Preventing Substance Use and Abuse in Utah

1
Preventing Substance Use and Abuse in Utah
State of Utah Division of Substance Abuse and
Mental Health

• Who Is At Risk
• And What Can We Do About It?
• The Utah Division of Substance Abuse and Mental
  Health is the State agency responsible for
  ensuring that prevention and treatment services
  for substance abuse and mental health are
  available statewide.

2
Goals of Presentation

• To educate the residents of Utah on the
  importance of preventing substance use/abuse
  among both youth and adults.
• To increase knowledge regarding the consequences
  of substance use/abuse in the State of Utah.
• To motivate lawmakers and stakeholders to
  designate additional dollars to the prevention of
  substance use/abuse in the State of Utah.

3
The State of Utah
Note Within many of the following slides,
comparisons are made between Utah and the United
States. In an effort to make this presentation
understood by the general population and all
target groups, data was included from the
National Survey on Drug Use and Health via the
National Outcomes Measure report for the state of
Utah, and does not include statistical analysis
between Utah and the United States. Because of
this, and due to demographic and other
differences between the samples, caution must be
used when interpreting this data.
4
Targeted Geographical Area The State of Utah

• Utah was the 45th state to enter the United
  States (January 4, 1896).
• Utah ranks as the 34th most populous state in the
  United States with a total population of
  2,645,330.
• Approximately ¾ (76) of Utahs population lives
  along the Wasatch front (Salt Lake, Davis, Utah,
  and Weber counties).
• Utah is 84,916 sq. miles 65 of which is owned
  by the federal government.
• Sources www.utah.gov, US Census Bureau, 2007
  estimates

5
Targeted Population The State of
Utah

• Utah ranks 1st in the US for the average
  household size (3.08 persons/household as
  compared to 2.61 for US).
• Utah has an equal number of males and females,
  which is similar to the gender distribution for
  the US.
• The majority of Utahs population is White
  (89.1) as compared to 73.9 for the US.
• The median age of Utah residents is 28.4 as
  compared to 36.4 for the US.

Source US Census Bureau, 2006 American Community
Survey
6
Targeted Population The State of
Utah (continued)
Source US Census Bureau, 2006 American Community
Survey
7
Targeted Population The State of Utah (continued)
Source www.utah.gov and US Census Bureau, 2000
8
Utah Quick Facts Regarding Substance Abuse

• Alcohol continues to be the most commonly abused
  substance in Utah.
• Methamphetamine use has increased at an alarming
  rate it is the primary illicit drug of choice
  for all individuals over 18 exceeding
  marijuana, heroin and cocaine use.
• Fatalities due to prescription medication
  continue to be on the rise in Utah. In 2003,
  poisoning surpassed motor vehicle crashes as the
  leading cause of injury death in Utah. The
  majority of these deaths involved opioids.
• Source www.utah.gov and www.health.utah.gov

9
Epidemiological Indicator Data for Substance
Abuse in Utah
10
Epidemiological Indicator Data for Substance
Abuse in Utah

• The State Epidemiological Outcomes Workgroup
  (SEOW)
• The State of Utah received funding in October
  2005 from the Federal Center for Substance Abuse
  Prevention (CSAP) to organize and convene a SEOW.
  
• The primary task of the SEOW is to collect and
  interpret data related to consumption and
  consequences of substance use and abuse in the
  State of Utah.
• Future work by the SEOW will begin to analyze
  substance use and consequence issues and trends
  at sub-state levels and in more specific
  populations within the state. Additionally, the
  data will be examined geographically and by
  demographic variables to determine which parts of
  the state and which populations are of highest
  need.

11
Epidemiological Indicator Data for Substance
Abuse in UtahSuccesses and Challenges

• Alcohol Use (2002-2005)
• While the percentage of Utah residents ages 12-17
  were less likely to use alcohol in the past 30
  days as compared to the US, these percentages
  continued to increase each year for Utah, as the
  US percentages decreased.
• Percentages for the Utah 18 and older population
  continued to be lower when compared to the US and
  stayed consistent over the past three fiscal
  years.

Source SAMHSAs National Survey on Drug Use and
Health, 2002, 2003, 2004 and 2005
12
Epidemiological Indicator Data for Substance
Abuse in UtahSuccesses and Challenges

• Alcohol Use (2002-2005)
• Both the 12-17 and 18 and older populations in
  Utah used alcohol more frequently as compared to
  the US population. In addition, while the US
  population stayed consistent over the three year
  period, Utahs rates increased overall for both
  the 12-17 and 18 and older populations.

Source SAMHSAs National Survey on Drug Use and
Health, 2002, 2003, 2004 and 2005
13
Epidemiological Indicator Data for Substance
Abuse in UtahSuccesses and Challenges

• Marijuana Use (2002-2005)
• While the percentage of Utah residents ages 12-17
  and 18 and older were less likely to use
  marijuana in the past 30 days as compared to the
  US, these percentages continued to increase each
  year for Utah, getting closer to the US average.

Source SAMHSAs National Survey on Drug Use and
Health, 2002, 2003, 2004 and 2005
14
Epidemiological Indicator Data for Substance
Abuse in UtahSuccesses and Challenges

• Marijuana Use (2003-2005)
• Utah marijuana users ages 12-17 smoked marijuana
  more days during the past 30 days as compared to
  the US population.

Source SAMHSAs National Survey on Drug Use and
Health, 2003, 2004 and 2005
15
Epidemiological Indicator Data for Substance
Abuse in UtahSuccesses and Challenges

• Illegal Drug Use other than marijuana
  (2002-2005)
• The percentage of Utah residents using illegal
  drugs other than marijuana for both the 12-17 and
  18 and older populations has continued to
  increase over the years, surpassing the US
  average.

Source SAMHSAs National Survey on Drug Use and
Health, 2002, 2003, 2004 and 2005
16
Epidemiological Indicator Data for Substance
Abuse in UtahSuccesses and Challenges

• Non-Medical Pain Reliever Use (2002-2005)
• The percentage of Utah residents using
  non-medical pain relievers for ages 12 and older
  has continued to increase over the years, and has
  continued to surpass the US average.

Source SAMHSAs National Survey on Drug Use and
Health, 2002, 2003, 2004 and 2005
17
Epidemiological Indicator Data for Substance
Abuse in UtahSuccesses and Challenges

• Drug Overdoses in 2006
• A total of 485 drug overdoses were investigated
  by the Office of the Medical Examiner (OME).
  Statistics for 466 of these cases are listed
  below, reporting that 2/3 (66) of the overdoses
  were related to non-illicit drugs only and an
  additional 14 of the overdoses were related to a
  combination of illicit and non-illicit drugs.

Source www.health.utah.gov
18
Epidemiological Indicator Data for Substance
Abuse in UtahSuccesses and Challenges

• Treatment (2002-2005)
• Utah residents 12 and older continue to have a
  more difficult time receiving treatment for
  illicit drug abuse as compared to the US
  population. In addition, trends are showing a
  decrease in availability of treatment for Utah
  residents.

Source SAMHSAs National Survey on Drug Use and
Health, 2002, 2003, 2004 and 2005
19
Epidemiological Indicator Data for Substance
Abuse in UtahSuccesses and Challenges

• Parent-Child Communication (2002-2005)
• The percentage of Utah parents who talk with
  their children about alcohol, tobacco and other
  drug use has steadily declined, and is now below
  the US average.

Source SAMHSAs National Survey on Drug Use and
Health, 2002, 2003, 2004 and 2005
20
Consequences of Substance Use and Abuse

• The consequences of substance use and abuse are
  many. Following is brief list of some of those
  consequences

21
Substance Abuse Services in Utah
22
Current Substance Abuse Services in Utah

• Statewide, 13 local substance abuse authorities
  offer outpatient treatment and prevention
  services to individuals and their family members.
  Every other year, these substance abuse
  authorities complete a resource inventory of
  substance abuse services and identify gaps in
  services as well.
• Residential and day treatment may be available
  and is dependent on local resources and
  priorities.
• Thirty-two (32) drug courts are operated
  statewide, offering nonviolent, drug abusing
  offenders with intensive, court supervised drug
  treatment as an alternative to jail or prison.
• Multiple prevention programs are operating in
  Utah schools, churches and communities.
• Source www.utah.gov

23
Current Substance Abuse Services in Utah
(continued)
Examples of three prevention programs in Utah
include
24
Current Substance Abuse Services in Utah
(continued)
25
Current Substance Abuse Services in Utah
(continued)
26
The Costs and Benefits of Prevention
27
Defining Cost, Effectiveness, and Benefit as They
Relate to Substance Abuse Prevention

• Cost can be defined as the monetary value of
  resources required to provide a substance abuse
  prevention service.
• Effectiveness can be defined as the potential to
  reduce an existing problem or to prevent/reduce
  the likelihood of a future problem so as to
  reduce future demand for health services (e.g.,
  substance abuse treatment) or other services
  (e.g., incarceration).
• Benefit can be measured as an economic and social
  value to an individual and society as a whole.
  Examples of how benefits might be measured
  include estimating lives saved reduction in
  the number of individuals requiring treatment
  reduction in crime, arrests or incarceration.

28
The Costs and Benefits of Prevention

• According to the Washington State Institute for
  Public Policy (2004), there is credible evidence
  that certain well-implemented prevention programs
  can achieve significantly more benefits than
  costs.
• Ultimately, taxpayers will be better off if
  investments are made in these successful
  research-based programs.

29
Costs and Benefits of Prevention (continued)

• In reviewing the economic benefits of prevention
  programs, the Washington State Institute for
  Public Policy (2004) found
• Investments in effective programs for juvenile
  offenders have the highest net benefit yielding
  a return of 1,900 to 31,200 per youth.
• Many substance abuse prevention programs for
  youth are relatively inexpensive and cost
  effective they are worth the investment.

30
Risk and Protective Factors
31
Risk and Protective Factor Model(Hawkins and
Catalano Model)

• Many states, school districts and local agencies
  have adopted the Risk and Protective Factor Model
  to guide their prevention efforts.
• This model is based on the simple premise that to
  prevent a problem from happening, we need to
  identify the factors that increase the risk of
  that problem developing and then find ways to
  reduce that risk.

The Hawkins and Catalano Model is one of several
theoretical perspectives used in the field of
prevention.
32
Risk Factors

• Risk factors are characteristics of school,
  community, and family environments, as well as
  characteristics of students and their peer
  groups.
• Researchers have identified 19 risk factors that
  are known to predict increased likelihood of drug
  use, delinquency, school drop-out, teen
  pregnancy, and violent behavior among youth.
• Of the 19 risk factors, 18 relate specifically to
  drug use. These 18 risk factors are addressed on
  the following slides.

33
Community Risk Factors Showing a Link to
Substance Abuse
Sources www.utah.gov and the Utah Board of
Juvenile Statistics, 2005 and 2007
34
Family Risk Factors Showing a Link to Substance
Abuse
Sources www.utah.gov and the Utah Board of
Juvenile Statistics, 2005 and 2007
35
School Risk Factors Showing a Link to Substance
Abuse
Sources www.utah.gov and the Utah Board of
Juvenile Statistics, 2005 and 2007
36
Peer/Individual Risk Factors Showing a Link to
Substance Abuse
Sources www.utah.gov and the Utah Board of
Juvenile Statistics, 2005 and 2007
37
Peer/Individual Risk Factors Showing a Link to
Substance Abuse (continued)
Sources www.utah.gov and the Utah Board of
Juvenile Statistics, 2005 and 2007
38
Protective Factors

• Protective factors exert a positive influence or
  buffer against the negative influence of risk,
  thus reducing the likelihood that adolescents
  will engage in problem behavior.
• Protective factors identified through research
  include social bonding to family, school,
  community and peers healthy beliefs and clear
  standards for behavior and individual
  characteristics.

39
Summary of Protective Factors by County
Sources Utah Board of Juvenile Statistics, 2005
and 2007
40
Risk and Protective Factors and their
Relationship to Prevention Programs

• By measuring risk and protective factors in a
  population, prevention programs can be
  implemented to reduce the elevated risk factors
  and increase the protective factors identified
  for each county/targeted area.

41
Legislative ExpendituresSubstance Abuse
Treatment vs. Prevention
42
Legislative ExpendituresSubstance Abuse
Treatment vs. Prevention

• Within the Division of Substance Abuse and Mental
  Health, the dollar amount spent on substance
  abuse treatment for the most current fiscal year
  (FY 2008) was easy to access. The total amount
  spent on treatment during this time period equals
  44,704,100 (state, federal and Medicaid funds).

43
Legislative ExpendituresSubstance Abuse
Treatment vs. Prevention

• Determining the dollar amount spent on substance
  abuse prevention during this same time period
  proved to be more difficult. After numerous
  telephone calls to many state analysts, only two
  contacts within the Utah Department of Health
  could provide some information regarding
  substance abuse prevention dollars spent

44
Legislative ExpendituresSubstance Abuse
Treatment vs. Prevention

• The Utah Tobacco Prevention and Control Program,
  produces annual reports providing budget
  information. The most recent report for FY 2007
  listed the total dollars spent, equaling
  18,317,678. However, when discussing this
  budget with the Program Manager, she stated that
  it was difficult to determine exactly how much of
  these dollars were spent on prevention as her
  staff does not record every minute of time spent
  within the program , whether it is related to
  prevention or another aspect of public health.
• Within the Utah Council for Crime and Prevention,
  approximately 25,000 is used to monitor the DARA
  program for the state of Utah. In addition,
  approximately 175,000 is spent on ad time for
  the Partnership for a Drug Free America, with
  additional dollars being provided by the TV
  stations (1-3 per every dollar provided by the
  state).

45
Legislative ExpendituresSubstance Abuse
Treatment vs. Prevention

• Additional Internet research into the amount of
  substance abuse prevention dollars spent in Utah
  led to House Bill 137, which provides 300,000
  over a two-year period (FY 2008 and FY 2009) for
  pain medication management and education. In
  essence, the goal of this Bill is to reduce
  deaths and other harm from prescription opiates
  utilized for chronic pain.

46
Legislative ExpendituresSubstance Abuse
Treatment vs. Prevention

• The Utah.gov website provides further information
  related to substance abuse prevention services
  offered throughout individual counties. Utah
  county websites also offer a wealth of
  information related to substance abuse prevention
  services offered within their counties (i.e.,
  Salt Lake County alone lists 20 providers of
  substance abuse prevention services). However,
  without an extensive review of agency funding
  amounts and funding sources, it is not possible
  to determine the amount of substance abuse
  prevention dollars spent in any given year.

47
Conclusions and Recommendations
48
Conclusions and Recommendations
49
Conclusions and Recommendations
50
Conclusions and Recommendations
51
Conclusions and Recommendations
52
Contact Information

• Craig PoVey
• State of Utah
• Division of Substance Abuse and Mental Health
• Phone [phone]
• E-mail clpovey_at_utah.gov
• Susannah Burt
• State of Utah
• Division of Substance Abuse and Mental Health
• Phone [phone]
• E-mail sburt_at_utah.gov