1. Substance Abuse on Martha’s Vineyard
Initial Qualitative Survey Results
DCHC Substance Abuse Committee
Analysis: Myra Stark ~
Sponsored by Dukes County Health Council
4/4/2019

2. Why were the interviews conducted?
Provide a snapshot of substance use disorder (SUD) on Martha’s Vineyard
Supply background information for a stakeholder meeting and a process to energize community efforts
To provide insight for quantitative study
4/4/2019

3. Who Was Interviewed? Law enforcement School professionals
Youth services organization
Business
Religious organizations
Civic volunteer groups
Health care workers
Behavioral health workers
State, local, & tribal agencies
Recovery community
Affected family members
4/4/2019

4. Three Conclusions
There is agreement about the severity and the nature of the SUD on MV.
Stakeholders believe that although there are “good people doing good work” to combat SUD, the extent of the problem has overwhelmed the available resources.
There is clear agreement about what needs to be done.
4/4/2019

5. What Is The Nature And Severity Of The SUD Problem On MV?
Stakeholder Assessments
High, crisis, rampant, out of control, epidemic, grave, shocking, unchecked, growing exponentially, deadly
Scale 1 to 10: 11/ x3
Major Problem
Prescription drugs leading to heroin or other dangerous combinations
alcohol and marijuana are widespread and viewed as the norm
4/4/2019

6. Changes That Have Led To The SUD Crisis
Dramatic increase in opiate use and deaths
Increase in overdoses
Overuse of opiate prescriptions
Availability of heroin
Inexpensive and plentiful
Social acceptance of marijuana
Normalization of alcohol use and getting high
4/4/2019

7. Most Harmful Substances
Opioids
Heroin
Alcohol
4/4/2019

8. What Is The Age Group With The Greatest Needs For SUD Services?
The entire age spectrum
18-30 years
School age
Older adults
4/4/2019

9. What Are Perceptions of Existing Resources?
Good things said about
Vineyard house, 12 step programs, YTF, IWYC, New Paths, changes in police approach
Self reported new services at Community Services
4/4/2019

10. How Do You Rate Available Treatment Options?
All but one stakeholder felt the options were poor or unacceptable
“We don’t have resources consistent with the level of the problem”
“Just playing catch up”
“ I see efforts, but not good results”
4/4/2019

11. Specific Treatment Option Perceptions
NO DETOX ON ISLAND!!
“I know the business model doesn’t support an on-island detox, but it (MV) has to have one.”
No residential inpatient treatment
Waiting for counseling or treatment
Expense of treatment
Limited access to medically assisted treatment
Cost, stigma, and family disruption of off-island treatment
4/4/2019

12. What Are The Problems in Existing Resources?
Communication
Fragmentation
Lack of confidentiality
Lack of transparency
“ Our resources don’t work together; we have turf wars.”
4/4/2019

13. What Should Be Done? Opportunities For Action
Seize the Day!
“ There has been a seismic shift happening over the opioid deaths. “
“This epidemic is the hurricane Sandy for Martha’s Vineyard. This is the single biggest effort that the Vineyard has been dealing with in my lifetime.”
“We do not want to waste this opportunity now that the community is stepping up.”
4/4/2019

14. Opportunities (cont’d)
Establish intervention care and continuity of care.
More trained substance abuse counselors.
More licensed medical providers (MDs, NPs)
Work together and include the recovery community!
“We can’t have turf wars. Can’t be like the airport.”
“We need to organize together, not against one another.”
Organizational accountability made clear
4/4/2019

15. Opportunities (cont’d)
Develop a public health approach for SUD, like any other epidemic such as Lyme disease
“If it were TB, we’d attack it as a public health problem.”
Raise public awareness of the issues and potentially effective solutions
Break through denial and normalization of unhealthy alcohol, marijuana, and drug use
4/4/2019