Colleton County’s Talk to Us Survey Welcome to the conclusion of a 9 month project to gather and analyze substance use disorder and health data. The Colleton Keys coalition and the Colleton Commission and the SC DAODAS has provided timely support for this undertaking. The hope is that the information received from the community and other data sources will set the course for future community services and programs that address substance use disorders and health conditions associated with those disorders. Needs Assessment Results & Conclusions From Closing Gaps to Opening Doors

Colleton County Learning Objectives Describe demographic and geographic characteristics of Colleton County Discuss needs assessment process and results Draw conclusions about next steps to make Colleton County a better place to live, work, and enjoy From Closing Gaps to Opening Doors

Demographic Characteristics Colleton County Demographic Characteristics 2014 Est. Colleton County Population FY 15 Agency Client Population 37,771 8687 less than 18 years old 7025 older than 65 22059 Between 18-64 19,678 Female 18,092 Male 335 Unique Admissions in FY15 23= less than 18 12= greater than 65 129= 18 – 29 207=30 - 64 135= Female 36.3% 236= Male 63.6% From Closing Gaps to Opening Doors

Demographic Characteristics Colleton County Demographic Characteristics Colleton County 22,247 White 14,466 Black 1057 Other From Closing Gaps to Opening Doors

Demographic Characteristics Colleton County Demographic Characteristics YTD 16 Agency Client Population 448 Admissions through March 21,2016 33% from all FY 2015 29 = 12 – 17 = 26% 187 = 18 – 29 = 0% 258 = 30 – 64 = 45% 12 = over 65 = 25% From Closing Gaps to Opening Doors

Something to know and remember: There are nine organizations in the Lowcountry that provides direct care for substance use disorder patient/clients. Services and programs range from prevention to residential to sub-acute detox to outpatient detox for opioid withdrawal management. From Closing Gaps to Opening Doors

Original Survey Project Layout

Needs Assessment Sources Talk 2 Us Community Survey = 362 responses 72% of 500 Goal Survey made possible with help and support of the: Colleton Keys Coalition on Substance Use Disorder The SC Department on Alcohol and Other Drug Abuse Services The Colleton County Board and staff of the Colleton Commission on Alcohol and Drug Abuse Special thanks to Press and Standard, Colleton County Library for being pick sites for completed surveys Local Agency Client Information (MIS) Other State and County Data Sources From Closing Gaps to Opening Doors

Colleton County Survey Findings From Closing Gaps to Opening Doors

Survey Demographics Colleton County Map includes percent of survey responses by resident zip code Highest percentage in Walterboro (29488); (29435) From Closing Gaps to Opening Doors

Survey Demographics Colleton County Gender Male 87 Female 170 Age 13-16 y/o 5 17-20 y/o 9 21-44 y/o 172 45-64 y/o 142 65+ y/o 29 From Closing Gaps to Opening Doors

Colleton County Survey Demographics From Closing Gaps to Opening Doors

Community Picks of Most Abused Drugs of Choice vs Agency Admissions Colleton County Community Picks of Most Abused Drugs of Choice vs Agency Admissions Survey Said… Alcohol, All Kinds 40% Marijuana 41% Cocaine/Crack 37.3% Amp/Meth 35.5%* Other Opiates 35.1%** Agency Admissions Alcohol 44% Marijuana 39% Cocaine/Crack 23% Amp/Meth 14% Other Opiates 13% It appears that the community is saying that persons using meth and opiates are not entering treatment services, at least not in Colleton County. While an increase in opioid substance use disorder admissions has increased over the last 12 months, more admissions are expected as a result of a statewide tightening of distribution of opioid type medications. Synonymous with that is the possible increase in heroin use, abuse, and addiction. From Closing Gaps to Opening Doors

Facts You Should Know *Benzodiazepines **Opiate Pain Medications Colleton County Facts You Should Know *Benzodiazepines Stimulate type drugs like amphetamines 5189 patients received 23,601 prescriptions 1,445,320 medications dispensed In Colleton in FY2015 **Opiate Pain Medications 13,227 patients received 45,353 prescriptions 3,361246 medications dispensed In Colleton in Fy2015 It appears that the community is saying that persons using meth and opiates are not entering treatment services, at least not in Colleton County. While an increase in opioid substance use disorder admissions has increased over the last 12 months, more admissions are expected as a result of a statewide tightening of distribution of opioid type medications. Synonymous with that is the possible increase in heroin use, abuse, and addiction. SC DHEC Report From Closing Gaps to Opening Doors

The Community Needs To Know More About Colleton County The Community Needs To Know More About Heroin drugs (34.6%) Street obtained pain medications (19.9%) Cocaine (19.7%) From Closing Gaps to Opening Doors

Colleton County Community Survey Says! Not enough being done in Colleton County around… Meth drugs (27.5%) Marijuana (25.4%) Street obtained pain medications (24.7%) Cocaine/crack drugs (24.2%) Heroin drugs (19.4%) From Closing Gaps to Opening Doors

Prescription Drugs Medications with highest awareness of misuse Colleton County Prescription Drugs Medications with highest awareness of misuse Percocet Hydrocodone Oxycodone Oxycontin Medications with lowest awareness of misuse Adderal Loratab Ambien Ativan From Closing Gaps to Opening Doors

Colleton County Prescription Drugs Other medications of concern mentioned in survey comments included-- Sudafed Methadone Demerol Ritalin From Closing Gaps to Opening Doors

The Drug Marijuana Colleton County is… not prepared (50% vs. 18.4%) to deal with legalization of medical marijuana as it plays out in SC legislature. not prepared (54.1% vs. 14.7%) to deal with legalization of recreational marijuana as it plays out in other states not prepared (50.9% vs. 14.2%) to deal with the health and safety concerns for those who use marijuana From Closing Gaps to Opening Doors

General Community Attributes Colleton County General Community Attributes Reported Strengths Reported Challenges Educational (26.05) and recreational (25.9%) opportunities are better now than in the past. 56.3% reported Job opportunities were a challenge 53.5% reported a need for Mental health programs From Closing Gaps to Opening Doors

General Community Attributes Colleton County General Community Attributes Other Reported Needs Domestic violence initiatives– 52.7% Educational opportunities- 51.8% Treatment services for substance use disorders- 49.0% From Closing Gaps to Opening Doors

Colleton County Domestic Violence Top 3 perceived significant influencers on domestic violence 1. Past history of violent behavior in family (100%) 2. Uncontrolled use of alcohol and other drugs (84.1%) 3. Learned behavior in childhood (85.6%) From Closing Gaps to Opening Doors

Social and Economic Factors Colleton County Building A Culture of Health in Colleton County -County Health Rankings and Roadmaps- Colleton County vs South Carolina Quality of Life Poor or Fair Health Health Behaviors Adult Smoking Excessive Drinking Alcohol Impaired Driving Deaths Social and Economic Factors Unemployment Children in Poverty Physical Environment Severe Housing Problems Long Commute to Work 20% 16% 24% 20% 11% 14% 35% 42% 7.6% 9.5% 27% 39% 19% 16% 51% 31% From Closing Gaps to Opening Doors

Colleton County Quality of Life 42.2% says QOL isn’t improving fast enough or is poor. 4.1% says QOL is better than ever. From Closing Gaps to Opening Doors

Conclusions Top issues Top strengths Colleton County Conclusions Top issues Quality of life in general is an issue in Colleton County Introduce health and wellness practices in behavioral health programs and services Need to increase awareness of dangers of misusing prescription medications and other illegal drugs such as heroin and methamphetamine. Top strengths Strong participation from schools that support prevention and counseling services to youth. Strong participation from criminal justice system to reduce youth access to tobacco and alcohol through regular compliance checks at retail business’ From Closing Gaps to Opening Doors

Conclusions Top issues Top strengths Colleton County Conclusions Top issues Continue to recognize that beverage alcohol remains the number one legal drug of choice. Continue to reduce access to beverage alcohol by youth. Increase awareness that marijuana remains illegal and impacts health as well as maturation of youth and adults. Top strengths Growing interest in healthcare providers combating spread of opioid type medications. Growing strategies to protect children and families from impact of substance use disorders and other trauma. From Closing Gaps to Opening Doors

From Transition To Transformation Colleton County From Transition To Transformation The Colleton Commission on Alcohol and Drug Abuse is in a state of transition. From providing residential bedded programming to pregnant and parenting women in FY 14 With 11 staff members to zero To an outpatient only service delivery system in FY15. With 12 total staff members From Closing Gaps to Opening Doors

More Conclusions: From Transition To Transformation Colleton County More Conclusions: From Transition To Transformation From a schedule based format to more of an on-demand approach to patient/client engagement From relying on recurring state and federal funds to support programs and services to more self pay and third party payments for services received. From treating only select populations to diversifying services and programs to meet the needs of multiple client populations. From Closing Gaps to Opening Doors

More Conclusions: From Transition To Transformation Colleton County More Conclusions: From Transition To Transformation From limited evidence based substance use disorder service practices to broader client expectations from the standpoint of health and wellness. From working with a few community partners to working collaboratively with local healthcare professionals and practices to identify and treat chronic illnesses such as substance use disorders and more especially, opioid substance use disorders. From Closing Gaps to Opening Doors

From Closing Gaps to Opening Doors Colleton County From Closing Gaps to Opening Doors From Closing Gaps to Opening Doors

Transformation Practices Prevention Strategies Information dissemination specifically towards: Heroin, Available street medications, Cocaine, Methamphetamine, Marijuana, Oxycontin Information dissemination on high risk behaviors associated with substance use disorders HIV TB Hep C From Closing Gaps to Opening Doors

Transformation Practices Treatment – Intervention Strategies Expand behavioral health services for primary healthcare providers Provide access to Medication Assisted Treatment for patient/clients who have opioid misuse and abuse diagnosis Provide access to better health and wellness messaging for all patient/clients particularly in the areas of HIV, Tb, Hep C From Closing Gaps to Opening Doors

Transformation Practices Treatment-Intervention Strategies Enhance Partnership with Department of Social Services Help protect children and families from being de-stabilized due to substance use disorders and other traumas Enhance Service Delivery System to include expanded levels of care. In the absence of an IOP, develop more intense traditional outpatient service opportunities. From Closing Gaps to Opening Doors

Transformation Practices Administrative Strategies Create an impression that reflects an environment of confidentiality, safety, health, and helpful information. Patient/client engagement is critical to their overall treatment outcomes and must be an ongoing condition during all services and programs. From Closing Gaps to Opening Doors

Things You Should Know Colleton County From Closing Gaps to Opening Doors

Colleton County Contact Information Colleton Commission on Alcohol and Drug Abuse 1439 Thunderbolt Drive Walterboro, SC  29488 Phone: 843-538-4343 Fax: 843-538-7613   HOURS OF OPERATION Office Hours: Monday-Friday 8:30am - 5pm STAFF CONTACTS Ronald Rickenbaker, Director, director@lowcountrybhsa.org John Sells, Prevention Specialist: jsells@lowcountrybhsa.org From Closing Gaps to Opening Doors