Massachusetts General Hospital

Revere CARES is an award winning coalition with 350 members from across the community dedicated to preventing alcohol and drug abuse among Revere youth. Coalition members represent a variety of sectors, including parents, youth, government officials, educators, health professionals, first responders and law enforcement. The Coalition oversees two major initiatives, the Alcohol, Tobacco, and other Drugs (ATOD) and the Food & Fitness Initiatives.  Since 1997, the Coalition has taken a comprehensive approach to reducing youth substance use through strengthening policies to limit access to ATOD and enforce consequences, changing community norms through education, developing and supporting alternative activities for youth and advocating for age-appropriate treatment. Additionally, in light of concerning trends of fatal and non-fatal opioid overdoses among adults in the community, Revere CARES’ ATOD initiative has expanded in recent years to include opioid overdose prevention.

Revere CARES’ substance abuse prevention efforts engage the community in a variety of ways. These strategies can be categorized into four areas of activities: policy development and enforcement, educational opportunities, community collaboration, and access to services. Examples of these strategies include (but are not limited to) the following:

 Gateway Drug Initiative Activities

• Policy: Strengthen policies to limit access to ATOD and enforce consequences. These efforts have included advocacy at licensing commission hearings, compliance checks, and support for the rollback of bar closing hours in Revere.
• Education: Change in social norms. In collaboration with Revere Public Schools, the Revere Police Department, and several other local groups, Revere CARES launched the ‘Power of Know’ campaign to increase community awareness about the risk, harm and penalties associated with ATOD use.
• Collaboration: Provide educational opportunities for parents and develop a parent network. Through the STOP Act Grant, Revere CARES has conducted parent coffee sessions in order to provide parents with opportunities to connect with each other and to learn about how substance use affects youth brain development. 
• Services: Increase alternative activities for youth. Since 2000, Revere CARES has collaborated with the City of Revere and local after school providers to obtain funding for youth programming that has now become institutionalized throughout the community.

 Opioid Overdose Prevention Activities

• Policy: Advocate for Good Samaritan Bill and Narcan First Responder Pilot. The Revere CARES Opiates Task Force has actively advocated for initiatives that decrease the chances of fatal opiod overdoses in the community, including the Good Samaritan Bill. Additionally, Revere CARES supported the First Responder Narcan pilot program at the Revere Fire Department, which reversed 12 opioid overdoses in its first year of existence, giving individuals struggling with addiction an opportunity to obtain treatment.
• Education: Implement opioid overdose prevention trainings and outreach to active users and ‘bystanders’ (i.e., family/friends of active users). Through the MassCALL 2 Grant, Revere CARES has supported the City of Revere in providing trainings that inform community members about the risks associated with opioid use, how to decrease the risks of overdose, how to recognize the signs of an overdose, and how to respond in the event of an overdose.
• Collaboration: Support the Revere Police and Health Departments in establishing a medication disposal program. With the approval of the U.S. Drug Enforcement Agency, a drop-box has been installed at the Revere Police Department so that community members can anonymously dispose of their medications in order to prevent youth from accessing dangerous substances and to protect the environment from improper disposal.
• Services: Develop a Drop-In Center in the community. Under the advisement of the Revere CARES Opiates Task Force, the City of Revere has established a program at North Suffolk Mental Health that engages active users and their bystanders. Community members—regardless of insurance status—are invited to ‘drop-in’ during operating hours to access resources and learn more about possible treatment options.

Since 2001, Revere’s rates of alcohol use among high school students have been considerably higher than state rates. Over the past 10 years, however, Revere has consistently declined and dipped below the state rate (Revere: 62%, Massachusetts: 68%). Additionally, the percent decrease from 2001 to 2011 for Revere is 25% compared to the State decrease of 16%. 

The rates of current drinking among high school students have declined both in Revere and at the State level.  However, in 2009, Revere (at 43%) dropped slightly below the State rate (of 44%) and was on par with the state rate of 40% in 2011. 

The percent of high school youth who reported binge drinking (5 or more drinks at least once in the past 30 days) decreased from 41% in 1999 to 24% in 2011, a 41% decrease.

In FY2011, the parent Power of Action campaign was launched and a proclamation adopting the campaign was signed by the Mayor. The campaign encourages parents to: 1) talk to their children about not using drugs and alcohol; 2) set and enforce consequences for breaking the rules; 3) and connect with other parents and community members to reduce substance abuse. During parent teacher conferences in the fall, parents at all Revere Public Schools are asked to sign the Power of Action pledge which outlines  the previously mentioned action steps that parents should take to prevent youth substance use. Parents who sign the pledge can also provide their contact information in order to receive updates from the coalition about other available resources to support them as they parent for prevention. In late 2011, 1,034 parents signed the pledge drive, and we collected 1,400 email addresses.

As part of the Power of Action campaign, Revere CARES also sponsored a series of parent coffees in which parents received education on how substance use impacts youth development, and they were educated on how to use this knowledge effectively to talk to their children, set and enforce rules, and communicate with other parents and community members. From July 2009 through August 2012, a total of 26 parent coffees sessions, which served a total of 176 participants (133 English-speaking, 43 Spanish-speaking), were held.  Six of the 26 coffee sessions were in Spanish. This year the Coalition also sponsored a new series of three Skill Building Workshops, and 26 parents participated. During these workshops parents discussed how to help their teens make responsible decisions around alcohol and drug use, how to identify warning signs, how set and enforce consequences, and where to go if they needed help. 

In FY 2012, the coalition also added a new resource for parents called, “Conversations For Prevention.”  This online resource helps parents send a clear message of "no alcohol and drug use" and set expectations for their teens.  This English and Spanish resource includes audio conversations, transcripts, and expert advice on:  staring a conversation, setting ground rules, networking with other parents, creating an agreement between parents, marijuana, and what to do when your child needs help. 

In FY2012, approximately 60 students (36 of whom receive stipends as Peer Leaders) were members of the four leadership clubs at Revere High School. These leadership clubs are co-sponsored by the coalition and Revere Public Schools.

The Above the Influence campaign was reenergizing during the second annual Community Walk to Recovery on September 23, 2012. The second year, students who attended the walk had an opportunity participated in pre-walk rally where the superintendent of schools and a member of the city councilor spoke to them. Students also to listened to the recovery stories of young people from a treatment residence in a near by community.  During the rally students also took part in an art project.  Students were given a square piece of fabric in which they could create a visual expression of what it meant to them to be Above the Influence.  The fabric squares were glued to a large banner which the students carried with them on the 2 mile walk.  Over 350 students attended the event and received an Above the Influence t-shirt.   http://reverecares.org/2012/10/recovery-month-events/

In November and December, 2012 Revere CARES staff and Power of Know leaders organized and conducted the “Get The Facts” Contest.  This contest was created to address the concern discovered during the focus groups that students don’t always have the correct perception about the harms of drugs and alcohol, and specially marijuana.  The “Get the Facts” contest is a fun way to engage students in learning about how drugs and alcohol can negatively impact them. A total of 523 middle and high school students participated in the contest and received a campaign promotion item.

According to a review of Revere’s death certificate data, the number of deaths involving one or more opioid has declined (2009: 15 deaths, 2010: 10 deaths, 2011: 8 deaths—preliminary data). The Revere CARES Opiates Task Force worked towards its goal of decreasing opioid overdose deaths in FY2012 by reinvesting its energy in collaborating with key stakeholders and by increasing the capacity of the community to sustain overdose prevention efforts.  In 2012, Revere CARES worked closely with the City of Revere to re-establish funding through the MassCALL 2 grant for a drop-in center at North Suffolk Mental Health in order to better support families of opioid users.

In 2010, the Opiates Task Force also facilitated the development of a First Responder Narcan Pilot Program at the Revere Fire Department (RFD) in collaboration with the MA Department of Public Health, which was the first of its kind in the Commonwealth of Massachusetts.  The Revere Fire Department has continued to demonstrate its invaluable role as a partner in preventing overdoses in the community. The First Responder Narcan Pilot Program at the RFD was renewed in February 2011, allowing the City to continue its ability to save lives at the scene of an overdose.  As of August 2012, Narcan administered by the RFD had successfully reversed a total 63 overdoses over the course of the entire pilot.

In August 2012, Good Samaritan legislation took effect in the Commonwealth. This legislation gives limited protection to individuals at the scene of an overdose in order to decrease the fears around calling 911. Revere CARES is a member of the Good Samaritan campaign steering committee and actively advocated for this legislation.

Kitty Bowman

Phone: 781 485-6132