For the past eleven years your smiling face has adorned my desk, touching my heart the morning of each workday, my vision of innocence, standing all in white, on the steps of St. Francis De Sales Church, your new gold cross sparkling in the sunlight. Your Prom photo is still the first thing I see when I open my wallet each morning. ‘Suddenly’ the paper pronounced, but we know that is not true. Drugs and addiction don’t work that way. It would be too easy. It sneaks up on you, ending innocence, destroying promise, and injuring the whole family. This time the loving arms of your parents could no longer hold you in the warmth of their protection. Your friends pass in singular file. With tears in their eyes, they smile at the visions of your past, speechless with sadness. They kneel before your coffin and then share with us a comforting hug and kiss.”

From “A Father’s Tale,” published in The Charlestown Patriot-Bridge, as part of a Charlestown Substance Abuse Coalition campaign to raise community awareness of the drug problem in the community. This young woman would be 25 years old today.

Substance Abuse has a devastating impact on health, the quality of community life, and the utilization and cost of health services. Citizens of Charlestown and Revere have formed community coalitions to fight substance abuse among youth, with the help of the MGH Center for Community Health Improvement. These communities employ science-based strategies including raising awareness, advocating for public policy changes, implementing prevention programs and successfully developing additional treatment resources. These efforts are resulting in modest but steady improvements in measures of drug and alcohol use as well as in communities attitudes and beliefs about their abilities to affect the problem.

Charlestown Substance Abuse Coalition
Beth Rosenshein, Director

In response to alarming levels of substance abuse, community leaders, the police, social service agencies, MGH Charlestown, residents and others came together in the winter of 2004 to form the Charlestown Substance Abuse Coalition (CSAC). CSAC was further galvanized to action by the tragic overdose of two prominent youth in April of 2004, one of whom died.

The mission of the Coalition is:
“We are a community-based Coalition of residents businesses, organizations, professionals, and advocates who work together to reduce substance abuse among youth, adults, and families. Through a unified collaborative approach, we utilize existing community resources, organize programs to respond to identified needs and harness the energy and commitment of all to provide a safe, healthy environment in Charlestown.”

CSAC’s guiding principles are as follows:
“The CSAC believes that in order to be successful, it needs to identify, assess, organize and maximize the assets and successes of our community. We value a collaborative approach that is inclusive of everyone who lives/works in Charlestown. We are committed to these values:

• Honesty and integrity in working together towards our mission
• Listening to one another and learning from our successes and failures
• Calling our community to action through outreach, awareness and a commitment to our mission
• Including youth and parents in the entire process
• Being respectful of and accountable to our community”

Partnerships and Activities

CSAC works to achieve its goal through four strategies:

• Changing community norms, attitudes and behaviors about alcohol and other substance abuse.
• Increasing the safety of the neighborhood and quality of life for all by decreasing the supply of drugs, levels of crime, violence and other consequences of substance abuse through collaboration with the law enforcement and judicial systems.
• Increasing access to and resources for successful treatment and recovery from substance abuse for Charlestown residents and families afflicted with addiction.
• Strengthening protective factors and decreasing risk factors for families, youth, and young adults through education, prevention, and intervention strategies.

CSAC includes a wide collaboration of MGH Charlestown, the Boston Police Community Service Office, Charlestown Court House, representatives of elected officials, the Charlestown Boys & Girls Club, the John F. Kennedy Center, Charlestown Community Centers, Charlestown Against Drugs, the Charlestown Recovery House, Youth Service Providers Network, Charlestown MissionSafe, Charlestown Neighborhood Council, Charlestown Neighborhood Watch Coalition, Charlestown Business Association, Student Support Team Leaders and Principals from local Boston Public Schools, property managers from public housing developments, the Boston Housing Authority Residents’ Association, street workers, local parishes, the Dennis McLaughlin House of Charlestown, Charlestown Mother’s Association, Boston Public Health Commission (BPHC), the MA Organization for Addiction and Recovery, the Greater Boston Regional Center for Healthy Communities, and many individual residents.

2007 Program Accomplishments

• CSAC is in its second year of a five year, $500,000 Drug Free Communities grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to focus on youth. 
• CSAC also received funding from Boston Public Health Commission to retain its designation as a NoDrug Coalition for the fourth year.
• CSAC held four community-wide forums which created community dialogue and awareness. Presenters included Dr. Nancy Norman, Acting Director, Boston Public Health Commission and Mary Ann Solberg, former Deputy Director, White Office of National Drug Control Policy.
• Groundbreaking for a new Charlestown Police Station was held on July 3, 2007.
• Boston Police Department Area A-1 received a 40% increase in Police resources for Charlestown, including an additional anti-crime car and a beat cop.
• Charlestown Neighborhood Watch Coalition expanded to fifty-one streets in the community.  
• Groundbreaking for the Charlestown Recovery House, a planned 25 bed transitional housing program for men in recovery, was held on October 1, 2007.
• MGH committed one million dollars over five years to support MGH Charlestown in locating mental health and substance abuse services at the Bunker Hill Housing Development. A Clinical Director/substance abuse counselor, mental health clinician and referral specialist have been hired. Official opening is slated for early 2008.
• CSAC is in its second year of implementing the AllStars program, a science-based substance abuse prevention program at the Warren-Prescott K-8 School. The entire fifth grade class (49) went through the program in the 2006-2007 school year.  The same class is receiving the Booster program in school year 2007-2008, while the current fifth grade class is receiving the Core program.
• CSAC organized the Charlestown Sports Collaborative to coordinate youth sports organizations in expanding outreach to all eligible Charlestown youth and in enhancing adult volunteer participation.  In 2007 the Institute for Sport Coaching conducted a “Successful Youth Coaching Workshop” for twenty-two new and returning local volunteers.
• CSAC partnered with the two public middle schools in Charlestown to create and administer a youth health survey to all students in grades six through eight.  The survey collected data from 392 students on attitudes and behaviors around drug use, violence, and trauma. Although anonymous, the instrument collected zip codes for students, thus allowing Charlestown-specific data to be analyzed.  This data will be gathered every two years.

2007 Program Data:
(All data and statistics were calculated and provided by the Boston Public Health Commission.)

• More Charlestown residents are accessing treatment.  Admission rates to publicly-funded substance abuse treatment programs for Charlestown residents was 25.9 (per 1,000) in fiscal year 2004 and increased to 37.1 (per 1,000) in FY2006.
• Emergency Medical Service responses to heroin overdose calls to Charlestown declined 17.7% between calendar year 2003 and fiscal year 2006.
• While overdoses increased across the City of Boston by 29 percent from FY 2005 to FY 2006, Charlestown’s overdose numbers decreased by 11 percent during the same period.
• Between calendar years 2002 and 2005, Charlestown’s drug abuse mortality rates decreased by 41percent from 63.8 to 37.7 (deaths per 100,000).

Revere Cares
Kitty Bowman, Director

Revere CARES (Community Awareness, Resources, and Education to Prevent Substance Abuse), founded in 1997, is a community coalition dedicated to reducing and preventing alcohol and drug use among youth in Revere and to building a healthier community. As described below, Revere CARES has enabled Revere to make measurable gains in reducing youth alcohol and other drug use.

Revere CARES builds on the strengths of the community to increase protective factors for youth and to decrease risk factors.  Revere CARES includes a growing and diverse group including concerned parents and other adults, teens, Revere Public Schools, the Revere Police and Fire Departments, the Chamber of Commerce, community based providers, churches and others from the faith community, and elected and government officials. Revere CARES is changing the community norms within which Revere youth make choices about tobacco, alcohol and drug use.

The Coalition uses research-based strategies and is based on the belief that a community that works together to send clear and consistent messages about substance abuse to teens, offers positive alternative activities, and makes appropriate services available can reduce alcohol and drug use among youth. The Coalition measures its success not only by indicators of substance use, but also in terms of community change that is sustainable for the long term. Revere CARES Coalition focuses on four priorities:

• Advocating for public policy changes and enforcement efforts
• Conducting community awareness campaigns about the harms of substance abuse
• Implementing science-based prevention and early intervention programs for youth
• Building a healthier community by collaborating with others

2007 Program Accomplishments
2007 was a productive year for Revere CARES in all its priority areas. Accomplishments include: 

• Public policy changes and enforcement efforts:
• Revere CARES and Revere Police Department completed an assessment of gang activity in Revere, and issued a community wide gang violence prevention plan.
• The City of Revere received the Shannon Gang Violence grant award from the Executive Office of Public Safety for the second year in a row, and Revere CARES was awarded a Youth Violence Coalition Expansion grant from the Department of Public Health.
• Revere CARES is organizing public advocacy to roll back bar hours from 2:00 a.m. to 1:00 a.m., concurrent with most neighboring communities. The city experiences a large influx of people at 1:00 a.m. for “last call” at local bars. Neighboring Lynn, the only other city with a 2:00 a.m. closing time, is in final appeals process to roll back bar hours, and city leaders are concerned that this will increase further the volume of bar-related traffic into Revere.

Implementing science-based programs and interventions.

• Recognizing the importance of positive alternative activities for youth in reducing drug and alcohol use and preventing violence, Revere CARES provided technical assistance and staff support to CASTLES, an alumni group that raised $50,000 for after school scholarships and enrichment activities; assisted Revere Public Schools in obtaining a 21st Century Community Learning Center Grant that will provide after school programming for 200 students for three years; and successfully advocated for a Revere Public School  After-school Project Director position to oversee after school program development, funding strategies, and partnerships.
• Revere CARES works with Revere High School to provide substance abuse education for athletes, freshman, and sophomores, and to support the Power of Know Club, a high school peer education program.
• Revere CARES served on the community advisory board for the Strengthening Families Program at North Suffolk Mental Health and the Second Step program in the Revere Public Schools, both science-based programs designed to build protective factors among families and children to delay and reduce substance abuse among youth.

Increasing awareness about substance abuse.

• Revere CARES collaborated with Mother’s Against Drunk Driving, local teen leaders, and alcohol outlets on a Sticker Shock Campaign to place stickers reading, “Hey You! It is ILLEGAL to purchase alcohol for people under age 21”on all multi-packs of beer, wine coolers and alcopops (sweet alcohol drinks marketed to teens).
• Revere CARES conducted the Power of Know, a comprehensive media campaign designed to increase parents’ awareness of their role in reducing underage substance abuse. As part of the campaign, 837 caregivers pledged to ask the “who, what, where, and when questions”; to talk to their children about alcohol, tobacco and drugs; and to model responsible use of alcohol.  The Parents Who Host Lose the Most campaign was designed to inform parents about the civil and criminal penalties associated with hosting teen parties where alcohol is served.
• Revere CARES hosted the First Annual Revere Beach Memorial honoring 104 people who lost their lives to alcohol and drugs at sunset, September 16th at the William G. Reinstein Bandstand on Revere Beach. Over 250 participated in this candle light vigil.

Building a healthier community.

• Approximately 20 businesses participated in an internet-based Summer Job Bank for Revere youth offered in collaboration with the Revere Chamber of Commerce.
• Revere CARES collaborated with Revere High School to establish the RHS Connect Club, a violence prevention club, of thirteen students who conducted a participatory action research project to assess and improve school climate in collaboration with the high school administration. RHS Connect developed, implemented, and analyzed survey data from over 1200 student respondents to identify priority areas for fostering connection among students and faculty.

Revere CARES conducted its third biennial Community Survey with support from the Revere Public School System, MGH Revere and the Mayor to measure resident perceptions and experiences with youth substance use as well as new information on resident beliefs about their overall health and feelings about their community.  

• The City of Revere, Revere Beach Partnership, Revere First, Revere Beautification Group, MGH Revere HealthCare Center, WIC, and Revere CARES worked together to support a multicultural Farmer’s Market on Revere Beach from July through October. Revere CARES contributions include obtaining funding for promotional activities, facilitating farmers’ market meetings, and coordinating volunteers.
• MGH Center for Community Health Improvement, MGH for Children and Revere CARES are partnering to develop a comprehensive environmental food and fitness initiative.
• With support from MGH and Revere CARES, Revere will expand beach-based activities for youth, career awareness courses and related paid summer service learning opportunities for Revere High School Juniors.

 
Program Data

The following data from Revere’s Youth Risk and Behavior Survey show the gains made from 1999 to 2007 through community substance abuse prevention, intervention and policy efforts.  Following national and local trends, Revere students reported less tobacco, alcohol and marijuana use over time. In addition, Revere high school students have reported an increased difficulty ease in obtaining substances, suggesting policy and community efforts may have contributed to this change. 

Tobacco use is steadily declining:

• Among High School Students, the percent of youth ever having smoked steadily declined from 69 percent to 54 percent (22 percent decrease).  The percent currently smoking steadily declined from 37 percent to 25 percent (32 percent decrease).
• Among Middle School Students, the percent of youth ever having smoked has steadily declined from 51 percent to 28 percent representing a 45 percent decrease and the percent of youth who reported smoking in the past 30 days has steadily declined since 2001 from 20 percent to 8 percent in 2007 representing a 60 percent decrease.

Some alcohol indicators are declining:

• Among High School Students:  Following national and local trends, the percent of students who reported ever drinking alcohol, past 30 day use and binge drinking have all decreased since 1999, however in some cases these decreases have not been steady over time. The percent of youth who reported ever having been drunk has steadily declined from 66 percent to 53 percent (20 percent decrease) and the percent of youth who reported frequent binge drinking (5 or more drinks in a row on 6 or more occasions in the past month) has steadily dropped from 14 percent in 1999 to 7 percent in 2007 (50 percent decrease).
• Among Middle School Students: The percent of youth who have ever drunk alcohol declined from 58 percent to 42 percent with a slight increase in 2005 before declining in 2007. This represents a 28 percent decrease between 1999 and 2005. 

Marijuana use is declining:

• Among High School Students, the percent of youth ever having used marijuana steadily declined from 54 percent to 44 percent (19 percent decrease). The percent of past 30 day use of marijuana steadily declined from 35 percent to 26 percent (26 percent decrease).
• Among Middle School Students, the percent of youth ever having used marijuana has fluctuated between 22 percent and 21 percent over the past six years; however, this change drastically declined from 21 percent in 2005 to 14 percent in 2007 representing a 33 percent decrease between these two years.

Additional indicators:

• Among High School Students, since 2001, rates of perception of ease of obtaining tobacco (86 percent in 1999 to 67 percent in 2007), alcohol (83 percent in 1999 to 67 percent in 2007) and marijuana (83 percent in 2001 to 64 percent in 2007) have steadily decreased over time.

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