Leadership throughout the two county region needs your help. Opioids, heroin, alcohol and other drugs have been crippling our community for years. Help us address this issue by completing the following survey.

A coalition of local substance use disorder, behavioral health, and public health agencies are conducting a study on substance use disorder needs and gaps in services. This study is very important and will help us document high priority needs and seek over $1M in funding for new or expanded programs in our community.

Please complete the following survey. It has several sections and is designed to help us understand the views of the community in general as well as people directly effected by substance use disorders, meaning concerned friends and family and individuals recovering from substance abuse. Some questions describe specific types of substance use disorder services with which you may not be familiar. If you do not feel comfortable or knowledgeable, please check the no opinion/unsure box for the particular question rather than skip the question entirely.

Please Note: Because of the intentionally broad distribution of this survey, you may receive more than one request to complete it. We apologize for this inconvenience and ask that you disregard any additional requests to complete the survey.

Your responses are kept confidential and will not be used for any other purpose. If you would like to participate in a drawing for one of five $100 Gift Cards, are over the age of 18 and a resident of Allegany or Cattaraugus counties, please add your email address on the last page of the survey after you complete the entire survey. Completed surveys are due by November 1, 2019.

Questions? Contact Mike Prutsman at the Council on Addiction Recovery Services, Inc. (716) 373-4303 ext. 513, or William Penman at the Allegany Council on Alcohol and Substance Abuse, Inc. at (585) 593-6738.

Thanks so much!
Tell us about yourself

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* 1. What is your age?

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* 2. Sex at birth?

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* 3. What is your sexual orientation?

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* 4. Are you currently employed or retired? If so, please check the one that applies best:

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* 5. What is your main insurance?

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* 6. During the past year, what was the total combined income for you and the family members you live with?

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* 7. In the past year, have you or any family members you live with been unable to get any of the following when it was really needed? Check all that apply.

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* 8. Has lack of transportation kept you or anyone you know from behavioral health related appointments, meetings, work, or from getting things needed for daily living? Check all that apply.

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Communities of Allegany and Cattaraugus County and Zip Codes

Communities of Allegany and Cattaraugus County and Zip Codes

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* 9. In what area of the region do you reside?
Please refer to the map above.

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* 10. How did you learn about this survey?

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* 11. Do you have a family doctor/primary care practitioner?

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* 12. If yes, when was your last medical appointment?

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* 13. If relevant, did your primary care provider discuss the potential for problems you might experience with any pain or stress related medications?

Tell us about your view of the substance abuse problem in the area

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* 14. Please indicate the severity of Allegany and Cattaraugus Counties' problem with the following substances:

  I don't believe it is a problem at all I believe it is an isolated and rare problem impacting a few I believe it is a moderate problem I believe it is a major problem impacting many I am not sure how severe the problem is
Opioids
Heroin
Marijuana
Amphetamines
Cocaine
Alcohol
Vaping

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* 15. Please indicate if anyone you know has been impacted by substance abuse in the following way:

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* 16. Has anyone you know recently gone to a hospital ER for care because of a substance use disorder?

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* 17. Thinking about substance abuse, please indicate who you feel is influential in helping individuals seek treatment.

  Extremely Influential Somewhat Influential Not Influential at All No opinion/Unsure
Parents
Spouse or Significant Other
Children
Faith Leader
Employer
Friends
Doctor or Other Healthcare Professionals
Counselor or Therapist
School Personnel
Law Enforcement Personnel
Judge or Other Court Personnel
Social Worker

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* 18. What are the causes of substance abuse in the two county area?

  Extremely Influential Somewhat Influential Not Influential at All No opinion/Unsure
Addiction began with the use of a prescription pain medication
Experimentation with other illicit or legalized drugs or gateway drugs were a contributing factor
Opiates are “a less costly alternative to other drugs"
Peer influence or peer pressure
Lack of education about the impact and potential consequences of heroin and opioid use
Lack of school prevention education
Untreated mental illness
Lack of constructive and healthy alternatives (to deal with the hardships of life)
Unemployment

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* 19. Please rate the importance of the following organizations or groups in promoting healthy lifestyles and discouraging substance abuse:

  Highly Important Important Not Important No opinion/Unsure
Schools
Families
Faith based organizations
Civic groups or clubs
County government
Primary care providers
Local media
Local businesses
Social media
Local government (town councils, etc.)

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* 20. Looking back on your knowledge of people who abuse substances, please indicate what you feel providers and the community could have done to prevent the problem (please check all that apply):

  Highly Important Important Not Important No Opinion/Unsure
More community-based prevention messaging; i.e. billboards, radio ads, print ads
Less access to prescription pain medications
Greater law enforcement consequences
Increased drug testing; i.e. workplace, court mandates, etc.
Greater access to drug education in schools
More discussion with healthcare providers at time of prescribing prescription pain medications
More discussion with pharmacists at time of dispensing prescription pain medications
Emphasize that the acceptance of alcohol, binge drinking and recreational drug use are major pathways to substance abuse of many types (heroin, opiates, speed, tranquilizers, alcohol)

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* 21. What communication strategies do you feel would most help individuals at-risk or impacted by substance abuse (check all that apply):

Tell us about your view of substance abuse services in the area

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* 22. Please rate the importance of the following aspects of substance use disorder services:

  Highly Important Important Not Important No opinion/Unsure
Urgent Care – walk-ins, especially weekends or evenings
Credentials of staff
Scheduled appointments on weekends or evenings
Proximity to home
Proximity to employer
Home visits
Ability to access substance use disorder counselors or recovery staff on the phone or online/telehealth

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* 23. What forms of treatment are most important to individuals with substance use disorders in Allegany and Cattaraugus Counties?

  Extremely Important Somewhat Important Not Important at all No opinion/Unsure
Medication-assisted treatment (especially for heroin and opiate use)
Behavioral therapy
Detoxification services
Peer support groups
Faith-based support groups
Online support groups and resources
Inpatient drug treatment facilities
Long-term residential treatment services
Outpatient addiction counseling
Services for pregnant women
Jail based services

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* 24. Please indicate whether the following services are available or not for Allegany and Cattaraugus County residents with substance use disorders.

  Available Locally Not Available Locally Local Availability Unknown
Medication-assisted treatment (especially for heroin and opiate abuse)
Behavioral therapy
Detoxification services
Peer support groups
Faith-based support groups
Online support groups and resources
Inpatient drug treatment facilities
Long-term residential treatment services
Outpatient addiction counseling
Services for pregnant women
Jail based services

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* 25. What additional resources in Allegany and Cattaraugus Counties do you feel are most important in assisting individuals in recovery from substance abuse avoid relapse? Please check all that apply:

  Extremely Important Somewhat Important Not Important at all No opinion/Unsure
Housing assistance programs
Job readiness services
Food and nutrition assistance programs
Temporary cash assistance program
Pain self-management workshops
Food pantries
Public transportation services
Peer advocacy programs
Crisis intervention services
Service coordination/case management services
Employment services
Financial literacy programs
Childcare
Daycare services
Pain clinic
Health Insurance

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* 26. Please indicate whether these additional resources are available locally for people with substance use disorders:

  Available Locally Not Available Locally Local Availability Unknown
Housing assistance programs
Job readiness services
Food and nutrition assistance programs
Temporary cash assistance program
Pain self-management workshops
Food pantries
Public transportation services
Peer advocacy programs
Crisis intervention services
Service coordination/case management services
Employment services
Financial literacy programs
Childcare
Daycare services
Pain clinic
Health Insurance

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* 27. If someone you know’s addiction started from prescription pain killers, please indicate why medications were initially prescribed (check all that apply):

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* 28. Thinking about someone you know's experience with substance abuse, do you feel mandatory drug testing is an effective way to reduce recurrent use?

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* 29. Identify barriers in treatment and/or recovery for those living in Allegany and Cattaraugus Counties who have substance use disorders.

  Heroin/Opioids
Barrier to Treatment 		Heroin/Opioids
Barrier to Recovery 		Other Substance Abuse
Barrier to Treatment 		Other Substance Abuse
Barrier to Recovery
Services are not available locally
Unsure of what services are available
Transportation
Lack of insurance
Co-pays too high
High insurance deductibles
Insurance limitations to adequate time in treatment
Services not available in a timely manner
Stigma associated with addiction
Lack of beds in treatment facilities
Rejection for treatment by insurance carrier
Not ready to stop using
Does not feel treatment is needed or is unnecessary
Negative effect on employment

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* 30. If someone you know is currently in recovery for substance abuse, please indicate what was the defining factor for seeking help (check all that apply)

  Heroin/Opioids Other Substance Abuse
Work Issues or Loss of Job
Court Mandate
Legal Ramifications
Decline in Health
Loss of Children
Loss of Friends
Separation from Significant Other
Overdose

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* 31. Please share your view of gaps in prevention, treatment, and recovery services or new substance use disorder programs.

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* 32. Please take a moment to share any general comments you have about the substance use disorder problem in the area.

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* 33. If you would like to receive a summary of survey results in December 2019, please indicate your basis for interest and provide your email address below.

Basis for Interest:

The coalition's name is the Appalachia Substance Use Disorder and Mental Health Services Coalition. It was formed approximately one year ago and includes:
• Council on Addiction Recovery Services, Inc. - CAReS, Olean, NY
• Allegany Council on Alcohol and Substance Abuse, Inc. - ACASA, Wellsville, NY
• Southern Tier Health Care System, Inc. - STHCS, Olean, NY
• Allegany County Community Services, Wellsville, NY
• Allegany County Public Health, Wellsville, NY
• Cattaraugus County Community Services, Olean, NY
• Cattaraugus County Public Health, Olean, NY
• Clarity Community Wellness, Wellsville, NY

Many thanks to Ardent Solutions of Wellsville, NY for permission to use material from their 2016 survey on heroin and opioid abuse in Allegany County.

Proprietary Material exclusive of PRAPARE questions 5, 6, 7, and 8. These questions come from the national PRAPARE social determinants of health assessment protocol, developed and owned by the National Association of Community Health Centers (NACHC), in partnership with the Association of Asian Pacific Community Health Organization (AAPCHO), the Oregon Primary Care Association (OPCA), and the Institute for Alternative Futures (IAF). For more information, visit www.nachc.org/prapare.

QUESTIONS?  Please contact Gregory Bonk, HMS Associates, Getzville, NY at (716) 868 - 6448 regarding citations or use. October 2019.

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