[Music and background noise]
Phil Roberts: This is the hub of this five-town area, Appleton, Hope, Lincolnville, Rockport, and Camden.
We live in a very mobile society.
While we've got a charming scenery around us, it doesn't prevent drug trafficking from going on here.
Carly Dorskey: We are like in the middle of no where, so it is hard to like, find something to do when we don't have any place to go.
Marie Libby: Despite all of the programs we have done there are still kids who are using inhalants.
[Music and background noise]
Amelia Mank: I'm not going to lie. I like cars and hanging out and stuff. But I also really like this.
Heidi Baker: I think just keeping children working and having an activity is a huge part and that's what Communities That Care really has done here. It is a lot of work.
It is a lot of preparation to get an animal ready.
They go from a calf that can't be handled at all, to a you know, a twelve hundred pound animal that they are able to lead around.
Alice Flint: You just show them who is boss and make sure they listen to you, and then they eventually will just follow you around.
[Music and background noise]
Jen Curtis: We can't be with them every minute, but if we empower them here, then we know they have greater opportunity to feel confident in that situation and make their own choice.
Skye Bedell: When you are climbing up the rock wall it feels just like a, sort of like a weightlessness sometimes, and sometimes you feel the challenging part of it.
Phil Roberts: That's the great thing about the Communities That Care.
The age bracket that they deal with.
Before that attitude, those behavioral patterns develop.
[Music and background noise]
Adam Kohlstrom: The fact is the data backs up what it is that CTC has chosen to do and to be a part of.
So when I interact with teenagers, or when we are a part of anything that we are doing with teenagers, we are not just making our best guess.
Amelia Hank: It's just like taught me in school, to like step up and be a part of my group and take charge and taught me a lot of like, life skills.
Gino Ames: Shows them that there are different options from just hanging out on the street corner, watching tv. They learn that they can be productive in different activities.
Skye Bedell: It's very much like a confidence builder because after you are done you can feel like you can do anything.
Female speaker and music: Keep your body nice and close to the wall. Challenge yourself.
Carol Krause: That was a great video.
Thank you, Maine for sharing that. That was terrific.
I know that our folks, our expert panel here have some questions for the folks in Maine and I know that Dr. Volkow wants to start one right away.
Dr. Volkow: I enjoyed seeing that program in Maine, but tell them Christina how do the CTC programs look in your community?
Ted Tomita: Well, thank you first of all for inviting me all of the way from Freeport, Illinois.
Freeport is a community of about twelve thousand families in Northwest Illinois.
And as a business leader, I volunteer to head our work group called the Risk and Protective Factors Work Group.
And I am currently the chair of our entire coalition.
So as a work group we analyze the student survey data, and the CTC data, and other community information.
And we prioritize our problem areas. We found substance abuse, family management, and low commitment to school are three prioritized areas.
So what we did was we implemented two programs to address these issues.
The Guiding Good Choices Parenting Workshop and Lions-Skills Adolescent Skills Workshop for sixth graders.
So, once we implemented those programs we saw that we had some great results after looking at the data again.
So we continue our efforts in the coalition and it looks very promising for us and we continue our efforts.
Marie Roda: Okay. And Esmeralda, if you could tell us a little bit more about what you have done in your community in Quincy, Washington, that would be wonderful.
Esmeralda Blancas: Quincy is a small community.
Population of about five thousand and located North Central in the state of Washington.
And our area of concern in our community was gangs and substance abuse.
I got involved with Communities That Care while working as a community health worker for a local community health center.
One of — the prevention program that I taught was called Guiding Good Choices where I facilitated in both English and Spanish.
My daughter, Christina, she was involved in a prevention program as well called Smart Moves, where we taught kids how to deal with peer pressure.
Marie Roda: Christina, you joined in this program.
You were involved in this program, correct?
Christina Blancas: Yes.
Marie Roda: Now, what did you learn?
What was some of the things that you took away from that program.
Christina Blancas: Well, Smart Moves taught me about the drugs and alcohol that are out there and how they could affect me, and it also taught me how to deal with peer pressure and how to say no to drugs.
Marie Roda: So it's working?
Christina Blancas: Yes.
Marie Roda: That's great. That's great.
Carol Krause: Do you have a follow-up?
Dr. Volkow: Yes. What kind of changes — A question from Washington?
Carol Krause: Yes, Dr. Volkow asked what kinds of changes they have seen in their communities in Washington and Illinois.
Marie Roda: Would you two like to answer that? What kinds of changes have you seen in your communities? You could just stand up right where you are. That would be great.
Ted Tomita: Well, we've seen the community come together as a coalition.
We have the school district, the health network, the church community.
People volunteering all kind of pulling together in the same direction and really latching on to something we can hold on to in terms of a data-driven, we see the results kind of process.
So, we see it as a great addition to our community.
Marie Roda: Esmeralda, how about you?
Esmeralda Blancas: I would just like to add to what he said that in our community we also see a lot of family bonding and more communication within the families, which is really important, too.
Carol Krause: I know that Director Kerlikowske has a question for the folks in Maine.
Director Kerlikowske: Can you tell me how you engage the key stakeholders and then do they really make a long-term commitment through CTC?
Marie Roda: I think we have Jen to answer that question.
Jen Curtis: My name is Jen Curtis and I'm from the — YMCA, and from the very first meeting it was clear that CTC was going to allow our community to be successful in reaching out to the youth and the adults in our community, and I can vividly remember walking into the YMCA.
We had a community meeting, and this is over six years ago, and I walked into the meeting, and I looked around and there were businessmen, and there were law enforcement officers, and superintendent of schools, school counselors, and it was clear that this was going to be a new approach to meeting the needs of our community, and it wasn't going to be an approach that just haphazard.
It wasn't a flash in the pan, it was something that was going to be systematically implemented and one of the key pieces is that the needs were identified.
There was an educational component that was clear.
We as a community needed to know these were the needs. However, in that same meeting, the resources at our fingertips were also addressed.
And how could we clearly match the needs and our community's resources was the most empowering.
And the powerful part of that is that as a collective body, we knew that we could tackle the needs of our community.
The longevity piece, that can't be answered in one moment. It's trust.
And I think trust comes through time and showing that... it works.
And that the children in our community really are being empowered and they are able to — that you can see the protective factors being boosted in our youth and also the adults understand their role in reducing the risk factors in our communities, so longevity I think is knowing that CTC will be there and help our community address the needs of our community whether they are needs of today or they are changing.
Carol Krause: I know Dr. Hawkins has a question.
Dr. Hawkins: Communities That Care has a big emphasis on data collection, on collecting information.
Is that realistic, that emphasis on data collection, and is it helpful, or is it difficult?
Hank Lunn: Thank you. I'm Hank Lunn.
I'm a member of the Data Work Force for the CTC, and over the past several years we have been looking at all of the data that has been accrued from the local schools, the state and the national statistics.
And by looking at that information we have been able to say where are the problems, and where are the risk factors in our community, and to deal with them in a more pragmatic way.
In order for us to be able to understand the data we have been collecting, many of us have gone through extensive training, and to understand what the data does say, and therefore we were able to go out into the community and help the community to understand that these statistics that we have are just not numbers.
These are real people that are involved in our problems in our area.
Therefore, the community becomes much more behind the program and we are understanding better within our organization and in the community how to deal with the problems we are facing.
And, therefore, we can use programs that are data-driven, scientifically based, and therefore we hopefully can address the issues in a very pragmatic way and not this idea that, you know, we look at sometimes statistics and so forth or programs and we say, well, that feels good.
But, that isn't what we need. It is not subjective.
We need to have data-driven, scientific-based, information.
Carol Krause: Thank you, and we have just time for one more question from Director Harding.
Frances Harding: One of the most difficult pieces of the plan is sustainability.
So, I was wondering if you have a plan for sustainability for — to keep the success that you have seen for the last six years.
Ken Gardener: Ms. Harding, this is Ken Gardener.
I'm a business leader in the area and also a member of the five-town Communities That Care board.
Very good question. Sustainability I think is an issue that every community has to address regardless of what the programming is.
I will say that I think it requires two parts here.
One is obviously you've got to have a community involvement.
You know, I don't care whether you are a business leader or civic leader or politician.
You know, you are in government.
It doesn't matter if you are a mama or daddy or you are young or old.
Young being me.
Thank you very much. [laughter] I don't think it really matters.
As a community you've got to come together.
You've got to get involved.
I mean, that's first and foremost.
The other piece obviously is the financial piece. You know, it takes money to run programs.
Collectively as a community coming together as a coalition, nonprofits, joining together, like-minded, you know, trying to accomplish the same thing.
That's what it requires.
So it requires work in the community. It also requires financial support.
Carol Krause: Thank you so much and by the way, I know you are on the stage of the Camden Opera House.
Is anybody there going to sing for us?
No? All right.
We need to shift gears here.
I know they have more questions, but I also know that we are running out of time and the folks in Maine have some questions for our experts.
So, Marie, who's next?
Marie Roda: Yes, we do. We have -- who would like to ask a question of our experts in Washington?
Phil Roberts: Mr. Kerlikowske, I'm Phil Roberts and I'm the Police Chief here in Camden.
We talked about some of the activities that can be done by the public to help in prevention but I'm wondering if you have some ideas about what law enforcement can do?
Director Kerlikowske: You know I think that's a great question, and after a long time in this business I know that my former colleagues now like you, understand that preventing crime is a real hallmark of a good police department, and preventing young people from going down the path of either drug abuse and abuse of alcohol, et cetera, is just critically important.
Local police officers are part of their communities.
They live in the neighborhoods, they coach, they volunteer, they do an awful lot. But, I also think besides all of the work that you do being a partner in the prevention programs and the Communities That Care.
The quick story I will tell you is that last week we announced our Methamphetamine Media Campaign in St. Louis.
We had a young man with us that's been in recovery for over five years, and he lost everything. He lost his children, when his mother was dying of cancer he wasn't able to see her.
All because he was addicted to Methamphetamine.
He made one telling statement at the press conference and he said when I was on my way to being -- to going to see his mother he said he was stopped by the police and arrested and he said that officer changed my life.
He said that the way he treated me with compassion and dignity helped me after a long downward plane for me to get the help that I needed.
Well, now he is a drug abuse counselor and he has been clean and sober for five years. It was most impressive and I hope everybody recognizes the law enforcement component and prevention. Thanks.
Carol Krause: That's a great story.
Any more questions for our experts?
Marie Roda: I think we have a young person here who would like to ask a question.
Isaiah: Hi. I'm Isaiah from Hope Elementary School, and I was wondering can science really be used to help prevent kids from using drugs and alcohol?
Carol Krause: That's for you, Dr. Volkow.
Dr. Volkow: Yes, indeed, science provides us with the facts and the knowledge about what drugs are doing to the brain and for example, through science we now know that the greatest vulnerability for substance abuse and addiction is during adolescence.
We also know that they are the effects of the drugs themselves that actually change the way that the brain develops.
And we also know that when individuals are intoxicated with alcohol, the function of the brain changes in such a way that they are much more likely to engage in risky behaviors that can increase the risks not just for addiction per se, but for criminal behavior or for other medical diseases like HIV Aids.
We also know another fact is that our kids at schools are really have a misperception of how many other kids are taking drugs and usually think there are many more that are actually doing it and that increases the risk for taking them.
And the other aspect about it is that we now know through science what prevention measures work and we clearly know that prevention of substance abuse and addiction work and it improves the outcomes of an individual's life.
But, at the end of the day, of course, it is every person's life and you want to empower them with the knowledge that is evidence-based and it is scientific about why it is not a good idea to take drugs.
Carol Krause: That was a great question.
Any more from Maine?
Marie Roda: Yes, we do.
Adam Kohlstrom: Ms. Harding, my name is Adam Kohlstrom and I'm the pastor at Chestnut Street Baptist Church right across the street from us here at the Opera House in Camden, Maine.
My question is I know how we got started here, but how can other communities get started with Prevention Programs?
What's the best strategy?
Frances Harding: The best strategy is exactly the strategy that you are using.
And using the framework of assessing a community for their needs and bringing in all of the members of the community to discuss that assessment, and helping the community to see how they can align their resources in the community to address the particular problem that you want, that you agree to address is really the best way to get people engaged.
We ask community members to come to the table wearing the hat they normally wear or hats that they wear in normal life. So we are not asking anybody to come in as experts.
We want them to come to the table as a parent, as a teacher, law enforcement, health official, member of the clergy, whichever job you are currently holding or the job of being a parent and also going to work.
To bring the talents and the expertise that you have naturally because what we are talking about is doing three things. We want to be able to look at the policies and the regulations that we have that will affect the problem that we have all decided around the table to approach.
We then want to bring in our law enforcement, our teachers, our parents that are going to enforce that new policy, that regulation or the law, and finally our ultimate goal is to create that normative change, the change to the behavior in your communities so that you not only reduce the problem that you are focusing on, but you are also, again, going to the direction of healthier and safer communities.
Carol Krause: Before we continue with the questions, thank you.
Before we continue with the questions, and we can have a few more, I wanted to say that Director Kerlikowske has been called back to the White House. This happens.
So I'm going to give him a chance to say a couple more words before we continue with the questions.
Director Kerlikowske: Good, thanks.
I can't tell you how much I appreciate NIDA and the people of Maine and everyone for this.
Seeing the success of Communities That Care and seeing the work that is being done, and the collaboration in that community and in particular, I think should give a lot of heart to a lot of people across the country.
And when the President looks at a National Drug Strategy this year or next year, you can certainly count on the fact that prevention and treatment will play a very significant role, and it has to be one that involves everyone.
So thank you so much for the opportunity.
Carol Krause: Thanks for participating.
While you are unhooking, is his mic unhooked?
We will continue with some more questions and you can go ahead and unhook him, and by the way, the White House is only a couple of blocks from here so we know he is going to make it back on time.
Any more questions now?
We can continue from Maine.
Female speaker: I am one of the local school superintendents and a five-town Communities That Care board member.
We all know that economically it is a very difficult time and finding necessary revenue sources to implement prevention programs and other community programs is a challenge.
Dr. Hawkins, can you share with us potential financial resources, communities who are interested in implementing prevention programs could access?
Dr. Hawkins: That's a very good question.
It costs about, in this trial we provided about seventy-five thousand dollars a year for communities to implement tested and effective preventative interventions, and we also provided resources for our community coordinator during the time of the trial, and that is another fifty to seventy thousand, so we are talking about one hundred twenty-five to one hundred and fifty thousand dollars a year.
Now, there are sources as Fran Harding said earlier, like the Drug-Free Communities Program, like the Strategic Prevention Framework, the CSAP and SAMHSA have made available.
There are also funds within education of various titles that can support prevention activities because as we know, those children who are falling behind academically in school are loosing their their commitment to school are at greater risk for substance abuse, and so those resources can be used to support tutoring and other academic focused programs.
One of the questions I think we need to begin to ask is can we really afford not to do prevention. We have done some preliminary estimates with regard to the findings that we have just reported today, and archives of Pediatrics and Adolescent Medicine recently.
And a very conservative estimate of the benefits to individuals and to the communities that have done Communities That Care in this trial, is that for every dollar that has been invested in Communities That Care, five dollars and thirty cents of benefit has been accrued because of less criminal behavior and less tobacco use.
This doesn't even count the alcohol use findings which haven't yet been added into this equation.
We are going to save money in terms of juvenile justice costs, criminal justice costs, incarceration costs, costs due to morbidity and mortality associated with tobacco use and the use of other drugs, if we invest in prevention in this way.
And it also means that we in our communities have to begin to think about using local resources.
Not relying exclusively on grant funded programs from the federal government or from the state, but really think about how can we reorient some of our dollars in our own community to support the Communities That Care or the Prevention Strategies in our communities that build stronger communities and that will ultimately save money through our communities in the long run.
Carol Krause: Thank you, Dr. Hawkins.
I'm told we have time for one more question from Maine for any of our three experts here.
Dalene Dutton: Well, I am very enthused about what I have been hearing in Washington and I was just wondering if there are any other plans to promote the Communities That Care system from SAMHSA or maybe CSAP or are there any plans for providing technical assistance or any funds to help other communities get started?
Carol Krause: Yes. I guess you are the one that gets to answer that, right?
Frances Harding: They are all looking at me.
Of course there are.
We truly believe and are following the research and the science that tells us that our communities are the focal point of our success of changing our country to become healthier and safe and alcohol and substance abuse-free for our youth.
And in saying that, we are continuing to offer grant opportunities for our Strategic Prevention Framework. Within that framework, it is a flexible enough funding opportunity that Communities That Care fit within.
All of our other community programs that focus on particular populations, like our HIV Aids population, for example, or older adult population.
All have this nucleus of a program of following a planning process that Communities That Care also fit in.
As far as specifically the training, we offer training through our center for the application of prevention research and technology, fondly known as our CAPRTS that do offer training regionally across the country.
On our website is the — all of the contact information you would need to find out where the CAPRTS trainings are and how you would call and apply for a particular training for your area.
Carol Krause: Thank you so much.
We have got to start wrapping things up here right now.
Dr. Hawkins, do you have any final words?
Dr. Hawkins: I just want to say two things.
One is I want to thank Dalene Dutton for the work she has done in coordinating the work of the five-town Communities That Care effort in the five towns that we've just been hearing from.
It has been exciting to see that effort and to watch that community thrive and grow well beyond the funding of the study of that coalition continues today and it is really exciting to see everyone there and it is much due to much of the work that Dalene has done.
The other thing I would like to say is that I am so happy and optimistic to see that we can now prevent problems like substance abuse and crime community-wide.
We can have population effects in prevention when we use the advances of prevention science, the knowledge about risk and protective factors and when we use tested effective programs and choose those at the community level that best meet the needs of our community, address the risk factors that need to be addressed, strengthen the protective factors that need strengthening and I'm glad that we've have had the opportunity to work with Communities That Care to develop it and I'm very happy that CSAP has made that part of what CSAP is making available to this nation.
Carol Krause: Thank you.
How about you, Frances Harding?
Frances Harding: I will jump on that and say that I, too, am pleased that we have finally gotten to the position in the field of prevention that we have the science to help guide us in making wise choices especially during this time of our watching every dollar and where it goes.
It doesn't much matter if you choose to use the Strategic Prevention Framework as your planning document, whether you use Communities That Care as your planning tool, whether you are a home grown coalition that is receiving funding from our friends at the CADCA Institute.
The issue that we are looking at and we are supporting is helping the country understand working within your community structure, working with evidence-based practices, bringing in your schools and your parents that are so very critical as well as the other partners, and doing that planning process from assessing your needs to actually evaluating your success is the message that I would leave you which I truly believe and SAMHSA is working towards really making a difference and in the normative effects of substance abuse and alcohol use across the country.
Carol Krause: Thank you.
Before we have final words from Dr. Volkow, I'd like to thank the awesome communities of Appleton, Camden, Hope, Lincolnville and Rockport, Maine.
Our guests from Washington State and Illinois, our crew at the Camden Opera House, Marie Roda and Dalene Dutton for helping to pull all of this together.
Dalene you are a real hero, thank you.
Thanks also to the crew here at the National Press Club and to the many people from NIDA's equally awesome Office of Science Policy and Communication who made this event happen.
Do we have any final words from Maine?
Marie Roda: Dalene?
Dalene Dutton: I just want to say it's been really wonderful to hear support for prevention at this level.
We know it works here and we're really glad to hear that you folks there also are supporting it.
So thank you very much.
Carol Krause: Dr. Volkow, do you have some final words?
Dr. Volkow: Yes, indeed.
I think that today we have seen, thanks to the science and the work of Dr. David Hawkins and his colleagues, that community treatment programs for prevention work.
We have objective data.
They work actually not just only reducing substance abuse, but they also work on reducing criminal behavior and delinquent behavior.
You also actually pointed out they are cost effective for every dollar that you spend you are going to save five to ten dollars in consequences.
But, actually more importantly you are going to gear the life of the a person to be successful.
I also want to thank him and also thank SAMHSA for being able to develop the tools and make them available so that communities can be empowered to actually take action into their hands and reduce substance abuse in their communities.
I, of course, also want to thank Gil Kerlikowske who has left from ONDCP and my very thanks to both of you for not just your participation in this program but for your commitment to the prevention of substance abuse in our country.
Thanks very much.
Carol Krause: Thank you, Dr. Volkow. Thanks to all for joining us today.
Todays' entire program will be available on SAMHSA's website at prevention.samhsa.gov.