EASTON — Parents, elected officials, police, heads of organizations and concerned citizens gathered at the Easton Middle School gymnasium on Wednesday, July 17, to open a dialogue about what some are calling a growing substance abuse problem in Talbot County.

"The problem with substance abuse in the county is not new; we have a long history and culture of abuse," said Gary Pearce, executive director of Talbot Partnership for Alcohol and Other Drug Prevention. "The problem is not defined by recent deaths, but rather by total social costs to our community, including overdoses, crashes, sexual assaults  crime, arrests, family violence and, I think, importantly, the erosion of human potential, particularly with our youth, which has reached unacceptably high levels and impact all levels of our community."  

The point of the meeting was to provide updated information about substance abuse in the county, and it included presentations of facts of substance abuse, what law enforcement is seeing, signs of substance use and addiction, and what research says does and doesn't work when it comes to dealing with a substance abuse problems, including strategies for community change.

Talbot County Health Officer Kathy Foster, giving the first presentation, provided the audience with a list of facts relating to substance abuse.

Foster said the Talbot County Health Department is the largest provider of addictions treatment services in the county and serves about 450 clients a year; 300 of those individuals are getting treatment for the first time, with the overwhelming majority of the clients being under 40 years old.

She said 70 percent of the population the health department serves are white men, 20 percent are white women and 10 percent are minorities.

About 80 percent of the clients are there because of direct contact with the legal system, 3 percent are referred by other health agencies or employers and 17 percent are self-referred.

"The self-referred clients are usually heroin users or long-term alcohol users who are in a crisis situation," Foster said. "Frequently, they need immediate inpatient treatment."

Alcohol use is the primary treatment issue for adult clients, but 50 percent of the health department's clients use two or more drugs, and 30 percent use three or more drugs, according to Foster. 

Foster said the health department is seeing an increase in heroin use in adults older than 18, particularly intravenous heroin use. Heroin is particularly popular among white men between 20 and 25 years of age, she said, and the number of clients the department admitted reporting heroin as their drug of choice increased from 5 to 10 percent in 2012.

She said 30 percent of the health department's adult clients have a co-occurring mental health diagnosis, specifically depression.

"Seventy percent of our clients are gainfully employed, and you and I interact with them on a regular basis as we conduct business in our community," Foster said.

Talbot County has had 21 unintentional intoxication deaths from 2007 to 2012, with 14 of the deaths related to opiates and six of them to heroin, according to Foster.

Emergency medical services are trained to administer the drug narcan as a treatment in situations where opiate overdoses are suspected and death by means of overdose could result. 

Foster said in Talbot County, EMS administered narcan 38 times between June 2012 and May 2013, and in 55 percent of the situations the patient responded positively to treatment, meaning the likelihood of the drugs being opioids was very strong.

Foster said there has been a sharp decline in adolescents entering treatment over the past two years, but when 18-year-olds enter treatment, they usually admit to a two- to three-year history of substance abuse. 

Currently, the greatest source for adolescent referrals is the legal judicial system, Foster said, but two years ago it was schools.

Of the adolescents entering into the department's treatment program, 80 percent are white males, 15 percent are black males and 5 percent are white girls, she said, and added that 65 percent of them have a co-occurring mental health disorder, usually attention deficit disorder or depression.

She said the average adolescent in the program is 16 or 17 years old and is using alcohol and marijuana.

"What the data and the trends tell me is this — Talbot County is a community where we have an alcohol and other substance abuse problem in our adults, as well as our adolescents. Some of the substances people are using has changed recently, but the underlying reason has not," Foster said. "We have a community culture that accepts alcohol and drug abuse. Alcohol and other substances are easy to obtain in our homes and our community, and we fail to recognize when someone needs help and respond accordingly. If we want to change our situation, we've got to change our culture."

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(1) comment

Doctor B
Doctor B

Talbot Health Department & Talbot Partnership
Town Hall Meeting
July 17, 2013 – Easton Middle School Gymnasium
Presentation by
Kathleen H. Foster, RN - Health Department Health Officer

Good evening and thank you for being here tonight.
On a daily basis as Health Officer I see that drug abuse in our community has many faces – from
• new babies born to moms who used drugs during pregnancy to our
• adolescents, our
• adults and our
• senior citizens.
It also takes many forms – from
• alcohol to
• marijuana and
• other illegal drugs as well as
• prescription medications.
Hopefully tonight we will all gain a better understanding of the issues that challenge us in Talbot County.
The Talbot County Health Department, which is the largest provider of addiction treatment services in the county, serves about
• 450 clients per year.
• 300 of these individuals are receiving treatment for the first time. The overwhelming majority of clients are
• under 40 years of age.
• 70% of
the population we serve are Caucasian males,
• 20% are Caucasian females and
• 10% are minorities. About
• 80% of our adult clients enter treatment as a result of contact with the legal/judicial system;
• 3% are referred by other helping agencies or employers and
• 17% are self referrals. The self referred clients
are usually
o heroin users or
o long term alcohol users and tend to be
o in a crisis situation. Frequently they need immediate
o inpatient treatment.
Although alcohol abuse is the primary treatment issue for our
adults,
• 50% or more use 2 or more drugs and
• 30% use 3 or more.
In our adult (18 and over) population, we are seeing an
• increase in heroin use, particularly
• IV heroin use. Heroin is particularly popular in
• Caucasian males between 20 and 25 years of age. The number of clients we admitted who reported
• heroin as their drug of choice increased from 5 to 10% in 2012.
• 30% of our adult clients have a co-occurring mental health diagnosis, usually depression.
• 70% of our clients are gainfully employed and you and I interact with them on a regular basis as we conduct business in our community.
The University of Maryland Shore Medical Center at Easton’s out-patient treatment program serves
• 155 adult clients a year. They report seeing the same trends as the Health Department. Their primary treatment issue is alcohol but most clients have abused or do abuse something else. They have seen an increase of opiate dependence in the past 2 years, both in prescription medication and heroin use.
By the time patients using opiates are admitted to their treatment program, they are frequently intravenous users. Most clients indicate they have 3 to 4 friends who are also heavily involved in substance use but are not in treatment.
Talbot County has had
• 21 unintentional intoxication deaths in the time period from 2007 – 2012.
• 14 of these deaths were related to opioid use;
• 6 of them heroin. Our rates had declined in 2008 through 2011 but
• [rates] increased sharply in 2012.

Emergency Medical Services (EMS) is trained and authorized to administer the drug
• “Narcan” as a treatment in emergency situations where opioid overdose is suspected and an intoxication death could result. In Talbot County this occurred
• 38 times between June 2012 and May 2013. In
• 21 or 55% of those cases, the patient responded positively to this treatment indicating the likely presence of opioids. The majority of the cases were
• Caucasian males aged 20 to 25.
The Talbot County Health Department is the only provider of adolescent addiction treatment services (age 18 and under) in the county. We have seen
• a sharp decline in adolescents entering treatment in the last 2 years. In
o 2010, 48 adolescents were enrolled. In
o 2012, only 33 adolescents sought services; This is
o more than a 30% reduction in persons served.
Yet, when our 18 year olds are admitted for treatment they routinely report a 2 to 3 year history of substance use. The sources of our referrals for our adolescents have also changed in the last 2 years; and now mirror exactly what we see with our adult population.
Currently the greatest source for adolescent referrals [for treatment] is the
• legal/judicial system just as it is for adults.
• Two years ago the greatest source of referrals was our schools.

In our adolescent program,
• 80% of our clients are Caucasian males,
• 15% are African American males and
• 5% are Caucasian female.
• 65 % of our adolescents have co-occurring mental health issues, usually ADHD or depression.
The average adolescent in our program is
• 16 or 17 years old and is
• using alcohol and
• marijuana.
Adolescents who are 18 years of age can be treated in the adolescent or adult program. The decision as to which program will best meet the treatment needs of the 18 year old is made by the counselor who conducts the admission assessment. Sadly, we are currently seeing that the majority of our 18 year olds are assigned to the adult program because of the depth of their drug involvement.
Talbot County has a long history of very high per capita alcohol consumption rates. In
• 2011 we had one alcohol license for every 343 residents.
• The state average is 1:818.
• Talbot County had the 5th highest binge drinking rate from 2006 – 2010 for 18 – 24 year olds. In 2007 our
• 12th grade students who completed The Maryland Adolescent Survey ranked
o number 1 in Maryland for alcohol consumption rates
o and binge drinking rates. These 12th graders are
o now among that population of young adults where we are seeing IV heroin use.
In a community needs assessment conducted by the Talbot Family Network this spring, 30 indicators of healthy and safe communities were assessed. Concern regarding adult and adolescent substance use was ranked 4 among the top 4 issues in our community by not only agency leaders but
also the youth and the nearly 400 adults who participated in responding to the survey.
I could continue to stand here and recite data but my time is limited. Regardless, the outcome on trends would be the same.
What the data and the trends tell me is this:
• Talbot County is a community where we have an alcohol and other substance abuse problem in our adults as well as our adolescents. This is not a new problem – it has existed for many years. Some of the substances we are using have changed recently but the underlying problem has not.
• We have a community culture that accepts alcohol and other substance abuse.
• Alcohol and other substances are easy to obtain in our homes and our community and
• we fail to recognize when someone needs help and respond quickly and appropriately.
If we hope to alter what’s happening in our community, we have to work together as a community and change our culture.

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