Hancock County Substance Abuse Prevention Strategic Planning and

							Hancock County Substance Abuse Prevention Strategic Planning and Environmental Programming

Partners: • Hancock County Planning Commission • Healthy Peninsula • Healthy Acadia • Union River Healthy Communities • Bucksport Bay Healthy Communities • Hancock County Sheriff’s Office • WEBSITE: www.healthyhancock.org

Revised: 01/10/07

Purpose and Goals
County Substance Abuse Prevention Plans Reasons for this Meeting
• • • Case for Intervention Planning what to do Public involvement

Relapse

Denial

This Presentation
• • • Review findings about Hancock County Identify priority issues Turn these priorities into strategies

Maintenance

Contemplation

Life Course Analysis • Youth • Adult • Seniors (65+)

Action

CMCA Program for Substance Abuse Intervention
Changing Behaviors Enforcement and the perception of
enforcement – Measurement: Likelihood of being caught for violation of laws – Intervention: Surveillance and arrests

Changing Attitudes Adult attitudes and perception of adult attitudes
in community – Measurement: adults in the community think substance abuse is wrong – Intervention: Sticker shock

Parental monitoring and the perception of
parental monitoring – Measurement: likelihood of being caught by parents – Intervention:

Parental attitudes and the perception of parental
attitudes – Measurement: parents think underage substance abuse is “very wrong” – Intervention:

Ease of access and the perception of ease of
access – Measurement: how easy alcohol and drugs are to get – Intervention: Retail sting operations, Server Training

Social benefits of substance abuse and the
perception of social benefits – Measurement: likelihood that one would be seen as “cool” if using alcohol or drugs – Intervention: Social norms marketing and Non-punitive school policies

Youth

Source: MYDAUS, 2006

Youth

Source: MYDAUS, 2006

Youth

Entering and Exiting School
Drop-out rates are high • County drop-out rates are less than half the national average, but are rising and are among Maine’s highest. • High School Completion Rates (76%) are the lowest in Maine.
Drop Out Rates
7% 6% 5% 4% 3% Hancock State

1990-91

1991-92

1992-93

1993-94

1994-95

1995-96

1996-97

1997-98

1998-99

1999-00

2000-01

2001-02

2002-03

2003-04

Source: Maine Department of Education

2004-05

Substance Abuse Implications • Dropping out • Can result from substance abuse • Can lead to greater substance abuse

2% 1% 0%

Youth Crime and Substance Abuse
• Youth drug and alcohol arrests increased between 1991 and 2002 • Arrests = Crime Rate * Arrest Rate – 2004 Substance Abuse Task force increased arrests significantly – Drugs and alcohol use is often combined • In one recent compliance check (DATE?) with Hancock County eight retailers all sold alcohol to minor. • Speak to Sheriff and DA about arrestprosecution relationship – Recent data from Substance Abuse Task Force
Per 100,000 Juveniles age 10-17

Youth

Hancock Juvenile Arrests for Alcohol Violations age 10-17
1400

1200

1000

800

600

400

200

0 Hancock State Totals

1991 349.08 433.38

1992 603.50 392.71

1993 229.18 336.88

1994 318.11 395.84

1995 378.92 501.17

1996 417.46 653.68

1997 505.44 607.74

1998 587.23 699.42

1999 1106.45 637.41

2000 721.72 670.55

2001 1082.07 692.88

2002 1238.04 684.94

Protective and Risk Factors Youth
Protective factors are positively influenced through caring relationships with family, friends, school and community. School Interest in schoolwork and success Positive school experiences Proud of accomplishments Community and Peers Good social skills Positive reinforcement and opportunities for community involvement Positive peer group Family Family rewards for positive involvement Primary caregiver/parent interested in child’s school successes
Sources:

Youth

Risk factors affect all age groups, however the impact increases as children get older Not interested in schoolwork or school success Low commitment to school Lower academic achievement Poor family management Person who lives in home who uses alcohol/drugs Parental attitudes favorable to antisocial behavior

New factors emerge by grade 10
Friends’ use of drugs/alcohol Intention to use drugs/alcohol Perceived risk of drug use low Early initiation of drug/alcohol use Laws and norms favorable to drug use

A Parent’s Guide to: Your Infants and Child’s Resilience, Protection, and Threats Healthy Peninsula 2004 Community Assessment Maine Youth Drug and Alcohol Use Survey (MYDAUS) 2006

Adult
Data from the Household Study
• • • Usage Patterns Shift from Drugs to Alcohol Check with Acadia about Opiate Data – fastest growing rate of opiate abuse – Major Campaign on this issue – President’s Office – ask for contact Publication – Kim Johnson – additional information

•

Adult Adult Substance Abuse and Crime
• Adult substance abuse related crime rates closely mirror state patterns • Alcohol related violations have remained nearly level, but continue to be the highest contributor to violations. • Drug related violations are increasing.

Arrest Rates are Rising Statewide Drug Related Arrests are Rising Fastest
Between 1995 to 2004: • Arrests for all crimes in Maine increased 8.7% • Arrests for drug abuse violations in Maine increased 65% • Marijuana remains the primary drug of abuse in Maine • Use and availability of cocaine, heroin, and diverted pharmaceuticals continue to increase. • Since 1995, arrests for other dangerous nonnarcotics violations, including ecstasy and methamphetamine, have increased 248%.

Adult

Source: Maine Statistical Analysis Center Muskie School of Public Service MAINE CRIME AND JUSTICE BRIEF SERIES: II

Protective and Risk Factors Adult (19+)

Adult

Protective Factors Supportive family Supportive peer group Beliefs/attitudes about alcoholself/peers Consequences for misuse impact decision making when using alcohol

Risk Factors Separation/divorce Loss of spouse/partner Change in Social Economic Status Loss of or interruption of employment Continuation of adverse effects from childhood Beliefs/attitudes about alcohol-self/peers Alcohol/drugs are easily accessible in home High exposure

Source: Adapted from: Monitoring The Future National Survey Results On Drug Use, 1975-2005

Seniors

Seniors are far more likely to engage in alcohol abuse than other recreational drugs.

Source: University of Maine Center on Aging “Hancock County and Statewide Needs, Resources, and Readiness Assessment on Older Adult Alcohol Abuse” (2006)

Health Issues

Source: University of Maine Center on Aging “Hancock County and Statewide Needs, Resources, and Readiness Assessment on Older Adult Alcohol Abuse” (2006)

All Ages

Prescription Data State of Maine
Drug Type % of State Total

• • • •

A high percentage of prescriptions include narcotics and tranquilizers Doctor shopping Electronic prescription monitoring is one way to improve tracking Ask Acadia Hospital –people in Tx by zip code.
Tranquilizers

Stimulants

Others 0.83% 10.10%

34.34%

54.73%

Narcotics Total Scripts: 1,977,415

Data collection from July 2005 - June 2006

Maine PMP Office of Substance Abuse

Source: Maine’s Prescription Monitoring Program Maine Benzo Conference, 2006

Protective and Risk Factors Older Adult/Senior

Protective Factors

Risk Factors Spouse/partner death Income lower so self esteem may be lower and thus social status Lower physical abilities Declining health Loss/reduction of hearing, sight, memory Separated from children by distance Loss of income if had to go into a retirement home or senior housing unit Loss of social supports and activities Isolation/lack of independence Lack of transportation

Access to resources, housing, healthcare Social supports Supportive family relationships Knowledge of how to safeguard their health and skills to do so Sense of purpose and identity Lives independently with few supports

Source: 2006-Central East Addiction Technology Transfer Center-The Danya Institute-Silver Springs, MD 20910 Source: Hancock County and Statewide Needs, Resources, and Readi ness Assessment on Older Adult Alcohol Abuse-University of Maine Center on Aging-August, 2006

Questions
• What are the causes for use abuse and dependency to drugs and alcohol in your area?

Relapse

Denial

•
•

What patterns are you seeing?
What are some solutions? What has worked and what hasn't? Patterns of substance abuse are evident at the individual and community level. What patterns of drug and alcohol use, abuse and dependency are you seeing in your community?

•

Maintenance

Contemplation

•

Action

Optional Slides

Maine’s Underage Drinking Prevention Mechanism of Change Model

Phase II: Work on identified priority intervening environmental factors for underage drinking:
enforcement ease of access to alcohol parental attitudes parental monitoring social benefits of substance use adult attitudes in community

Changes in peer factors

Phase I: Work on building prevention infrastructure across Maine Phase III: Expand on Phase II and work on additional factors/ subpopulations identified by data analysis

Changes in individuals’ attitudes / perceptions / beliefs

Outcome: Reduction in underage drinking/ substance use behavior

SPF SIG Steps 1, 2 and 3: Assessment, Mobilization, and Planning

SPF SIG Step 4: Implementation SPF SIG Step 5: Evaluation and Monitoring

Population Growth and Aging
Hancock County

60,000 50,000 40,000 30,000

1,400,000 1,200,000 1,000,000 800,000 600,000

The population of Hancock County is growing • Migration is driving population growth and social. • Seasonal residents and tourists dramatically increase Hancock County’s Summer population. Hancock County is Aging • Aging boomers and in-migration contribute to a record setting population of elderly. • A smaller second echo of the baby boom is starting as baby boomer grandchildren are born. Substance Abuse Implications • Population growth is expected to increase the level of substance abuse, though not necessarily the rates. • A closer look at substance abuse among the elderly is merited • Migration introduces change, potentially adding to the diversity of substance abuse patterns.

20,000 10,000 0

400,000 200,000 -

100 to 104 years 90 years 80 years 70 years 60 years 50 years 40 years 30 years 20 years 10 years Under 1 year -600 -400 -200 Female 0 Male 200 400 600

9 18 0 1 18 0 3 18 0 5 18 0 7 18 0 9 19 0 1 19 0 3 19 0 5 19 0 7 19 0 90

17

Hancock

Maine

Hancock County

Source: US Census, 2000

Maine

From Rural to Suburban
Hancock County is (sub)urbanizing: • Population and economic growth are contributing to new housing construction in rural areas.

Growing

• High land and housing costs are pushing affordable housing into Hancock County’s interior.
• Enclaves of higher-priced shorefront homes are more likely to be occupied only seasonally. Substance Abuse Implications • Interior communities of Hancock County have very limited local resources to cope with problems associated with substance abuse. • Not all drug problems are “urban” – illegal methamphetamine labs are often located in remote rural places. • Property crimes rates may be rising – including recent break-ins in seasonal homes.

Growing

Grown

Source: Maine State Planning Office

Economic Patterns
Seasonality • Unemployment rates are highly seasonal, with summer labor shortages and high off-season unemployment • MDI is particularly connected to tourism with more than 120 liquor licenses
Substance Abuse Implications • Seasonal unemployment can contribute to substance abuse among the unemployed and marginally employed. • Seasonal, temporary and part time employees are far less likely to have health insurance, access to employee assistance programs (EAP) and programs that treat substance abuse. • Seasonal jobs often include sales of alcoholic beverages
$1 4, 000 Bu ilding Su pply Fo od General M ercha ndise Oth er R etail $6 ,0 00 Au to $4 ,0 00 $2 ,0 00 $0 JAN FE B M AR AP R M AY JU N JU L AU G SE P OCT N OV D EC R estaurants Lo dging $1 2, 000 $1 0, 000 $8 ,0 00

1999 Ta xa ble Monthly Sa le s (1,000)
Ba r H arbor

Binge Drinking
• Binge drinking in the prior two weeks is reported by more than 25% of High School students in 11th and 12th grades.

Youth

Source: MYDAUS, 2006

Marijuana Use
• One third report marijuana use in eleventh grade

Youth

Source: MYDAUS, 2006

Risk Factors – Students in Grade 8
Community, Family and School Factors
Interaction with Antisocial Peers

Youth

Individual and Peer Factors
Lower Academic Achievement

Sensation Seeking

Parental Attitude Favorable to Antisocial Behavior*

Rewards for Antisocial Behavior

Low Commitment to School

Attitudes Favorable to Antisocial Behavior

Poor Family Management

Rebelliousness

Perceived Availability of Handguns 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100%

Hancock County

Maine

Source: MYDAUS, 2006

Protective Factors – Students in Grade 8
• • Protective Factors score higher than risk factors Top five protective factors are illustrated here. Positive reinforcement and community opportunities for involvement rank low for Hancock County and Maine.
School Opportunities for Positive Involvement Social Skills

Youth

•

Belief in the Moral Order

School Rewards for Positive Involvement Family Rewards for Positive Involvement
0% 20% 40% 60% 80% 100%

Protective Factors – Students in Grade 6
Social Skills

Youth

Belief in the Moral Order School Opportunities for Positive Involvement School Rewards for Positive Involvement Family Opportunities for Positive Involvement Family Attachment Community Opportunities for Positive Involvement Family Rewards for Positive Involvement Community Rewards for Positive Involvement
0% 10% 20% 30% 40% 50% 60% 70% 80%

Hancock County

Maine

Youth

Risk Factors – Students in Grade 10
Sensation Seeking
Laws and Norms Favorable to Drug Use Parental Attitude Favorable to Antisocial Behavior* Lower Academic Achievement

Interaction with Antisocial Peers Attitudes Favorable to Antisocial Behavior Rewards for Antisocial Behavior

Low Commitment to School

Friends’ Use of Drugs
Family History of Antisocial Behavior

Intention to Use Drugs
Perceived Availability of Drugs

Perceived Risk of Drug Use Attitudes Favorable to Drug Use

Poor Family Management Parental Attitude Favorable to Drug Use* Perceived Availability of Handguns
0% 10% 20% 30% 40% 50% 60%
0% 10% 20% 30% 40% 50% 60% 70%

Rebelliousness

Early Initiation of Drug Use

Adult
Driving Under the Influence

Adult

Protective and Risk Factors-Adults (19+)
Protective Risk

Supportive family
Supportive peer group Beliefs/attitudes about alcohol-self/peers Consequences for misuse impact decision making when using alcohol

Change in SES
Separation/divorce Loss of spouse/partner Loss/interruption of employment

Continuation of adverse effects from childhood
Alcohol/drugs are easily accessible in home Beliefs/attitudes about alcohol-self/peers High exposure Availability/Ease of access
Source: Adapted from: Monitoring The Future National Survey Results On Drug Use, 1975-2005

Youth

Pro-Social Behavior
• More than 80% of students report participating in clubs, organizations or other after-school projects.

Prescription Drug Use
State Average: 1.50 Scripts/Person

All Ages
Maine Counties Scripts per Person

1.58

1.58

1.56

1.32
1.49 1.44 1.55

1.74

1.66

1.45
1.31 1.39 1.54 1.64

1.56

1.57

Source: OSA, PMP Program, 2006

July 05 through June 06

Seniors

Protective and Risk Factors-Older Adult
Protective Access to resources: housing, health care Social Supports Supportive family relationships Knowledge of how to safe guard their health and skills to do so Sense of: purpose and identity Live independently with few supports Risk Spouse/partner death Income lower so self esteem may be lower and thus social status lower Lower physical abilities Declining health Loss/reduction of hearing, sight, memory Separated from children Loss of income if had to go into retirement home or senior housing unit Loss of social supports and activities Isolation/lack of independence Lack of transportation
Source: 2006-Central East Addiction Technology Transfer Center-The Danya Institute-Silver Springs, MD 20910 Source: Hancock County and Statewide Needs, Resources, and Readiness Assessment on Older Adult Alcohol Abuse--University of Maine Center on Aging-August, 2006

Healthy Hancock
Healthy Maine Partnerships

Coastal Hancock Healthy Communities
Gouldsboro, Sorrento, Sullivan, Steuben, Winter Harbor

Healthy Acadia
Bucksport, Orland, Verona Island, Prospect Trenton, Lamoine, Bar Harbor, Mt. Desert, Swan’s Island, Southwest Harbor, Tremont, Frenchboro

Healthy Peninsula Project
Blue Hill, Sedgwick, Brooklin, Castine, Penobscot, Surry Deer Isle, Stonington

Towns

Ellsworth, Aurora, Hancock, Dedham, Otis, Osborne, Mariaville, Franklin, Amherst, Waltham, Easbrook, Great Pond

Healthy Community Coalitions

Union River Healthy Communities

Bucksport Bay Healthy Communities

Healthy Acadia

Healthy Peninsula Project

Healthy Island

Organization Partners
Hancock Co Planning Commission
Jim Fisher Planner Downeast Health Services Helena Peterson – Director Valerie Kenney – Program Assistant Steven Johndro – Comm Hlth Specialist (& OneME Coord) Emilia Bachrach – Youth Coord/VISTA Ellsworth School Dept Kelly Fitzgerald – School Hlth Coord Katrina Kane – Supt of Schools MCMH Iris Simon – Health Educator Doug Jones - CEO Bucksport School Dept Kate Yerxa – School Hlth Coord Marc Curtis – Supt of Schools Town of Bucksport Mary Jane Bush – Health Planner BBHC MDI Hospital Doug Michael – Director Vacant – Health Educator Irene GreeneMurphy – Substance Abuse Coord (OneME) School Union 98 Jenny Gott, RN – School Hlth Coord Blue Hill Memorial Hospital Barbara Peppey – Director Donna Madonna – Program Asst Josephine Jacobs – VISTA Youth Coord Linda Jaffe – PATH/OneME Coord School AU 76

Meredith Gray – Director, Healthy Island Heather Barton – Lindloff – School Hlth Coord

Univ Me Cooperative Extension
Joyce Kleffner Nutritionist

Jim Fisher - Chair

Committees

Evaluation & Research

Mary Jane Bush Chair Policy Education

Jenny Gott - Chair

State Level Partners

Bureau of Health

Dora Ann Mills MD Dir Commissioner Nickolas

Healthy Maine Partnerships

Cathy Ramaika-Project Officer Andy Finch-Senior Prog Officer Barbara Leonard-Director

Mary Beth Welton – Pgm Manager (PTM) Chris Lyman, MS, CHES – Comm Hlth Specialist (Community Health Program)

OSA – OneME

Lee Anne Dodge – OneME Coordinator

ME Network of Healthy Communities