The Public’s Health: Six-tier strategy targets substance abuse

KAREN SULLIVAN for The Montana Standard

Substance abuse is the No. 1 health issue in Butte-Silver Bow, and collaborators in the community are working to develop a plan to address the problem.

Substance abuse in the state as a whole is a reigning health issue, ranking among the top concerns in most Montana communities.

Locally, a substance abuse task force, created last year by Butte-Silver Bow Chief Executive Dave Palmer, is at work to develop local strategies to address substance abuse and substance use disorders. The task force is ably facilitated by local therapist Laura Cross, president of Butte Cares, an organization that focuses on substance abuse prevention.

Statewide, a strategic plan has been developed to address substance use disorders. The plan will define statewide strategies through 2019.

“More than 100 people die every year from drug overdose in Montana, and almost 22,000 hospital or ER visits annually are attributable to alcohol and drug use,” says the introduction to the document, titled “Addressing Substance Use Disorder in Montana.” “The impacts of substance use span every generation and cut across socioeconomic lines, from children in our foster care system to seniors prescribed opioids for chronic pain.”

At the local task force’s first meeting a few months back, Mike Thatcher, chief executive officer of Butte’s Community, Counseling, and Correctional Services, Inc., underscored how substance abuse crosses every spectrum. Thatcher said CCCS officials are contacted weekly by Butte people worried about themselves or a family member and looking for assistance.

The state plan says rural states such as Montana are limited in ability to provide access to “robust, evidence-based systems to prevent, treat and manage” substance use disorders. However, with that reality in mind, the Montana plan — developed after five meetings were held statewide, with 114 people participating and 82 agencies represented — forwarded six areas for targeted strategy. They are partnerships; prevention and education; enforcement; monitoring; treatment; and family and community resources.

At the beginning of the state plan, Montana Gov. Steve Bullock wrote a letter saying that “we are in the midst of a significant public health crisis.” Bullock added, “drug overdose deaths have been on the rise nationally, and although alcohol abuse is more prevalent in Montana, opioid and methamphetamine use are a significant cause for concern as well. Drug overdoses are the third leading cause of injury-related death in Montana, accounting for 1,334 deaths between 2003 and 2014.”

Here’s what is going on in Montana — an estimated 64,000 residents have a substance use disorder; 90 percent of those with these disorders are not receiving treatment. Annually in the state, 390 deaths can be attributed to alcohol, with 34 percent of all traffic fatalities in the state being alcohol-related. Twenty percent of Montana adults report binge drinking in the last year, compared to 16 percent of adults in the United States, and seven percent of Montanans ages 12 and over are dependent on abusing alcohol.

In regard to methamphetamine, Montana has seen a 427 percent increase in meth violations from 2010 through 2015; 46 percent of all open Child and Family Services placements involve meth.

Regarding marijuana, 122,000 Montanans ages 12 and over are estimated to have used in the last year. Of drug violations in the state, 57 percent involve marijuana. Thirteen percent of high school students report using marijuana in the past month, even though 62 percent of youths believe smoking marijuana regularly is harmful.

And illicit drugs — in 2015, 116 heroin arrests were made in the state, up from four 10 years prior. Three percent of Montanans ages 12 and up — 18,000 people — say they are dependent on or abusing illicit drugs. Five percent of adults ages 18 to 25 report using cocaine in the past year.

“This challenge strains our families, our hospitals and healthcare providers, our health and our public safety,” Bullock wrote in his letter, adding that the plan “focuses not only on preventing deaths, but finding treatment and support for those struggling with substance use disorders so that our communities may heal.”

Please watch for future columns that will illustrate the contents of the state plan, and strategies being developed by the local task force.

I’m with Bullock — this is a straining challenge. But I very much look forward to working with local task force members to develop partnerships and prevention and education strategies, to beef up enforcement measures, to build monitoring strategies, to facilitate best-in-class treatment options, and to further develop family and community resources. It will take a village.

Karen Sullivan is Butte-Silver Bow Health Officer and Director of the Health Department. Her column, The Public’s Health, appears weekly on The Montana Standard’s health page.

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