Kû Aloha Ola Mau
- formerly Drug Addiction Services of Hawai`i
A place of healing and recovery
www.dashhawaii.org
- Hui Ho`omaika`i Ika Poe O Hawai`i - Opiod Treatment Program
- Buprenorphine Services Program
- Hui Ho`ola O Na Nahulu O Hawai`i
- Early Intervention Services Program
- Primary and Psychiatric Care
- Hepatitis C - The Silent Epidemic in Hawai`i
- Models Program (Mahu Wahine of Oahu developing empowering life skills)
Hui Ho`omaika`i Ika Poe O Hawai`i
Opioid Treatment Program
"Together we bring out the beauty and goodness in the people of Hawai`i"
Honolulu Clinic Phone: (808) 538-0704
Hilo Clinic Phone: (808) 961-6822
Mission Statement
To create a healing environment free of stigma which provides the opportunity for our haumana to identify and build upon their unique gifts and qualities to create healthy, fulfilling and productive lifestyles which will benefit themselves and the broader community.
We will reach our goals in partnership with our haumana to address spiritual, physical, social, vocational and emotional areas. Fostered by mutual respect, a sense of connection to community and purpose in life will bring out the beauty and goodness �ho`omaikai� in all persons. Evidenced based practices, culturally respectful approaches and a sense of spirituality provide hope and success for people from all walks of life who are dependent on opiates.
Target population
The programs serves adults 18 and over and adolescents with parental consent who are either are or have been addicted to opiates including but not limited to pain medication such as oxycontin, and others and heroin and other illicit narcotics. Participants include local residents as well as participants of other programs on the mainland and from other countries who are in Hawaii on a temporary transfer basis.
Program description
The program provides outreach, interim services, HIV and other communicable disease prevention education, pharmacotherapies such as methadone and psychiatric medication, primary care, psychiatric consultation and substance abuse treatment and continuing care services. Prenatal counseling, hepatitis support group and methadone/NA recovery groups are also offered on site. The program provides short and long term detoxification and maintenance treatment. A haumana (student/participant) advisory board provides support and feedback to continue excellent services and to empower the participant population.
Services
The project offers a mix of activities and curriculum which includes relapse prevention, individual and group counseling, family counseling and drug and alcohol education. Support for vocational and educational needs are provided directly or through referral. Case management and individualized services are creative, participant directed and comprehensive targeted to medical, psychiatric, social, economical, and spiritual needs.
Staffing
The program is run by the Clinical Supervisors, who are CSACs in the Honolulu and Hilo Clinics. They are supervised by the Clinical Director, Marcia Tsue Horiuchi, DCSW, LCSW, CSAC. Seven substance abuse counselors with extensive experience and/or master's degrees provide direct care. The Medical Director is Dr. Joseph Turban, M.D., FACEP and Dr. Charles Park, an addiction Psychiatrist, is available for on-site psychiatric consults. Dr. Samuel Reuben, M.D is the Medical Director in Hilo. Lisa Cook, the Executive Director is the Program Sponsor for both sites. Acupuncturist is Dr. James Zhong.
Site
The facilities are located in Honolulu at 1130 N. Nimitz. Hwy. Ste. C-302 and in Hilo at 900 Leilani Street. The Honolulu site is ten minutes from the Honolulu airport on Nimitz. The Hilo site is five minutes from the airport and one block from the main road.
Funding
The Alcohol and Drug Abuse Division pays for the indigent who do not have QUEST or are not eligible due to exceeding the income status. They also pay for the counseling services for those who have Medicaid insurance. Kû Aloha takes HMSA QUEST and ALOHA CARE QUEST. There are also slots for those referred by Needle Exchange. Haumana (participants) may pay for their own treatment services as well. Some private insurances will reimburse for medication fees.
History
Drug Addiction Services of Hawaii, Inc. initially provided methadone treatment in 1976. This group was primarily comprised of career criminals addicted to heroin. Services were limited and the modality was little known; although the population was fairly large compared to other treatment programs. Since then over 8,000 addicted have been treated and treatment services expanded to include primary and psychiatric care and a comprehensive continuum of care.
Ten years ago, the organization began studying the role of spirituality in treatment and successful recovery. This focus led to a culturally based, assets approach which led to the formation of a drug free program, Hui Ho`ola. Today, Kû Aloha is working towards a full integration of spirituality in all of its programs and services.
Success
Decrease in drug use, increase in stability, decrease in arrest rates for new charges, decrease emergency room visits and psychiatric disturbances, and increases in educational/vocational activities and drug free social activities are some of the measures of success. Hui Ho`omaikai's success parallels that of the Alcohol and Drug Abuse Division's stated rates for all treatment programs in Hawaii.
Defined outcome measures are tacked on a semi-annual and annual basis. There is a consistent increase with active clients who live in a stable living environment, who are not arrested on new charges and who do not access the emergency room. Also indicated are decreased drug usage and psychological distress.
Drug Usage
DASH treated 520 persons addicted to opiates in fiscal year 2000. In treatment,
- 90% were living in a stable environment
- 96% were not arrested on new charges.
- 51% were engaged in education/training programs.
- 16% were involved in the care of children, parents or other family members
- 18% were homemakers.
Psychological distress
- 92% of haumana still enrolled in the program did not access the emergency room for medical services.
- 93% of haumana still enrolled in the program were not hospitalized for medical problems.
- 61% of haumana enrolled in the program did not psychological distress.
- Six month follow-up of discharged haumana found 91% did not access the emergency room since discharge and 87% were not hospitalized for medical complications.
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Buprenorphine Services Program
Beginning in May 2005, Kû Aloha Honolulu and Hilo began offering buprenorphine services.
Buprenorphine is a medication in tablet form and taken sublingually (dissolve under the tongue) to treat opiate addiction. It provides for a simpler and more focused program of recovery.
Enrolling in the program requires an intake and assessment appointment with a counselor and then an appointment to see the Kû Aloha physician for a medical assessment.
Those who are interested should contact staff at 538-0704 on Oahu and (808) 961-6822 on the Big Island for an appointment. Our physicians have been specifically trained on the use of this medication which requires a special license.
We look forward to working with you on this road to recovery.
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Hui Ho`ola O Na Nahulu O Hawai`i
Hui Clinic Phone: (808) 982-9555
Mission Statement
To create a healing community, grounded in the spirit and culture of Hawai`i that reaches out to Hawaiians of all ethnicities suffering from the disease of addiction.
We will reach our goals through one vision and one heart to create an environment of healing for the disease of addiction, to enhance access to culturally appropriate services, to ensure a team approach to treatment and to increase effectiveness of treatment and recovery services.
Target population
Hui Ho`ola serves Native Hawaiians and adults and their families from other cultures who are suffering from substance abuse. In addition preventive intervention activities are provided for adolescents in the Puna area of the Big Island. Hui Ho`ola accepts clients with referrals from the community, other social service agencies, and self referrals.
Program description
The Hui provides substance abuse prevention, education, treatment and continuing care services. It is a spiritually based program utilizing traditional cultural healing modalities, ceremonies, practices and activities which are embedded within evidenced based practices in the addictions field. Core Hawaiian values, which are universally oriented, provide the guidance for the program and its activities from administration and management to the day to day "life" of the program and its participants.
Services include screening, assessment, intake, intensive outpatient, outpatient treatment, continuing care and prevention intervention. The Hui also conducts outreach and provides presentations to community groups on request.
Services
The project offers a mix of activities and curriculum which includes relapse prevention, individual and group counseling, family counseling and drug and alcohol education, traditional cultural ceremonies and other activities are a regular part of the weekly schedule. Support for vocational and educational needs are provided directly or through referral. Transportation is also provided to and from the project and healing sites for those in need.
Hui Ho `ola offers traditional healing methods to include Ho`oponopono (Hawaiian spiritual counseling), Lomilomi (Hawaiian spiritual massage), Acupuncture and Reiki.
Staffing
The Project Coordinator Sarah Kelaukila Carter; Clinical Supervisor, Randal Like and the cultural providers have extensive history and knowledge of the Hawaiian culture. One staff member is tri-lingual in Hawaiian, English and Filipino. The Clinical Supervisor is a Hawaii Certified Substance Abuse Counselors. The Staff Assistant/Driver provider transports na haumana to and from their homes and Hui sites. The traditional counselor provides counseling, assessment and other treatment services.
Provider of ho`oponopono include, Uncle Howard Pe`a. Aunty Ulu Garmond provides consultation to the Hui staff. Former providers include Aunty Abbie Napeahi and Aunty Kolani Chartrand who guided the project from its beginnings to a full healing center. Aunty Kolani Chartrand was a Kumu Hula and taught hula to the haumana (students/program participants). Gene Abraham is a licensed acupuncturist and Mariposa Blanco is a licensed lomilomi practitioner.
The traditional counselor provides counseling, assessment until and through treatment services.
Site
The Hui accepts referrals from all parts of the Big Island; however, its sites are in East Hawaii. The counseling facility is located at 15-1926 Puakalo Street in Kea`au, Hawaii. It is a comfortable two story, handicap accessible home on one acre of land.
The Kapoho Cultural Educational Center is in Kapoho. It is an acre of undeveloped land utilized for traditional ceremonies, overnight retreats, farming, hula, aquaculture and graduation ceremonies. A large pavilion and a handicap accessible restroom provide shade and comfort deep in the private area where there are few houses and no traffic.
Funding
The project is funded by the Alcohol and Drug Abuse Division and the Hawaii Community Foundation. Under the current funding, 41 adults per year may access treatment. The project also receives monetary, in kind donations and participates in collaborative activities with various other individuals, social services and business groups such as the Queen Liliuokalani Children's Center and the Pahoa Business Association.
History
The Hui was developed out of a grant from the Center for Substance Abuse Treatment in 1997 provided to the Alcohol and Drug Abuse Division. Its core approach is based upon the assets model which focuses on the community knowing its own strength, needs and resources and on building capacity. The Hui's Policy Steering Committee, comprised of community members and members of the target population has provided much guidance and assistance to all aspects of the program.
Success
The Hui's outcomes include decrease in unemployment by 14%, increase in monthly income, and decrease in arrest rates. There was a decrease in utilization of inpatient and emergency room services. Improvements in self-esteem, problem solving skills and reduction in other drug use reached statistically significant improvements. Family functioning, psychological symptoms, cohesion and other protective factors also improved. These results were compiled through an independent evaluation of the program over three years ending in 2006 which confirmed that these changes were directly related to the program efforts.
- 81% of haumana are either employed, attending school or engaged in an educational/training program since discharge.
- 91% of haumana are living in a stable environment 6 months after discharge
- 100% of haumana did not miss school or work due to drinking or drug use 6 months after discharge.
- 72% of haumana did not use drugs and/or alcohol for 30 days prior to a 6 month follow up survey.
- 96% of haumana had no arrests since discharge.
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Early Intervention Services Program
Honolulu Clinic Phone: (808) 538-0704
Hilo Clinic Phone: (808) 961-6822
Mission Statement
Injection drug users represent the second highest numbers of AIDS cases. In response to this crisis, Kû Aloha recognizes the critical position it is in to help stop AIDS in Hawaii and to advocate for adequate provision of services by the social services system for HIV infected drug users. Therefore, Kû Aloha is also committed to direct its expertise to community education, leadership, advocacy and competent, compassionate care and treatment of substance abusing populations, their sexual partners and their families.
Target population
The programs serves adults and adolescents who are participants in drug and alcohol treatment programs that are purchase of service providers of the Alcohol and Drug Abuse Division of the Department of Health. The programs are located on Oahu, the Big Island, Maui and Kauai.
Program description
The EIS program provides on site nursing, education and counseling, and phlebotomy services toward the early detection, prevention of transmission and medical case management related to HIV and other communicable diseases. Early detection includes risk assessment and HIV testing.
Services
A group education session is held with all participants. Those who wish to be tested for HIV will meet individually with an EIS worker for a pretest counseling session. The same worker will return with the test results to provide post-test counseling and results. Once someone has been identified as having HIV, medical case management is initiated for as long as the need for services exist. Should a participant leave a particular treatment program after receiving early intervention services in treatment, they may continue to access EIS at the Kû Aloha facilities.
Staffing
EIS staffing is designed to ensure that participants receive professional care and that education is oriented towards behavioral change. The project coordinator schedules group sessions, coordinates with other programs and provides overall leadership of the program. Nurses create medical case management plans for anyone who is HIV positive. Medical assistants provide phlebotomy services. All staff is trained in group presentations, pre and post test counseling for HIV requiring DOH certification and in communicable disease prevention.
Funding
Early Intervention Services are funded by federal funds which are received by the Alcohol and Drug Abuse Division and contracted out to Kû Aloha Ola Mau.
History
In the 1980's, Kû Aloha Ola Mau received its first known AIDS haumana who had AIDS, in treatment. At that time, the employees of Kû Aloha made a unanimous and firm commitment to work with this population and initiate steps to interrupt the transmission of this once deadly disease. HIV risk assessment processes and education began with 100 injection drug users on the Kû Aloha opioid treatment program. As more substance abusers became included in risk groups, Kû Aloha expanded its efforts to the rest of the treatment population. Outreach services were also initiated to those not in treatment to provide prevention education and to save lives who might some day want treatment. In addition, because the stigma of drug use and HIV was so strong, Kû Aloha took the position to support and ensure competent, compassionate care for those with HIV/AIDS for the rest of their lives. This decision initiated intensive case management services for Kû Aloha haumana in need or at high risk for infection.
In the mid 1980's, the problem of hepatitis B infections arose and testing found that at least 86% of haumana on the opioid treatment program were positive for Hep B. In the mid 1990's, the majority of these haumana were found infected with Hepatitis C. These discoveries validated the continuing need for EIS services today. Kû Aloha today provides medical and psychiatric interventions in response to these problems through its other programs. Without intervention, the spread of these diseases to the general population is in a precarious state.
Success
Consumer satisfaction of EIS services in both participants and agencies are consistently rated very high. EIS is appreciated and increasing the number of persons tested for HIV each year. The program target is to educate 600 persons per year. In fiscal year 2003, EIS provided services to 1,214 individuals in substance abuse treatment and tested 142 persons for HIV.
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Primary and Psychiatric Care
Kû Aloha's physicians and nurses provide on-site medical and mental health care treatment of patients who may have medical or psychiatric complications. Primary care services are offered through Kû Aloha's clinics in Honolulu, and Hilo in an effort to provide easily accessible medical care tailored to those with problems of addiction.
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Hepatitis C - The Silent Epidemic in Hawai`i
Injection drug users are over 60% of those who are infected with Hepatitis C in Hawai`i. They also represent the second wave of the AIDS epidemic.
In response to this crisis, Kû Aloha recognizes the critical position it is in to help stop Hepatitis B & C and HIV/AIDS in Hawai`i and to advocate for adequate provision of services by the social services system for the infected drug user. Therefore, Kû Aloha is committed to direct its expertise to community education, leadership, advocacy and competent, compassionate care and treatment of substance abusing populations, their sexual partners and their families.
What is Viral Hepatitis?
Viral hepatitis refers to several common diseases that can lead to serious liver damage, including cirrhosis, liver cancer and liver failure and possibly death. The problem of viral hepatitis infection and transmission is critical in Hawai`i. The State ranks first in the nation for Hepatitis B. Hepatitis infection generally occurs within two weeks of the first needle use by injection drug users (IDU) in Hawai`i. Eighty-five percent (85%) of IDU in opioid treatment have already tested positive for Hepatitis B and/or C.
Most people who are infected with chronic hepatitis B and/or C do not even know it.
People who have injected illicit drugs even once in the past, people who have had unprotected sex with multiple sex partners and people who have had a blood transfusion in the US before July 1992 are especially at risk of having been infected with hepatitis C. 85% of hepatitis C positive people will have hepatitis C for life unless they receive treatment.
Most people will not show signs of starting to have liver disease until 10 to 35 years after they become infected. Drinking alcohol appears to advance liver disease in people who are hepatitis C positive. Do not drink alcohol if you have hepatitis C!
Become immunized with hepatitis A and hepatitis B vaccine if you are an injection drug users or if you are infected with hepatitis C.
If you have not already been immunized see your physician (or the Dept. of Health if you do not have health insurance) to become vaccinated. You should also get pneumonia and flu (influenza) vaccines.
Hepatitis C positive people can become very ill if they become infected with the hepatitis A or hepatitis B virus. It is recommended that you become vaccinated for these other hepatitis viruses. (There is still no vaccine for the hepatitis C virus.)
Why should I be tested for Hepatitis C now?
Many people wait to be tested because they do not feel ill. However, most people, who have chronic hepatitis C, do not feel ill until they have end stage liver disease. Some of you may be waiting to be tested until it is too late to be treated.
Hepatitis C alone infects approximately 20,000 people in Hawai`i and most people do not even know it.
10,000 people die from hepatitis C each year in the USA. This will grow to 30,000 deaths per year within the next ten years unless people are tests and treated for this silent disease.
What can I do?
Important information that you need to know about hepatitis C:
Get Tested for hepatitis C if you have had any of these Risk factors in the past:
- Shared drug needles, "cookers", water to mix drugs with and/or cotton filters; drug straws; body piercing needles; tattoo needles and Inks,
- Blood transfusion or solid organ transplant before July 1992,
- Unprotected sex with multiple partners or history of sexually transmitted disease,
- Elevated liver blood tests or rejection from a blood bank after donating blood,
- Previous diagnosis of non-a non-b hepatitis, hepatitis B or HIV, or
- Born to a mother who had hepatitis C.
Other issues to prevent the spread of hepatitis C or to prevent becoming infected by another strain (or genotype) of hepatitis C:
- Do not share drug needles, "cookers", injection water, cotton filters and/or other drug using equipment and wash your hands with soap and water before touching drug using equipment or cotton filters
- Do not share drug straws
- Do not share items that might have blood on them
- Cover all cuts and sores on the skin
- Do not share personal care items (e.g., razor, toothbrush, nail clippers)
- Do not share home therapy (e.g., needles)
- Do not share body piercing needles; tattoo needles and/or Inks
- Do not have unprotected sex with multiple partners
It is advisable for IDUs to start washing their hands with soap and water before they inject any drug with others to make sure that they do not contaminate the cotton filter or other drug using equipment with viruses by touching them. You cannot see the viruses that may be on your fingers tips that you may have pick up by touching an area that was exposed to contaminated blood.
When you are ready to treat your Hepatitis B or C�.
Kû Aloha wants you to feel as safe, comfortable and successful as possible.
All of Kû Aloha's Hepatitis, Chemical Dependency and / or Methadone Services are completely confidential!
Get more information or make an appointment with Dr. Alan Tice at Kû Aloha by calling Ken Akinaka, MRA, Hepatitis Clinical Treatment Coordinator 24-Hr. Cell # 808-221-6204 or email him at [email protected].
For more information about Hepatitis B or C and / or referrals in Hawai`i, please call 211.
Alan D. Tice, MD, FACP, is an Associate Professor John A Burns School of Medicine, University of Hawai`i, Honolulu, Hawai`i
He specializes in infectious disease management. He teaches physicians, medical and counseling staff on how to treat hepatitis C and other infectious diseases.
Dr. Tice was recently elected to the Council of the Infectious Diseases Society of America. He is also the editor of Current Treatment Options in Infectious Diseases and a section editor for Infectious Diseases in Clinical Practice, ID Alert, ID News and other journals. He has constructed the IDLinks.com and OPAT.com web pages for infectious disease specialists.
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Models Program
(Mahu Wahine of Oahu developing empowering life skills)
Honolulu Clinic Phone: (808) 538-0704
Target Population
This project targets the most economically and socially disadvantaged of all Asian and Pacific Islanders who are generally overlooked by other health promotion programs and who are at highest risk for HIV infection: this population is primarily comprised of male-to-female transgenders (TG�s)�persons who are born male, identify as female and live as women.
Program Description
This project provides an integrated program that includes: culturally appropriate interventions provided by peer-group role models who will mentor participants as they provide prevention education; HIV counseling and testing; and group-level interventions and life-management skills.
Services
Services provided to participants include HIV prevention interventions such as the use of role model stories, small group intervention based on Social Learning Theory, peer-led small groups and peer outreach events utilizing the Manpowerment Project intervention, group level interventions which combine HIV-related knowledge along with consciousness-raising or social skills training in a culturally competent approach. Prevention case management, substance abuse information, mentoring parenting education, provider training, alternative activities, cultural values, support groups and HIV information are provided.
Staffing
Kû Aloha staff include a Clinical Director, Marcia Tsue-Horiuchi, LCSW, DCSW to oversee the project; and a Peer Outreach worker(Scout) to attract and engage new participants and provide direct services and a Project Coordinator (Scout). An evaluator is hired as a consultant to provide evaluation of service outcomes.
Site
The direct services of this project are provided primarily out of offices at 1130 N. Nimitz Highway, suite C-302. However, during retreats and other events, other places such as hotels are utilized. Administrative offices are located in the Nimitz Business Center at 1130 N. Nimitz Hwy. suite C-302.
Funding
Funding for this project comes from the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention.
Success
The goals of the project include: 1) Provide 10 hours of HIV and Substance Abuse prevention education and 1 hour education on cultural values; 2) Provide mentoring and case management; 3) Change attitudes and behaviors that put this community at risk; 3) Promote alternative activities that enable participants to live healthy lives; and 4) Promote awareness of HIV status through counseling and HIV testing.
Results:
- Goal 1: Achieved and ongoing. Several cohorts have received the training and the curriculum has been updated in its approach to a more upbeat style since inception.
- Goal 2: The number of community based organizations providing integrated substance abuse and HIV prevention to minority youth and adults at-risk have increased.
- Goal 3: Agencies on the Advisory Board have received information that may be helpful in their efforts to integrate HIV and substance abuse prevention agencies.
- Goal 4: Two scouts have successfully passed the certification to provide HIV counseling and testing by the State of Hawaii.
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