Presentation from Julie Hynes | May 28, 2015 www.preventionlane.org/casa

1. Julie Hynes, MA, CPS
May 28, 2015
www.preventionlane.org/CASA

2. This Evening’s Focus
• Current conditions in substance abuse –
Lane County
• Risk factors that lead
to those conditions
• A prevention perspective
• Resources for talking
to kids and families
• Q&A throughout

4. “It’s All
Connected”

5. MOST COMMONLY CODED MEDICAL
CONDITIONS in the Trillium Medicaid
Population, 2014
1. Depression
2. Smoking
3. Asthma
4. PTSD
5. Diabetes
6. Adult Obesity
7. Chemical Dependency
8. Attention Deficit Disorder
9. Bipolar Disorder
10. COPD
Source: ACA Conditions in the Trillium Community Health Plan Medicaid Population, 2014. Trillium Community Health Plan, 2015.

6. of Americans who meet the
medical criteria for
addiction started
smoking, drinking, or using other
drugs
before age 18.

7. of Americans who meet the
medical criteria for
addiction started
smoking, drinking, or using
other drugs
before age 18.

8. The top two
drugs used by
high school
students in
Lane County…

10. Alcohol is the drug of choice for youth
Source: Student Wellness Survey, 2014
8th Grade Students – past 30 days

11. MOTOR VEHICLE INJURY
is the leading cause of
death among Oregonians
age 10-24.
What is #2?

12. SUICIDE is the 2nd
leading cause of death
among Oregonians ages
10-24.
Source: Oregon Health Authority (2014)

13. 2014 Student Wellness Survey

14. COMMON RISK FACTORS
ENVIRONMENTAL
• Economic and social deprivation
• Social isolation
• Neighborhood and community disorganization
• Transition and mobility especially between
elementary, middle and high schools
• Community laws and norms favorable toward
use
• Availability at home, school, neighborhood

15. COMMON RISK FACTORS
DEVELOPMENTAL / FAMILY
• Family history of alcoholism/addiction quadruples risk
of becoming addicted
• Family management problems
• Early antisocial behavior combined with withdrawal
and/or hyperactivity
• Parental drug use or positive attitude towards use
• Academic failure not tied to ability, especially in mid to
late elementary school

16. COMMON RISK FACTORS
DEVELOPMENTAL / FAMILY
• Little commitment to school
• Alienation, rebelliousness, lack of social bonding
• Friends who use drugs is one of the strongest
predictors
• Favorable attitude toward drug use
• Early first use of drugs prior to age 15-twice the risk of
addiction

17. What is almost ALWAYS a KEY
underlying issue?
TRAUMA.

18. Adverse Childhood Experiences (ACEs)
• ACEs are experiences in childhood that
are hurtful
• Sometimes referred to as
toxic stress or childhood trauma

19. What are ACEs?
Growing up (prior to age 18) in a household
with:
• Physical abuse
• Emotional abuse
• Sexual abuse
• Emotional or physical neglect
• Loss of parent due to divorce, abandonment, or
death
• Substance use
• Mental illness
• Incarcerated household member

20. What are ACEs?
Growing up (prior to age 18) in a household
with:
• Physical abuse
• Emotional abuse
• Sexual abuse
• Emotional or physical neglect
• Loss of parent due to divorce, abandonment, or death
• Substance use
• Mental illness
• Incarcerated household member
http://www.cdc.gov/violenceprevention/acestudy/index.html

21. ACE Scores are Significant
• Points are attributed for exposure to each type of
adverse event (0 to 10).
• The higher the ACE score, the greater likelihood of
negative outcomes, such as:
– Smoking, drug & alcohol abuse
– Depression, suicide
– Obesity, heart disease

22. ACE SCORES
IN OREGON
Source: The Ford Family Foundation , 2014

23. Why is this Important?
Because ACEs are:
• Surprisingly common
• Occur in clusters
• The basis for many common public health concerns
• Strong predictors of later health risks, disease,
and death

24. Centers for Disease Control and Prevention: http://www.cdc.gov
Generational
Transmission of
ACEs

25. ACEs Often Last a Lifetime…
But They Don’t Have To
• Healing can
occur
• The cycle can be
broken
• Safe, stable,
nurturing
relationships
heal both parent
and child

26. What Can Be Done About ACEs
Increase Protective Factors
– Conditions that increase health and well being
– Critical for everyone regardless of age, sex, ethnicity or
racial heritage, economic status, special needs, or the
dynamics of the family unit
– Buffers that provide support and coping strategies and
reduce impact of risk factors

27. What Can Be Done About ACEs
Protective Factors
– Parental Resilience
– Social Connections
– Knowledge of Parenting and Child Development
– Concrete Support in Time of Need
– Nurturing and Positive Relationships
Center for the Study of Social Policy’s Strengthening Families, A Protective Factors Framework

28. What Can Be Done About ACEs
Individual Level Strategies
• Parent/Family Education & Support
• Child Education/skill-building
• Screening, Early Intervention & Treatment
Relationship Level Strategies
• Parent-Child Centers (for parent training and education)
• Early Childhood Home Visitation (evidence-based programs)
Community, Organizational, and Social Level Strategies
• Public Awareness Campaigns
• Training providers on ACEs, resiliency, trauma-informed care/tools
• Creating trauma-informed, safe and nurturing schools, worksites,
communities

29. Start by Keeping in Mind…
• What is viewed as a problem by health
professionals may actually be a personal
solution to pain.
• Dismissing these coping devices as “bad
habits” or “self-destructive behaviors”
misses their functionality.

30. And…
• What is predictable is preventable.
• We don’t bounce back, we bounce forward;
• It’s not what’s wrong with you… it’s what
happened to you!

31. Our Challenge
• We can and must reduce the number of
ACEs for all children
• We can and must “immunize” kids against
the affects of ACEs
• We can and must work to prevent ACEs

32. • Build Resilience:
–Doing well in the face of adversity
• Facilitate Healing
Our CHallenge

33. Tobacco, alcohol, and
other drug use/abuse
Scientific consensus that we can
prevent these problems
Delinquency and crime
Premature or unsafe sex
Depression and
suicidality
School failure, dropout

35. Pre-
conceptio
n
Prenatal/
Infancy
Early
Childhood
Childhood
Early
Adolescence
Adolescence
Family
• Prenatal care
• Home visiting
• Evidence-based parenting
programs
• Evidence-based kernels
Schools
• High-quality preschool and daycare
• Classroom-based prevention curricula
• Evidence-based kernels
• Afterschool programs
Community
• Community organizing to improve neighborhood environments
• Support for evidence-based strategies
• Support for out-of-school activities
• Evidence-based kernels
Policy
• Community members have ensured access to services to meet
basic needs
• Promotion and support of healthy lifestyles
• Policy to promote and support evidence-based strategies
Prevention strategies
by developmental phase and domain

37. “ The solution of
all adult
problems
tomorrow
depends in
large measure
upon the way
our children
grow up
today. ”
- Margaret Mead

38. preventionlane.org
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