Identifying Local Prevention Needs

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Identifying Local Prevention Needs
with a Community DEN (Drug Epidemiology
Network)

• Jim Hall
• Center for the Study and Prevention of Substance
  Abuse
• Nova Southeastern University

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Data to Dollars
Data
Information
Resources
Plan
,
Action
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Community Drug Abuse Epidemiology
Information for Action
The Local Drug Epidemiology Network (DEN)
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New State Requirement

• All Community Coalitions Must Have a Needs
  Assessment Workgroup
• DEN
• Community Resources
• Community Needs
• For
• Logic Model and
• State Funding

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A Local DENDrug Epidemiology Network

• Explores the Nature and Extent of Substance Abuse
  at the Community Level
• Linked to Floridas State Epidemiology Work Group
  
• (FL SEW)

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Epidemiology

• The study of determinates of health-related
  conditions in terms of people,
• place, and
• time.

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Epidemiology of Substance Abuse

• Consumption
• Who?
• How Many?
• Consequences
• What's Happening?
• Contributing Factors
• Determinates
• Risk and
• Protective Factors

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Consumption

• Prevalence
• Proportion () of given population
• In terms of People, Place, and Time
• Incidence
• New Cases
• First-time Use
• Measure of Outbreak and Spread

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Consequences

• Deaths
• Medical Emergencies
• Dependency/Addiction
• Violence
• Crime
• Mental Illness

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DENs Provide Information for Action
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DENs Provide Information for Action
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Strategic Framework
S U D O K U
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Strategic Framework
S U D O K U
Assessment
Capacity Building
Strategic Planning
Implementation
Evaluation
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Logic Model
Local Contributing Factors
Substance Related Consequence
Substance Use Behavior
Intervening Variables
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Intervening Variables

• Availability or Access
• Purchased
• Social
• Perceived Harmfulness
• Social Norms
• Family
• Peers
• Community
• Enforcement
• Promotion

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Logic Model
Local Contributing Factors
Substance Related Consequence
Substance Use Behavior
Intervening Variables
Consequences Consumption Determinates

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Strategy and Evaluation
Evaluation Element (Process Outcome)
Local Contributing Factor
Proposed Strategy
Determinates Consumption,
Consequences,
and Determinates
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DENs in Florida

• Established DENs
• Miami 1987
• Ft. Lauderdale 1996
• Tampa 2006
• Jacksonville 2006
• Developing DENs
• Orlando
• St. Augustine
• Palm Beach
• St. Petersburg

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National Institute of Drug Abuse Community
Epidemiology Work Group (CEWG)
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National UpdateNIDA CEWG January 2007
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Prevalence of Substance Abuse
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National Survey on Drug Use and Health
(NSDUH)2002-2006Previously the National
Household Survey on Drug Use (NHSDU)
1965-2001

• Substance Abuse and Mental Health Services
  Administration

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Other Surveys

• Youth Risk Behavior Surveillance Survey
• (YRBS) High School Students (9-12)
• Center for Disease Control and Prevention
• USA, Florida, Hillsborough, Orlando, Palm Beach,
  Broward, and Miami-Dade
• Florida Youth Substance Abuse Survey
• (FL-YSAS) Middle and High School Students
• Florida DCF
• Monitoring the Future Survey (MTF)
• National School Survey (8, 10, 12th grades)
• National Institute on Drug Abuse (NIDA)

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Current Alcohol UseAmong Americans Aged 12 and
Above

• 126 Million
• 51.8

• 60.5 million
• smoke cigarettes
• 25

Source NSDUH 2005
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Current Alcohol UseAmong Americans Aged 12 and
Above

• 125,309,000
• 50.9

• 61,565,000
• smoke
• cigarettes
• 25

Source NSDUH 2006
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Current Use of Selected Illicit Drugs among
Persons Aged 12 or Older 2005 n
19,700,000 People
Percent Using in Past Month
Source 2005 NSDUH
Any Drug
Psycho-therapeutics
Hallucinogens
Marijuana
Cocaine
Inhalants
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Current Use of Selected Illicit Drugs among
Persons Aged 12 or Older 2006 n
20,400,000 People
Percent Using in Past Month
Source 2006 NSDUH
Any Drug
Psycho-therapeutics
Hallucinogens
Marijuana
Cocaine
Inhalants
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NSDUH Sub-State Data in Florida by DCF District
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Florida Youth Substance Abuse Survey 2000 2006
ATOD Trends
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Incidence of Substance Abuse
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Annual Numbers of New Users of Marijuana1965-2005
Fig 5.1
Thousands of New Users
Source National Household Survey
on Drug Use and NSDUH 2002
1973
1978
2001
2005
1990
1965
2005
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Annual Numbers of New Users of Marijuana1965-2002
Fig 5.1
Thousands of New Users
Source National Household Survey
on Drug Use
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Annual Numbers of New Users of Marijuana
Cigarettes1965-2005
Fig 5.1
Thousands of New Users
Source National Household Survey
on Drug Use and NSDUH 2002
2005 63 lt 18 yrs
2005
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Consequences of Substance Abuse
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Heroin-Related Deaths in Florida 2000 - 2006
Source FDLE Florida Medical Examiners
Commission Reports 2000-2006
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Narcotic Medication Abuse Tracked in Florida
2000-2005

• Hydrocodone
• Oxycodone
• Methadone

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Opiate-Related Deaths in Florida 2000 - 2005
Source FDLE Florida Medical Examiners Commission
Reports 2000-2005
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Number of Deaths Related to 5 Rx Narcotic
Analgesics by Florida Medical Examiner
Districts 2006 (Oxycodone, Hydrocodone,
Methadone, Morphine, Propoxyphene)
Source FDLE Florida Medical Examiners
Commission Report 2006
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Cocaine-Related Deaths in Florida 1991-2006
Source FDLE Florida Medical Examiners
Commission Report 2006
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Cocaine-Related Deaths in Florida 1991-2006
Source FDLE Florida Medical Examiners
Commission Report 2006
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Polysubstance Use Among State of Florida
Cocaine-Related Deaths 2001 - 2006
Cocaine Plus
Cocaine Only
  SOURCE Florida Department of Law Enforcement,
Florida Medical Examiners Commission
Reports
2001- 2006
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Alcohol and other Drugs Detected in
Cocaine-Related Deaths in Florida during 2005
n 1,943
52 of Cocaine Deaths with Rx Medicine Source
Florida Medical Examiners
Commission 2005
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Hospital ED ReportsSource SAMHSA-DAWN Live!
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Club Drug Indicators
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A DEN For Every County

• For (not necessarily in)
• Community Coalition Link
• Required for Strategic Prevention Framework Grant
• Fund annual 2,000-5,000
• OK to start with single issue
• Underage Drinking
• Alcohol
• Marijuana
• Methamphetamine
• Then Expand
• Its a Developmental Process

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DENs and SPF/SIG

• Not to determine who has a problem
• Nor to prioritize funding
• Everyone has a problem
• DEN Ids Nature Extent
• Who is impacted
• What determinates can be changed
• How to engage SPF locally

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DENs and SPF/SIG

• Not to Fund who has worse problem
• Not a competitive process
• But fund all who can define local problems and
  focus findings on planning and implementation
• Incentive to engage SPF

Info For Action
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DEN Resources for Downloading

• NIDA Manual
• CEWG Reports
• Local Sample Reports
• Data Resources
• Consumption
• Consequences
• Criminal Justice
• PowerPoint Programs

Assessing Drug Abuse Resources for Florida
Community Drug Epidemiology Networks  
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Community Epidemiology Surveillance NetworksDENs

• What are DENs
• History
• Purpose
• Advantages
• Sources of Information
• How DENs are organized
• Guidelines for 1st Meeting
• Who to Invite
• Tips on setting up and maintaining DENs

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Data From Different Sources

• Surveys
• Treatment
• Hospital
• ED
• Admit Discharge
• Mortality
• Other Health
• Poison Control Center
• Telephone Helpline
• Infectious Disease
• Criminal Justice
• Qualitative Research
• University Researchers

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Networking and Reporting

• Relationships
• with Info
• Sources
• Public vs. Private
• Making Contact
• Developing Relationships
• Reporting
• References
• Web Sites with Data Info

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National UpdateNIDA CEWG ReportJanuary 2007
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FL-SEW November 2006Report
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FL DEN Reports
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CD Disk Includes County Reports for Southeast
Florida
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Sub State Data 2002-2004
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