Birmingham is the most populous city in Alabama and the county seat in Jefferson County. Residents in Jefferson County drink excessively, smoke as adults, and die from alcohol-impaired driving causes at rates that are higher than national rates, although Alabama state averages are higher than Jefferson County for the same indicators, the Community Health Needs Assessment (CHNA) 2016 publishes. Violent crime and poverty rates are higher for Jefferson County residents than national averages while they are lower than statewide averages as well.
In Alabama, 2.6 percent of residents struggled with illicit drug dependence or abuse in 2013 and 2014, which was the same as national averages, the Behavioral Health Barometer: Alabama, 2015 publishes. Alcohol dependence or abuse rates were slightly lower than national averages, as 5.8 percent of Alabama residents battled these each year for 2013 and 2014 compared to a national average of 6.5 percent.
Mental health and addiction treatment services are overseen by the Alabama Department of Mental Health (ADMH). For the fiscal year (FY) 2014, the Alabama Community Health Improvement Plan (CHIP) publishes that over 75,000 residents received public substance abuse prevention services, close to 100,000 residents received public mental health services, and more than 21,000 residents received public substance abuse treatment services. Behavioral health services are offered in Birmingham by community-based providers, state-run programs, and private organizations.
Opioid and Other Forms of Drug Abuse in Birmingham
Opioid drugs have become a massive issue all over the United States, and Alabama has been hit particularly hard. Highly addictive prescription opioids are dispensed to treat pain at alarming rates, and Alabama Mediapublishes that Alabama residents have the highest rate of prescription opioid use in the entire United States.
In 2015, over 5.5 million opioid prescriptions were written in Alabama. Increased access to these drugs heightens the odds that they will be diverted and misused, which brings a host of negative consequences, not the least of which is the potential for a fatal overdose. Prescription opioid misuse is giving rise to illicit opioid abuse, and abuse of heroin and synthetic fentanyl is up as well.
In Jefferson County in June 2017, there were 25 overdose fatalities involving fentanyl (which is 50 times more potent than heroin) and heroin. Alabama Media reports that fentanyl overdose deaths doubled in Jefferson County between 2015 and 2016, up to a total of 248 fatalities involving the potent opioid, which is often used to “cut” heroin, potentially without the buyer’s knowledge.
According to the 2015 Drug Threat Assessment published by the Gulf Coast High Intensity Drug Trafficking Area (GC HIDTA), heroin is the number one drug threat in Birmingham. Throughout the GC HIDTA, which also includes other counties in Alabama, Louisiana, Arkansas, Mississippi, and Tennessee, methamphetamine, cocaine, and marijuana are top drug threats in the region.
The Alabama Epidemiological Profile: Alcohol, Tobacco, Other Drugs Usage and Abuse 2016 divides the state into four regions based on geographical information, and Birmingham, as part of Jefferson County, falls into Region 2. Jefferson County is the most populous county of all 14 counties in Region 2.
The following information lists Region 2 as having the highest percentage when compared to the rest of Alabama for these indicators:
- Past-month adult (18 and older) illicit drug use (other than marijuana)
- Past-month youth (ages 12-17) illicit drug use (other than marijuana)
- Past-month adult marijuana use
- Past-month youth marijuana use
- Past-year adult nonmedical use of prescription painkillers
- Past-year youth nonmedical use of prescription painkillers (tied with Regions 3 and 4)
- Past-year adult alcohol abuse and/or dependence (tied with Region 4)
- Past-year youth alcohol abuse and/or dependence (tied with Region 1)
- Past-year treatment gap between adults who needed treatment for alcohol abuse and those who received help (tied with Region 4)
- Past-year treatment gap between youth who needed treatment for alcohol abuse and those who received help (tied with Regions 1 and 4)
- Past-year treatment gap between youth who needed treatment for illicit drug use and those who received help (tied with Region 3)
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Local Addiction Laws, Crime, and Drug Courts
Nearly 40 percent of the 736 drug overdose deaths in Alabama in 2015 involved an opioid drug, the Joint Economic Committee (JEC) Democratic staff publishes. The Alabama Opioid Overdose and Addiction Council was formed in 2017 via Executive Order 708, which was signed into law by Alabama Governor Kay Ivey. Since its inception, the council has recommended increasing access to the opioid antagonist drug naloxone (Narcan) in order to combat opioid overdoses, Alabama Media publishes. In Jefferson County, the Jefferson County Department of Health (JCDH) operates a naloxone clinic that offers free training to anyone who wishes to learn how to administer the potentially lifesaving antidote. Overdose kits are offered free of charge and without a prescription to residents who have undergone the training.
HB208, or the “Good Samaritan law” protects citizens who administer naloxone to try and reverse an overdose, the Alabama Public Health department reports. The council also recommended improvements to the Alabama Prescription Drug Monitoring Program (PDMP) to make it easier to use and report potential problematic patterns of drug use, misuse, and diversion.
Drugs and crime often go together, as individuals under the influence of drugs are at a higher risk for committing or being the victim of a crime. Rates of robbery, assault, violent crimes, and property crimes all increase in a community when drug abuse and/or addiction rates rise.
Around three-quarters of inmates entering the system through the Alabama Department of Corrections struggle with an underlying issue, the Alabama Drug Task Force (ADTF) publishes.
In a partnership between the Jefferson County Criminal Court System and the Birmingham/Bessemer Treatment Alternatives to Safer Communities (TASC) Program, Jefferson County Adult Drug Court Programs serve adults arrested on felony drug charges. These programs are individual and provide mental health and addiction services for eligible individuals; upon completion of the program, drug charges may be dropped. The TASC program serves residents of Jefferson County to provide necessary treatment services instead of clogging up the jails and prisons for drug- or mental health-related offenses.
Getting Help for Mental Health and Addiction in Birmingham
There are several options for behavioral healthcare services in the Birmingham area. The Single State Authority on drug and alcohol abuse and addiction and mental health services in Alabama is the Alabama Department of Mental Health (ADMH). This department manages, oversees, distributes federal grants and funds, and contracts with community-based providers to ensure a comprehensive and integrated level of care for Alabama residents.
Prevention, treatment, and recovery support services within Alabama are overseen by the Division of Mental Health & Substance Abuse Services of ADMH. Services include case management, detox, early intervention, outpatient services, opioid treatment medication management, partial hospitalization programs (PHPs), residential treatment, and residential transitional living arrangements and services.
Public programs may operate on a sliding payment scale based on what residents can pay or have health insurance coverage to cover. Private programs are regulated by the state authority, and providers can become certified through the Alabama Association of Addiction Counselors (AAAC). Private programs may be more readily accessible and offer more amenities and services.
To find local treatment options in Birmingham, residents can use the Points of Contact listing for treatment options and referral information. Public services and providers are also listed by county through the ADMH Substance Abuse Provider Directory. State-recognized treatment centers and providers can also be found using the Substance Abuse and Mental Health Services Administration’s Behavioral Health Treatment Services Locator.
The greater Birmingham area is served by the Alabama Regional Medical Services (ARMS), which provides care to all residents regardless of insurance coverage or ability to pay using the Sliding Fee Discount Program (SFDS). The Jefferson County Department of Health (JCDH) also offers community-based services and programs for Birmingham residents.
Additional treatment, referral, educational, and support services include:
- Coalition for a Tobacco-Free Alabama: to prevent and control tobacco use in Alabama
- Alabama Tobacco Quitline: educational information, referrals, and coaching to stop tobacco use
- Council on Substance Abuse (CASA) – NCADD (National Council on Alcoholism and Drug Dependence): a nonprofit, private organization enhancing understanding of the disease of addiction as a member of the Community Anti-Drug Coalition of America (CADCA)
- 2-1-1 Connects Alabama: a referral service connecting individuals with services and support as a free and confidential initial point of contact
- NAMI Alabama: a nonprofit organization aiming to alleviate stigmatize surrounding mental health and provide support and advocacy for families and individuals battling mental illness
- United Way of Central Alabama: a nonprofit organization advocating for a healthy community by providing a range of services and programs for residents
- Birmingham Alcoholics Anonymous (AA): a peer recovery support group offering meetings and a 12-Step model for sobriety
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