting poverty-related barriers to self-sufficiency is an important approach in the treatment of drug addiction among marginalized populations. Individuals seeking treatment in Baltimore's publicly funded treatment programs have a variety of social problems that impact on their prognosis. For example, nearly 70% of new admissions in 1999 were unemployed and only 47% had graduated from high school. It is difficult for a newly recovering drug dependent person without adequate education or job skills to obtain and hold a job unless vocational and education services are provided. Some patients may either be homeless or living with substance using relatives or friends. Living with drug users while attending treatment makes recovery from addiction extremely difficult.

While high-quality drug treatment reduces drug use, it may not necessarily improve a patient's housing, education, or employment status. One approach to improving a patient's outcome in these areas is to integrate ancillary services that target an individual's specific needs within a drug treatment program. This "one-stop shopping" approach has been shown to be effective with medical and psychiatric care, family therapy and vocational training. An alternative approach is the use of case management to link treatment to community-based resources. Programs may consider using incentives with either approach to encourage patients to receive needed services. Addressing these needs through targeted services increases the likelihood that marginalized, recovering drug dependent people will both reduce drug use and become productive and valued members of their families and communities.

To enhance outcomes and improve the quality of life for treatment participants, OSI-Baltimore funds efforts to integrate addiction treatment with ancillary community-based support services. These activities may focus on linking treatment to any number of services such as recovery housing, job training and placement, G.E.D. training or childcare. The Tackling Drug Addiction initiative places special emphasis on initiatives that increase patient access to comprehensive care through sustainable systemic change, for example, by linking public funds available for mental health care to the drug treatment system. Applicants may develop programs that integrate services at a drug treatment clinic or that use case management to access and coordinate services. Proposals that embrace case management approaches should provide training for ancillary service providers to meet the special needs of recovering people. OSI-Baltimore encourages applicants to include evaluations within their proposals.

The National Institute on Drug Abuse's Clinical Trials Network in Baltimore provides an excellent local opportunity to transfer science-based treatments into the public system. The OSI-Baltimore Tackling Drug Addiction initiative seeks to enhance this opportunity with strategic grantmaking that builds upon the Network. Accordingly, grants may enable non-participating agencies to add services proven to be effective through the Clinical Trials Network. In addition, the initiative will consider efforts that successfully integrate pharmacotherapy with counseling in novel ways. These may include providing medication treatment (e.g., buprenorphine, a recently approved treatment for heroin addiction) within a faith-based counseling program, an outpatient drug-free program or a medical clinic.

Priority 2

To engage more drug-dependent citizens in the treatment system by supporting aggressive outreach efforts and by removing barriers to treatment entry.

The majority of uninsured drug-addicted people in Baltimore are neither in nor seeking treatment. Thus, reaching out to these citizens is an important means of facilitating treatment entry. Unfortunately, as in most U.S. cities, Baltimore's public treatment system has supported little outreach in the past. The notable exception is the city's needle-exchange program, the largest such program administered by a municipality. Research has confirmed that this program significantly reduces the spread of HIV and serves as a conduit to drug treatment for persons who otherwise would not be seeking care. Furthermore, patients referred from Baltimore's needle exchange program, despite having a worse prognosis at the outset, respond well to treatment. In recognition of this, NIDA has funded a study in Baltimore to improve drug treatment entry rates among individuals in the needle exchange program.

As Baltimore's treatment capacity expands, outreach efforts can increase the number of people in treatment, engage underrepresented patient populations in care and attract patients at an earlier stage of addiction. Therefore, selected OSI-Baltimore grants seek to support outreach efforts that attract people into treatment within community settings. Efforts, for example, could be based in social service and health care agencies or in religious institutions. Street outreach by recovering people or medication-based strategies, such as interim maintenance which provides methadone to heroin-addicted individuals waiting for counseling to become available, are but two examples of possible projects. Outreach efforts could also target prisoners prior to their release.

Priority 3

To promote a comprehensive, high-quality public treatment system by supporting infrastructure development and advocacy and public education efforts.

The public treatment system, under the direction of BSAS, has gone through a period of enormous growth since 1995. Given the importance and difficulty of its charge, BSAS must function at maximum capacity to create and sustain a model treatment system. With this goal in mind, a number of OSI-Baltimore grants seeks to strengthen BSAS's ability to design, manage, evaluate, and promote a comprehensive, high-quality treatment system.

For example, to help focus BSAS's diverse board, OSI-Baltimore supported a strategic planning process which clarified the organization's mission as well as the board's structure and responsibilities. Other OSI-Baltimore support enables BSAS to meet its expanded mission and responsibilities. With Tackling Drug Addiction initiative funding, a research director tracks and reports on best practices and innovative approaches in the field and uses BSAS's extensive data management system to conduct quality improvement activities. A director of communication and advocacy helps broaden public support and increase funding for the treatment effort.

To give public treatment system access to some of the most experienced and creative leaders in the field, OSI-Baltimore helped BSAS establish a Scientific Advisory Committee. Through an ongoing series of meetings, this internationally distinguished group has become familiar with the strengths and weaknesses of Baltimore's treatment system and with local needs. Drawing on research findings and on exemplary treatment programs nationwide, the Scientific Advisory Committee advises the BSAS staff and board on programs and approaches that will strengthen the local treatment system. This effort is coordinated with NIDA's Clinical Trials Network and allows Baltimore to take full advantage of the best science-based treatments available.

The Tackling Drug Addiction initiative also funds activities that educate policymakers and the public about the nature of addiction, the effectiveness of treatment and the strengths and weaknesses of the treatment delivery system in Baltimore. The public is generally not aware of the extensive data that document the successful outcomes of treatment and that support outreach and the provision of comprehensive services. Dissemination of research-based information of this kind, including data on treatment's cost effectiveness, will give the public the information and confidence it needs to support the development of a comprehensive and accessible treatment system. Finally, the initiative supports advocacy that mobilizes different constituencies in support of Baltimore's efforts to create a comprehensive, accessible and high-quality treatment system.

Application Process

STEP 1: Letter of Inquiry

Applicants should submit a copy of the IRS letter stating tax-exempt status and a letter of inquiry not exceeding three pages which includes: a description of the program to be funded; the qualifications of the organization to carry out the program; the ways in which the program reflects the priorities of the Tackling Drug Addiction initiative; and the amount requested.

STEP 2: Proposal Submission

If OSI determines that the proposal is of interest, it will invite the applicant to submit a full proposal. Applicants submitting a grant proposal should use the following format:

On institutional letterhead, the cover page should include:

1. a one-sentence description of the proposed initiative;
2. the amount requested from OSI-Baltimore;
3. the total organizational budget;
4. the name of the organization that would serve as the fiscal sponsor for the grant if awarded;
5. a contact name, address, and telephone number.

The proposal should describe:

1. the need or issue to be addressed;
2. the organization's capacity to carry out the proposal;
3. the program's objectives;
4. the program's activities and methodology;
5. the program's expected outcomes;
6. the financial sustainability of the program;
7. the organization's plans to assess the program's impact.

Applicants should also explain how the proposal would effect long-term change in policy or practice, and how that change relates to open society values and to strengthening open society in the Baltimore region.

Appendices to the proposal should include:

1. a budget for the project or program for every year funding is requested;
2. a list of current and proposed funders of the project or program;
3. a one-page program implementation timeline for year one of the proposed project or program;
4. resumes of the organization's director, project director and other key staff;
5. a copy of the IRS letter stating the organization's tax-exempt status, if not submitted with the letter of inquiry;
6. a copy of the organization's overall budget;
7. a copy of the organization's most recent annual report and audit (or financial statement).

To learn more about the program, please contact Robert Schwartz at rschwartz@sorosny.org or 1-410-234-1091, ext. 207.