Intergenerational drug use has plagued Santa Fe communities for decades, but prenatal exposure to drugs and alcohol may be on the rise, according to findings in a Santa Fe Municipal Drug Task Force Community Conversations Draft Report released March 28.

More than 200 participants in the study point to stigma, insufficient treatment options and lack of community awareness of available services as some of the major obstacles that continue to stand in the way of breaking the cycle. They also largely shared the perception that treating addiction as a criminal issue has failed to reduce problematic drug and alcohol use in our communities.

"We found that not all drug and alcohol use is problematic, but the human toll of problematic alcohol and drug use on individuals and families is devastating," said Michelle Lis, a consultant working with the Santa Fe Municipal Drug Task Force on the report, at a task force meeting on March 28.

The consultant conducted interviews with drug users, family members and community stakeholders such as hospital staff and police, included input from 231 individuals, 13 community focus groups, and more than 40 law enforcement officers.

Participants expressed the perception that stigma and shame-based conversations around drug and alcohol abuse and fear of persecution often prevent people from seeking treatment. Negative stereotypes are more likely to impact immigrant communities, poor people and people of color. They also "lead to real discrimination within the legal and criminal justice system," according to the findings, which highlights a need for more linguistically and culturally appropriate outreach efforts in immigrant and native communities, greater emphasis on early education programs to prevent problematic use, and expansion of support services available to youth in schools.

At the same time, when individuals do seek treatment or are referred through law enforcement and medical providers, available services are perceived as inadequate and unable to meet the demand.

The report keeps confidential the identity of respondents. One reported waiting 14 years to get into a recovery program in Santa Fe. While that might be an outlier with other circumstances at play, long wait periods are common and often lead to relapse for individuals leaving prisons, hospitals and other sober environments. This finding highlights a whole string of problems that have to do with the coordination of care between hospitals, prisons, treatment services and communities, Lis said.

All of these factors play a role in the generational problem of drug and alcohol abuse in our communities, which was cited as an issue in need of significant attention.

"Stakeholders often witnessed examples of heroin use among two generations of family members," it states, and one health care worker is quoted as saying, "We are seeing more drug exposed newborns at the hospital when we screen babies at birth."

Many participants were also unaware of services that do exist, highlighting the need for community outreach and education across the board.

Santa Fe has increasingly embraced a harm-reduction approach to the opioid crisis in recent years, including the expansion of services that distribute Narcan, a drug that reverses the lethal effects of an overdose, syringe exchange programs, and the Law Enforcement Assisted Diversion (LEAD) program, which allows police officers to defer people to evidence-based intervention programs as an alternative to incarceration. Yet lack of community awareness of the harm-reduction services and programs available means that they are not having as great an impact as they could.

Finally, participants overwhelmingly stated that criminalization of drug use and incarceration of users only makes the problem worse, especially because there are few treatment options available to inmates. The Metropolitan Detention Center in Bernalillo is the only facility in the state to offer medication-assisted treatment programs, which use drugs such as suboxone and methadone to aid in the recovery from opiate addictions. The Albuquerque Journal reports that prisoners who detox with the aid of the MAT programs experience much lower rates of overdose death upon release than their peers.

Emily Kaltenbach, who is the senior director for the Drug Policy Alliance's New Mexico office and the task force chair, said at the meeting on Thursday that the findings presented in the report will inform how the task force moves forward in searching for community and policy solutions that could help break the cycle of substance abuse.

Read the report here.