CCB MEDIA PHOTO
Cheryl Bartlett, who heads Cape Cod Healthcare’s substance abuse prevention initiative, speaks at Independence House’s Domestic Violence Awareness Month Community Breakfast. Behind her are cut-outs representing the people killed in domestic violence incidents this year in Massachusetts.
HYANNIS – New Capewide programs to deal with the opiate abuse epidemic include prevention efforts with middle school-aged children and help for addicted mothers and their babies.
The programs were outlined by Cheryl Bartlett, who leads Cape Cod Healthcare’s substance abuse prevention initiative, at last week’s annual Domestic Violence Awareness Month Community Breakfast.
Bartlett said the programs are part of a comprehensive plan on substance abuse put together by county officials. She said prevention is one of the key facets of the plan.
“One of the focuses for Cape Cod Healthcare is to try to help the next generation to be a healthier generation,” Bartlett said to a full room gathered at the annual breakfast at the Doubletree Hotel Thursday morning. “In many ways, this generation that we’re losing to opiate overdoses is already addicted—and we definitely need to find better ways to help them—but wouldn’t it be better if we could take this next generation down a different path.”
Bartlett said the comprehensive youth prevention and education initiative is focused on sixth graders, which is the age that studies show young people can begin risky behaviors that can lead to substance abuse.
“We’re really trying to look at getting into sixth grades across the Cape with a basic life skills training,” she said.
The curriculum gives young students tools and role-playing situations so they can learn to say no in peer pressure situations.
Another program for children, Bartlett said, comes out of a bill currently before the state legislature, called Adolescent Screening, Brief Intervention and Referral to Treatment, a confidential questionnaire that school nurses give to students to try to assess what level of risks children are in for substance abuse.
“We’re trying to see if we can’t get this screening in for the middle school children, 7th or 8th graders, to try to get to kids earlier,” she said.
For students who are determined to be at high risk for substance abuse, they would get in school counseling, Bartlett said. Gosnold, the Cape’s largest substance abuse treatment agency, has counselors in 15 Cape Cod schools already to provide such counseling, she said.
“There’s really clear evidence that if we can give kids some kind of intervention in sixth, seventh and eighth grade that it has very long term lasting impacts,” she said.
Bartlett said she is also working on baseline behavior risk surveys to put in place prior to the questionnaire program, so officials can track the program’s progess.
The surveying is part of an existing Drug Free Communities program, Bartlett said. On Cape Cod, Falmouth is the only designated drug-free community through the Falmouth Prevention Partnership, but Bartlett said she wants to work to get more towns into the Drug Free Communities program.
Listing other programs for students, Bartlett said, the program Calmer Choice is already in local schools to help younger children deal with stress and to give them tools to make good choices.
The Recovery Youth Coalition is made up of local young people who want to tell their stories of how they got into trouble with addiction and then how they took a path to recovery. Bartlett said she hopes to help get those speakers into local schools as well.
Bartlett also announced a grant called Moms Do Care to work with pregnant and postpartum women. Massachusetts has higher than national rates of children born exposed to substances and born withdrawing from opiates, which is called neonatal abstinence syndrome, Bartlett explained.
She said, Cape Cod Healthcare will be hiring a physician who is in recovery from opiate addiction herself to reach out and find pregnant women to be in the program. The program seeks to give the mothers resources to better care for themselves; to get them into prenatal care earlier; to get OB/GYNs certified to be able to prescribe medication that mothers need when they are opiate addicted; and to give recovery support after they deliver for six months of post-partum care to try to prevent relapse.
Support groups for mothers of opiate addicted babies already exist in Falmouth and Hyannis, Bartlett said.
When it comes to the opiate abuse epidemic, Bartlett also said over-prescribing is a big problem.
“About 80 percent of people that are addicted to heroin began their addiction with a prescription opiate and so we really need to address the over-prescribing of opiates and really try to make an impact there,” she said.
The focus of this year’s Domestic Violence Awareness Month breakfast was how substance abuse affects domestic violence.
Bartlett said, “I’m actually thrilled with the topic today and bringing together the conversation of domestic violence and substance abuse because I can remember back then where we wanted to say it had no relationship. I think it was because we didn’t want to give alcohol the excuse for people that did perpetrate [domestic violence]. But to me it made no sense to not be able to have the correlation because there is clear evidence that’s really beginning to shape how we work with this population.”
Barlett emphasized that the links between substance abuse and domestic violence are not a case of cause and effect. “The alcohol does not cause the violent behavior. We know this is about power and control,” she said.
Bartlett said that studies have linked violent behavior with alcohol consumption. One study showed 92 percent reported drinking or using drugs on the day that they committed their offense and about 50 to 70 percent of batterers were under the influence at the time of the attack.
“So alcohol seems to be the primary substance that may acerbate some of the behaviors around violence,” she said.
Bartlett, who was formerly the state’s Commissioner of the Department of Public Health said, she worked on a number of programs related to domestic violence while serving in that position, including the Sexual Abuse and Domestic Violence program, which provides funding for Independence House and other programs for community-based prevention efforts and support for survivors of domestic violence.
There was also the Batterer’s Intervention Program, which Bartlett said is a sometimes controversial court-ordered program for men to come together to talk about what triggers their behavior.
She said she also worked on the Sexual Assault Nurse Examiner Program (SANE), for nurses on the front lines of domestic violence taking care of people who are badly injured, giving care and collecting forensic evidence.
Bills that were passed in 2014 that Bartlett said she was glad to see in the areas of domestic violence and substance abuse are a comprehensive domestic violence piece of legislation; a gun control bill; and a first-in-the-nation omnibus substance abuse bill that made it law that in Massachusetts someone cannot be denied treatment for up to 14 days if they and their physician believe it is necessary.
Bartlett said the state’s Bureau of Substance Abuse Services works on four areas: prevention with youth; intervention or harm reduction; treatment; and recovery. Those will also be the basis for county programs.
“I think we’ve seen with this opiate epidemic that we need new treatment models and we need new treatment options available for people,” Bartlett said.
She compared substance use disorders, which have a 40 to 60 percent relapse rate, with other chronic relapsing diseases like diabetes, asthma and hypertension.
“We often put blame on the person to go to treatment once and not get better. And when they relapse, we blame then instead of putting them back into treatment,” she said of people substance use disorders. She said that the insurance companies have been punitive with treatment but at the state level, she said, that problem is being addressed with new legislation coming out of the governor’s office.
By, Laura Reckford, CapeCod.com NewsCenter
Reaching a particularly high risk group of children (the children whose parents are active, imprisoned, or recovering) is essential as children “learn what they live”.