Substance Abuse in Greenville County, SC RESULTS OF A 2003 STUDY.

Substance Abuse in Greenville County, SCSubstance Abuse in

Greenville County, SC

RESULTS OF A 2003 STUDY

Study Project ManagementStudy 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.

Community Assessment Methodology

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.

Planning, Implementation and Evaluation Process

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.

The Results Are In!!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 County’s share of the bill is more than $503 MILLION.

Upwards of 5% of Greenville County’s 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.

Scope of the ProblemScope 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.

Greenville County Ranks Highest in the State

Greenville County Ranks Highest in the State

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

County Population In Need

of Treatment According to

DAODAS

Greenville

Charleston

Spartanburg

Anderson

Greenville County Population In Need of Treatment in 2000

(DSM-IV Diagnosis of Substance Abuse or Dependence)

Greenville County Population In Need of Treatment in 2000

(DSM-IV Diagnosis of Substance Abuse or Dependence)

Total 30,488age 12 and older

(40% are dependent, 60% are abusers)

Male 21,786 Age 12-17 5,293Female 8,702 Age 18-24 7,556

Age 25-44 12,680White 26,761 Age 45-64 4,696African- Age 65-up 263American/Other 3,727

Who drinks and who needs help?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 Greenville’s Health at 35%

Community Responses from Survey Respondents

Community Responses from Survey Respondents

94% believe that substance abuse/dependence is a treatable illness

59% believe that a person can overcome substance abuse with enough will power

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

According to faith-based focus group participants, substance abuse is involved in their counseling efforts 100% of the time!

Biology/GenesBiology/Genes EnvironmentEnvironment

DRUGDRUG

AddictionAddiction

Brain Mechanisms

1.ADDICTION INVOLVES MULTIPLE FACTORS

1.ADDICTION INVOLVES MULTIPLE FACTORS

2. 2. ADDICTION IS A DEVELOPMENTAL ADDICTION IS A DEVELOPMENTAL DISEASEDISEASE

starts in adolescence and childhoodstarts in adolescence and childhood

2. 2. ADDICTION IS A DEVELOPMENTAL ADDICTION IS A DEVELOPMENTAL DISEASEDISEASE

starts in adolescence and childhoodstarts in adolescence and childhood

NIAAA National Epidemiologic Survey on Alcohol and Related Conditions, 2003NIAAA National Epidemiologic Survey on Alcohol and Related Conditions, 2003NIAAA National Epidemiologic Survey on Alcohol and Related Conditions, 2003NIAAA National Epidemiologic Survey on Alcohol and Related Conditions, 2003

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0.0%0.0%

0.2%0.2%

0.4%0.4%

0.6%0.6%0.8%0.8%

1.0%1.0%

1.2%1.2%

1.4%1.4%

1.6%1.6%

55 1010 1515 1818 2525 3030 3535 4040 4545 5050 5555 6060 6565 7070AgeAge

Age at cannabis use disorder as per DSM IV

Healthy Heart Diseased Heart

Decreased Heart Metabolism in Heart Disease PatientDecreased Heart Metabolism in Heart Disease Patient

3. ADDICTION IS A DISEASE OF THE BRAIN

as other diseases it affects the tissue function

Sources: From the laboratories of Drs. N. Volkow and H. SchelbertSources: From the laboratories of Drs. N. Volkow and H. Schelbert

Control Cocaine Abuser

Decreased Brain Metabolism in Drug Abuse PatientDecreased Brain Metabolism in Drug Abuse Patient

Partial Recovery of Brain Dopamine Transportersin Methamphetamine (METH)

Abuser After Protracted Abstinence

Normal Control METH Abuser(1 month detox)

METH Abuser(24 months detox)

0

3

ml/gm

Source: Volkow, ND et al., Journal of Neuroscience 21, 9414-9418, 2001.

4. ADDICTION CAN BE TREATED

Relapse Rates Are Similar for Drug Dependence And Other Chronic Illnesses

Relapse Rates Are Similar for Drug Dependence And Other Chronic Illnesses

00

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3030

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8080

9090

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Drug Dependence

Drug Dependence

Type I DiabetesType I

DiabetesHypertensionHypertension AsthmaAsthma

40 t

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Source: McLellan, A.T. et al., JAMA, Vol 284(13), October 4, 2000.Source: McLellan, A.T. et al., JAMA, Vol 284(13), October 4, 2000.

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Per

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apse Addiction Treatment Does WorkAddiction Treatment Does Work

Treatment WorksTreatment Works

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

Where are people who need treatment? The Teachable Moment:

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 Nation’s # 1 Health Problem “ Robert Wood Johnson Foundation 2001 study

But What Is Not Working….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

Study Imperatives…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

RESULTS OF TASK FORCE RESULTS OF TASK FORCE WORKWORKRESULTS OF TASK FORCE RESULTS OF TASK FORCE WORKWORK 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.

FAVOR GreenvilleFAVOR Greenville

New organization formed in 2004 by the original Leadership Council to see that results of study were achieved in the community:

Independent BoardResource Team of ProvidersMembers Aligned with national and state initiative

Make No Little Plans.Make No Little Plans.

They have no magic to stir men’s 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