Nevada County
2010 Drug and Alcohol Data Report
Sponsored by:
Coalition for a Drug Free Nevada County
Nevada County Health and Human Services
Agency
Community Recovery Resources
Submitted by Ariel King Lovett and Pamela Geisler, Evaluation Consultants
Revised 4/11/2011
1
Table of Contents
1.
Executive Summary................................................................................................. 3
2.
Introduction…. ......................................................................................................... 5
2.1 Objectives of the Report ................................................................................ 5
2.2 How the Report is Organized ........................................................................ 6
2.3 Data sources ..................................................................................................... 6
3.
Drug and Alcohol Trends and Prevalence Data and Analysis ..................... 7
3.1 Youth Use ....................................................................................................... 7
3.2 Adult Use ........................................................................................................ 13
4.
Current Substance Abuse Prevention and Treatment Strategies .............. 21
4.1 Prevention Strategies .................................................................................... 21
4.2 Treatment Strategies...................................................................................... 24
5.
Conclusions and Recommendations ................................................................ 28
5.
Citations...... .............................................................................................................. 30
Special thanks to the following organizations for providing information and support to
make this report possible:
Grass Valley Police Department
Nevada County Courts
Nevada County Department of Information and General Services
Nevada County Sheriff’s Department
Nevada County Superintendent of Schools
Sierra Nevada Memorial Hospital
2
1. Executive Summary
Headlines were made in mid-September 2010 when the Substance Abuse and Mental Health
Administration (SAMHSA) released the 2009 National Survey on Drug Use and Health (NSDUH)
showing that the use of illicit drugs among Americans had increased. According to this survey, the
overall rate of current illicit drug use in the United States rose from 8.0 percent of the population
aged 12 and older in 2008 to 8.7 percent in 2009. This rise in overall drug use was driven in large
part by increases in marijuana use, non-medical use of prescription drugs, and increased
methamphetamine use. (http://www.samhsa.gov/newsroom/advisories/1009152021.aspx)) However,
while the nation struggles with increased methamphetamine use, this reports shows that at the same
time Nevada County reduced overall methamphetamine use, demonstrated by multiple indicators.
This represents an incredible result of a targeted community focus to combat the meth problem
over the last five years. This community has demonstrated that focused cross-sector community
engagement works; that coordinated prevention and treatment efforts can impact a large-scale public
health and safety problem.
However, drug and alcohol abuse remains a persistent and major problem in this rural county. Data
shows the California substate Region 21 in which Nevada County is located as having the third
highest rate of illicit drug use in the past month in the State2. Further, our region demonstrates the
highest average in the State for those needing but not receiving treatment for alcohol and illicit drug
use (Office of Applied Studies, SAMHSA). This data is underscored by evidence suggesting that
substance abuse is a prevalent and persistent concern for local community members. According to
the 2010 12th Annual Grass Valley Police Department Citizen Attitude Survey, “our community still
considers drug abuse to be our most serious problem, followed by alcohol abuse”.
Multiple stakeholders brought together by the Coalition for a Drug Free Nevada County, including
local healthcare providers, schools, treatment providers, and the criminal justice entities, combined
efforts to develop this report. Partners collected and aggregated local data and standardized data to
create an overall picture of substance abuse in Nevada County. The report focuses on two
subgroups (adults and youth) and four primary substances of abuse: alcohol, marijuana,
methamphetamine, and opiates. These four make up 97% of all treatment admission in Nevada
County. A trajectory of local alcohol and other drug (AOD) trends over time and as compared with
State and National statistics is shown to the extent possible.
The picture that emerges, over the past decade, shows that high rates of alcohol use have stayed
fairly “flat”; methamphetamine use has increased and then decreased dramatically; marijuana use
indicators have increased incrementally, while prescription drug indicators have increased
exponentially. In terms of arrests, alcohol-related crimes dwarf all other substances.
A wide range of prevention and treatment services are available and some strategies have proven
effective at reducing the impact of substance abuse on the community. Gaps also exist, and
burgeoning waiting lists for treatment services and funding limitations threaten even successful
1
2
El Dorado, Napa, Nevada, Placer, Sacramento, Sierra, Solano, Sonoma, Sutter, Yolo, Yuba
Also notable is that our region is among the top 15 of regions needing and not receiving treatment nationwide.
3
programs. While some excellent services are available, it is a fragile structure, with much to be done
to create a service system with the capacity to meet the needs of this community. At the same time,
overwhelming evidence demonstrates that substance abuse treatment is cost-effective and reduces
violent crime. Based on what has worked, and where gaps exist, this report concludes that Nevada
County should focus on five principle strategies to reduce substance abuse and its impacts: 1)
Enhance Collaboration among Sectors; 2) Foster Community Engagement; 3) Support treatment
services, and focus on proactive, early treatment 4) Sustain programming related to alcohol and
prescription drug use prevention 5) Effect systemic and environmental changes (community changes
in norms and policies).
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2. Introduction
2.1
Objectives of the Report
The primary objective of this report is to provide an overall perspective of substance abuse in
Nevada County for service providers, community stakeholders, and policymakers. To do this,
indicators have been drawn from multiple sources as available, aggregated, and analyzed to provide a
trend or brief analysis.
Alcohol and other drug (AOD) problems have many causes and manifestations. AOD use creates or
exacerbates multiple health, safety, and social problems. The labor and costs of taxpayer supported
systems are driven or complicated by AOD use –schools (in which student readiness to learn or
school climate is compromised), law, justice and correctional system operations, foster care
placements, community and personal health problems, domestic violence, and mental health care.
The foundation for meaningful action to address any public health problem is information.
However, alcohol and other drug abuse and dependence are not directly observable and are difficult
to quantify. Stigma, denial, illegality, and lack of established data collection systems can conceal
AOD use and dependence. The use of AOD creates ripples throughout society. As the County
Alcohol and Drug Program Administrators Association of California (CAADPAC) writes “Not
every alcoholic is arrested for DUI. Not every heroin addict overdoses. Until an individual shows up
on the ‘radar screen’ of law enforcement, the health system, a treatment program, or in some other
institutional setting, they are statistically invisible even though they have long made their impact felt
in other ways.” For example, the Nevada County Child Protective Services Program Manager
reports that at least 85% (“low estimate”) of current cases are related to substance abuse. (Email
communication, October 2010).
This report provides a snapshot of recent Nevada County AOD trends and indicators. Despite data
limitations of varied indicators, the report provides context and comparison over time or
comparison to state or national data. Utilizing over a dozen data sources, evaluators and Coalition
for a Drug Free Nevada County members have identified trends, both positive and challenging, as
well as current strategies, promising practices, and next steps in prevention and treatment.
5
2.2
How the Report is Organized
This report contains six sections:
1. Executive Summary.
2. Introduction includes objectives, organization, and primary data sources of the report.
3. Drug and Alcohol Trends and Prevalence Data and Analysis highlights key indicators in local
substance use patterns and prevalence separately for adults and youth specific to four primary
substances: alcohol, marijuana, methamphetamine, and opiates. These were chosen due to their
prevalence and risk, and presented separately to allow for the demonstration of varied trends and
patterns of use. Data for each substance is condensed in charts to show status of various AOD
problems, followed by a brief analysis of salient trends or relevant related data.
4. Current Substance Abuse Prevention and Treatment Strategies provides a summary of
current programs, services and providers in Nevada County as well as service gaps or deficits.
5. Conclusions and Recommendations.
6. Citations.
2.3
Data sources
Data was collected from standardized sources as well as local sources as follows:
1) Standardized Data Sources:
 California Department of Justice
 California Department of Public Health
 California Department of Education
 National Institute on Drug Abuse (NIDA): Indicators of Substance Abuse
Consequences (ISAC)
 California Healthy Kids Surveys
 National Survey on Drug Use and Health, Substance Abuse and Mental Health
Administration
2) Local partner data
 Local Sheriff and Police Departments
 Sierra Nevada Memorial Hospital Emergency Room Admission Data
 Local service providers (Community Recovery Resources) admission and testing data
 Nevada County Sheriff’s Department Coroner
 Nevada County Behavioral Health, CalOMS Data
6
3. Drug and Alcohol Trends and Prevalence Data and Analysis
3.1 Data, Trends and Analysis of Youth Substance Use
Summary and Scope of Problem: Research shows that the earlier a person starts using AOD, the more
likely they are to develop serious problems as an adult. Nevada County parents and youth perceive
an urgency to address alcohol and other drug use. In the California School Climate Survey, 95% of
school teachers and other school personnel in Nevada Joint Union High School district see
substance abuse as a problem. As a matter of fact, 67% see it as moderate to severe, more than any
other problems (e.g. bullying, disruptive student behavior, or truancy etc.). AOD prevention was the
primary need indicated by both students and parents in 1046 surveys collected during preparation
for the 2009 Safe School/Healthy Students proposal, and data supports this: 42% of youth have
used marijuana by 11th grade, and overall, 64% of all youth have consumed alcohol or drugs (2007
California Health Kids Survey, CHKS). Nevada County currently ranks 7th in the State for the highest
rate of juvenile drug arrests (Socioeconomic Mapping and Resource Topography System 2007) an
improvement from third in the last measured period (2006). We know that escalation of substance
use occurs at certain points. For example, with regard to marijuana use in the past 30 days among
kids in Western Nevada County, 0% of 5th graders, 6% of 7th graders, and 22% of 9th graders have
used, while 42% of 11th graders have used (CHKS). Not only does prevalence of use increase with
age but it increases at a disproportionately high rate compared to regional and state averages for the
same indicators. In general, Nevada County has lower averages for 5th graders; is on par with or
below state averages in 7th and 9th grades, and by high school grades may exceed regional and state
averages. For example, in the 2005/2006 CHKS, 37 percent of 11th grade respondents in Nevada
County reported being high from using drugs at least once. This is one of the highest rates reported
in the Nine County Region. In the same survey, 39% of 11th graders responded that had been
offered drugs on school campuses, slightly higher than the state average. This may demonstrate an
opportunity for targeted interventions at specific points in time.
While there is widespread concern regarding youth substance use, this perception is somewhat
juxtaposed by the fact that 30-40% of youth believe that alcohol and marijuana are harmless (NC
Drug Free Coalition 2005). Generational use and abuse within families may contribute to youth AOD
use/abuse; according to Community Recovery Resources (CoRR), 80% of the youth enrolled in
their programs report a family history of substance abuse, and 36% of youth report they obtain
alcohol in their homes, while 29% report obtaining marijuana at home (2005). A combination of
data from a variety of sources demonstrates that early and frequent alcohol and other drug use is
very real and problematic in Nevada County.
Figure 1. Juvenile Misdemeanor Arrests Reported Nevada County 2003-2008
2003
2004
2005
2006
2007
Marijuana
133
111
134
94
56
Other Drugs
21
22
18
11
17
Drunk and Liquor laws
58
58
66
40
60
Driving Under Influence
6
13
3
5
7
TOTAL
220
204
213
176
120
2008
53
7
30
3
93
(Source: http://stats.doj.ca.gov/cjsc_stats/prof09/29/4C.htm
7
Narcotics
Marijuana
Dangerous Drugs*
TOTAL
Figure 2. Juvenile Felon Arrests Reported
Nevada County 2003-2008
2003
2004
2005
2006
2007
2
0
8
7
5
8
6
8
5
7
9
1
12
4
4
19
7
28
16
16
2008
3
4
3
10
(Source: http://stats.doj.ca.gov/cjsc_stats/prof08/29/3C.htm)
* Dangerous drugs include stimulants, depressants, hallucinogens, illegally diverted pharmaceuticals, inhalants, and anabolic
steroids.
Juvenile felony arrests peak in 2005 and then decrease.
2004-2005
2005-2006
2006-2007
2007-2008
2008-2009
Figure 3. High School Suspensions and Expulsions
Nevada County (all 11 districts), 2004-2009
Percent
Percent
Suspensions Expulsions
Enrollment
Expelled
Suspended
556
28
11,899
0.24%
4.67%
652
18
12,531
0.14%
5.20%
617
31
14,555
0.21%
4.24%
630
32
13,649
0.23%
4.62%
686
33
14,099
0.23%
4.87%
(Source: California Department of Education Safe & Healthy Kids Program Office, 2004-2009)
The above chart shows fairly consistent trends in drug/violence related disciplinary actions
at schools in Nevada County.
2007
2008
2009
Figure 4. Emergency Room Data
Sierra Nevada Memorial Hospital, Youth 17 and Under
MethamPrescription/
Alcohol
Marijuana
phetamine
Opiate/Other
37
8
2
13
31
24
0
10
45
21
3
4
Total
60
65
73
(Source: Emergency Room Data, Sierra Nevada Memorial Hospital 2007-2009)
While causes of admissions vary year to year, this chart demonstrates a continual increase of
13 admissions—a 22% increase from the first to most recent year.
Youth Alcohol Use
Data, Trends, and Analysis
Data from all sources indicates that alcohol use by minors continues to be a serious problem for
Nevada County. Parents and other adults perceive alcohol use to be a problem; data from state
surveys, law enforcement, educational entities, hospital admissions, and local community-based
organizations corroborate this perception. With respect to youth and alcohol, we can look at data
sets for both acquisition and use.
8
California Healthy Kids Survey (CHKS) data demonstrates trends over the past few years. On
average the onset of drinking age parallels the state average.
Acquisition of alcohol by youth in Nevada County is easy. In a Youth Development Survey
administered to all participants in Friday Night Live, FNL Mentoring, and Club Live programs in
the County, respondents affirmed CHKS findings, reporting that it is easy for youth to get alcohol,
tobacco, and other drugs in their community. Between 25%-44% of middle school participants and
between 52%-93% of high school participants responded that it was easy. (STOP Baseline Data Report,
Oct. 2010) Limited data from key informant interviews and surveys conducted in Grass Valley in
2010 as part of the STOP Act grant evaluation captures local youth and adult perceptions around
youth alcohol use and acquisition. An important finding from the survey is that parents are less likely
than others to think that youth are obtaining alcohol from homes. Perhaps the most important
finding from this survey is that young females and young males (those under age 25 years) have very
different answers to the question of how youth obtain alcohol. A much higher percentage of young
females think that youth who drink get alcohol at parties—two-thirds of young women compared to
one-fifth of young men. Strangers are the number one source for alcohol according to young men
in this sample, by far.
Other data indicate that youth drinking is a problem. In 2008, the most recent year for which
statistics are shown on the California Department of Justice website, 414 youth were arrested for
being “Drunk,” and 755 youth were arrested for driving under the influence. Over the past three
years, there has been an annual average admission rate of 38 youth ages 17 and younger to Sierra
Nevada Memorial Hospital Emergency Room for alcohol-related problems such as poisoning and
overdosing. CHKS data indicates that the frequency of alcohol use is also of concern. In the 2009
survey for Nevada Joint Union High School District (NJUHSD), past 30 day use was reported at
24% for 9th graders and 38% for 11th graders. Reporting of past 30 day use by NJUHSD students
has increased in recent years as the chart below demonstrates.
Figure 5. Reported Alcohol Use
Nevada Joint Union High School District, 2005-2009
(Source: California Healthy Kids Survey Data 2005-2009)
Above: Past 30 day use by NJUHSD 9th and 11th grade students has increased in recent years.
Figure 6. Reported Alcohol Use
Tahoe Truckee Unified School District, 2006-2008
9
Percent
60%
49%
35%
40%
45%
31%
20%
0%
2006
2008
% of 9th Grade
Students Who Used
Alcohol during the
Past 30 Days
% of 11th Grade
Students Who Used
Alcohol during the
Past 30 Days
Year
(Source: California Healthy Kids Survey Data)
Above: Student-reported rates of past 30 day use at Tahoe Truckee Unified show downward
usage trends, but higher rates of use overall than NU.
Figure 7. Drinking and Driving or Riding with a Driver Who Had Been Drinking, by Grade
Level, Gender, and Number of Times
Nevada County, 2006-2008
Female
Nevada
County
7th
Grade
9th
Grade
11th
Grade
NonTraditio
nal
Male
1 or
more
Times
1
Time
2
Times
3-6
Times
7
Times
or
More
1 or
more
Times
1 Time
2
Times
3-6
Times
7
Times
or
More
44.6%
19.1%
9.8%
6.7%
9.0%
44.8%
17.0%
7.3%
7.8%
12.7%
23.6%
7.8%
5.4%
5.1%
5.4%
18.2%
6.1%
4.0%
3.0%
5.8%
26.7%
11.3%
5.8%
6.4%
3.1%
25.3%
6.8%
4.9%
5.9%
7.7%
46.4%
1.8%
14.3%
17.9%
12.5%
63.1%
7.7%
9.2%
21.5%
(Source: http://www.kidsdata.org)
The above table indicates that nearly half of high school students have ridden with a driver
who has been drinking, or have driven drunk themselves.
Youth Marijuana Use
Data, Trends, and Analysis
Data regarding youth marijuana use reveals interesting trends that are similar for both girls and boys.
The onset of use is on par or slightly less than state averages (with available comparative data
beginning with 7th grade youth.) By the time youth enter high school, Nevada County youth are
using marijuana at approximately the same rate as their peers statewide. However, as Nevada
County youth progress in high school, they begin to use marijuana at rates greater than the average
of their peers statewide.
10
Percent
Figure 8. Reported Marijuana Use Nevada County Females, 2006-2008
25%
20%
15%
10%
5%
0%
CA, Female
NC, Female
7th Grade
9th Grade
11th Grade
Grade Level
(Source: http://www.kidsdata.org/data/topic/table/marijuana-use-gender.aspx?f=1&loc=2,334&ch=a,a,626)
Above: Marijuana use in NC girls demonstrates significant increases between grades 7-11;
equal to and then exceeding State rates.
30%
20%
t
Percent
Figure 9. Reported Marijuana Use
Nevada County Males, 2006-2008
CA, Male
NC, Male
10%
0%
7th Grade
9th Grade
11th Grade
Grade Level
(Source: http://www.kidsdata.org/data/topic/table/marijuana-use-gender.aspx?f=1&loc=2,334&ch=a,a,626)
Above: Marijuana use in NC boys demonstrates significant increases between grades 7-11;
first below, and then exceeding State rates.
This data is concerning for two primary reasons: 1) marijuana use may continue to increase as youth
become adults; and 2) marijuana may be a “gateway” drug that leads to use of other drugs, increasing
the chances of these youth using other drugs as they transition out of high school and into
adulthood. Nevada County’s high adult “other” drug use rates indicate that this may be true. This
data also suggests that high school may be the most opportune time to implement drug-focused
prevention and intervention programs.
Other data substantiates problems with youth marijuana-related use. From 2007-2009, there was
annual average of 18 Emergency Room admissions of youth ages 17 from marijuana at Sierra
Nevada Memorial Hospital. In 2008, the most recent year for which statistics are shown on the
California Department of Justice website, 135 youth were arrested for marijuana with misdemeanor
charges and four youth were arrested with a felony charge.
11
Youth Methamphetamine Use
Data, Trends, and Analysis
In April 2005, the Nevada County Grand Jury proclaimed that the manufacture and use of
methamphetamine had risen to epidemic proportions. Emergency Room hospital data indicates that
methamphetamine use is a serious problem for the adult population, although some youth use it as
well. Research clearly demonstrates that adult methamphetamine use can be mitigated or prevented
by intervening in the lives of youth who are using other less serious substance in their adolescence.
There is no statistically significant data specific to youth methamphetamine use.
Youth Prescription/Opiates Use
Data, Trends, and Analysis
Use of prescription opiates among youth is a primary concern among treatment providers locally
and nationally. More teens abuse prescription drugs than any illicit drug except marijuana — more
than cocaine, heroin, and methamphetamine combined, according to the 2006 National Survey on
Drug Use and Health (NSDUH). Nationally, more than 2.1 million teens ages 12 to 17 reported
abusing prescription drugs in 2006. Among 12- and 13-year-olds, prescription drugs are their drug of
choice (NSDUH, 2007). Prescription painkillers like Vicodin and OxyContin are the most often
abused prescription drugs (NSDUH, 2007). The most recent Monitoring the Future Survey (MTF)
found that past-year abuse of Vicodin is particularly high among 8th, 10th, and 12th graders, with
nearly one in 10 high school seniors reporting taking it in the past year without a doctor’s approval
(MTF, 2007). And the trend is growing; over a five year period (2002-2007), past year use of
OxyContin increased by 30 percent (MTF, 2007). Locally, treatment providers report increasing
admissions of youth using opiates, specifically prescription drugs and painkillers. Further, providers
are concerned about the progression of prescription opiate abuse leading to heroin use, a trend that
has been documented nationally. Heroin use involves needle use, increasing the risk of spreading
diseases such as Hepatitis and HIV.
Figure 10. Percent of 9th graders who have used/tried prescription pain killers not
prescribed to them 4 or more times)
1
2
Percent
1
0
8
6
4
2
0
NJUHSD 9th
Graders
NJUHSD 11th
2007-08
Graders
TTUSD 9th
2009-10
Graders
TTUSD 11th
Graders
(Source: California Healthy Kids Survey Data)
Percentage of students reporting misuse of painkillers increased slightly for 9th graders; and
in Truckee, more 9th graders than 11th graders had misused prescription painkillers.
12
3.2 Data, Trends and Analysis of Adult Substance Use
Summary and Scope of Problem: The SAMHSA Office of Applied Studies National Survey on Drug Use
and Health (NSDUH) data show California’s sub-state region 2, which includes Nevada County, as
having the third highest rate of illicit drug use in the past month in the State. Further, our region
demonstrates the highest average in the State for those needing but not receiving treatment for
alcohol and illicit drug use (Office of Applied Studies, SAMHSA).
Figure 11. Nevada County, Placer County, CA Comparison of AOD Hospitalization Rates
(County 1 is Nevada County (circles), County 2 is Placer County (squares) and All Counties is all counties in
California (diamonds)) (Source: http://aodindicators.org/index.php)
Nevada County hospitalization rates due to alcohol or other drugs are higher than
neighboring Placer County, and more similar to State rates.
Compare County/State
Hospitalizations
2003
2004
2005
2006
2007
Placer
352
360
384
378
426
Population
290,871
303,522
312,241
320,851
327,388
Rate per 100,000
121.02
118.61
122.98
117.81
130.12
Nevada
181
182
207
189
217
Population
97,151
98,994
99,303
99,434
100,219
Rate per 100,000
186.31
183.85
208.45
190.08
216.53
Hospitalizations California Total
77,521
77,424
75,579
75,136
77,679
Population California Total (10-69)
35,989,853 36,505,465 36,957,436 37,380,870 37,810,582
Rate per 100,000
215.4
212.09
204.5
201
205.44
(Source: http://aodindicators.org/index.php)
13
Adult Alcohol
Data, Trends and Analysis
Nevada County residents reported the second highest rate of binge drinking in the region at 17.6
percent. In comparison, the regional binge drinking rate was 14.7 percent. (2003 California Health
Interview Survey) Arrests (and bookings) for Driving Under the Influence (DUI) have remained fairly
steady over the last ten years, following data from local law enforcement arrests and bookings as
well as California State Department of Justice felony and misdemeanor data. Arrests are consistent
between 1200 and 1400 between 2002 and 2009. (See fig. 12 below) Drunk in public arrests show a
similar pattern; a fairly consistent trend of between 500-600 arrests per year for the past 8 years.
Figure 14, shown below, shows Nevada County to have a much higher rate of alcohol involved
motor vehicle accidents than Placer County or the State as a whole. Alcohol-related offenses are a
persistent and consistent challenge, with indicators demonstrating ongoing abuse of this substance
in Nevada County similar to national averages.
Figure 12. Number of Arrests for Driving Under the Influence
Nevada County, 2001-2009
1,400
1,200
1,000
800
Arrests
Number of Arrests
1,600
600
400
200
-
2001 200 2003 2004 2005 2006 2007 2008 2009
Year
(Source: Nevada County Sheriff’s data, 2001-2009)
Arrests (and bookings) for Driving Under the Influence (DUI) have remained fairly steady
over the last ten years.
14
Figure 13. Nevada County, Placer County, California Comparison of Alcohol Involved Motor
Vehicle Accidents
(County 1 is Nevada County (circles), County 2 is Placer County (squares) and All Counties is all counties in
California (diamonds) (Source: http://aodindicators.org/index.php)
Nevada County has a much higher rate of alcohol involved motor vehicle accidents than
Placer County or the State as a whole
County/State
Nevada
Population
Rate per 100,000
Placer
Population
Rate per 100,000
California
Population Total
Rate per 100,000
2004
2005
2006
2007
2008
198
203
154
189
178
98,994
99,303
99,434
100,219
101,012
200.01
204.42
154.88
188.59
176.22
442
421
417
399
384
303,522
312,241
320,851
327,388
333,998
145.62
134.83
129.97
121.87
114.97
50,492
50,862
52,769
53,083
50,143
36,505,465 36,957,436 37,380,870 37,810,582 38,246,598
138.31
137.62
141.17
140.39
131.1
(Source: http://aodindicators.org/index.php)
15
Adult Marijuana Use -Data, Trends, and Analysis
National Survey on Drug Use and Health data show our region has the highest rate of marijuana use
in 2009 in California, and correspondingly, one of the lowest perceptions of risk. Data representing
the number of arrests for marijuana possession in NC shows a steady increase over time.
Figure 14. Number of Arrests for Possession Marijuana
Nevada County, 2001-2009
80
70
# of Arrests
60
50
40
30
20
10
-
2001
2002
2003
2004
2005
Year
2006
2007
2008
2009
(Source: Nevada County Sheriff’s booking data, 2001-2009)
Number of arrests for marijuana possession in Nevada County shows a steady increase over
time and a threefold increase over the past decade.
Adult Methamphetamine Use- Data, Trends, and Analysis
Data representing number of arrests for possession of methamphetamine looks similar to a bell
curve over the last decade, with slightly higher rates of arrest currently than there were ten years ago.
There were nearly 150 arrests in 2000, which then nearly tripled in the following 5 years to peak of
nearly 400 arrests in 2005. The trend then reversed, with about 190 arrests in 2009.
Figure 15. Number of Arrests for Possession Methamphetamines
Nevada County, 2001-2009
# of Arrests
500
400
300
200
100
2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
(Source: Nevada County Sheriff’s booking data, 2001-2009)
Indicators around methamphetamine in NC in the last decade are interesting,
because all indicators demonstrate a rise, a peak, and a subsequent decline .
16
This trend of declining prevalence occurs despite data showing that methamphetamine availability
and production has increased in California and nationally. (USDOJ, National Drug Threat Assessment
2010). An interesting corollary is that in 2005 the Nevada County Board of Supervisors released a
Grand Jury study on the deleterious effects of the methamphetamine “epidemic” on this county
(What You Don’t Know Can Hurt You, 2005) and in 2006, the Coalition for a Drug Free Nevada
County became funded by a SAMHSA Drug Free Communities grant to focus on
methamphetamine abuse. This decline is consistent with California State statistics that show a
decline in treatment admissions for methamphetamine (ADP FactSheet, Methamphetamine Uses in
Treatment). Given the fact that methamphetamine production has not decreased nationwide, it may
be reasonable to correlate declining methamphetamine problem in Nevada County and California
with focused efforts of law enforcement, education, prevention and treatment strategies employed
over the last five years.
Adult Prescription, Opiates, and Other Drug Use
Data, Trends, and Analysis
Arrests rates of persons possessing a controlled substance (e.g. cocaine, cocaine base, heroin, and
prescription drugs such as codeine or hydrocodone without lawful prescription) have increased
dramatically since the turn of the century. Although patterns are somewhat erratic, there is a clear
upward trend with an approximate sevenfold increase over the past decade. Similarly, possessing or
purchasing a controlled substance for sale increased over the same period.
Figure 16. Number of Arrests for Possession of a Controlled Substance
Nevada County, 2001-2009
# of Arrests
250
200
150
100
50
-
2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
(Source: Nevada County Sheriff’s data, 2001-2009)
Above: Although patterns are somewhat erratic, there is a clear upward trend of
arrests for possession of a controlled substance with an approximate sevenfold increase over
the past decade.
17
Figure 17. Arrest by Possession Type Nevada County, 2001-2009
1,600
1,400
Controlled Substances
1,200
Marijuana Possession
DUI
Drunk in Public
800
Arrests
Number of Arrests
Meth Possession
1,000
600
400
200
-
2001
2002
2003
2004
2005
2006
2007
2008
2009
Year
(Source: Nevada County Sheriff’s Data, 2001-2009)
Alcohol related arrest rates (DUI and Drunk in Public) are over 10 times higher than
rates for the 2nd most prevalent offense: methamphetamine possession.
Figure 18. Nevada County, Placer County, California Comparison of AOD Arrest Rates
Compare County/State
Arrests
2004
2005
2006
2007
2008
Nevada
1,933
1,947
1,886
1,746
1,753
Population (10-69)
78,405
78,140
78,495
79,332
79,972
Rate per 100,000
2,465.40
2,491.68
2,402.70
2,200.88
2,192.02
Placer
4,786
5,355
5,950
6,175
5,986
Population (10-69)
236,322
239,237
246,285
251,622
256,741
Rate per 100,000
2,025.20
2,238.37
2,415.90
2,454.08
2,331.53
California
599,185
608,722
631,547
637,556
632,171
Population Total (10-69)
28,395,122 28,775,905 29,183,297 29,558,540 29,910,167
Rate per 100,000
2,110.17
2,115.39
2,164.07
2,156.93
2,113.57
(Source: http://aodindicators.org/index.php)
18
Figure 18. County/State Comparison of Alcohol/Drug Arrests Rates per 100,00
(County 1 is Nevada County (circles), County 2 is Placer County (squares) and All Counties is all counties in
California (diamonds)
(Source: http://aodindicators.org/index.php)
Drug and alcohol arrest rates have dropped in Nevada County, but remain higher than the
state.
Year
2002
2003
2004
2005
2006
2007
2008
2009
Figure 19. Drug Induced Deaths
Nevada County, 2002-2009
Suicide
Undetermined
Accidental
Total
1
0
6
7
0
4
6
10
1
3
5
9
0
1
6
7
1
3
8
12
4
5
13
22
2
1
7
10
4
2
4
10
(Source: Nevada County Sheriff’s Department Coroner Report)
Drug induced death rates in Nevada County are higher than state averages, but have
improved from local peaks in 2006 and 2007. (CA Department of Public Health 2007, 2010).
19
The following table demonstrates an increase in overall treatment admissions for the past five years.
The County’s population has increased by approximately 6% (U.S. Census Bureau) while treatment
admissions have increased by 75% (CalOmsTx data, below).
Figure 20. Treatment Admissions, All Ages
Nevada County, Fiscal Years 2005-2006 through 2009-2010
Year
Male
Female
Total
2005-2006
199
189
388
2006-2007
379
245
624
2007-2008
320
316
636
2008-2009
398
317
715
2009-2010
351
326
679
(Source: CalOmsTx Data, December 2010 extraction. CalOMS Treatment (CalOMS Tx) is California’s data collection and
reporting system for alcohol and other drug treatment services.)
Countywide treatment admissions have increased by 75% between 2005 and 2010.
Although overall adult felony arrests in Nevada County have decreased in years 2000-2008 by nearly
one-third, drug-related felonies have increased from 161 to 205. Drug-related arrests compose onethird of all felony arrests. Similar patterns exist for misdemeanors, with men’s rates slightly down,
women’s up, and misdemeanor arrests for other drugs up by 130% (62 to 152) (Office of the Attorney
General http://stats.doj.ca.gov/cjsc_stats/prof08/29/3B.htm).
The following table summarizes treatment admissions for all ages in Nevada County for the four
primary substance categories this report focuses on, which comprise 97% of all admissions.
Figure 21. Treatment Admissions by Four Major Categories, All Ages
Nevada County, Fiscal Years 2005-2006 through 2009-2010
% of total
Year
Methamphetamine Opiates* Marijuana Alcohol admissions
2005-2006
241
15
29
92
97%
2006-2007
295
61
81
168
97%
2007-2008
261
93
67
184
95%
2008-2009
242
124
111
217
97%
2009-2010
189
144
115
206
96%
* Opiates = heroin, oxycodone/oxycontin, other opiates or synthetics
(Source: CalOmsTx Data, December 2010 extraction.)
The data demonstrates in increase overall in total admissions in each category except
methamphetamine. Increase in admissions for opiates is exponential, with an over 700%
increase in the 5-year period.
20
4.
Current Strategies to Address Substance Abuse
4.1
Strategy: PREVENTION
Research on adolescent brain development shows the value of focusing prevention on young people:
those who reach the age of 21 without developing an addiction are very unlikely to do so afterward. (2010
National Drug Control Strategy.) Recently (2009), an intensive community assessment involving numerous
stakeholders from diverse public and private sectors identified high levels of alcohol, tobacco and drug
use/abuse as the most pressing problem facing Nevada County schools and youth. (SS/HS needs
assessments prior to proposal writing and program implementation.) During this process, student problem
behaviors and community risk and protective factors were identified. The following is a succinct
summary of student, parent, and school personnel input:
Figure 22. AOD-related Problem Behaviors, Risk Factor, and Protective Factors
Nevada County
Student Problem Behaviors
Community Risk Factors
Protective Factors
 ATOD use/abuse, overdoses
 Truancy
 Selling drugs on campus
 Using drugs on campus/
attending school on a substance
 Campus drug use by some
harmful to other students
 Insufficient ATOD progs.
 Establishment of
supporting entire family
Coalition for a Drug-Free
 Insufficient ATOD curricula NC in 2006
 Lack of affordable, accessible  Recent growth/funding of
mentoring programs
activities
 Some evening/ after Easy access to ATOD
school activities for youth
ATOD abuse/use by parents
(Source: Development of SS/HS Proposal)
Implementation of many of these key prevention strategies began in 2007. Since then, other
important steps have been taken. In 2009, on behalf of the Coalition for a Drug-Free Nevada
County (CDFNC), Community Recovery Resources (CoRR) received a grant from the Substance
Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, for a
Sober Truth on Preventing Underage Drinking Act (STOP Act) project. Later in 2009,
collaboration between Nevada County Superintendent of Schools and Nevada County Health and
Human Services Agency, Nevada County Probation, and multiple non-profit partners secured a
federal Safe Schools/Healthy Students grant. These funding sources support components of most
of Nevada County’s current prevention initiatives. Below is a summary of current local prevention
strategies.
a) 40 Assets Trainings
The 40 Developmental Assets is a framework for helping parents and others build assets in all
children, infant through teen. Over the last 4 years, nearly 25 volunteers have been trained to
present 40 Asset Workshops for community members. Currently, a 40 Asset Committee is in the
process of developing a training video in cooperation with Sierra Mentoring Partnership to present
40 Asset workshops in the Family Resource Centers.
b) Drug Free Workplace Policies (DFW)
Multiple local businesses have instituted drug-free workplace policies. Activities implemented
through various partner efforts facilitate peer-to-peer discussion of the positive effects of a drug-free
workplace and policy implementation. Workshops were held on drug-free workplaces (DFW)
through a collaborative effort of Coalition for a Drug Free Nevada County and CoRR, with partners
21
including the Chamber of Commerce, Nevada County Contractors Association, and the Economic
Resource Council (ERC). CoRR offered free DFW trainings to local businesses on DFW policies
and benefits to employer and employee, also providing DFW resource and training manual. The
Coalition is invigorating this campaign in 2011.
c) Safe Schools/Healthy Students (SS/HS) School-based prevention activities
SS/HS is a comprehensive initiative funded for four years to promote safe, healthy, drug-free
schools. Prevention strategies include increasing access to resources, including parenting classes and
mental health services, through school-based Family Resource Centers. SS/HS implements
evidenced-based prevention initiatives at each grade level K-12. These include delivering the
following AOD prevention curricula: Second Step, Steps to Respect, and Project Alert as well as
after-school and summer programs delivering AOD curriculum and enrichments.
d) Friday Night Live
Nevada County Friday Night Live Partnership, ATOD (Alcohol Tobacco and Other Drugs)
Prevention and Youth Development programs currently serve about 200 middle school and high
school aged youth, and provide 13 school and community based chapters. Initiatives include:
 Peer to Peer Mentoring programs
 Social Host Ordinance Campaign (SHO), to reduce alcohol-related problem associated with
social access to alcohol; Develop and implement social marketing campaign, known as
"Adults Committed to Youth".
 Tobacco Retail License Ordinance for the Town of Truckee
 Smoke-Free Movies, pushing for legislation at the state level to regulate PG and PG-13
movies. TEEN Health education and awareness projects (Peer Advocates).
e) The New Generation (NEO)
The name "NEO" came from the prefix defined as "new". What it means is "a new choice", or "a
new way of thinking" around living a drug free lifestyle. NEO, the youth-sector of CDFNC,
provides youth with the opportunity to take on leadership roles, support local young bands and
artists, and implement strategies to positively change the youth perceptions of AOD use.
Accomplishments in recent years include:
 forming two active clubs at Nevada Union High School
 implementing multiple well-attended ongoing activities, including BMX bicycle events;
performance; dances, etc.
 providing music (bands) at Thursday Night Market for youth
 creating the Big Buddy program at Lyman Gilmore
 collaborating with the Nevada County Fair Board and Law enforcement to discourage
youth-binge drinking and social hosting
 providing a collaborative space for youth leaders to meet
 working with Grass Valley businesses to provide a discount to youth that wear “NEO”
shirts on Fridays
 advocating for smoke free parks and trails
22
f) Mentoring Initiatives
Mentoring is identified by the US Department of Justice as a primary prevention strategy. The Sierra
Mentoring Partnership (SMP) was founded to create a bridge between a caring community and
youth in need through the development and support of safe, effective mentoring programs. SMP
acts as an advocacy and umbrella organization for mentoring, assuring that there is no duplication of
services, identifying gaps in services, and working to insure each program reaches its potential. SMP
supports the efforts of youth serving programs resulting in improved efficiency and increased
capacity to provide services for Nevada County children who are considered at-risk or high-risk. In
total, these programs serve 325 youth in Nevada County with excellent outcomes.
g) “Clean Out Your Cabinets” – Prescription Drug collection
The Coalition developed prescription drug disposal plan in partnership with Nevada County
Recycles, local pharmacies, and law enforcement (GVPD). To date nearly 2500 pounds of
prescription drugs have been collected through this initiative. As a result of this effort, disposal bins
are available at Grass Valley Police Department, Behavioral Health, and Kmart Pharmacy in Grass
Valley.
h) Social Hosting ordinances (future effort)
Friday Night Live, law enforcement, schools and parent groups have partnered to plan to
disseminate social hosting laws information. The goal of this is to change a pervasive perception in
the County that adult hosting of “drinking parties” for minors is acceptable.
i) Screening, brief intervention and referral to treatment (SBIRT)
In partnership with UCLA’s Integrated Substance Abuse programs and Community Recovery
Resources, the Coalition for a Drug Free Nevada County has provided training for healthcare
professionals (and has more trainings scheduled). In past studies, similar interventions have been
shown to reduce future re-injury and/or re-hospitalization. The goal is to teach providers how to
screen their patients for alcohol and other drug problems. For those in need of treatment, brief
intervention skills can facilitate improved understanding of and follow-through with referrals to
treatment services.
23
4.2
Strategy: TREATMENT
Increasingly, nationwide studies demonstrate the efficacy of substance abuse treatment from a
public safety and public cost perspective. This includes studies demonstrating that increases in
substance abuse treatment admissions are associated with decreases in crime rates and reduced
incarceration rates. In fact, California has been an important case study, experiencing decreased
incarceration rates when the number of people sent to drug treatment programs increased (primarily
through Proposition 36). Violent crime fell as well. Some were concerned that the decrease in
incarceration resulting from Prop 36 would lead to an increase in violent crime. In fact, from 2000
to 2004 California’s violent crime rate decreased by 11.2 percent.
Substance abuse treatment also appears to be more cost-effective than prison or other punitive
measures. Independent analysis of Prop 36 by the University of California and The Justice Policy
Institute both found considerable fiscal savings; JPI estimates that California saved a total of $412
million on prison and jail operating costs alone over six and a half years, and the UC shows a total of
$173.3 million in savings to the California government in the first year alone. The Washington State
Institute for Public Policy (WSIPP) found that drug treatment conducted within the community is
extremely beneficial in terms of cost, especially compared to prison. Every dollar spent on drug
treatment in the community is estimated to return $18.52 in benefits to society.
Like other specialized areas of healthcare, substance abuse treatment research and practice are
developing rapidly. Current best-practice trends include:
1) Recovery oriented approach: A recovery oriented system of care identifies and builds upon each individual’s
assets, strengths, and areas of health and competence to support achieving a sense of mastery over his or her condition
while regaining a meaningful, constructive, sense of membership in the broader community. This approach involves
a no wrong door perspective and encourages entry at any time. It emphasizes a collaborative,
strengths-based treatment process using evidence-based curriculum.
2) Addressing co-occurring disorders: Based on SAMHSA’s Blueprint for Change, it is estimated
that over 50% of those with a substance use disorder also have other complicating mental health
disorders. It is further estimated that over 70% of those with mental health disorders also have
substance abuse disorders. This drives a need to create services that can identify and support dually
diagnosed patients.
3) Integrated health model: Utilizing an approach that integrates primary healthcare with
comprehensive substance abuse and mental health services. Statistics addressed above concerning
the prevalence of dually diagnosed patients are compounded by the reality that both mental health
clients and substance abuse clients have a greater risk of multiple physical health problems. Research
shows substance abuse to be an underlying cause of many health problems, leading to increased risk
of cardiovascular disease, cancer, liver problems, and even osteoporosis and damage to the nervous
system. Very frequently, people with substance abuse and mental health issues have not maintained
preventive health screenings and have un-treated primary health and dental conditions.
Nevada County Providers/Services:
Strengths: Nevada County providers offer a range of effective treatment services, including
adolescent prevention and treatment, residential treatment for women, transitional housing, schoolbased interventions, criminal justice system programs, and various types of group and individual
counseling and therapy at multiple sites. Principal providers of drug and alcohol treatment in
Nevada County include Nevada County Behavioral Health Department (county government),
24
Community Recovery Resources (CoRR) (non-profit), Progress House, and Common Goals (forprofit entity). Demand exceeds service capacity (described below).
Figure 23. Overview of Local Treatment Service Providers
Nevada County
Local Service Providers:
Common Goals (Nevada City): Outpatient services in Grass Valley/Nevada City areas.
CoRR’s Grass Valley Outpatient Center – serving Grass Valley/ Nevada City areas with
prevention/outreach services, adult/adolescent outpatient substance abuse/mental health treatment
programs, criminal justice programs, co-occurring programs, and complimentary services including
medical and psychological.
CoRR’s Hope House- a residential facility serving 10 women with up to 6 total children.
CoRR’s Transitional housing –6 different locations throughout Nevada County (including Truckee)
provide supported temporary (6-12 months) housing for men, women, and women/with children.
CoRR’s Truckee Service Center – serving Truckee and surrounding areas with a smaller scale of
programs offered at the Grass Valley Service Center.
CoRR’s South County Service Center –serving the outer lying areas of southwestern Nevada County
with a smaller scale of the programs offered at the Grass Valley Service Center with a steady
enrollment of approximately 100 on any given day.
Nevada County Behavioral Health Department: Provides treatment to Medi-Cal eligible severely
mentally ill and dual-diagnosis clients.
Progress House: Male only short-term residential of 19 beds in Nevada City.
Court Programs: Drug Courts and Treatment Alternatives to Incarceration programs are popular,
widely praised and rapidly expanding alternative approaches of dealing with drug offenders and
people charged with nonviolent crimes who are drug users. Drug Courts substitute mandatory
treatment for incarceration. They have been in operation nationwide since 1989, and multiple studies
demonstrate enduring outcomes of reduced recidivism rates and cost savings, including evaluations
specific to Nevada County. Nevada County operates three alternative drug courts:
Juvenile Drug Court: Juvenile Drug Court is a voluntary program for persons under the age of 18
who have a drug or alcohol problem. The program requires regular appearances at court, random
testing, individual, group, and family counseling and a variety of other recovery activities.
Evaluation demonstrates that 94% of program graduates have not had subsequent drug
convictions since completing this program in Nevada County.
Nevada County Adult Felony Drug Court: Drug Court is a voluntary program for persons who
are otherwise committed to prison, whose crimes are related to serious drug addiction, and who
want help. Initial inpatient treatment is dependent on their initial assessment. The program
includes out-patient treatment, self-help meetings, and witnessed drug testing. The participant will
be required to return to Court bi-weekly. The counseling will decrease as they gain recovery.
Evaluation demonstrates that 92% of program graduates have not had subsequent drug
convictions since completing this program in Nevada County.
Prop 36 Drug Court: Under Proposition 36, certain non-violent adult offenders who use or
possess illegal drugs will receive drug treatment rather than incarceration. Eligible offenders
receive up to one year of drug treatment and six months of aftercare. The court may sanction
offenders who are not amenable to treatment or who violate their probation terms. Vocational
25
training, family counseling, literacy training, and other services may also be provided. Evaluation
demonstrates that 87% of program graduates have not had subsequent drug convictions
since completing this program in Nevada County.
Figure 24. Nevada County Drug Court 2 Year Re-arrest Rates
80%
67%
60%
50%
40%
t
Percent
70%
30%
20%
18%
20%
10%
0%
Drug Court
Graduates
All Drug Court
participants
Comparison
Group
Group
(Source: Nevada County Courts Data Collection)
An evaluation of Nevada County Drug courts coordinated by the State of California demonstrated
them to be highly effective. The total cost of events related to recidivism for the Nevada County
Drug Court per drug court graduate was $4,327 and per drug court participant (regardless of
graduation status) was $9,429, while the cost per comparison group member was $25,673. The
difference between the drug court and comparison group was $16,244 per participant. This amount
represents the recidivism cost savings due to participation in drug court over 2 years. If this amount
is multiplied by the total number of participants who have entered the program since its inception
(approximately 92 offenders) the total amount “saved” by the program due to positive outcomes for
its participants (i.e., lower recidivism related events) is $1,494,448. (California Drug Courts, Costs and
Benefits, NPC Research 2009)
Treatment Deficits: Gaps and deficits exist in service availability, and stakeholders recognize a
need to expand service variety and capacity. Local and regional data substantiate this need. Existing
services are over-impacted, and certain services do not exist locally at all. Inpatient treatment for
men, women, and youth is insufficient, with burgeoning waiting lists and some treatment options
that are simply not available such as adolescent residential treatment and men’s detoxification
treatment.
Significant data was garnered through a local and regional needs assessment conducted in November
2009 that surveyed all treatment providers within a 100-mile radius of Grass Valley to determine
availability of services. Primary and compelling findings included:
 Lack of Existing Comprehensive and Specific Services: Regionally, few treatment providers
surveyed offer all services (Prevention, Detoxification, Outpatient, Residential, Criminal
Justice, Family, Adolescent, Transitional housing,) and certain services (e.g. adolescent and
family services) are offered by fewer than 15% of providers; only 12% of providers offer allmale services and a quarter offer all-female.
26

Demand for services: More than 50% of the facilities interviewed had a waiting list for
service access and often the average wait was quite significant, suggesting a need for greater
substance dependence/mental health treatment capacity. The overwhelming majority--86%-of service providers were at 75-100% capacity.
Collaboration between Nevada County providers is productive, and multiple stakeholders are
working together to address these issues. Active partnerships between County government and nonprofits creatively leverage resources to meet gaps. Notably, the local provider CoRR recently
obtained a 9.3 million dollar loan to construct a multi-building treatment facility in Grass Valley.
This will greatly expand service capacity in the County and is expected to address several gaps,
including providing medically supervised detoxification; adolescent residential; and men’s residential.
27
5.
Conclusions and Recommendations
The following five areas are recommended areas of focus for Nevada County to reduce the
prevalence and severity of substance use and abuse.
1) Enhance Collaboration among Sectors
A combination of prevention, education, access to treatment (substance abuse, health, and mental
health), and enforcement of drug laws may be the most effective approach to addressing substance
abuse in Nevada County. Successes achieved by the Coalition for a Drug Free Nevada County
(CDFNC), such as the prescription drug collection program, demonstrate the capacity and efficiency
of such collaborations; this effort between CoRR, Grass Valley Police Department (GVPD), Nevada
County Recycling, and local churches and businesses has resulted in over 2500 pounds of drugs
collected. While it is too early to evaluate success of the Safe Schools/Healthy Students initiative, the
cross-sector collaboration between prevention, treatment, and enforcement efforts involving
schools, Nevada County Behavioral Health, CoRR, mentoring partners, and Nevada County
Probation and GVPD is promising. It is apparent that Nevada County Courts, treatment providers,
County departments, schools, and law enforcement work well together and achieve impressive
results. Next steps should focus on fostering stronger relationships with the medical sector, the
business community, and the faith-based sector. The medical sector can be highly effective in
education; referral to treatment; and targeting prescription drug abuse. The business community may
play a more active role in youth mentoring; fiscal support; and drug-free work policies, and the faithbased community may assist with supportive programs, education, counseling and referral.
2) Foster Community Engagement
There is strong evidence suggesting that the community’s perception is that drug, alcohol, and other
substance abuse is prevalent and of great concern. This is especially true for families with schoolage children. The geographic, rural demography of the Nevada County community poses some
challenges, but place-based community engagement (e.g. through schools, Family Resource Centers)
can be effective even so. This includes school-based efforts (such as implementing evidence-based
curriculum and providing after-school programs) and engagement of parents, youth, and community
partners (exemplified by NEO). Because substance abuse is perceived to be a significant problem,
there is a real opportunity to transform community members concerns into action that may prevent
or decrease substance abuse.
3) Support treatment services, and focus on proactive, early treatment
Implementation of proposed plans such as “Screening, brief intervention and referral to treatment (SBIRT)”
may increase identification of substance abuse problems early on in a primary care setting before
additional or clinical problems are manifest. This may be particularly effective in pediatric clinics, so
that young people who are experimenting with alcohol and/or drugs or have underlying mental
health issues can receive treatment before they are adversely impacted though arrests, overdoses, or
other serious problems. Additionally, as overwhelming data demonstrates that treatment is costeffective and reduces violence crime, maintaining treatment programs to address the disease of
addiction (and related mental health issues) for people of all ages and genders is important.
28
4) Sustain programming related to alcohol and prescription drug use
Research has shown that rural youth tend to have higher rates of abuse of alcohol,
methamphetamine, and inhalants (Cronk and Savela). Programs that specifically address these
substances may serve to prevent adult abuse, and peer-based programming has been shown to be
highly effective. The SS/HS program is initiating substance abuse prevention programs, including
some peer-to-peer supports; sustaining aspects of this initiative after its 4-year funding expires
should be considered. Similarly, the sustainability of community-wide strategies through the
Coalition for a Drug Free Nevada County (e.g. prescription drug collection; social hosting; drug-free
workplace) should be a priority.
5) Engage in systemic and environmental change
Environmental strategies focus on changing the underlying contextual processes that contribute to
substance use and have been found to be very efficient (Wisconsin Clearinghouse for Prevention Resource).
Strategies directed at the shared environment are efficient because they affect every member of the
target population. Environmental strategies have enduring effects. When policy, regulation, or
norms are changed they remain so for a very long time. Also, environmental strategies are often
easily sustained and cost effective. Fledgling environmental strategies currently spearheaded by the
Coalition for a Drug Free Nevada County include social host ordinances and drug-free workplaces.
A possible next step is to develop strong relationships working with local medical providers to
analyze prescribing practices.
Conclusion:
This report discusses prevalence of substance use and abuse, consequences of such activity, and
actions that Nevada County partners are taking to prevent and treat substance abuse. Analysis of
relevant data demonstrates that the prevalence of substance misuse and abuse in this community is a
challenge, impacting public health, safety, and quality of life, and increasing workload on public
service and healthcare systems. Positive trends exist, such as reductions in abuse of certain
substances and reduced cost and violent crime following interventions. However, alarming trends
appear as well; for example, the dramatic rise in opiate use. Nevada County has been creative and
successful in addressing the problem of substance abuse, particularly in the reduction of
methamphetamine, in many ways and there are great efforts moving forward. However, gaps persist
due to limited investments. Primary partners are committed to continue producing this report as a
tool to monitor success and plan effectively to sustain proven practices, expand services to more
individuals in need, and enhance services to address gaps to better serve Nevada County residents.
Creating and sustaining a robust continuum of care that addresses substance abuse and related
mental health issues is essential to sustain a safe, healthy, and thriving Nevada County.
29
6.
Citations
1. National survey reveals increases in substance use from 2008 to 2009. (9/16/10). Retrieved
from Newsroom Advisories, U.S. Department of Health and Human Services. Substance
Abuse and Mental Health Services Administration.
http://www.samhsa.gov/newsroom/advisories/1009152021.aspx
2. Substate Estimates from the 2006-2008 National Surveys on Drug Use and Health. (2010).
Office of Applied Studies, Substance Abuse and Mental Health Services Administration.
Rockville, MD. http://oas.samhsa.gov/substate2k10/2k8Substate.pdf
3. Grass Valley Police Department 2010 Citizen Attitude Survey Results. (March, 2010).
4. California Healthy Kids Survey, California Department of Education (Safe and Healthy Kids
Program Office) and WestEd (Health and Human Development Department). (2005, 2007
and 2009).
5. Socioeconomic Mapping and Resource Topography System (SMART) (2007.
http://smart.gismapping.info/smart/About.aspx
6. California Department of Justice. Total misdemeanor arrests by gender, offense and arrest
rate.
7. Nevada County. http://stats.doj.ca.gov/cjsc_stats/prof08/29/4A.htm)
8. California Department of Justice. Juvenile felony arrests by gender, offense and arrest rate,
Nevada County. http://stats.doj.ca.gov/cjsc_stats/prof08/29/3C.htm
9. California Department of Education Safe & Healthy Kids Program Office. (2004-2009).
10. Sierra Nevada Memorial Hospital, Emergency Room Data (2007-2009).
11. El-Askari, Galen. (October 2010). STOP Act Baseline Data Report Baseline Data Report on
Outcomes.
12. Kids Data.org (http://www.kidsdata.org/data/topic/table/marijuana-usegender.aspx?f=1&loc=2,334&ch=a,a,626)
13. Kids Data.org http://www.kidsdata.org/data/topic/table/marijuana-usegender.aspx?f=1&loc=2,334&ch=a,a,626)
14. Monitoring the Future Survey, NIDA InfoFacts High School and Youth Trends. (Retrieved
11/25/10). National Institute on Drug Abuse, National Institutes of Health
http://www.drugabuse.gov/infofacts/hsyouthtrends.html
15. U.S. Census Bureau. (Retrieved 12/20/10).
http://quickfacts.census.gov/qfd/states/06/06057.html
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16. CalOmsTx Data, (Retrieved 12/27/10).
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