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.
- 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: Increase youth’s perception of harm of use of alcohol, as measured by youth who think people are at great risk of harming themselves (physically or in other ways) if they have five or more drinks of alcohol once or twice a week.
Goal 2: Increase youth’s perception that parents think it is wrong or very wrong for youth to have one or two drinks of alcohol nearly every day.
Goal 3: Increase number of CNHHP member sites screening for substance misuse.
Goal 4: Increase number of referrals of individuals to needed substance misuse treatment and recovery services.
Strategic Approach –
STRATEGY 1: Implement public health outreach and education to increase the perception of alcohol and marijuana-related risk among parents, youth and the general community.
STRATEGY 2: Promote adoption of universal screening for substance misuse by CNHHP partners, to increase opportunities for early intervention and engagement of individuals to prevention, treatment and recovery.
STRATEGY 3: Adopt tools and systems to enhance efficiency and effectiveness of referrals to needed prevention, treatment and recovery services, and optimize closed loop referrals.
STRATEGY 4: Provide training and education to partners, staff and the community in ACEs and trauma-informed approaches to prevention, treatment and recovery services.
STRATEGY 5: Provide stigma-reduction education, outreach and training to partners, staff and the community.
STRATEGY 6: Build capacity to provide trauma-informed early intervention and mentoring to youth, young adults and families at high risk of substance misuse, substance use disorder and/or opioid use disorder, and negative consequences including family separation and justice involvement.
