Untangling Substance Use in Western Maine - Opportunities for Solidarity

How do we understand health regionally? What mechanisms do we use as a community to describe county health and take collective action to address top areas of concern? The Oxford County Wellness Collaborative has created a data hub unique to Oxford County. This data hub describes Oxford County’s top health concerns (identified through the biennial Community Health Needs Assessment, or CHNA) and those actions and activities being taken by local community organizations to address these regional health priorities. We hope by creating this resource, we can help empower further regional collaborations, grant writing, and deeper understandings and insights into what community health, and the actions being taken to improve it, looks like across the county. For more information on the data hub, read the previous blog post ‘A New Look at Oxford County Health Data’ and feel free to contact OCWC with any further questions. In the 2019 CHNA process, substance use was identified as one of four top health concerns in Oxford County. As we approach the next CHNA process in November 2021, data indicates substance use is still at the forefront of regional concerns.

Oxford County, like many rural counties across the U.S., has struggled with rising substance use trends over the last ten years. This can be seen across measures such as babies born exposed / affected by substances, emergency department overdoses, overdose deaths and other metrics. In 2012, 2.2% of babies born to Oxford County residents were exposed / affected by substances at birth, in 2020 that had increased to 14.9% of babies. Prior to the pandemic, some metrics had started to indicate a plateau, suggesting that the work being done to improve harm reduction, recovery and prevention efforts across the county was starting to pay off.

However, some of the gains observed in 2017–2019, were erased by the impacts of the COVID-19 pandemic. In the last two years Oxford County is again seeing higher rates of substance use across measures including adult excessive drinking, infants born exposed to substances and emergency department overdoses. Some of the graphs below show the beginning of these upward trends in 2020 and data projections into 2021 show trends are continuing. According to the County Health Rankings, adult excessive drinking for 2021 is projected at an all time high of 20% in Oxford County. Emergency department (ED) overdoses in the first quarter of 2021 accounted for 61 individuals across Oxford County, the highest quarter ever recorded in this county. These trends mimic state and national trends where ED suspected overdoses across the state of Maine have increased throughout the course of the pandemic and studies have shown an increase in excessive drinking nationwide.

Another graph showing the “percentage of high school students who have used any tobacco product in the past 30 days” (a question asked by the Maine Integrated Youth Health Survey) shows an unsettling upward trend of tobacco use among Oxford County youth even prior to the pandemic—and in sharp contrast to the state trendline which shows a slow decrease in usage. These measures bring up questions such as, “what conditions in Oxford County are producing higher tobacco use among school age kids then the rest of Maine? What efforts were working to reduce substance use among pregnant women between 2017–2019 and how can we strengthen and adapt these efforts in the face of pandemic conditions? What can we do as a community to change the community context which is fostering a growing trend of substance use among adults and youth?”

Community efforts to mitigate harm, support recovery and prevent addiction have been ramped up over the last five years. These efforts have included a growing support system of recovery coaches trained regionally, with—despite pandemic conditions—29 recovery coaches trained in 2020 across organizations including the Lakes Region Recovery Center, Western Maine Addiction Recovery Initiative(WMARI) and the new Larry Labonte Recovery Center located in Rumford. Additionally, WMARI, with the help of many community partners, annually supports a Substance Use Disorder (SUD) conference and Recovery Rally. Both events bring awareness and strategies, such as naloxone training, to enhance efforts to address substance use regionally. Community Concepts has helped to support substance use counseling in schools since 2018. The below data helps to describe some of this regional work as it has evolved over time. It also sheds light on how the COVID-19 pandemic impacted types of responses occurring where large group gatherings—such as the SUD conference and Recovery Rally—were canceled in 2020 while the region also saw a huge increase in recovery coaches being trained.