To the editor:
In 2015, The Nantucket Alliance for Substance Abuse Prevention (A.S.A.P.) hired consultant Dr Jeffrey Rodman to conduct a community Pride Survey as part of a larger Community Needs Assessment. The focus of the Pride Survey was to assess the level of risk our Nantucket Youth were facing for substance abuse/dependence and mental health challenges, now and in the future.
Pride Surveys was created in 1982 by professors at Georgia State University and Western Kentucky University. Their purpose at the time was to help local schools measure student alcohol, tobacco, and other drug use through the use of student surveys. Since then, the survey company operates Nationally developing a full range of scalable survey products that measure behavior on many crucial issues that can affect learning, such as family, discipline, safety, activities, gangs, and more.
In a joint 2014 statement, the President’s Office of National Drug Control Policy (ONDCP), the Health and Human Services Administration (HHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) said:
“The use, misuse, and abuse of alcohol and other drugs are a crisis across the country and around the world. By 2020, mental health and substance abuse disorders will surpass all physical diseases as a major cause of disability worldwide. Recognizing the impact that this disease has on our children, our families, our economy and our future, action that is immediate, far reaching, and impactful is required. The lives of our citizens and especially our children and future generations depend on comprehensive and collaborative efforts now and going forward.
Annually, throughout the United States problems associated with alcohol and drug use adversely affects an estimated 23 million people, including our nation’s youth. Like physical illnesses, mental and substance use disorders can be prevented and treated. Left untreated or poorly managed the impact of this disease can extend far beyond the individual and his/her family and can impose enormous costs on local communities and society at large.”
The findings of the 2015 Nantucket Pride Survey were arresting.
• One of the most disheartening findings was that the average age of initiation for first time alcohol use in Nantucket Youth was 9 years old. The National average at the time was 12 years old.
• Another disturbing finding was that Nantucket has the most liquor outlets per capita in the Nation, comparable only to one other island community in Hawaii.
Below are the top five Nantucket prioritized risk factors identified in the 2015 survey, which put our Nantucket Youth at higher risk than the National average for substance abuse and dependence and associated mental health conditions. (For the full report, please email me for the PDF file - email@example.com ):
#1 - Family History of Substance Abuse (FAMILY)
Indicators include the number of adults (18 and older) in state supported AOD programs (Alcohol and Other Drugs Programs). Research shows a strong, consistent, and direct correlation between family history of AOD use and higher risk for youth to engage in problem behaviors such as drug abuse. When children are raised in a family or are around adults with a history of problem behaviors (e.g., violence or Alcohol Tobacco/Nicotine and Other Drug use), the children are more likely to engage in these behaviors. An astronomical number of heroin admissions in Massachusetts (all ages) accounted for 54.2% of the state’s treatment admissions in 2014, undergirding Nantucket’s 2015 PRIDE Survey results revealing across-the-board ATOD usage above the national average.
#2 - Availability of Substances (COMMUNITY)
Indicators for this risk factor include the number of retail alcohol and tobacco sales outlets on record in relationship to the total population. The availability of cigarettes, alcohol, marijuana, and other illegal drugs has been related to the use of these substances by adolescents. Nantucket’s 51 alcohol retail establishments are equivalent to 470 outlets per 100,000 total population, which is excessively high. The resort island’s party culture, wealthy visitors, and habit for having even the youngest teens work in the tourist industry makes substance readily available.
#3 - Favorable Attitudes Toward the Problem Behavior (INDIVIDUAL)
Indicators: attitudes regarding marijuana laws; disapproval of drug use for: binge drinking, cigarettes, cocaine, marijuana; perceived harmfulness of use of: alcohol, binge drinking, cigarettes, cocaine, marijuana. From 2015 PRIDE Data, since 2013, student’s perception of risk or harm from all substances has decreased. The perception of risk or harm from alcohol and marijuana remains below national averages. From 2015 Community Survey, a large number of respondents reported significant concern about the local drug and alcohol abuse issues, and many believe more than half of Nantucket’s youth are using marijuana or alcohol
#4 - Community Laws & Norms Favorable to the Problem Behavior (COMMUNITY)
Indicators include attitudes favoring gun control; average length of prison sentence; disposition of juveniles arrested; sentencing below federal guidelines; and school polices regarding alcohol, tobacco and drugs. Life on Nantucket is casual and fairly isolated. The island’s population swells during tourist season. It is a party place. Heroin use on Nantucket is skyrocketing, especially during summer months. Parents often serve alcohol at the parties they host for their children, and other parents find this practice unobjectionable. Nearly 20% more high school seniors in Nantucket are currently using marijuana than their national counterparts. Many parents believe more than half of Nantucket’s high school students are using marijuana. (2015 Community Survey)
#5 - Favorable Parental Attitudes Toward the Problem Behavior (FAMILY)
Indicators include adult alcohol-related arrests; adult property crime arrests; adult violent crime arrests; alcohol and tobacco use during pregnancy; and babies born affected by alcohol or other drugs. Astoundingly, 92% of survey respondents agreed that “home parties for teens too often serve alcoholic beverages provided by adults.” Furthermore, a majority of survey respondents believe there is “too little concern expressed by adults about the community’s drug problem.”
It's now 2023. We have yet to address any of these findings and risk factors as a community.
We have yet to educate our youth - starting in elementary school - about the very real perils of early substance use. We, as a community, still have no prevention plan or public education in place. The use of harm reduction models is not enough.
Fentanyl has now hit our island since this survey was conducted and has already caused several fatal overdoses, not to mention innumerable non-fatal overdoses, including some Highschool youth. You have only to look to the data to conclude we are now at a critical point. The plumbing problem in the Highschool is only a symptom of a much larger problem playing out, much like a canary in a coal mine, forewarning us. We don’t get many chances to get this right.
The plumbing issue, student vandalism and vaping will need to be solved by the Highschool. However, it is NOT the responsibility of our school leaders to solve our community wide issue of generational substance misuse and family dysfunction. A comprehensive prevention and education plan for NPS is necessary, but our school system is NOT where the issues start.
Our island culture’s favorable attitude toward drinking and drugging is certainly inherent to resort communities. Our economy has depended on this culture, even normalized it, to the detriment of our children. If a culture change is what would shift risk factors for our island youth, then perhaps Nantucket could reinvent itself as a model of wellness in the world, not a cautionary tale of a legacy of generational addiction and family dysfunction veiled in a luxury destination.
Could we imagine developing a multi-pronged public relations campaign which could include: public education about what low risk alcohol use actually looks like, prevention programs for all ages, and the promotion of our growing Nantucket wellness community? We are a small enough contained community, 30 miles out to sea, that can realistically accomplish this. It could be a new economic model - the promotion of wellness.
Which community stakeholders could step forward?
Could the Chamber of Commerce spearhead an effort to attract visitors who prioritize wellness?
Could the Town find money in its budget for more behavioral health support and to develop a lasting plan for continuity of care, to address our community’s needs, because “Left untreated or poorly managed the impact of this disease can extend far beyond the individual and his/her family and can impose enormous costs on local communities and society at large”?
What are we waiting for? It’s our children we’re gambling with now, with fentanyl in our backyard.
Candice Tétrault, She/Her/Hers
Coach, in private practice
Family Education Facilitator, Gosnold Inc.
Former Alcohol Education Instructor, Fairwinds Counseling Center
Active member of the Nantucket Recovery Community
Parent of a Highschooler