Substance Misuse and Addiction

Partners in Community Wellness Meeting Minutes

March 4th, 2016
July 7th, 2016
May 5th, 2016


Background and Importance

Substance misuse is one of the most prevalent and problematic public health issues that poses a wide range of safety and health risks, impacting physical, social and emotional well-being. Substance misuse, involving alcohol, illicit drugs, misuse of prescription drugs, or combinations of all of these behaviors, is associated with a complex range of negative consequences for health and well-being of individuals, families and communities.  In addition to contributing to both acute and chronic disease and injury, substance abuse is associated with destructive social conditions, including family dysfunction, lower prosperity, domestic violence and crime.

Alcohol remains the most prevalent substance misused in the United States and in New Hampshire. Underage drinking, binge drinking, regular heavy drinking and drinking during pregnancy are some forms of alcohol misuse that pose highest risk. Marijuana is the illicit drug most likely to be used by teens and young adults. A majority of people being admitted to treatment programs in NH cite marijuana as a primary or secondary reason for seeking treatment. Marijuana use has a wide range of effects, particularly on cardiopulmonary and mental health, and is also known to be a contributing factor leading to the use of other drugs.  The chart below displays rates of current substance misuse (reported use in the past 30 days) among high school aged youth in the Winnipesaukee Region, which are similar to rates for the state overall.

In recent years, the misuse of prescription drugs, particularly prescription pain relievers, has significantly increased as a risk to individual health and can be a contributing factor leading to misuse of other drugs including heroin and a cause of unintentional overdose and mortality.  The table below displays data describing the significant rise of opioid misuse in the region and the state, which has become epidemic. 

Geographic Area

Percent Increase in Emergency Department Visits for  Opioid Misuse;

2013 to 2014

Percent Increase in Opioid Related Deaths;

2013 to 2014

Belknap County

32%

110%

New Hampshire

112%

79%

Data Sources: NH Emergency Medical Services and Office of the Medical Examiner, 2013-2014

Regional Initiatives and Opportunities

The Substance Misuse and Addiction Leadership Team is working to develop improved capacity and strategies to prevent and reduce substance abuse through this Community Health Improvement Plan.  Regional assets and opportunities for supporting this work include:

  • There is an established, volunteer-based Leadership Team focusing on our suicide prevention and substance use disorder initiatives , which is comprised of both substance use disorder and mental health content experts from across our region.
  • The Partners in Prevention (PIP) Regional Network provides support to local coalitions and prevention providers working to reduce the impact of substance abuse and suicide on individuals and families in our region.
  • The Winnipesaukee region is part of New Hampshire’s Regional Network System for the prevention and reduction of substance misuse, which is a coordinated system made up of regional substance misuse coordinators and networks of community stakeholders who lead, plan, support, monitor, and carry out prevention efforts to influence choices and behaviors that promote healthy lives, safe neighborhoods, and thriving economies.
  • Horizons Counseling Center has partnered with many other Belknap County stakeholders to develop and implement the Belknap County Recovery Court to address the connection between addiction and crime.
  • Horizons is also working with LRGHealthcare to expand access to medical assisted treatment for individuals with opiate addiction.
  • Currently, there are three active local community coalitions in the region and interest is building in other communities. Local coalitions include:
    o    Gilford Drug & Alcohol Task Force
    o    Franklin Mayor’s Drug Task Force (www.franklinnh.org)
    o    Stand Up Laconia (www.standuplaconia.com) 
  • Alignment of regional efforts with the State Plan for Reducing Substance Misuse and Promoting Recovery: Collective Action, Collective Impact.
  • Efforts are guided by a community engagement model that benefits from the participation of six core community sectors who are both impacted by substance use disorders and who play a valuable role in community-based and sector-specific best practice efforts.  The six sectors are identified as:  Business, Education, Health, Safety, Government and Community Based Supports.

Goals, Objectives and Strategic Approach


(Also refer to the separate Winnipesaukee Region 2015-2018 Substance Misuse Prevention Strategic Plan for additional detail on specific prevention goals, objectives and strategies.)


Goal 1

Prevent and reduce substance misuse among youth and young adults (18-25) with emphasis on misuse of alcohol, tobacco, marijuana, and opiates (prescription drugs and heroin)

Objective 1

Decrease past 30-day use among high school aged youth, as tracked by the Youth Risk Behavior Survey (YRBS).

·         Alcohol: From 34.6% (2013) to < 20% (2019)

·         Tobacco: From 17.6% (2013) to < 10% (2019)

·         Marijuana: From 23.1% (2013) to < 15% (2019)

·         Non-medical use of Prescription Drugs: From 8.1% (2013) to < 5% (2019)

·        Heroin (lifetime use): From 3.5% (2013) to < 1% (2019)

Objective 2

(developmental)

Increase community understanding of the root causes contributing to substance misuse among 18-25 year olds.

Objective 3

(developmental)

Increase identification and application of relevant research-based strategies to address substance misuse among young adults.

Goal 2

Cultivate expanded leadership to improve understanding of the impact of alcohol and other drug misuse in the region

Objective 1

Offer educational opportunities to lawmakers and policymakers annually to increase their awareness of alcohol and other drug costs, impacts, the savings realized from efforts and services, and the health outcomes of individuals being served.

Objective 2

Engage at least four employers as regular participants in Public Health Council Workgroups addressing this priority area.

Goal 3

Promote the implementation of standardized, effective policies, practices and programs across multiple sectors within the region including education, business, local government, community supports,  and law enforcement/criminal justice

Objective 1

Provide 3 trainings per year on effective policies, practices and programs across multiple sectors.

Objective 2

(developmental)

Support implementation of effective policy, practice, and programs with sufficient, on-going technical assistance.

Objective 3

(developmental)

Expand best practice prevention efforts to elementary and middle school youth including determination of key data sources and tools that may better identify youth at high-risk for substance misuse.

Objective 4

Provide relevant substance use disorder training in higher education for at least three majors and study areas.

Goal 4

Increase local capacity to address substance misuse and addiction across the region

Objective 1

Increase the number of operational local community coalitions in the region from 3 to 5.

Objective 2

(developmental)

Increase treatment options across the region for youth and adults to meet gaps identified in regional assessment (assessment completed May 2016). 

Objective 3

(developmental)

Increase peer-based recovery supports across the region for youth and adults to meet gaps identified in regional assessment (assessment completed May 2016).

Goal 5

Complete an assessment of gaps in services and limitations on access across the substance misuse “continuum of care” prevention-intervention-treatment and recovery supports and services

Objective 1

Assessment of current prevention, intervention, treatment and recovery supports and services completed by May 2016.

Goal 6

Develop a regional strategic plan to address identified gaps in services across the continuum of care, including expanded treatment options and peer-based recovery supports

Objective 1

Continuum of Care Strategic Plan completed by September 2016.


Strategic Approach


STRATEGY 1:  Leadership – Cultivate expanded leadership, particularly among state lawmakers and policy makers, to improve understanding of the impact of alcohol and other drug abuse in the state; to improve understanding of effective policies, programs and practices to address misuse; and to develop champions for such efforts.
STRATEGY 2:  Financial resourcing – advocate for and support adequate, sustained financial resourcing of alcohol and drug abuse prevention, intervention, treatment and recovery supports.
STRATEGY 3: Public education – increase public awareness relative to the harm and consequences of alcohol and drug misuse, treatment and recovery support services available, and that recovery is achievable.
STRATEGY 4: Training and professional development – support training availability and access relative to alcohol and other drug topics for a wide range of professionals and practitioners within different community sectors.
STRATEGY 5: Collaboration – Foster partnerships among key community sectors including alignment of efforts with the financial stability partnership.
STRATEGY 6:  Technical assistance – Provide technical assistance to Support and enhance efforts of existing local coalitions (stand up Laconia, Franklin mayor’s drug task force, Gilford drug & alcohol task force), to develop local coalitions in additional communities, and to Expand treatment services and recovery supports for youth and adults.
STRATEGY 7: Data utilization – continue to collect and share data about the impact of alcohol and drug abuse on individuals, families, communities and community sectors, and about successful efforts to reduce misuse and promote recovery.
STRATEGY 8: Effective policy, practice and programs – promote the implementation of effective policies, practices and programs across and within community sectors and systems and through a combination of direct programming, early intervention and environmental change activities.




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