rx in reading - constant...
TRANSCRIPT
T h e s t o r y o f o n e c o a l i t i o n ’ s j o u r n e y
Rx in Reading
Presented by: Erica McNamara, MPH, Certified Prevention Specialist SP020410-DFC
Read ing , Massachuse t t s
E s tab l i shed 1644
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Our Town R e a d i n g M A
24,747
8,688 p o p u l a t i o n
h o u s e h o l d s
1,353 v e t e r a n s
Town government comprises an elected and representative TOWN MEETING meeting, a 5-member elected BOARD OF SELECTMAN and 1 appointed TOWN MANAGER serving suburban Reading.
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White Asian Hispanic Black/African-Amer.
R e a d i n g M A
Racial/Ethnic Composition
Our People
97%
E a r n e d H . S . d i p l o m a + O w n e r - o c c u p i e d h o u s i n g M a n a g e m e n t o c c u p a t i o n
83% 53%
S t u d e n t s i n g r a d e s 6 - 1 2 2,400
2 0 1 0 U . S . C e n s u s D a t a
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R e a d i n g M A
4,392 P r e K - 1 2
Our Facts
R e a d i n g M A
2005 Concerned about 110 opioid-related hospitalizations & loss of 9 young adults to heroin overdoses. No coordinated action.
Timeline Coalition Development
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2007 Established RCASA, recruited 24-sector leaders, developed data-driven strategic plan and secured funding.
2009 Youth leaders become involved in leading prevention projects and working with adult sector leaders.
2013 Youth substance use rates begin decline. Evaluation show progress towards outcomes.
2011 Major policies implemented & coalition leaders start to see tipping point of coordinated action.
Individual vs Community
Stages of Change
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Strategic Prevention Framework
Assessment
Capacity-Building
Planning
Implementation
Evaluation
PROGRESS
RELAPSE/SPEED BUMPS
SUSTA
INA
BILITY
CU
LTUR
AL C
OM
PETENC
Y
Our Challenge R e a d i n g M A
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Our Structure
PROJECT DIRECTOR
BOARD OF DIRECTORS 24-members/12 sectors
YOUTH LEADERSHIP
Outreach Coordinator
Seasonal Youth Organizer
Fiscal Agent Town of Reading
Executive Partner Reading School District
Executive Partner Reading Police Department
COMMUNITY INPUT Data, Dialogues, Youth/Parent outreach, & Resident Connections
R e a d i n g M A
• Raised over $1,567,000 since 2008 in grant funds to reduce substance abuse and successfully implement community collaboration efforts based on our Strategic Plan. We are continually seeking additional support to enhance our sustainability. The Town provided financial support for 2 full-time staff for a period of 15 months in between grant projects and has provided extensive in-kind support. Together, RCASA projects have resulted in progress towards our primary goals:
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4-year grant - $193,992
SAMHSA STOP Act
Underage drinking prevention
Expires 9/29/16
2-year grant - $100K
SAMHSA Project Aware-LEA
Youth Mental Health
First Aid training
Expires 9/29/16)
5-year grant - $625,000 SAMHSA/ONDCP
Substance abuse
prevention
Expires 9/29/19
Cost/Benefit
D i s t r i b u t o r s o p e r a t i n g f r o m 3 n e a r b y c i t i e s
p r i m a r i l y s u p p l y R e a d i n g ’ s d r u g m a r k e t .
Routes 95/128/93
New England High Intensity Drug Trafficking Area
R e a d i n g ’ s l o c a t i o n a t t h e b u s i e s t h i g h w a y i n t e r c h a n g e i n N e w E n g l a n d c r e a t e s
o p p o r t u n i t i e s f o r t r a n s i e n t b u y e r s , a n d s e l l e r s o f d r u g s a s w e l l a s t h o s e w i t h i n
R e a d i n g t o t a r g e t c u s t o m e r s f r o m n e a r , a n d f a r .
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Top 4 Regional Drug Threats
COCAINE HEROIN MARIJUANA PHARMACEUTICALS
Risk Behavior Survey
Pride Surveys- School/Parents Law Enforcement Survey
Coalition Readiness
Disciplinary records Police Calls for Service
Fire Service/Narcan Death certificates
Focus groups, community dialogues,
town halls, world cafes, youth groups, social media and parent
chats.
Local norms Environment Resources
Comparisons
Our Assessment Unders tand ing Read ing
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Ques t i ons I n te rac t i ons Vo i ces Con tex t
R e a d i n g M A
‘not here’ ‘not my kid’
Gen Amnesia
False sense
Of Protection
Access
Style
forget or ‘underestimate severity’
easy to get alcohol, Rx, nicotine, marijuana
early/frequent/heavy
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Opportunity
Most
Connected
Pause
Most youth have the opportunity to go to challenging schools, participate in quality
sports/activities, and engage in creative opportunities
Most youth do not use substances at all caveat: - behaviors get more attention and
mislead youth about norms.
Most youth care about what their family, teachers, faith leaders, & other adults think
and want to be more connected.
Most youth really do pause and consider what can happen if they use.
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Our Capacity R e a d i n g M A
Sectors work
Build Trust Start Small
Harness Energy Pay Attention
Work your sectors
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R e a d i n g M A
Our mission is to strategically address our substance abuse problem that youth in Reading, Massachusetts abuse alcohol, prescription drugs, nicotine,
and other illegal drugs at unacceptably high rates that emerge early in adolescence, happen frequently, and indicate heavy use.
Our Planning . . . s a f e , v i b r a n t , a n d h e a l t h y R e a d i n g i n w h i c h a l l m e m b e r s - y o u n g t o o l d -
e n g a g e i n m a k i n g h e a l t h y d e c i s i o n s a n d a c t i v e l y w o r k t o g e t h e r t o e n s u r e t h a t t o d a y ’ s r e s o u r c e s s h a p e t o m o r r o w ’ s s t r e n g t h s .
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R e a d i n g M A
using data-driven program development reflecting best practices, local needs and community input.
R e d u c e d t e e n s u b s t a n c e u s e r a t e s
by partnering with Police, Town Government, School District, and Board of Health to collect unwanted Rx, enact policies and promote accountability.
R e d u c e d t e e n a c c e s s t o a l c o h o l & R x
supported by interdepartmental programming involving school/police to divert youth from court system and provide alternatives to school suspension.
R e d u c e d t o l e r a n c e f o r y o u t h s u b s t a n c e u s e
REDUCE
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youth substance abuse
R e a d i n g M A
of the strategic prevention framework and substance use disorders in Reading (40 community events) leading to better data collection, info-sharing, and coalition involvement.
I m p r o v e d m u l t i - s e c t o r a w a r e n e s s
Higher # of trained school personnel, first responders, community leaders, and youth advocates addressing front line substance abuse & mental health issues. More educated residents including parents of teens and pre-teens.
I m p r o v e d t r a i n i n g f o r a d u l t s
by actively engaging in district and regional partnerships in and around Reading including Reading Public Schools Multi-tiered System of Support, Mystic Valley Public Health Coalition (Opioid Intervention), and Eastern Middlesex DA’s Opioid Task Force.
I m p r o v e d l o c a l a n d r e g i o n a l r e s p o n s e
IMPROVE
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multi-sector collaboration
R e a d i n g M A
P r o v i d e d i s i n c e n t i v e s t o m i s u s e R x t h a t a r e r e l e v a n t a n d c o m p e l l i n g .
P r o v i d e a n e a s y a c c e s s p o i n t f o r r e s i d e n t s t o t u r n i n u n w a n t e d R x 2 4 / 7 .
I n f o r m a l l s e c t o r s a b o u t t h e l o c a l m e d i c a t i o n d i s p o s a l p r o g r a m .
I n c r e a s e s k i l l - b u i l d i n g o p p o r t u n i t i e s o n R x p r e v e n t i o n f o r g r a d e s 6 - 1 2 .
I m p r o v e R x m o n i t o r i n g p r a c t i c e s a n d m e d i c a t i o n s a f e t y .
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Strategies R e a d i n g M A
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1778 1997
2681
3915
4900 5072 # Rx bottles
Turn in unwanted meds • Launched in 2009 • 1st in region • Police 24/7 drop box • 22,444 Rx bottles total • 65% narcotics • Over 1,000,000 pills
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Rx Round Up
R e a d i n g M A Our Implementation
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R e a d i n g M A
Vendor: Citizen Observer
Product: TIP 411
Features
100% anonymous
Messages can be responded to in real time creating an instant
two way live "chat".
Launched in 2011 in Reading following a homicide of a young adult in our community over $$
and pills.
430 tips processed.
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Cross-Tab: Rx misuse & Perceived risk
50%
17%
12% 67%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Used a non-prescribed drug in past 30 days toget high
Perceived using a non-prescribed drug to gethigh posed "great risk"
No Heroin UseReported Heroin Use
Reported heroin use Reading YRBS High School 2013, n=74 or 7% of total sample)
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Local Police Data: Analyzing Rx Overdoses Calls for Service from 2013-2014 (overdose or suicide attempt)
Suicide Attempts using Rx
57%
Accidental Ods from Heroin & Perc-30s
30%
Accidental Ods from
Other Drugs
4%
Alcohol Poisoning
9%
Incident Type
13-17 14%
18-21 9%
21-29 24%
30-39 43%
50-59 10%
Suicide Attempts/Drug Overdoses by Age
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Local Police Data: Analyzing Rx Overdoses Calls for Service from 2013-2014 (overdose or suicide attempt)
DRUG(S) INVOLVED IN SUICIDE ATTEMPT/DRUG OVERDOSES
CLONAZAPAM, KLONOPIN, LORAZEPAM, VALIUM, DIAZEPAM 9
HEROIN 5
HYDROMORPHONE, OXYCODONE, PERC-30 3
AMBIEN, ANTIBIOTIC, LIBRIUM, GHB 4
ALCOHOL 2
OTC 2
Narcan, a lifesaving medication reverses the effect of an opioid overdose.
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61
32 29 37
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16 15 17
2005-2006 2007-2008 2009-2010 2011-2012 2013-2014 YTD3/1/14
Overdoses Narcan administered
Reading Fire Department: Calls for Service
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In addition to accidental overdoses and suicide attempts, log reports pertaining to substance abuse point to a variety of other related issues.
Underage drinking, youth marijuana use, adult marijuana
use, illegal possession of pills, doctor
shopping/med seeking,
operating under the influence of alcohol or drugs
Grandparents seeking
help…worried about adult child or grandchild’s
substance abuse or
grandchild’s welfare.
Family reports…
problems after adult child or young adult comes home from rehab or
treatment.
Spouse or partner needing help to due to
partner’s substance
abuse including domestic violence,
problems with children and other issues.
Local Police Data: Other Findings
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Our Rx Education
1 5 , 0 0 0 p e o p l e r e a c h e d
D i a l o g u e s E v e n t s O u t r e a c h M e d i a W o r k s h o p s
R e a d i n g M A
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Our Youth M a k i n g p r e v e n t i o n f u n
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Rx Misuse: High School
13%
8%
12%
11%
12%
10%
Rx misuse (lifetime)
Rx misuse (past 30 days)
RYRBS 2015 RYRBS 2013 RYRBS 2011 In 2015
Girls reported higher lifetime
misuse of Rx tranquilizers compared to male peers.
Boys reported higher rate of injection drug
use compared to female peers.
R e a d i n g M A
H.S. Substance Use R e a d i n g M A
Lifetime Use Current Use
Reading YRBS High School, 2015
Illegal Drug InjectionHeroinCocaineNon-prescribed RxMarijuanaAlcohol
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5%
3% 2%
4% 7%
2%
6% 4%
3%
2011 2013 2015
Local Change
1st use prior to 13 Current Rx misuse Lifetime Rx misuse
Rx Misuse- Middle School
95%
92%
Using Rx notprescribed to you
Opioid Addiction Prevention Bill (H.No.4056) School-related mandates
1. Create Substance Abuse & Education policies informed by state and Board of Health
• School Committee Policy previously established
2. Verbally Conduct Student Substance Abuse Screening
• 2016-2017: Pilot SBIRT
3. Incorporate Addiction & Substance Abuse into Driver’s Ed. curriculum & Concussion Safety Training
• H.S. Education in compliance (M.S./E.S. –to review) • Parent Education (Local programs & online training)
Source: Long & DiPietro, LLP Memo for M.A.S.S., 4/25/16 & Reading Public Schools Planning Committee 30
We need to further reduce access to
Rx drugs through better monitoring,
improve perception of r isk, increase
awareness about their addictive
potential, and conduct screening.
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What’s next?
C a l l D i r e c t o r
Erica McNamara, MPH, CPS Phone: 781.942.6793
E m a i l
Contact G e t i n t o u c h
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www.edline.net/pages/ReadingPublicSchools/Community/RCASA