Hancock County Substance Abuse Prevention Strategic Planning and Environmental Programming

1. Hancock CountySubstance Abuse PreventionStrategic 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

2. County Substance Abuse Prevention Plans Reasons for this Meeting Case for Intervention Planning what to do Public involvement This Presentation Review findings about Hancock County Identify priority issues Turn these priorities into strategies Life Course Analysis Youth Adult Seniors (65+) Purpose and Goals

3. Changing Behaviors Enforcement and the perception of enforcement Measurement: Likelihood of being caught for violation of laws Intervention: Surveillance and arrests Parental monitoring and the perception of parental monitoring Measurement: likelihood of being caught by parents Intervention: Ease of accessand the perception of ease of access Measurement: how easy alcohol and drugs are to get Intervention: Retail sting operations, Server Training Changing Attitudes Adult attitudesand perception of adult attitudes in community Measurement: adults in the community think substance abuse is wrong Intervention: Sticker shock Parental attitudes and the perception of parental attitudes Measurement: parents think underage substance abuse is “very wrong” Intervention: 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 CMCA Program for Substance Abuse Intervention

4. Youth Source: MYDAUS, 2006

5. Youth Source: MYDAUS, 2006

6. 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. Substance Abuse Implications • Dropping out • Can result from substance abuse • Can lead to greater substance abuse Source: Maine Department of Education

7. Youth 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 arrest-prosecution relationship • Recent data from Substance Abuse Task Force

8. Protective and Risk Factors Youth 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 • 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 Sources: 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

9. 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

10. 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.

11. 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 non-narcotics violations, including ecstasy and methamphetamine, have increased 248%. Adult Arrest Rates are Rising StatewideDrug Related Arrests are Rising Fastest Source: Maine Statistical Analysis Center Muskie School of Public Service MAINE CRIME AND JUSTICE BRIEF SERIES: II

12. Adult Protective and Risk FactorsAdult (19+) Protective Factors Supportive family Supportive peer group Beliefs/attitudes about alcohol-self/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

13. 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)

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

15. All Ages Prescription Data State of Maine • 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. Source: Maine’s Prescription Monitoring Program Maine Benzo Conference, 2006

16. Protective and Risk FactorsOlder Adult/Senior 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 Protective Factors 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

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

18. Optional Slides

19. SPF SIG Steps 1, 2 and 3: Assessment, Mobilization, and Planning SPF SIG Step 4: Implementation • 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 Outcome: Reduction in underage drinking/ substance use behavior Changes in individuals’ attitudes / perceptions / beliefs Phase III: Expand on Phase II and work on additional factors/ subpopulations identified by data analysis SPF SIG Step 5: Evaluation and Monitoring Maine’s Underage Drinking Prevention Mechanism of Change Model

20. Population Growth and Aging • 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. Source: US Census, 2000

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

22. 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

23. Youth Binge Drinking • Binge drinking in the prior two weeks is reported by more than 25% of High School students in 11th and 12th grades. Source: MYDAUS, 2006

24. Youth Marijuana Use • One third report marijuana use in eleventh grade Source: MYDAUS, 2006

25. Youth Risk Factors – Students in Grade 8 Community, Family and School Factors Individual and Peer Factors Hancock County Maine Source: MYDAUS, 2006

26. Youth 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.

27. Youth Protective Factors – Students in Grade 6 Hancock County Maine

28. Youth Risk Factors – Students in Grade 10

29. Adult Driving Under the Influence

30. Adult Protective and Risk Factors-Adults (19+) Source: Adapted from: Monitoring The Future National Survey Results On Drug Use, 1975-2005

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

32. State Average: 1.50 Scripts/Person 1.32 1.74 1.49 1.55 1.44 1.45 1.57 1.56 1.64 1.31 1.39 1.54 All Ages Prescription Drug Use Maine Counties Scripts per Person 1.58 1.56 1.58 1.66 Source: OSA, PMP Program, 2006 July 05 through June 06

33. Seniors Protective and Risk Factors-Older Adult 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

34. Healthy Hancock Healthy Maine Partnerships Coastal Hancock Healthy Communities Healthy Acadia Healthy Peninsula Project Ellsworth, Aurora, Hancock, Dedham, Otis, Osborne, Mariaville, Franklin, Amherst, Waltham, Easbrook, Great Pond Trenton, Lamoine, Bar Harbor, Mt. Desert, Swan’s Island, Southwest Harbor, Tremont, Frenchboro Blue Hill, Sedgwick, Brooklin, Castine, Penobscot, Surry Gouldsboro, Sorrento, Sullivan, Steuben, Winter Harbor Bucksport, Orland, Verona Island, Prospect Deer Isle, Stonington Towns Healthy Acadia Healthy Peninsula Project Bucksport Bay Healthy Communities Healthy Island Union River Healthy Communities Healthy Community Coalitions Organization Partners Hancock Co Planning Commission Downeast Health Services Ellsworth School Dept MCMH Bucksport School Dept MDI Hospital School Union 98 Blue Hill Memorial Hospital School AU 76 Helena Peterson – Director Valerie Kenney – Program Assistant Steven Johndro – Comm Hlth Specialist (& OneME Coord) Emilia Bachrach – Youth Coord/VISTA Kelly Fitzgerald – School Hlth Coord Katrina Kane – Supt of Schools Iris Simon – Health Educator Doug Jones - CEO Kate Yerxa – School Hlth Coord Marc Curtis – Supt of Schools Doug Michael – Director Vacant – Health Educator Irene Greene-Murphy – Substance Abuse Coord (OneME) Jenny Gott, RN – School Hlth Coord Barbara Peppey – Director Donna Madonna – Program Asst Josephine Jacobs – VISTA Youth Coord Linda Jaffe – PATH/OneME Coord Jim Fisher - Planner Meredith Gray – Director, Healthy Island Heather Barton – Lindloff – School Hlth Coord Univ Me Cooperative Extension Town of Bucksport Joyce Kleffner - Nutritionist Mary Jane Bush – Health Planner BBHC Evaluation & Research Policy Education Jim Fisher - Chair Mary Jane Bush - Chair Jenny Gott - Chair Committees State Level Partners 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) Bureau of Health Dora Ann Mills MD Dir Commissioner Nickolas Healthy Maine Partnerships OSA – OneME Lee Anne Dodge – OneME Coordinator ME Network of Healthy Communities