Substance abuse is not just a medical problem, but one with societal, economic, political and numerous other ramifications.

That realization underlies the creation of the faculty development program in substance abuse by the Addiction Research Institute in the Wayne State University School of Medicine. The program's basic goals are to increase clinical knowledge and skills, and give participating faculty fellows and the people they share knowledge with­ a sense that they can make a difference in the lives of people suffering with substance abuse problems.

While it strives to institutionalize curricular innovations for medical professionals, the program also seeks to increase community-academic linkage focused on prevention of substance abuse.

Institute Director Eugene Schoener says those goals made the institute a natural fit for a grant from the Center for Substance Abuse Prevention (CSAP), a part of the U.S. Department of Health and Human Services.

The institute is nearing the end of the second year of a three-year, $750,000 award from CSAP in order to broaden its effort to link WSU academicians and clinicians with the community. While the project overlaps with initiatives in the federal empowerment zone program, it was awarded independently, says Schoener, who established the institute in 1985 to address a broad range of policy, prevention and training issues related to substance abuse.

The linkage effort began in earnest last year, following an intensive self-assessment by faculty participants and a learner-centered training program to meet their individual needs.

"We anticipate that the faculty fellows will achieve palpable results for the community and WSU in a host of ways," Schoener says. Those include innovative community prevention services; training and motivating local health care providers; creating new culturally specific prevention strategies; educating professional peers and trainees about physician-initiated prevention; and serving as change agents for the health care community. Fellows work with teams comprising academic colleagues, graduate trainees, medical students and community-based clinicians.

Currently, five faculty fellows are supported by the grant. They include Eric Ayers, assistant professor of internal medicine and pediatrics; Stan Golec, assistant professor of psychiatry; Melinda Henderson, assistant professor of psychiatry; John Hopper, assistant professor of internal medicine and pediatrics; and Lawrence Warbasse III, assistant professor of internal medicine.

The fellows' collective aim is to develop strong personal and professional relationships with individuals in community-based organizations (CBOs) and the communities they serve. Ayers, for example, has a long-standing concern for young African American men who engage in risky behavior, especially the use and abuse of psychotropic agents.

As a result, Ayers established a link with Detroit's Burton Detention Center. He is working currently with detainees at the center to develop a computer game that rewards healthy behaviors by advancing players to the next level of the game.

Hopper also is trying to use a visual approach to prevention in his work with young men at the Boniface Human Services agency, which serves much of southwest Detroit's Latino community. In the first stage of a video production on prevention, Hopper has asked the youths to take photographs of what they see in their neighborhoods as the consequences of substance abuse. They also have been asked to photograph what they see as the positive features of their community.

Hopper says the exercise forces young people to think creatively about the problems of substance abuse and has the added benefit of producing a training tool for counselors.

The program's other linkage efforts include:

· Golec's work with the chronic mentally ill in the Crisis Center of Detroit Receiving Hospital. His efforts are aimed at prevention of substance abuse and decreased utilization of hospital services through aggressive, early intervention for those patients;

· Henderson's affiliation with the American Indian Health Center of Detroit. Working alongside counselors there on cases involving substance abuse and personality disorders, she has learned that the conventional approach recommended for such patients must be tailored to fit the center's culturally derived holistic approach; and

· Warbasse's efforts to establish an affiliation with the Grand Traverse Band (GTB) of Ottawa and Chippewa Indians to design culturally specific patient placement criteria. Additionally, he would like to expand the group's treatment efforts by encouraging development of early intervention and prevention strategies.

Warbasse and other faculty fellows visited the Traverse City area Sept. 18-20 to share what they've learned about institutionally based brief intervention with Michigan doctors attending the annual meeting of the American College of Physicians. While in the area, they also participated in the GTB Wellness Lodge training exercises and shared experiences with their staff.

"We were received as friends and were truly honored by the gift of this training," Schoener says.

The exchange is an example of the "learn while teaching" approach taken by the fellows in all of their community linkage efforts.

"We don't go to these agencies asking to study them or telling them what wonderful knowledge we have to offer them," Schoener says. "Wisdom comes from sharing."

Participants say the learner-centered nature of the faculty development program has made for an invaluable experience. Schoener and the fellows agree it has helped members of the institute, the agencies and the community to better understand and deal with problems related to substance abuse.

"It's a real, firsthand way to enrich our own cultural competence while helping to bring the latest academic and clinical perspectives on prevention and treatment to the community where it is really needed," Schoener says. "We often end up learning more than we could ever teach."