Cumberland County Assessment for Substance Abuse 
The Cumberland County SPEP Collective 
June 2007 
 
Assessment Committee Responsibilities 
 
County: 	Cumberland County 	

Committee Member 	Affiliation 	Role/Responsibility 	
 
Lucie Rioux 	Communities Promoting Health Coalition 	Collective Member and Core Group Member 	
 
Amanda Beal 
 	Communities Promoting Health Coalition 	Collective Member and Core Group Member 	
 
Kaki Dimock 
 	PROP 	Collective Member and Core Group Member 	
 
Erica Schmitz 
 	MCD/ 21 Reasons 	Collective Member and Core Group Member 	
 
Ronnie Katz 
 	Health and Human Services City of Portland 	Collective Member and Core Group Member 	
Christina Lamarre 	Raymond Mentoring 	Collective Member 	
Dona Forke 	Bridgton HMP 	Collective Member 	
Sandy Hale 	Westbrook School Dept. 	Collective Member 	
Malory Shaughnessy 	MASAP, Cumberland County Commissioners 	Collective Member 	
Bethany Sanborn 	Healthy Portland HMP 	Collective Member 	
Tina Harnett Pettingill 	Health and Human Services City of Portland 	Collective Member 	
Lee Anne Dodge 	USM	CollectiveMember	
Scott Gagnon 	Day One 	Collective Member 	
Carol Troy 	The Women’s Project 	Collective Member 	
Margaret Jones 	Day One 	Collective Member 	
Bob Scarpelli 	South Portland Police 	Collective Member 	
mike Clifford 	Portland Public Schools 	Collective Member 	
Robin Haley 	Falmouth Public Schools 	Collective Member 	
John Kenney 	Cumberland/ North Yarmouth Public Schools 	Collective Member 	
Melissa Fochesato 	21 Reasons 	Collective Member 	
Colleen Taylor-Capano 	Gray/ New Gloucester parents 	Collective Member 	
Lynn Doxey 	City of Portland, Minority Health Dept.  	Collective Member 	
Stephanie Duggan 	District Attorney’s Office 	Collective Member 	
 
Martin Lynch  	MSAD 15 	Collective Member 	

 
Indicator Data for Substance Use Among Middle and High School Students  
(from County Profile Supplement) 
 
Indicator 	Overall Rate of use, 2006 	Group with highest rates, 2006 	Compared to state? 	Other notes 	
Lifetime use: alcohol 	48.8% 	12th graders 	 Higher 
 Lower 
 About the same 	Big increase in percent lifetime use between 8th and 9th grade 
 	
Lifetime use: marijuana 	25.6% 	12th graders  	 Higher 
 Lower 
 About the same 	10% of students have used Marijuana a few times, while 14% have used it more than 10 times. 	
Lifetime misuse: prescription drugs 	11.6%  	12th graders 	 Higher 
 Lower 
 About the same 	Rates have actually decreased over the last few data cycles in Cumberland County 
 	
Previous 30-day use: alcohol 	29.7%	12th graders 	 Higher 
 Lower 
 About the same 	There is a 13% increase in 30-day alcohol use between 8th and 9th grade.   
 	
marijuana 			 Lower 
 About the 
 Higher 	Cumb. Co has higher rates of use in 11th and 12th grade.  The data also indicates that 5% of students have used marijuanamore than 10 times in the past 30 days 11th and 12th grade have about the same 	
prescription drugs Previous 2-week 			 Lower t
 About 
 Higher 	rates of use  
 	
participation in bidrinking by grade Previous 2-week n			 Lower t
 About 
 Higher 	 
 	
participation in bidrinking by gender Age first tried alcoh			 Lower t
 About 	 
A	
				 	
Age first tried marijuana 	37% 14 and older      	      	N/A 	Age of first marijuana use increased over time 	

 
Substances of greatest concern in our county: 
 
• Binge drinking is of great concern.  There is a huge increase in 30-day use between 8th and 9th grade and over a third of 12th graders have participated in binge drinking in the past 30 days.  
• Marijuana is of concern since over a quarter of 12th graders report past 30-day use.   

Subpopulations/age groups of particular concern in our county: 
 
• 9th graders are of particular concern for binge drinking not just because of the increase in drinking, but also because of their vulnerable position within the school environment.  They report the greatest amount of fear for their safety during this year and report much greater access to drugs and alcohol than they did in 8th grade.   
• 11th and 12th graders are of particular concern in regards to marijuana use considering their especially high rates of use (statistically significantly higher than the state).  It is also concerning that 12% of 11th and 12th graders first tried marijuana before the age of 14. 

Substances consumed in our county at a higher rate than the state: 
 
Marijuana 
 
Areas where we need more information (such as who, what, where, why and when): 
 
We need more information about what happens as 8th graders move into the high school setting.  What changes in their lives, in the school environment, in their development, in the social environment, etc., that would contribute to the much higher rates of use and binge drinking.  We also need more information about marijuana use.  Who is smoking, where they are smoking and for what reasons.  There is a big gap in info about marijuana in general.

Indicator Data for Substance Use Among Adults 
(from County Profile Supplement) 

Indicator 	County: Rate of use 	State:  
Rate of Use 	Compared to state? 	Other notes 	
Lifetime use among adults: alcohol 	94.2%	91.8%	 Higher 
 Lower 
 About the same 	      	
Lifetime use among adults: marijuana 	49.1%	40.5%	 Higher 
 Lower 
 About the same 	Marijuana use is almost 9% higher in Cumberland  Co. although it is not clear whether the difference is statistically significant. (no p-value indicated) 	
Lifetime use among adults: prescription drugs 	4%	4.9%	 Higher 
 Lower 
 About the same 	Not enough information to determine statistical significance 	
Previous 30-day use among adults: alcohol 	67.9%	56.6%	 Higher 
 Lower 
 About the same 	Previous 30-day use is 10% higher in Cumberland  Co 	
Previous 30-day use among adults: marijuana 	4.7%	4%	 Higher 
 Lower 
 About the same 	Not enough information to determine statistical significance 	
Previous 12-month participation in binge drinking 	48.7%	50.8%	 Higher 
 Lower 
 About the same 	 

Previous 30-day participation in binge drinking 	27.5%	27.8%	 Higher 
 Lower 
 About the same 	      	
Previous 12-month binge drinking by gender (not available for all counties) 	Men:54.6% 
Women:43% 	Men: 57% 
Women: 44% 	 Higher 
 Lower 
 About the same 	Men have a 10% higher rate of binge drinking than women  	
Individuals crossing the threshold for prescription drugs 	Female: 60.5% 
 
Male: 39.2% 	Female:62.7% 
 
Male: 37.3% 	 Higher 
 Lower 
 About the same 	20% more females cross the threshold than males 	
Median age of individuals crossing the threshold 	43	42	 Higher 
 Lower 
 About the same 	      	

Substances of greatest concern in our county: 
Alcohol use.    Almost half the population has binged in the past year and more than a quarter have in the past 30 days.   

Substances consumed in our county at a higher rate than the state: 
Marijuana appears to be consumed at a higher rate although unsure if percentage difference is statistically significant.   
 
Areas where we need more information (such as who, what, where, why and when): 
I need to look at the actually data that the marijuana stats came from.  I want to know who are the binge drinkers more specifically.  We know that men are more likely than women to binge but we need more information on various age groups, and subpopulations to better assess the problem. 

Consequences of concern in my county among particular subpopulations/age groups: 
 
• Binge drinking  

 Indicator Data: Substance Use Consequences Among Youth 
(from County Profile Supplement) 

Indicator 	Rate of consequence in most recent year: County 	Compared to state? 	Trends over time? 	Other notes 	
Juvenile arrests for alcohol violations 	346 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	There has been a decrease in alcohol arrests over the last ten years, but it has held steady for the past 4 years 	
Juvenile arrests for drug violations 	475 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	Since 1996, the year with the highest rate, arrests are down, but over the past 4 years there has been an increase of almost 100 arrests per 100,000 youth 	
Percent of all youth drivers (under 21) in fatal crashes who were alcohol-involved 	4.4 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	A slight increase.  Cumberland Co. has a very low percent of youth involved in fatal accidents involved with alcohol 	
Suspensions/removals due to alcohol or drugs  	N/A 	 Higher 
 Lower 
 About the same 	N/A 	Lower in Alcohol and other drugs but higher percentage of removals due to Marijuana 

 
Consequences of concern in my county: 
Cumberland Co has lower rates of most of the consequence data but arrests are not always a good way to track the consequences.  Considering that use rates seem to be similar, it doesn’t necessarily follow that arrest rates would be so much lower.  Because Cumberland Co is home to the biggest city in Maine, it is possible that the police do not have as much time and energy to concentrate on drugs and alcohol compared to the rest of the state.   
 
Consequences in which my county exceeds the state: 
Suspensions for Marijuana are higher in our county 
 
Consequences where we need more information (such as who, what, where, why and when): 
In general, we need more consequence data.  There is limited data in the county profile that gives us a really good sense of the consequences of youth drug and alcohol use.  We need more info on the problems it causes in the home environment, on schooling, on health, etc. 
Indicator Data: Substance Use Consequences Among Adults 
(from County Profile Supplement) 

Indicator 	Rate of consequence in most recent year: County 	Compared to state? 	Trends over time? 	Other notes 	
Deaths by underlying cause 	      	N/A 	 Increase 
 Decrease 
 No change 	      	
Rates of reported crimes per 1,000 people, by type 	6.8	N/A	 Increase 
 Decrease 
 No change 	      	
Arrests for alcohol violations, age 18 and older  	954 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	      	
Adult OUI arrests, age 18 and older 	712 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	      	
Arrests for drug violations, age 18 and older 	312 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	      	
Percent of total fatal crashes over 5 years that were alcohol-related 	39% 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	Compared to other counties? One of the highest 	
Percent of all young adult drivers (21 to 29) in fatal crashes who were alcohol-involved 	56.7% 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	This graph is astounding!  The state decreased the percentage while Cumberland Co went up by 18%  	
Percent of all adult drivers (30 and older) in fatal crashes who were alcohol-involved 	20.7%      	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	      	
Overdose deaths 	17 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	The rate is less than it was the year before but it is higher than the previous 5 years. 	
Treatment admissions (all ages) 	1132 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	      	
Percent of total treatment admissions (18 and older) involving alcohol 	66.8% 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	      	
Percent of total treatment admissions (18 and older) involving marijuana 	26.8% 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	      	
Percent of total treatment admissions (18 and older) involving prescription drugs (not available for all counties) 	28.9% 	 Higher 
 Lower 
 About the same 	 Increase 
 Decrease 
 No change 	      	

Consequences of concern in my county: 
 
The fatal car accidents involving alcohol among the 18-24 year old population is very concerning.  The percentages have gone up considerably even while the rates in the state have gone down. 
Overdose deaths are also of great concern in our county.  The rates are much higher than the rest of the state. 

Consequences of concern in my county among particular subpopulations/age groups: 
 
The 18-24 year old population is of great concern  
 
Consequences in which my county exceeds the state: 
 
Fatal car crashes for young adults 
Overdose deaths 
Treatment admissions involving prescription drugs 
 
Consequences where we need more information (such as who, what, where, why and when): 
We need much more consequence data concerning other health problems and monetary consequences 
 
Review of Past Needs Assessments 
 
County Name: 	Cumberland County 	
Person Completing Form: 	Liz Blackwell-Moore 	
Completion Date: 	      	

Once you have collected the past assessments that have been conducted in your county, fill out the grid below. 
 
Who conducted it and when? 	What geographic area did it cover? 	What age group(s) did it cover? 	What type of information is in the assessment ? 	What were the key findings relevant to substance abuse prevention? 	
1. Child and Family Services at PROP:2005 
 	Cumberland County 	Parents of children in Head Start Program 	Concerns of parents of children 	Drug and alcohol abuse were a small concern of parents with children in head start 	
2. MYDAUS County data:2006 
 	-Cumberland County 
-All School Districts in the County except for 1 	6th-12th grade 	Use and consequence data, risk and protective behaviors 	Binge drinking is a major problem in our county and we have high rates of marijuana use 	
3. One Maine One Coalition: 2003 
 	Portland	Youth
 	Info on how youth get access to alcohol, why they drink, and the environment 	Family and community were found to be major focus areas for alcohol interventions 	
4. USM Core Data Surveys 
 	Cumberland Country 	College students 	Substance abuse and alcohol use data among college students 	Patterns of use and consequence data for college students  	
5. The Women’s Project: 2006 
 	Cumberland County Colleges 	College age women 	Percentages of alcohol use among women, reasons for use. 	High percent of women were binge drinking and they believed it was normative behavior 
 	
6. Portland DFC Needs Assessment and Asset Mapping:2006 
 	Portland	Youth	Community/environmentdomain, Family/Parent domain, and Individual/Peer Domain 	 Public’s priorities are similar to the OSA Priorties 	
7. CPHC DFC Needs Assessment and Asset Mapping:2006 
 	Buxton, Gorham, Hollis, Raymond, Scarborough, Standish, Windham, South Portland and Westbrook 	Youth 	Results from focus groups with youth and parents 	Parents unaware of child use. Mixed messages from parents and media. Lack of community organizing. 	
8. CPHC Community health Assessment 
 
 	Buxton, Gorham, Hollis, Raymond, Scarborough, Standish, Windham, South Portland and Westbrook 	All ages 	Mostly data on chronic disease and alcohol use 	Higher rates of adult drinking than the state 
Higher rates of binge drinking than the state 	
9.  Bridgton Community Assessment: 2004 	Bridgton, Naples, Sebago, and Casco 	Youth	Substance abusedata,mostly from the MYDAUS 	 Substance use by teens and their low perception of risk of alcohol use 	
10. Poverty in Maine 2006 by Maine Community Action Association 	Cumberland County 	All ages 	Socio-economic data 	Socio-economic data of the county 	
11.   BRFSS State of Maine Data 	State of Maine 	Adults over 18 	Alcohol use  	Binge and heavy drinking statistics for the state by different criteria (eg: age, race, gender, etc) 	
12. Overdose Data: 2006 	Cumberland County 	Adults over 18 	Overdose statistics 	Cumberland Co has the highest percentage of overdose deaths 
 	
13.  Maine Safe and Drug Free Schools and Communities Act Program: 2004-2005 	State of Maine 	Youth 	Stats on incidents of student removal due to drug and alcohol use 	Marijuana accounted for over half the school removals 	

List any regions in your county in which an assessment that included substance abuse has not been conducted and why (if known):  

With a thorough search, no assessment could be found in the 95 corridor region, which includes, Falmouth, Yarmouth, North Yarmouth, Cumberland, Pownal, and Freeport.  Some information has been collected about Freeport by the HMP in Sagadahoc County, but that information is bundled with the rest of their county.  It can be assumed that assessment has been completed in that area because they are not currently covered by an HMP. 
 
 Assessment Report  

County Name: 	Cumberland County 	
Person Completing Form: 	Liz Blackwell-Moore 	
Completion Date: 	5/29/07 	

Section 1: What you learned initially  
 
From your initial review of existing data and prior assessments,  
 
1. What consumption patterns are of particular concern in your county?  Why?  Among which population(s)? Please make sure you list the source of your information. 
• High-risk drinking among youth (MYDAUS ‘06) 
• High-risk drinking among young adults (County profile, USM core data) 
• Marijuana Use among youth (MYDAUS ‘06) 
• Cocaine Use (Arrest data) 
• Prescription Drug Use (MYDAUS ’06 and national data on young adults) 

2. What consequences are of concern?  Why?  Please make sure you list the source of your information. 
• Correlation between alcohol and other drug use (MYDAUS ’06) 
• High rates of sexual risks with alcohol use for youth (CASA) 
• High rates of fatal traffic accidents involving young adults and alcohol (County Profile) 
• High Rates of sexual assault when either or both parties have been using alcohol (CASA and The Women’s Project Study) 
• Cocaine use is linked to high rates of crime (DEA arrest data) 

Please see Appendix A: Highlights from Preliminary Assessment 
 
3. What knowledge gaps exist?   

After brainstorming the contributing factors for the areas of concern, the Collective created a list of questions to address the gaps in knowledge that exist after the preliminary assessment.  Below are the questions: 
12-17 year olds 
• Are youth self-medicating with marijuana 
• What is the perception of risk of driving while high as compared to drinking and driving 
• Why do youth use marijuana? 
• What types of non-substance related activities are there for youth to do on a weekend night? 
• What is the interplay between alcohol and other drugs?  Would lower alcohol rates mean lower drug use rates overall? 
• What are the rewards in school/family/community, for antisocial behavior? 

18-25 year olds 
• Why does this age group use marijuana? 
• What types of non-substance related activities are there for young adults to do on a weekend night? 
• What is the interplay between alcohol and other drugs?   
• What is their perception of the dangers of crack vs. cocaine? 
• What is college students perception of the students that live in chem.-free housing? 

25+ year olds, Parents 
• Questions around parents use of marijuana and their perceptions and/or acceptability of children’s use 
• Parental perception of youth prescription drug use, their knowledge of youth use, and where youth get access to prescription drugs 
• What is the interplay between alcohol and other drugs?   

Possible Key Informant Questions: 
• Is law-enforcement trained to look for prescription drugs when they break up a house party with youth? 
• Are cashiers trained to look for suspicious purchases of over-the-counter medications? 
• Have “No Child Left Behind” standards left prescription drug use off the radar of schools? 
• How do workplace employers reward employees with alcohol?  What are workplace rules around alcohol and drugs and how are those rules enforced? 

 Focus Group Plan: 
 
Focus Group Name 	Age group	Population? 	Location	Date	Time	Facilitators	
The Women's Project 	18-25 	Women in recovery		Thurs. March 15th  	9:30-10:30 	Liz and Dona 	
Raymond Parent 	over 25 	Rural parents 	Raymond elementary 	Jan. 31st  	6-7 pm 	Kaki and Christina 	
Raymond Youth 	12 to 17 	Rural youth  	Raymond elementary 	Jan. 31st  	6-7pm 	Liz and Amanda 	
Prop Peer Leader 	12 to 17 	Mostly refugee and immigrant population 	Riverton	Thurs. Feb. 22	3:30-4:30 	Liz and Amanda 	
Leadership and Resiliency Project 	12 to 17 	Targeted at-risk  youth in high school 	Westbrook 	Fri. Feb. 2 	  	Amanda and Chanda 	
High School Class 	16-17 	  	  	 March 22 	9:40am 	Amanda and Chanda 	
Day One Transitional Housing Program 	18-25 	People in Recovery 	Transitional House 	Wed. March 14 	5:00-6:00 	Liz and Lucie 	
Cumberland County Jail 	18 -25 	Men 	 CCJ 	Tues. March 13 		Ronni and Amanda (PPH)	

** For focus group questions and results, please see Appendix B and C 

 

 
 
Key Leader Meeting Plan: 
 
Zone  	Date and Time 	Location 	Liaison 	
Zone 1 	Wed. Feb 28, 4-6pm 	Windham Public Library 	Christina Lamarre 	
Zone 2 	Wed. Feb 28, 2:30-4:30	Falmouth High School Library 	RobinHaley	
Zone 3 	March 13, 11-1 	Portland City Hall 	Ronnie Katz 	
Zone 4 	Mon. March 5, 4-6 	St. Max's Church 	Lucie Rioux 	

** For Key leader questions and results, please see Appendix D and E

Section 2:  Putting it all together 
 
Please see Appendix F: Key Findings Summary 
 
1. High risk drinking among youth: 12-17 years old 
 
Consequences: 
Fatalities: Nationally, 5000 people under the age of 21 die annually from alcohol-related injuries involving underage drinking.  1900 die annually from traffic accidents. (Surgeon General) 
Increase in Sexual Risks:  
• Nationally, Almost 9 out of 10 (88%) 15-24 year-olds say that people their age drink or use drugs before having sex at least “sometimes”- including 50% who say this happens “a lot”.   
• 24% of sexually active 15-17 year-olds reported doing more sexually than planned because they had been drinking or using drugs (Kaiser) 
• In Maine, of currently sexually active high school students, 26% reported that they drank or used drugs before their last intercourse. (Maine YRBS 2005) 

Suicide: In Maine, 81% of attempted suicides among 15-24 year-olds were from poisoning (often including alcohol).  (Maine Youth Suicide Prevention Program) 
Early alcohol use increases risk of dependence:  40% of people who used alcohol before age 15 also describe their behavior and drinking at some point in their lives in ways consistent with an alcohol dependence diagnosis. (Surgeon General) 
Academic Problems:  Of Maine general education high school students who are removed from school for prohibited behavior, 30% are removed due to drug-related acts (which includes alcohol). (Lobster Book 2005-2006) 
Developmental Consequences:  Recent studies show that early alcohol use may have detrimental effects on the developing brain, including neurocognitive impairment.  (Surgeon general) 
 
Contributing Factors: 
Retail Access/ Availability 
• Shoplifting- placement of alcohol in stores is convenient for stealing 
• Lack of lock caps in hard alcohol bottles (like the one’s Shaw’s has) 
• Youth employees of stores getting alcohol at stores or allowing other youth to buy  

Social Access/ Availability 
• Alcohol easy to access at home for 6th-8th graders 
• Adults purchasing alcohol for underage drinkers (includes adults the youth know, and adults who they meet outside of a alcohol outlet) 
• The ability of youth to drive increases their ability to drink outside of adult supervision (pit parties in the woods, house parties, etc) 
• Cell phone use makes it easy to create parties at the last minute 

Price: 
• Deals on alcohol make it easier for youth to afford it 
• Cumberland County has the highest median income in the state, many receive allowances and/or work outside the home which means youth have more money to afford alcohol.   

Enforcement: 
• Perception that they won’t get caught: 
o Parties are hard to find 
o Pit parties in the woods are hard to find 
o In urban areas, there are many other priorities above underage drinking 
o They never hear of other kids getting caught unless they do something stupid, like get in a car accident 
• Lack of resources at Police Departments 
• Police culture:  Perception is that it’s not a crime, it’s a rite of passage, we all did it 
• Keg registration tags are easy to remove 

Perceived Risk: 
• High perceived risk for drinking and driving but not for anything else related to alcohol use 
• Perception that hard alcohol is more dangerous than beer 
• Perception that fruity drinks aren’t as dangerous?? 

Community Climate: 
• Lack of support from enforcement community 
• The perception from adults that it’s no big deal, we all went through it and survived 
• Lack of chem.-free activities that are affordable, accessible, and appropriate for the age group 
• Driving is expected and the bus is not a viable option. 
• My space/ utube create expectations for youth around behavior (lots of video and pictures of other young people drinking or being drunk) 

Family Climate: 
• Parental attitude that supports drinking 
• Parents drinking a lot in the home 
• Alcohol available at home 
• Parents don’t want kids to drive so they let them drink at their homes 
• Pressure from parents for high achievement 
• Family history of addiction, mental health issues, sexual assault 

School Climate: 
• Perception of safety at school is low during 1st years in high school in Cumberland Co. 
• Lack of interventions and prevention of substance abuse at schools 
• More pressure for high academic achievement, to fit in and do well in all areas 
• Perception that it’s not a big deal if I get caught, teachers don’t care it they use 
• Off campus privileges during the school day offer unsupervised times to use 
• Jr. High and High schools begin to use “Push-out” rules (ie:  the expectations of kids get tougher and more authoritarian without working on engagement of kids) 

Developmental Transitions: 
• Expectations and perceptions of self change from middle school to high school 
• Driving opens up new opportunities for independence and substance use 
• Personal/sexual identity is changing during this time 

 

2.  High Risk Drinking among Young Adults: 18-25 years old 
Consequences: 
Increase in Sexual Risks: 
• Alcohol Use by victim, perpetrator, or both, has been implicated in 46 to 75 percent of date rapes among college students (Kaiser) 
• Among adults aged 18-30, heavy drinkers are five times as likely as non-heavy drinkers to have at least ten sex partners in a year.  Multiple sex partners is a primary risk factor for transmission of STDs, including HIV.  (Kaiser) 
• Heavy drinkers between the ages of 18-25 were more than twice as likely to contract an STD in the past year than young adults who abstained from alcohol.  (SAMHSA) 

FASD:  Each year, 40,000 infants in the US are affected by FASD (Fetal Alcohol Spectrum Disorders), the leading known cause of mental retardation and birth defects.  (National Organization on Fetal Alcohol Syndrome) 
Traffic Fatalities: HUGE increase (18%) in fatal accidents involving alcohol within this age group 
Addiction:  18-20 year olds have the highest prevalence of DSM-IV alcohol dependence 
Contributing Factors: 
Retail Access/ Availability: 
• Upper class people and older friends buy for the underage in this age group 
• If the person looks older they don’t get carded 

Social Access/ Availability: 
• Independent living makes it easy to have parties 
• Older friends buy for underage drinkers 

Price: 
• Affordable 
• Price specials that target younger age groups, ie: 50 cent drafts  

Promotion: 
• Big Marketing by Big Alcohol 
• Movies about this age groups are alcohol centric and promote binge drinking 
• Alcohol ads feature young beautiful people 

Enforcement: 
• Campus security is inconsistent 
• Campus Administration does not prioritize alcohol as a major problem 
• Not a priority for police (compared to other issues like violence) 

Perceived Risk: 
• Lack of information about: serving size, alcohol content, harm reduction strategies, etc 
• Now legal for this age group, so perceived risk is reduced further 
• Campus police are not consistent and do not prioritize alcohol 

Community Climate: 
• Some workplaces promote drinking as part of their climate 
• Alcohol is the “least of all evils” 
• Lack of intervention resources (treatment to quit) for people with no insurance/ low income  

Family Climate: 
• 18 is the “on-your-own” age, family encourages them to do their own thing 
• Parents are more likely to condone drinking by this age group and be more relaxed about rules at home. 

School Climate: 
• Alcohol connected the school identity and loyalty, especially by alumni (via memories) 
• Ostracizism by other students for not participating in drinking/drugs 

Developmental Transitions: 
• Lack of maturity, ie: identifying responsible drinking 
• Struggling with new found independence and identity 

3.  Marijuana Use (all ages) 
Consequences: 
Academic Problems:  Marijuana use, possession and distribution make up 41% of all drug and alcohol related incidents resulting in student removal in Maine (Lobster Book 2004) 
 
Contributing Factors: 
Retail Access/ Availability: 
• Easy to access 

Social Access/ Availability: 
• Socially acceptable especially among parents who use or have used 

Price: 
• Generally inexpensive 

Promotion: 
• Medical Marijuana debate has given new positive recognition to marijuana 
• Seen as “natural”, healthier than cigarettes 

Enforcement: 
• Not a priority for police and therefore there is a lack of enforcement 

Perceived Risk: 
• Perception that it is not addictive 
• Minor legal consequences and low perceived legal consequences 
• Lack of knowledge that it can lead to depression/ ADHD 
• Perception that it is safer to drive while high than to drink and drive 

Community Climate: 
• Community supervision is lacking in some areas, lack of community relationships, rural areas where houses are far apart 
• Lack of activities for young people after school, at night, on weekends 
• Nothing to do at night on college campuses, lack of intellectual conversation 

Family Climate: 
• Lack of family fun/social activities that do not involve substances 
• Many parents use or have used in their lifetime 
• Parental supervision is lacking especially right after school 

School Climate: 
•  Arts/music/ dance programs have been cut and there is a lack of creative outlets within school 
• Lack of physical education and physical activity in school so youth get bored 
• Youth do not learn to self-organize their unstructured time/play 

Developmental Transitions: 
• Using pot to lubricate social interaction during transition times, ie: high school and college 
• Self-medicating for ADHD is common 
• Getting a license 

4.  Prescription Drug Misuse (all ages) 
Consequences: 
Overdose: Visits to emergency rooms arising from nonmedical use of prescription and over-the-counter drugs rose 21%  between 2004 and 2005 (SAMHSA and DAWN network) 
Addiction:  New England has the 2nd highest rate of prescription drug addiction in the U.S. 
Contributing Factors: 
Retail Access/ Availability: 
• Easily prescribed (ER, Doctor, Dentist) 
• Internet access (legit and black market) 
• Fake symptoms to get Rx 
• Over-the-counter meds are very easy to get 

Social Access/ Availability: 
• Out of medicine cabinet of parents 
• From friends at college who are prescribed the meds 
• Increase use of email/codes 
• Get it from partner 

Price: 
• Over-the-counter meds are inexpensive 
• Rx is covered by insurance and subsidized so it’s inexpensive 
• Stealing is free 
• Sex for drugs costs no money 

Promotion: 
• Media ad saturation for prescription drugs 
• Promoting to Doctors, incentives from Rx companies help promote use of certain drugs 
• Huge drug company lobbying 

Enforcement: 
• Hard to detect 
• Police may not be looking for Rx when busting a party 
• Child protection services may not be trained to look for Rx abuse 
• OSA monitoring system may not detect who the abuser is, just the name of the person who has gone over the threshold 

Perceived Risk: 
• Low perceived risk because it is approved by doctor and on tv ads 
• Ignorance to existence of RX abuse problem 

Community Climate: 
• Denial about the problem 
• Ignorance and obliviousness to the problem 
• Lack of training for cashiers around suspicious purchases of over-the-counter meds 

Family Climate: 
• Relationships/partner pressures from and/ or acceptance of use 

School Climate: 
• Not addressed in school health classes 
• No-child left behind standard move this issue off the radar of school admin and teachers 

Developmental Transitions: 
• Self-medicating as a result of prior trauma 

5. Crack Cocaine/ Cocaine Use 
Consequences: 
Drug Arrests:  Cocaine and Crack Cocaine made up more than 50% of the drug arrests of people over 18 in Cumberland County in 2005 and the first half of 2006.  (Maine DEA) 
Death:  In 2005, 26.7% of all drug deaths occurred in Cumberland County (but only 20% of the population in Maine). (Maine Drug-Related Mortality Patterns (1997-2005) Cumberland County, ME) 
Contributing Factors: 
Retail Access/ Availability: 
• N/A 

Social Access/ Availability: 
• Coke is more available at parties because it is more socially acceptable than Crack 

Price: 
• Crack is cheap and cheaper than coke 

Promotion: 
• Underground dealer marketing difficult to address 

Enforcement: 
• Strong enforcement related to behavior 
• Users behave badly, receive attention from law enforcement and then the drug is discovered 
• Sentencing laws are harsher from Crack than Cocaine, reinforcing the perception that cocaine isn’t as dangerous 

Perceived Risk: 
• Coke is perceived as cool, for rich people, models and people who drive BMWs 

Community Climate: 
• People who use coke and crack are perceived to be the “worst” kind of substance user 
• There is a connection between crack, poverty, and racism  
• Acceptable to use cocaine in a busy restaurant by the cooks (cash based job, working late hours, working fast) 

Family Climate: 
• Parental recreational use has negative impact on children 
• Dramatic erosion of family system when member is addicted 

School Climate: 
• Some students use coke to help them stay up to work on papers or stay up late for the party 
• Fierce competition for academic achievement and athletic achievement may contribute to the use of cocaine by some students 

Developmental Transitions: 
• Both college and non college age young adults are exposed to cocaine/ crack 

Section 3:  Capacity Assessment 
 
Please See Appendix F for the Capacity Report  
 
13. Which areas of capacity will assist you in the development of your strategic plan? 

Combined, the members of the core group are incredibly knowledgeable about substance abuse prevention, conducting assessments, and strategic planning.  Their guidance will assist greatly in creating structure for the larger Collective strategic planning meetings.  The Collective, with members from many sectors of the county, will bring their knowledge of the local issues and their cultural competence to the strategic planning process.  Combined, the core group and the collective are the greatest assets to the project.   
 There are currently 2 DFC recipients in Cumberland County; one at CPHC and one at 21 Reasons.  These 2 grants enable the projects to build the capacity and the ability of the substance abuse coalitions acting in their communities. 
 
14. Which areas of capacity will be included in your strategic plan as areas that you will work on in the coming years and why? 
• Continued Data collection on non-college 18-25 year old population 
• Continued Data Collection for Cocaine and creation of a task force 
• Finding Consequence data for Marijuana use 

During the assessment process, it became clear that there is a lack of data on Cocaine use but a perception in certain sub-populations that there are high rates of Cocaine use.  Especially in the more urban communities, focus group participants and law enforcement officers expressed their anecdotal opinion that cocaine use is on the rise.  No quantitative data specifically on rates of cocaine use could be found but it is something that the Collective would like to build the capacity to collect in the future.  There are also enough people concerned about the influx and increase in crack and cocaine use that the creation of a task force to work on the problem is possible in the future.  
Healthy Androscoggin, in Androscoggin County, completed an extensive research project on substance abuse among the non-college 18-25 year old population.  From the data collected, it is clear that rates of use are much higher and that the issues surrounding use are different than the college 18-25 year old population.  This research alerted the Cumberland County Collective to the need for more extensive data collection among this population in Cumberland County.  The time frame of this current project did not allow the Collective to do extensive research on this population.  It has become a high priority for capacity building activities. 
Finding consequence data for marijuana use is not just a local issue but a national one as well.  There has recently been some new data published but it came after the assessment period of this project.  The Collective did not want to lose the focus of marijuana use because of the lack of consequence data and evidenced-based strategies; as a result, the Collective has decided to make it a priority for capacity building.