Substance Abuse Lenawee, Michigan

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1QAZ

2012-2013

Year-End Outcome and

Evaluation Report

Lenawee Substance Abuse Prevention Coalition

400 W. South St.

Adrian, MI 49221

517.263.7861

[email protected]

www.drugpreventionlenawee.com

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Table of Contents

I. Introduction …………..…………………………………………………3

Mission and Vision……………………………………………………..4

Structure, Linkages, and Collaborative Partners……………...………..4

II. Budget: Revenue and Distribution…………………….……..……….5

III. Behavioral and System Outcomes ……..……………………..……….6

Goal 1: Capacity Building………………………………….….………...6

Goal 2: Alcohol ………………………………………………..………..10

Goal 3: Tobacco..……………………………………………………….16

Goal 4: Prescription Drugs…………………..………………………….17

IV. Overall evaluation of LSAPC…………………………..……………….13

Strengths, Weaknesses, Opportunities, Challenges/Threats…………….20

Challenges and Lessons Learned……………………….……………….20

Future Plans and Next Steps……………………………....…………….20

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Clinton, Eaton, Gratiot, Hillsdale

INTRODUCTION TO LENAWEE SUBSTANCE ABUSE PREVENTION COALITION

The Lenawee Substance Abuse Prevention Coalition (LSAPC) is a diverse, formalized organization of concerned key leaders and dedicated community members. We work collaboratively to build and sustain a public health model of alcohol, tobacco and other drug use and abuse prevention. The Coalition identifies and addresses risk and protective factors affecting alcohol, tobacco and other drug problems facing the youth in Lenawee County. Our community-wide approach to substance abuse prevention pursues prevention resources and expertise. Community needs are identified through data driven analysis, thereby strategic planning is based on the local community profile. Effective programs are selected through research into evidence based interventions proven in communities with similar demographic structure. The Coalition makes funding decisions targeted to outcome based prevention programs, policies and practices. The Planning, Implementation and Evaluation Committee adhere to the 2010-2015 Strategic Plan. The Strategic Prevention Framework is our guide to building capacity, and creating environmental level change. LSAPC members convene monthly to focus on substance abuse prevention needs, gaps in services, and evaluation of outcomes in our community. Members engage in critical dialogue of data collection and analysis, information dissemination, community engagement and mobilization, and education. Through our collaboration we coordinate, develop, plan, and advocate for sustainable, embedded substance abuse prevention services for Lenawee County. Coalition members represent diverse sectors of the community including parents, youth, law enforcement, school administrators, treatment and prevention specialists, health professionals, mental health specialists, public officials, media, community-based organizations, and concerned citizens. Community Action Agency (CAA) located in Adrian, Michigan is a licensed substance abuse prevention agency and is the fiduciary agency for LSAPC. CAA strives to promote self-sufficiency by providing various programs to the community in the areas of community development, economic self-sufficiency, education, health and nutrition, housing, and informational services. LSAPC has been awarded federal grants and the regional Coordinating agency is Washtenaw Community Health Organization (WCHO). WCHO develops comprehensive plans for substance abuse prevention services consistent with guidelines established by the Michigan Department of Community Health (MDCH).

2012-2013 LSAPC MEMBERS,

COLLABORATORS, AND

CONTRIBUTORS

Adrian College

Adrian Public Schools

Catholic Charities of Lenawee

Communities in Schools of Lenawee

Community Action Agency

Community Members

Counseling of Lenawee

Greater Lenawee Tobacco

Reduction Coalition

Hudson Pharmacy

Lenawee Community Collaborative

Lenawee Community Mental

Health Authority

Lenawee County Health Department

Lenawee County Sheriff’s Office

Lenawee Department of Human

Services

Lenawee Intermediate School District

McCullough, Vargas, and

Associates

Michigan State Police

NAACP of Lenawee

Q-95 Radio

Promedica Health Systems

Siena Heights University

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MISSION STATEMENT To prevent and reduce alcohol, tobacco, and other drug misuse and abuse among youth and adults in the Lenawee community through community planning, education, support, and collaboration. VISION STATEMENT Lenawee County will become a healthier and safer place to live by reducing the use and abuse of alcohol, tobacco, and other drugs in the community. STRUCTURE, LINKAGES, AND COLLABORATIVE PARTNERS

The LSAPC staff consists of one-full time Coalition Coordinator, one half-time Coalition Assistant, two part-time Student Assistance Program Coordinators, and the fiduciary agency supervisor. In addition, the coalition is led by its Chairperson and Vice Chairperson who facilitate Coalition meetings, and lead the Planning, Implementation and Evaluation (PIE) Committee. The coalition consists of both active and associate members which are defined within the bylaws. The structure of the organization is illustrated below.

The LSAPC has established both formal and informal partnerships with community agencies and organizations.

Catholic Charities of Lenawee is the fiduciary agency for the Student Assistance Program. The Student Assistance Program was developed to provide an alternative to suspension and expulsion of students for substance abuse. It provides brief screenings, referral for assessment and treatment when indicated, group education and counseling, and substance abuse prevention education for students, parents and school staff for selected Lenawee County schools.

Planning,

Implementation

and Evaluation

Committee

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LSAPC contracts with the Lenawee Sheriff’s Office to reduce social and retail availability of alcohol to underage youth and other alcohol related problems throughout the county. In consideration of prevention funding, the Lenawee Sheriff’s Office provides vendor education to all liquor licensees in Lenawee. Law enforcement also conduct alcohol compliance checks yearly during prom and graduation season.

LSAPC BUDGET: REVENUE AND DISTRIBUTION The total budget for the LSAPC for the 2012-2013 Fiscal Year was $155,000.00 which consisted of funds from the Michigan Department of Community Health (MDCH) Funding Allocation and liquor tax (PA2) funds. The table and chart below display how the MDCH funding and PA-2 funding was distributed during the fiscal year. The staff and fringe benefits cover three LSAPC staff positions which include 100% of the Coalition Coordinator’s salary, 50% of the Coalition Assistant’s salary, and approximately 5% of the salary of the supervisor of the fiduciary agency, Community Action Agency. For this fiscal year, the LSAPC held contracts with the Lenawee Sheriff’s Office, the LSAPC Web Designer, and Catholic Charities.

2012-2013 Budget Distribution (MDCH and PA-2 Funding Allocations)

Salaries and

Fringe Benefits

Contracts Supplies (Computer, Office, and Program Supplies; Printing; Photocopying; and Postage)

Travel (Mileage, Training/

Conference Expenses for

Staff and Members)

Space Indirect Costs

Other Costs

(Computer Services, Meeting

Costs, Program

and Activity

Costs, and Phone)

$85,207 $36,700 $4,377 $4,000 $8,800 $12,696 $3,220

Total Budget: $155,000.00

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BEHAVIORAL AND SYSTEM OUTCOMES

GOAL 1: CAPACITY BUILDING: The LSAPC continues to build infrastructure to sustain substance abuse prevention and

institutionalize the SPF five steps. This work is evidenced by the following summaries:

DEVELOPED COMPREHENSIVE STRATEGIC PLANS; ACTION PLANS, COMMUNICATIONS PLAN, LOGIC MODELS

AND IMPLEMENTATION PLAN The LSAPC developed the 2012-2013 Implementation Plans with guidance from MidSouth

Substance Abuse Commission (MSSAC). Planning aligned with the Lenawee 2010 to 2015

Strategic Plan. On October 1, 2012 LSAPC transitioned from MidSouth to our new

coordinating agency, Washtenaw Community Health Organization (WCHO). This

integration is attributed to the Patient Protection and Affordable Care Act of 2010, a

national healthcare realignment of substance use disorders system and mental health

services into an integrated and improved behavioral system in our community. Integration

simplifies and reduces administrative costs to ensure maximum dollars are devoted to

direct services. It is projected that this alignment will enhance local control of healthcare

funds, ensure access to care for all individuals and reduce barriers for individuals who have

both substance use and mental health issues. Lenawee County Commissioners passed the

integration resolution in a unanimous vote in April, 2012. The LSAPC 2012-13

Implementation Plan, as submitted to MidSouth was accepted by WCHO and programming

has been consistent with the accepted goals and strategies delineated therein.

In planning and writing the 2012-13 Implementation, LSAPC strictly complies with the five

components of the Strategic Prevention Framework, and several key concepts of the

Recovery Oriented System of Care. Planned programs are evidence based interventions.

Outcome measures were developed and projections made for 2012. Strategic planning for

the 2012-13 year started at Planning, Implementation, and Evaluation (PIE) Committee.

Coalition staff drafted the Implementation Plan and Coalition members unanimously

approved it at the August 1st, 2012 meeting. Action plans and logic models were then

developed.

DATA DRIVEN DECISION MAKING

From data analysis findings, LSAPC formulated data driven plans. Through review and

analysis of data at the local, regional, state, and national level, the LSAPC discovered that

although alcohol continues to be the substance most abused by youth, prescription drug

abuse is trending high in our community. Research by the Centers for Disease Control

indicates that there is a growing national epidemic of prescription painkiller overdoses

leading to a record number of deaths. Therefore, prevention of prescription drug abuse

was emphasized in our work in 2012-13. Additionally, research from Substance Abuse and

mental Health Services Administration indicates that nonmedical use of prescription pain

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relievers may raise the risk of users turning to heroin use, which local data indicates to be

at rates lower than state and national averages in Lenawee.

The Michigan Profile for Healthy Youth (MiPHY) is an online student health survey offered by the Michigan Departments of Education and Community Health to support local and regional needs assessment. The MiPHY provides student results on health risk behaviors including substance use, violence, physical activity, nutrition, sexual behavior, and emotional health in grades 7, 9, and 11. The survey also measures risk and protective factors most predictive of alcohol, tobacco, and other drug use and violence. MiPHY results, along with other school-reported data, will help schools make data-driven decisions to improve programming funded under the Title IV Safe and Drug-Free Schools (SDFS) program of the No Child Left Behind Act of 2001 as well as other prevention and health promotion programming.

In 2012 Lenawee MiPHY data indicated the following: 13.5% of Lenawee seventh grade students have ever taken painkillers such as Oxycontin, Codeine, Percocet, or Tylenol III without a doctor’s prescription whereas 6.6% of Lenawee high school students reported doing the same in the 30 days before the survey. The problem is highest among the youngest, the 7th graders, and higher among 9th graders than 11th graders (8.1% compared to 4.4%). Emphasizing data driven decision making, the LSAPC is a member organization of the Lenawee Health Network. The Lenawee Health Network conducted and published the 2011 Lenawee County Community Health Assessment. The data contained in this report is invaluable to substance abuse prevention professionals as we prioritize local needs and incorporate action plans into our strategies to improve the health of our community. This report is based upon data obtained from responses to written surveys that were conducted in October through December 2011. These surveys focused on three age groups: Adult ages 19 and over, youth ages 12 to 18, and children ages 0 to 11 (with parents providing responses for this age group). The last comprehensive community assessment of this kind was conducted over ten years ago. To address the need for an updated study, ProMedica Bixby Hospital applied for and was awarded an $85,000 Rural Health Network Development Planning Grant for the purpose of organizing a community network and to conduct the county assessment. Thus the Lenawee Health Network was formed. LSAPC members use this report in our planning process and to collaborate with other community agencies to address the identified issues in order to improve the health of our community. The Lenawee Health Assessment indicated the following data: No Lenawee County adults reported using other recreational drugs such as cocaine, methamphetamines, heroin, LSD, inhalants, or Ecstasy. 9% of adults had used medication not prescribed for them or they took more than prescribed to feel good or high and/or more active or alert during the past 6 months. When asked about their frequency of medication misuse in the past six months, 38% of Lenawee County adults who used these drugs did so almost every day and 35% did so less than once per month.

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Lenawee County adults used the following over-the-counter medications in a way that was not intended: cold and cough medicines (11%), sleeping pills (3%), energy boosters (2%), weight loss or diet pills (2%), and motion sickness pills (1%). 10% of youth used medications that were not prescribed for them or took more than prescribed to feel good or get high at some time in their lives, increasing to 22% of those ages 17-18. Youth who misused prescription medications got them in the following ways: a friend gave it to them (47%), their parents gave it to them (29%), they took it from a friend or family member (17%), bought it from someone else (15%), bought it from a friend (10%), and another family member gave them it to them (9%). 10% of youth used inhalants, 3% used steroids, 3% used cocaine, 2% used methamphetamines, and 1% used heroin.

Nationally, about 15.7 million persons aged 12 or older used prescription-type drugs non-medically in the past year, and 6.7 million did so in the past month. Nonmedical use of

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prescription drugs ranks as the second most common class of illicit drug use in the United States. Recent data indicate that the rate of use declined slightly between 2010 and 2011 and suggest that National, State, and local efforts to reduce prescription drug misuse may be beginning to have an impact.

From these findings, LSAPC data driven plans were formulated to prevent prescription

drug abuse through education and through the Big Red Barrel Drop Box program and DEA

take back events. The LSAPC continuously reviews and analyzes outcome data from the

interventions implemented to combat prescription drug abuse. 573 pounds of unused,

unwanted or expires pills have been recovered through take back events and Big Red

Barrel Drop Boxes since 2010. In 2012-13 law enforcement collected 494.5 pounds of that

total.

RECRUIT STRATEGIC STAKEHOLDER MEMBERSHIP AND PROVIDE NEW MEMBER

ORIENTATION

New members joined the LSAPC from the media, youth, and community sectors of Lenawee. These elections maintained the statutory eligibility requirements for the Drug Free Communities grant.

The LSAPC consists of at least one representative from each of 12 sectors, namely, youth, parents, business, media, school, youth-serving organization, law enforcement, religious/ fraternal organization, civic/ volunteer groups, healthcare professional, government agency, and others involved in reducing substance abuse. All new members were provided with a one half day training and orientation to the LSAPC, our history, current members, the Strategic Prevention Framework, Recovery Oriented Systems of Care, needs assessment, cultural competency, outcome evaluation and our programs. 100% of respondents indicated that the New Member orientation made them confident in their understanding of coalitions, LSAPC coalition history, the Strategic Prevention Framework, and LSAPC Implementation Plan.

OUTCOME EVALUATION REPORT LSAPC staff developed, and the Coalition approved this Year-End Outcomes Evaluation Report for submission to WCHO. Reporting requirements were met throughout the year according to the 2012-2013 Program Services Timeline established by the Coordinating Agency; LSAPC filed Quarterly Financial Status Reports, Quarterly Implementation Plan Progress Reports, Quarterly Prevention Data System Reporting, the Youth Access to Tobacco Activity Report, the Coalition Fiduciary Action Plan, Updated Tobacco Vendor and Law Enforcement List, 9-D Evidence Based Programmatic Updates Six Month Report, SYNAR Activity Report, and the Year End Report to WCHO. Monthly, data is entered in the Michigan Prevention Data System. The data system is a contract requirement for all MSSAC funded direct service prevention activities. This web-based system stores data and information about LSAPC prevention activities and is immediately available for review at WCHO and also the Michigan Department of Community Health/Bureau of Substance Abuse and Addiction Services.

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Goal 2: Alcohol

Alcohol Vendor Education and Compliance Checks

The LSAPC incorporates environmental interventions that use liquor regulations to restrict youth access to alcohol. Through increasing law enforcement we increase the actual and perceived risk of arrest for driving after drinking and at the same time reduce youth access to alcohol by training alcohol retailers to avoid selling to minors and adults who provide alcohol to minors.

Alcohol Compliance Checks are conducted through a partnership among Washtenaw Community Health Organization, Lenawee Sheriff’s Office, and the Lenawee Substance Abuse Prevention Coalition so we all can live in a healthy and safe community. Together we help keep alcohol out of the hands of our youth by providing alcohol vendor education, vendor education panels, responsible alcohol server training and certification and compliance checks. Alcohol compliance checks send a strong message: Well-publicized compliance check operations are good public relations, compliance operations send a message to the community that providing alcohol to young people is not acceptable, publicity surrounding compliance check operations may affect the attitudes of parents and other adult alcohol providers by sending a consistent message that underage drinking is not acceptable. Compliance checks can save lives!

Alcohol consumption by young people has a profound effect on our nation, our communities, our families, and our children. Alcohol use by teens is related to traffic crashes, crime, teenage pregnancies, sexually transmitted diseases, suicides, drownings, and poor performance in school. Extensive research indicates that while many alcohol establishments act responsibly in refusing sales to underage buyers, a significant number of establishments continue to sell to people under the legal drinking age of 21. Evidence shows that regular compliance checks of establishments that sell or serve alcohol decrease sales to underage youth.

In 2012-13 the LSAPC facilitated on-site vendor education with 100% of Lenawee alcohol vendors. Additionally, group vendor education panels were held with 25 participants in attendance, representing 14 local alcohol vendors. Representatives from the Michigan Liquor Control Commission (MLCC), the Michigan State Police, Lenawee County Sheriff’s Department, Lenawee County Health Department, and Techniques for Alcohol Management (TAM) served on a panel and provided information and resources to the participants. During the group sessions, participants were provided information on the Michigan Liquor Laws including the proper way to check identification and to calculate age for liquor sales as well as the consequences for selling alcohol to minors. New keg registration rules were reviewed. Outcomes included: 94% of the participants agreed that this training increased their understanding and awareness of the Michigan Liquor Laws, 94% of the participants agreed that this training increased their understanding of the consequences of selling alcohol to minors, and 100% of the participants agreed that this training helped them to understand the proper way to check identification and to calculate age for liquor sales.

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The following chart documents the trends in the rate of alcohol sales to minors from 2007-2013.

FISCAL

YEAR SALES TO

MINORS TOTAL NUMBER

OF COMPLIANCE

CHECKS 2007-2008 9 105 2008-2009 14 149 2009-2010 20 164 2010-2011 32 161 2011-2012 24 157 2012-2013 18 139

As we evaluate the effectiveness of our strategies for the 2012-2013 fiscal year, we

examine changes in behavior and systems. As we seek to address the problem of alcohol-

related traffic crashes, injuries, and fatalities in Lenawee County, we implemented such

strategies as alcohol vendor education, compliance checks, and responsible alcohol server

training. To determine the potential impact or contribution of these strategies, we examine

the sales rate of the local alcohol vendors as well as the traffic crash data provided by the

Michigan State Police Drunk Driving Audit.

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Michigan Annual Drunk Driving Audit:

15%

85%

2011-2012 Alcohol Compliance Checks Sales

Rate

sales

no sales

The following charts demonstrate the rates for alcohol involved traffic crashes over the past several years for Lenawee County. LENAWEE COUNTY ALCOHOL INVOLVED TRAFFIC CRASH SUMMARY

YEAR FATAL

ALCOHOL

INVOLVED

CRASHES

PERSONAL

INJURY

ALCOHOL

INVOLVED

CRASHES

PROPERTY

DAMAGE

ALCOHOL

INVOLVED

CRASHES

PERSONS

KILLED PERSONS

INJURED

2005 1 60 90 1 84

2006 4 40 67 5 50

2007 2 41 63 2 52

2008 3 37 48 3 56

2009 6 35 60 7 51

2010 1 56 61 2 77

2011 5 56 103 5 71

2012 2 39 41 2 54

9%

91%

2009-2010 Alcohol Compliance Check Rate

Sales

No Sales

14%

86%

2012-2013 Alcohol Compliance Check Sales

Rate

sales

no sales

9%

91%

2007-2008 Alcohol Compliance Check Rate

Sales

No Sales

12%

88%

2008-2009 Alcohol Compliance Check Rate

Sales

No Sales

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TIPS Responsible Alcohol Server Training

The LSAPC strives to enhance responsible beverage service by training, testing, and

assisting beverage servers and retailers in the development of policies and procedures to

reduce intoxication and driving after drinking. In 2012-13 the Coalition’s TIPS trainer

promoted training directly to all 164 liquor licensees in Lenawee at half the market price.

This program aims to help communities reduce alcohol-related accidents and incidents of

violence and the injuries that result from them. Monthly TIPS trainings were offered this

year with twenty-one servers earning certification. Intoxication rate factors and behavior

cues are taught in a setting respectful of the server’s expertise and people skills in the

field. Blood alcohol content, identification checking process, and liability issues are some

of the topics discussed.

STUDENT ASSISTANCE PROGRAM (SAP)

The Student Assistance Program continues to be a successful and well received early

problem identification protocol and referral system. During 2012-2013, LSAPC and the

SAP worked closely with the Adrian 7/8, Madison High School, Onsted Middle and High

School, and Lenawee Juvenile Court. The SAP coordinator has been made available as an

additional resource for students and teachers in participating and interested schools. SAP

continues to provide educational presentations to students in health classes, staff, parents,

and administration. In addition, the SAP program partnered with Communities in Schools

of Lenawee and held a guest speaker presentation, Mr. Scott Kelley, Executive Director of

Bases Teen Center, for parents regarding Synthetic Substances. An additional new service

(provided with a grant) this year was a teen prevention group at Onsted High School

facilitated by a Catholic Charities Substance Abuse Counselor. The group serviced an

average of 10 students for 6 group sessions. The Graduation Coach at Onsted High School

wrote:

“The group of Onsted High School students thoroughly enjoyed the Substance Abuse

Prevention group with Dudley Campfield of Catholic Charities. The information was not

only informative, but was presented in an interesting way that allowed the students to

learn without realizing that they were in a prevention group. Dudley brought many real life

stories that held the interest of the group and left them anticipating the next session.

Students all reported that they thought they knew more about drugs and their effects on

the body than before the group started. Students report they are more likely the use the

information to make positive choices about drugs in the future.”

The SAP program provided a Teen Substance Abuse Prevention Group for students who

needed additional education and support about prevention of using substances and due to

not being recommended for outpatient treatment. The students were recommended due to

violating school substance abuse policies or as a requirement of Juvenile Court. The group

utilized a variety of resources to create positive alternatives and ideas to cope with triggers

driving substance use.

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The SAP program continues to provide a substance abuse resource referral list and

educational materials available to students, parents, staff, and community members.

LIFE OF AN ATHLETE The LSAPC implemented Life of an Athlete (LOA) at Onsted schools during the 2012-2013

fiscal year. In December, two teachers went to Lake Placid, New York, to the Olympic

Training Center for LOA training. Al Craven, professor at Adrian College, and Jeff

Thompson, teacher in the Onsted Community Schools brought back dynamic information

which they call “STAND out!”, and is an adaptation of LOA. The local adaptation delivers

the alcohol, tobacco and drug messages to the entire student body and stresses the

information is vital to a comprehensive lifestyle choice. This expands the program scope

from strictly athletes. Mr. Thompson presented the LOA/ STAND out! Message to the fall

sports parents and athletes in August. He educated those in attendance of sleep

deprivation, alcohol and marijuana on athletic and academic performance. Several parents

thanked Mr. Thompson for the presentation, saying they gained insight into better health

for their student athlete. He will present again at the winter sports parent meeting. At that

time it is expected that he will be assisted by Adrian College students.

Al Craven presented LOA to the Lenawee Health Network in February. He will present LOA

to the teacher education students at Adrian College in October, and Adrian High School

health classes during the 2013-14 school year. Mr. Craven has supplied student intern

support to the coalition which improved the Coalition website, Big Red Barrel

Implementation event, and the Sober Party night at the college.

PARENTS WHO HOST LOSE THE MOST

The LSAPC “Parents Who Host Lose the Most; Don’t be a party to underage drinking” public

awareness campaign goals are to educate parents about the health and safety risks of

serving alcohol tat teen house parties and to increase awareness of and compliance with

Michigan underage drinking laws. Materials were distributed throughout the county in

the spring during prom and graduation season. Florists, restaurants, law enforcement, the

Adrian Skatery, and businesses displayed table tents, posters, and handed out fact sheets.

Florists placed ‘Parents Who Host’ stickers on corsage and boutonniere packages. Pizza

restaurants put ‘Parents Who Host’ stickers on their pizza delivery boxes. The LSAPC staff

developed a Michigan fact card to supplement the project as the Ohio fact cards provided

by the program were inaccurate for our community. Every prom committee, principal and

board of education member in Lenawee was sent a letter with PWH materials enclosed.

Extended campaign services were made available to each. The Adrian High School prom

committee welcomed LSAPC staff support of their after prom. The Hudson Board of

Education accepted the LSAPC offer of PWH fact cards and distributed them throughout

graduation baccalaureate activities.

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ABOVE THE INFLUENCE

Above the Influence” is a national television, radio, and print campaign produced by leading national advertising agencies placed on broadcast programs frequently watched by teens at levels of exposure comparable to nationally advertised brands.

“Above the Influence” is sponsored by the Office of National Drug Control Policy (ONDCP). The campaign is designed to reduce adolescent marijuana use using message strategies, emphasizing marijuana’s inconsistency with personal aspirations and autonomy. Self-reported exposure to the ONDCP campaign predicted reduced marijuana use, and analyses partially support indirect effects of the campaign via aspirations and autonomy.

One of the aims of the present research was to test the hypothesis that media campaigns such as these might influence substance use behavior by reinforcing beliefs that substance non-use is consistent with youths’ aspirations and autonomy drives.

The ONDCP “Above the Influence” campaign is trending towards positive impacts on attitudes and behavior, and that these effects may be explained in part by impact on perceptions that personal autonomy and aspirations are linked to substance non-use.

In 2012-13, the LSAPC expended grant funding previously received from the Lenawee Youth Council. Youth from the teen group at Adrian Boys & Girls Club met with LSAPC staff several times to talk about substance abuse. One young man indicated, “…using drugs just doesn’t make common sense.” Cultural competence required sensitivity toward youth who experience drug abuse at home. Further, one youth shared that he is in recovery from drug abuse. B&G Club staff supported Above the Influence as a program about youth being themselves and not letting negative influence get to them. Pressure to drink, do drugs or do anything that goes against who youth are in order to fit in—that’s negative influence. LSAPC presents Above the Influence to teens who want to stay above it. T-shirts and sunglasses were ordered with Above the Influence and B&G Club logos. Youth personalized the t-shirts with anti-drug messages to be role models for younger club members. At the Club 4th of July celebration, the youth wore their gear in a parade. The younger youth also received and wore sunglasses in the parade. Candy was provided by LSAPC to throw during their parade, modeling drug free, positive influence.

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GOAL 3: TOBACCO VENDOR EDUCATION AND SYNAR CHECKS

The LSAPC facilitated on-site vendor education to 100% of tobacco vendors in Lenawee

County with the collaboration of coalition members and Lenawee Sheriff’s Office. Tobacco

vendor education packets contained the popular age sign, required display stickers, a copy

of the Youth Tobacco Act, information about the Michigan vertical driver’s licenses, and

samples of store policies for tobacco sales. Retailers play an important role in protecting

youth from the risks associated with using tobacco. Through this environmental approach

to reducing retail access to tobacco, LSAPC plays a role in changing behavior and improving

public health.

The federal SYNAR Amendment requires states to have laws in place prohibiting the sale

and distribution of tobacco products to persons under 18 and to enforce those laws

effectively. Consequently, annual SYNAR checks are required by the amendment. Each year,

a random sample of tobacco vendors is selected by the State to participate in civilian checks.

The LSAPC has continued to participate in SYNAR checks as required by the State of

Michigan. For the 2012-2013 fiscal year, the SYNAR draw for Lenawee County was one

vendor with no sales for a sales rate of 0%.

To examine the impact of our tobacco prevention strategies including tobacco vendor

education, we analyze our data regarding SYNAR checks in Lenawee County. The following

table illustrates the sample sizes and sale rates for the past ten years.

Fiscal Year

SYNAR Draw

Number of Sales

Sale Rate

2002-2003 8 3 38% 2003-2004 0 0 0% 2004-2005 6 3 50% 2005-2006 7 1 14% 2006-2007 6 1 17% 2007-2008 8 1 13% 2008-2009 4 0 0% 2009-2010 6 2 33% 2010-2011 6 1 17% 2011-2012 2 0 0% 2012-2013 1 0 0%

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0

1

2

3

4

5

6

7

8

SYNAR Draw Number of Sales Sale Rate

Tobacco Compliance Checks 2002-2003

2003-2004

2004-2005

2005-2006

2006-2007

2007-2008

2008-2009

2009-2010

2010-2011

2011-2012

2012-2013

Collaboration between the LSAPC and the Greater Lenawee Tobacco Reduction Coalition

(GLTRC) is active and effective. The chairperson of GLTRC also serves as a member of the

LSAPC whose staff actively participates monthly in GLTRC meetings and special events.

This year the GLTRC received a grant from The National Association of County and City

Health Officials. Through that planning grant the GLTRC developed its local mission,

objectives and action plan. Objectives include changing tobacco social norms, and reducing

teen and adult smoking rates in Lenawee.

The GLTRC celebrated Kick Butts Day in 2013. In partnership with the Lenawee Youth

Council, the GLTRC strung a clothesline at the Human Services Building hung with 147 t-

shirts, one representing each death in Lenawee each year from smoking.

The GLTRC implemented the Love Your Lungs poster contest in 2013. Over 200 anti-

tobacco entries received from Lenawee students in grades four through eight... The awards

ceremony was well attended by students, their parents and friends and County

Commissioners Smith and Stimson. Presentation of awards was made by State

Representative, Nancy Jenkins. Free ice cream was donated by Culvers, the Drug Free Bee

made an appearance and participants were encouraged to spin the ‘smokers roulette wheel’

and play ‘fish for facts’, both educational activities.

GOAL 4: PRESCRIPTION DRUGS

The Lenawee Substance Abuse Prevention Coalition strategy for proper disposal of

prescription drugs is the Big Red Barrel drop box project. This is an extension of the

Livingston County Community Alliance Big Red Barrel drop box project. This project

provides a free, secure, convenient and environmentally responsible disposal method to

remove potentially dangerous expired, unused or unneeded medications from the

community. Since May 1, 2013 the Big Red Barrel drop boxes are permanent prescription

drug collection units located at the Lenawee Sheriff’s Office, Adrian, Tecumseh, and Hudson

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Police Departments, and since August, 2013 at Blissfield and Morenci Police Departments.

The goals of the program are:

Goal 1: Collection of unused, unneeded and expired controlled and non-controlled

substances to reduce accessibility to them by abusers and to ensure proper disposal.

Goal 2: Raise awareness of the Big Red Barrel drop box project and the prevalence of drug

abuse and the harm it causes. Effective prevention includes educating parents, youth,

healthcare providers, educators, and the community that abuse of prescription drugs is

dangerous. Parents’ lack of awareness of the prevalence of teenage prescription abuse

leads to insecurely stored drugs being accessed for abuse.

The disposal of the collected drugs is done by law enforcement in the same way evidence is

handled. Collected drugs are incinerated at special facilities which are capable of high

temperature destruction. In this way, active ingredients are neutralized before disposal.

Data is collected at the permanent take back central location. Outcomes are measured by

the weight of the drugs collected and measured by law enforcement. Lenawee residents

are made aware of the service through media advertisement.

This program grew out of collaboration among law enforcement, pharmacists, hospitals,

and the LSAPC. In 2010 law enforcement began participating in national take back events

sponsored by the DEA every six months. On April 27, 2013 the latest national take back

event expanded involvement to include Promedica and University of Toledo Pharmacy

students.

The partnership allowed expanded service to the community in that Promedica accepted

liquid medications, inhalers, and syringes for disposal, which formerly could not be

accepted. The total collected was 74.5 pounds of pills, one large black metal barrel of

bagged liquids and 8 containers of sharps. The Lenawee Sheriff’s Office took the pills to the

Sheriff’s Office to be picked up by the DEA for incinerated and Promedica Bixby Hospital

disposed of the liquids and sharps. After blacking out all personal information, the pills

containers were then taken to be recycled.

During this collection event, several participants shared stories such as the following: one

person had saved his used syringes for 17 years. One family dropped of 4 boxes of used

inhalers. One person dropped off very old over the counter medications such as Alum,

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salve, Boric acid, iodine and charcoal tablets. One person dropped off an unused medication

dated back in 1966 and one that was filled at the former Rinks store in Adrian.

Nationally nearly 1.6 million pounds—almost 774 tons—of prescription drugs were turned

into periodic events sponsored by the DEA at almost 5,700 sites operated by nearly 4,300

of the DEA’s local law enforcement partners. Lenawee’s event in September of 2012

collected more than double the amount of pills as the event six months earlier, with more

community agencies partnering through the Lenawee Health Network to advertise the

event and an added location at the Tecumseh Police Department.

Sheriff Jack Welsh worked with the Lenawee Substance Abuse Prevention Coalition and the

Livingston County Community Alliance to design the permanent drug take back program.

He said, “Collection of drugs periodically is not enough for people who have drugs after a

death in the family. Many people are done with their medicine or have changes to what

they take and need a safe way to dispose of the left-overs. When drugs are unlocked and

unattended, other people, including youth in Lenawee are accessing and abusing them. The

cost to our community is high and the Big Red Barrel Drop Boxes are one way we can make

drugs less available for abuse, addiction and overdose deaths.”

Medicines that languish in home cabinets create a public health and safety concern because

they are highly susceptible to diversion, misuse, and abuse. Rates of prescription drug

abuse in the U.S. are alarmingly high--more Americans currently abuse prescription drugs

than the number of those using cocaine, hallucinogens, and heroin combined, according to

the 2011 National Survey on Drug Use and Health. Studies show that a majority of abused

prescription drugs are obtained from family and friends, including from the home medicine

cabinet. Since 2010 556 pounds of unused, unwanted or expired medications have been

taken back by our program. This restricts the availability of people to abuse medications, a

known contributor to heroin abuse.

55

65

34

5798

136

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Pounds of Drugs Collected

Sept. 2010

Apr. 2011

Oct. 2011

Apr. 2012

Sept. 2012

Big Red Barrels 2013

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As implementation begins on additional prevention strategies in the upcoming year, the

LSAPC hopes to have additional data that speaks to behavioral and system changes. The

implementation and evaluation of SAP and AlcoholEdu program in select schools sites will

provide us with fundamental statistics that illustrate the LSAPC’s contributions to

preventing and reducing substance misuse and abuse in Lenawee County.

INTERNAL COALITION EVALUATION Evaluation is a fundamental step of the Strategic Prevention Framework which guides the

prevention work of the LSAPC. This step involves measuring the impact of our programs

and practices. The Internal Coalition Evaluation measures the effectiveness, efficiency, and

fidelity of implementation in relation to the strategic plan. The results from 2011-12

survey demonstrate that our Coalition is achieving our goals. The internal evaluation asked

coalition members to examine the coalition within the areas of:

Community Ownership

Organizational Effectiveness

Comprehensive Prevention Approach

Commitment to Results Orientation

Linkage Relationship between Coalition and Communities

STRENGTHS, WEAKNESSES, OPPORTUNITIES AND CHALLENGES/THREATS

The results from analysis of the 2012-2013 Internal Coalition Evaluation are documented

below.

Strengths

Targeted areas for Improvement

The coalition has goals and objectives guided, developed, and endorsed multiple coalition members and staff and endorsed by community consensus.

Community acknowledges the ATOD issue, but does little to address the problem.

The coalition has broad-based representation and participation from all community sectors, including those who are part of under-represented groups and minorities.

Community is somewhat aware of ATOD issue, and believe that one or two organizations (school and law enforcement can solve the problem.)

Most coalition members have a thorough understanding of effective evidence-based prevention programs, policies, and practices.

A comprehensive needs assessment is conducted and targets problems based on these priorities.

The coalition knows the players and politics of the community and makes them work to their advantage.

The community regularly (about monthly) gets information regarding the coalition activities.

More than one high profile community leader champions the coalition cause.

The coalition understands the politics and players in the community but is unable to access or influence.

The coalition meets regularly to monitor prevention programs and activities, plan future strategies to evaluate the current prevention system and its service array based on identified needs.

Primary funding for coalition activity comes from one source – sporadic funding from other small agency grants.

Members have broad-based community representation and most have been active two or more years. Special efforts are made to recruit, retain, and recognize member contribution.

One or two formal sub-committees with five or more members address various coalition issues or tasks.

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Meets regularly with leadership for planning purposes, has a comprehensive work plan, by-laws, budget, project staff, AND is action oriented, focused, and purposeful in all meetings.

Meetings are regularly attended with both core leadership and broad-based community representation.

Multiple sources of funding are provided via direct and in-kind sources have been used for two or more years.

The coalition has adopted a vision/mission statement and regularly reviews and revisits it.

Regular, systematic, and ongoing communication methods are used to keep members informed (minutes, email, updates, newsletters, website, etc.).

Programs and activities target at least two domains within one age group.

The coalition has adopted a vision/mission statement that is heavily promoted on coalition documents and products and regularly reviews and revisits it to guide decisions and priorities.

Reviews impact of coalition efforts on the community regarding pre-determined process outcomes (such as new partnerships, funding, grant proposals written, policy changes, etc.).

Conflict and tension emerges occasionally, but is resolved in creative, productive ways that make the organization healthier.

Programs, policies, and practices sponsored or supported by the coalition are a mix of research-based and locally developed.

Multiple groups or organizations have input and carry out the work.

Programs supported by the coalition maintain and periodically review attendance data.

A systematic, transparent, and inclusive process of conducting needs assessment, reviewing priorities, and developing programs and strategies with established mechanisms to evaluate outcomes is incorporated into a formal plan presented to the community.

Community level data is collected and used primarily for internal purposes such as needs assessment, grant writing, and program planning

A comprehensive plan that includes the use of data-driven logic models is developed and formally adopted by the coalition and community.

Programs and activities target three or more domains across multiple age groups.

Programs, policies, and practices sponsored or supported by the coalition are research-based and have been proven effective for the target population.

Programs sponsored by the coalition are primarily focused on the universal* population with selected* focus when appropriate. Places high value and appropriate resources on evaluation as a way to demonstrate progress and effectiveness. Use evaluation results for leveraging resources and partnerships.

Annually collect, monitor, and review membership, satisfaction, and effectiveness information to make “mid-course” corrections.

Programs supported by the coalition are evaluated using process and behavioral outcome data to speak to the effectiveness of the program. Program outcome data is collected and shared with coalition and program staff. Program changes and additional recommendations are made as a result of this data.

The coalition has direct oversight of prevention programs and activities. Significant amounts of the coalition meeting time are used to discuss and monitor major prevention activities.

Coalition is highly involved in the prevention activities by contributing to decisions, volunteers or resources, and has assisted with day to day activities when called upon.

Coalition members are highly knowledgeable of prevention programs and activities, and actively involved in supporting them, making referrals, and identify additional resources as needed.

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Current Status of Recovery Oriented System of Care

WCHO embraces the philosophy that individuals with substance use/ addiction disorders can recover. This ROSC model focuses on the primary principles of recovery and wellness while teaching self-management principles. The model also ensures that the individual is offered a level of service that is based on his or her readiness for change. The Lenawee Coalition has the attitude toward developing effective institutional collaboration of entities, individuals, and service functions that can provide and integrate services that address behavioral and health care needs. We adhere to the SAMHSA model embodied in the following statement: “A ROSC is a coordinated network of community-based services and supports that is person-centered and builds on the strengths and resiliencies of individuals, families, and communities to achieve abstinence and improved health, wellness, and quality of life for those with or at risk of alcohol and drug problems.” Prevention services use community collaboration and strategic partnerships to support the family of a recovering person seeking stability, and the community that is seeking a way to promote healthy pathways for its exposed youth away from alcohol and drug use. In 2012-13 WCOH formed a Lenawee ROSC planning group. Together, this multi-discipline group addressed ROSC orientation for the Lenawee Sobriety Court, town hall meetings, motivational interviewing training, peer recovery coach training, adolescent services, data, and family engagement groups. The goal is to bring diverse stakeholders together to dialogue about their perspectives, to explore the state of the system locally and assess the strengths and limitations in the current system regarding ROSC. CHALLENGES AND LESSONS LEARNED

This first year building new relationships with our Coordinating Agency, WCHO, has been exciting

and encouraging. Outcomes from the Coalition work tells of improved programs and new

strategies.

We learned through data that youth who use alcohol, tobacco and other drugs are at a higher risk

for suicide and sexual activity than their non-using peers. We learned that retail liquor vendors

continue to make alcohol accessible to youth. We learned that our campaigns to change social

norms continue to be important and that more resources need to be invested in more effective

communication of our messages.

Many partners worked actively on different parts of an overall mission. Keeping ourselves and

our programs pointing in the same direction is difficult without good coordination.

Communication of what opportunities exist for working together in the future will be a priority in

the future. Volunteer time makes a difference specifically to the quality of our programs and

increases the cultural relevance of our work. Funders want to know investment outcomes and

community health impact. It is a long road to making behavioral change in Lenawee. It takes

hard work to see movement in substance abuse prevention and it requires constantly renewed

effort and commitment. We share outcome information to keep coalition encouraged.