Editor's Note: Over the five Saturdays in March, the Clinton Herald is publishing a series about the use and abuse of opioid drugs in Clinton and how those statistics fit into the state and national scope of the opioid abuse crisis. Today's installment is part four of the series.
The local rumor mill and social media were working overtime three months ago.
An incident at Clinton Middle School had just occurred, where officials say there were a couple of issues where students at the school were partaking in improper behavior related to substances. They can't say whether they were opioids, but the substances were "inappropriate."
With Christmas break approaching and the community already asking questions, the district joined local residents in creating a town hall forum, days after the incidents caught local attention.
Clinton Police Capt. Bill Greenwalt said the community's ability to rally together ushered in a positive outcome during a difficult situation.
"Administrators, teachers, officers, the PTA and the community, with these one or two instances, we responded with a town hall meeting," Greenwalt said. "We had a lot of positive feedback. It sends a message that it was a shock to us and we don't see that on a regular basis."
The town hall featured dozens of residents, set up as a panel discussion with area officials.
Maintaining that connection within families is crucial in not only the process of recovery, but also in stopping substance abuse issues from happening, Leslie Mussmann, prevention director with the Area Substance Abuse Council in Clinton and Jackson counties, said.
If admitted for treatment, ASAC encourages engagement right away with the family unit. From a prevention perspective, though, Mussmann would like to see that conversation between ASAC and family members to start before substance abuse problems occur.
"We recognize there are some risk factors," Mussmann said. "Some people have risk factors where there could be some problems in the future. We're looking for ways to connect with those families within the community and get them resources so they don't reach that point of having a substance abuse issue."
ASAC and other community organizations devote much of those resources on Clinton's youth. And it's for a good reason, officials say.
Drug use at an early age is a predictor of a substance use disorder later in life, according to the National Institute on Drug Abuse.
The majority of people who have substance use disorder started using before the age of 18 and developed their disorder by the age of 20, according to the institute. Twenty-five percent of children who begin abusing prescription drugs at age 13 or younger develop a substance use disorder at some time in their lives, according to the institute.
"We know statistically that kids have decided if they are not going to use substances by the time they are 16," Mussmann said. "We know we have to get them honestly at the elementary level."
The Clinton community maintains a strong working relationship between different organizations.
ASAC, the Clinton County Sheriff's Department with the DARE program, the Gateway Impact Coalition and other community groups work with surrounding schools to educate about drugs and alcohol. Inviting community groups into the Clinton School District has taken on increased attention recently, Clinton High School Principal J.R. Kuch said.
"We've been more open as a district with outside agencies coming into our district," Kuch said. "There are some supports that they have that we don't have the training to go through. We've done a better job of providing support for kids that really do need it."
Nationally, students are engaging less in the use of illicit drugs, other than marijuana, at 20-year lows. According to district officials, there isn't an issue in the Clinton School District with prescription opioids or heroin.
When surveying eighth, 10th and 12th graders nationally, the Monitoring the Future study found that students were partaking in illicit drugs and alcohol at historic lows for the annual study, which has surveyed approximately 50,000 teenagers each year since 1991.
According to the 2017 study, past-year misuse of Vicodin among 12th graders has dropped dramatically in the past 15 years, from 9.6 percent in 2002 to 2 percent in 2017. The misuse of all prescription opioids among 12th graders has dropped significantly, according to the survey, despite high opioid overdose rates among adults.
School officials are seeing a similar trend play out in the Clinton School District.
"We're pleased to say we don't believe we have an opioid problem with any of our schools," Greenwalt said. "Do we see opioids in other parts of the community? Absolutely. Did we have a couple of instances that we dealt with for prescription pills? Yes. But we couldn't say if they were opioids. We're happy to say we don't have issues with our students in opioids in our schools."
Clinton School District Superintendent Gary DeLacy concurred. While this is his first year as superintendent at the Clinton School District, he formerly taught at the school, and has been an administrator in Iowa schools since 2001.
During his time in education, students' issues with illegal substances are focused on two items.
"The bigger issues, and it's been the same for the last 20 to 30 years, are alcohol and marijuana," DeLacy said. "I still think those are the drugs of choice. Some of it, even though you hear the things about prescriptions being left out for people, I still think there is greater access for marijuana and alcohol for minors."
It's not a complete rosy picture with the student population within the Clinton School District, though. Since coming back to the district this school year, DeLacy has identified adverse childhood experiences as being one the issues to overcome for the district.
Adverse childhood experiences are a common theme when discussing addiction. Hospital workers, treatment specialists and school officials have all pointed to this description as being a major piece to consider when identifying future problems for children and young adults.
What is it?
Adverse childhood experiences are potentially traumatic events that can have negative, lasting effects on health and well-being. In Iowa, according to Child Trends, the most common adverse childhood experience is divorce, followed by economic hardship, alcohol abuse, exposure to mental illness and domestic violence.
In Clinton, economic hardship is more common than the rest of Iowa, with a median household income of $43,803. The state of Iowa's median household income is $56,247. However, Clinton's divorce rate is lower than the state of Iowa's average, with most recent figures netting a 0.8 divorce rate, lower than the state's average of 1.5.
DeLacy noted that parental drug abuse and parental incarceration are negatively affecting students when they come to school.
"Most of the kids that walk in here in my office, I look in their hearts and eyes and they're fundamentally good," DeLacy said. "But they have zero support system. That's my biggest concern after nine months here. How do we address that? We have a very at-risk population in my opinion."
It's not that adverse childhood experiences are a new idea either.
It's just now that there's a definition and more research, DeLacy said. According to a 2017 study, for every additional adverse childhood experience score, the rate of the number of prescription drugs used increased by 62 percent. Another study cited that each adverse childhood experience increased the likelihood of early initiation into illicit drug use by 2- to 4-fold.
"When I was a teacher, did we have the same issues in 1985, '86 and '87? Absolutely," DeLacy said. "We didn't have a name for it. What's happened is it's more research-based, with things behind it. Now there's training. We need to be zeroed in on these symptoms and we have some direction. It was very informal in how we handled it in the '80s and '90s. It's a lot more formalized nowadays with the structure."
Creating a safe environment for children who experience these traumatic life events is what Mussmann focuses on when identifying treatment.
"We do a lot with adverse childhood experiences that most of us adults won't ever experience," Mussmann said. "They're exposed to this on a daily basis. We have to make them feel safe. We create safety plans. What do you do if Mom and Dad are using? We work with them on alternatives for their lives."
Training on adverse childhood experiences has taken hold within the Clinton School District. School Resource Officers recently joined other staff members in attending training on the topic.
DeLacy also believes Clinton Middle School's Capturing Kids Hearts initiative to be implemented next year will create another avenue in helping students who experience trauma in their home lives. Capturing Kids Hearts is an initiative that develops self-managing classrooms and attempts to decrease discipline issues through techniques such as a social contract.
"This is about relationships and building relationships with students who sometimes may struggle at home," DeLacy said. "It's important to establish relationships and let those students know that you are a valued person, and if you are in trouble, you have a caring adult here that's willing to do that."