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 wellbeing 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 trends in current substance misuse (reported use in the past 30 days) among high school aged youth in the Pemi- Baker Region, which show a significant decline in use rates in recent years.
Despite the gains noted among youth substance misuse on the previous chart, the misuse of prescription drugs, particularly prescription pain relievers, has significantly increased in the state and nation 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.
Regional Initiatives and Opportunities –
Regional assets and opportunities for supporting work in this area include:
The Central NH Region has had three local coalitions that are each working at the community-level to bring stakeholders together to develop a change in local contributing factors, including perception of risk, perception of peer and parent disapproval, and access to substances.
- CADY (Communities for Alcohol- and Drug-Free Youth)
- Lin-Wood Coalition for a Healthy Community are well established entities with very active membership, including youth leadership and positive youth development programs, strong relationships, and stellar outcomes in their respective communities.
- In recent months, a newly emerging grassroots coalition, Stand Up Newfound (S.U.N.), has formed in response to community concern over the opioid epidemic.
**The Plymouth Police Department in collaboration with CADY and Speare Memorial Hospital hosts a medication drop box in Plymouth for the Pemi-Baker region and the Bristol Police Departments hosts one for the Newfound region.
**There are high levels of readiness and partnerships to address these issues as evidenced by the extensive collaborations and underwriting of CADY initiatives and local youth programs by community partners over many years to include the annual CADY Regional Prevention Summit which routinely draws up to 200 participants.
**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 that impacted by substance use disorders and that 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.
Goal 1: Decrease the percentage of high-school aged youth who report using alcohol in the past 30 days from 38.9% to 34% by 2019
Goal 2: Decrease the percentage of high-school aged youth who report using marijuana in the past 30 days from 28% to 24% by 2019
Goal 3: Decrease the percentage of high school aged youth who report misusing prescription drugs in the past 30 days from 12% to 8% by 2019
Goal 4: Decrease the percentage who report binging on alcohol in the past 30 days:
- High school aged youth: from 22.7% (2013) to 18% (2019)
- Young adult college students: from 53% (2015) to 49% (2019)
- Adults: from 20.7% (2014) to 18% (2019)
Goal 5: Decrease the number of opioid-related deaths in Grafton County from 17 (2014) to less than 10 by 2019.
Goal 6: Increase local capacity to address substance misuse and addiction across the region.
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, 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 misuse 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.