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."