Substance Abuse in Greenville County, SC

1
Substance Abuse in Greenville County, SC
RESULTS OF A 2003 STUDY
2
Study Project Management

• 80 member broad-based Steering Committee made up
  of community leaders, elected officials, and
  service providers.
• Executive Committee included Jane Pressly,
  Marcia Barker, Kat Rice, Shannon Owen, Carol
  Reeves, Mark Ring, and Dr. Kevin Polley
• Retained Pittsburgh, PA-based Tripp Umbach
  Healthcare to conduct assessment and planning
  process.

3
Community Assessment Methodology

• Steering Committee interviews.
• Greenville County secondary data collection.
• Household telephone survey to 385 residents.
• Inventory survey to all substance abuse service
  providers.
• Mailed employer survey.
• 6 focus groups.

4
Planning, Implementation and Evaluation Process

• Steering Committee planning sessions.
• Substance abuse services asset map.
• Economic impact data collection and model
  development (frequent updates)
• Final report, strategic imperatives, and
  consultant recommendations.

5
The Results Are In!!

• South Carolina spends more than 5 BILLION on
  substance abuse including criminal justice,
  social service, healthcare, lost productivity and
  treatment.
• Greenville Countys share of the bill is more
  than 503 MILLION.

• Upwards of 5 of Greenville Countys total
  economy is lost to the cost of substance abuse.
• The effects of substance abuse cost every man,
  woman and child in Greenville County 1,300 per
  year.

6
Scope of the Problem

• 55 of Greenville County residents believe that
  substance abuse negatively affects the community.
• 60 of Greenville County residents are personally
  impacted by substance abuse. (Either they,
  someone they live with, or a close family member,
  friend or co-worker has a substance abuse problem
  that interferes with daily activity.)
• 34 in Greenville County drink compared to 58
  nationally. Alternately, 46.6 of Americans age
  12 and older reported being current drinkers of
  alcohol in 2002 survey.
• In Greenville 1.56 drinks per sitting is the norm
  while the national average is 1.38 drinks per
  sitting.
• Greenville County residents who do drink alcohol
  consume 8 more by volume than the national
  average.

7
Greenville County Ranks Highest in the State
8
Greenville County Population In Need of
Treatment in 2000(DSM-IV Diagnosis of Substance
Abuse or Dependence)

• Total 30,488
• age 12 and older
• (40 are dependent, 60 are abusers)
• Male 21,786 Age 12-17 5,293
• Female 8,702 Age 18-24 7,556
• Age 25-44 12,680
• White 26,761 Age 45-64 4,696
• African- Age 65-up 263
• American/Other 3,727

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Who drinks and who needs help?

• Pop. Of Greenville County 379,616
• Pop. Of County 12 and older 297,962
• Drinkers/Users 101,307
• (34 12 and older drink/use)
• Needing Treatment 30,488
• Drinkers Needing Treatment 30
• 2003 Substance Abuse Study
• 1998 Assessing Greenvilles Health at 35

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Community Responses from Survey Respondents

• 73 believe that Jesus Christ is the answer to
  substance abuse and/or dependence
• When asked where do you turn for help, the top
  answers were AA, Church, Hospital or Physicians,
  Phone Book

• 94 believe that substance abuse/dependence is a
  treatable illness
• 59 believe that a person can overcome substance
  abuse with enough will power

According to faith-based focus group
participants, substance abuse is involved in
their counseling efforts 100 of the time!
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1. ADDICTION INVOLVES MULTIPLE FACTORS

Biology/Genes
Environment
DRUG
Brain Mechanisms
Addiction
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2. ADDICTION IS A DEVELOPMENTAL DISEASE starts
in adolescence and childhood
1.6
1.4
1.2
in each age group who develop first-time
cannabis use disorder
1.0
0.6
0.8
0.4
0.2
0.0
5
10
15
18
25
30
35
40
45
50
55
60
65
70
Age
Age at cannabis use disorder as per DSM IV
NIAAA National Epidemiologic Survey on Alcohol
and Related Conditions, 2003
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3. ADDICTION IS A DISEASE OF THE BRAIN as other
diseases it affects the tissue function
Decreased Heart Metabolism in Heart Disease
Patient
Healthy Heart
Diseased Heart
Sources From the laboratories of Drs. N. Volkow
and H. Schelbert
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4. ADDICTION CAN BE TREATED
Partial Recovery of Brain Dopamine
Transporters in Methamphetamine (METH) Abuser
After Protracted Abstinence
3
0
ml/gm
METH Abuser (1 month detox)
Normal Control
METH Abuser (24 months detox)
Source Volkow, ND et al., Journal of
Neuroscience 21, 9414-9418, 2001.
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Relapse Rates Are Similar for Drug Dependence
And Other Chronic Illnesses
Addiction Treatment Does Work
100
90
80
70
60
Percent of Patients Who Relapse
50
40
30
20
10
0
Drug Dependence
Type I Diabetes
Hypertension
Asthma
Source McLellan, A.T. et al., JAMA, Vol 284(13),
October 4, 2000.
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Treatment Works

• For every 1 invested in substance abuse
  treatment, 7 is saved in costs to the community.
  

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Where are people who need treatment? The
Teachable Moment

• 40 of injured patients in trauma centers have
  positive blood alcohol levels
• Between 25 and 40 of all general hospital
  patients are there because of complications
  related to alcoholism
• At least 50 of all people arrested for major
  crimes were using illicit drugs at the time of
  their arrest.
• In 1990, 1 million arrests were made for drug
  offenses and 3 million for alcohol offenses.
• Substance Abuse The Nations 1 Health Problem
  Robert Wood Johnson Foundation 2001 study

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But What Is Not Working.

• SHAME AND STIGMA
• DENIAL BOLSTERED BY BILLION ADVERTISING
• LACK OF PARITY IN HEALTH INSURANCE COVERAGE
  LACK OF EFFECTIVE TREATMENT
• 1947 ALCOHOL EXCLUSION LAW EMBEDDED IN MODEL
  UNIFORM ACCIDENT AND SICKNESS POLICY PROVISION
  LAW (UPPL) Allows insurers to deny coverage to
  individuals injured as a result of being under
  the influence of alcohol or narcotics
• CRIMINAL JUSTICE ISSUE VERSUS PUBLIC HEALTH ISSUE

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Study Imperatives

• Develop and implement a coordinated continuum of
  care
• Increase awareness of substance abuse issues,
  impacts and available services
• Increase community and spiritual-based approaches
• Increase services available for youth

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RESULTS OF TASK FORCE WORK

• Develop a centralized system to access services
  functions may include  awareness building,
  screening and referral, outreach, advocacy,
  education (to include programs for clergy and
  physicians) and evaluation.
• Increase/improve adult inpatient/residential
  treatment services, to include post-treatment
  housing.
• Develop/build a residential youth facility.

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FAVOR Greenville

• New organization formed in 2004 by the original
  Leadership Council to see that results of study
  were achieved in the community
• Independent Board
• Resource Team of Providers
• Members
• Aligned with national and state initiative

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Make No Little Plans.

• They have no magic to stir mens blood and
  probably themselves will not be realized.
• Make big plans aim high in hope and work,
  remembering that a noble, logical diagram once
  recorded will never die, but long after we are
  gone will be a living thing asserting itself with
  ever growing insistency. Daniel Burnham 1907