Treatnet: Improving Treatment Around the Globe
Twenty-five million of the world’s 15- to 64-year-olds are drug addicts or problem users,
according to the World Drug Report 2006 published by the United Nations Office on Drugs and Crime
UNODC does much more than compile statistics on this problem. The office seeks to improve substance
abuse treatment in countries around the globe. Through its Treatnet initiative, UNODC has established
an international network of resource centers to share information about state-of-the-art approaches
to treatment and rehabilitation.
“Our colleagues overseas want to find out what treatment approaches work, how to do them, and how they can adapt them to their own countries.”
—Winnie Mitchell, M.P.A.
International Officer at SAMHSA
Another UNODC project focuses exclusively on Central America. (See Expanding Treatment in Central America.) The
common goal of both efforts? To train trainers about best practices in substance abuse treatment
so that they can then improve the skills of treatment providers in their home countries.
“Our colleagues overseas want to find out what treatment approaches work, how to do them,
and how they can adapt them to their own countries,” explained Winnie Mitchell, M.P.A.,
International Officer at SAMHSA. “SAMHSA’s work through the Addiction Technology
Transfer Centers (ATTCs) was a major contributing factor to Treatnet, along with other work from India,
the United Kingdom, Australia, and Canada.
In addition, UNODC, the World Health Organization
(WHO), and other leading addiction treatment groups around the world had developed materials already.
Specifically, SAMHSA’s ATTC training network idea was helpful in UNODC’s development
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Launched in 2005, the Treatnet initiative began with the selection of 20 substance abuse treatment
and rehabilitation organizations to serve as resource centers. Representing both governmental
agencies and nongovernmental organizations, the resource centers are spread across six
continents. Participating countries include Australia, Brazil, Canada, China, Colombia, Egypt,
Germany, India, Indonesia, Iran, Kazakhstan, Kenya, Mexico, Nigeria, Russia, Spain, Sweden, the
United Kingdom, and the United States.
The initiative’s ultimate goal, emphasized Ms. Mitchell, is to improve substance abuse
To achieve that goal, a consortium of 10 institutions led by the Integrated Substance Abuse Programs
at the University of California Los Angeles (UCLA) has developed a curriculum for use in instructing
trainers. They, in turn, can use the materials to train treatment providers in their home countries.
The four-volume training package, which includes manuals on screening, treatment, special populations,
and administration, covers just about everything providers need to know to offer the best possible
substance abuse treatment.
Participating countries include Australia, Brazil, Canada, China, Colombia, Egypt, Germany,
India, Indonesia, Iran, Kazakhstan, Kenya, Mexico, Nigeria, Russia, Spain, Sweden, the United Kingdom,
and the United States.
“We heard from and worked with a consortium of addiction experts from around the world
to collect evidence-based practice materials and best-practice documents to provide the foundation
for our training materials,” said Richard A. Rawson, Ph.D., Associate Director of the Integrated
Substance Abuse Programs, Principal Investigator of the Pacific Southwest ATTC, and a professor
of psychiatry and biobehavioral sciences at UCLA.
“We synthesized materials from publications and reports from more than 15 countries. Among
the most important resources were the Blending Initiative materials and SAMHSA’s Treatment
Improvement Protocols (TIPs) from the Center for Substance Abuse Treatment (CSAT),” Dr.
The Blending Initiative, which helped inform the core curriculum, is a joint
effort of SAMHSA, the National Institute on Drug Abuse, and the ATTCs. (See SAMHSA
The “Screening, Assessment, and Treatment Planning” volume, for instance, features a module adapted
from a Blending Initiative product called Treatment Planning: Utilizing the
Addiction Severity Index. The “Elements of Psychosocial Treatment” volume borrows extensively from CSAT’s TIPs,
including those on motivational interviewing and stimulant use disorders.
The “Detoxification, Pharmacotherapies, and Special Populations” volume draws on SAMHSA and Blending
Initiative materials on buprenorphine and methadone.
Still under development is a volume called “Program Management Strategies.” This volume will include
a module on clinical supervision based on the Clinical Supervision One: Building Chemical
Dependency Counselor Skills curriculum developed by Steve Gallon, Ph.D., Principal Investigator
of the Northwest Frontier ATTC, as a way to help supervisors ensure that their staff follow evidence-based
practices. (See SAMHSA News online, March/April 2005.)
In addition to Dr. Gallon, Anne Helene Skinstad, Ph.D., of the Prairielands ATTC, and Nancy Roget,
M.S., of the Mountain West ATTC, also helped develop the curriculum. “The ATTCs provided
a well-tested and solid model for Treatnet,” Dr. Gallon said.
The first three volumes feature instructor’s guides plus PowerPoint presentations. The
fourth volume will provide a brief overview, plus links to online materials. “We don’t
do training with that one, per se,” explained Dr. Rawson. “Instead of a lecture format,
that volume is more about giving people access to information they can use.”
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Trainings in the United Kingdom
Dr. Rawson and his team already put the training materials to use in intensive, 3-week, training-of-trainer
events. Last winter, trainers from the Treatnet resource centers gathered at UCLA and at satellite
sites in the United Kingdom and Australia for intensive training based on the three manuals.
Thomas Freese, Ph.D., Director of the Pacific Southwest ATTC and Director of Training at the
Integrated Substance Abuse Programs, led the training of trainers in the United Kingdom.
“The professionals we trained were already so competent and capable and so excited and
eager for the knowledge, it was clear that they were going to do a really excellent job using
these materials in their home countries,” said Dr. Freese.
Now those training participants have fanned out around the world to share what they’ve
learned with frontline treatment providers. “I’ve been extraordinarily impressed
by how much work the trainers have done,” said Dr. Rawson. “They’ve already
trained 500 people on much of the training package material.”
To keep that momentum going, Dr. Rawson and his team are providing email and telephone mentoring
to the trainers. “We’re all learning together, sharing what we know, and working
towards a common goal. As a global community, that’s important.”
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