Region 5 Prevention Resource Center provides the following services:
7.31.2020 8:30 am – 4:30 pm
Requirements: Reliable internet connection and use of a webcam.
Audience: Texas HHSC funded Prevention Providers in Region 5.
Registration priority will be given to HHSC funded substance use prevention providers in Region 5. Approved registrants will receive an email confirmation with the Zoom link to attend.
To see all trainings offered through other PRCs in the state, go to http://www.preventiontexas.org/trainings-by-region/
The 2018 Texas School Survey of Drug and Alcohol Use asked students in grades 7 through 12 about their alcohol use. Among the respondents in Region 5:
Region 5 students drink alcohol more frequently than Texas students as a whole.
Nearly 28% of students in Region 5 report that they normally drink alcohol at least once a month—compared with about 20% of students in Texas overall.
Within Region 5, frequency increases with age, with a notable jump in usage between grades 8 and 9. Among 12th-graders in Region 5, over 41% say they normally use alcohol at least once a month.
Binge drinking is typically defined as having more than 5 drinks of alcohol in a two-hour period. Nearly 18% of Region 5 students have engaged in binge drinking at least one day in the month before the survey; in Texas as a whole, that figure is just over 12% of students.
Like other risky behaviors related to alcohol use, binge drinking is more frequent among older students. Almost 26% of 12th-graders report that they’ve engaged in binge drinking at least one day in the past month.
Around 20% of Region 5 students said they think drinking alcohol is “not very dangerous” or “not at all dangerous” for kids to drink. Just under 17% of students in Texas overall reported these views.
Within Region 5, perception of risk largely tracks with age. Among 7th graders, around 13% said they thought drinking alcohol was “not very” or “not at all” dangerous. Among 12th graders, this figure was over 22%.
Where do students in Region 5 get alcohol?
“Friends” and “Parties” were the most common sources for getting alcohol among students in Region 5, though a relatively large number of students (20%) reported that they “seldom” were able to obtain alcohol from home.
To explore this data in more depth, use the drop-down menu below.
Use the drop-down filter to select an alcohol source. The two charts will show data for that source, comparing Region 5 to Texas (top) and different grade levels within Region 5.
Note that only two of the five responses are shown here, for simplicity.
• Centers for Disease Control and Prevention (CDC): Teen Substance Use and Risks
• Substance Abuse and Mental Health Services Administration: Find Help and Treatment
• ADACNET: Preventing Abuse by Reaching Today’s Youth (PARTY)
All data is from the 2018 Texas School Survey of Drug and Alcohol Use. Statewide data can be found here (pdf); Region 5 data is here (pdf). Note that percentages have been weighted to reflect the proportion within the population.
Tobacco Prevention Coordinator
The mission of the Prevention Resource Center 5 is to serve as a central data repository for region 5 and become a resource for organizations, coalitions, and agencies throughout the 15 counties of the region.
The goal is to strengthen collaborations, increase awareness and serve as a resource focused on developing a sustainable infrastructure to support the creation, storage, visualization and exchange of local, regional, and statewide data.
To achieve this mission, PRC5 aims to enhance data sharing by identifying, collecting, interpreting, and analyzing data specific to behavioral health statistics, trends, and service gaps.
The center focuses on developing data products highlighting local, regional, and statewide trends which are available through social media, email blasts, and data newsletters.
Buy drugs and illegal products online
Alcohol and Drug Abuse Council of Deep East Texas
Coordinated Training Services
Texas Department of State Health Services
Nacogdoches Safe & Drug-Free Community Coalition
National Clearinghouse for Alcohol and Drug Information
Center for Substance Abuse Prevention
National Institute on Drug Abuse
South East Texas Regional Planning Commission
Texas Tobacco Law
Smokeless Tobacco Education
Substance Abuse Division – South East Texas Regional Planning Commission
Center on Addiction and Substance Abuse
Community Anti-Drug Coalitions of America
National Institute on Alcohol Abuse and Alcoholism
Alcohol Rehab Guide – 1-844-500-2558
Office on National Drug Control Policy
Drug Enforcement Administration
Local Mental Health Authorities
Our Regional Education Service Centers Region 5 Education Service Center
Region 6 Education Service Center
Region 7 Education Service Center
Texas Prevention Training Services
Southwest Prevention Center
Contents Executive Summary … 1Introduction … 3Prevention Resource Centers … 3Conceptual Framework of This Report … 4Report Purpose and Methods … 8Demographic Overview … 9State Demographics by Region … 10State Socioeconomics by Region … 14Regional Demographics by County … 15Regional Socioeconomics by County …17Environmental Risk Factors … 19Within Schools … 20Criminal Activity … 21Regional Mental Health and Mental Illness … 22Accessibility … 23Environmental Protective Factors … 26Protective Factors: Community Domain … 26Protective Factors: School Domain … 27Protective Factors: Family Domain … 28Protective Factors: Individual Domain . 32Regional Consumption … 34Alcohol … 34Marijuana … 35Other Drugs … 36Prescription Drugs … 37Emerging Trends … 39Consequences … 41Consequences: Mortality, Morbidity … 41Consequences: Legal … 41Consequences: Qualitative Data … 43
2023 Regional Needs AssessmentRegion in Focus … 44Gaps in Services … 44Regional Partners … 45Regional Successes … 45Conclusion … 46Key Findings … 46Moving Forward … 46Appendix A: PRC Regions and Counties . 48Appendix B: Glossary of Terms and Key Concepts … 49Appendix C: List of Tables … 51Appendix D: List of Graphs … 52
1Executive SummaryThe Regional Needs Assessment (RNA) is a document created by the Prevention Resource Center (PRC)in Region 5 along with Evaluators from PRCs across the State of Texas and supported by the Alcohol andDrug Abuse Council (ADAC) of Deep East Texas and the Texas Department of State Health Services(DSHS). The PRC 5 serves 15 counties in Southeast Texas.This assessment was designed to aid PRCs, DSHS, and community stakeholders in long-term strategicprevention planning based on most current information relative to the unique needs of the diversecommunities in the State of Texas. This document presents a summary of statistics relevant to risk andprotective factors associated with drug use, as well as consumption patterns and consequences data, at thesame time it offers insights related to gaps in services and data availability challenges.A team of regional evaluators has procured national, state, regional, and local data through partnerships ofcollaboration with diverse agencies in sectors such as law enforcement, public health, and education,among others. Secondary qualitative data collection has also been conducted, in the form of surveys, focusgroups, and interviews with key informants. The information obtained through these partnerships has beensynthesized in the form of this Regional Needs Assessment (RNA). PRC 5 recognizes those collaboratorswho contributed to the creation of this RNA.Region 5 has some unique characteristics. It experienced the second lowest population growth among theregions. It has a larger older population compared to both Texas and the United States, and has a notablyhigher concentration of Black and less Hispanic/Latino population. Overall, it is more language proficientthan the state and the nation except for certain areas such as Jefferson County more like the U.S. at 8.23%limited English proficiency. With only one metropolitan area, Beaumont-Port Arthur, Region 5 is morerural than the rest of the state and the U.S., on average, Families in rural areas must travel to accessservices. Region 5 has a lower per capita income and the highest percentage of single-parent householdscompared to other regions. Although the statistics show an unemployment rate of 5.9%, recentannouncements of plant and company closures/layoffs will likely increase that figure. The school dropoutrate is less than the state rate but some counties exceed the Texas rate. The violent crime index for theregion is well over the Texas rate.Main findings from this assessment include:1. Alcohol continues to be the most commonly used/abused substance across age groups, with 29% ofstudents reporting “very easy” access, and over 80% considering underage drinking to be dangerous orvery dangerous, but 70% of all 12th graders reporting having used alcohol at sometime in their life.2. While opioid prescription medication use has decreased, the illegal trafficking and subsequent abuse ofopioids such as heroin and fentanyl, a powerful synthetic opioid analgesic that is similar to morphine butis 50 to 100 times more potent (drugabuse.gov), is dominating the illegal drug trade.3. Marijuana and alcohol are associated with school absences with. 23% of students reporting “very easy”access to marijuana and over 50% perceiving it as somewhat or very dangerous. Despite the danger, overtwenty percent of high schoolers report having used it in the last 30 days. Although synthetic marijuanaconsumption appears to be decreasing, law enforcement and community organizations verbally report it isstill a major concern.
2023 Regional Needs Assessment24. The average use of first use for any substance, alcohol or drugs, is approximately 13 years old. Whenpeople find themselves in court or in treatment it is likely to be for amphetamines, cocaine, cannabis,alcohol, sedatives, or polysubstance use.5. In addition to gaps in services which need to be filled to prop up adolescents and adults with protectionagainst risks related to alcohol and drugs, there are gaps in data which need to be filled to be able topinpoint more clearly the most crucial needs and how they can best be met.
3IntroductionThe Department of State Health Services (DSHS), Substance Abuse & Mental Health ServicesAdministration (SAMHSA), funds approximately 188 school and community-based programs statewideto prevent the use and consequences of alcohol, tobacco, and other drugs (ATOD) among Texas youth andfamilies. These programs provide evidence-based curricula and effective preventionstrategies identified by SAMHSA’s Center forSubstance Abuse Prevention (CSAP).The Strategic Prevention Framework providedby the Center for Substance Abuse Prevention(CSAP) guides many prevention activities inTexas. In 2004, Texas received a state incentivegrant from CSAP to implement the StrategicPrevention Framework in close collaborationwith local communities in order to tailorservices to meet local needs for substance abuseprevention. The prevention frameworkprovides a continuum of services that target thethree classifications of prevention activitiesunder the Institute of Medicine (IOM), whichare universal, selective, and indicated.The Department of State Health ServicesSubstance Abuse Services funds PreventionResource Centers (PRCs) across the state ofTexas. These centers are part of a largernetwork of youth prevention programsproviding direct prevention education to youthin schools and the community, as well ascommunity coalitions that focus onimplementing effective environmental strategies. This network of substance abuse prevention servicesworks to improve the welfare of Texans by discouraging and reducing substance use and abuse. Theirwork provides valuable resources to enhance and improve our state’s prevention services aimed to addressour state’s three prevention priorities to reduce: (1) underage drinking, (2) marijuana use, and (3) non-medical prescription drug abuse.Prevention Resource CentersThere are eleven regional Prevention Resource Centers (PRCs) servicing the State of Texas. Each PRCacts as the central data repository and substance abuse prevention training liaison for their region. Datacollection efforts carried out by PRC are focused on the state’s prevention priorities of alcohol (underagedrinking), marijuana, and prescription drug use, as well as other illicit drugs.
2023 Regional Needs Assessment4Our PurposePrevention Resource Centers have four fundamental objectives: (1) collect data relevant to ATODconsumption among adolescents and adults, as well as to share findings with community partners via theRegional Needs Assessment, presentations, and data reports, (2) ensure sustainability of a RegionalEpidemiological Workgroup focused on identifying strategies related to data collection, gaps in data, andprevention needs, (3) coordinate regional prevention trainings and conduct media awareness activitiesrelated to risks and consequences of ATOD use, and (4) provide tobacco education to retailers to encouragecompliance with state law and reduce sales to minors.What Evaluators DoRegional PRC Evaluators are primarily tasked with developing data collection strategies and tools,performing data analysis, and disseminating findings to the community. Data collection strategies aredeveloped around drug use risk and protective factors, consumption data, and related consequences. Alongwith Community Liaisons and Tobacco Specialists, PRC Evaluators engage in building collaborativepartnerships with key community members who aid in securing access to information.How We Help the CommunityPRCs provide technical assistance and consultation to providers, community groups and other stakeholdersrelated to data collection activities for the data repository. PRCs also contribute to the increase instakeholders’ knowledge and understanding of the populations they serve, improve programs, and makedata-driven decisions. Additionally, the program provides a way to identify community strengths as wellas gaps in services and areas of improvement.Our RegionsCurrent areas serviced by a Prevention Resource Center are:Region 1Panhandle and South PlainsRegion 2Northwest TexasRegion 3Dallas/Fort Worth MetroplexRegion 4Upper East TexasRegion 5Southeast TexasRegion 6Gulf CoastRegion 7Central TexasRegion 8Upper South TexasRegion 9West TexasRegion 10Upper Rio GrandeRegion 11Rio Grande Valley/Lower South TexasConceptual Framework of This ReportTwo guiding concepts will appear throughout the report: a focus on the youth population, and the use ofan empirical approach from a public health framework. For strategic prevention planning related to drugand alcohol use among youth populations, this report is based on three main aspects: risk and protectivefactors, consumption patterns, and consequences of drug use.AdolescenceAccording to the National Institute on Drug Abuse, there is a higher likelihood for people to begin abusingdrugs—including tobacco, alcohol, and illegal and prescription drugs—during adolescence and young
2023 Regional Needs Assessment5adulthood. The teenage years are a critical period of vulnerability to substance use disorders given thatthe brain is still developing and some brain areas are less developed when compared to other parts of thebrain (i.e. during teenage years, the amygdala is more highly developed when compared to the prefrontalcortex which can negatively impact judgements and decision-making).The Texas Department of State Health Services operationally defined adolescents as individuals who areage 13-17 (Texas Administrative Code 441, rule 25). However, organizations can have varying criteria foradolescents. For example, the World Health Organization (WHO) and American PsychologicalAssociation both defined adolescence as individuals who are age 10-19. In addition, WHO identifiedadolescence as a period in human growth and development that represents one of the critical transitions inan individual’s lifespan. Furthermore, a tremendous pace in growth and change that is second only to thatof infancy characterizes an adolescent. Behavior patterns developed during this process, such as substanceuse and sexual risk taking, can have long-lasting effects on future health and well-being.The information presented in the current document is comprised of regional and state data, which generallydefined adolescence as individuals age 10 through 17-19. The data reviewed in the current document hasbeen collected from multiple sources and will consist of varying demographic and subsets of age. Forexample, some domains of youth data determine that adolescence ends when an individual reaches aparticular age, such as 17 or 18. Other data sources may combine two categories that may allow for ahigher cut off age, such as 21.EpidemiologyEpidemiology is the theoretical framework for which this document evaluates the impact of drug andalcohol use on the public at large. The Substance Abuse and Mental Health Services Administration(SAMHSA) has stated that epidemiology helps prevention professionals identify and analyze communitypatterns of substance misuse and the various factors that influence behavior. Epidemiology frames drugand alcohol use as a public health concern that is both preventable and treatable.SAMHSA has also adopted the epi-framework for the purpose of surveying and monitoring systems,which currently provide indicators regarding the use of drugs and alcohol nationally. Ultimately, theWHO, SAMHSA, and several other organizations are endeavoring to create an ongoing systematicinfrastructure (such as a data repository) that will enable effective analysis and strategic planning for thenation’s disease burden, while identifying demographics at risk and evaluating appropriate policyimplementation for prevention and treatment.
2023 Regional Needs Assessment6Risk and Protective FactorsFor many years, the notion that the physical properties of drugs and alcohol were the primary determinantof addiction was the prevalent belief. However, it is now accepted that the individual’s environmental andbiological attributes play a notable role in the potential for the development of addiction. More than 20years of research has examined the characteristics of effective prevention programs. One componentshared by effective programs is a focus on risk and protective factors that influence drug use amongadolescents.Protective factors are characteristics that decrease an individual’s risk for a substance abuse disorder.Examples of protective factors are strong and positive family bonds, parental monitoring of children’sactivities and peers, and clear rules of conduct that are consistently enforced within the family. Risk factorsincrease the likelihood of substance abuse problems. Examples of risk factors include chaotic homeenvironments, history of parental abuse of substances, parental mental illnesses, poverty, and failure inschool performance.
2023 Regional Needs Assessment7Risk and protective factors are classified under four main domains: community, school, family, andindividual/peers. Each of these domains has its own risk factors and preventive factors that affect thelikeliness of the individual’s alcohol or drug abuse.Consumption Patterns and Consequences: Relationship not CausalityConsequences and consumption patterns share a complex relationship; they are deeply intertwined andoften occur in the context of other factors such as lifestyle, culture, or education level. It is a challengingtask to determine if consumption of alcohol and other drugs has led to a consequence, or if a seeminglyapparent consequence has resulted in consumption of a substance. This report examines rates ofconsumption among adolescents and related consequences in the context of their cyclical relationship; itis not the intention of this report to infer causality between consumption patterns and consequences.Consumption Patterns DefinedSAMHSA defines consumption as “the use and high-risk use of alcohol, tobacco, and illicit drugs.Consumption includes patterns of use of alcohol, tobacco, and illicit drugs, including initiation of use,regular or typical use, and high-risk use.” Some examples of consumption factors for alcohol include termsof frequency, behaviors, and trends, such as current use (within the previous 30 days), current bingedrinking, heavy drinking, age of initial use, drinking and driving, alcohol consumption during pregnancy,and per capita sales. Consumption factors associated with illicit drugs may include route of administrationsuch as intravenous use and needle sharing.The concept also encompasses standardization of substance unit, duration of use, route of administration,and intensity of use. Understanding the measurement of the substance consumed plays a vital role inconsumption rates. With alcohol, for instance, beverages are available in various sizes and by volume ofalcohol. Variation occurs between beer, wine and distilled spirits, and, within each of those categories, thepercentage of the pure alcohol may vary. Consequently, a unit of alcohol must be standardized in order toderive meaningful and accurate relationships between consumption patterns and consequences.The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines a “drink” as half an ounce ofalcohol, or 12 ounces of beer, a 5-ounce glass of wine, or 1.5 ounce shot of distilled spirits. With regardto intake, the NIAAA has also established a rubric for understanding the spectrum of consuming alcoholicbeverages. Binge drinking has historically been operationalized as more than five drinks within aconclusive episode of drinking. The NIAAA (2004) defines it further as the drinking behaviors that raisean individual’s Blood Alcohol Concentration (BAC) up to or above the level of .08%, which is typically5 or more drinks for men, and 4 or more for women, within a two-hour time span. A lower BAC, on the
2023 Regional Needs Assessment8other hand, over longer spans of time predicates risky drinking while “benders” are considered two ormore days of sustained heavy drinking.ConsequencesFor the purpose of the RNA, consequences are defined as adverse social, health, and safety problems oroutcomes associated with use of alcohol and other drugs. Consequences include events such as mortality,morbidity, violence, crime, health problems, academic failure, and other undesired events for whichalcohol and/or drugs are consistently involved. Although a specific substance may not be the single causeof a consequence, measureable evidence must support a link to alcohol and/or drugs as a contributingfactor to the consequence.The World Health Organization estimates alcohol use as the world’s third leading risk factor for loss ofhealthy life, and that the world disease burden attributed to alcohol is greater than that for tobacco andillicit drugs. In addition, stakeholders and policymakers have a stake in the monetary costs associated withsubstance-related consequences. State and regional level data related to consequences of alcohol and otherdrug use are summarized in later sections of this report.StakeholdersReaders of this document who may be involved in or affected by the topics covered include stakeholdersfrom a variety of disciplines such as substance use prevention and treatment providers; medical providers;school districts and higher education; substance prevention coalitions; city, county, and state leaders; andcommunity members interested in increasing their knowledge of public health factors related to drugconsumption. The information presented in this report aims to contribute to program planning, evidence-based decision making, and community education.The executive summary found at the beginning of this report provides highlights of the report for thoseseeking a brief overview. Since readers of this report will come from a variety of professional fields withvarying definitions of concepts related to substance abuse prevention, a description of definitions can befound in the section titled “Key Concepts.” The core of the report focuses on substance use risk andprotective factors, consumption patterns, and consequences.Report Purpose and MethodsThe needs assessment was developed to provide relevant substance abuse prevention data related toadolescents throughout the state. Specifically, this regional assessment serves the following purposes:• To discover patterns of substance use among adolescents and monitor changes in substance usetrends over time:• To identify gaps in data where critical substance abuse information is missing;• To determine regional differences and disparities throughout the state;• To identify substance use issues that are unique to specific communities and regions in the state;• To provide a comprehensive resource tool for local providers to design relevant, data-drivenprevention and intervention programs targeted to needs;• To provide data to local providers to support grant-writing activities and provide justification forfunding requests;• To assist policy-makers in program planning and policy decisions regarding substance abuseprevention, intervention, and treatment in the state of Texas.
2023 Regional Needs Assessment9MethodologyThe state evaluator and the regional evaluators collected primary and secondary data at the county,regional, and state levels between September 1, 2015 and May 30, 2023. The state evaluator met with theregional evaluators at a statewide conference in September 2015 to discuss the expectations of the regionalneeds assessment for the third year.Between September 2015 and June 2023, the state evaluator met with regional evaluators via bi-weeklyconference calls to discuss the criteria for processing and collecting data. The information was primarilygathered through established secondary sources including federal and state government agencies. Inaddition, region-specific data collected through local law enforcement, community coalitions, schooldistricts and local-level governments are included to address the unique regional needs of the community.Furthermore, qualitative data was collected through primary sources such as surveys and focus groupsconducted with stakeholders and participants at the regional level.Primary and secondary data sources were identified when developing the methodology behind thisdocument. Readers can expect to find information from the American Community Survey of the U.S.Census, Texas Department of Public Safety, Texas School Survey (TSS) of Drug and Alcohol Use, andthe Community Commons, among others. In addition, adults and youth in the region were selected asprimary sources.Quantitative Data SelectionRelevant data elements were determined and reliable data sources were identified through a collaborativeprocess among the team of regional evaluators and with support from resources provided by the SouthwestRegional Center for Applied Prevention Technologies (CAPT). For the purpose of this Regional NeedsAssessment, the Regional Evaluators and the Statewide Prevention Evaluator chose secondary datasources as the main resource for this document based on the following criteria:• Relevance: The data source provides an appropriate measure of substance use consumption,consequence, and related risk and protective factors.• Timeliness: Our attempt is to provide the most recent data available (within the last five years);however, older data might be provided for comparison purposes.• Methodologically sound data that used well-documented methodology with valid and reliable datacollection tools.• Representative: We chose data that most accurately reflects the target population in Texas andacross the eleven human services regions.• Accuracy: Data is an accurate measure of the associated indicator.Qualitative Data SelectionInterviews were conducted with community organizations and law enforcement. All groups that wereinterviewed provided valuable qualitative data that gives a further insight on local substance use trends.Demographic OverviewThe starting point for any thorough analysis of descriptors of a region is setting its context in the state. Thefollowing section will describe basic demographics for the state of Texas and the regional variances,including information about Region 5. The state and regional demographics are followed by regionaldemographics by county designed to identify local variances and patterns.
2023 Regional Needs Assessment10State Demographics by RegionThe state of Texas demographic section describes statewide conditions and Region 5 comparisons ifknown for the following categories: Population, Age, Race, Ethnicity, Language, Concentrations ofPopulations, and General Socioeconomics which includes: Per Capita Income, Household Composition,Employment Rates, Industry, TANF Recipients, Food Stamp Recipients, and Free/Reduced School LunchRecipients.PopulationTexas is a state of vast land area and a rapidly growing population. In 2015, Texas was ranked as thesecond most populous state with a population of 27,469,114. Texas was also ranked as the second-fastestgrowing state; the population for the State of Texas grew an estimated 9.24 percent in 5 years. Below areshown the regional components of Texas’ significant population increases during the 2010-2015 period.Note that Region 6 (Houston and surrounding counties) led the growth component, followed Midland-Odessa area of Region 9 and that of Austin and surrounding counties in Region 7. Region 5 experiencedthe second smallest amount of population growth in the State. AgeTexas’ population is significantly younger than the United States as a whole. In the categories of youth(aged 0-19), Texas stands at 29.3% while the U.S. is 25.8%. The younger population is also revealed inthe category of persons 65 years and over, where Texas has fewer in that group (11.8%) than the U.S. at14.5%. Region 5 does not have the concentration of youth (26.4%) as does Texas, and has a larger olderpopulation (16.2%) in comparison to both Texas and the United States.
2023 Regional Needs Assessment Source: U.S. Census Bureau, 2015 Population, Population Change, and Components of Change.Age, Race and EthnicityThroughout Texas, students age 5 through 19 years of age represent 22.1% of the total population.Although Hispanics make up 39.6% of the total population, they make up 49.1% of the children age 5through 19. Accessed July 27, 2023.Race and EthnicityTexas is an increasingly diverse state with a strong Hispanic representation. The table below shows theracial and ethnic make-up of Texas’ population, which is represented by slightly fewer black and otherraces and significantly higher Hispanic or Latino population. Region 5 has notably higher concentrationof Black and less Hispanic/Latino than either Texas or the United States.
2023 Regional Needs Assessment LanguageTexas has a significantly higher number of residents that are foreign-born (16.5%) than the U.S. as a whole(13.1%). As a result, there are also significantly higher numbers of the population (ages 5+, 2010-2014)that report a “language other than English is spoken at home,” with Texas at 34.9% compared to 20.9%nationally.Another similar indicator is the population with limited English proficiency (LEP). In Texas, it is muchhigher at 14.22% of the population versus 8.60% for the U.S. Persons are considered to have limitedEnglish proficiency if they indicated that they spoke a language other than English, and if they spokeEnglish less than "very well,” measured as a percentage of the population aged 5 or older. Note thesignificantly higher percentages in the border counties surrounding the El Paso (Region 10) andBrownsville (Region 11) metro areas. Region 5 has a lower rate of persons with limited Englishproficiency, 5.46%, than either Texas or the U.S.0.00%10.00%20.00%30.00%40.00%50.00%60.00%70.00%White Alone, NotHispanicBlack Alone, NotHispanicHispanicOtherRace and EthnicityU.S.TexasRegion 5
2023 Regional Needs Assessment Concentrations of PopulationsTexas’ land area of 268,580.82 square miles places it as the 2nd largest state, behind Alaska. Texas’ 96.3persons per square mile (density) is close to the national average of 87.3, with New Jersey (1195.5) andAlaska (1.2) representing the highest and lowest density.Table 6 below contains the 2010 Census designations of populations by urban and rural status. To qualifyas an urban area (UA), the territory identified according to criteria must encompass at least 2,500 people,at least 1,500 of whom reside outside institutional group quarters. Areas adjacent to urban areas and urbancores (UC) are also designated as urban when they are non-residential, but contain urban land uses, orwhen they contain low population, but link outlying densely settled territory with the densely settled core.“Rural” areas consist of all territory, population, and housing units located outside UAs and UCs.Geographic entities, such as metropolitan areas, counties, minor civil divisions, places, and census tracts,often contain both urban and rural territory, population, and housing units.The United States has 80.9% of people living in urban areas with 19.1% living in rural areas. Texas ismore urban with 84.7% urban and 14.3% rural. Region 5 is more rural with only 56.3% urban and 43.7%rural.
2023 Regional Needs Assessment14United States312,471,327252,746,52780.89%59,724,80019.11%State Socioeconomics by RegionPer Capita IncomePer the 2010-2015 American Community Survey of the U.S. Census, Texas is in the mid-range among the50 states with a per capita income of $26,513 compared to the United States’ per capita income of $28,555.The Region 5 per capita income is lower, $21,109.Household CompositionIn 2023, it was estimated by County Health Rankings and Roadmaps that Region 5 had 267,054households. In addition, it was reported that a single parent headed 70,844 of those households. Based onthis data, Region 5 has the highest percent of single-parent households compared to other regions. It isestimated that 39.13% of households in Region 5 are classified as single-parents which is higher whencompared with the percentage for the United States, 33.6%, and Texas (as a whole) 33.39%.Employment RatesThe term “unemployed” describes individuals who are not currently working but are actively seekingemployment. Region 5 has an estimated labor force size of 325,724 people. From the total labor force,306,596 individuals are estimated to be employed while an estimated 19,128 individuals are out of work.Using these figures, Region 5 has an unemployment rate of 5.9%. Recent announcements of plant andcompany closures and various layoffs will increase that figure.IndustryThe economy of Region 5 centers on the following industries: Agriculture (including chicken farming andprocessing), Forestry (including harvesting, transportation, and milling), Healthcare (including personalcare and service), and Oil Refining (limited to the Beaumont area).Temporary Assistance for Needy Families (TANF) RecipientsTANF is a State funded program created to provide temporary cash assistance to help families becomeself-sufficient. Each individual that qualifies for assistance may receive 60 months of assistance duringone’s lifetime. In December 2015, an estimated 654 individuals were receiving TANF benefits in Region5 and, on average, each qualifying individuals received an average monthly payment of 142 dollars.Food Assistance RecipientsIn Region 5, there are an estimated 1,655,984 cases of individuals receiving food assistance benefits. It isestimated that Region 5 has 3,565,473 individuals receiving food assistance benefits with an averagemonthly payment of 256 dollars per month. In total, all counties in Region 5 spend $409,179,807 to providefood assistance benefits to communities.Free and Reduced-Price School Lunch RecipientsRegion 5 currently has 155,512 students enrolled in schools across all counties. 64.56% of the totalnumbers of students, 100,401 students, were reported as eligible to receive free or reduced price lunch.According to The Texas Department of Agriculture Food and Nutrition Division, to qualify for free orreduced lunch, a student must be enrolled in a Texas public school and must be a Texas resident. Inaddition, household size and household income are part of the selection criteria. For example, in 2023, ahousehold of four cannot earn more than 44,836 dollars (before taxes) in order for their child to receivefree or reduced lunch at school.
2023 Regional Needs Assessment15Regional Demographics by CountyRegion 5 has 15 counties: 1) Angelina, 2) Hardin, 3) Houston, 4) Jasper, 5) Jefferson, 6) Nacogdoches, 7)Newton, 8) Orange, 9) Polk, 10) Sabine, 11) San Augustine, 12) San Jacinto, 13) Shelby, 14) Trinity, 15)Tyler. Texas was the fifth fastest growing state in the country from 2000 to 2010 and experienced thesecond fastest growth from 2010 to 2015 according to the U.S. Census. The Census Bureau also reportedthat Texas experienced an increase of 4.3 million people, making Texas the state with the largest increasein actual population in the last decade.PopulationRegion 5 has a total population of 766,560 people. The fastest growing county is San Jacinto County,which grew by an estimated 2.7% from 2010 to 2014. Eight Region 5 counties experienced growth whilethe other 7 counties experienced negative growth. Houston, Sabine, and Trinity counties have experiencedthe most negative growth, around -4%.Race/Ethnicity Native AmericansThe Census recognizes the Alabama-Coushatta Tribes of Texas as a separate population group for whichcensus data is collected. 990 persons live in the tribal area, 182 of whom were born in a different state.537 or 54.2% are female. 38.4 percent are age 18 years or over. Of the 312 households, 212 are consideredfamilies of which 29.8 percent are led by a female head of house.There are 308 students 3 years and over enrolled in school. Of the population 25 years old 76 percent havea high school degree or higher. 3.3% have a bachelor’s degree or higher.Of the 715 people age 16 and over, 306 are employed in the civilian labor force with 7.1 percentunemployment rate. 25.2 % of adult over 18 years old are living below poverty level, with 39.3% of relatedchildren below poverty level. There are 31 households where the grandparent is responsible for thegrandchildren. Thirteen percent of individuals age 5 and over speak English less than “very well.”
2023 Regional Needs Assessment16Source: U.S. Census Bureau, Census 2000 American Indian and Alaska Native Summary FileLanguageIn Region 5, the majority of residents are proficient in English. However, there is a sizeable portion of thepopulation over the age of 5 that have limited English proficiency. An estimated 5.27 percent of residentsin Region 5 have limited English proficiency. Jefferson County has the highest number of residents withlimited English proficiency with an estimated 19,358 residents, or 8.23 percent of the population ofJefferson County. Sabine County has the lowest number of residents with limited English proficiency with95 residents, or 0.95 percent of the population of Sabine County.Concentrations of Populations by CountyRegion 5 is primarily comprised of small towns and rural communities. With the exception of theBeaumont-Port Arthur, Texas, a statistical metropolitan area in Jefferson County, Region 5 has no othertown with a population larger than 100,000. The separate population group of Native Americans, theAlabama-Coushatta Tribe of Texas has occupied their area since the late 1700’s, before Texas became astate.
2023 Regional Needs Assessment17Regional Socioeconomics by CountyPer Capita Income by CountyPer capita income is a measure of average income earned per person for a given area in a specific year.Per capita income is calculated by dividing the area’s total income by its total population. Total income isthe sum of all money received by an individual, a household, or an organization for a specific region (e.g.,a county).In Texas, the per capita, or average, income for 2014 was estimated to be 26,512 dollars. The per capitaincome for the entire United States was estimated to be 28,554 dollars. For Region 5, the per capita incomewas estimated to be 21,109 dollars, which is considerably lower than the estimated per capita income forthe State of Texas or the United States.Employment by CountyIn Region 5, the county with the highest unemployment rate is Sabine County with 8.9 percentunemployment and the lowest is Nacogdoches County with 4.2 percent unemployment.
2023 Regional Needs Assessment18Poverty by County Assistance with food can be taken as an indication of poverty or need. Food assistance information includesTemporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP)food assistance benefits formerly “food stamps”, and free and reduced school priced lunch in schools.Temporary Assistance for Needy Families (TANF) Recipients by CountyIn Region 5, Jefferson County has the largest number of recipients, 252 individuals. In addition, SabineCounty had the lowest number of TANF recipients with a reported number of zero cases.
2023 Regional Needs Assessment19Food Assistance Benefits by County.TABLE 14 – FOOD ASSISTANCE BENEFITS, BY COUNTYCountyNumber of Cases # of Recipients Total FB Payment Average Monthly Payment Environmental Risk FactorsThe environmental risk factors are negative influences related to consumption of alcohol, drug, orprescription medicine by minors, consumption of illegal substances, over-consumption of legalconsumption, or dependence/addiction to substances. The relationship is not assumed to be causation, butpeople experiencing one or more risk factors without having protective factors in their lives, may be moreprone to problems with substances. Some risk factors can also be viewed as consequences if the assumed
2023 Regional Needs Assessment20causal relationship is reversed, with consumption leading to, for example, a greater dropout rate, schoolabsences, etc.Within SchoolsThe dropout rate for Region 5 is less than that for the entire state, though the rates for Angelina County,Nacogdoches County and Trinity County are higher than the state rate.School DisciplineSchool absences were higher for marijuana and alcohol users than for those student who did not use those substances
2023 Regional Needs Assessment21Criminal ActivityIndex Violent Crime, Property CrimeTexas participates in the Uniform Crime Reporting (UCR) program which uses a Crime Index focused onseven serious crimes, both violent and property crimes. In 2015, Region 5 had an estimated violent crimeindex rate of 167.6, or 1,034 violent crime arrests, well over the rate for the State of Texas, 116.9, or32,083 arrests. In Region 5, the most common violent crime is assault with 831 arrests, followed byrobbery with 117 reported arrests.The serious property crimes included in the index include burglary, larceny, and auto theft. The Texascrime index for property crimes is 432.6. In Region 5 ten of the fifteen counties have property crimeindices that exceed the Texas index.Local Legal Citations Related to Alcohol and DrugsTaking Nacogdoches as an example of local citations related to alcohol and drugs, there are many typesof offences related to drugs and alcohol. The Daily Sentinel in Nacogdoches tracked the citations issuedfor a year based on the daily police reports.TABLE 16 – CITATIONS ISSUED FOR 2015, NACOGDOCHESOFFENCETOTALSPossession of Marijuana512Possession of a Controlled Substance333Driving While Intoxicated457Second DWI62Public Intoxication439Possession of Dangerous Drug29Open Container5Delivery of Controlled Substance3Possession of Synthetic Marijuana8Possession of an Inhalant4Possession of Drug Paraphernalia60Public Intoxication under 2133Driving While Intoxicated under 2139Possession of Drug Paraphernalia6Possession of a Controlled Substance under 2120Possession of Marijuana under 2150Delivery of Controlled Substance1
2023 Regional Needs Assessment22State Arrest Data Related to Alcohol and Drugs Other Dangerous Source: dps.texas.gov/crimereports/14/citCh9,pdfRegional Mental Health and Mental IllnessSuicide is an indication of mental illness. The counties in Region 5 have a large variance in the rate ofsuicide per 1000 residents with Jefferson County the lowest and Sabine County the highest.Suicide Rates by County0510152025JeffersonNacogdochesAngelinaShelbyNewtonHoustonJasperHardinTrinityOrangeSan AugustineTylerSan JacintoPolkSabineSuicide Mortality Rate Per 1,000 Population (2013)Suicide Rate
2023 Regional Needs Assessment23Psychiatric Hospital AdmissionsThere are a limited number of locations where serious psychiatric problems can be cared for in an inpatientsetting in Region 5.Burke in Lufkin, Texas, provides comprehensive mental health services in the region. Burke’s MentalHealth Emergency Center (MHEC) provides counseling and mental health services and is the firstfreestanding rural comprehensive psychiatric emergency program in which psychiatric services areperformed entirely by emergency telepsychiatrists. It serves a population of 370,000 over 11,000 squaremiles. Its MHEC Residential Detox unit served 255 individuals from the area during calendar year 2015.Spindletop in Beaumont, Texas, provides mental health services on an outpatient and residential basis. Itspsychiatric inpatient services are provided through arrangements with The Memorial Hermann BehavioralHealth Center, also in Beaumont. As a functioning inpatient crisis unit, The Memorial HermannBehavioral Health Center provides an array of programs and services of short-term duration within astructured residential setting to individuals who exhibit primary psychiatric disorders to such an extentthat stabilization in an inpatient setting is warranted. The primary goal of services is to restore theindividual to a level of functioning, which will enable discharge to a less restrictive level of care as quicklyas possible. The illnesses and emotional problems vary widely from mood disorders such as depression,to alcohol or drug abuse induced psychiatric events.The Medical Center of Southeast Texas (SETX), located in Port Arthur, Texas, provides inpatient capacityfor patients with mental illness from Hardin, Jefferson and Orange counties among others.Adolescents and Adults Receiving Substance Abuse TreatmentAngelina County’s Drug Court showed the following in the 12-month treatment program:• 42 total admissions (25 males; 17 females) for abuse of amphetamines, cocaine, polysubstance,and cannabis (top 4).• The TRF specialized female outpatient treatment admitted 55 females for abuse of amphetamines,opioids, cannabis, and cocaine.• The TRA adult outpatient treatment program handled 44 males, 25 females, and 1 Transgenderfor abuse of amphetamines, alcohol, cannabis, and cocaine.• TRY the youth outpatient treatment program served 55 males and 25 females for abuse ofcannabis, amphetamine, alcohol, and sedatives.• The adult probation outpatient treatment program, TAIP, handled 72 males and 33 females forabuse of alcohol, cannabis, amphetamine, and cocaine.The adult parole and probation outpatient treatment program, 3 months of intensive outpatient treatmentfollowed by 9 months of regular outpatient treatment, served 153 males and 39 females for abuse ofamphetamines, alcohol, cannabis, and cocaine.The Alcohol and Drug Abuse Council of Deep East Texas’ Outreach, Screening, Assessment, and Referral(OSAR) service screened 1081 adults age 18 and over, and 136 youth under age 18. 705 adults werereferred to treatment as well as 121 youth referrals. The top four drugs of abuse were amphetamine,alcohol, cannabis, and opioids.Source: OSAR logs maintained by ADAC, September 2014 – August 2015AccessibilityPerceived Ease of Access to AlcoholIn 2014, 28.8 percent of Region 5 students reported having “very easy” access to alcohol, with thepercentages increasing from one grade to the next.
2023 Regional Needs Assessment Source: Texas School Survey, 2014Source: Texas School Survey, 2014Alcohol Retail Permit Density and ViolationsIn 2023, the Texas Alcoholic Beverage Commission (TABC) reported that Region 5 had a total 2,909active alcohol retail permits. In total, Region 5 has a land area of 12,010.5 square miles, which calculatesto be that Region 5 has .24 permits for every square mile of land, lower than the rate for the State of Texas,which has .34 active alcohol retail permits per square mile. In Region 5, Jefferson and Orange Countyhave the highest density of active alcohol retail permits. Trinity County has the lowest density of activealcohol retail permits. Never HeardofImpossibleVery Difficult Somewhat Difficult SomewhatEasyV ery EasyEase of Access to AlcoholAllGrade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12
2023 Regional Needs Assessment Perceived Access to MarijuanaIn 2014, 23.1 percent of Texas students in grades 6 through 12 reported having “very easy” access tomarijuana. Students in grade 11 reported the highest rate of easy access to marijuana, while only 4 percentof students in grade 6 reported having easy access to marijuana. 48.3 percent of students in grade 12considered the access “very easy.
2023 Regional Needs Assessment26Environmental Protective FactorsProtective Factors: Community DomainCommunity CoalitionsCommunity Coalitions work to reduce the use of harmful substances by influencing public policy, laws,attitudes and behaviors to foster healthy life-long choices.• The Coalition in Lufkin, Texas• NAC-CAN Coalition in Nacogdoches, Texas• Healthy Nacogdoches in Nacogdoches, Texas• Triangle Area Network in Beaumont, TexasRegional CoalitionsThe Rural East Texas Health Network (RETHN) has had a vital role in the development and continuingoperations of the MHEC, Burke’s detox and treatment project with ADAC. RETHN is the collaborativeinitiative of partners within the East Texas area that have contributed to the continued support of thedelivery of health care services in Rural East Texas.Treatment/Intervention Providers• Spindletop in Beaumont – Treatment• Land Manor in Beaumont – Treatment• Southeast Texas Council on Alcohol and Drug Abuse in Beaumont, Texas – Treatment• Alcohol and Drug Abuse Council- Youth Prevention Intervention program• Alcohol and Drug Abuse Council- TreatmentLocal Social Services• Health and Human Service Commission• Mosaic Center in Lufkin, TexasLaw Enforcement Capacity and Support• Local Sheriff Departments• Police Departments• Juvenile Detention Centers• Juvenile and Adult Probation offices• Justices of the Peace• Parole Departments• School Resource OfficersHealthy Youth Activities• Cub/Boys Scouts• Girls Scouts• Boys and Girls Club• Parks and RecreationReligion and Prevention• Seasons of Hope in Lufkin, Texas
2023 Regional Needs Assessment27Protective Factors: School DomainYouth Prevention Programs• Youth Prevention Universal (YPU) - The YPU program targets youth participants enrolled inelementary settings grades 1-3rd. The Alcohol and Drug Abuse Council (ADAC) oversees thisgrant, which is funded with the Department of State Health Services (DSHS). Staff is trained inthe Too Good for Drugs curriculum. The curriculum is state approved and is research based. Staffdelivers services in classroom settings to both male and female participants in multiple countieswithin the Deep East Texas region. Summer services including alternative activities, tobaccopresentations, and curriculum based support groups are provided to youth in local summer camps,Boys and Girls Clubs and local housing authorities.• Youth Prevention Selective (YPS) - The YPS program targets youth in elementary settings grades3-5. The Alcohol and Drug Abuse Council (ADAC) oversees this grant, which is funded with theDepartment of State Health Services. Staff is trained in the Curriculum Based Support Group(CBSG) curriculum, which is a part of the Rainbows Days curriculum. The curriculum is stateapproved and is research based. Staff delivers services in a classroom setting to youth in multiplecounties in the Deep East Texas region. Summer services are provided to youth in local summercamps, Boys and Girls Clubs and local housing authorities. Summer services include alternativeactivities, tobacco presentations and curriculum based support groups when possible.• Youth Prevention Intervention (YPI) – The YPI program has a target audience of youth in grades9-12 enrolled in a high school setting. The Alcohol and Drug Abuse Council (ADAC) overseesthis grant, which is funded with the Department of State Health Services. Staff is trained in theProject Toward No Drug-use curriculum. The curriculum is state approved and is research based.Staff delivers services in small group settings on school campuses, detention centers, alternativecampuses, and summer camp locations. Groups consist of both male and female students and arerestricted to no more than 15 students per group cycle. Summer services included curriculum-based groups, alternative activities, and tobacco education, which is provided to youth in localsummer camps, Boys and Girls Clubs and local housing authorities.Students Receiving AOD (Alcohol and Other Drugs) Education in School• Alcohol and Drug Abuse Council (ADAC) Preventing Abuse by Reaching Today’s Youth(PARTY) prevention program provides services to 12 counties in the Deep East Texas Regionincluding Angelina, Houston, Jasper, Nacogdoches, Newton, Polk, Sabine, San Augustine, SanJacinto, Shelby, Trinity, and Tyler. Staff works with area school campuses, housing authorities,Head Starts, churches, community events, colleges, retirement centers, Girls Scouts/Boys Scoutsand Boys and Girls Clubs. Utilizing multiple educational platforms staff rely on presentations,puppet shows, educational games and interactive activities to gain the attention of each age groupthey meet. Leo the Drug Free Lion, a life-size costume, is the mascot for the PARTY departmentand serves as an excellent way to connect with the younger audience.High School to College and Academic Achievement• Staff in the YPI program work closely with school counselors and guidance officers to reinforcethe need to continue education on a collegiate level. The goal with participants in the program isto provide an opportunity for them to utilize skills gained in-group including goal setting and gooddecision-making skills while planning their future. Staff encourages students to make efforts withschool counselors in regards to applications for college admission as well as financial aidassistance when needed.
2023 Regional Needs Assessment28Protective Factors: Family DomainThe Texas School Survey (TSS) of Drug and Alcohol Use surveys students in grades 7 through 12 ofschools that opt to administer the survey. The results can show the effect of having two parents in thehousehold, and shows the students who would seek help from adults for substance abuse problems. Afamily with two parents is likely to provide more supervision and support than a family with only oneparent present. The results indicate lower prevalence of substance use for those who live with 2 parents. Source: Texas School Survey, 2014The TSS also asks the students about their parents’ opinions about tobacco, alcohol and drug use. Studentswho are aware of a parent’s disapproval of activities surrounding drugs and alcohol are less likely toproceed into more dangerous activities. The survey also asks about whether the child’s friends feel closeto their parents, whether parents attend PTA and/or school open housesThere are many agencies that provide services to families to strengthen them against many problemsfamilies face. For example, the Angelina Coalition has a large number of agencies and programs, some ofwhich serve multiple counties. The Beaumont area would likely have a similar list of supportive/protectiveefforts. Smaller communities and counties may have some local representatives of these same agencies orprograms or might have their own. It is likely that families in rural areas would have to travel to access theprotective factors that are available locally in the larger cities and counties. The Interagency Coalition ofAngelina County recently updated their listing of agencies and phone numbers. The agencies are listedhere in the first category in which they appear on the list. Many of the agencies could also be consideredprotective in the Community Domain. (Service To At-Risk Youth)Family Crisis Center of East TX 24 Hr. HotlineHarold’s House – E Texas Alliance for ChildrenLegal Aid for Survivors of Sexual Assault (LASSA)Adoption and Foster CareServicesBair FoundationBuckner Foster Care & AdoptionPregnancy Help Center of LufkinAlcohol/Drug AbuseAlcohol & Drug Abuse Council (ADAC)Alcoholics AnonymousAmerican Cancer Society Tobacco Quit LineCelebrate RecoveryLost & Found (formerly known as Greyson’s Place)Lufkin Dream Center
2023 Regional Needs Assessment29Most Excellent Way (Adult)Partnership for a Drug-Free TexasSerenity HouseChild/Adolescent ServicesAngelina County & Cities Health DistrictHIV&STD Counseling & EducationPrimary Care, CHIPS ProviderMaternal & Infant HealthImmunizationsWomen’s Care/Family PlanningWomen, Infants & Children (WIC)Boys and Girls ClubBuckner Children and Family ServicesBurke Early Childhood InterventionChildren’s Protective Services (CPS)Court Appointed Special Advocates (CASA)Concerned Black Men of LufkinCrossover Counseling and CoachingDepartment of State Health ServicesEast Texas Support Services Child Care ManagementFamily Counseling AssociatesHarold’s House – E. Texas Alliance for ChildrenHead StartKurth Memorial LibraryLove, INCLiving Water Equine TherapyLufkin Parks and RecreationLufkin Workforce SolutionsTexas AgriLife Extension ServicesTexas Health StepsCounseling/Mentoring Services Angelina CollegeBurkeConsumer Credit Counseling ServicesFamily Counseling AssociatesFor Kids Sake Parenting ProgramLufkin Veteran’s Administration ClinicMosaic CenterNAACPSFA Counseling CenterCrisis Intervention/EmergencyServicesAlcoholics/Narcotics AnonymousAngelina County Juvenile Probation DepartmentChristian Information & Service Center (CISC)Diboll Christian OutreachEmergency Mental Health ServicesRed CrossSalvation ArmyUnited WayDisability ServicesGoodwill IndustriesRelay Texas (TTY/TDD Access for Voice or Hearing Impaired)Social Security Administration
2023 Regional Needs Assessment30Texas Department of Assistive and Rehabilitation Services (DARS)Division for Blind ServicesLufkin Division for Rehabilitation ServicesDept. of Aging & Disability ServicesThe District (Transit)Education/TrainingAlzheimer’s AssociationBuckner Family PathwaysCommunities in Schools of Deep East TexasLufkin High SchoolLufkin Middle School/Coston Primary/Herty ElementaryEmpowerment Christian Ministries, Inc. (ECMI)Head StartHealth Horizons of East TexasEast Texas Fun BunchEven Start Family LiteracyGateway Community Partners, Inc.Impact LufkinJD’s Center of H.O.P.E.Legacy Institute for Financial Education (LIFE)Lufkin Adult Learning CenterMaintain the KnowledgePinewood Park Learning CenterPineywoods Area Health Education (AHEC)Stubblefield Learning CenterElderly ServicesAdult Protective ServicesAlzheimer’s AssociationAngelina County Senior Citizens CenterArea Agency on Aging of Deep East TexasLewis Toran Retirement CommunitySalvation Army Adult Day CenterSocial Security AdministrationTimber Pointe Apartment HomesEmployment ServicesGateway Community Partners, Inc.Texas Department of Human ServicesTexas Veterans CommissionFinancial Assistance (Food,Clothing, Utilities.,Transportation, $$$)Area Agency on Aging of Deep East TexasCommunity ActionCommunity Rx HelpConsumer Credit Counseling ServicesDiboll Christian OutreachEast Texas Food BankGodtel MinistriesHouse of CompassionMedicaid, TANF, SNAPHousing AssistanceCommunity ActionCreekside EstatesDETCOG Regional Housing AuthorityDiboll Housing AuthorityHabitat for Humanity
2023 Regional Needs Assessment31High Point PlazaHuntington Housing AuthorityInez Tims ApartmentsJoe Elliott HouseLoftus Lane ApartmentsMinistry in ActionPineywoods HOME TeamPioneer Crossing for Families/SeniorsSeasons of HopeStephen’s CourtUSDA Rural Housing DevelopmentImmigration/CitizenshipLufkin Adult Learning CenterU.S. Congressional District OfficeIntellectual and DevelopmentalServicesInnovative Homes of Deep East TexasLufkin Learning CenterOak Creek CenterSt. Giles LivingLegal/Civil Rights ServicesAttorney General – Child SupportLegal Aid for Survivors of Sexual Assault (LASSA)Lone Star Legal AidState Representative District OfficeTexas Workers CompensationMedical/Dental/Health Services American Cancer SocietyAngelina County Indigent Health CareCaring for ChildrenEast Texas Community Health-DentalEast Texas Support Services Medical Transportation/MedicaidHealth Horizons of East TexasHospice in the PinesJoe Elliott HouseJoseph House – Devoted to End of Life CarePolk Diabetes Education CenterTexas Health StepsTexCare Partnership (CHIPS)Mental Health ServicesAngelina Mental HealthcareEmergency Mental Health Services LineRehabilitation ServicesMemorial Outpatient Therapy CenterSupervision & CorrectionsAdult and Juvenile Probation DepartmentsTransportation Services(various already listed)Veteran’s Services(various already listed)In addition to the multitude of agencies and services listed by the Coalition, there are also two hospitals inLufkin. CHI St. Luke’s Health Memorial – Lufkin and Woodland Heights Medical Center serve Lufkinand the surrounding area.
2023 Regional Needs Assessment32Protective Factors: Individual DomainIndividual Screening and TreatmentThe Alcohol and Drug Abuse Council of Deep East Texas provides Outreach, Screening, Assessment, andReferral (OSAR) service for both youth and adultsLife Skills Learned in YP ProgramsThe Youth Prevention (YP) programs within the Alcohol and Drug Abuse Council (ADAC) utilize stateapproved curricula that offer life skills in the area(s) of:• Communication skills and the importance of utilizing good communication daily• Decision-making skills are taught to offer guidance on steering youth into healthy decisionsrelated to maintaining a drug free lifestyle.• Goal setting guidelines are provided for identification of future success with youth.• Attendance/school bonding encourages youth to participate in school based functioning ensuringsuccess in their education.Mental Health and Family Recovery ServicesWithin the region:• In Beaumont County Baptist Hospital has a chemical dependency program and medical detox.• In Angelina County Oceans Behavioral Hospital accepts inpatients age 55 and over andoutpatients at least 21 years old but does not do detox admissions.• Burke Center’s Mental Health Emergency Center (MHEC) in Lufkin provides an extendedobservation unit clinically staffed (including medical and nursing professionals), psychiatricallysupervised environment with immediate access to urgent or emergent medical evaluation andtreatment as well as a crisis residential unit providing short-term, community-based residential,crisis treatment to persons who may pose some risk of harm to self or others and who may havefairly severe functional impairment. The Residential Detox unit served 255 individuals from thearea during calendar year 2015.Youth EmploymentWhen jobs are available for young people, they have less time to turn to illicit activities, and they havefunds available for personal use, rather than turning to buying and selling drugs to generate income.
2023 Regional Needs Assessment33Youth Perception of Risk and HarmApproximately 80% of students consider underage drinking to be dangerous or very dangerous.Source: Texas School Survey, 2014At every grade level, over 50% of the students perceive that marijuana is somewhat or very dangerous.This opinion is protective of the student from being tempted to use this drug.Perceived Risk of Harm from MarijuanaSource: Texas School Survey, 201401020304050607080PercentStudents’ Perceptions of the Dangers ofUnderage Drinking, by GradeVery DangerousSomewhat DangerousNot Very DangerousNot Dangerous at AllDo Not Know020406080100All6789101112PercentGrade LevelStudents’ Perceptions ofRisk of Harm from Marijuana, By GradeVery DangerousSomewhat Dangerous Not Very DangerousNot Dangerous at AllDo Not Know
2023 Regional Needs Assessment34Regional ConsumptionThis section, Regional Consumption, presents the statistical rates pertaining to adolescent use of the threeprimary substances that are the focus of this report: alcohol, marijuana, and prescription drugs. Some ofthe data are from the Texas School Survey report, which is generated every two years, so may be identicalto the data in last year’s Regional Needs Assessment.AlcoholAlcohol in the Deep East Texas region continues to be the most abused drug among youth and adults.Factors that enhance the problem within this region include the rural nature of the majority of the countiesserved, consumption by adolescents, a lack of resources, and lack of activities to participate in as analternative to drinking. In addition, because alcohol is legal and most often socially accepted among adults,it is an environmental risk factor that has to be taken into account concerning underage drinking. Someparents allow, or even encourage, underage drinking, although others do not. In rural communities, theprotection from enforcement for those caught drinking due to officers knowing the family keeps manyyoung people from facing consequences that could help to deter future use.Age of InitiationIn 2014, the Youth Risk Behavior Survey (YRBS) reported that 18.1 percent of Texas students stated thatthey had consumed alcohol prior to their thirteenth birthday. More males reported that they consumedalcohol before age 13 compared to females. Alcohol is the most commonly used substance amongadolescents, followed by marijuana. Source: Texas School Survey, 2014Sixth graders who use or have used alcohol started when they were an average of 9.8 years old. Twelfthgraders who use or have used alcohol started when they were an average of 14.7 years old. Each step ingrade is reflected by one-half to one-year increase in age of first use.For all students in Region 5, the average age of initial use of alcohol was 12.8 years old. 40.7% of allstudents began use of alcohol when they were less than 13 years old.
2023 Regional Needs Assessment35Alcohol: Current and Lifetime UseAlcohol consumption is higher for those in 12th grade compared to those in all grades. Both groupsanswered that they had used alcohol in the past at a higher rate than their answer for current use. High riskuse of alcohol consisting of underage drinking, drinking before driving and binge drinking, is higher for12th graders than for the group as a whole. Source: Texas School Survey, 2014Alcohol: Qualitative DataFindings reported from prevention providers in the region, including DSHS funded Youth Prevention (YP)programs, are consistent in relation to alcohol use among males or females. The marketing of alcohol tominors merely fuels the use of alcohol by females with the lure of “alco-pops” and other enticing imagesof product usage. The over glamorization of alcohol along with the societal appeal to the adolescent girlto appear older and socially accepted has created an increase in the use of these alcohol products amonggirls.MarijuanaMarijuana: Age of Initiation/Early InitiationIncluding all students 6th through 12th grade, the average age of the first use of cigarettes and use ofprescription drugs for non-medical purposes is 13.1 years old, with alcohol and marijuana having anaverage starting age of approximately 13 and a half.
2023 Regional Needs Assessment36Findings from the Youth Risk Behavior Survey:• 8.2% of high school students in Texas reported having tried marijuana before the age of 13.• 10.5% of the boys reported having tried marijuana before the age of 13.• 5.9% of the girls reported having tried marijuana before the age of 13.Marijuana: Current UseFindings from the Youth Risk Behavior Survey:• 20.5% of high school students in Texas reported having tried marijuana at least once during the30 days prior to the survey.• 22.0% of the boys reported having tried marijuana at least once during the 30 days prior to thesurvey.• 18.9% of the girls reported having tried marijuana at least once during the 30 days prior to thesurvey.Marijuana: Lifetime UseFindings from the Youth Risk Behavior Survey:18• 37.5% of high school students in Texas reported having tried marijuana at least once in theirlifetime.• 40.0% of the boys reported having tried marijuana at least once in their lifetime.• 35.1% of the girls reported having tried marijuana at least once in their lifetime.Marijuana: Qualitative DataResults of interviews conducted with stakeholders in the treatment field revealed that the use of marijuanais the #1 ranked drug reported from adolescents enrolled in programming. This program is the YouthCannabis Program targeting youth experiencing issues related to substances including, but not limited tomarijuana. Staff members report there is a rise among use of synthetics but the continued use of naturalmarijuana continues to be an issue.Other DrugsEarly Initiation of Drugs70.30%12.50 %6.30%5.20%2.80%2.80%First Specific Drug Associated with Initiation ofIllicit Drug Use Age 12 or Older: 2013MarijuanaPain Relievers InhalantsTranquilizers StimulantsHallucinogens
2023 Regional Needs Assessment37Source: Texas School Survey, 2014Prescription DrugsThe risk of prescription drug abuse among adolescents is a growing concern. Some of the mostcommonly abused prescription drugs are:• OxyContin (Oxycodone HCI controlled-released)• Zoloft (sertraline HCI)• Valium (diazepam)• Suboxone (buprenorphine HCI and naloxone)• Fentora (fentanyl citrate)• Vicodin (hydrocodone bitartrate and acetaminophen)• Adderall XR (amphetamine/dextroamphetamine)• Percocet (oxycodone acetaminophen)• Ambien (zolpidem tartrate)• Ritalin/Focalin (methylphenidate HCI)• Xanax XR (alprazolam)Age of Initiation/Early InitiationFindings from Texas Department of State Health Services: Texas Drug Facts Among Youth 2014:• In 2014 about 10.8 percent of students report using codeine cough syrup non-medically at somepoint in their lives, and 5.1 percent reported that they used in the past month. Two years prior in2012, 10.8 percent of students also reported using codeine cough syrup non-medically at somepoint in their lives, but only 4.0 percent had reported using in the past month. These prevalence%21.29.1 %%7.3%8.41.8 %50.5 %%23.2%13.7%22.4%6.60.0 %10.0 %%20.0%30.0%40.0%50.0%60.0AlcoholMarijuanaRx DrugsTobaccoSynthetic MarijuanaSubstance Comparison, Texas, Grades 7-12Current UseLifetime Use
2023 Regional Needs Assessment38rates suggest that use of codeine cough syrup remains stable concerning lifetime use but there wasan increase in reports of use in the past month.• Use of two commonly abused narcotic prescription drugs: oxycodone products (OxyContin,Percodan, Percocet) and hydrocodone products (Vicodin, Lortab, Lorcet) were first asked in the2008 school survey. About 2.5 percent of students in 2014 reported using oxycodone productsnon-medically in their lifetime and 5.2 percent reported using hydrocodone products non-medically in their lifetime. Both prevalence rates were lower when compared to the rates reportedin 2012.Prescription Drugs: Current UseFindings from TSS shows that prescription drugs are used non-medically by 7.3% of the Texas studentsin grades 7 through 12 during the 30 days previous to the survey administration. This compares to 7.7%of the students in Region 5. Source: Texas School Survey, 2014Prescription Drugs: Lifetime Use13.7% of Texas students in grades 7 through 12 reported ever having used prescription drugs not to treatan appropriate illness/condition. This compares to 13.9% of the students in the region.Prescription Drugs: Qualitative DataInterviews with prevention experts within the field have offered input related to nonmedical prescriptiondrug abuse among adolescents. They report that adolescents, in some part, are buying non-medicalprescriptions off the street. However, the majority of prescription drugs are taken from friends’ and familymembers’ homes. The students have reported taking medication from parents, grandparents and otherfamily members, directly from the home medicine cabinet.The added danger of adolescents mixing prescription medication along with alcohol is also a problem.Students did not seem to understand the lethal dangers of this dangerous combination.
2023 Regional Needs Assessment39Emerging TrendsSynthetic CannabinoidsAccording to the Texas Poison Center Network, 684 individuals reported synthetic marijuana exposure in2015, which was a decrease in exposures from 2014, with 782 reported cases. Synthetic marijuana hasbeen popular in recent years due to its wide availability and lack of drug testing for the substance. Over the past several years, new regulations placed on prescription medication have influenced a decreasein the use of opioid painkillers. In 2010, the Texas Poison Center Network (TPCN) had 6,437 cases ofopioid exposures. In 2015, the number of reported opioid exposure had reduced to 5,303 cases, which isthe lowest rate since 2009. Between 2009 and 2015, the TPCN received 41,233 opioid exposure cases ofwhich 58.6 percent of the cases involved females. The majority of the reported cases involved women over20, and males comprise 41.4 percent of reported cases. Between 2009 and 2015, Region 5 had 1,737reported cases of opioid exposure.
2023 Regional Needs Assessment40Source: Texas Poison Center Network, 2015While the use of opioid prescription pain medication is decreasing, the abuse of opioids remains asignificant problem. According to the United States Drug Enforcement Agency (DEA) and the 2014National Survey on Drug Use and Health, nonmedical use of pain relievers in the United States is around4.3 million. This estimated population size is second only to the number of marijuana users.The steady demand for illegal pain medication has given traffickers the incentive to produce morecounterfeit pills containing fentanyl in order to increase their revenues and meet the demands for theseproducts in the illegal market.The DEA’s National Forensic Laboratory Information System (NFLIS) is a DEA systematically collectsresults from drug chemistry analyses conducted by state, local, and federal forensic laboratories across thecountry. During analyses of the exhibits, laboratories may identify several distinct drug reports within anexhibit; therefore, an exhibit reported to NFLIS may include up to three drug reports:NUMBER OF FENTANYL EXHIBITS, 2004-2015Source: National Forensic Laboratory Information System (NFLIS) 347120016122 1 24 5 0Number of Reported OpioidExposure CasesCountiesReported Opioid Cases (2015)
2023 Regional Needs Assessment41ConsequencesConsequences: Mortality, MorbidityDrug and Alcohol Related FatalitiesFrom 2001-2009, Region 5 had an estimated 1,479 deaths that were determined to be drug related. Inaddition, it was estimated that 575 people died from alcohol-induced causes.Drug and Alcohol Related Hospital AdmissionsWhile regional and county data about hospital admissions are not available, the Community Health NeedsAssessments of CHI St. Luke’s Health Memorial for Lufkin, Livingston and San Augustine provide someinformation about discharge diagnoses. Under Injury and Poisoning #960-979 “poisoning by drugs,medicinals and biological substances” there were 31 inpatients discharged, 8 outpatients, and 66discharges from the Lufkin hospital location. Under #980-989 “toxic effects of substances chieflynonmedical as to source” there were 3 inpatient discharges, 29 outpatient, and 138 emergency discharges.Similar figures for Livingston and San Augustine are available. The diagnoses are not directly identifiableas due to alcohol and drugs, but some cases are undoubtedly related.Consequences: LegalLegal Consequences: Driving Under the InfluenceBy February 2023, Region 5 had an estimated 1,231 individuals incarcerated for alcohol and drug relatedoffenses. In Texas it is “illegal for a minor to operate a motor vehicle in a public place while having anydetectable amount of alcohol in the minor’s system.” It is an offense for both minors and adults “if theperson is intoxicated while operating a motor vehicle in a public place.”Source Texas Alcoholic Beverage Commission websiteThe Texas Department of Transportation (TX DOT) estimated that between 2010-2015, 149,108 vehiclecrashes have been the result of drunk driving. From the total 149,108 alcohol-related crashes, 6,241 haveended in fatalities. In Region 5, there have been 4,529 alcohol-related crashes, which led to 284 fatalitiesfrom 2010-2015.Jefferson County has the highest total number of alcohol-related crashes and fatalities in Region 5.However, if the number of crashes per 100,000 population is compared in each county, Shelby County hasthe higher per capita alcohol related crash rate in Region 5. In addition, San Augustine County has thehighest alcohol-related crash fatalities per capita rate in Region 5.
2023 Regional Needs Assessment Source: Texas Department of TransportationLegal Consequences: Substance Use Criminal Charges and Court CasesThe Texas Department of Public Safety (TxDPS) reported that, in 2014, Region 5 had 6,516 alcohol relatedarrests. It was also reported that minors committed only 84 of the alcohol related offenses; theoverwhelming majority of alcohol related offenses, 6,432 cases, were committed adults.Jefferson County was reported as the county with the most alcohol related offenses in Region 5. However,Nacogdoches County has the highest per capita alcohol offense rate with 1354.46 offenses per every100,000 individuals. Shelby County also has a higher per capita rate of alcohol related offenses(1252.09/100k) when compared to Jefferson County.
2023 Regional Needs Assessment43Legal Consequences: Underage Drinking/Drug Use and ArrestsThe Texas rates of juvenile violations per 100,000 population, 13.80, is exceeded by three counties inRegion 5, Nacogdoches, Sabine, and Shelby. The rate of DUIs for the state, 1.63, is exceed in JasperCounty. The State rate for public intoxication, 5.06, is exceeded in Hardin, Jefferson, Nacogdoches, andSan Augustine Counties. 3,8403,840Texas3,66713.804341.631,3455.06Source: Texas DPS, 2014Consequences: Qualitative DataConcerning the consequences in regards to the abuse of marijuana, it is consistently reported throughoutthe region, especially by juvenile probation, that synthetic marijuana is still the greatest concern. It is notnecessarily that the number of users has increased, rather the adverse reactions to the synthetics is moresevere than the reaction to marijuana. The actions and extreme behavior of those suffering from theseadverse reactions only highlight the potential danger and possible lethality even more.There is a general misconception that marijuana, including synthetic marijuana, is a safer alternativecompared to other drugs such as methamphetamine. The legalization discourse that is taking place acrossthe nation concerning marijuana, and the push for the legalization of medical marijuana, has contributedto a desensitization to the fact that marijuana is still an illegal, federally controlled (Schedule I) drug.Adolescents use this dialog to justify their claim for using and abusing marijuana.Feedback from those active in the prevention field provided an example of an adolescent who reportedthere was nothing wrong with the use of marijuana since the individual had used marijuana for variousmedical purposes. Adolescents are being inundated with opinions of how this is a “safe” drug for use withno dangerous side effects.
2023 Regional Needs Assessment44In the Deep East Texas region alcohol continues to be the most abused drug among youth and adults.Factors that enhance the problem within this region include the rural nature of the majority of the countiesserved, and, as reported by adolescents, a lack of resources and activities to participate in as an alternativeto drinking. In addition, because alcohol is legal and most often socially accepted among adults, it is anenvironmental risk factor that has to be taken into account concerning underage drinking. Some parentsallow, or even encourage underage drinking, while others do not, as reported in the Texas School Survey.In rural communities, there is protection from enforcement for those caught drinking because some officersknow the family, keeping many young individuals from facing consequences that otherwise could help todeter future engagement in use.Within the region are two large universities and three junior colleges. Parties and social engagementswithin these institutions include an underage crowd and often feature drinking as a major part of theentertainment. Drinking parties in college tend to be an acceptable rite of passage for teens who want toconsider themselves as adult for some purposes even though they are legally underage for alcohol use.The use of substances such as alcohol, marijuana, and prescription drugs will always have consequenceswhether intended or unintended. Adolescents carry with them a sense of invulnerability, immune to themisfortunes that befall others. In the mind of the adolescent, whose brain is still developing and maturing,logically anticipating possible consequences is an aptitude yet to be mastered.Region in FocusGaps in ServicesThe challenges identified within the Deep East Texas Region include challenges for both adult and youthservices.Current prevention providers in the region are able to offer services to students in both elementary andhigh school settings. There are currently no funded services to meet the needs of the middle schoolpopulation, which includes the 6th, 7th and 8th grade adolescents in the region. During this transitionaltimeframe, students are at high risk of experimentation but face a lack of services.Prevention providers in the Hardin, Jefferson, and Orange counties no longer have prevention serviceswhich results in lack of any prevention providers administering DSHS programming.Many smaller counties within the region do not have direct access to service and utilize surrounding largercounties as a hub for service. Transportation becomes an even greater hurdle to accessing service as thosein need are forced to travel outside the county in which they reside to access service.Gaps in DataRegion 5 has a large number of small towns and rural communities that lack the resources of morepopulated towns and cities. Within these counties (e.g., San Augustine County) data on substance use andother factors are not readily available. Due to these factors, it was not possible to collect data on severalkey factors.• It was not possible to collect data from local and regional hospitals directly related to theconsequences of alcohol and drugs. The Community Health Needs Assessments of CHI St. Luke’sHealth Memorial had some information about inpatient, outpatient and emergency roomdischarges, but they could not be directly related to substance use. Many of the hospitals citedprivacy laws preventing them from sharing data with outside organizations.
2023 Regional Needs Assessment45• There was not a sizeable amount of information regarding synthetic marijuana use. Although thecurrent document briefly discussed synthetic marijuana, it is difficult to retrieve reliable data, soqualitative data from individual interviews must suffice.• After interviews with law enforcement and community group, heroin was reportedly rising inselect counties in Region 5. Because many data sources report heroin use along with other opioiduse (i.e., narcotic painkillers) it is difficult to discern which opioid substances are being reported.• Another new topic, fentanyl, does not yet have regional statistics. Since the usage is confused withother drugs and substances with which it might be combined, there may never be reliable statisticsat the local level.• The family domain is one that Region 5 has little data, with plans to obtain more data next yearusing the Texas School Survey, and searching for other sources.Regional Partners• Burke – provides service for mental health services for both youth and adult. Burke is utilized asa referral source for individuals who are dealing with both alcohol and mental health issues.• Love INC. – provides services including food, shelter, and assistance with daily living necessitiessuch as electricity and water.• Salvation Army – provides emergency shelter for homeless offers meals for those hungry in thecommunity and provides assistance during disaster relief. Services are utilized for those who arein need.• Local hospitals – continuum of care from emergency room, inpatient to outpatient and referralsfor individuals who are suffering with substance abuse issues.• The Coalition – local funded coalition working with community initiatives to engage and gainsupport of the community in relation to alcohol, tobacco, and prescription drug abuse.• Drug courts – offers a second opportunity for those who have a drug problem and need to enter astructured, accountable yearlong program toward sobriety.• Probation: adult and juvenile – coordinates continuum of care needs for those on probation andparole for offenses related to substance abuse.• Parole – aids in fulfilling requirements for those individuals who have been released from prisonand have to maintain a level of substance abuse help.• United Way – local agency that offers financial support to agencies that are reaching out toindividuals in the communities in need of service.Regional SuccessesIn October 2015 there was an ADAC office added in Beaumont for the expansion of Outreach, Screening,Assessment and Referral OSAR services to Hardin, Jefferson and Orange counties. This office locationallows staff to be available in the Beaumont area to meet with clients seeking substance abuse treatmentservices in a similar fashion that clients can access services at the other office locations in Lufkin andNacogdoches.Community coalitions within Lufkin and Nacogdoches have been making great strides in raisingawareness on alcohol and marijuana issues through significant environmental changes and throughsubstantial work with community partners.
2023 Regional Needs Assessment46ConclusionKey FindingsDeep East Texas is comprised largely of rural communities, forests, and small towns. Beaumont (JeffersonCounty) is the only city in Region with a population over 100,000. Many of the counties within Region 5with smaller communities and rural areas have fewer community resources. In addition, transportation isa barrier due to the long distances between rural areas and more heavily populated communities whereservices are more readily available.Interestingly, the use of alcohol and tobacco was not mentioned frequently when community groups wereinterviewed. However, community coalitions within Lufkin and Nacogdoches have been making greatstrides in raising awareness on these very issues through significant environmental changes and throughsubstantial work with community partners. Information obtained from community partners involvedincludes a continued concern in the area of marijuana use. Admission rates within local treatment basedprograms show marijuana as a key drug of abuse among adults and youth.1. Alcohol continues to be the most commonly used/abused substance across age groups, with 29% ofstudents reporting “very easy” access, and over 80% considering underage drinking to be dangerous orvery dangerous, but 70% of all 12th graders reporting having used alcohol at some time in their life.2. While opioid prescription medication use has decreased, the illegal trafficking and subsequent abuse ofopioids such as heroin and fentanyl, a powerful synthetic opioid analgesic that is similar to morphine butis 50 to 100 times more potent (drugabuse.gov), is dominating the illegal drug trade.3. Marijuana and alcohol are associated with school absences with. 23% of students reporting “very easy”access.to marijuana and over 50% perceiving it as somewhat or very dangerous. Despite the danger, overtwenty percent of high schoolers report having used it in the last 30 days. In talking with communityofficials and organizations, concerns about synthetic marijuana are frequent topics of conversation. Policedepartments and probation offices throughout Region 5 report a lack of resources for the treatment ofsynthetic marijuana use. Although synthetic marijuana consumption appears to be decreasing, lawenforcement and community organizations verbally report it is still a major concern because of the violent,erratic behavior and the medical repercussions of smoking or inhaling a substance whose origin or strengthis unknown.4. The average use of first use for any substance, alcohol or drugs, is approximately 13 years old. Whenpeople find themselves in court or in treatment it is likely to be for amphetamines, cocaine, cannabis,alcohol, sedatives, or polysubstance use.5. In addition to gaps in services which need to be filled to prop up adolescents and adults with protectionagainst risks related to alcohol and drugs, there are gaps in data which need to be filled to be able topinpoint more clearly the most crucial needs and how they can best be met.Moving ForwardExpansion of ADAC prevention services will be added to existing youth prevention services. Currentfunding provided prevention based programming to local communities but did not include outlying ruralcommunities. The addition of expansion grants will allow school age participants in San Jacinto, Shelby,
2023 Regional Needs Assessment47San Augustine, Newton, Sabine and Houston counties to receive curriculum based support group services,tobacco education and referral services when appropriate.PRC 5 has already begun to increase networking efforts in rural communities to address lack of services.In addition, PRC 5 is making an effort to increase the number of data sharing relationships. Furthermore,PRC 5 is attempting to communicate and work with more community organizations. One of the majorgoals of the PRC is to find quantitative data relevant to specific localities. By expanding the number ofdata sources, more insightful information regarding substance use in our Region will be made available tocommunity organizations, stakeholders, law enforcement, and the public. Through our efforts, we hope toestablish more working relationships with organizations in rural communities, expand the number of ourdata sources, and increase the number of people who receive this document, the Region 5 Regional NeedsAssessment (RNA).
2023 Regional Needs Assessment48Appendix A: PRC Regions and CountiesRegion 1Armstrong, Bailey, Briscoe, Carson, Castro, Childress, Cochran,Collingsworth, Crosby, Dallam, Deaf Smith, Dickens, Donley, Floyd, Gray,Hale, Hall, Hansford, Hartley, Hemphill, Hockley, Hutchinson, King, Lamb,Lipscomb, Lubbock, Lynn, Moore, Motley, Ochiltree, Oldham, Parmer,Potter, Randall, Roberts, Sherman, Swisher, Terry, Wheeler, and Yoakum(41)Region 2Archer, Baylor, Brown, Callahan, Clay, Coleman, Comanche, Cottle,Eastland, Fisher, Foard, Hardeman, Haskell, Jack, Jones, Kent, Knox,Mitchell, Montague, Nolan, Runnels, Scurry, Shackelford, Stonewall,Stephens, Taylor, Throckmorton, Wichita, Wilbarger, and Young (30)Region 3Collin, Cooke, Dallas, Denton, Ellis, Earth, Fannin, Grayson, Hood, Hunt,Johnson, Kaufman, Navarro, Palo Pinto, Parker, Rockwall, Somervell,Tarrant, and Wise (19)Region 4Anderson, Bowie, Camp, Cass, Cherokee, Delta, Franklin, Gregg,Harrison, Henderson, Hopkins, Lamar, Marion, Morris, Panola, Rains, RedRiver, Rusk, Smith, Titus, Upshur, Van Zandt, and Wood (23)Region 5Angelina, Hardin, Houston, Jasper, Jefferson, Nacogdoches, Newton,Orange, Polk, Sabine, San Augustine, San Jacinto, Shelby, Trinity, andTyler (15)Region 6Austin, Brazoria, Chambers, Colorado, Fort Bend, Galveston, Harris,Liberty, Matagorda, Montgomery, Walker, Waller, and Wharton (13)Region 7Bastrop, Bell, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell,Coryell, Falls, Fayette, Freestone, Grimes, Hamilton, Hays, Hill,Lampasas, Lee, Leon, Limestone, Llano, Madison, McLennan, Milam,Mills, Robertson, San Saba, Travis, Washington, and Williamson (30)Region 8Atascosa, Bandera, Bexar, Calhoun, Comal, DeWitt, Dimmit, Edwards,Frio, Gillespie, Goliad, Gonzales, Guadalupe, Jackson, Karnes, Kendall,Kerr, Kinney, La Salle, Lavaca, Maverick, Medina, Real, Uvalde, ValVerde, Victoria, Wilson, and Zavala (28)Region 9Andrews, Borden, Coke, Concho, Crane, Crockett, Dawson, Ector,Gaines, Glasscock, Howard, Irion, Kimble, Loving, Martin, Mason,McCulloch, Menard, Midland, Pecos, Regan, Reeves, Schleicher, Sterling,Sutton, Terrell, Tom Green, Upton, Ward, and Winkler (30)Region 10 Brewster, Culberson, El Paso, Hudspeth, Jeff Davis, and Presidio (6)Region 11 Aransas, Bee, Brooks, Cameron, Duval, Hidalgo, Jim Hogg, Jim Wells,Kenedy, Kleberg, Live Oak, McMullen, Nueces, Refugio, San Patricio,Starr, Webb, Willacy, and Zapata (19)
2023 Regional Needs Assessment49Appendix B: Glossary of Terms and Key Concepts30 Day UseThe percentage of people who have used a substance in the 30 daysbefore they participated in the survey.ATODAlcohol, tobacco, and other drugs.AdolescentAn individual between the ages of 12 and 17 years.DSHSDepartment of State Health ServicesEpidemiologyEpidemiology is concerned with the distribution and determinantsof health and diseases, sickness, injuries, disabilities, and death inpopulations.EvaluationSystematic application of scientific and statistical procedures formeasuring program conceptualization, design, implementation, andutility; making comparisons based on these measurements; and theuse of the resulting information to optimize program outcomes.IncidenceA measure of the risk for new substance abuse cases within theregion.PRCPrevention Resource CenterPrevalenceThe proportion of the population within the region that already havea certain substance abuse problem.Protective FactorConditions or attributes (skills, strengths, resources, supports orcoping strategies) in individuals, families, communities or the largersociety that help people deal more effectively with stressful eventsand mitigate or eliminate risk in families and communities.Risk FactorConditions, behaviors, or attributes in individuals, families,communities or the larger society that contribute to or increase therisk in families and communities.SPFStrategic Prevention Framework. The idea behind the SPF is to usefindings from public health research along with evidence-basedprevention programs to build capacity and sustainable prevention.This, in turn, promotes resilience and decreases risk factors inindividuals, families, and communities.
2023 Regional Needs Assessment50Substance AbuseWhen alcohol or drug use adversely affects the health of the user orwhen the use of a substance imposes social and personal costs.Abuse might be used to describe the behavior of a woman who hasfour glasses of wine one evening and wakes up the next day with ahangover.Substance MisuseThe use of a substance for a purpose not consistent with legal ormedical guidelines. This term often describes the use of aprescription drug in a way that varies from the medical direction,such as taking more than the prescribed amount of a drug or usingsomeone else’s prescribed drug for medical or recreational use.Substance UseThe consumption of low and/or infrequent doses of alcohol andother drugs such that damaging consequences may be rare or minor.Substance use might include an occasional glass of wine or beer withdinner, or the legal use of prescription medication as directed by adoctor to relieve pain or to treat a behavioral health disorder.SUDSubstance Use DisorderTPIITexas Prevention Impact IndexTSSTexas Student SurveyVOICESVolunteers Offering Involvement in Communities to ExpandServices. Essentially, VOICES is a community coalition dedicatedto create positive changes in attitudes, behaviors, and policies toprevent and reduce at-risk behavior in youth. They focus on changesin alcohol, marijuana, and prescription drugs.YRBSYouth Risk Behavior Surveillance Survey
2023 Regional Needs Assessment51Appendix C: List of TablesTable TitlePage1 POPULATION AND PERCENT CHANGE, 2010-2015, BY REGION102 POPULATION BY AGE CATEGORY, BY REGION113 STATE POPULATION BY AGE, RACE AND ETHNICITY114 POPULATION RACE AND ETHNICITY, BY REGION125 LIMITED ENGLISH PROFICIENCY, BY REGION136 URBAN AND RURAL POPULATIONS, BY REGION137 RACE/ETHNICITY, BY COUNTY158 ENGLISH PROFICIENCY, BY COUNTY169 COUNTY SEATS, BY COUNTY1610 PER CAPITA INCOME, BY COUNTY1711 EMPLOYMENT/UNEMPLOYMENT RATES, BY COUNTY1712 POVERTY RATE, BY COUNTY1813 TANF RECIPIENTS, BY COUNTY1814 FOOD ASSISTANCE BENEFITS, BY COUNTY1915 FREE/REDUCED LUNCH, BY COUNTY1916 CITATIONS ISSUED FOR 2015, NACOGDOCHES2117 STATE ARREST DATA RELATED TO DRUGS AND ALCOHOL, 20142218 STUDENTS REPORTING IT IS “VERY EASY” TO ACCESS ALCOHOL2419 ACTIVE TABC RETAIL PERMITS, BY COUNTY2520 PREVALENCE EVER USED, LIVING WITH 2 PARENTS OR NOT, REGIONS5&62821 ANGELINA INTERAGENCY COALITION2822 MALE / FEMALE EMPLOYMENT, TEENS AND YOUNG ADULTS, BYCOUNTY3223 AVERAGE AGE OF FIRST USE OF ALCOHOL3424 ALCOHOL INITIATION, GRADES 6-12, BY REGION3425 ALCOHOL CONSUMPTION, ALL GRADES 6-12 AND GRADE 12, BY REGION3526 AVERAGE AGE OF FIRST USE OF ALL SUBSTANCES3527 MARIJUANA: AVERAGE AGE OF FIRST USE BY GRADE3528 # PRESCRIPTIONS PER CAPITA BY DEA DRUG SCHEDULE TYPE, 20143829 EXPOSURE TO SYNTHETIC MARIJUANA, 2010-2015, BY COUNTY3930 2010-2015 DUI CRASH AND FATALITY RATE BY COUNTY4131 ALCOHOL RELATED ADULT ARRESTS BY COUNTY4232 ALCOHOL JUVENILE ARRESTS BY COUNTY43
2023 Regional Needs Assessment52Appendix D: List of GraphsGraph TitlePageRace and Ethnicity12Dropout Rate by County20Student Absences by User Types20Suicide Rates by County23Ease of Access to Alcohol by Grade24Ease of Access to Marijuana by Grade25Students’ Perceptions of Dangers of Underage Drinking, by Grade33Students’ Perceptions of Risk of Harm from Marijuana33First Specific Drug Associated with Initiation of Illicit Drug Use Age 12 or Older: 201336Substance Comparison, Texas, Grades 7-1237Reported Opioid Cases by County40Number of Fentanyl Exhibits, 2004-201540
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