BEST PRACTICES in 

APPALACHIAN SUBSTANCE ABUSE

From the Sharing Best Practices: A Partner Approach to

Substance Abuse Conference

July 27, 2009

United States Department of Health and Human Services

Health Resources and Services Administration

The Office of Rural Health Policy

December 2010

 
 2 

This document was prepared for the U.S. Department of Health and Human Services (HHS), 

Health Resources and Services Administration (HRSA), Office of Rural Health Policy (ORHP)

under HRSA Contract #HHSH250200866012C. This publication lists non-Federal resources in 

order to provide additional information to consumers. The views and content in these 

resources have not been formally approved by HHS. Listing these resources is not an 

endorsement by HHS or its components. 
 3 

Table of Contents

INTRODUCTION ..........................................................................................................................................................4

SELECTION OF GRANTEES ...........................................................................................................................................5

METHODOLOGIES.......................................................................................................................................................5

EMERGING THEMES ...................................................................................................................................................6

REGION-WIDE AGENCY THEMES ................................................................................................................................6

CONFERENCE SUB-THEMES........................................................................................................................................7

PROFILE OVERVIEW....................................................................................................................................................8

CHARLESTON AREA MEDICAL CENTER’S WOMEN AND CHILDREN’S HOSPITAL AND HEALTH EDUCATION AND

RESEARCH INSTITUTE..............................................................................................................................................9

COALITION ON APPALACHIAN SUBSTANCE ABUSE POLICY ................................................................................. 10

HEALTH CARE FOUNDATION OF NORTH MISSISSIPPI .......................................................................................... 11

KENTUCKY ADMINISTRATIVE OFFICE OF THE COURTS DRUG COURT DEPARTMENT .......................................... 13

KENTUCKY RIVER COMMUNITY CARE.................................................................................................................. 14

KENTUCKY RIVER FOOTHILLS DEVELOPMENT COUNCIL, INC............................................................................... 15

MORGAN COUNTY BEHAVIORAL HEALTH CHOICES............................................................................................. 16

PEOPLE ENCOURAGING PEOPLE COALITION ....................................................................................................... 18

ROWAN COUNTY UNITE ...................................................................................................................................... 19

STEUBEN COUNTY COMMUNITY SERVICES ......................................................................................................... 20

EAST TENNESSEE STATE UNIVERSITY................................................................................................................... 21

LOGIC MODELS ........................................................................................................................................................ 23

RESOURCE GUIDE .................................................................................................................................................... 25
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BEST PRACTICES IN APPALACHIAN SUBSTANCE ABUSE

From

Sharing Best Practices: A Partner Approach to

Substance Abuse in Appalachia

Introduction

Grantees from the Appalachian Regional Commission’s (http://www.arc.gov) 2008 substance abuse 

competition highlighted their best practice projects to address substance abuse at a day-long 

conference sponsored by the Health Resources and Services Administration (HRSA), Office of Rural 

Health Policy on July 27, 2009 at the Carnegie Hotel in Johnson City, Tennessee. Representatives from 

nearly every State in the Appalachian region and three Federal agencies heard reports from 10 

grantees from the Appalachian Regional Commission’s (ARC) 2008 round of substance abuse grants 

and the 2006 Substance Abuse Conference. 

This Manual of Best Practices outlines the strategies and themes of these grantees. The projects 

represented strategic, collaborative models of prevention and service using evidence-based and 

community-based assets. These grantees make efficacious use of multiple partnerships to meet 

identified needs within a framework that promotes sustainable and place-specific interventions. The

plans were formatted to serve people within local communities by providing needed and appropriate 

programs and services within criteria that vulnerable populations, policy makers, and community 

stakeholders require unique support. 

“Sharing Best Practices” was more than a title of the 

conference. Several Federal agencies shared how their 

strategies intersected with the health issues of rural 

communities. All of the grantees illustrated the benefits 

of cooperative collaborations. Partnerships are the key 

to establishing broad support of programs, gathering 

critical funding and community support, promoting 

interventions among diverse populations and sustaining 

efforts over time. 

In April of 2008 representatives of HRSA’s Office of Rural Health Policy

(http://www.ruralhealth.hrsa.gov) and the Substance Abuse and Mental Health Services 

Administration (http://www.samhsa.gov) identified funding mechanisms available to help communities 

to address issues of substance abuse in Appalachia. Each agency promised an avenue of support: ARC 

would award competitive grants for substance abuse projects; the Office of Rural Health Policy (ORHP) 

would host a conference of best practices involving those grantees; and the Substance Abuse and 

Mental Health Services (SAMHSA) offered to bring together the Single State Authorities for each State 

containing designated Appalachian counties to discuss issues of mutual concern on the topic. This 

confluence of three Federal agencies with the ability to make an impact on substance abuse issues in 

the region pledged to continue future collaboration. 

“Community programs seemed to make 

the difference between case study 

counties.”

Michael Meit, commenting on the NORC 

report, Analysis of Substance Abuse and 

Mental Health Disparities in the 

Appalachian Region and Access to 

Treatment Services
 5 

The first round of nine ARC substance abuse grants was awarded in the fall of 2008. A subsequent 

series of grants was awarded in the fall of 2009. The July 2009 conference funded by ORHP highlighted 

the best practices exemplified by these competitive awards for substance abuse. This conference had 

high expectations for useable outcomes voiced by an outstanding caliber of grantee presenters. 

Organized into a series of three panels moderated by members of the ARC’s Appalachian Health Policy 

Advisory Council and interwoven with presentations from the three Federal agencies, the proceedings 

provided opportunities for cross pollination of ideas and information. 

Selection of Grantees

While the primary goal of this round of ARC Substance Abuse grants was to address gaps in local 

substance abuse issues in the areas of education, treatment and prevention, these projects involved a 

variety of community stakeholders, built sustainable community 

capacity and leveraged resources from other sources. 

The grantees were selected based on the: 

“Collaboration diversifies 

opportunities for sustainability”

George Brown, 

Public Health Analyst, Office of 

Rural Health Policy

• Feasibility of proposal and likelihood of achieving proposed 

outcomes; 

• Capability of applicant and expertise in relevant program 

areas, grants management, and community development;

• Level of community support, including private sector match and overall level of cash and in-kind 

match; 

• Articulation of clear, measurable outcomes and the impact of the program; 

• Outreach activities to other communities, focusing on disseminating or promoting the program 

and the ability of the project to be replicated in the Region; 

• Sustainability of effort and the ability to continue the activity upon conclusion of grant period;

• With additional consideration for 

o Distressed and At-Risk counties (economic designations by the ARC) 

o Multi-State collaboration

Methodologies

Execution strategies revealed relatively consistent methods among grantees for tackling grant projects. 

Data mining and local assessment were uniformly used to establish root causes of problems to be 

addressed and for tailoring appropriate interventions to targeted populations. Community needs 

assessments reflect quantitative and qualitative data collection via community forums, surveys, 

listening sessions and the strengths/weaknesses and opportunities/threats analysis of local issues and 

other approaches to the problem. Some grantees 

developed models for change using analysis of local 

conditions.

One method for “proofing” a strategy’s effectiveness 

is by a logic model. A logic model can test underlying 

assumptions and the validity of the change model or 

be an output of the intervention along with a

“The National Survey on Drug Use and Health

(NSDUH) indicated nearly 7 million Americans 

exhibit the diagnostic criteria for illicit drug 

abuse or dependence.” 

Nicholas Reuter, Senior Public Health Analyst, 

Substance Abuse and Mental Health Services 

Administration
 6 

community assessment, strategic action plan, evaluation plan and/or sustainability plan. Logic models 

can help organizations fit the planned intervention to intended outcomes, rank priorities, distribute

resources, evaluate, and translate results. Grantees were able to show how their projects’ 

interventions contributed to their goals. Two samples of logic models from grantee projects are 

outlined in this report (following the grantee profiles). 

Emerging Themes

Patterns that emerged from the panel presentations and the agencies were based in the shared vision 

of partners joining together across disciplines to break cycles of addiction and abuse and to create new 

standards of care, service, expectation, and hope. The primary groupings that formed the basis for the 

panels were taken from apparent similarities in strategies for target populations. Prevention 

Strategies with At-Risk Populations addressed how four grantees use innovative ways to reduce drug 

use and increase protective assets for pregnant addicted females, children, at-risk and addicted youth, 

and adolescent girls. Community Education strategies were methods by which Kentucky and regional 

coalitions provide increased opportunities and awareness of drug use prevention in the form of minigrants, prevention programs and clearinghouse functions, including a research journal on Appalachian 

health. Training and Assessment was a strategy that connected courts and addiction counselors, 

healthcare providers with new information on treatment and diversion, and incarcerated individuals 

with community resources. Expectations of common themes and approaches were derived from these 

groupings and additional themes were discovered. 

Region-Wide Agency Themes

ORHP and SAMHSA are Federal entities with nationwide programming. ARC is a Federal-State 

partnership that encompasses the entire Appalachian region. The complementary approaches and 

strengths of the three entities formed another thematic overlay of strategies that work effectively to 

address substance abuse and encourage prevention and treatment partnerships. Each of the three 

agencies, HRSA/ORHP, SAMHSA, and ARC, has clearly identifiable strengths and experience. Grantees 

recognized the following themes that were exemplified by these agencies’ methods of connecting with 

people in meaningful ways with additional emphases on community or workforce education and 

training: 

• Network development and service collaboration – Office of Rural Health Policy

• Regionalism – Appalachian Regional Commission

• Community coalition building – Substance Abuse and Mental Health Services Administration
 7 

Conference Sub-Themes

Sub-Themes Importance to Substance Abuse Best Practices

Partnerships Partnerships with like-minded organizations and community stakeholders 

are essential to creating the strength and depth necessary to deliver valid 

programs and sustain community acceptance.

Multiple 

strategies

Groups address substance abuse issues with more than one strategy, i.e. 

workforce training, service delivery, education, community participation, 

etc.

Culture/place Place-based issues affect community perceptions of use and abuse of drugs 

as well as perceptions of effective measures to prevent substance use and 

abuse, deliver treatment and contribute to recovery. Generational drug 

use patterns and faith/religious issues are two examples. 

Appalachia 

within the 

national context

Most substance abuse data are collected and reported at State or national 

levels. These data determine funding allocations and are used by the 

media when reporting national substance use trends. Data from 

Appalachian counties compared to national data puts local and regional 

problems in a national context. 

Programs that 

work

Programs with a history of success incorporate innovative communitybased methods and have evidence-based origins.

Persistence Grantees have strong, long term partners with whom they work to 

accomplish goals and the endurance to stay the course.

Cross border 

connections

Grantees report substance abuse issues that cross county and State 

borders. 

Data Grantees use national and State data but also find local data sources. 

Centralized data and consistency across data sets increase usability and 

reliability. Grantees seek out and use available data to establish clearly 

defined problems and solutions but would like to see more research on 

Appalachian issues.

Increased 

resources

The pool of resources and support for prevention activities is enlarging 

through the efforts of the Federal agencies and grantees’ awareness of 

evidence-based programs, data and research. However, more can be done.

Reduced 

stigma/fear

Grantees reported that fear of seeking treatment, social stigma, and 

apprehensions about self revelation were evident among users, treatment 

providers, and communities.

Primary care 

prevention

Grantees illustrated a need for more knowledge about substance abuse 

diagnosis and treatment by primary health care providers and the need for 

drug use prevention at early ages. 

Social and other 

infrastructure

Grantees pointed to the importance of community and family support in 

prevention and the need for identifying and implementing mechanisms to 

increase involvement by law enforcement, courts, parents, and churches.
 8 

Profile Overview

The following pages detail each grantee’s project title, problem, goals and objectives, project 

strategies, expected outcomes, target audience and themes, background and contact information. 

This basic informational overview provides insight into why each program was deemed a best practice 

on substance abuse prevention or treatment. 

Grantee Project

Charleston Area Medical Center’s Women and 

Children’s Hospital and Health Education and Research 

Institute

Drug Addicted Mom and Baby Task Force

Coalition on Appalachian Substance Abuse Policy Clearinghouse on Appalachian Substance 

Abuse

Health Care Foundation of North Mississippi HealthWorks!

Kentucky Administrative Office of the Courts Certified Alcohol and Drug Counselor 

Training

Kentucky River Community Care Prescription Medication Diversion 

Education with Physicians, Dentists and 

Pharmacists

Kentucky River Foothills Development Council Partnership with Estill and Powell County 

ASAP Board

Morgan County Behavioral Health Choices Assets & Life Skills for Morgan County 

Youth

People Encouraging People Coalition PEP – People Encouraging People

Rowan County UNITE United We Stand Campaign

Steuben County Community Services Provision of Services for Chemically 

Dependent Individuals of a Rural Re-Entry 

Population

East Tennessee State University’s Office of Rural and 

Community Health and Community Partnerships

Explorations of Substance Abuse Issue in 

Appalachian Communities
 9 

CHARLESTON AREA MEDICAL CENTER’S WOMEN AND CHILDREN’S HOSPITAL and HEALTH 

EDUCATION AND RESEARCH INSTITUTE

The Charleston Area Medical Center Health System (CAMC) was created in 1984 to meet the challenges 

of providing high-tech, health services to West Virginians, joining seven hospitals with a history of 

community service. CAMC is the non-profit parent corporation of multiple hospitals and health care 

companies including the Women and Children’s Hospital. More than 3,000 babies born there each 

year, many are high-risk births. The hospital is home to the region's largest and busiest Level III 

neonatal intensive care unit and pediatric intensive care unit.

Contact

Denise Burgess, Director of Obstetrical Services

Charleston Area Medical Center Women and Children’s Hospital

800 Pennsylvania Avenue, Charleston, WV 25302

304.388.2158

Denise.burgess@camc.org

http://www.camcinstitute.org

Project Title Partnering for a Drug-Free Pregnancy: Drug Addicted Mom and Baby Task Force

Target Audience Addicted pregnant women; medical staff

Goals and Objectives

“When a person is in distress, show me 

only the human being.” 

Rabbi Mosche ben Maimon

“We want to reduce barriers so that this is 

a place of compassion.” 

Denise Burgess

 

• Increase referrals to treatment

• Improve early intervention to enhance prenatal care

• Reduce number of Neonatal Intensive Care Unit admissions for addicted babies

Project Strategies

• Educate staff to provide early intervention and 

referrals for drug using pregnant women

• Collaborate with women in recovery through the 

Drug Addicted Moms and Babies (DAMB) multidisciplinary task force

• Dialectical Behavior Therapy (DBT) Group focused 

on coping skills

• Certified Addictions Counselor (CAC) in clinic 

• Marketing - clinic posters, postcards, etc.

• Enhance the network of other health care facilities 

in same training and techniques

Projected Outcomes

• Reduced barriers

• Enhanced network

• Increased referrals

• Utilization of DBT group

Agency Themes

• Regional networking

• Education 

• Workforce training 

Sub-themes

• Partnerships

• Primary Care Prevention

• Reduced stigma/fear

• Increased resources

• Data

• Culture/place

• Multiple strategies

• Appalachia in the national context

• Persistence
COALITION ON APPALACHIAN SUBSTANCE ABUSE POLICY

Communication about substance abuse in Appalachia is limited to national, state or regionally 

aggregated data and information. CASAP is a regional coalition of regional and local service providers, 

researchers, leaders, planners, treatment professionals and community coalitions which seek to 

change public policy, to increase human and financial resources, to develop educational materials, to 

provide a forum for knowledge exchange to address substance abuse in Appalachia and to decrease 

the destructive impact of substance abuse on personal, community and economic development. Since 

2001, CASAP has contributed to recognition of substance abuse as a regional health issue.

Contact

Randy E. Jessee, CASAP President 

PO Box 9054 

Gray, TN 37615

423.439.3720

rjessee@frontierhealth.org

http://www.appalachiancoalition.com 

or Kris Bowers, Membership Services Coordinator

Bowersk@etsu.edu or Coalitionasap1@aol.com

Project Title Clearinghouse on Appalachian Substance Abuse and Appalachian Health Journal

Target Audience Appalachian researchers, treatment providers, policy makers, and community 

coalitions, et al.

Goals and Objectives

“As people begin to cooperate with 

each other there is no partner that is 

not valuable in the process.”

“We need more champions and 

leadership.”

Randy Jessee

 

• Link to validated data and capacity-building resources

• Concentrate regional resources for regional or county – level data

• Improve local capacity to make decisions about substance abuse

Project Strategies

• Expand website to include links to data and information

• Initiate a peer-reviewed Appalachian health journal focused on substance abuse issues

• Consolidate information about community assessments

Project Outcomes

• Comprehensive interactive website with links to 

resources for research and data, community 

development, and policy makers

• The Journal of Appalachian Health e-publication 

with content about place-based, regional, 

substance abuse issues 

• Report of community assessments and review of 

current assessment recommendations

Agency Themes

• Regional Networking 

• Education

Sub-themes

• Partnership and persistence 

• Culture/place and Appalachia in the 

national context

• Cross border connections 

• Increased resources and centralized data

• Multiple strategies
11

HEALTH CARE FOUNDATION OF NORTH MISSISSIPPI

Developed in partnership between Memorial Health System (NMHS), the Health Care Foundation of 

North Mississippi and North Mississippi Health Services, Healthworks! North Mississippi came about as 

an extension of NMHS’s goal to improve health in the region. The use of alcohol, cigarettes, marijuana, 

and prescription drugs by girls has seen an upward trend in local data that shows more girls than boys 

started using marijuana since 2002 and a higher rate of misuse of prescription drugs by girls than boys.

Contact

Donna Loden, Imaginator of Awesome Experiences & Education Coordinator, 

HealthWorks! North Mississippi

219 S. Industrial Rd. 

Tupelo, MS 38801

662.377.KIDS (5437)

Donna.loden@nmhs.net 

http://www.nmhs.net/hcf/ 

http://nmiss.healthworkskids.org/healthworks-mississippi

Project Title HEALTHWORKS!

Target Audience Kindergarten through 8th grade: pre-adolescent and adolescent girls

Goals and Objectives

Provide pre-adolescent girls (and boys) with skills to resist experimentation with alcohol, tobacco, and 

other drugs by focusing on root causes of substance abuse for girls:

“We focused on the root causes of substance 

abuse with research to identify local 

conditions.”

“Girls are at great risk for poor self esteem 

issues which can lead to drug use.” 

Donna Loden 

• Low self-esteem

• Poor self-confidence

• Susceptibility to peer pressure

• Excessive concern about weight and appearance

• Poor decision –making skills

• Limited knowledge about personal health and healthy choices

• Weak parental bonds

Project Strategies

Provide a comprehensive drug prevention and health education program for girls in kindergarten 

through 8th grade through the HealthWorks! Program and other local healthful activities at the 

HealthWorks! North Mississippi Kids Museum

Projected Outcomes

• Fewer girls in north Mississippi and Alabama will use substances

• At least 4,000 elementary and middle school-aged in 20 MS counties and 4 AL counties will attend 

one or more substance abuse programs

• At least 100 parent/caregiver- daughter dyads will participate in BodyWorks
12

• At least 80% of participants will express satisfaction and demonstrate knowledge gain measured by 

program-specific evaluation tools

Agency Themes

• Regional Education for youth

Sub-themes

• Partnerships

• Reduced stigma/fear

• Increased resources

• Programs that work

• Culture/place

• Multiple strategies

• Appalachia in the national context

• Persistence
13

KENTUCKY ADMINISTRATIVE OFFICE OF THE COURTS DRUG COURT DEPARTMENT

The Kentucky Drug Court seeks to intervene and break the cycle of substance abuse, addiction, and 

crime by coordinating the efforts of the judiciary, prosecution, defense bar, probation, law 

enforcement, social services, and mental health treatment providers. Drug Court achieves substantial 

reductions in drug use and criminal behavior in drug-addicted offenders. Lack of substance abuse 

treatment professionals (Certified Alcohol and Drug Counselors) inhibits this effort.

Contact

Connie Payne, Executive Officer

Administrative Office of the Courts

100 Millcreek Park

Frankfort, KY 40602

502.573.2350

conniepayne@kycourts.net 

Project Title Certified Alcohol and Drug Counselor (CADC) Training

Target Audience 

Drug Courts, Comprehensive Cares, Operation Unlawful Narcotics Investigations, Treatment and 

Education (UNITE), juvenile/family drug courts, probation and parole, and other treatment agencies

Goals and Objectives

“Drug courts depend on community 

coalitions.”

“There is a ‘pill pipeline’ from Kentucky to 

Florida”

 Connie Payne

• Provide an opportunity for qualified person to test for CADC certification

• Increase numbers of qualified treatment providers in the region

Project Strategies

Train counselors to provide CADC supervision and 

regulation and counseling to increase number of 

trained counselors in state and

• Increase # of Drug Court participants

• Increase # of arrests by officers of UNITE officers

• Increase education by UNITE regarding treatment

• Decrease abuse of prescription drugs

Projected Outcomes

Short Term:

• 50% completion rate

• Assist students in prior Operation UNITE funded 

CADC classes to complete classes 

• Create a professional network and community 

teambuilding by providing intense substance 

abuse information to a variety of disciplines

Long Term: 

• Additional CADCs to serve the 

Appalachian region

• 25% of students take/pass CADC exam

• Creation of strong partnership among 

Drug Courts and Comprehensive Cares in 

Appalachia

Agency Themes

• Regional workforce 

• Education 

Sub-themes

• Partnerships

• Appalachia in the national context

• Increased resources

• Persistence

• Data
14

KENTUCKY RIVER COMMUNITY CARE

A private nonprofit community mental health center dedicated to improving the health and well-being 

of the people of eight counties in the Kentucky River area, KRCC provides services for mental health, 

developmental disability, substance abuse, and trauma. Prescription drug misuse, abuse and diversion 

are problems in the eight Southeastern counties of the Kentucky River Region as seen by data in a 2008 

NORC study indicated abuse of opiates and synthetics as a key issue in Appalachia; the National Center 

on Addiction and Substance Abuse (CASA) survey of primary care physicians indicating approximately 

94% of physicians missed or misdiagnosed addiction and 41% of pediatricians fail to diagnose illegal 

drug abuse in drug abusing teenage patients.

Contacts

Donna Hardin, Regional Prevention Center 

Director, 

Kentucky River Community Care, Inc.

79 Little Grapevine Creek Rd.

Hazard, KY 41701

606.436.5761 x 7110

dyhardin@yahoo.com

Judy Martin

606.436.5761 x 7116

Judy.martin@krccnet.com

http://www.krccnet.com 

“MDs want to make a difference in their 

communities.”

“Academic detailing requires face-to face 

interaction.” Judy Martin

“Appalachian culture places a significant

importance on primary care physicians.” 

 Donna Hardin

 

Project Title Prescription Medication Diversion Education with Physicians, Dentists, and 

Pharmacists

Target Audience Kentucky River Physicians, Dentists and Pharmacists

Goals and Objectives

• Establish and strengthen collaboration among physicians, 

dentists and pharmacists in the Kentucky River region

• Reduce prescription drug diversion and abuse among youth 

and adults in the Kentucky River region by providing intensive 

Academic Detailing to physicians, dentists, and pharmacists

Project Strategies

Training and education: Academic detailing among physicians, 

dentists and pharmacists in the Kentucky River region

Projected Outcomes

• Increased perception of risk of addictive Rx use

• Increased disapproval of addictive Rx use by youth and adults

• Decrease in frequency of addictive Rx use

• Increased knowledge of Kentucky All Schedule Prescription 

Electronic Reporting (KASPER) opiate prescribing

• Increased use of KASPER

• Increased disapproval of addictive Rx drug use among adults

• Increased substance abuse treatment 

Agency Themes

• Agency networking

• Workforce education and 

training 

Sub-themes

• Partnerships

• Primary care prevention
15

KENTUCKY RIVER FOOTHILLS DEVELOPMENT COUNCIL, INC.

The Kentucky River Foothills Development Council, Inc. (KRFDC) is a community action agency. 

Established in 1962, Foothills embraces a philosophy of needs-based strategies and family-based 

services leading to family self-sufficiency and economic self-reliance. KRFDC is committed to the 

promise of helping people and changing lives. The agency identified access to drugs as a primary 

problem within the four counties. 

Contact

April Stone, Director of Community Services, 

Kentucky Foothills Development Council

209 River Drive

Irvine, KY 40336

606.723.6629

Cfn1@foothillscap.org 

Sharon Hensley, Estill/Powell ASAP Board Coordinator, 

Bluegrass Prevention Program

448 N. Madison Ave,

Irvine, KY 40336

606.723.7187

sharonmhensley@irvineonline.net

“Our communities have shown 

that they can be “good stewards” 

of money.” 

 April Stone 

Project Title Project REAL: Resources for Empowering Appalachian Lives

Target Audience Kentucky Counties: Clark, Estill, Powell and Rowan

Goals and Objectives

• Provide community –based prevention strategies targeting adults 

and children by expanding a highly successful “mini-grant” program 

already being implemented by the local Kentucky Agency for 

Substance Abuse Policy (ASAP) Board

• Provide the Guiding Good Choices curriculum to families in the 

communities of Stanton, Clay City, Irvine, and Ravenna

Project Strategies

• Administer mini-grants for local alcohol, tobacco and other drug (ATOD) prevention activities 

through Project Relevant Education About the Law (REAL)’s collaboration with ASAP board

• Provide Guiding Good Choices training to local schools, faith organizations, parents, and other 

citizen groups in Stanton, Clay City, Irvine, and Ravenna, Kentucky

Projected Outcomes

• The local ASAP Board will provide 10 mini-grant awards 

up to $3,000 to community providers for approved 

ATOD prevention and supportive activities and offer 

Guiding Good Choices curriculum twice in each 

community. Each program will serve 15-20 families for 

a total of 120-160 families over the project period. 

• Long term we will build capacity to provide education 

and prevention of drug abuse.

Agency Themes

• Networking

• Community Education 

Sub-themes

• Partnerships

• Programs that work

• Reduced stigma/fear

• Culture/place

• Multiple strategies

• Persistence
16

MORGAN COUNTY BEHAVIORAL HEALTH CHOICES

Morgan county Behavioral Health Choices (MCBHC) is committed to assisting the citizens of Morgan 

County with any form of alcohol or other drug related problem that affects the individual, family or 

society. Established in 1976, the MCBHC offers prevention, positive alternatives, outpatient 

assessment, and counseling services. As identified by local Community Needs Assessments, the lack of 

essential assets by Morgan County Youth that provide protective factors at home, school and in the 

community contribute to adolescent substance use.

Contact

Elaine Shuster, Executive Director

Morgan Behavioral Health Choices

915 S. Riverside Dr.

PO Box 522

McConnelsville, OH 43756

740.962.6933

eshustermbhc@embarqmail.com 

http://morganbhc.org/index.html 

Project Title Asset & Life Skills for Morgan County Youth

Target Audience 3rd, 7th and 8th grade students in Morgan County, OH

Goals and Objectives

“We want to increase internal and external assets.” 

“In our culture parents give alcohol to their children: ‘If 

it’s fine for them, it’s ok for the kids.’”

Elaine Shuster

• Provide information to Morgan County 3rd, 7th and 8th grades about students’ use of alcohol and 

other drugs 

• Address a wide range of risk and protective factors: Raise self-esteem, reduce stress, reduce 

anxiety, improve anger management skills, overcome shyness, increase communication skills and 

problem solving, build relationships, avoid violence, and resist peer pressure 

• Improve internal assets and external assets 

• Introduce creative activities to stimulate minds and provide alternatives to substance use

Project Strategies

Deliver Life Skills program, an evidenced-based program intervention to 3rd, 7th, and 8th grades 

Projected Outcomes

• Students involved will be able to: 

o identify at least three harmful effects of alcohol, tobacco or other drugs (ATOD) use

o demonstrate positive effective communication skills in class sessions and activities

o demonstrate the use of a resistance skill 

• 80 % of children in summer camps will report

o increase in at least five assets

o positive experience with a young adult or adult mentor 

• High school students will report at least two assets positively impacted 
17

o Information taken to parents by children may influence decisions about using ATOD and may 

increase children’s assets 

Agency Themes

• Coalition

• Community education

Sub-themes

• Partnerships

• Reduced stigma/fear

• Data

• Multiple strategies

• Persistence
18

PEOPLE ENCOURAGING PEOPLE COALITION

PEP is an Operation Unlawful Narcotics Investigations, Treatment and Education (UNITE) coalition in 

Lee County. UNITE works to rid communities of illegal drug use through undercover narcotics 

investigations, coordinated treatment for abusers, support to families and friends of substance 

abusers, and public education about the dangers of using drugs. 

Eastern Kentucky has a high incidence of addiction to opium-derived prescription medicines. 

Detoxification and rehab centers may deal with the short term problem while mental recovery is more 

difficult. PEP is a recovery program.

Contact

Brenda Campbell, Executive Director, PEP

PO Box 285

Beattyville, KY 41311

606.464.0494

pepcoalition@bellsouth.net 

http://peopleencouragingpeople.blogspot.com/

http://www.operationunite.org/coalitions/lee

 

Project Title Realizing Our Potential by Exploring Our Past

Target Audience Citizens of Lee County, KY at risk for, or struggling with, addiction

Goals and Objectives

“Our people need hope.”

“My heart is broken by what drug abuse 

has done to my community.”

“Keeping people busy helps them think 

more about their work than about their 

addiction.” 

Brenda Campbell

• Involve those at risk for or struggling with addiction recovery, an opportunity to participate in 

community life

• Challenge the minds of the community

• Instill pride in Appalachian heritage

Project Strategies

Provide mountain arts classes to at-risk youth and community members with local instructors by 

• Providing positive opportunities to be creative and learn about traditional mountain activities and

• Involving interested community members with the at-risk population

Projected Outcomes

• Less incidence of substance abuse 

• Improve community cohesion 

• Create employment opportunities

• Pride in their accomplishments and their 

Appalachian heritage

Agency Themes

• Coalition 

• Community Education

Sub-themes

• Partnerships

• Reduced stigma/fear

• Increased resources

• Culture/place

• Appalachia in the national context

• Persistence

• Multiple strategies
19

ROWAN COUNTY UNITE

The Rowan Operation Unlawful Narcotics Investigation, Treatment and Education (UNITE) coalition has 

been working hard to educate the people of Rowan County about the drug problem. They have an 

ongoing project to educate senior citizens about the danger of prescription drugs. They sponsor three 

school-based clubs as well as numerous prevention activities for the community during the year.

Substance abuse in the community was identified from data from the law enforcement and court 

system, medical data, community norms 

assessments, community needs assessments, and 

Kentucky Incentives for Prevention (KIP) data.

Contact

Dana Quesinberry, Chair

Rowan County UNITE

PO Box 591

Morehead, KY 40351

606.776.3078

quesdb@roadrunner.com 

http://operationunite.org/coalitions/rowen/

Project Title UNITED We Stand Campaign

Target Audience Rowan County 

Goals and Objectives

“There is only as much substance abuse in a community 

as a community allows.”

“Substance abuse is like the dog under the sofa. Just 

because he can’t see you, he thinks you can’t see him. 

We’re getting ready to move the sofa.”

“Parents want to know what to do.” 

Dana Quesinberry

• Increase the community knowledge of and ability to combat the substance abuse problem

• Increase access to prevention and treatment services

• Increase law enforcement tools to combat the substance abuse problems

Project Strategies

• Execute a media campaign about substance abuse

• Provide community, law enforcement and parent trainings, i.e. “How to Drug Proof Your Kid”

• Give scholarships for training Certified Prevention Specialist and Drug and Alcohol Counselors

Projected Outcomes

• Community becomes more knowledgeable 

about substance abuse

• Community is better prepared to prevent 

and combat substance abuse

• Treatment and enforcement gaps are 

closed

Agency Themes

• Community Coalition

• Workforce Education

Sub-themes

• Partnerships

• Reduced stigma/fear

• Increased resources

• Culture/place

• Multiple strategies

• Persistence

• Programs that work
20

STEUBEN COUNTY COMMUNITY SERVICES

For five years the Building Independence for the Long Term (BILT) Program of the Steuben County 

Department of Social Services has focused on developing community collaboration and partnerships 

around issues of homelessness, mental health and drug and alcohol services with a focus on planning, 

implementation and collaboration for case management and treatment.

The Steuben County Department of Social Services has traditionally high levels of homeless individuals 

with addiction issues. 

Contact

Christina Pellegrino, BILT Coordinator

Steuben County Community Services

3 E. Pulteney Squ.

Bath, NY 14810

607.664.2102

Christina.pellegrino@co.steuben.ny.us 

http://www.steubencony.org/dss.html

Project Title Provision of Services for Chemically Dependent Individuals of a Rural Re-Entry 

Population

Target Audience Released incarcerated individuals in Steuben County, NY

Goals and Objectives

“We will link released incarcerated individuals to 

outpatient services, community resources and 

stable housing.”

 

 Christina Pellegrino

• Employ a fulltime re-entry case manager to assess, 

identify, and link those with addictions to 

appropriate services prior to incarceration release in 

order to prevent relapse and promote a healthy 

transition into the community.

• Link a primary care physician with detoxification and 

rehabilitation services which will allow patients to 

move seamlessly into primary care at time of 

discharge. 

Project Strategies

• Coordination of services by a re-entry case manager 

to ensure access to supports necessary for success 

with addiction recovery, linkage with community 

resources and stable housing

• Reducing duplication of services and conflicts from 

providers 

• Assistance in moving clients seamlessly from inpatient care to a primary care physician in an 

outpatient setting

Projected Outcomes

• Movement of individuals toward selfsufficiency Individualized Service Plans

• Reduction in crisis re-admissions

• Reduction in re-arrest/offense rates

• Reduction in probation/parole violations

• Program sustainability through public 

and private revenue

Agency Themes

• Networking

• Education 

• Workforce training 

Sub-themes

• Partnerships

• Primary Prevention

• Reduced stigma/fear

• Increased resources

• Multiple strategies

• Persistence
21

EAST TENNESSEE STATE UNIVERSITY

OFFICE OF RURAL AND COMMUNITY HEALTH AND COMMUNITY PARTNERSHIPS

The Office of Rural and Community Partnerships bridges the gap between community and academic 

public health issues in Central Appalachia. It has a history with the Appalachian Regional Commission 

in addressing those issues.

Rural Appalachian counties have fewer community resources related to education, economic 

development and health care for addressing substance abuse as a threat to the health of the public. 

Appalachia represents a distinct population regarding needs and service delivery.

Contact

Bruce Behringer, Director 

ETSU Office of Rural and Community Health 

and Community Partnerships

PO Box 70142

Johnson City, TN 37614

423.439.7809

behringe@etsu.edu

or Kris Bowers 423.439.7156

Bowersk@etsu.edu

http://www.etsu.edu/kellogg/Substance%20Abuse.asp 

Project Title Exploration of Substance Abuse Issues in Appalachian Communities

Target Audience Appalachian community teams

Goals and Objectives

• To define the scope of methamphetamine and other Appalachian substance abuse threats 

• To provide a forum and learning atmosphere for multi-stakeholder community teams

• To enable communities to address substance abuse issues in place with effective tools

• To identify additional research avenues for studying Appalachia substance abuse

• To add to substance abuse knowledge base in Appalachia

Project Strategies

• 3-tier approach to identifying problem: Workshop, Invitational conference, Research wrap-up plus 

long term follow-up

• Multi-stakeholder community team approach with small challenge grants for plan implementation

Projected Outcomes

• Workshop delineating need for common language among stakeholders and a community approach 

to address substance abuse in Appalachia 

• Conference for 26 community teams involving learning, community plans, and challenge grants to 

implement plans

• Definition of Appalachian substance abuse 

• Evaluation of community’s projects

• Reunion conference of community teams

• Model from which to study community action 
22

Agency Themes

• Regional community 

• Capacity building

Sub-themes

• Partnerships

• Increased resources

• Data connections

• Multiple strategies

• Appalachia in the national context

• Persistence 
23

Logic Models 

Sample LOGICS MODEL for the

Charleston Area Medical Center Health Education and Research Institute Charleston,

WV Drug Addicted Mom and Baby Task Force

Problem: Significant number of NICU admissions for addicted babies

Mission/Purpose: Drug-free newborns

Context or Conditions: Significant drug use among pregnant women (moms) in target area (354 

positive drug urinalyses)

Goals: 

• Improve early intervention to enhance prenatal care 

• Reduce number of NICU admissions 

• Reduce drug use and addiction during pregnancy and delivery

• Increase referrals when moms have positive drug test during prenatal care 

Inputs /Resources Activities/Strategies Outputs Expected 

Outcomes

Sectors Involved

• Nurses (NICU,OB,L&D)

• Physician 

• Medical students

• Social workers

• Certified Drug 

Counselor

• Community 

involvement

• ARC grant funding 

Constraints

• Fear and stigma from 

patients

• Resources limited for 

poly drug users

• Stigma from staff/ 

judgmental attitudes

• Treatment drop out 

when confronted 

about addiction 

• Providing early 

intervention and 

referrals for drug-using 

pregnant women

• Educating staff on 

judgmental attitudes

• Marketing , e.g., posters 

and postcards in clinic 

• Dialectical Behavior 

Therapy (DBT) Group 

• Certified Addiction 

Counselor (CAC) in clinic 

to work with moms 

• Collaborating with 

women in recovery 

through the Drug 

Addictive Mom and 

Baby (DAMB)

• Policy change - universal 

drug screenings for 

moms

 

• Reduction of 

judgmental 

attitudes

• Reduction in 

number of drug 

addicted babies 

• Network of other 

health care 

facilities 

• Coping and 

tolerance skills

• CAC to intervene 

to improve 

prenatal care

• Self-sufficient 

DBT group

• Data screening 

policy 

• Barriers 

reduced

• Network 

enhanced 

• Early 

intervention

• Decreased 

NICU 

admissions

• Decreased 

addiction 
24

Sample LOGIC MODEL for the

HEALTHWORKS! Project of the Health Care Foundation of North Mississippi, Tupelo, MS

Problem: The increased vulnerability of girls (K-8) to substance use

Mission/Purpose: To reduce vulnerability to substance use among girls

Context or Conditions: 

• Use of alcohol, cigarettes, marijuana, and prescription drugs is trending upward for girls

• Since 2002, more girls than boys started using marijuana

• In 2004, more girls than boys started using alcohol and tobacco

• Annually, teen girls misuse prescription drugs at rates higher than boys

(Sources: Youth Risk Behavioral Survey-Mississippi, High School Survey/Youth Tobacco 

Survey 2007)

Goal: To teach girls to resist experimentation with alcohol, tobacco, and other drugs.

Inputs /Resources Activities/Strategies Outputs Expected Outcomes

Partnership

• North Mississippi 

Medical Center

• Lee County Medical 

Alliance

• Junior Auxiliary of 

Tupelo

• Teachers

• Mentors

• Social Science 

Research Center 

(SSRC) at 

Mississippi State 

University

• Grant Funding

Targeted Population

• Kindergarten 

through 8th

grade/preadolescent and 

adolescent girls

Bodyworks 

• 7-week obesity 

prevention 

program for girls 

ages 9-13 and their 

parents/caregivers

• One class 

completed with 21 

dyads;

• Work Your Body 

Camp completed 

with 14 dyads; class 

set for fall 2009

Lighten Up – 

Running is Fun 

• Ten 90-min sessions 

focus on nutrition, 

fitness, race 

participation

• One class of 28 

completed. 

Emphasis is on 

having fun while 

being healthy

• Personal and 

family eating 

habits 

improve

• Personal and 

family physical

/exercise 

habits 

improve

•Understanding 

of root causes 

of substance 

abuse 

• Increased self-esteem

• Increased self-confidence 

• Reduced susceptibility

• Increased decision-making skills

• Increased knowledge about 

personal health and healthy 

choices

• Increased parental bond

• Resistance to experimentation

Process Outcomes

• At least 4,000 elementary and 

middle school-aged in 20 MS 

and four AL counties will attend 

one or more substance abuse 

programs.

• At least 100 parent/ caregiverdaughter dyads will participate 

in Bodyworks.

• At least 80% of participants will 

express satisfaction and 

demonstration gains in 

knowledge as measured by 

program specific evaluation 

tools. 
This publication lists non-Federal resources in order to provide additional information to consumers. The 

views and content in these resources have not been formally approved by the U.S. Department of Health and 

Human Services (HHS). Listing these resources is not an endorsement by HHS or its components.

25

Resource Guide

Evidence-based programs

SAMHSA’s National Registry of Effective 

Programs 

http://www.nrepp.samhsa.gov/ 

Examples of Research-Based Drug Abuse 

Prevention Programs

http://drugabuse.gov/Prevention/examples.html 

National Institute on Drug Abuse http://www.nida.nih.gov/nidahome.html

Promising Practices Network (Rand 

Corporation)

http://www.promisingpractices.net/default.asp 

Preventing Drug Abuse among Children and 

Adolescents

http://drugabuse.gov/Prevention/PrevOpen.html 

Planning for Drug Abuse Prevention in the 

Community

http://drugabuse.gov/Prevention/planning.html 

Applying Prevention Principles to Drug 

Abuse Prevention Programs

http://drugabuse.gov/Prevention/applying.html 

NIDA Resources for Parents and teachers http://backtoschool.drugabuse.gov/

Reclaiming the Futures http://www.reclaimingfutures.org/ 

Community Anti-Drug Coalitions of America http://www.cadca.org/

Robert Wood Johnson Foundation 

Cross Systems Financing Report

http://www.rwjf.org/pr/product.jsp?id=40248 

Child Welfare League of America http://www.cwla.org/default.htm 

US Dept. of Education Center for Alcohol 

and Other Drug Abuse and Violence 

http://www.higheredcenter.org/ 

National Survey on Drug Use and Health http://www.oas.samhsa.gov/nhsda.htm

Analysis of Substance Abuse and Mental 

Health Disparities in the Appalachian 

Region and Access to Treatment Services

http://www.norc.org/projects/Analysis+of+Substa

nce+Abuse+and+Mental+Health+Disparities+in+t

he+Appalachian+Region+and+Access+to+Tr.htm
This publication lists non-Federal resources in order to provide additional information to consumers. The views and 

content in these resources have not been formally approved by the U.S. Department of Health and Human Services 

(HHS). Listing these resources is not an endorsement by HHS or its components.

26

Publications

SAMHSA brochure: Reducing Substance 

Abuse in America

http://www.samhsa.gov/pubs/sa/SA_challenge.htm

CADCA Publications http://www.cadca.org/about/institute/institutepublications

SAMHSA Toolkit: Sustaining Grassroots 

Community-Based Programs

http://ncadi.samhsa.gov/tech/rss/newpubs1.xml 

WebMD for Parents: Prevention Strategies http://www.webmd.com/mental-health/alcoholabuse/teen-alcohol-and-drug-abuse-preventionstrategies 

Learning for Life and DEA booklet: Drug 

Prevention for Teens

http://www.learning-for-life.org/lfl/resources/99-

349.pdf 

Parents: The Anti Drug http://www.theantidrug.com/ 

Teens and drug abuse articles http://www.teen-drug-abuse.org/ 

National Youth Violence Prevention Center http://www.safeyouth.gov/Pages/Home.aspx

Faith and Service Technical Education 

Network

http://www.urbanministry.org/wiki/best-practiceschecklist-youth-substance-abuse-prevention