MACOMB COUNTY OFFICE OF SUBSTANCE ABUSE
MCOSA NEWS Fall 2009
The MCOSA news is published by the Macomb County Office of Substance Abuse, 22550 Hall
Road, Clinton Township, MI 48036 (586) 469-5278 or (586) 469-5568 (FAX) with support from the
Macomb County Community Mental Health Board and Macomb County Board of Commissioners.
MCOSA ADVISORY COUNCIL
Ms. Joelene Beckett Ms. Kathy Rager Ms. Patti Steele
Mr. Gary M. Burnett Ms. Elizabeth (Betty) Risher Ms. Karen Stetson
Mr. Eric Jackson Mr. Kenneth Roberts Ms. Kim Szajna
Ms. Theresa Morin Mr. James Skelton Ms Janet Teltow
Mr. Jeffrey Oldham Ms. Joanne Smyth (Acting chair)
MCCMH Board Representative:
Ms. Jan Wilson Ms. Patricia Bill (alternate)
Mr. Randy O'Brien, Director
Ms. Helen Klingert, Assistant Director
Mr. Dana Gire, Prevention & Training Coordinator
Ms. Dawn Radzioch, Prevention & Training Assistant
Ms. Kathleen Parzynski, Data & Finance Coordinator
Ms. Yvonne Tipton, Data & Finance Assistant
Ms. Karen West, Account Clerk
Ms. Donna Onifer, Account Clerk
Ms. Lisa Carrizales, Secretary
Vacant, Quality Assurance Coordinator
SUBSTANCE ABUSE CERTIFICATION
The Michigan Certification Board for Addiction Professionals (MCBAP) currently offers certification
in the following areas:
CAAC- Certified Advanced Addiction Counselor
CAC-R Certified Addictions Professional-IC&RC Reciprocal (formerly CAC-II)
CCS-R Certified Clinical Supervisor-IC&RC Reciprocal
CPS-R Certified Prevention Specialist-IC&RC Reciprocal
CPC-R Certified Prevention Consultant-IC&RC Reciprocal
CCJP Certified Criminal Justice Professional
For questions please contact Michigan Certification Board for Addiction Professionals
(www.mcbap.com) or call (517) 347-0891.
Both the IC&RC and Michigan Addiction Fundamentals exams are given through MCBAP. Please
contact them at www.mcbap.com to register or to order study guides.
MCOSA NEWS Fall 2009
Comiings and Goiings
Com ngs and Go ngs
Good-Bye Dana Gire
It is with mixed emotions that we say good-bye to Dana upon his retirement. He has been an icon
for prevention efforts across Michigan since 1974 when MCOSA was created. He has worked for
Macomb County since 1971. Yes, that is 39 years of service! He deserves to enjoy a long, healthy,
happy retirement and we wish him the best. His wisdom and guidance will be sorely missed, since
Dana has chosen to retire on January 29, 2010. The next time you see him at one of his many
meeting or committees please wish him well. Dana has set an extremely high bar both locally and
statewide where his efforts have had an impact in countless ways. THANK YOU Dana for your
years of service.
Good-Bye Donald Habkirk
After 30 years Mr. Don Habkirk, Director of Community Mental Health, has decided to retire. We
have been privileged to work with Don and his progressive, compassionate views. Don’s
collaborative nature has brought him in contact with many agencies and individuals over the years
and his humor and style have been greatly appreciated. We hope he enjoys his well-deserved
retirement. Don will be with CMH until the end of February as he trains his replacement. Don, we
wish you happiness in your retirement!
Good-Bye Bob Slaine
Mr. Robert Slain, Deputy Director of Community Mental Health will also be retiring after 34 years of
commendable service! Bob’s many and varied responsibilities have brought him in contact with
many of you over the years. He will be leaving CMH near the end of January so please join MCOSA
in wishing Bob a healthy and enjoyable retirement.
Welcome Kathleen Parzynski
Welcome to Kathleen Parzynski, our new Data and Finance Coordinator. Ms. Parzynski has been
with Macomb County for the past three years, working at Martha T. Berry, Medical Care Facility as
the Business Services Manager. She has extensive healthcare experience in all areas of finance,
accounting, budgets, forecasting and auditing. Ms. Parzynski received her Bachelors Degree in
Accounting from Detroit College of Business and her Masters in Business Administration from
Central Michigan University. Kathleen is single and has four adult children and three wonderful
grandsons ages 2 ½, to 2 months. She has stated “I look forward to working at MCOSA, meeting
everyone and learning more about the programs.”
Welcome John Kinch
As you may have heard, Mr. John Kinch has been selected as the new Community Mental Health
Director. John has 24 years experience with Macomb CMH; he will be transitioning into his new
position over the next two months. Officially he will be taking over for Don Habkirk on March 1,
2010. Please join us in congratulating John on his new position.
MCOSA NEWS Fall 2009
PREVENTION COORDINATOR RECEIVES AWARD
Our very own Dana Gire, Prevention Coordinator here at MCOSA, was honored at the Michigan
Substance Abuse Conference this past September when he received the 2009 Gary Pepe
Prevention Award. The Award was given by the Michigan Association of Substance Abuse
Coordinating Agencies in recognition of his outstanding leadership in the field of the prevention of
substance use disorders. MCOSA has appreciated Dana’s insight and direction over the years.
CHIPPEWA VALLEY COALITION FOR YOUTH AND FAMILIES RECEIVES
A FEDERAL GRANT
Congratulations to Chippewa Valley Coalition for Youth and Families on being awarded a Drug Free
Communities Grant. This five year grant will give the coalition the opportunity to expand and fulfill
their activities which focus on a variety of strategies to combat youth substance abuse.
MACOMB CHECKS UNDERAGE TOBACCO SALES
Macomb County teens with adult chaperones checked 49 tobacco retailers to verify they are
complying with the federal Synar Amendment. The youth attempted to purchase cigarettes in
randomly selected retailers and vending machine outlets.
These teens do not actually purchase tobacco products but follow state protocol when asking a
store clerk to sell them a pack of cigarettes. Compliance is recorded for the survey but teen do not
violate the Youth Tobacco Act which states that: "The purchase of Tobacco Products by a minor
under 18 years of age and the provision of Tobacco Products to a minor are prohibited by law. A
minor unlawfully purchasing or using Tobacco Products is subject to criminal penalties."
This year 90% of retailers checked did NOT sell to minors. Macomb County Office of Substance
Abuse would like to thank those retailers for their cooperation in following this law. This effort is
done yearly in cooperation with the Michigan Department of Community Health, Bureau of
Substance Abuse & Addiction Services (BSAAS). Michigan is required to demonstrate that their
Youth Tobacco Laws are being enforced to reduce access of tobacco products to minors.
Unfortunately, a few retailers and businesses ignore the law and continue making profits on selling
tobacco to children.
Tobacco is the number one cause of preventable death in our society. Each year thousands of
teens become addicted to tobacco. The short-term goal of this project is to determine how many
retailers are illegally selling tobacco to minors. Our long-term goal is to create awareness of the
youth tobacco problem and reduce the sales of tobacco to minors, therefore preventing some of our
children from beginning a lifetime addiction to tobacco.
PROJECT REMEDY UPDATE
Our local SPF-SIG project is moving local coalitions into the age of technology. The Project has
worked with most of the “hot spot” coalitions helping them learn how to use current social marketing
trends like facebook and wikispaces. To find out more about this project visit
http://projectremedy.wikispaces.com or contact Jamie Siefert or Pamela Werling at CARE (586)
MCOSA NEWS Fall 2009
MICHIGAN IS THE 38th STATE TO GO SMOKEFREE!
December 10, 2009, the Michigan Senate passed, and the House concurred with HB 4377, which
bans smoking in most public places statewide. It is currently on its way to Governor Granholm’s
desk to be signed into law.
Here are some of the high (and low) lights of this historic legislation:
· The bill’s official title is “The Dr. Ron Davis Act of 2009”
· Under this legislation, ALL BARS AND RESTAURANTS will be non-smoking.
· The effective date is May 1, 2010
· The labor union exemption that was included in the original version of this bill has been
· Tobacco specialty stores may be exempted provided they meet the following requirements:
Their primary purpose must be the retail sale of tobacco products and smoking paraphernalia.
Owners must prove that the store generated 75% or more of its total gross annual income from the
on-site sale of tobacco products and smoking paraphernalia (online sales DO NOT COUNT).
This does NOT include any establishment with any type of liquor, food, or restaurant license.
Translation: 95% of the hookah bars will have a choice – “Get rid of your food license or get rid of
· Cigar bars may be exempted provided they meet the following requirements:
They must be in existence on May 1, 2010.
Cigar bars MUST have an installed on-site humidor.
Owners must file an affidavit proving that the cigar bar generated 10% or more of its total gross
annual income from the on-site sale of cigars and the rental of on-site humidors.
The smoking area must be physically separated and enclosed on all sides from any non-smoking
The cigar bar prohibits the smoking of all other tobacco products (no hookah, no pipes, no
The cigar bar allows only the smoking of cigars on the premises that retail for over $1.00 per cigar
(none of those cigarettes masquerading as “little cigars”).
You must purchase the cigar on the premises if you’d like to smoke in the cigar bar.
· Casinos are partially exempted (Only the gaming floors of casinos are exempted). All bars
and restaurants that are in or are part of a casino may not allow smoking.
· This bill passed 24-13 in the Senate and 75-30 in the House.
Although we would have preferred a comprehensive bill without exemptions, this is still a very well
written bill and will protect a majority of Michigan’s workers from the dangers of secondhand
smoke. More importantly, this legislation passed because of CITIZENS’ EFFORTS. It was
tireless phone calls, visits to legislators, emails, and letters that kept the pressure up and
ultimately got this passed. Thank you, all of you. Now, go celebrate! Regina B. Calcagno, J.D.,
MCOSA NEWS Fall 2009
KICK BUTTS DAY is March 24, 2010
Kick Butts Day is a national day of activism that empowers youth to speak up and take action
against Big Tobacco at more than 2,000 events from coast to coast. As a teacher, youth leader, or
health advocate, you can organize events and mobilize students to raise awareness about the
problems of tobacco use in your school or community.
MALE ATHLETES DRINK MORE, SMOKE LESS
Adolescent males who play team sports are less likely to smoke cigarettes or be depressed but are
more likely to drink alcohol and get into fights, whereas sports participation generally reduces risky
behavior among girls, Bloomberg.com reported November 9, 2009.
Male athletes had binge-drinking rates 40 percent higher than non-athletes, and were 30 percent
more likely to get in fights, but 30 percent less likely to be depressed and 20 percent less likely to
smoke. Playing sports cut the smoking risk in half for girls.
"Sports team participation appears to have both protective and risk-enhancing associations," said
Susan M. Conner of the Injury Prevention Center at University Hospitals' Rainbow Babies &
Children's Hospital in Cleveland, who based her findings on surveys of 13,000 U.S. high-school
students. "These results indicate that healthy lifestyle benefits are not universal and do not apply
equally across genders."
The findings were presented at a recent meeting of the American Public Health Association.
WHAT ARE THEY? and WHY USE THEM IN PREVENTION?
Environmental strategies are focused on changing aspects of the environment that contribute to the
use of alcohol and other drugs. Specifically, environmental strategies aim to decrease the social
and health consequences of substance abuse by limiting access to substances and changing social
norms that are accepting and permissive of substance abuse. They can change public laws,
policies and practices to create environments that decrease the probability of substance abuse.
Environmental theory suggests that there are three critical components to environmental strategies
of prevention: community norms, availability of substances and local regulations. It proposes that
strategies targeting all youth in a community differ from those utilized when targeting individual
youth. Environmental strategies are meant to support all community youth in positive activities and
thwart them in negative actions.
In contrast and broadly defined, individual strategies are short-term actions focused on changing
individual behavior, while environmental strategies involve longer-term, potentially permanent
changes that have a broader reach (e.g., policies and laws that affect all members of society). The
most effective prevention plans will use both environmental and individual substance abuse
MCOSA NEWS Fall 2009
ALCOHOLICS HAVE HARD TIME PROCESSING EMOTIONS
Brain damage caused by excessive drinking can impair the ability to read facial expressions and
blunt emotions even among those in long-term recovery from alcoholism, Science Daily report.
Alcohol-related deficits in the amygdala and hippocampus regions of the brain can hinder the ability
of current and former alcoholics from maintaining healthy relationships, researchers said. Study
author Ksenija Marinkovic of the University of California at San Diego and colleagues based their
conclusions on studies using functional MRI scans.
"Alcoholics also have problems in judging the emotional expressions on people's faces," said
Marinkovic. "This can result in miscommunication during emotionally charged situations and lead to
unnecessary conflicts and difficulties in interpersonal relationships. The resulting negative
repercussions can, in turn, contribute to increased drinking."
"The neuroimaging evidence from our study suggests that deficient activation of limbic structures
inside the temporal lobes -- the amygdala and hippocampus -- may underlie emotional difficulties in
abstinent long-term alcoholics," explained Marinkovic. "Whereas nonalcoholic adult men showed
stronger activation in the amygdala and hippocampus when viewing faces with emotional
expressions, the alcoholics showed decreased activation in these brain areas, and furthermore
responded in an undifferentiated manner to all facial expressions. The alcoholics also were
impaired on the intelligence-appraisal task, possibly due to their dampened amygdala activity."
The study was published online in the journal Alcoholism: Clinical & Experimental Research.
SAMHSA LAUNCHES FUNDING WEBSITE
A new website by the Substance Abuse and Mental Health Services Administration (SAMHSA)
includes current information on addiction and mental health funding for treatment, prevention, and
interventions, as well as an archive of funding-related reports, news and other information.
The site also includes a weekly roundup of federal addiction and mental health funding news, called
the Weekly Financing News Pulse, which includes grant announcements, analysis, and details on
Congressional budget hearings.
You can subscribe to the Pulse at the SAMHSA eNetwork site www.samhsa.gov/enetwork.
MCOSA NEWS Fall 2009
EVIDENCE OF POTENTIAL DANGERS SMOKING MARUJUANA
A Canadian study reported in Medical News Today found that smoking marijuana, like smoking
tobacco, has toxic effects on cells, challenging the popular belief that smoking marijuana is safer
than smoking cigarettes. The study in the August 17 issue of ACS' Chemical Research in
Toxicology, a monthly journal.
Rebecca Maertens and colleagues note that people often view marijuana as a "natural" product and
less harmful than tobacco. As public attitudes toward marijuana change and legal restrictions ease
in some countries, use of marijuana is increasing. Scientists know that marijuana smoke has
adverse effects on the lungs. However, there is little knowledge about marijuana's potential to
cause lung cancer due to the difficulty in identifying and studying people who have smoked only
The new study begins to address that question by comparing marijuana smoke vs. tobacco smoke
in terms of toxicity to cells and to DNA. Scientists exposed cultured animal cells and bacteria to
condensed smoke samples from both marijuana and tobacco. There were distinct differences in the
degree and type of toxicity elicited by marijuana and cigarette smoke. Marijuana smoke caused
significantly more damage to cells and DNA than tobacco smoke, the researchers note. However,
tobacco smoke caused chromosome damage while marijuana did not.
The article, "The Genotoxicity of Mainstream and Sidestream Marijuana and Tobacco Smoke
Condensates" is available at:
TOLERANCE OF MARIJUANA REFLECTED IN SENIORS' USE
Some members of the Baby Boomer generation not only remain tolerant of marijuana use but also
continue to smoke the drug themselves, the Washington Post reported Nov. 16.
"I know literally hundreds of people my age who smoke," said Joe Lee, 62, a vintage-records dealer
in Rockville, MD. "They are upright citizens, good parents who are holding down jobs. You take two
or three puffs, and you're good to go. I'm not a Rastafarian; I don't treat this as some holy
sacrament. But pot is fun."
Nearly 10 percent of Americans ages 50-59 reported marijuana use in 2007, up from 5.1 percent in
2002. Some older users never stopped smoking, while others have returned to using as tolerance
"We're concerned by the public-health impact of this," said Peter Delany of the Substance Abuse
and Mental Health Services Administration. "Doctors need to be more sensitive to it. They may ask
older patients about alcohol now but not think to ask about illicit drug use."
"I don't think more people in their 50s are smoking marijuana. I think we are just more comfortable
talking about it," said travel writer Rick Steves, 54. "It's just not that big a deal anymore. It's another
recreational drug, like alcohol."
MCOSA NEWS Fall 2009
"Stop and think. If you're pregnant, don't drink."
WHAT IS FETAL ALCOHOL SPECTRUM DISORDER?
FASD is an umbrella term describing the range of effects that can occur in an
individual whose mother drank alcohol during pregnancy. These effects may include
physical, mental, behavioral, and/or learning disabilities with possible lifelong
implications. Each year in the U.S., as many as 40,000 babies are born with an FASD.
The cost to the nation for FAS alone is about $6 billion a year.
The term FASD refers to a spectrum of conditions that include fetal alcohol syndrome
(FAS), fetal alcohol effects (FAE), alcohol-related neurodevelopmental disorder
(ARND), and alcohol-related birth defects (ARBD). Although disorders within the
spectrum can be diagnosed, the term FASD itself is not intended for use as a clinical
To learn more about FASD contact Community Assessment Referral & Education at
(586) 541-0033 or visit www.careofmacomb.com, www.mcfares.org or
ILLICIT DRUG USE RISING AMONG THOSE IN THEIR 50s
As baby boomers pass the half-century mark, many are celebrating with more than cake and ice
cream. Use of illicit drugs among 50- to 59-year-olds has nearly doubled during the past five years,
according to a report from the Substance Abuse and Mental Health Services Administration
The report, An Examination of Trends in Illicit Drug Use among Adults Aged 50 to 59 in the United
States, found that past-year drug use among this age group increased from 5.1 percent in 2002 to
9.4 percent in 2007. These 2007 trends in prevalence rates of past year include: any illicit drug use
(9.4%), marijuana use (5.7%), and nonmedical use of prescription drugs (4.0%). SAMHSA officials
attributed the increase to more Baby Boomers entering their 50s and continuing their patterns of
"These findings show that many in the Woodstock generation continue to use illicit drugs as they
age," said SAMHSA Acting Administrator Eric Broderick. "This continued use poses medical risks to
these individuals and is likely to put further strains on the nation's health-care system -- highlighting
the value of preventing drug use from ever starting."
For more detailed information, see
MCOSA NEWS - LICENSING Fall 2009
In keeping with the requirements of Public Act 368 of 1978, the Macomb County Community Mental health – Office of
Substance Abuse is requesting community comment on new and renewal substance abuse license applications.
Any individual or organization who offers, or purports to offer, substance abuse prevention or treatment services and
charges for those services must be licensed through the Michigan Department of Consumer and industry Services, unless
they are already licensed in certain specific disciplines. Opportunities to comment on license applications are provided
through the local Coordinating Agency (Macomb County Community Mental Health – Office of Substance Abuse) and its
If you wish to provide comments about any of the programs listed below, please contact the Macomb County Office of
Substance Abuse at (586) 469-5278. We would prefer comments in writing, but you may call or request a hearing before
the Macomb County Community Mental Health – Office of Substance Abuse Advisory Council at its next meeting. The
Advisory Council meets at 8:30 a.m. on the first Wednesday of each month.
A full and current list of Licensed Substance Abuse providers can be obtained through the state at
37th District Court-Warren (COURT)
38th Eastpointe Municipal Court (COURT) Macomb County Probation Department (COURT)
39th District Court-Roseville (COURT) Macomb Family Services-Clinton Twp. (OP,CAIT,SARF,INT)
40th District Court-St. Clair Shores (COURT,CAIT) Macomb Family Services-Richmond (OP,CAIT,SARF,INT)
41-A District Court-Sterling Hts (COURT) Macomb Family Services-Romeo (OP,CAIT,SARF, INT)
41-B District Court-Clinton Twp. (COURT) Macomb Family Services-Shelby Twp. (OP,CAIT,SARF,INT)
41-B District Court-Mt. Clemens (COURT) Macomb Intermediate School District-Clinton Twp. (CAIT)
42-2 District Court-New Baltimore (COURT) Mental Morphosis-Warren (OP, SARF)
Metro Family Support Counseling-Sterling Hts (OP, INT, EI, CM)
Advanced Counseling Services-St. Clair Shores (OP) MRL Consultants-Mt. Clemens (CAIT)
Alcohol Highway Safety program-Fraser (CAIT) New Alternatives Inc-Centerline (OP,SARF)
Alt. Community Living dba New Passages-Mt. Clemens (OP, PEER,INT,CM) New Oakland Child, Adolescent & Family-Clinton Twp. (OP)
Alt. Community Living dba new Passages-Warren (OP, INT) Oakland Psychological Clinics-Fraser (OP,CAIT)
Biomedical Beh Health Systems-Clinton Twp. (METH,OP) Options Counseling Service-Eastpointe (OP,CAIT,SARF)
Catanese Counseling-New Baltimore (CAIT,OP) Person Centered Counseling Services –Mt Clemens (SARD,CAIT,OP)
Catholic Services of Macomb-Clinton Twp. (OP) Perspectives of Troy-Sterling Hts (OP)
Catholic Services of Macomb-Warren (OP) PHC dba Harbor Oaks-New Baltimore (INT,OP,CAIT,SARF)
Chambers Consulting-East Pointe (CAIT,SARF) PHC Pioneer Counseling Center-Clinton Twp. (OP,SARF)
Choices Counseling Center–Roseville (OP,CAIT,SARF) PHC Pioneer Counseling Center-Sterling Hts (OP, INT, SARF)
Christian Community Development Corp-Mt. Clemens (CAIT) Potters House C.I.P.-Warren (CAIT)
Clinton Counseling Center-Jail Program-Mt. Clemens (OP,CAIT) Premier Services-Madison Hts (METH,OP)
Clinton Counseling Center-Mt. Clemens (OP,CAIT,SARF, INT) Premier Services-Warren (METH,OP, INT)
Community Assessment Referral & Educ.-Fraser (SARF,CAIT,Org Dev, 309,CM) PREVCO-Fraser (CAIT)
Community Programs – Waterford (Out of County DEX, RES) Rainbow Treatment Cetner-St. Clair Shores (OP)
Completion House-Truning Point-Otter Lake (Out of County RES) Renewal Christian Counseling-Clinton Twp. (CAIT,OP,SARF)
Completion House-Turning Point-Pontiac (Out of County RES,OP) S.A.T.E.C. LLC – Roseville (OP, SARF, CM)
CUBE–Clinton Twp. (CAIT) Sacred Heart dba Clearview-Port Huron (Out of County RES)
Debra Gainor-Shelby Twp. (OP,SARF) Sacred Heart-Memphis (DEX,RES, OP, METH, EI, INT, PEER,CM)
Diagnostic Assessment Center- SCS (OP, SARF, CAIT, PEER) Sacred Heart-New Haven (OP,CAIT,SARF,INT,EI,PEER,CM)
Dr Ronald Fenton & Assoc – Clinton Twp. (SARF, OP) Sacred Heart-Warren (OP,CAIT, SARF, PEER, INT, EI, CM)
Driver Intervention Program-Richmond (CAIT) Salvation Army Harbor Light-Macomb (RES,DEX,RES,OP,CAIT,SARF)
Eastwood Clinics-Clinton Twp. (OP,SARF, INT) St. Joseph’s Center for Beh. Medicine-Clinton Twp. (OP)
Eastwood Clinics-Eastpointe (OP,SARF,CAIT, INT) SHAR –Self Help Addiction Rehabilitation –Warren (PEER, EI, CAIT, RES, OP,
Eastwood Clinics-Royal Oak (Out of County RES) CM, INT)
Everest Association-Utica (CAIT) T&G Corporation – Warren (OP, INT, CM, IP)
Evergreen Counseling Center-Shelby Twp (OP) Time Out Counseling-Warren (OP,CAIT,SARF)
Health Management Systems of America-Eastpointe (SARF) Tina Persha-Shelby Twp. (OP,CAIT,SARF)
Health Management Systems of America-Shelby Twp. (SARF) Ventures Assertive Community Treatment (INT, OP)
Health Management Systems of America-Sterling Hts (SARF) Wentworth and Assoc PC- Utica (OP, INT, SARF)
Henry Ford Beh. Services CD-Clinton Twp. (OP,CAIT)
Interventions-Clinton Twp. (OP,CAIT,SARF)
Introspections-Sterling Hts (OP,SARF)
Kairos Healthcare-Bridgeport (Out of County ADOL RES, INT, CM, SARF, OP, CAIT)
Kenvin-St. Clair Shores (CAIT)
Khalil Family Wellness &ntervention LLC– Eastpointe (SARF,OP,CAIT) Key: CAIT = information/prevention/problem assistance
Life Map, L.L.C. – Chesterfield (OP, SARF, CAIT) CM = case management
Lutheran Child & Family Services of MI –Warren (SARF,OP,CM,CAIT) COURT = designated screening agency
EI = early intervention
INT = integrated treatment
IP = Inpatient
OP = outpatient
PEER = peer recovery and support
RES = residential
SARF = screening assessment referral & follow-up
METH = methadone
ADOL = adolescent