Kelly Pajala: An important measure in substance misuse prevention

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In the last few days of the legislative session I am reflecting on the things that feel like actual accomplishments, even if they appear to be small. I will say that "accomplishment" strikes me as being a bill that actually ends up becoming law. Of course, some of what gets passed into law on any given year is often many years in the making. There are several important examples of that: raising the age to purchase tobacco products to 21; funding assistance for the deployment of broadband in underserved communities; and funding clean water initiatives. Other laws seem to spring up suddenly because of specific circumstance in the here and now: protecting reproductive rights, and banning internet sales of tobacco substitutes. Some bills need further work and consideration to make it into the "Green Books," as someone who values due diligence and process, recognizing that is important.

Sometimes a "no vote" simply means a good idea needs more work. Sometimes it hinges on a single word in bill. The amount of time spent on discussions over whether to use the word "may" versus "shall" in any given piece of legislation is astounding and yet so incredibly important. At times it is amazing that both Houses of the Legislature and the Governor can agree on anything and yet every year that manages to happen through hard work and compromise.

I had the pleasure of working on S.146 this year and because of the collaborative effort with the Senate Health and Welfare Committee, that bill is on its way to the Governor. This bill might appear to be a small change but it is actually a substantial shift in policy and process. S.146 is an act relating to substance misuse prevention. In a nutshell, this bill takes three separate boards and councils, each working on prevention misuse of a specific substance and combines them into one board working to reduce substance misuse of all substances.

Vermont is often ranked one of the healthiest states in the country — almost always among the top two are three. While this is something to celebrate, we fall short when it comes to substance misuse. Vermont has some of the highest substance misuse rates in the nation, including high rates of smoking and drinking during pregnancy, binge drinking among young adults, and cannabis use among youth. And, the opioid crisis continues to take lives. We must get ahead of this problem — and make sure Vermonters grow up and live in a state where healthy choices are the norm, and substance misuse and dependence do not affect so many of our citizens.

Preventing substance misuse reduces the risks that contribute to alcohol, tobacco or other drug dependence — while promoting protective factors that support healthy lifestyles and communities. Because upstream evidence-based prevention focuses on promoting positive protective factors, it is not substance-specific — meaning the same strategies work to prevent alcohol, tobacco and drug misuse.

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Prevention works at the individual, family, school, community and policy levels. Programs and services that help communities become as healthy and involved as they can be are a key part of alcohol, tobacco and drug use prevention in Vermont. Bringing communities together is a job for many people from all walks of life, including law enforcement, parents, students, community coalitions, and health care providers. Alcohol and drug prevention programs help support communities to grow in wellness and health at all stages of life.

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Sensitivity to, and inclusion of, the cultural values of the community enhances effectiveness.

The most effective prevention efforts include strategies and services across multiple environments to support a comprehensive approach toward preventing and reducing alcohol, tobacco and other drug use.

Evidence-based prevention works. We know that from evaluations of models such as the "Iceland Model" you have heard about in the media, as well as from models built and evaluated here in Vermont, like the Collaborative. These models create programing and policy that support healthy activities within the community, encourage positive human connection both within family units and the community at large and help build resilience that can carry an individual through a lifetime. A recent remark from a colleague struck me as encompassing the current prevention landscape: "The opposite of addiction is not sobriety, it is connection."

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S.146 seeks to build on the strength Vermont has in those already doing prevention work in our communities and move us forward to invest, evaluate and promote the best possible prevention practices that can be replicated across the State. We know that substance misuse prevention is not substance-specific, so this bill combines the Alcohol and drug abuse Council, the Tobacco Evaluation and Review Board and the Opioid Coordination Council and creates the Substance Misuse Prevention Oversight and Advisory Council. We know that prevention requires engagement across sectors, and the new Council will include members from many walks of life including the Director of Trauma Prevention and Resilience Development, youth, persons with lived experience with substance misuse and professionals from across many disciplines who focus on prevention.

S.146 also creates the position of Chief Prevention Officer whose purpose will be to integrate prevention efforts statewide, across all agencies of government and in areas that are not traditionally considered substance misuse prevention efforts. For example programming that creates points of connection for older Vermonters, not just school age youth, are being looked at as prevention work. The Chief Prevention Officer will work with this new council to create policy and programming to help our population at all stages of life have the resources to make health choices and be connected to community.

It was an honor to work on this bill and to be a part of the messy business of creating laws in general. As this session comes to an end, as a body we are already looking ahead to the bills that need more consideration to make it across the finish line before this biennium comes to an end.

State Rep. Kelly Pajala is an independent representing the Windham-Bennington-Windsor District. The opinions expressed by columnists do not necessarily reflect the views of the Brattleboro Reformer.


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