Substance Abuse on Martha’s Vineyard Initial Qualitative Survey Results DCHC Substance Abuse Committee Analysis: Myra Stark ~ Sponsored by Dukes County Health Council 4/4/2019

Why were the interviews conducted? Provide a snapshot of substance use disorder (SUD) on Martha’s Vineyard Supply background information for a stakeholder meeting and a process to energize community efforts To provide insight for quantitative study 4/4/2019

Who Was Interviewed? Law enforcement School professionals Youth services organization Business Religious organizations Civic volunteer groups Health care workers Behavioral health workers State, local, & tribal agencies Recovery community Affected family members 4/4/2019

Three Conclusions There is agreement about the severity and the nature of the SUD on MV. Stakeholders believe that although there are “good people doing good work” to combat SUD, the extent of the problem has overwhelmed the available resources. There is clear agreement about what needs to be done. 4/4/2019

What Is The Nature And Severity Of The SUD Problem On MV? Stakeholder Assessments High, crisis, rampant, out of control, epidemic, grave, shocking, unchecked, growing exponentially, deadly Scale 1 to 10: 11/10 10x3 Major Problem Prescription drugs leading to heroin or other dangerous combinations alcohol and marijuana are widespread and viewed as the norm 4/4/2019

Changes That Have Led To The SUD Crisis Dramatic increase in opiate use and deaths Increase in overdoses Overuse of opiate prescriptions Availability of heroin Inexpensive and plentiful Social acceptance of marijuana Normalization of alcohol use and getting high 4/4/2019

Most Harmful Substances Opioids Heroin Alcohol 4/4/2019

What Is The Age Group With The Greatest Needs For SUD Services? The entire age spectrum 18-30 years School age Older adults 4/4/2019

What Are Perceptions of Existing Resources? Good things said about Vineyard house, 12 step programs, YTF, IWYC, New Paths, changes in police approach Self reported new services at Community Services 4/4/2019

How Do You Rate Available Treatment Options? All but one stakeholder felt the options were poor or unacceptable “We don’t have resources consistent with the level of the problem” “Just playing catch up” “ I see efforts, but not good results” 4/4/2019

Specific Treatment Option Perceptions NO DETOX ON ISLAND!! “I know the business model doesn’t support an on-island detox, but it (MV) has to have one.” No residential inpatient treatment Waiting for counseling or treatment Expense of treatment Limited access to medically assisted treatment Cost, stigma, and family disruption of off-island treatment 4/4/2019

What Are The Problems in Existing Resources? Communication Fragmentation Lack of confidentiality Lack of transparency “ Our resources don’t work together; we have turf wars.” 4/4/2019

What Should Be Done? Opportunities For Action Seize the Day! “ There has been a seismic shift happening over the opioid deaths. “ “This epidemic is the hurricane Sandy for Martha’s Vineyard. This is the single biggest effort that the Vineyard has been dealing with in my lifetime.” “We do not want to waste this opportunity now that the community is stepping up.” 4/4/2019

Opportunities (cont’d) Establish intervention care and continuity of care. More trained substance abuse counselors. More licensed medical providers (MDs, NPs) Work together and include the recovery community! “We can’t have turf wars. Can’t be like the airport.” “We need to organize together, not against one another.” Organizational accountability made clear 4/4/2019

Opportunities (cont’d) Develop a public health approach for SUD, like any other epidemic such as Lyme disease “If it were TB, we’d attack it as a public health problem.” Raise public awareness of the issues and potentially effective solutions Break through denial and normalization of unhealthy alcohol, marijuana, and drug use 4/4/2019