Community Needs Assessment Regarding Youth Substance
ommunity Needs AssessmentC Regarding Youth Substance Use in Franklin County and the North Quabbin. Conducted Oct 2015-Jan 2016 by members of the CTC Coordinating Council & Community Action Youth Programs staff
Executive Summary This report is the product of acommunity assessment processconducted by the CommunitiesThat Care Coalition, under theleadership of the Coalition’sCoordinating Council andRegional School Health TaskForce. It includes findings fromyouth surveys, key stakeholderinterviews and parent and youthfocus groups on the topic ofyouth substance use in FranklinCounty and the North Quabbin. Youth substance use is widelyseen to be a problem locally.While surveys indicate that mostlocal young people are not usingsubstances, the problem iscommon enough to provokeconcern, particularly among thosewho work with high-risk segmentsof the youth population. Student surveys indicate thatalcohol is the most commonlyused substance. Youth focusgroups identified both the “fun”and potential harm in alcohol.Adults interviewed expressedconcern about youth drinking andperceived some level of tolerancein the community for youthalcohol use. Attitudes about marijuana arechanging rapidly. Local youngpeople are increasingly likely tothink that marijuana use is notharmful—or even believe it ishelpful for certain conditions. Thiscasual attitude concerns adultswho work with youth, given theadverse changes they see inyoung people who use marijuanaregularly. Some adults expressedconcern that using marijuanamight be a prelude to usingharder drugs for some youth,perhaps by priming the developing brain for addiction, orby drawing youth into circles offriends who are using and whohave ready access. Cigarette smoking has declined,and youth tend to see smokingas risky and not “cool.” Ecigarettes are on the rise, and whilemany youth in focus groups sawlittle harm in vaping, some adultsworried that vaping could be anentrée into tobacco use. Less prevalent, but of graveconcern, is youth use ofprescription drugs without adoctor’s orders. Of these,amphetamines (such as Adderall)are the most commonly used,followed by narcotics (such asOxyContin). In focus groups,youth expressed clear ideasabout how prescription drugs, aswell as alcohol, tobacco andmarijuana can be used as a 2
coping mechanism, with specificsubstances for specificproblems: Adderall to cram for atest, alcohol to relieve socialanxiety, marijuana to addressADHD, and so on. The issue on the minds of manyinterviewed is the opioid crisis.Community awareness aboutthe opioid crisis is high, andyouth and adults alikeunderstand its potential forharm. Heroin addiction is not asvisible to middle and high schoolyouth as is other drug use, in partbecause of the stigma attached toheroin use, and in part becausethe bulk of the problem occursamong older youth. (But not all ofit; school personnel typically areaware of and working with a fewstudents who are struggling withopioid abuse.) Interviews and focus groups gave the impression that the opioidcrisis has had a dual effect: forsome, youth use of alcohol andmarijuana seems lessconsequential by comparison, andfor others, the crisis provides allthe more reason to be concernedabout youth alcohol andmarijuana use if it paves the wayfor some young people to tryharder drugs. Youth may use substances tofeel good, to self-medicate, orto fit in. Their choices areinfluenced by norms in theirfamilies, schools and communities,and they hear a variety ofmessages in those environments.The messages they receive athome differ from one family toanother, with some familiesadamantly against youth use andothers providing what they believeis a “safe space” to keep youngpeople who are drinking off the roads. The messages youth receivein community range from vigilantenforcement of minimum age ofpurchase laws to ubiquitous ads foralcohol and pop cultureglamorization of substance use.Most key stakeholders interviewedagreed that schools consistentlycommunicate “no use” standardsand are generally successful atdiscouraging substance possessionand use on school grounds. Someparents and youth disagreed andcited examples of substance use inschool. Key stakeholders and focus groupparticipants offered suggestions toaddress youth substance use in theareas of prevention, education foryouth and for parents, enhancedtreatment resources for youth,reduced stigma around substanceuse, and an increase in positiveopportunities for youth. 3
Preface Youth survey data indicate that astrong majority of local middleand high school students do NOTuse substances: 7 in 10 do notdrink, about 8 in 10 do not usemarijuana, and 9 in 10 do notsmoke cigarettes. That said, a substantial number ofyoung people DO use these andother substances. As part of aperiodic community assessment,the Coalition therefore chose tosupplement annual survey datawith focus groups and interviewsto flesh out the context for thatuse. The Coalition sought outinterviews with school personnel,service providers, and lawenforcement officials who workdirectly with youth who use, andheld focus groups with parentsand youth who are familiar with orembedded in local youth culture,including a high-risk segment ofthat culture.The purpose of the interviews andfocus groups, then, was not togeneralize about the state of localyouth, but to turn the spotlight onsubstance use, including the use oftobacco, alcohol, illegal drugs, andprescription drugs without adoctor’s orders.What follows is a summary ofviews expressed by severalmembers of the communitywho have extensive experiencewrestling in one way or anotherwith local youth substance use.In this report, quotes are in blackitalicized text, and the intervieweeor focus group participant isidentified by sector. Charts arefrom the Franklin County/NorthQuabbin Prevention NeedsAssessment, 2003-2015, and showcombined results for the 5 districtsthat have participated in the surveysince 2003 (n 964 to 1339). 4
Thanks Are Due: To the following CoordinatingCouncil members who conductedinterviews with key stakeholdersand focus groups with parents: Thanks are also due to the keystakeholders interviewed, whocame from the followingorganizations:The design and conduct ofinterviews and focus groupswas a collective effort, and thisreport presents thecontributions of manyindividuals and organizations inFranklin County and the NorthQuabbin. Kat Allen (Partnership for Youth); LevBen-Ezra (Community Action YouthPrograms); Heather Bialecki-Canning(North Quabbin CommunityCoalition); Jessie Cooley (BigBrothers Big Sisters); JenniferDesjardins (Heywood HealthcareCHART); Maureen Donovan(Greenfield Safe Schools, SafeStreets); Laurie Loisel (NW DistrictAttorney’s Office); Kara McLaughlin(Gill-Montague Community SchoolPartnership); Rachel Stoler(Partnership for Youth); JeanetteVoas (Partnership for Youth); MelissaWard (Partnership for Youth). Athol Royalston Middle School, TheBrickhouse, Clinical and SupportOptions, Community Health Center ofFranklin County, DIAL/SELF,Franklin/Hampshire Juvenile Court,Greenfield High School, GreenfieldPolice Department, Mohawk TrailRegional School, Montague PoliceDepartment, Northfield PoliceDepartment, Northwest DistrictAttorney’s Office, Orange PoliceDepartment, Quabbin YouthInitiative, Turners Fall High School. And to Community Action YouthPrograms staff who conductedfocus groups with youth: Mohawk Trail Regional School, GreatFalls Middle School, North QuabbinPatch Tanisha Arena, Myck LeMay, TyannaNormandin, Sam Scovill And, finally, to the youth andparents who participated in focusgroups and spoke openly aboutthis sensitive topic. And to the following organizationsthat hosted parent focus groups: 5
Methods Key Stakeholder Interviews The CTC Coordinating Council tookjoint responsibility for conductinginterviews of key school staff,community service providers, and lawenforcement personnel. Eleven members of the CoordinatingCouncil brainstormed ideas forpotential interviewees and assignedinterviewers to two or threestakeholders each. A core group designed the interviewprotocol, with guidance from JessicaPayne, Ph.D, a qualitative researchspecialist at Partners for a HealthierCommunity in Springfield, fromWilliam Geary, Ph.D., Deputy Directorof Evaluation and Research inCADCA’s Coalition Institute, and fromBen Spooner, our MassTAPP TAProvider. Two Coordinating Council membersattended each interview, one to posequestions with appropriate probesfor additional information, and oneto take notes. The notes were thensubmitted to the interviewee forapproval, and returned forcompilation into this summarydocument. From November 2015 toJanuary 2016, our team of 11interviewers completed interviewswith 29 key stakeholders. 6
Methods Focus Groups with At-Risk Youth Community Action Youth Programstook responsibility for conductingfocus groups with at-risk youngpeople. Five Community Action staffmembers participated in designingand conducting the focus groups. With guidance from the CoordinatingCouncil on topics to be explored, theteam developed a script andrecruited young people toparticipate. The team conducted six groups witha total of 40 in-school and out-ofschool youth ranging in age from 14to 23, including one group of 6 youthin out-of-home-placement. Questions addressed youthperspectives on substances and theconsequences of using them, as wellas availability and means of access.Two or three staff members attendedeach focus group, with onefacilitating the discussion and one ortwo taking detailed notes. Each member of the team of fivereviewed all the notes. The teamdiscussed their observations,identified themes, and reported outon each of those themes. In February 2016, the young peoplewho participated in the focus groupstook part in a digital storytellingproject on local substance use. 7
Methods Focus Groups with Parents of Teens The protocol for focus groups withparents was developed in parallelwith that for the key stakeholderinterviews, with advice from Dr.Payne, Dr. Geary, and Ben Spooner.Two of the focus groups were in fairlyhigh-risk, lower SES communitygroups, and two were in groups ofwell-educated highly involvedparents. Three focus groups were held with atotal of 18 parents. A fourth mixedgroup included 2 parents, 2 teachers,and one principal. Two to three Coordinating Councilmembers attended each focus group,with one facilitating and one or twotaking notes. 8
Methods Student Health Surveys The Coalition has conducted a youthhealth survey every year since 2003.Five local school districts participatedin the first survey, and four moredistricts joined the process in 2006and 2007. The Coalition nowcollaborates with all nine area middleand high school districts (AtholRoyalston, Four Rivers Charter PublicSchool, Franklin County TechnicalSchool, Frontier, Gill-Montague,Greenfield, Mohawk Trail, PioneerValley, and RC Mahar) to administerthe survey annually to all 8th, 10th,and 12th graders. Each survey fills a data need: thePrevention Needs Assessment goes“deep” with its exploration of riskfactors; the Youth Risk BehaviorSurvey goes “wide” by covering abroad range of health behaviors; andthe custom survey provides a checkon issues of current local interest. The survey process cycles throughthree different survey instruments:the Prevention Needs Assessment,the Youth Risk Behavior Survey, anda custom survey designed by theRegional School Health Task Force, aCoalition workgroup withrepresentation from each of the ninedistricts. Since the surveys collect informationfrom a broad swath of local youth,they provide some context for themore focused individual perspectivesthat emerged from interviews andfocus groups. In some cases,interviews and focus groups confirmsurvey findings. In other cases, theydiverge. The data shown in this report are allfrom the Prevention NeedsAssessment. It has been conductedfive times since 2003, providingconsistent data to trace trends overthat period. 9
SUBSTANCEUSEYouth Substance Usein Franklin County and the North %TobaccoCigarettes10%HeroinPrescription DrugsPrescriptiondrugs0%20032006200920122015% of local youth reporting recent (past 30 day) use of eachsubstance. Data for 8th, 10th and 12th grades combined.Heroin
8th grade marijuana use has declined since2003. After an initial decline, 10th use heldsteady and 12th grade use rose.Young people today are less likely tobelieve that using marijuana is risky thanthey were a decade ago.MarijuanaMost 10th & 12th graders believe marijuanais easy to get. Over time, 8th graders havecome to believe it is hard to get.PrevalenceAttitudesAccess
Marijuana:PrevalenceBoth young people and the adults who work with youngpeople in the schools, in the community, and in the courtstypically believe that youth marijuana use is commonplaceand normalized.“Kids will freely admit to using marijuana and it seems pretty common.”COMMUNITY PROVIDER“In the morning, it’s easy to smoke, along the train tracks or just driving.” YOUTH“Everybody smokes pot – we all know that.” YOUTH“Since the change in marijuana laws, we are seeing a definite upsurge in useamong young people.” LAW ENFORCEMENT“Marijuana is such a widely used drug now that you’re going to see that inevery part of the community.” SCHOOL STAFF While survey data still show marijuanause trailing alcohol use, many of thoseinterviewed believed marijuana to bethe most used substance.A school staff member expressed a different perspective:“There are small subgroups who smoke pot regularly, but there are not a lot ofkids who use moderately. There’s a group that comes to school stoned. Theydon’t come to school a lot. They don’t try in school. They’re disconnected.”SCHOOL STAFF 12
Marijuana:AttitudesOf all substances, marijuana is perceived to be the leastconsequential in terms of health, social acceptance, andlegal repercussions.“People I know tend not to put alcohol, cigarettes, and marijuana in thecategory of drugs or substances. They aren’t defined that way unless they’reconsidered hardcore like heroin, coke, meth, pills.” YOUTH Participants in the YouthFocus group: Did not see marijuana as a problemdrug, but rather as something“natural” that can help with a varietyof medical conditions;“Kids who smoke marijuana think it’s not harmful. They don’t connect fallinggrades with pot smoking.” SCHOOL STAFFFor some, the opioid crisis has made marijuana seemrelatively benign. For others the crisis heightens concernthat marijuana could serve as a gateway to harder drugs.“Marijuana is less dangerous than alcohol. There’s more concern about thethings that are physically more harmful. There are bigger fish to fry.” PARENT Did not see marijuana as addictive;“There’s been so much talk about prescription drugs and heroin that peopleare almost desensitized to alcohol and marijuana.” LAW ENFORCEMENT Did not believe that using marijuanacarried any stigma or broke anyimportant rules.“Marijuana scares me. I think it’s a gateway to prescription medication andheroin.” LAW ENFORCEMENT 13
Marijuana:Access“Everyone knows someone who sells pot.”YOUTH“Marijuana is everywhere and very easy to get.” SCHOOL STAFFAll youth focus group participantsknew where to get marijuana,primarily from peers. They said itwas the easiest of substances toobtain.“You can ask anyone for pot and either they have it or they know someone.”Many adults had a similar impressionthat marijuana is available“everywhere.”“Most of the kids are getting from their peers, both in school and in theirneighborhoods. You can’t walk through town and not see a way to score if youwant to. It is everywhere.” COMMUNITY PROVIDERYOUTH“People grow it and sell it. I know someone who has three huge plants andtheir parents sell it.” YOUTH 14
8th and 10th grade alcohol use has steadilydeclined since 2003. After an initialdecline, 12th grade use has crept back up.AlcoholYoung people today are somewhat morelikely to believe that regular use of alcoholis risky than they were a decade ago.On the whole, local young people arefinding alcohol less readily available todaythan they did in 2003.PrevalenceAttitudesAccess
Alcohol:Prevalence“It’s rare for kids to come in to school smelling like alcohol or pot. That’s notthe norm.” SCHOOL STAFFInterviews and focus groupsconfirmed survey findings that fewlocal middle school students areusing alcohol, and that drinkingbecomes more common in highschool.“We don’t hear much about alcohol. Our older youth (21 ) sometimes talkabout it.” COMMUNITY PROVIDERWhile many choose not to use,alcohol use is a behavior that cutsacross group lines, largely as part ofa party scene.“Even students who are high achievers use [alcohol]. It’s something thatoccurs across the spectrum. It’s not everyone, but all groups are affected.”And yet, several adults, reflecting ontheir own high school experience,commented that alcohol is not thecenterpiece of youth culture it was“back in the day” in part becausemarijuana use has becomenormalized.“I hear about drinking mainly from high schoolers, usually away from schooland usually on the weekends. You see it on social media.” SCHOOL STAFFSCHOOL STAFF“If they’re drinking, then they’re probably also smoking weed. There’s a bigoverlap.” SCHOOL STAFF“I don’t think substance use is as bad as it used to be. I see it in age 19-25, butnot so much in the school system. I think of older youth. My nieces are 18-20and I see posts of them on FB holding a beer.” PARENT 16
Alcohol:Attitudes“Drinking is used as a social lubricant to do things a person may be nervousabout.” YOUTH“Being drunk is different from being a social drinker.” YOUTH“Alcohol is extremely dangerous . It’s a poison if they’re prone to having it bea problem to them. They don’t know enough about it. They think they’reinvincible.” PARENTYouth focus group participantsdescribed drinking alcohol as a funactivity. They said that drinking,even heavily, is okay at parties,though they frowned on dailydrinking.Parents in focus groups expressedconcern about youth alcohol use.School personnel said they receivedmixed responses from parents whosechildren were caught using.“I’m not a drinker. It doesn’t happen in our house .We talk about it a lot. Theperception is that it will lead to harm.” PARENTThere are parents who know what’s going on and provide what they see as asafe house, a place where their kids’ friends come over and drink in thebasement. Some parents think it’s okay for 16-17 years olds.” SCHOOL STAFF“Some parents don’t even see danger in drinking at all. I’ve heard fromparents, “My child does not do drugs, they just smoke pot and drink.” Or“They are just drinking beer.” SCHOOL STAFF“If you have a basement full of kids drinking, a certain percentage will do fine,a certain percentage will go on to be alcoholics, and a certain percentage willgo on to die of a heroin overdose. But the social attitude is they’ll all do fine.”COMMUNITY PROVIDER 17
Alcohol:AccessLocal young people typically acquirealcohol at parties, or by having anolder friend or sibling purchase it forthem.Home is another common source,with and without parent permission;many youth mentioned stealingalcohol from parents.Although a couple of young peoplementioned using fake IDs, otherstakeholders interviewed said theythought the barriers to underagesales were high in the region.“A lot of kids steal alcohol from their parents’ homes. And there are enoughpeople in their early 20s hanging around doing nothing that are willing tobuy it for younger people.” LAW ENFORCEMENT“Kids graduate from here and don’t go anywhere. So there are older kidswho are still in the social circles of high school students.” SCHOOL STAFF“We’re pretty good about alcohol compliance checks with the ABCC. Mostof the businesses are wary about it, which is good.” LAW ENFORCEMENT“You can get alcohol by sneaking it out of the store.”YOUTH 18
Local youth cigarette use has declinedsince 2003.TobaccoLocal young people understand thatsmoking cigarettes is risky.On the whole, local young people arefinding cigarettes less readily availabletoday than they did in 2003.PrevalenceAttitudesAccess
Tobacco:Prevalence Interviews and focus groups corroborate survey findingsthat fewer youth are smoking cigarettes than in past years.However, smoking remains common in high-risk groups.“I see a lot of kids smoking cigarettes, but not as much as we used tosee in the past.” LAW ENFORCEMENTThose who do smoke do nottypically smoke occasionally orjust at parties; the smokers thatyouth focus group participantsknew were daily users.“Cigarette smoking is down. I haven’t heard much about vaping.” LAWENFORCEMENT“There’s not many new kids getting hooked on it.”YOUTHChewing tobacco is said to bepopular in some circles. Vapingmay be more widespread, andyoung people are vaping avariety of substances (marijuanaand Adderall were mentioned).“They may think that chewing tobacco is healthier than smoking. Idon’t hear much about vaping. It’s more expensive than cigarettes.”Vaping may be flying under theradar at school; youth tended tobe more aware of vaping onschool grounds than the adultsinterviewed.“There have been incidents of vaping in school because students feelthey can get away with it. We don’t smell it.” LAW ENFORCEMENTPARENT“Teens vape in schools. There are strawberry and pineapple flavors.Vaping is a common thing.” YOUTH“They vape pot. They can vape all sorts of stuff, their pills.”PARENT 20
Tobacco:Attitudes“It’s very unpopular for kids to smoke cigarettes.” SCHOOL STAFF“Everyone who smokes knows it sucks.” YOUTH“No one thinks cigarettes are cool anymore ‘cause they cause cancer.” YOUTHParticipants in the youth focusgroups expressed distaste forsmoking and articulated anunderstanding of its health effects.“Vaping doesn’t smell as bad as a cigarette.” YOUTH“Vaping is better for you then smoking so I don’t have to worry about it.”YOUTHYouth tended to see vaping as lessharmful and socially preferable tosmoking cigarettes.Some adults expressed concernabout vaping as an entrée totobacco use.“There’s more of an emphasis around telling kids not to smoke cigarettesthan not to use marijuana.” PARENT“I’m worried about the e-cigarettes that everyone is using. There’s not clearresearch and they’re not well regulated, and I wonder how many kids arestarting to use cigarettes by starting with this.” COMMUNITY PROVIDER 21
Tobacco:AccessYouth focus group participants saidthat retailers consistently card, sothey may have an older peer orsibling buy cigarettes for them, orapproach a stranger outside a storeto make the purchase.Peer networks at school are anothersource of cigarettes or vapingsupplies, as are parents.A few youth mentioned “bumming”single cigarettes on the street, orpicking up partially smokedcigarettes from the ground.“My mom gets 5 packs of cigarettes at a time. She doesn’t notice if one goesmissing.” YOUTH“Raising the age to 21 for tobacco use I think helped out a lot. You can’tsupply yourself downtown anymore. That’s huge.” LAW ENFORCEMENT“I see a lot of adolescents smoking cigarettes. The good thing is that you haveto be 21 in this town to purchase, but they still get them.” LAW ENFORCEMENT“I’ve seen kids pick up some cigarettes off the ground to get stuff out of it. It’sgross, but it’s cheaper.” YOUTH 22
After alcohol, marijuana and tobacco, prescription drugs (used without a doctor’s order) are the substances local youth usemost. Of these, amphetamines (e.g. Adderall, Dexedrine) are the most commonly used. On the whole, young people believeprescription drug use is risky, and they say their parents and peers maintain strong norms against youth use.PrescriptionDrugsPrevalenceAttitudesAccess
Prescription Drugs:PrevalenceSome of those interviewedthought the problem was risingand others thought it might bedown from a few years ago.Many mentioned Adderall as acommonly used substance,either taken as a pill, or crushedand snorted or vaped.Two stakeholders interviewedalso mentioned cough syrup as asubstance some young peopleare abusing.Several suggested that youngpeople may not know whatthey’re taking when they usepills recreationally. Key stakeholder interviews and parent focus groups showwide awareness and concern about youth prescription druguse – and acknowledgement that use is challenging todetect and quantify.“It’s very ambiguous and hard to detect. We’ll see students acting differentlyand suspect they’re using, but there are so many things you can blame theirbehavior on – like puberty – so it’s hard to know.” SCHOOL STAFF“Illicit use of prescription medication, from my experience, was really bad 4 or5 years ago and I haven’t seen it as much recently. I’m not saying it isn’t here,but I haven’t seen it much.” LAW ENFORCEMENT“There has always been a group of kids who use prescription drugs. It’s a smallpercentage .I think kids are more wary than they used to be.” SCHOOL STAFF“Prescription drugs are a problem. They are consumed during school and thisincludes Adderall. Not as many Vicodin & OxyContin due to the communityawareness initiatives.” LAW ENFORCEMENT“There are pill parties, where kids steal pills from medicine cabinets and putthem out and just take them, not knowing about the effects.” SCHOOL STAFF 24
Prescription Drugs:Attitudes“I would never mess with something like that.” YOUTH“Most of us perceive prescription drugs as risky.” YOUTHYouth focus group participantsfelt it was acceptable to takeprescription drugs for an“appropriate” purpose, likeusing Adderall for studying oropioids for pain.Youth also expressed warinessand an understanding thatprescription drugs can lead toaddiction.Adults were uniformly alarmedby prescription drug use.“It starts with pill usage and then they switch over to heroin.” YOUTHEveryone wants their kid diagnosed with ADHD, and then they’re going on toother drugs.” PARENT“The prescription medications scare me the most. Some people think it’s safe,and that is what has led kids into heroin.” LAW ENFORCEMENT“Experimenting can quickly become a fast track to hell. Opiate pain medicationis so physically addicting that it quickly becomes more than about getting highanymore. Everyone thinks they won’t ever take the next step.” COMMUNITY PROVIDER 25
Prescription Drugs:Access“People are always asking if you want to pop Adderall.” YOUTH“Prescription drugs come from kids who don’t like taking their own drugs soinstead they sell it and get money for it.” YOUTH“If your parents ask you to pick up their prescription, take some and act like thepharmacy made a mistake.” YOUTHPrescription drugs come fromteens’ own prescriptions, or fromtheir parents’ or grandparents’medicine cabinets, and then maybe further disseminated throughpeer networks.“I think they are getting their substances from medicine cabinets from theirparents or grandparents or had them prescribed for themselves, and takingthem and selling them.” SCHOOL STAFF“I wonder how much more frequent it is in children who are being cared for bytheir grandparents because they were taken away from their parents by DCF –and their grandparents are more likely to have opioids in the house.” COMMUNITYPROVIDER 26
Survey data has not provided evidence ofchange in heroin use among local middleand high school students.HeroinPrevalenceAttitudesAccess
Heroin:Prevalence Most of the key stakeholders said they perceived the heroincrisis to be greatest among older youth, but many expressedconcern that use of other drugs in high school was pavingthe way for later addiction for some youth. Some wonderedhow much heroin use might be going undetected.“It’s not younger kids, it’s mostly older kids. I have seen older kids who look likethey’ve had it a lot.” YOUTH Stakeholders identifieddifferent paths todependence:some follow a gradualprogression from alcohol andmarijuana to harder substancesothers transition fromlegitimately prescribed opiatesto illicit opioid useothers leap directly to heroinaddiction.“Heroin between the age group of say 19-30 is obviously a major problem,and it’s obviously starting somewhere, but in the high school it might bestarting with alcohol and marijuana.” LAW ENFORCEMENT“Some young people started addiction with pain pills. They were athletes, gotinjured, got pills, got addicted. When the doctor stopped prescribing, theyfound it’s cheaper to get heroin on the street. It’s a very common story.” LAWENFORCEMENT“There’s a very quick jump to heroin, not a slow progression from one drug toanother. They just try it right off the bat It’s straight from out one night, trythis, and then they’re hooked.” LAW ENFORCEMENT“A lot of it goes unreported, especially with IV drug use, because of the socialstigma of using needles.” COMMUNITY PROVIDER 28
Heroin:Attitudes Interviewees and focus group participants expressed deepconcern, sadness and fear about the opioid crisis.“I get the impression that the community as a whole is aware and really worriedand wanting to do something.” COMMUNITY PROVIDER“People don’t advertise that they’re doing it, because people see it as bad.” YOUTH“There is so much more stigma and pressure to hide and keep it secret with IVdrug use.” COMMUNITY PROVIDER“Our young people typically have strong negative feelings about heroin. But thatmay be partly because we have a younger group here.” COMMUNITY PROVIDER“I think a lot of our youth are really scared about what they see in thecommunity, especially opiate addiction. I hear them talking about that.”Youth focus group participants sawheroin use as really risky and “bad”and were aware of potential harmsof heroin use, including addiction,overdose and death.COMMUNITY PROVIDER“Adults who work in the system think it’s terrifying. It’s everywhere, every child isat risk. It doesn’t take a lot for a child to become addicted and we really don’tknow what to do about it.” LAW ENFORCEMENT 29
Heroin:Access Focus groups and interviews supported survey findings thatheroin is not as
Police Department, Mohawk Trail Regional School, Montague Police Department, Northfield Police Department, Northwest District Attorney’s Office, Orange Police Department, Quabbin Youth Initiative, Turners Fall High School. And to the following organizations that hosted parent focus groups: Moha
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