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The Power of Community Norms and Values
The Story of Lewiston, Maine
Presented by:Scott M. Gagnon, MPPSubstance Abuse and Tobacco Prevention Services ManagerHealthy Androscoggin
Workshop Objectives
Importance of community norms and values
Developing messages that resonate with target audiences
Organizing a successful marijuana education panel or town hall
Engaging and getting covered by the media
Community & Coalition Overview
Population: 107,609 (US Census, 2010)
Mix of rural and urban 55% of population lives in
urban Lewiston/Auburn (aka L/A)
Primarily Caucasian population (93%) Lewiston – 86% Large Franco-American population
Growing population of refugees (Somali/Somali Bantu) in L/A
15.5% of population is 65+ Population in poverty (14.8%)
above Maine average
Community Overview – Androscoggin County & Lewiston
Other characteristics of Lewiston
Population 36,400 (2013 estimate) 48% of the population of French
ancestry 29.9% identify with French-Canadian
ancestry 11.2% are “New Mainers”; immigrant
populations of Somali, Somali Bantu, Sudanese, Djibouti, etc.
16% of population over age of 18 are Veterans
Religious community with over 18 churches
Coalition IntroductionBegan in 1995 as a grassroots group (Tobacco-Free LA) Evolved to HA in 2001 with expanded goals
Nutrition Physical Activity Lead Poisoning Prevention Tobacco Substance Abuse
Project Unite! is the multi-sector, community based task force within the Healthy Androscoggin coalition that advises the substance abuse prevention strategies.
Vision: The communities of Healthy Androscoggin are the healthiest in Maine. Mission: Empowering people and improving the public health of the communities of Healthy Androscoggin, through ongoing planning,
community action, education and advocacy.
Steering Committee
Project Unite! Organization Chart
VetCorps Task Force
Alcohol Enforcement
Team
Prescription Drug Task Force
Other Ad Hoc Workgroups
Event Planning Workgroups
Youth Tobacco Use Underage Drinking Youth and Young Adult Marijuana Use Youth and Young Adult Prescription Drug Abuse
Four Priority Areas
2013 Past 30-Day Use of Four Priority Substances*
Middle School
High School
Tobacco (Cigarettes) 4.3% 10.7%
Alcohol 6.3% 23.6%
Marijuana 6.9% 18.9%
Prescription Drugs 3.3% 4.7%Maine Integrated Youth Health Survey, 2013
Youth Marijuana Data – Middle School
Androscoggin Maine
Past 30 Day Use 7% 4%
Easy to Obtain 24% 18%
Parents accepting of use 7% 5%
Low perceived risk of harm from regular use
36% 29%
Maine Integrated Youth Health Survey, 2013
Middle School Summary
Androscoggin County had the largest percentage of all counties in most measures
About 1 out of 8 Androscoggin County middle school students reported ever using marijuana.
Over 1 out of 5 Androscoggin County middle school students who use reported starting before age 11.
Percentage of females reporting past 30 day use of marijuana is larger than percentage of males.
Youth Marijuana Data– High School
Androscoggin Maine
Past 30 Day Use 19% 22%
Easy to Obtain 56% 56%
Parents accepting of use 15% 15%
Low perceived risk of harm from regular use
53% 53%
Peers accepting of regular use 50% 53%
Maine Integrated Youth Health Survey, 2013
High School Summary
About 1 out of 5 high school students in Androscoggin have used marijuana in past 30 days.
Of those who have used, 1 out of 4 used before the age of 13. Big increase in percentage of students who see no risks from
regular marijuana use. Over half of high school students in Androscoggin believe
there is no/slight risk from regular marijuana use. Percentage of males reporting past 30 day use of marijuana is
10 points higher than percentage of females.
The Marijuana Policy Landscape in Maine Bills introduced to legalize recreational marijuana
were voted down in 2013 and 2014 Another bill expected to be introduced in 2015. Three cities targeted for November 2014 ballot.
York
South Portland
Lewiston Expectations for bills that could strengthen, or
weaken, existing medical marijuana regulations. Statewide voter referendum eyed for November 2016
Marijuana Policy Project
Legalize Maine
Marijuana Prevention Objectives and Strategies
Healthy Androscoggin Marijuana Objectives & Strategies
SAMHSA-approved Drug Free Communities Objectives Impact Parental Attitudes and Knowledge
around youth marijuana use▪ Strategy 1: Community education to increase
parental knowledge of the risks of youth marijuana use.
▪ Strategy 2: Increase knowledge and skills amongst professionals who work with parents and youth.
▪ Strategy 3: Provide support to local governments and school boards with policies addressing medical and recreational marijuana
DFC Activities
Disseminate state and national materials
Develop localized materials with local data
Support local government and other entities around policy (City of Lewiston e-cig policy)
Educational opportunities for educators, health, behavioral health, and other professionals.
Social Marketing Convene Marijuana Town Hall
Marijuana Objectives & Strategies Cont’d
Objectives funded by Maine Office of Substance Abuse and Mental Health Services (SAMHS) Increase communications to the public
about the risk and harm of marijuana use▪ Use SAMHS-developed materials to provide
educational sessions for residents▪ Disseminate information and/or materials to
residents.
Prevention & Education Initiatives
Social Marketing Campaign Marijuana Town Halls Chamber of Commerce Brown Bag Presentations Table Talks Screening, Brief Intervention, Referral to
Treatment (SBIRT) training for medical providers Drug Impairment Training for Education
Professionals Youth Engagement and Empowerment
Drug Facts Week & In-school presentations
Groups & organizations working on state-level prevention
Maine Office of Substance Abuse and Mental Health ServicesMarijuana Work GroupFunding for Healthy Maine Partnershipswww.Maineparents.net
Maine Alliance to Prevent Substance Abuse Marijuana and Public Health Issues
SAM Maine (Smart Approaches to Marijuana) Advocating for science-informed public policyCommunity presentations on the science of today’s
marijuana.www.learnaboutsam.org
Governor’s Substance Abuse Services Commission
Maine’s Marijuana Education Toolkit
PowerPoint Slide Bank 5 Key Messages Pregnancy and Breastfeeding Rack
Cards Maineparents.net Various PSAs and other materials
created by SAMHS and Marijuana Workgroup
Healthy Androscoggin Partners
Alcohol Enforcement Team Lewiston/Auburn Public Health Committee Western District Coordinating Council Bates College Kaplan University University of Southern Maine – L/A Androscoggin Chamber of Commerce Gleason Media – Z105.5 Turner Publishing DFD Russell Medical Centers Tri-County Mental Health Services School Districts Advocates for Children
Community Norms andFive Key Messages
Community Norms & Values
Community norms are important risk and protective factors in substance abuse
Community and family values are also key Education Youth striving and thriving Healthy development Healthy workforce Public safety
Making the Connection
Community Values
Family Values
Community Education
on Substances
Community Norms
Environmental
Strategies
•Past success with underage drinking•Androscoggin County slashed underage drinking rates – lowest rate in Maine.
Marijuana use changes teens’ brains, bodies, and behaviors. Help Maine teens have safe, healthy and successful futures!
Impairment Health Future Success Addiction Perception of Harm and
Normalization
Marijuana use lowers teens’ good judgment and self-control.
Heavy marijuana use is linked to an increased risk of a motor vehicle crashes.
Nationally, in 2011, 57% of Emergency Department visits for illicit drug use among 12-24 year olds involved marijuana.
Using marijuana weekly or more has also been shown to double a teen's risk of depression or anxiety.
Ashbridge, M. & Hayden, JA (2012) Acute Cannabis Consumption and Motor Vehicle Collision Risk: Systematic Review of Observational Studies and Meta-analysis. British Medical Journal, 344:e356.Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network, 2011:National Estimates of Drug-Related Emergency Department Visits. HHS Publication No. (SMA) 13-4760,DAWN Series D-39. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013Hayatbakhsh, M.R. et al. (2007) Cannabis and anxiety and depression in young adults: A large prospective study. Journal of the American Academy of Child and Adolescent Psychiatry, 46(3):408-17. Patton, GC et al. (2002) Cannabis use and mental health in young people: cohort study. British Medical Journal, 325:1195-1198.
Marijuana use damages teen brains and bodies.
Studies indicate that problems with attention, learning, memory and processing speeds can be associated with heavy marijuana use during adolescence.
The amount of tar inhaled by marijuana smokers and the level of carbon monoxide absorbed are 3 to 5 times greater than from tobacco smoke.
Marijuana contains more cancer causing chemicals than tobacco. Meier, MH et. al (2012) Persistent Cannabis Users Show Neuropsychological Decline from Childhood to Midlife. Proceedings of the National Academy of Sciences. 109(40) e2657-e2664.Jacobus, J., Bava, S. et. al. (2009) Functional Consequences of Marijuana Use in Adolescents. Pharmacology, Biochemistry and Behavior 92(4).Drugs and Human Performance Fact Sheets - Cannabis / Marijuana ( D 9 -Tetrahydrocannabinol, THC). National Highway Traffic Safety Administration, n.d. Accessed at: http://www.nhtsa.gov/people/injury/research/job185drugs/cannabis.htm .The British Lung Foundation (2012) The Impact of Cannabis on Your Lungs. Accessed at: http://www.blf.org.uk/Files/8ec171b2-9b7e-49d9-b3b1-a07e00f11c05/The-impact-of-cannabis-on-your-lungs---BLF-report-2012.pdf
Marijuana use keeps teens from doing their best. Marijuana use in teens has been linked to lower academic
performance and reduced job prospects. Heavy marijuana users experience attention and memory
problems which last beyond the time when they are high. Studies indicate these problems can worsen with years of regular use.
Meier, MH et. al (2012) Persistent Cannabis Users Show Neuropsychological Decline from Childhood to Midlife. Proceedings of the National Academy of Sciences. 109(40) e2657-e2664.
Solowij N, Stephens RS, Roffman RA, et al. (2002) Cognitive Functioning of Long-term Heavy Cannabis Users Seeking Treatment. JAMA, 287(9):1123-1131.
Teens who use marijuana are at an increased risk for addiction. Research has established that marijuana is addictive and that it
is three times more likely to lead to dependence among adolescents than adults.
About 1 in 6 of those who start using marijuana in their teens develop addiction
Nationally, in 2011, 872,000 persons reported receiving treatment for marijuana use
Gfroerer, JC, Wu, LT., & Penne, MA. (2002). Initiation of Marijuana Use: Trends, Patterns, and Implications (Analytic Series: A-17, DHHS Publication No. SMA 02-3711). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.
Wagner, FA & Anthony, JC (2002) From first drug use to drug dependence; developmental periods of risk for dependence upon cannabis, cocaine, and alcohol. Neuropsychopharmacology 26(4), 479 488.‐
Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-44, HHS Publication No. (SMA) 12-4713. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012.
Marijuana is neither safe nor benign Today’s marijuana is far more potent: The average THC content
in marijuana has risen from under 4% in 1983 to more than 10% in 2008.
Greater marijuana potency means a smaller amount can make someone higher, faster- and perhaps far more intoxicated than they can handle.
Mehmedic Z, et al (2010) Potency Trends of r9-THC and Other Cannabinoids in Confiscated Cannabis Preparations from 1993 to 2008. Journal of Forensic Science, 55(5):1209-17.
ibid
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1960
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1992
1993
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
THC
0.2
0.24
0.390000000000001
0.47
1 1 1.5
3.3
3.3
3.5
3.5
3.1
3.1
4 4.54
5.16
4.96
4.67
5.4
6.18
7.26
7.18
8.33
8.09
9.08
10.27
10.25
9.91
10.96
11.42
CBD
NaN
NaN
NaN
NaN
NaN
NaN
NaN
NaN
0.28
0.310000000000001
0.380000000000001
0.36
0.330000000000001
0.310000000000001
0.42
0.4
0.41
0.43
0.45
0.47
0.42
0.46
0.46
0.46
0.53
0.48
0.41
NaN
NaN
NaN
1
3
5
7
9
11
13
MA
RIJ
UA
NA
PO
TEN
CY
CBD:NON-
Psychoactive Ingredient
Average THC and CBD Levels in the US: 1960 -
2011
Source: Mehmedic et al., 2010
THC:Psychoactive Ingredient
Public Safety: Marijuana increases risks to everyone on the road.
Marijuana use, and its impairment of motor coordination and reaction time, doubles the risk of car crashes.
Cannabinoids, the drug class that includes marijuana, ranked as the number one drug found in Maine impaired driving cases (Jan 2009-Aug 2011) when a Drug Recognition Expert was called in.
M. Asbridge, J.A. Hayden, J.L. Cartwright. (2012) Acute cannabis consumption and motor vehicle collision risk; systematic review of observational studies and meta-analysis. British Medical Journal, 344 : e536: DOI: 10.1136/bmj.e536Brunell, D. (Maine Dept. of Transportation), Pierce, S. (Maine Dept. of Health and Human Services), Drug Recognition Experts. (March 2012) Maine Drug and Alcohol Crash Related Data. [Powerpoint slides]
Boil it down
Don’t barrage your audiences with data
Give them what they want Listen to their fears and concerns
(they are usually in the questions) We are immersed in this, most in our
audiences are not.
Keep it simple and straightforward
Visuals Grab AttentionSHOW them that today’s marijuana is not the marijuana of the 60s.
Making Drug Use Appealing to Youth
Marijuana Town HallsGet this out into the community!
Town Halls
Two town halls held in Lewiston in 2014 Town Hall #1 – May 2014
Was part of DFC workplan submitted in March 2013 Goal – educate public on new marijuana data, latest
research, and to hear from professionals in the community dealing with issues first hand
Town Hall #2 – October 2014 Request from City of Lewiston and Lewiston/Auburn
Public Health Committee Goal – address emerging questions from the
community around marijuana , learn from local experts, and give parents prevention tools.
May 2014 Androscoggin County Town Hall
Opening Remarks Presentation Panel Moderated by: Mike Chavez, Maine State
Police Kevin Cowell, D.O., MPH – DFD Russell Medical Centers Vicky Wiegman, M.Ed, CAS – Lewiston High School Travis Doboszenski – Tri-County Mental Health Services Craig Johnson - Lewiston Police Department Scott Gagnon , MPP– Healthy Androscoggin
Q & A with Panelists Just One Thing – How will you get involved?
October 2014 Town Hall for City of Lewiston
Welcome/Introduction (10 mins) Presentation (20 mins)
Local data Latest science on marijuana & impacts to health Prevention tips for parents
Moderated Panel (30-40 mins) Youth Medical Law Enforcement Education Behavioral Health
Q & A (20-30 mins)
Take aways
Moderate attendance but huge local & state media coverage. Covered by all major news affiliates and
state papers. Stories from medical and behavioral
health treatment professionals hit home
Visuals of the edibles were eye-opening and jaw-dropping
New partnerships were forged with panelists
Tips
Plan early If funding is an issue, look for free spaces
May Town Hall was in a public library October Town Hall was at the middle school
Think about transportation and accessibility
Prevention tips for parents Get audience engaged. Promotion, promotion, promotion! (not
just ads) – listservs and networks
Tips continued
Make a plan for Q & A Live mic or screened questions?
Discuss how you will handle “controversy” And prepare panelists
Don’t get hooked into a debate Have resources available for
concerned audience membersDon’t be afraid of controversy, just be
prepared for it.
Getting Media Coverage
Monitor marijuana coverage in your area. Who has the “marijuana beat”? They aren’t covering prevention? Reach out and say
Hi! Relationship building
Meet & Greet, Follow on Twitter Media list – maintain It’s a partnership – symbiotic relationship
You want your messages out, they really want to cover marijuana
Reporting isn’t always going to be great, but don’t give up on them.
More on Media
Don’t forget the smaller papers, public access, college papers
Get coalition members and multiple sectors involved. Educators sharing academic impacts Doctors sharing what they see & hear in exam
room Employers sharing workplace
safety/productivity issues Message validation through triangulation
More buy-in as the public hears from more voices.
2014 Election OutcomesTwo out of Three Maine Cities Reject Legalization Ordinances
A Tale of Three Cities
York – Board of Selectmen refuse to put on ballot
South Portland – Passes 52% vs 48%
Lewiston – Fails 45% vs 55%
South Portland
One Two Three/Four
Five Absentee
LePage (R) 23.2 26.9 36.1 35.9 32.3
Michaud (D) 66.7 62.3 53.9 55.1 55.7
Bear Bait Ban
68.4 67.8 58.9 59.9 64.4
Legalize MJ 57.8 55.4 50.0 52.6 42.9
Districts that had strongest support for Democrat and for the bear-baiting ban had the strongest support for marijuana legalization ordinance.
Districts with stronger support for Republican showed less support for marijuana legalization ordinance.
Lewiston
1 2 3 4 5 6 7 C-V
LePage (R)
41.0 58.0 29.3 59.1 40.0 62.8 58.3 45.6
Michaud (D)
50.9 34.3 62.7 32.9 50.5 29.9 32.9 45.6
Bear Bait Ban
59.0 46.4 63.9 46.2 53.3 44.1 50.0 56.1
Legalize MJ
54.2 41.1 65.7 42.6 56.9 43.6 45.4 36.6
Every district that voted for Governor Paul LePage (R) also voted against the bear-bait ban and the marijuana legalization ordinance.
Absentee ballots were against legalization almost 2 to 3, however were split between Gubernatorial candidates and voted in favor of bear-bait ban.
The Bottom Line
The public has questions and concerns
You have the science and research Meet the community where they are
at Get the community involved!
You can do it! You can have an impact!
Healthy Androscoggin & SAM Maine Social Media
www.facebook.com/healthyandroscogginwww.facebook.com/
MaineProjectSAM
@ScottMGagnon@HealthyAndro@maine_SAM
Other Resources
Maine Alliance to Prevent Substance Abuse http://www.masap.org/site/mapsa.asp
Maine Parents – prevention tools for parents http://www.maineparents.net
Healthy Androscoggin www.healthyandroscoggin.org
Contact Info
Scott M. Gagnon, MPP300 Main StreetLewiston, ME 04240207-795-2120
Healthy Androscoggin: [email protected]
SAM Maine: [email protected]
