Download Desired Outcomes - Elizabeth Boeve

KENT COUNTY
COMMUNITY PROBLEM –
SUBSTANCE ABUSE
AMONG TEENS
Elizabeth Boeve, Shawn Bolen, Hilary Edmondson,
Danielle Kokkonen, & Erin Swartz
Community Problem Diagnosis
Risk of substance abuse among
adolescence of Kent County, Michigan
related to social and economic factors
as evidenced by…
Child Poverty Graph
Inadequate Social Support. (2014).
Inadequate Social Support
Inadequate Social Support. (2014).
United States Statistics
• In 2013, 7.0 percent of 8th graders, 18.0 percent of 10th
graders, and 22.7 percent of 12th graders used marijuana in
the past month, up from 5.8 percent, 13.8 percent, and 19.4
percent in 2008.
• The synthetic stimulants known as “bath salts” were added to
the survey in 2012; in 2013, just 0.9 percent of seniors had
used these drugs in the past year.
• In 2013, 15.0 percent of high school seniors used a
prescription drug non-medically in the past year.
• Positive trends in the past several years include reduced use of
inhalants and less use of cocaine, especially crack
cocaine. Past-year inhalant use by younger teens continued a
downward trend in 2013, with 5.2 percent of 8th graders and
3.5 percent of 10th graders reporting use.
DrugFacts: High School and Youth Trends (2014)
Michigan Statistics
• Approximately 103,000 (11.4 percent)
adolescents in Michigan used an illicit drug
in the past month; 73,000 (8.1 percent)
used Marijuana, and 53,000 (5.9 percent)
used an illicit drug other than Marijuana
• Rates for illicit drug use other than
Marijuana were significantly higher among
adolescent females than males
• Rates of current Alcohol use among
adolescents were significantly higher for
females (18.3 percent) than males (15.7
percent)
• In Michigan 44,000 adolescents (25,000
males and 19,000 females) needed, but did
not receive treatment for past-year drug
problems
•
Michigan Teen Drug Rehab (n.d.)
Kent County Statistics
• Twelve percent of Kent County high school students have
tried alcohol before age 13 3.
• The average age of first use of marijuana is 13.9 years
• The earlier the onset of drug use, the higher the likelihood
of addiction as well as community ramifications. 6.5-7.3%
of Kent County students took prescription medication in
the last 30 days that did not belong to them. White
students were more likely to take stimulants than their
peers while African American and Hispanic/Latino were
more likely to than their peers to take pain killers.
Kent County Substance Abuse Prevention Plan 2012-2016 (n.d.)
2011 Community Health Needs Assessment and Health Profile (n.d.)
INTERVENTION
An intervention is necessary when someone
is addicted to substances such as narcotics
and alcohol. If this person is unable to accept
responsibility for the repercussions of their
addiction, interventions are vital.
Early Intervention Services
• Educational Programs – The best way to prevent addiction to
•
•
substance abuse is by educating our children at a young
age to stay away from drugs and alcohol. If an individual
has an understanding of the harmful effects from drugs
and alcohol, they will be more likely to avoid using them.
Brief Intervention Services – shorter duration and less
extensive interventions that may be more appealing to
adolescents, they can be delivered virtually anywhere
Outpatient Treatment – an adolescent would typically attend
treatment a few hours per day dependent on how much
progress is being made.
Advanced Intervention Services
– Through communication with the entire
family, risk factors are identified among the adolescent’s
family to try to correct the problem.
Group Therapy - A psychosocial session with a group of
adolescents who are all undergoing addiction therapy.
Residential Inpatient Treatment – Program that offers treatment
services in a residential setting.
Medically-Managed Inpatient Treatment – Hospitalization due to
an adolescent’s substance abuse being more severe,
requiring around the clock medical care and observation.
• Family Therapy
•
•
•
Nurses Roles in Substance Abuse Intervention
 School Nurses
• Are at the forefront and are able to read the complex issue of drug
abuse among youth.
• As the number one health care professional inside the school
facility, the school nurse is in a position to give community-based
information in a confidential manner and to help by referring
families to prevention services in substance abuse programs.
• School nurses play an important role in preventing prescription
and illicit drug abuse. by providing education to students, families,
and school staff about the effects different drugs have on the brain
and body.
• In Kent County, there are 18 community public schools across six
districts that employ nurses to provide on-site medical services to
students to promote health and prevent disease among students
(Coalition for Community schools 2013).
Nurses Roles (continued)
• “The Supreme Court has ruled that random student drug testing
(RSDT) is allowed in the public school system for all middle and high
school-age students involved in extracurricular activities. Initially,
courts allowed public schools to conduct random testing only on
student athletes. In June 2002, the U.S. Supreme Court broadened
the authority of public schools to test all students enrolled in
extracurricular activities for illegal drugs” (Buchan, 2013).
• The rationale for schools to adopt random student drug testing is to
decrease illicit drug use among students via two routes.
1.
2.
The first route is schools hope it will serve as a deterrent and give
students a reason to resist peer pressure to take drugs.
Second, drug testing can identify adolescents who have started using
drugs, which would allow for early interventions and referral for treatment
(Buchan, 2013).
• School nurses need to make this population of students and their
parents aware of random drug testing and the reasoning behind the
importance of this national program.
Nurses Roles (continued)
 Substance Abuse Nurses
• The focus is at the individual level and towards the client.
• Provides screening and assessments to identify the patient that
has become victim to drug use.
• Challenges arise among clients with a substance abuse
disorder, for example, the client may mask their symptoms or
deny any high-risk behaviors.
• Emotional support must be provided to this type of client, and
understanding and patience are vital when intervening with
someone who has some sort of addiction to drugs.
• Follow-up and support is important to these clients to help
prevent a relapse and to help maintain their success at
defeating their addiction.
Multisystemic Therapy
What is multisystemic therapy? A treatment approach
that targets multiple systems that contribute to the
development of delinquent behavior in adolescents,
including family, peers, school, and the neighborhood. It
is an advanced intervention service such as family
therapy.
 Why is this intervention important? This intervention
combines factors that are very influential to an
adolescent.
 Where would services be provided? Therapy would be
provided in natural environments, such as at home or at
school, to make the child more at ease with places they
are more comfortable with.
Multisystemic Therapy (continued)
• This type of therapy may be the best practice regarding
substance abuse among adolescents.
• The treatment plan is designed with youth and family strengths
in mind and focused at empowering families.
• This intervention has been successfully used in Midland
County in Michigan.
• A report in 2009, showed that evidence-based programs
helped Midland County build healthier families, reduce
recidivism, and saved almost $2 million with this program
(Multisystemic Therapy, 2009).
• Since 1998, there has been a steady decline in the number of
adolescents that are involved in substance abuse and juvenile
delinquency as a result of this type of intervention.
• Multisystemic Therapy will be successful in Kent County as
well, due to similarities among these two Michigan counties.
Multisystemic Therapy (continued)
• The focus is to treat the individual by including all of the
key players, such as family, peers, and neighbors.
• This is an intensive family and community-based
treatment that addresses the multiple influences that our
youth have.
• Taking into account this whole team of players, there is
little recidivism and the goal is to stop the cycle of sending
youths that have gone through therapy back into a
dysfunctional environment.
• Both counties have problems with substance abuse
among adolescents. Kent County has the potential to
decrease the incidence of abuse, just the same as
Midland County did.
Multisystemic Therapy (continued)
• A grant is a great way to receive the money necessary to
fund this type of intervention.
• A grant can be used for a base from which supplies can be
provided, to pay the social workers and nurses that implement the
program and for advertisement to make the public aware of the
program.
o Midland County was able to receive a grant from the Dow
Foundation to implement this evidence-based therapeutic
program.
o Kent County has the potential to receive a grant from the
DeVos Foundation.
• No permission is needed to implement this intervention. If
funding was available, this type of therapy can be implemented.
Multisystemic Therapy (continued)
• In Midland County, the investment into this type of therapy
has proved successful.
For every $1 spent on Multisystemic Therapy in Midland
County today, there is an expected return of $12.40 to
$38.52 to taxpayers and crime victims in the years ahead
(Allen, 2009).
DESIRED OUTCOMES
The prevention and reduction of
substance abuse in adolescents
in Kent, County Michigan
Outcomes Intervention Services
• Short term success
measurements
• Percentage of adolescents with
increased awareness of the
impact of substance abuse
• Percentage of adolescents who
report value of early
intervention services
• Percentage of adolescents who
view substance abuse as
harmful at time of completion of
program compared to start of
program
• Long term success
measurements
• Percentage of adolescents who
participated in early intervention
services and are not substance
abusers
• Percentage of adolescents with
a reduction in frequency of
substance abuse with treatment
• Average age of onset of
substance use decreased
Evaluation of current outcomes
• Surveys of students in the 7th, 9th, and 11th grade
from schools across the State of Michigan along with
Kent County’s results for 2009/2010 school year
highlight disparities in several areas:
• Tobacco & marijuana use is more common among
boys;
• Prescription drug & alcohol use is more common
among girls;
• Tobacco use is most common among white and
American Indian students;
• Drug & alcohol use is more common among
African American & Hispanic students;
(Michigan Public Health Institute, 2012)
Recent Kent County Data
• Youth in Kent county is proportionally better than
Michigan in most substance use and abuse risk
factors.
• Youth in Kent County were less likely to have used any
tobacco in the past 30 days than other Michigan youths.
(Michigan Public Health Institute, 2011)
Recent Kent County Data
Kent County Prevention Coalition, 2010
Kent County has lower rates of youth ever using
marijuana. Kent County has lower rates of youth
using marijuana within the past 30 days than
Michigan adolescents overall.
(Michigan Public Health Institute, 2011)
Recent Kent County Data
• Twenty-two percent of Kent County youth report that they rode in a car driven
by a peer who had been drinking alcohol one or more times during the past
30 days. Also, 7.5% of Kent County students reported that they drove a car
when they had been drinking alcohol one or more times during the past 30
days. This data is lower than Michigan averages.
(Michigan Public Health
Institute, 2011)
References
Allen, D. (2009). State of Michigan Annual Report. Midland County
Forty-Second Circuit Court – Family Division.
Probate Court
Buchan, M. (2013, June). Drug Testing in Schools. Journal of National Association of
School Nurses. Retrieved from:
http://www.nasn.org/Policy/Advocacy/PositionPapersand
Reports/NASN/PositionStatementsFullView/tabid/462/ArticleId/568/Drug-Testing-inSchools-Adopted-June-2013.
Coalition for Community Schools. (2013). Community Schools Initiative. Kent School
Services Network. Retrieved from: http://www.communityschools.org/assets.
DrugFacts: High School and Youth Trends (2014) National Institute on Drug Abuse.
Retrieved April 10, 2014 from http://www.drugabuse.gov/publications/drugfacts/highschool-youth-trends.
Health Needs Assessment and Health Profile. (2011). Spectrum Health. Retrieved on
April 11, 2014 from
http://www.spectrumhealth.org/documents/Kent_County_CHNA_Report_no_cover.pdf.
References
Inadequate Social Support. (2014). County Health Rankings and Roadmaps. Retrieved
on April 10, 2014 from
http://www.countyhealthrankings.org/app/michigan/2014/rankings/kent/county/outcome
s/overall/snapshot.
Kent County Prevention Coalition. (2010). Mobilizing change in Kent 2010 report to the
community [Report]. Retrieved from kcpreventioncoalition.org
Kent County Substance Abuse Prevention Plan 2012-2016. ( n.d.) Kent County
prevention coalition. Retrieved on April 10, 2014 from
http://kcpreventioncoalition.org/files/KCPC_strategic_plan_2012_2016.pdf.Community.
Michigan Teen Drug Rehab. (n.d.) Inspirations. Retrieved on April 11, 2014 from
http://www.inspirationsyouth.com/find-state/michigan-teen-drug-alcohol-rehab/.
Michigan Public Health Institute. (2011). 2012 community health improvement plan.
Retrieved from http://www.kentcountychna.org/pdfs/KentCoCHNA_Final.pdf
Michigan Public Health Institute. (2011). 2011 community health needs assessment and
health profile. Retrieved from
http://www.naccho.org/topics/infrastructure/accreditation/upload/Kent-CHA.pdf