Spurring community change is like an old-fashioned barn raising.
Everyone who is able to do so pitches in and makes use of any available resources.
That’s why community coalitions are essential partners in Maine’s continuum of prevention, treatment, and recovery.
There are dozens of such coalitions, funded by the Maine Center for Disease Control and Prevention (Maine CDC) and/or the federal Drug-Free Communities Grants or other grants. Historically their focus has been on primary prevention—intervening before a problem, such as teaching social-emotional skills to middle schoolers so they have the skills to make safe decisions regarding substance use. Increasingly, prevention coalitions are also working with treatment, harm-reduction and recovery-focused community partners.
Megan Scott manages the Substance Use Prevention Team within Maine CDC, which distributes funding to 19 prevention coalitions from York to Caribou.
“Coalitions are the preferred model to impact public health issues like substance misuse because they engage a community in all its sectors,” Scott says. “The folks who lead the coalitions are often certified prevention specialists, and they engage with policymakers, schools, civic organizations, healthcare and law enforcement. They know the community and have a few unique interventions based on community level need, but overall, they are doing a lot of the same things—working with schools and business on substance use policies, offering prevention programs directly to students, working with law enforcement, offering classes and support for parents and other caring adults. There are things that these coalitions have in common because we know we will be most successful when we work at the community level.”
Examples include working with businesses to update smoke-free policies to include cannabis, providing Responsible Beverage Seller trainings, and engaging youth in underage drinking prevention efforts through a program like Sticker Shock where they put stickers on alcohol bottles warning that providing alcohol to minors (under 21) is illegal.
“They’re all dealing with the same issues as a result of too much access to tobacco, too much access to cannabis and alcohol,” Scott says.
“One of the ways I measure success is through the relationships that are built. For example, in Gardiner there’s a successful organization called Healthy Communities of the Capital Area that leads a coalition and youth group. Youths went to the mayor’s office afterschool and asked straight out why there were so many cannabis shops downtown. To me, that’s a success. Youth were empowered to ask what message the community wants to send.”
The coalitions, too, work in coalition. They help each other by sharing what works in their community—and might also work in another. One coalition has a great idea, implements it and shares it with the rest of the state— or, in the case of SoPo Unite— the nation.
The following are a few stories— among many.
SoPo Unite’s Restorative Substance Use Policy
One of Scott’s favorite success stories is the restorative substance use policy developed by SoPo Unite, which has become a model both within the state and nationally.
Under the old model, a substance use violation at South Portland High School meant a suspension of 7-10 days. “A student gets caught using a substance and they get suspended for a week, and what do you think they’re going to do?” Scott says. The policy served no one, which is why teachers and coaches under-reported substance use.
Under the Restorative Substance Use Policy in effect since 2018, the student is required to see a Licensed Alcohol and Drug Counselor (LACD), who determines where they are on the continuum of use. The student may spend a few days with an in-school restorative coordinator, taking accountability for their behavior and getting any support they might need (in addition to completing regular schoolwork). Or they may be assigned to a 12-hour Student Intervention and Reintegration Program (SIRP). If the student is on an athletic team, they go on a probationary status— remaining part of the team though temporarily unable to compete.
“Rather than punishing students, we’re helping them turn things around,” says Lee Anne Dodge, the SoPo Unite program director embedded in South Portland High School. “We’ve seen really positive outcomes.”
The restorative policy grows the student’s support networks rather than severing them. Dodge notes that 70% of students continue to see the LACD longer than required to do so. Having found help, they accept it voluntarily.
SoPo Unite is one of 15 Drug-Free Communities Coalitions in Maine and one of over 700 nationwide. Research shows that anywhere there is one of these multi-sector community coalitions, the rates of youth substance use go down. Each coalition brings together all sectors of the community—including parents, school staff, police, healthcare, business, civic and faith-based groups and organizations that serve young people.
“Trying to change this school policy had an effect throughout the community, working with the school board, law enforcement, the school social worker, parents and businesses,” Scott says. “It had such a big impact on the community even outside the school walls, which is the power of prevention.”
Once the South Portland community took that leap of faith and began seeing positive results, SoPo Unite was featured in national articles by the Pew Charitable Trust article (“How One School Is Tackling the Youth Vaping Epidemic”) and NPR (“Just How Hard Is It to Quit Vaping”). Since then, the coalition has made presentations to communities in at least 10 other states that are considering creating their own restorative policies.
Power of Prevention’s Prime for Life ® Program
“The Prime for Life work that Power of Prevention did in a recovery center was a huge success,” Scott says. “Some of these parents didn’t feel equipped to talk with their kids about substance use, and once they have Prime for Life training, they realize they are the best people to talk with their kids. They are empowered and have the words.”
Power of Prevention, a program of Cary Medical Center in Caribou, is a local coalition that works with community partners to make Aroostook County a healthier place to live and work. The coalition runs a successful Prime for Life program to get participants thinking about the consequences of high-risk choices, practicing how to refuse substances, understanding the phases of addiction and planning for the future. It is taught at high schools, recovery centers and at Aroostook County Jail.
“Prime for Life is a conversation; it’s not just harping at people,” says Project Lead Kim Parent. “It’s really thinking about your choices and how to do things differently moving forward. In the jail, we’ve had people coming out stay in recovery, go back to school and get a degree. Prime for Life was the seed that was planted in their life that helped them change and grow and bloom.”
Power of Prevention also:
• Runs a Sticker Shock program: Alcohol sold during specific times of year is stickered with a reminder not to share alcohol with anyone under 21.
• Collaborates with Healthy Acadia to get medical professionals thinking about how to avoid over-prescribing, which leads to excess prescription drugs in the community.
• Provides naloxone training for law enforcement/fire/emergency medical services units.
• Collaborated with Boys & Girls Clubs of Border Towns to host a Youth Prevention Week.
• Publishes an annual resource guide for prevention, treatment and recovery resources (powerofprevention.org).
Somerset Public Health Building Referral Pathways
Somerset Public Health is a Skowhegan-based coalition of staff members, community members, organizations and businesses working together to improve health in Somerset County, with a growing focus area on substance use prevention, treatment and recovery.
“I can’t stress enough the importance of having a group of organizations that can really work together to solve problems,” says Matt L’Italien, director of Somerset Public Health. “We work together to find those win-wins where we can have some mutual obligation and mutual accountability to one another to make things happen that otherwise wouldn’t. Collectively we can have a greater impact.”
As a coalition, Somerset Public Health:
• Builds referral pathways between jail and substance use treatment and between primary care, emergency care and behavioral health care (including Kennebec Behavioral Health)
• Works with schools to help build resilience and prevent substance use and tobacco use/vaping in youth
• Teaches healthy eating on a budget (SNAP-ED) and encourages physical activity (Move More Kids, funded by the New Balance Foundation)
• Connects people in treatment and recovery with sober living homes
• Connects people to work opportunities (Eastern Maine Development Corporation; Connecting with Opportunities)
• Provides narcan training
More prevention coalitions statewide
Southern Maine
Choose To Be Healthy www.facebook.comchoosetobehealthy/Coastal Healthy
Communities Coalition (CHCC) www.une.edu/chcc
Partners for Healthier Communities https://www.facebook.com/partnersforhealthiercommunities/The Opportunity Alliance www.opportunityalliance.org/
SoPo Unite https://www.southportland.org/departments/police-department/community-programs/sopo-unite/
Be the Influence https://betheinfluencewrw.org/
Casco Bay Create Awareness Now www.cascobaycan.org
Westbrook Partners for Prevention https://westbrookpartnersforprevention.org/
Portland Public Health https://www.portlandmaine.gov/224/Emergency-Resources
Midcoast
Southern Midcoast Communities for Prevention http://accesshealthme.org/
Healthy Lincoln County http://www.healthylincolncounty.org/
Knox County Community Health Coalition https://www.facebook.com/knoxcountycommunityhealthcoalition
Western Maine
RACE to Recovery Consortium www.mainehealth.org/franklin-community-healthnetwork/healthy-communities
Healthy Community Coalition https://mainehealth.org/franklin-community-healthnetwork/healthy-communities
Healthy Oxford Hills https://healthyoxfordhills.org
Healthy Androscoggin www.healthyandroscoggin.org
Central Maine
Kennebec Behavioral Health http://www.kbhmaine.org/substanceabusetreatment
Healthy Communities of the Capital Area (HCCA) www.hccame.org
Somerset Public Health www.somersetpublichealth.org
Downeast Maine
Healthy Acadia https://healthyacadia.org/
Northern Maine
Power of Prevention http://www.carymedicalcenter.org/
Bangor Public Health http://www.bangorpublichealth.org/
Wabanaki Public Health www.wabankipublichealth.org
Mayo Regional Hospital http://www.mayohospital.com/departments/communityoutreach/