Regional Needs Assessment 2018 - prc6.org€¦ · all of these sources of data demonstrate...

2018

Regional Needs Assessment 2018

EPIDEMIOLOGICAL PROFILE, YOUTH SUBSTANCE USE AND

MISUSE TRENDS, AND PREVENTION EFFORTS IN THE TEXAS GULF

COAST REGION

PREVENTION RESOURCE CENTER: REGION 6

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Table of Contents Executive Summary ................................................................................................................ v

Key findings: ....................................................................................................................... v

Prevention Resource Centers .................................................................................................. vii

Our Purpose ....................................................................................................................... vii

Regions ............................................................................................................................. vii

How We Help the Community ............................................................................................ viii

Conceptual Framework...................................................................................................... ix

Adolescence ...................................................................................................................... ix

Epidemiology ..................................................................................................................... ix

Risk and Protective Factors ................................................................................................. ix

Consumption Patterns ......................................................................................................... x

Consequences .................................................................................................................... xi

Audience ........................................................................................................................... xii

Introduction.......................................................................................................................... 1

Purpose .............................................................................................................................. 1

Audience ............................................................................................................................ 3

Methodology .......................................................................................................................... 4

Process ............................................................................................................................... 4

Quantitative Data Selection ................................................................................................. 4

Surveys ........................................................................................................................................... 4

Secondary Data and Longitudinally Presented Data ....................................................................... 4

Regional Profile and Demographics .......................................................................................... 5

Population .......................................................................................................................... 5

Age.................................................................................................................................................. 5

Race, Ethnicity and Concentrations of Populations ......................................................................... 9

Limited English Proficiency ........................................................................................................... 14

Risk Factors ........................................................................................................................... 15

Society Domain .................................................................................................................. 15

Per Capita Income ......................................................................................................................... 16

Employment ................................................................................................................................. 18

Household Composition ................................................................................................................ 18

Temporary Assistance for Needy Families (TANF) Recipients ....................................................... 19

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Supplemental Nutrition Assistance Program (SNAP) Recipients ................................................... 19

Children eligible for Free and Reduced Cost Lunch ........................................................................ 19

Uninsured Children ........................................................................................................................ 19

Catastrophic Events: Hurricane Harvey ......................................................................................... 25

Community Domain ........................................................................................................... 25

Child Homelessness ...................................................................................................................... 25

Criminal Activity ............................................................................................................................ 27

Drug Seizures and Drug Trafficking ............................................................................................... 32

Availability .................................................................................................................................... 33

School Domain ................................................................................................................ 35

Dropout Rates ............................................................................................................................... 35

School Discipline and Alcohol and Drugs on School Property ........................................................ 35

Family Domain .................................................................................................................. 40

Parental Approval of Consumption ............................................................................................... 40

Peer Domain ...................................................................................................................... 42

Cultural Norm and Youth Perceptions of Peer Consumption ......................................................... 42

Perceived Access to Alcohol, Marijuana, Prescription Drugs, and Tobacco ................................... 43

Individual Domain ............................................................................................................. 46

Mental Health ............................................................................................................................... 46

Suicide .......................................................................................................................................... 47

Regional Consumption Patterns ............................................................................................. 48

Alcohol ............................................................................................................................. 48

Early Initiation ............................................................................................................................... 48

Current use, Lifetime Use, and Current High-risk Use.................................................................... 48

Marijuana ......................................................................................................................... 49


Current Use, Lifetime Use, and Current High-risk Use ................................................................... 49

Prescription Drugs .............................................................................................................. 51

Current Use and Lifetime Use ........................................................................................................ 51

Tobacco ............................................................................................................................. 51


Current Use and Lifetime Use ........................................................................................................ 51

Emerging Trends ................................................................................................................ 53

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Texas School Survey (TSS), Statewide Longitudinal Trends .......................................................... 53

Youth Behavior Surveillance System (YRBSS) Statewide Longitudinal Trends .............................. 55

Consequences ....................................................................................................................... 57

Mortality ........................................................................................................................... 57

Overdose Deaths ........................................................................................................................... 57

Drug and Alcohol Related Fatalities .............................................................................................. 59

Legal .................................................................................................................................59

Substance Use, Driving Under the Influence, and Criminal Charges .............................................. 59

Hospitalization and Treatment ........................................................................................... 62

Hospital Use Due to AOD .............................................................................................................. 62

Emergency Room Admissions due to Alcohol and Other Drugs .................................................... 64

Protective Factors ...............................................................................................................65

Society Domain ..................................................................................................................65

Counteradvertising ........................................................................................................................ 66

Influencing Community Norms ..................................................................................................... 66

Promoting Community Activism ................................................................................................... 67

Community Domain ...........................................................................................................67

Community Partners and Community Coalitions .......................................................................... 67

Treatment/Intervention Providers ................................................................................................. 70

School Domain ................................................................................................................ 70

Youth Prevention Programs .......................................................................................................... 70

Alcohol, Tobacco, and Other Drugs Education in School ................................................................71

Alternative Peer Groups and Recovery High Schools ..................................................................... 72

High School Completion and Graduation Rates ............................................................................. 73

Family Domain ................................................................................................................ 74

Communication between Parent and Child Regarding Alcohol, Tobacco, and other Drugs ........... 74

Parental Attitudes toward Alcohol and Drug Consumption ........................................................... 74

Peer Domain ....................................................................................................................76

Adolescent Recovery Oriented Systems of Care ............................................................................ 76

Perception of Peer Consumption versus Actual Peer Consumption ............................................... 76

Individual Domain .......................................................................................................... 78

Life Skills Learned in Youth Prevention Programs ......................................................................... 78

Youth Perception of Risk and Harm of Alcohol, Marijuana, Prescription Drugs, and Tobacco ....... 78

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Region in Focus .................................................................................................................. 80

Gaps in Services ............................................................................................................. 80

Gaps in Data .................................................................................................................. 80

Regional Successes ............................................................................................................ 81

Appendix A .......................................................................................................................... 84

References ........................................................................................................................ 84

Appendix B .......................................................................................................................... 88

Glossary of Terms .............................................................................................................. 88

Appendix C........................................................................................................................... 91

List of Tables .................................................................................................................... 91

Appendix D ...........................................................................................................................93

List of Figures ....................................................................................................................93

Appendix E ........................................................................................................................... 96

Texas Department of Public Safety, Houston Police Department Drug Seizures, June 2017-June

2018 ................................................................................................................................. 96

Appendix F ............................................................................................................................97

Sample of Region 6 HHSC-Funded Substance Abuse Prevention Coalition Work Quarterly Work –

1st Quarter, FY2018 ............................................................................................................97

Appendix G ......................................................................................................................... 100

Young Adult and Adult Mental Health and Substance Abuse Treatment Providers in Region 6 100

Child and Adolescent Mental Health and Substance Abuse Treatment Providers in Region 6 .. 107

Buprenorphine Treatment Providers in Region 6 ................................................................. 112

Appendix H ......................................................................................................................... 125

HHSC-Funded Prevention Programs, Region 6, Fiscal Year 2018 .......................................... 125

Appendix I ........................................................................................................................... 128

Suggested Citation ........................................................................................................... 128

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Executive Summary The Regional Needs Assessment (RNA) is a document created by the Prevention Resource Center (PRC)

in Region 6 along with Evaluators from PRCs across the state of Texas and supported by The Council on

Recovery and the Texas Health and Human Resources Commission (HHSC). The PRC 6 serves 13 counties

in the Texas Gulf Coast Region.

This RNA was designed to aid PRCs, HHSC, and community stakeholders in long-term strategic

prevention planning based on most current information relative to the unique needs of the diverse

communities in the state of Texas. This document will present demographics, summaries of statistics,

and prevalence rates relevant to risk and protective factors associated with substance use and misuse, as

well as consumption patterns and consequences data. This RNA will also provide insight related to gaps

in services and data availability challenges.

A team of regional evaluators has procured national, state, regional, and local data through partnerships

and collaboration with diverse agencies in sectors such as law enforcement, public health, and education,

among others. The data obtained through these partnerships have been synthesized and compiled into

this comprehensive reference source. PRC 6 staff members recognize those collaborators who

contributed to the creation of this RNA.

Key findings: 1. The counties that make up Region 6 range from large and densely populated (Harris County at

1,704.9 square miles with 2,601 estimated population per square mile) to smaller and less

densely populated (Colorado County at 960.3 square miles of total land area with 21.7

estimated population per square mile). From a county rankings perspective, Matagorda County

tended to rank highest on variables such as unemployment rates, percentages of children from

single-parent households, and rates of Supplemental Nutrition Assistance Program (SNAP)

recipients per 100,000 population. Conversely, Fort Bend ranked highest out of the 13 Region 6

counties on per capita income and lowest on variables such as SNAP recipients per 100,000

population, percentage of children eligible for free or reduced cost lunch, and percentage of

children without health insurance. Harris County law enforcement officials report the highest

level of violent and property crime out of all counties in Region 6 and also has the highest

alcohol sales permit density in Region 6 at 6.4 retailers per square mile.

2. Alcohol consumption remains the largest issue among youth, but multi-year statewide trends

show slight decreases in consumption. The RNA 2018 included consumption trends from the

latest round of data from the Youth Risk Behavior Surveillance System (YRBSS, 2017) and the

resulting trends for Texas youth in Grades 9-12 seem promising. However, one theme common

to the treatment episode data, perception of harm, and perception of parental approval is that

all of these sources of data demonstrate increasingly lenient perceptions and consumption data

patterns of marijuana, albeit minor at the present time. There is much still to be learned about

the long-term consequences of the legalization of marijuana through future research. However,

current research on the short-term consequences of recently-passed legislation legalizing

marijuana in Alaska, Colorado, Oregon, and Washington, and has already demonstrated a

plethora of issues that are particularly concerning from a substance abuse prevention

perspective – many of the social and legal consequences that are increasing with the

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legalization of marijuana are similar to the consequences seen with alcohol. For example,

consequences occurring in Colorado since the legalization of marijuana in 2012 include a 65

percent increase in first-time use in youth, an 8 percent increase in alcohol consumption, a 210

percent increase in four-year averages to poison control, and a crime rate that has increased 11

times faster than the rest of the United States.1 Also, 33.8 percent of persons who received

treatment in Texas in 2017 for misuse of any substance of any kind were youth ages 12-17 who

sought treatment for marijuana use disorder. This subcategory of youth make up the largest

subcategory, according to Center for Behavioral Health Statistics and Quality (2016),

Treatment Episode Data Set (TEDS), substantially more so than alcohol or any other substance

use disorder.2

3. Particularly regarding the national opioid crisis and how the state of Texas and Region 6 is

addressing this crisis, there are a few points of significant progress that are definitely worth

mentioning as a key finding, here. The first has to do with the American Medical Association’s

(AMA) tracking of the effectiveness of Prescription Drug Monitoring Programs (PDMP),3 which

found that Texas’ physicians’ PDMP system queries increased by 283 percent between 2016

(1,086,373) and 2017 (4,163,058). Also noteworthy of recognition is the increasing awareness

and availability of Naloxone with a standing order at many pharmacies in Texas, particularly

Walgreens, Walmart, and CVS Pharmacies, which have publicly committed at the corporate

level to honor the Texas standing order and stock Naloxone rescue kits. Finally, Appendix F

contains a list of all of the Buprenorphine treatment providers in Region 6. The increase in

Buprenorphine Medication Assisted Treatment (MAT) registered treatment providers and

increased PDMP use by physicians demonstrates positive changes resulting from the

implementation of protective factors, including recent Texas Targeted Opioid Response

(TTOR) funding, a $24.7 million grant to combat opioid addiction in Texas. Harris County,

alone, has 190 Buprenorphine treatment providers and Region 6 has 283.

1 Smart Approaches to Marijuana. Lessons learned from marijuana legalization in four U.S. states and D.C. March, 2018. https://learnaboutsam.org/wp-content/uploads/2018/04/SAM-Lessons-Learned-From-Marijuana-Legalization-Digital.pdf. Accessed July 30, 2018. 2 Center for Behavioral Health Statistics. Treatment Episode Data Set (TEDS). 2016. https://wwwdasis.samhsa.gov/webt/quicklink/TX17.htm. Substance Abuse and Mental Health Services Administration. Accessed July 25, 2018. 3 American Medical Association Opioid Task Force. Physicians’ progress to reverse the nation’s opioid epidemic. American Medical Association Opioid Task Force Progress Report 2018. American Medical Association. 2018. https://www.end-opioid-epidemic.org/wp-content/uploads/2018/05/AMA2018-OpioidReport-FINAL-updated.pdf. Accessed July 25, 2018.

https://learnaboutsam.org/wp-content/uploads/2018/04/SAM-Lessons-Learned-From-Marijuana-Legalization-Digital.pdf

https://www.end-opioid-epidemic.org/wp-content/uploads/2018/05/AMA2018-OpioidReport-FINAL-updated.pdf


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Prevention Resource Centers Our Purpose Prevention Resource Centers (PRC) are a program funded by the Texas Health and Human Services

Commission (HHSC) to provide data and information related to substance use and misuse, and to support

prevention collaboration efforts in Region 6 communities. There is one PRC located in each of the eleven

Texas Health Service Regions (see Figure 1) to provide support to prevention providers located in their

region with substance use data, trainings, media activities, and regional workgroups. PRCs have four

fundamental objectives related to services provided to partner agencies and the community in general:

(1) collect data relevant to alcohol, tobacco, and other drug (ATOD) use among adolescents and adults

and share findings with community partners (2) ensure sustainability of a Regional Epidemiological

Workgroup focused on identifying strategies related to data collection, gaps in data, and prevention

needs, (3) coordinate regional prevention trainings and conduct media awareness activities related to

risks and consequences of ATOD use, and (4) conduct voluntary compliance checks and education on

state tobacco laws to retailers.

Efforts carried out by PRCs are focused on the state’s three prevention priorities of underage drinking,

use of marijuana and other cannabinoids, and prescription drug misuse. Regional PRCs are tasked with

compiling and synthesizing data and disseminating findings to the community. Data collection strategies

are organized around risk and protective factors, consumption data, and related consequences

associated with substance use and misuse. PRCs engage in building collaborative partnerships with key

community members who aid in securing access to information.

Regions Figure 1. Current areas serviced by Prevention Resource Centers in Texas

Region 1 Panhandle and South Plains Region 2 Northwest Texas Region 3 Dallas/Fort Worth Metroplex Region 4 Upper East Texas Region 5 Southeast Texas Region 6 Gulf Coast Region 7 Central Texas Region 8 Upper South Texas Region 9 West Texas Region 10 Upper Rio Grande Region 11 Rio Grande Valley/Lower South Texas

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How We Help the Community PRCs provide technical assistance and consultation to providers, community groups, and other

stakeholders in identifying data and data resources related to substance use or other behavioral health

indicators. PRCs work to promote and educate the community on substance use and misuse and

associated consequences through various data products, media awareness activities, and an annual

regional needs assessment. These resources and information provide stakeholders with knowledge and

understanding of the local populations they serve, help guide programmatic decision making, and

provide community awareness and education related to substance use and misuse. Additionally, the

program provides a way to identify community strengths as well as gaps in services and areas of

improvement.

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Conceptual Framework As one reads through this needs assessment, two guiding concepts will appear throughout the report: a

focus on the youth population and the use of an empirical approach from a public health framework. For

the purpose of strategic prevention planning related to drug and alcohol use among youth populations,

this report is based on three main aspects: risk and protective factors, consumption patterns, and

consequences of substance use and misuse.

Adolescence The World Health Organization (WHO) identifies adolescence as a critical transition in the life span

characterized by tremendous growth and change, second only to infancy. This period of mental and

physical development poses a critical point of vulnerability where the use and misuse of substances, or

other risky behaviors, can have long-lasting negative effects on future health and well-being. This focus

of prevention efforts on adolescence is particularly important since about 90 percent of adults who are

clinically diagnosed with Substance Use Disorders (SUDs), began misusing substances before the age of

18. 4

The information presented in this document is compiled from multiple data sources and will therefore

consist of varying demographic subsets of age which generally define adolescence as ages 10 through

17-19. Some domains of youth data conclude with ages 17, 18 or 19, while others combine “adolescent”

and “young adult” to conclude with age 21.

Epidemiology The WHO describes epidemiology as the “study of the distribution and determinants of health-related

states or events (including disease), and the application of this study to the control of diseases and other

health problems.” This definition provides the theoretical framework through which this assessment

discusses the overall impact of substance use and misuse. Through this lens, epidemiology frames

substance use and misuse as a preventable and treatable public health concern. The Substance Abuse

and Mental Health Services Administration (SAMHSA) establishes epidemiology to identify and analyze

community patterns of substance misuse as well as the contributing factors influencing this behavior.

SAMHSA adopted an epidemiology-based framework on a national level while this needs assessment

establishes this framework on a regional level.

Risk and Protective Factors Researchers have examined the characteristics of effective prevention programs for decades. A couple

of components shared by effective programs are focus on risk and protective factors that influence

substance use and misuse among adolescents. Protective factors are characteristics that decrease an

individual’s risk for a substance use behaviors. Examples may include factors such as strong and positive

family bonds, parental monitoring of children's activities, and access to mentoring. Risk factors are

characteristics that increase the likelihood of substance use behaviors. Examples may include unstable

home environments, parental use of alcohol or drugs, parental mental illnesses, poverty levels, and poor

school performance. The complicated nature of studying and addressing SUD prevention has yielded an

involved model. Figure 2 features an adaptation from the chapter on prevention from the 2016 Oxford

4 Center on Addiction. CASA analysis of the National Survey on Drug Use and Health, 2009 [Data file]. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. https://www.centeronaddiction.org/addiction-prevention/teenage-addiction. Accessed July 18, 2018.

https://www.centeronaddiction.org/addiction-prevention/teenage-addiction


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Handbook on Substance Use and Substance Use Disorders (2016) and includes risk factors and protective

factors organized among the six domains of individual, peer, family, school, community, and society.5

This framework will serve as a guide for organizing and discussing risk factors and protective factors in

this RNA.

Figure 2. Risk and protective factors for alcohol and other drug use

Adapted from: D’Amico, EJ, Osilla, KC. Prevention and intervention in the school setting. In: KJ Sher ed. The Oxford Handbook of Substance Use and Substance Use Disorders. Vol. 2.New York, NY: Oxford University Press; 2016:678.

Consumption Patterns For the purpose of this RNA, and in following with operational definitions typically included in widely

used measures of substance consumption, such as the Texas School Survey of Drug and Alcohol Use

(TSS)6, the Texas Youth Risk Surveillance System (YRBSS)7, and the National Survey on Drug Use and

Health (NSDUH)8, consumption patterns are generally operationalized into three categories: lifetime use

(ever tried a substance, even once), school year use (past year use when surveying adults or youth outside

5 D’Amico, EJ, Chan Osilla, K, Stern, SA. Prevention and Intervention in the School Setting. In Sher, KJ, ed. The Oxford Handbook of Substance Use and Substance Use Disorders, Volume 2. New York, NY: Oxford University Press; 2016: 675-723. 6 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 State Report. 2016. http://www.texasschoolsurvey.org/Documents/Reports/State/16State712.pdf. Accessed May 30, 2018. 7 Texas Department of State Health Services. 2001-2017 High School Youth Risk Behavior Surveillance System Data. 2017. http://healthdata.dshs.texas.gov/HealthRisks/YRBS. Accessed April 27, 2018. 8 Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health. 2016. https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf. Accessed May 30, 2018.

http://www.texasschoolsurvey.org/Documents/Reports/State/16State712.pdf

http://healthdata.dshs.texas.gov/HealthRisks/YRBS

https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf

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of a school setting), and current use (use within the past 30 days). These three categories of consumption

patterns are used in the TSS to elicit self-reports from adolescents on their use and misuse of tobacco,

alcohol (underage drinking), marijuana, prescription drugs, and illicit drugs. The TSS, in turn, is used as

the primary outcome measure in reporting on Texas youth substance use and misuse in this RNA.

Due to its overarching and historical hold on the United States, there exists a plethora of information on

the evaluation of risk factors that contribute to Alcohol Use Disorder (AUD). According to SAMHSA, AUD

is ranked as the most wide-reaching SUD in the United States, for people ages 12 and older, followed by

Tobacco Use Disorder, then Cannabis Use Disorder, Stimulant Use Disorder, Hallucinogen Use Disorder,

and Opioid Use Disorder (presented in descending order by prevalence rates).9 When evaluating alcohol

consumption patterns in adolescents, more descriptive information beyond the aforementioned three

general consumption categories is often desired and can be tapped by adding specific quantifiers (i.e.,

per capita sales, frequency and trends of consumption, and definitions of binge drinking and heavy

drinking), and qualifiers (i.e., consequential behaviors, drinking and driving, alcohol consumption during

pregnancy) to the operationalization process. For example, the National Institute on Alcohol Abuse and

Alcoholism (NIAAA) has created very specific guidelines that are widely used in the in quantitative

measurement of alcohol consumption.10 These standards define binge drinking as the drinking behaviors

that raise an individual’s Blood Alcohol Concentration (BAC) up to or above the level of .08gm%, which

is typically five or more drinks for men and four or more drinks for women, within a two-hour time span.

At-risk or heavy drinking, is defined as more than four drinks a day or 14 drinks per week for men and

more than three drinks a day or seven drinks per week for women. “Benders” are considered two or more

days of sustained heavy drinking. See Figure 3 for the NIAAA’s operational definitions of the standard

drink.

Consequences One of the hallmarks of SUDs is the continued use of a substance despite harmful or negative

consequences. The consequences associated with SUDs tend to be developmentally, culturally, and

contextually dependent and the measurement and conceptualization of such associations has proven to

be quite difficult for various reasons, including the fact that consequences are not always caused or

worsened by substance use or misuse.11 Therefore, caution should be taken in the interpretation of the

data presented in this RNA. Caution in inferring relationships or direction of causality should be taken,

also, because only secondary data is reported out and no sophisticated analytic procedures are involved

once that secondary data is obtained by the PRCs and reported out in this RNA, which is intended to be

used as a resource.

9 Substance Abuse and Mental Health Services Administration. Substance use disorders. https://www.samhsa.gov/disorders/substance-use. Updated October 27, 2015. Accessed May 29, 2018. 10 National Institute for Alcohol Abuse and Alcoholism. What is a “standard” drink? https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/What-counts-as-a-drink/Whats-A-Standard-Drink.aspx. Accessed May 24, 2018. 11 Martin, CS., Langenbucher, JW, Chung, Sher, KJ. Truth or consequences in the diagnosis of substance use disorders. Addiction. 2014; 109(11): 1773-1778.

https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/What-counts-as-a-drink/Whats-A-Standard-Drink.aspx


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Figure 3. NIAAA (2004) rubric for operationalizing the standard drink by ounces and percent alcohol

across beverage type12

Audience Potential consumers of this RNA include stakeholders from a variety of disciplines: substance use

prevention and treatment providers; medical providers; school districts and higher education; substance

use prevention community coalitions; city, county, and state leaders; and community members

interested in increasing their knowledge of public health factors related to drug consumption. The

information presented in this report aims to contribute to program planning, evidence-based decision

making, and community education.

The executive summary found at the beginning of this report will provide highlights of the report for

those seeking a brief overview. Since readers of this report will come from a variety of professional fields,

each yielding specialized genres of professional terms and concepts related to substance use and misuse

prevention, a glossary of key concepts can be found in Appendix B of this RNA, following Appendix A,

which is the reference section. The core of the RNA focuses on risk factors, consumption patterns,

consequences, and protective factors. A list of tables and figures can be found in Appendices C and D.

12 National Institute for Alcohol Abuse and Alcoholism. What is a “standard” drink? https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/What-counts-as-a-drink/Whats-A-Standard-Drink.aspx. Accessed May 24, 2018.



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Introduction The Texas Health and Human Services Commission (HHSC) administers approximately 225 school and community-based prevention programs across 72 different providers with federal funding from the Substance Abuse Prevention and Treatment Block Grant to prevent the use and consequences of alcohol, tobacco and other drugs (ATOD) among Texas youth and families. These programs provide evidence-based curricula and effective prevention strategies identified by SAMHSA’s Center for Substance Abuse Prevention (CSAP). The Strategic Prevention Framework (SPF) provided by CSAP guides many prevention activities in Texas

(see Figure 4). In 2004, Texas received a state incentive grant from CSAP to implement the Strategic

Prevention Framework in close collaboration with local communities in order to tailor services to meet

local needs for substance abuse prevention. This prevention framework provides a continuum of services

that target the three classifications of prevention activities under the Institute of Medicine (IOM), which

are universal, selective, and indicated.13

The Health and Human Services Commission Substance Abuse Services funds Prevention Resource

Centers (PRCs) across the state of Texas. These centers are part of a larger network of youth prevention

programs providing direct prevention education to youth in schools and the community, as well as

community coalitions that focus on implementing effective environmental strategies. This network of

substance abuse prevention services work to improve the welfare of Texans by discouraging and

reducing substance use and misuse. Their work provides valuable resources to enhance and improve our

state's prevention services aimed to address our state’s three prevention priorities to reduce: (1)

underage drinking; (2) marijuana use; and (3) non-medical prescription drug abuse. These priorities are

outlined in the Texas Behavioral Health Strategic Plan developed in 2012.

Purpose This RNA reviews substance abuse data and related variables across the state that aid in substance abuse

prevention decision making. The Regional Needs Assessment (RNA) is a product of the partnership

between the regional Prevention Resource Centers and the Texas Department of State Health Services.

The RNA seeks to address the substance abuse prevention data needs at the state, county and local

levels. The RNA focuses on the state’s prevention priorities of alcohol (underage drinking), marijuana,

and prescription drugs and other drug use among adolescents in Texas. This RNA explores drug

consumption trends and consequences. Additionally, the report explores related risk and protective

factors as identified by the Center for Substance Abuse Prevention (CSAP).

13 SAMHSA. Strategic Prevention Framework. https://www.samhsa.gov/capt/applying-strategic-prevention-framework. Last updated June 5, 2017.Accessed July 30, 2017.

https://www.samhsa.gov/capt/applying-strategic-prevention-framework

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Figure 4. Strategic Prevention Framework (SPF)14

This RNA is a review of data on substance use and misuse, and related variables that will aid in decision

making at the county, regional, and state level. In this RNA, the reader will find the following: primary

focus on the state-delineated prevention priorities of alcohol (underage drinking), marijuana,

prescription drugs, and other drug use and misuse among adolescents; exploration of drug consumption

trends and consequences, particularly where adolescents are concerned; and an exploration of related

risk and protective factors as operationalized by CSAP.

Specifically, this RNA can serve in the following capacities:

To determine patterns of substance use among adolescents and monitor changes in substance

use trends over time;

To identify gaps in data where critical substance misuse information is missing;

To determine county-level differences and disparities;

To identify substance use issues that are unique to specific communities;

To provide a comprehensive resource tool for local providers to design relevant, data-driven

prevention and intervention programs targeted to needs;

To provide data to local providers to support their grant-writing activities and provide

justification for funding requests;

To assist policy-makers in program planning and policy decisions regarding substance misuse

prevention, intervention, and treatment at the region and state level.

14 Substance Abuse and Mental Health Services Administration. Strategic Prevention Framework. https://www.samhsa.gov/capt/applying-strategic-prevention-framework. Last updated June 5, 2017.Accessed July 30, 2017.



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The geographical scope of work for PRC Region 6 encompasses 13 counties (see Figure 5): Austin,

Brazoria, Chambers, Colorado, Fort Bend, Galveston, Harris, Liberty, Matagorda, Montgomery, Walker,

Waller, and Wharton.

Figure 5. Location and 13 counties of Region 6 in Texas

Audience Readers of this RNA include stakeholders from a variety of disciplines such as substance use prevention

and treatment providers; medical providers; school districts and higher education; substance use

prevention community coalitions; city, county, and state leaders; and community members interested in

increasing their knowledge of public health factors related to drug consumption. The information

presented in this RNA aims to contribute to program planning, evidence-based decision making, and

community education.

Source: Houston-Galveston Area Council

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Methodology Process The state evaluator and the regional evaluators collected primary and secondary data at the county,

regional, and state levels between September 1, 2017 and May 30, 2018. The state evaluator met with

the regional evaluators at a statewide conference in September 2017 to discuss the expectations of the

RNA for the fourth year.

Between September and July the State Evaluator meet with Regional Evaluators via bi-weekly

conference calls to discuss the criteria for processing and collecting data. The information is primarily

gathered through established secondary sources including federal and state government agencies. In

addition, region-specific data collected through local law enforcement, community coalitions, school

districts and local-level governments are included to address the unique regional needs of the

community. Additionally, qualitative data is collected through primary sources such as surveys and focus

groups conducted with stakeholders and participants at the regional level.

Primary and secondary data sources are identified when developing the methodology behind this

document. Readers can expect to find information from the American Community Survey, Texas

Department of Public Safety, Texas School Survey of Drug and Alcohol Use, and the Community

Commons, among others. Also, adults and youth in the region were selected as primary sources.

Quantitative Data Selection

Surveys Occasionally, organizations approach the PRC asking for guidance to construct and administer surveys

in order to collect information about how their adolescents perceive and consume ATOD. All survey

questions are either copied from tools that have been tested and vetted or they are subjected to rigorous

testing through focus groups or other research methods. Many of the questions used by the PRC

originate from the following quantitative survey tools:

Youth Risk Behavior Surveillance System

Texas School Survey

Secondary Data and Longitudinally Presented Data In an attempt to capture a richer depiction of possible trends in the data presented in this RNA, data

collection and reporting efforts consist of multi-year data where it is available from respective sources.

Most longitudinal presentations of data in this needs assessment consist of (but are not limited to) the

most recently-available data collected over three years in one-year intervals of data-collection, or the

most recently-available data collected over three data-collection intervals of more than one year (e.g.

data collection for the TSS is done in two-year intervals). Efforts are also made in presenting state-and

national-level data with county-level data for comparison purposes. However, where it is the case that

neither state-level nor national-level date are included in tables and figures, the assumption can be

made by the reader that this data is not made available at the time of the data request. Such requests

are made to numerous county, state, and national-level agencies during the development of this RNA.

PRC 6 RNA 2018

P a g e 5 | 140

Regional Profile and Demographics The Gulf Coast Region of Texas, also known as Health Service Region 6, encompasses thirteen counties

across which geological and geographical landscapes are as varied as there are counties. The various

terrains found in the state of Texas span costal-area beaches and wetlands, hill country positioned

centrally in Texas, ever-increasing suburban master-plan communities that border large cities, sprawling

refineries, and the urban concrete jungle of America’s fourth largest city. In fact, Houston is one of

Texas’ three largest cities that fall into the top ten most populous cities in the United States (Dallas and

San Antonio are the other two).

The Port of Houston is the largest of 10 seaports located along Texas’ 367-mile coastline of the Gulf of

Mexico. Texas’ 29 official ports of entry, including the Port of Houston, are well known as significant

contributors to the diverse and growing Texas economy.15 Houston was even featured in a recent Los

Angeles Times article that hails Houston as a “city whose stunning growth and high-volume immigration

have turned it into the most racially and ethnically diverse major metropolis in the country, surpassing

New York in 2010.”16

The thirteen counties of Texas Region 6 are home to more than 6.5 million people, with a little over 4.3

million people residing in Harris County, alone. About one quarter of Texas’ population resides in Region

6.

Population The population across the counties of Region 6 include a wide range of urban and rural settings. At the

county level, Tables 1 through 3 present general county-level population data regarding population

density,1718 age, race and ethnicity.

Age According to the U.S. Surgeon General’s recent report on addiction, behavioral health problems such as

substance use, violence, risky driving, mental health problems, and risky sexual activity are now the

leading causes of death for those aged 15-24.19 As previously indicated in the Conceptual Framework

section of this RNA, adolescence and young adulthood tend to be the stages in life where likelihood for

the onset of substance use and misuse —including tobacco, alcohol, and illegal and prescription drugs—

is significantly higher than in any other stage of life. Therefore, attention to populations in this age

range is of great importance in efforts of preventing substance use and misuse in Region 6.

Texas’ population tends to be younger than the population of the United States as a whole. Texas’ youth

population (under age 18) comprises 26.5 percent of the total population, compared to 23.1 percent

15 Hegar, G. Fiscal notes: Port of Houston. Texas Comptroller of Public Accounts. file:///C:/Users/mromain-harrott/Downloads/fn.pdf. Published April, 2017. Accessed July 30, 2017. 16 Coronado, G. How Houston has become the most diverse place in America. Los Angeles Times. http://www.latimes.com/nation/la-na-houston-diversity-2017-htmlstory.html. Published May 9, 2017. Accessed July 24, 2017. 17 Texas Demographic Center, Population Estimates and Projections Program. Preliminary Estimates of the Total Populations of Counties in Texas for July 1, 2016. http://demographics.texas.gov/Resources/TPEPP/Estimates/2016/Preliminary_2016_txpopest_county.pdf. 2016. Accessed June 5, 2018. 18U.S. Census Bureau. Map of Texas Counties by Land Area. 2010. http://www.texascounties.net/statistics/landarea.htm. Accessed June 5, 2018. 19 Source: U.S. Department of Health and Human Services. Facing addiction in America: the surgeon general’s report on alcohol, drugs, and health. https://addiction.surgeongeneral.gov/. Published 2017. Accessed July 30, 2017.

http://www.latimes.com/nation/la-na-houston-diversity-2017-htmlstory.html


http://www.texascounties.net/statistics/landarea.htm

https://addiction.surgeongeneral.gov/

PRC 6 RNA 2018

P a g e 6 | 140

nationwide.20 Tables 2 and 3 illustrate county-level population totals and percentages for several set

age ranges representing all life stages from birth to death.

Table 1. Region 6 county-level total population and population density estimates: 2012-201621

County

Population Estimate

Total Land Area (Square Miles)

Population Density (Per Square Mile)

Austin 29,107 646.5 45

Brazoria 338,419 1,357.8 249.2

Chambers 38,072 597.2 63.8

Colorado 20,792* 960.3 21.7*

Fort Bend 683,756 861.8 793.3

Galveston 314,485 379* 829.9

Harris 4,434,257** 1,704.9** 2,601**

Liberty 78,598 1,158.5 67.9

Matagorda 36,719 1,092.9 33.6

Montgomery 518,849 1,041.9 499

Walker 69,926 784.2 89.2

Waller 47,049 513.3 91.7

Wharton 41,377 1,086.2 38.1

Region 6 6,651,406 12,184.3 546

Texas 26,956,435 261,250.0 103.2

US 318,558,162 3,532,070.5 90.2

* Lowest population estimate, land area, and density per square mile

**Highest population estimate, land area, and density per square mile

20 US Census Bureau, American Community Survey. 5-Year Population Totals and Density Estimates by Regions and Counties 2012-2016. https://assessment.communitycommons.org/CHNA/SelectArea?reporttype=libraryCHNA. Accessed June 6, 2018.

21 US Census Bureau, American Community Survey. 5-Year Population Totals and Density Estimates by Regions and Counties 2012-2016.

https://assessment.communitycommons.org/CHNA/SelectArea?reporttype=libraryCHNA. Accessed June 6, 2018.

https://assessment.communitycommons.org/CHNA/SelectArea?reporttype=libraryCHNA


PRC 6 RNA 2018

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Table 2. Region 6 county-level population estimates and percentages by age category, Age 0-34: 2012-201622

*Lowest percentage of population in age range **Highest percentage of population in age range


Age 0-4 Age 5-17 Age 18-24 Age 25-34

Total % Total % Total % Total %

Austin 1,784 6.1% 5,341 18.4% 2,317 8.0%* 2,978 10.2%

Brazoria 24,558 7.3% 66,547 19.7% 28,438 8.4% 46,983 13.9%

Chambers 2,549 6.7% 8.039 21.1%** 3,278 8.0%* 4,866 12.8%

Colorado 1,302 6.3% 3,509 16.9% 1,678 8.1% 2,012 9.7%*

Fort Bend 48,114 7.0% 143,833 21.0% 57,373 8.4% 85,049 12.4%

Galveston 20, 611 6.6% 56,920 18.1% 27,888 8.9% 41,608 13.2%

Harris 347,531 7.8%** 859,868 19.4% 434,268 9.8% 718,046 16.2%**

Liberty 5,350 6.8% 14,446 18.4% 7,428 9.5% 10,771 13.7%

Matagorda 2,583 7.0% 6,993 19.0% 3,322 9.1% 4,354 11.9%

Montgomery 35,878 6.9% 103,228 19.9% 43,273 8.3% 65,426 12.6%

Walker 3,061 4.4%* 7,773 11.1%* 13,962 20.0% 9,976 14.3%

Waller 3,152 6.7% 8,154 17.3% 10,397 22.1%** 4,728 10.1%

Wharton 2,827 6.8% 7,946 19.2% 3,737 9.0% 5,003 12.1%

Region 6 499,300 7.5% 1,292,597 19.4% 637,359 9.6% 1,001800 15.1%

Texas 1,970,686 7.3% 5,161,790 19.2% 2,738,831 10.2% 3,840,350 14.5%

US 19,866,960 6.2% 53,745,478 16.9% 31,296,577 9.8% 42,881,649 13.6%


PRC 6 RNA 2018

P a g e 8 | 140

Table 3. Region 6 county-level population estimates and percentages by age category, Ages 35-65+: 2012-201623

Age 35-44 Age 45-54 Age 55-64 Age 65+

Total % Total % Total % Total %

Austin 3,492 12.0% 3,875 13.1% 4,139 14.2% 5,181 17.8%**

Brazoria 49,535 14.6% 46,811 13.8% 38,598 11.4% 36,949 10.9%

Chambers 5,127 13.5% 5,656 14.9%** 4,565 12.0% 3,992 10.5%

Colorado 2,054 9.9%* 2,830 13.6% 3,170 15.3%** 4,237 20.4%

Fort Bend 104,477 15.3%** 98,512 14.4% 81,485 11.9% 64,913 9.5%

Galveston 40,880 13% 44,871 14.3% 41,477 13.2% 40,230 12.8%

Harris 633,095 14.3% 565,231 12.8% 467,400 10.5%* 408,818 9.2%*

Liberty 10,157 12.9% 10,760 13.7% 9,607 12.2% 10,079 12.8%

Matagorda 3,955 10.8% 4,774 13% 5,089 13.9% 5,649 15.4%

Montgomery 71,498 13.8% 73,404 14.2% 63,544 12.3% 62,598 12.1%

Walker 9,727 13.9% 9,724 13.8% 7,720 11.0% 7,983 11.4%

Waller 4,650 9.9%* 5,481 11.7%* 5,106 10.9% 5,381 11.4%

Wharton 4,653 11.3% 5,305 12.8% 5,354 12.9% 6,552 15.8%

Region 6 943,300 14.2% 877,234 13.2% 737,254 11% 662,562 10.0%

Texas 3,642,463 13.5% 3,471,589 12.9% 2,958,735 11% 3,096,567 11.5%

US 40,548,400 13.6% 43,460,466 13.6% 40,061,742 12.6% 46,180,632 14.5%

*Lowest percentage of population in age range **Highest percentage of population in age range



PRC 6 RNA 2018

P a g e 9 | 140

Race, Ethnicity and Concentrations of Populations As most RNAs of this type typically present the general demographics of the population on which and

for which such assessments are prepared, so is the case, here, at least to the best extent possible.

Figure 6 displays each county’s race and ethnicity proportions in relation to the total population and

population density of the respective county.

Figure 6. Region 6 county-level population estimates, density, and percentages by race and ethnicity,

2012-201624

Austin County: Total Population, 29,107; Population Density, 45.0

Brazoria County: Total Population, 338,419; Population Density (per square mile), 249.2

24 US Census Bureau, American Community Survey. 5-Year Population Totals and Density Estimates by Regions and Counties 2012-2016.


White, 24,123,

83%

Black, 2,519, 9%

Asian, 15, 0%

Native American,

, 8, 0%

Native Hawaiian,

0, 0%

Other, 1,570, 5%

Multiple, 872, 3%

Race

Hispanic or Latino,

7,423, 26%

Non-Hispanic, 21,684,

74%

Ethnicity

White, 251,028,

74%

Black, 44,000,

13%

Asian, 20,810, 6%

Native American, , 1,422, 1%

Native Hawaiian,

11, 0%

Other, 14,388, 4%

Multiple, 6,760, 2%

Race

Hispanic or Latino,

98,927, 29%


71%

Ethnicity


PRC 6 RNA 2018

P a g e 10 | 140

Chambers County: Total Population, 38,072; Population Density (per square mile) 63.8

Colorado County: Total Population, 20,792; Population Density (per square mile), 21.7

Fort Bend County: Total Population, 683,756; Population Density (per square miles) 793.3

White, 33,013,

87%

Black, 3,061, 8%

Asian, 518, 1%

Native American, ,

56, 0%

Native Hawaiian,

0, 0%

Other, 913, 3%

Multiple, 511, 1%

Race

Hispanic or Latino,

8,047, 21%

Non-Hispanic,

30,025, 79%

Ethnicity

White, 15,576,

75%

Black, 2,864, 14%

Asian, 21, 0%

Native American, ,

113, 1%

Native Hawaiian,

0, 0%

Other, 2,132, 10% Multiple,

86, 0%

RaceHispanic

or Latino, 5,854, 28%

Non-Hispanic,

14,938, 72%

Ethnicity

White, 356,027,

52%Black,

141,901, 21%

Asian, 128,432,

19%

Native American, ,

1,717, 0%

Native Hawaiian,

230, 0%

Other, 37,179, 5%

Multiple, 18,270, 3%

RaceHispanic

or Latino, 164,065,

24%


76%

Ethnicity

PRC 6 RNA 2018

P a g e 11 | 140

Galveston County: Total Population 314,485; Population Density (per square mile), 829.9

Harris County: Total Population, 4,434,257; Population Density (per square mile), 2,601

Liberty County: Total Population, 78,598; Population Density (per square mile), 67.9

White, 245,054,

78%

Black, 41,083,

13%

Asian, 10,311, 3%


Native Hawaiian,

67, 0%


8,664, 3%

Race

Hispanic or Latino,

74,081, 24%


76%

Ethnicity

White, 2,804,918,

63%

Black, 839,349,

19%

Asian, 295,792,

7%


Native Hawaiian, 3,155, 0%


99,658, 2%

Race

Hispanic or Latino, 1,855,604,

42%

Non-Hispanic, 2,578,653,

58%

Ethnicity

White, 64,099,

82%

Black, 8,134, 10%

Asian, 513, 1%

Native American, ,

262, 0%

Native Hawaiian,

13, 0%

Other, 4,268, …

Multiple, 1,309, 2%

RaceHispanic

or Latino, 16,282,

21%

Non-Hispanic,

62,316, 79%

Ethnicity

PRC 6 RNA 2018

P a g e 12 | 140

Matagorda County: Total Population 36,719; Population Density (per square mile), 33.6

Montgomery County: Total Population, 518,849; Population Density (per square mile), 498

Walker County: Total Population, 69,926; Population Density (per square mile), 89.2

White, 28,199,

77%

Black, 3,909, 11%

Asian, 778, 2%

Native American, ,

109, 0%

Native Hawaiian,

86, 0%

Other, 2,393, 7%

Multiple, 1,245, 3%

Race

Hispanic or Latino,

14,927, 41%

Non-Hispanic,

21,792, 59%

Ethnicity

White, 448,305,

86%

Black, 22,986,

4%

Asian, 13,498, 3%


Native Hawaiian,

423, 0%

Other, 18,223, …

Multiple, 13,236, 3%

RaceHispanic

or Latino, 116,429,

22%


78%

Ethnicity

White, 51,148,

73%

Black, 16,100,

23%

Asian, 844, 1%

Native American, ,

186, 1%

Native Hawaiian,

10, 0%

Other, 875, 1%

Multiple, 763, 1%

RaceHispanic

or Latino, 12,313,

18%

Non-Hispanic,

57,613, 82%

Ethnicity

PRC 6 RNA 2018

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Waller County: Total Population, 47,049; Population Density (per square mile), 91.7

Wharton: Total Population, 41,377; Population Density (per square mile), 38.1

White, 31,581,

67%

Black, 11,946,

25%

Asian, 401, 1%

Native American, ,

138, 0%

Native Hawaiian,

18, 0%

Other, 1,819, …

Multiple, 1,146, 3%

RaceHispanic

or Latino, 13,657,

29%

Non-Hispanic,

33,392, 71%

Ethnicity

White, 33,682,

82%

Black, 5,834, 14%

Asian, 39, 0%

Native American, ,

42, 0%

Native Hawaiian,

0, 0%

Other, 1,342, 3%

Multiple, 438, 1%

Race

Hispanic or Latino,

16,401, 40%


60%

Ethnicity

PRC 6 RNA 2018

P a g e 14 | 140

Limited English Proficiency About 14 percent of the population in Texas is limited English proficient and about 16 percent of the

population in Region 6 is limited English proficient. The limited-English proficient population is more

likely to live in poverty, to be less educated compared to the English-proficient population in the United

States, and this is only to name a couple of factors possibly involved in the development of substance

use and substance misuse behaviors. Table 4 displays the five-year estimates for the percent of limited

English proficient population for each county in Region 6 and Texas.

Table 4. Region 6 county-level limited English proficient population estimates: 2012-201625

2012-2016 Five-year Estimates

County

Population > 5 Years

Population >5 Limited English Proficiency

Percent Population >5 Limited English Proficiency

Austin 27,323 2,191 8.02%

Brazoria 313,861 25,485 8.12%

Chambers 35,523 3,690 10.39%

Colorado 19,490 1,187 6.09%

Fort Bend 635,642 82,170 12.93%

Galveston 293,874 19,595 6.67%

Harris 4,086,726 829,253 20.29%**

Liberty 73,248 5,058 6.91%

Matagorda 34,136 4,227 12.38%

Montgomery 482,971 37,355 7.73%

Walker 66,865 3,973 5.94%*

Waller 43,897 5,079 11.57%

Wharton 38,550 3,456 8.96%

Region 6 6,152,106 1,022,719 16.62%

Texas 24,985,749 3,518,972 14.08%

*Lowest percentage of limited English proficient speakers

**Highest percentage of limited English proficient speakers



PRC 6 RNA 2018

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Risk Factors In following with the framework presented in Figure 2. Risk and protective factors for alcohol and other

drug use that was introduced on p. xii, risk factors will be discussed within the context of the domains of

Society, Community, School, Family, Peer, and Individual.


Society Domain There are many societal factors associated with the use and misuse of substances, such as poverty,

unemployment, discrimination, and unhealthy media messages promoting the use of substances. The

Surgeon General’s recent report on addiction specifically cites predictors of future substance use and

misuse consist of and often relate to physiological changes that occur over the course of development

or to factors in a person’s environment, such as transitions, parental divorce, and particularly, low

parental socioeconomic status. Although low socioeconomic status, among other risk factors, has been

found to have consistent effects across (and regardless of) gender and culture, it cannot be denied that

low income and disadvantaged populations experience greater exposure to environmental risk factors

PRC 6 RNA 2018

P a g e 16 | 140

and less exposure to protective factors than other populations in which parents’ socioeconomic status is

higher. 26

Per Capita Income Since socioeconomic status is an important variable in addressing the potential for youth to develop

substance use and misuse problems, evaluating per capita income in relation to the 2018 Federal

Poverty Level Guidelines reveals that many of the Region 6 counties’ per capita income amounts fall

below, at, or right above the federal poverty level guideline for a family of four ($24,600). Of course, as

per capita income is basically the county average, it is important to keep in mind that for every income

above the poverty level, there is an income below the poverty level. The Federal Poverty Level for 2018

is contingent upon the number of persons in a household. Figure 7 shows the 2018 Federal Poverty

Level guidelines for the 48 border states and Washington D.C. according to the number of persons per

household. 27 Table 5 shows the per capita income for each county in Region 6.

Figure 7. Federal Poverty Level: 201828

26 U.S. Department of Health and Human Services. Facing addiction in America: the surgeon general’s report on alcohol, drugs, and health. https://addiction.surgeongeneral.gov/. 2017. Accessed July 30, 2017. 27 U.S. Department of Health and Human Services. Federal poverty level guidelines. https://aspe.hhs.gov/poverty-guidelines. Accessed June 18, 2018. 28 U.S. Department of Health and Human Services. Federal poverty level guidelines. https://aspe.hhs.gov/poverty-guidelines. Accessed June 18, 2018.

$12,060 $16,240

$20,420 $24,600

$28,780

$32,960 $37,140

$41,320

$0

$10,000

$20,000

$30,000

$40,000

$50,000

Am

ou

nt

in D

olla

rs

Persons per Household

1 2 3 4 5 6 7 8


https://aspe.hhs.gov/poverty-guidelines


PRC 6 RNA 2018

P a g e 17 | 140

Table 5. Region 6 county-level per capita income: 2012-201629

County Total Population Total Income ($) Per Capita Income ($)

Austin 29,107 $825,210,100 $28,350

Brazoria 338,419 $10,552,059,000 $31,180

Chambers 38,072 $1,131,857,600 $29,729

Colorado 20,792 $543,932,700 $26,160

Fort Bend 683,756 $25,390,318,100 $37,133**

Galveston 314,485 $10,301,396,600 $32,756

Harris 4,434,257 $132,362,159,000 $29,849

Liberty 78,598 $1,734,259,900 $22,064

Matagorda 36,719 $842,292,000 $22,938

Montgomery 518,849 $18,632,769,500 $35,911

Walker 69,926 $1,148,109,900 $16,418*

Waller 47,049 $1,098,006,600 $23,337

Wharton 41,377 $961,827,100 $23,245

Region 6 6,651,406 $205,524,198,100 $30,899

Texas 26,956,435 $750,156,282,800 $27,828

United States 318,558,162 $9,502,305,741,900 $29,829

*Lowest per capita income

**Highest per capita income

29US Census Bureau, American Community Survey. 5-Year Population Totals and Density Estimates by Regions and Counties 2012-2016.



PRC 6 RNA 2018

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Employment Employment data are relevant to prevention because unemployment creates instability and reduces

access to health insurance, health services, healthy foods, and other necessities that contribute to

health status. 30 In Table 6, the most recently-available unemployment data for each of the 13 counties

in Region 6 can be seen for 2015, 2016, and 2017. 31 As of 2017, Colorado County has the lowest

unemployment rate (4.8%) in the Gulf Coast Region, where Matagorda County the highest

unemployment rates (7.2%) in the region.

Table 6. Region 6 county-level labor force totals and percent unemployment: 2015, 2016, 201732

2015 2016 2017

County

Labor Force Total

% Unemployed

Labor Force Total

% Unemployed

Labor Force Total

% Unemployed

Austin 13,997 4.6% 14,128 5.3% 13,997 4.3%

Brazoria 166,521 4.6% 168,419 5.2% 171,954 5.3%

Chambers 17,751 5.3% 17,991 6.1% 18,511 6.5%

Colorado 9,875 3.9% 9,758 4.8%* 10,080 3.8%*

Fort Bend 354,744 4.3% 359,594 5% 369,788 4.6%

Galveston 157,443 5% 158,813 5.3% 161,703 5.2%

Harris 2,227,364 4.6% 2,255,093 5.3% 2,268,944 5.0%

Liberty 30,850 6.9% 31,191 7.6%** 31,713 7.1%

Matagorda 17,123 6.7% 16,833 7.4% 16,930 7.2%**

Montgomery 257,402 4.2% 260,658 4.9% 267,342 4.3%

Walker 22,905 5.1% 23,663 5.3% 23,625 4.6%

Waller 21,593 4.8% 21,841 5.7% 22,201 4.9%

Wharton 21,164 4.4% 21,009 5% 21,054 4.5%

*Lowest unemployment rate

**Highest unemployment rate

Household Composition Household composition can also provide insight into potential risk and protective factors related to

substance use and misuse prevention. Children in households with only one adult are statistically at

greater risk for adverse health outcomes, including behavioral health outcomes such as substance use

and misuse. As indicated in Table 7, there exists a 25 percent range between the lowest and highest

30 U.S. Department of Health and Human Services. Facing addiction in America: the surgeon general’s report on alcohol, drugs, and health. https://addiction.surgeongeneral.gov/. Accessed July 30, 2017. 31 U.S. Bureau of Labor Statistics, Local Area Unemployment Statistics Information and Analysis. Labor Force Data by County, 2017 Annual Averages. 2017. https://www.bls.gov/lau/#tables. Accessed June 28, 2018. 32 U.S. Bureau of Labor Statistics, Local Area Unemployment Statistics Information and Analysis. Labor Force Data by County, 2017 Annual Averages. 2017. https://www.bls.gov/lau/#tables. Accessed June 28, 2018.


https://www.bls.gov/lau/#tables

PRC 6 RNA 2018

P a g e 19 | 140

percentages of single-parent households among the 13 counties in Region 6, with the most recent data

(2012-2016 population estimates) showing Matagorda County as holding the largest percentage of such

households (42%).

Temporary Assistance for Needy Families (TANF) Recipients The state of Texas provides a program called Temporary Assistance to Needy Families (TANF) to under-

employed and newly unemployed parents of children under age 19. TANF provides a stipend and

Medicaid benefits. The percentage of households in Texas that receive public assistance income of this

type varies significantly from county to county with the latest available data (2017) identifying Brazoria

county with the lowest TANF recipient rate of 62.6 per 100,000 and Liberty county with the highest

rates of TANF recipients at 176.9 per 100,000 (see Table 8) .3334

Supplemental Nutrition Assistance Program (SNAP) Recipients Another estimate of instability in the provision of basic needs for children is the estimated percentage

of households receiving the Supplemental Nutrition Assistance Program (SNAP) benefit (see Table 9).

According to the most recently available data (2016), Fort Bend is the county with the lowest rate of

SNAP recipients at 7,425.6 per 100,000. The Region 6 county that ranks highest in SNAP recipients is

Matagorda county at 18,346.9 per 100,000 (see Table 9).

Children eligible for Free and Reduced Cost Lunch Waller had highest percentage of children who were eligible for free and reduced cost lunch at 74

percent in 2016, where Fort Bend County had the lowest percentage of children who were eligible for

free and reduced cost lunch at 31 percent (see Table 10). Income eligibility guidelines for free and

reduced cost lunch programs can be found at https://www.fns.usda.gov/school-meals/fr-050818. 35

Uninsured Children Uninsured children are significantly more likely than insured children to not have a regular physician and

to not receive medical care due to expense, particularly where mental health is concerned.36 In Region 6,

the county with the lowest percentage of uninsured children as of 2016 was Fort Bend County at 7

percent. The counties with the highest percentage of uninsured children were Colorado County at 14

percent (see Table 11).

33 Temporary Assistance for Needy Families. Texas Health and Human Services Commission. https://hhs.texas.gov/about-hhs/records-statistics/data-statistics/data/statistics/temporary-assistance-needy-familites-tanf-statistics. Accessed June 29, 2018. 34 US Census Bureau, American Fact Finder. Annual Estimates of the Annual Population: April 1, 2010 to July 1, 2017. https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk. Accessed July 1, 2018. 35 United States Department of Agriculture Food and Nutrition Service. Child Nutrition Programs – Income Eligibility Guideline – (July 1, 2018 – June 30, 2019). Last published May 8, 2018. https://www.fns.usda.gov/school-meals/fr-050818. Accessed July 20, 2018. 36 Stevens, J., Harman, J.S., & Kelleher, J.K. Race/ethnicity and insurance status as factors associated with ADHD treatment patterns. Journal of Child and Adolescent Psychopharmacology. 2005; 15 (1) 88-96.

https://www.fns.usda.gov/school-meals/fr-050818

https://hhs.texas.gov/about-hhs/records-statistics/data-statistics/data/statistics/temporary-assistance-needy-familites-tanf-statistics


https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk


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Table 7. Region 6 county-level totals and percentages of children from single-parent households, five year estimates: 2010-2014, 2011-2015, 2012-20163738

2010-2014 Estimates 2011-2015 Estimates 2012-2016 Estimates

County

All Children

Total from SPHH

Percent From SPHH

All Children

Total from SPHH

Percent from SPHH

All Children

Total from SPHH

Percent from SPHH

Austin 7,095 2,087 29% 7,104 1,724 24% 7,090 2,058 29%

Brazoria 87,937 24,789 28% 88,979 24,493 28% 90,273 22,851 25%

Chambers 10,187 2,082 20%* 10,352 2,059 20%* 10,582 1,826 17%*

Colorado 4,842 1,532 32% 4,804 1321 27% 4,805 1,405 29%

Fort Bend 180,599 39,455 22% 18,5525 4,1533 22% 191,137 42,833 22%

Galveston 74,586 21,378 29% 75,307 21,967 29% 76,665 23,486 31%

Harris 1,165,195 414,441 36% 1,181,303 422,703 36% 1,198,261 434,302 36%

Liberty 19,078 5,204 27% 19,208 5,222 27% 19,701 5,196 26%

Matagorda 9,299 3,633 39% 9,401 3,692 39% 9,575 3,983 42%**

Montgomery 131,444 31,874 24% 135,041 32,671 24% 138,361 32,957 24%

Walker 10,709 3,755 35% 10,649 3,677 35% 10,543 3,156 30%

Waller 10,643 3,417 32% 10,759 3,197 30% 11,073 3,412 31%

Wharton 10,616 4,229 40%** 10,663 4,244 40%** 10,663 3,916 37%

Region 6 1,722,230 557,876 32% 1,749,095 568,503 33% 1,778,729 581,381

33%

Texas 6,933,496 2,314,900 33% 7,003,149 2,331,521 33% 7,076,774 2,358,262 33%

Note. SPHH = Single Parent Households.

*Lowest percent of children from single-parent households, **Highest percent of children from single-parent households

37 US Census Bureau, American Community Survey. 5-Year Population Totals and Density Estimates by Regions and Counties 2012-2016. https://assessment.communitycommons.org/CHNA/SelectArea?reporttype=libraryCHNA. Accessed June 6, 2018. 38 County Health Rankings and Roadmaps.Texas Data. 2018. http://www.countyhealthrankings.org/app/texas//compare/snapshot.Accessed June 18, 2018.


http://www.countyhealthrankings.org/app/texas/compare/snapshot

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Table 8. Region 6 county-level Temporary Assistance to Needy Families (TANF) recipients per 100,000: 2015, 2016, 20173940

2015 2016 2017

County

Population

TANF Recipients

Rate per 100,000

Population

TANF Recipients

Rate per 100,000

Population

TANF Recipients

Rate per 100,000

Austin 29,447 40 135.9 29,637 33 111.4 29,786 41 137.6

Brazoria 345,738 247 71.4 353,828 237 67* 362,457 227 62.6*

Chambers 39,059 38 97.3 40,283 34 84.4 41,441 32 77.2

Colorado 20,910 19 90.9 21,027 18 85.6 21,232 27 127.2

Fort Bend 713,881 466 65.3* 741,958 506 68.2 764,828 496 64.9

Galveston 321,305 470 146.3 329,306 417 126.6 335,036 482 143.9

Harris 4,551,362 6,705 147.3 4,617,041 6,284 136.1 4652980 6,722 144.5

Liberty 79,542 180 226.3** 81,377 143 175.7 83,658 148 176.9**

Matagorda 36,762 24 65.3* 37,117 48 129.3 36,840 49 133

Montgomery 535,214 399 74.6 554,522 406 73.2 570,934 474 83

Walker 70,718 100 141.4 71,701 79 110.2 72,245 71 98.3

Waller 48,639 70 143.9 50,058 66 131.9 51,307 64 124.7

Wharton 41,379 60 145 41,634 192 461.2** 41,968 58 138.2

Region 6 6,833,956 8,818 129 6,969,489 8,463 121.4 7,064,712 8,891 125.9

Texas 27,454,880 66,763 243.2 27,904,862 62,228 223 28,304,596 60,310 213.1

*Lowest rate of TANF recipients per 100,000

**Highest rate of TANF recipients per 100,000, TANF Basic and TANF State Programs 12-month average combined

39 Temporary Assistance for Needy Families. Texas Health and Human Services Commission. https://hhs.texas.gov/about-hhs/records-statistics/data-statistics/data/statistics/temporary-assistance-

needy-familites-tanf-statistics. Accessed June 29, 2018. 40 US Census Bureau, American Fact Finder. Annual Estimates of the Annual Population: April 1, 2010 to July 1, 2017. https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk. Accessed July 1, 2018.




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Table 9. Region 6 county-level Supplemental Nutrition Assistance Program (SNAP) recipients per 100,000: 2015, 2016, 201741

2015 2016 2017

County

Population

SNAP Recipients

Rate per 100,000

Population

SNAP Recipients

Rate per 100,000

Population

SNAP Recipients

Rate per 100,000

Austin 29,447 2,882 9,787.1 29,637 3,080 10,392.4 29,786 3,226 10,830.6

Brazoria 345,738 29,313 8,478.4 353,828 31,004 8,762.5 362,457 35,594 9,820.2

Chambers 39,059 3,105 7,949.5 40,283 3,162 7,849.5 41,441 3,832 9,246.9

Colorado 20,910 2,325 11,119.1 21,027 2,423 11,523.3 21,232 2,725 12,834.4

Fort Bend 713,881 48,885 6,847.8* 741,958 52,380 7,059.7* 764,828 56,793 7,425.6*

Galveston 321,305 35,762 11,130.2 329,306 37,844 11,492 335,036 39,646 11,833.4

Harris 4,551,362 630,278 13,848.1 4,617,041 672,219 14,559.5 4,652,980 712,352 15,309.6

Liberty 79,542 11,678 14,681.6 81,377 12,990 15,962.7 83,658 13,820 16,519.6

Matagorda 36,762 5,700 15,505.1** 37,117 6,001 16,167.8** 36,840 6,759 18,346.9**

Montgomery 535,214 40,936 7,648.5 554,522 44,991 8,113.5 570,934 47,574 8,332.7

Walker 70,718 6,601 9,334.3 71,701 6,870 9,581.5 72,245 7,907 10,944.7

Waller 48,639 6,073 12,485.9 50,058 6,382 12,749.2 51,307 6,265 12,210.8

Wharton 41,379 5,929 14,328.5 41,634 6,495 15,600.2 41,968 6,475 15,428.4

Region 6 6,833,956 829,468 12,137.5 6,969,489 885,840 12,710.3 7,064,712 942,967 13,347.6

Texas 27,454,880 3,784,329 13,783.8 27,904,862 3,867,476 13,859.5 28,304,596 3,943,512 13,932.4

*Lowest rate of SNAP recipients per 100,000

**Highest rate of SNAP recipients per 100,000

41 Texas Health and Human Services. Supplemental Nutritional Assistance Program (SNAP) Statistics. https://hhs.texas.gov/about-hhs/records-statistics/data-statistics/supplemental-nutritional-assistance-program-snap-statistics. Accessed July 20, 2018.

https://hhs.texas.gov/about-hhs/records-statistics/data-statistics/supplemental-nutritional-assistance-program-snap-statistics


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Table 10. Region 6 county-level percentages of children eligible for free or reduced cost lunch: 2014, 2015, 20164243

2014 2015 2016

County

Total Children

Total Eligible

% Eligible

Total Children

Total Eligible

% Eligible

Total Children

Total Eligible

% Eligible

Austin 7,046 3,171 45% 7,154 3,720 52% 7,231 3,688 51%

Brazoria 90,617 36,247 40% 92,812 41,765 45% 94,570 42,557 45%

Chambers 10,566 3,170 30%* 10,765 3,553 33% 11,052 3,537 32%

Colorado 4,745 2,610 55% 4,800 3,072 64% 4,834 2,997 62%

Fort Bend 191,211 57,363 30%* 198,356 63,474 32%* 205,323 63,650 31%*

Galveston 77,607 31,819 41% 79,267 34,877 44% 81,040 36,468 45%

Harris 1,203,611 710,131 59% 1,225,268 784,171 64% 1,239,281 805,533 65%

Liberty 19,607 10,588 54% 20,073 12,445 62% 20,835 12,918 62%

Matagorda 9,312 5,867 63% 9,376 6,188 66% 9,483 6,164 65%

Montgomery 139,078 50,068 36% 143,528 58,847 41% 147,950 59,180 40%

Walker 10,887 27,537 55% 11,029 6,397 58% 11,009 6,385 58%

Waller 11,237 7529 67%* 11,726 8,560 73%** 12,078 8,938 74%**

Wharton 10,663 6,078 57% 10,745 6,769 63% 10,809 7,242 67%

Region 6 1,786,187 952,178 53% 1,824,899 1,033,838 57% 1,855,495 1,059,257 57%

Texas 7,116,637 3,771,818 53% 7,224,377 4,262,382 59% 7,300,000 4,307,000 59%

*Lowest percentage of children eligible for free or reduced cost lunch

**Highest percentage of children eligible for free or reduced cost lunch

42 County Health Rankings and Roadmaps.Texas Data. 2018. http://www.countyhealthrankings.org/app/texas//compare/snapshot.Accessed June 18, 2018. 43 U.S. Department of Education, National Center for Education Statistics: Common Core Data. ELSI-Elementary and Secondary Information System.

https://nces.ed.gov/ccd/elsi/tableGenerator.aspx. Accessed April 24, 2018.


https://nces.ed.gov/ccd/elsi/tableGenerator.aspx

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Table 11. Region 6 county-level counts and percentages for uninsured children: 2014, 2015, 20164445

2014 2015 2016

County

Total Children

Total Uninsured

% Uninsured

Total Children

Total Uninsured

% Uninsured

Total Children

Total Uninsured

% Uninsured

Austin 7,154 1,025 14% 7,231 964 13%** 7,545 810 11%

Brazoria 92,812 9,468 10% 94,570 9,507 10% 98,662 8,546 9%

Chambers 10,765 1,414 13% 11,052 1,171 10% 11,683 1,164 10%

Colorado 4,800 725 15%** 4,834 619 12% 5,046 681 14%**

Fort Bend 198,356 17,529 9%* 205,323 14,884 7%* 216,084 14,425 7%*

Galveston 79,267 8,050 10% 81,040 7,044 9% 84,497 7,268 9%

Harris 1,225,268 153,466 12% 1,239,281 133,445 11% 1,279,559 135,569 11%

Liberty 20,073 2,692 13% 20,835 2,275 11% 21652 2,450 11%

Matagorda 9,376 1,170 12% 9,483 1,101 11% 9,829 1,061 11%

Montgomery 143,528 14,982 10% 147,950 12,761 9% 154,979 15,133 10%

Walker 11,029 1,463 13% 11,009 1,121 10% 11,213 1,183 11%

Waller 11,726 1,726 15%** 12,078 1,625 13%** 12,492 1,678 13%

Wharton 10,745 1,407 13% 10,809 1,458 13%** 11,177 1,379 12%

Region 6 1,824,899 215,117 12% 1,855,495 187,975 10% 1,924,418 191,347 10%

Texas 7,224,377 857,022 12% 7,300,000 747,567 10% 7,559,241 735,079 10%

*Lowest percentage of uninsured children

**Highest percentage of uninsured children

44 U.S. Census Bureau. 2008-2016 Small Area Health Insurance Estimates (SAHIE) Using the American Community Survey (ACS). Model-Based SAHIE Estimates for Counties and States: 2016. https://www.census.gov/data/datasets/time-series/demo/sahie/estimates-acs.html. Accessed June 28, 2018. 45 County Health Rankings and Roadmaps.Texas Data. 2018. http://www.countyhealthrankings.org/app/texas//compare/snapshot.Accessed June 18, 2018.

https://www.census.gov/data/datasets/time-series/demo/sahie/estimates-acs.html

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Catastrophic Events: Hurricane Harvey Parts of Region 6 were devastated in late August and early September of 2017 by Hurricane Harvey.

Severe flooding destroyed billions of dollars in housing and businesses and essentially impacted the

region in ways that are not yet seen in the data collection efforts just presented in the preceding tables

and pages regarding the county-level socioeconomic profiles of Region 6.

Community Domain

Child Homelessness There is an increased risk for substance misuse and SUDs in children who are transient or homeless.

Research indicates that a homeless child is 60 percent more likely to use drugs in his or her lifetime,

compared with a non-homeless child.46 Many homeless children experience chronic absenteeism and

increased school mobility which contributes to disruptions in learning, lower school achievement, and

an increased risk of dropping out of school. These students also face significant gaps in high school

graduation compared to their non-homeless peers.

In 2016, individuals under the age of 18 made up 1.2 percent (4,113) of the national homeless

population and individuals in the age range of 18-24 made up percent (33,851) of the national homeless

population.47 In Region 6 during the 2015-2016 school year, 17,316 students were identified as

homeless in public schools. As Table 12 shows, Region 6 saw a significant increase of over 10,000

students identified as homeless over the course of the 2016-2017 school year.48

46 Embleton L, Mwangi A, Vreeman R, Ayuku D, Braitstein P. The epidemiology of substance use among street children in resource-constrained settings: a systematic review and meta-analysis. Journal of Addiction. 2013. 47 U.S. Department of Housing and Urban Development, Office of Community Planning and Development. The 2016 Annual Homeless Assessment Report (AHAR) to Congress. https://www.hudexchange.info/resources/documents/2016-AHAR-Part-1.pdf, Published November, 2016. Accessed July 30, 2017. 48 Texas Education Agency. Year-end enrollment, homelessness enrollment, expulsions, in-school suspensions, and out-of-school suspensions. 2017. Report generated July 5, 2018.

https://www.hudexchange.info/resources/documents/2016-AHAR-Part-1.pdf

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Table 12. Region 6 county-level child homelessness and year-end enrollment rates: 2015, 2016, 20174950

2015 2016 2017

Homeless

Year-End School Enrollment

Homeless


Homeless


Austin 72 6,136 42 6,265 52 6,289

Brazoria 1,241 69,672 1,468 71,862 2506 74,124

Chambers 14 8,007 24 8,260 115 8,528

Colorado 75 3,766 93 3,861 104 3,977

Fort Bend 596 111,943 770 114,787 1828 117,345

Galveston 2,308 85,444 2,268 86,367 3,224 86,750

Harris 11,416 924,742 10,931 938,217 18,274 947,982

Liberty 499 16,425 538 17,001 770 17,937

Matagorda 88 7,669 83 7,808 115 7,786

Montgomery 483 106,749 620 110,511 1322 113,495

Walker 345 8,741 152 9,067 351 9,562

Waller 145 10,727 248 11,314 391 11,620

Wharton 98 8,800 79 8,849 109 8,936

Region 6 17,380 1,368,821 17,316 1,394,169 29,161 1,414,331

49 Texas Education Agency. County-level homelessness and year-end enrollment rates. 2015, 2016. http://tea.texas.gov/acctres/enroll_index.html. Accessed April, 2017. 50 Texas Education Agency. Year-end enrollment, homelessness enrollment, expulsions, in-school suspensions, and out-of-school suspensions. 2017. Report generated July 5, 2018.

http://tea.texas.gov/acctres/enroll_index.html

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Criminal Activity There are several risk factors associated with future development of substance use and misuse within the

community domain that can be linked to criminal activity. In the state of Texas, the Department of Public

Safety operationalizes criminal activity into two categories or indices: property crime index and violent

crime index. The property crime index is used to track and categorize the crimes of burglary, larceny, and

auto theft. The violent crime index is used to track and categorize the crimes of murder, rape, robbery,

and assault.51 Tables 13-16 display totals and rates per 100,000 for both indices of crime, as well as

subcategories for each of the indices, for each county in Region 6. As of 2016, Harris County ranked

highest in the number of property crimes at a rate of 3,505.4 per 100,000, where Colorado County ranked

lowest at a rate of 1,086.2 property crimes per 100,000. Accordingly, as of 2016, Harris County ranked

highest in violent crimes at a rate of 749.3 per 100,000 population. Montgomery County ranked lowest in

violent crimes at a rate of 159.7 per 100,000 population. See Tables 14 and 16 for more detailed

breakdowns of rates by crime subcategories.

51 Texas Department of Public Safety. Texas crime report for 2014, 2015, 2016.: http://www.dps.texas.gov/crimereports/13/citCh2.pdf. Accessed

July 10, 2018.

http://www.dps.texas.gov/crimereports/13/citCh2.pdf

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Table 13. Region 6 county-level indices of property crime per 100,000: 2014, 2015, 2016 52

2014 2015 2016

County

Total Population

Offenses

Rate per 100,000

Total Population

Offenses

Rate per 100,000

Total Population

Offenses

Rate per 100,000

Austin 29,160 461 1,580.9 29,354 417 1,420.6* 29,718 406 1,366.1

Brazoria 342,220 5,976 1,746.2 350,739 5,981 1,705.3 358,003 5,813 1,623.7

Chambers 33,315 809 2,428.3 34,701 847 2,440.9 35,244 846 2,400.4

Colorado 20,873 252 1,207.3* 20,725 282 1,360.6* 20,806 226 1,086.2*

Fort Bend 637,265 8,867 1,391.3 680,418 10,264 1,508.4 702,338 9,190 1,308.5

Galveston 325,519 9,223 2,833.3 333,684 8,335 2,497.8 340,859 8,839 2,593.2

Harris 4,455,105 170,412 3,825** 4,566,277 162,549 3,559.8** 4,646,498 162,877 3,505.4**

Liberty 77,750 2,291 2,946.7 78,882 1,918 2,431.5 80,209 1,699 2,118.2

Matagorda 36,825 1,116 3,030.5 36,548 1,157 3,165.7 36,674 1,228 3,348.4

Montgomery 512,534 8,317 1,622.8 531,732 8,807 1,656 547,297 7,942 1,451.2

Walker 69,470 1,291 1,858.4 703,41 1,177 1,673.3 70,997 1,019 1,435.2

Waller 45,186 812 1,797.1 46,933 727 1,549 48,644 680 1,398

Wharton 41,489 820 1,976.4 41,221 1,081 2,622.5 41,398 1,094 2,642.6

Region 6 6,626,711 210,647 3,178.8 6,821,555 203,542 2,983.8 6,958,685 201,859 2,900.8

Texas 27,026,606 804,555 2,988.0 27,468,896 775,392 2,822.8 27,821,692 765,537 2,751.6

*Lowest rate of property crime per 100,000 population

**Highest rate of property crime per 100,000 population

52Texas Department of Public Safety. Texas crime report for 2014, 2015, 2016. http://www.dps.texas.gov/crimereports/13/citCh2.pdf. Accessed June 30, 2018.


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Table 14. Region 6 county-level indices of property crime subcategories of burglary, grand larceny, and auto theft per 100,000: 201653

Burglary Grand Larceny Auto Theft

County

Total Population

Offenses

Rate per 100,000

Offenses

Rate per 100,000

Offenses

Rate per 100,000

Austin 29,718 136 457.6 239 804.2 31 104.3

Brazoria 358,003 996 278.2 4,427 1,236.6 390 108.9

Chambers 35,244 149 422.8 621 1,762 76 215.6

Colorado 20,806 63 302.8 134 644* 29 139.4

Fort Bend 702,338 1,998 284.5 6,643 945.8 549 78.2*

Galveston 340,859 1,617 474.4 6,590 1,933.4 632 185.4

Harris 4,646,498 30,224 650.5 112,162 2,413.9** 20,491 441**

Liberty 80,209 381 475 1,140 1,421.3 178 221.9

Matagorda 36,674 319 869.8** 878 2,394.1 31 84.5

Montgomery 547,297 1,505 275* 5,735 1,047.9 702 128.3

Walker 70,997 238 335.2 684 963.4 97 136.6

Waller 48,644 220 452.3 412 847 48 98.7

Wharton 41,398 215 519.3 815 1,968.7 64 154.6

Region 6 6,958,685 38,061 547 140,480 2,018.8 23,318 335.1

Texas 27,821,692 148,073 532.2 548,941 1,973.1 765,537 246.3

*Lowest rate of property crime subcategory per 100,000 population for 2016

**Highest rate of property crime subcategory per 100,000 population for 2016

53 Texas Department of Public Safety. Texas crime report for 2016. http://www.dps.texas.gov/crimereports/13/citCh2.pdf. Accessed June 30, 2018.


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Table 15. Region 6 county-level indices of violent crime per 100,000: 2014, 2015, 2016 54

2014 2015 2016

County

Total Population

Offenses

Rate per 100,000

Total Population

Offenses

Rate per 100,000

Total Population

Offenses

Rate per 100,000

Austin 29,160 80 274.3 29,354 65 221.5 29,718 60 201.9

Brazoria 342,220 604 176.5 350,739 570 162.5* 358,003 666 186

Chambers 33,315 90 270.1 34,701 124 357.3 35,244 149 422.8

Colorado 20,873 39 186.8 20,725 47 226.8 20,806 53 254.7

Fort Bend 637,265 1,409 221.1 680,418 1,333 195.9* 702,338 1,248 177.7

Galveston 325,519 877 269.4 333,684 842 252.3 340,859 1,005 294.9

Harris 4,455,105 32,307 725.1 4,566,277 32,980 722.2** 4,646,498 34,814 749.3**

Liberty 77,750 341 438.6 78,882 321 406.9 80,209 306 381.5

Matagorda 36,825 120 325.8 36,548 105 287.2 36,674 135 368.2

Montgomery 512,534 880 171.7 531,732 1,202 226 547,297 874 159.7*

Walker 69,470 264 380 70,341 262 372.5 70,997 265 373.3

Waller 45,186 163 360.7 46,933 229 487.9** 48,644 162 333

Wharton 41,489 191 460.3 41,221 150 363.9 41,398 173 418

Region 6 6,626,711 37,365 563.9 6,821,555 38,230 560.4 6,821,555 38,230 560.4

Texas 26,929,243 108,848 404.2 27,469,671 112,763 410.5 27,821,692 120,652 433.7

*Lowest rate of violent crime offenses per 100,000 population

**Highest rate of violent crime offenses per 100,000 population

54 Texas Department of Public Safety. Texas crime report for 2014, 2015, 2016. http://www.dps.texas.gov/crimereports/13/citCh2.pdf. Accessed June 30, 2018.


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Table 16. Region 6 county-level indices of violent crime subcategories of murder, rape, robbery, and assault per 100,000: 201655

Murder 2016 Rape 2016 Robbery 2016 Assault 2016

County

Total Population

Offenses

Rate per 100,000

Offenses

Rate per 100,000

Offenses

Rate per 100,000

Offenses

Rate per 100,000

Austin 29,718 0 0* 6 20.2 11 37 43 144.7

Brazoria 358,003 8 2.2 108 30.2 155 43.3 395 110.3

Chambers 35,244 3 8.5 19 53.9 18 51.1 109 309.3

Colorado 20,806 0 0* 7 33.6 8 38.5 38 182.6

Fort Bend 702,338 29 4.1 157 22.4 313 44.6 749 106.6

Galveston 340,859 19 5.6 214 62.8 241 70.7 531 155.8

Harris 4,646,498 409 8.8** 2,020 43.5 13,656 293.9** 18,729 403.1**

Liberty 80,209 4 5 51 63.6 24 29.9* 227 283

Matagorda 36,674 2 5.5 22 60 18 49.1 93 253.6

Montgomery 547,297 12 2.2 104 19* 199 36.4 559 102.1*

Walker 70,997 2 2.8 47 66.2 32 45.1 184 259.2

Waller 48,644 1 2.1 33 67.8** 18 37 110 226.1

Wharton 41,398 1 2.4 23 55.6 17 41.1 132 318.9

Region 6 6,958,685 490 7 2,811 40.4 14,710 211.4 21,899 314.7

Texas 27,821,692 1,473 5.3 13,320 47.9 33,250 119.5 72,609 261.0

*Lowest rate per 100,000 population

**Highest rate per 100,000 population

55Texas Department of Public Safety. Texas crime report for 2016. http://www.dps.texas.gov/crimereports/13/citCh2.pdf. Accessed June 30, 2018.


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Drug Seizures and Drug Trafficking The Houston High Intensity Drug Trafficking Area (HIDTA) division of the Drug Enforcement Agency

(DEA), within Region 6, provides a very important source of information regarding drug trafficking and

money laundering organizations in the Houston HIDTA. Figure 8 highlights the 17 counties in the

Houston HIDTA region: Aransas, Austin, Brazoria, Brooks, Fort Bend, Fort Bend, Galveston, Harris,

Jefferson, Jim Wells, Kennedy, Kleberg, Liberty, Montgomery, Nueces, Refugio, Walker, and Victoria.

According to the 2018 Houston HIDTA Drug Threat Assessment, marijuana, cocaine, and

methamphetamines are the most commonly seized drugs in the region. Of the large drug

trafficking organizations investigated by Houston HIDTA initiatives, cocaine was the highest

trafficked drug at 58 percent, followed by methamphetamines at 30 percent, next marijuana at 25

percent, and then heroin at 15 percent. Other substances like controlled prescription drugs, ecstasy

and other drugs were trafficked much less frequently.56

Figure 8. Houston HIDTA designated counties

Adapted from Houston Investigative Support Center. 2018 Houston High Intensity Drug Trafficking Area

(HIDTA) Threat Assessment. Office of National Drug Control Policy. 2018; p. 6.

56 Houston Investigative Support center. 2018 Houston High Intensity Drug Trafficking Area (HIDTA) Threat Assessment. Office of National Drug

Control Policy. 2018.

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If one’s goal is to follow drug seizure data from a more local perspective, Texas Department of Public

Safety (TxDPS) keeps an online current repository of every local law enforcement agency’s drug

seizures for each county. Reporting on the actual seizure data for each law enforcement agency for

each county in Region 6 is outside the scope of this RNA due to its extensive nature – Harris county,

alone, has 44 law enforcement agencies for which separate drug seizure reports are updated on a

monthly basis by the Texas DPS. This data and downloadable reports for each law enforcement agency

are available at https://txucr.nibrs.com/Report/DrugSeized. A printout of drug seizure data for Houston

Police Department is included in Appendix E as an example.57

Availability

Alcohol Retail Licenses and Sales Violations High availability has been defined as the “high number of alcohol outlets in a defined geographical area

or per a sector of the population.”58 Since the purchase of alcohol is legal for persons over the age of 20

in Texas, and most individuals with SUDs indicate that their addiction began during their adolescent or

young adult years, it is important to address accessibility of alcohol by looking at the number of alcohol

retailers holding active current permits in each county, as well as the density of such permits per square

mile in each county. Table 17 displays the variable of active current permit and density of permit for each

county in Region 6. Totals of active current alcohol retailer permits range from 94 permits in Colorado

County to 10,930 permits in Harris County. The permit density per square mile ranges from .1 permit for

Colorado, Liberty, and Matagorda Counties, to 6.1 permits in Harris County.

57Texas Department of Public Safety Crime in Texas Online. Drugs seized reports. https://txucr.nibrs.com/Report/DrugSeized. Accessed July 25, 2017. 58 U.S. Department of Health and Human Services. Facing addiction in America: the surgeon general’s report on alcohol, drugs, and health. https://addiction.surgeongeneral.gov/. Published 2017. Accessed July 30, 2017.

https://txucr.nibrs.com/Report/DrugSeized



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Table 17. Region 6 county-level counts of active alcohol sales permits and permit density per square mile:

201759

County

License Status - Current

Total Land Area (Square Miles)

Permit Density (per Square Mile)

Austin 107 646.49 .2

Brazoria 629 1,357.81 .5

Chambers 131 597.15 .2

Colorado 94 960.29 .1*

Fort Bend 1093 861.84 1.3

Galveston 1,042 378.95 2.7

Harris 10,930 1,704.86 6.4**

Liberty 172 1,158.45 .2

Matagorda 164 1,092.90 .2

Montgomery 1,179 1,041.92 1.1

Walker 126 784.19 .2

Waller 125 513.34 .2

Wharton 148 1,086.15 .1*

Region 6 15940 12,184.31 1.3

*Lowest permit density per square mile

**Highest permit density per square mile

59 Texas Alcoholic Beverage Commission. 2018. https://www.tabc.texas.gov/public_information/license_public_information.asp. Accessed July 2, 2018.

https://www.tabc.texas.gov/public_information/license_public_information.asp

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School Domain

Dropout Rates In Chapter 3 of the U.S. Surgeon General’s (2017) report on addiction, risk factors that occur in the

school domain are listed and defined. Academic failure, particularly that which begins occurring in late

elementary school, as well as lack of commitment to school, have been linked to school dropout rates,

which in turn, may increase risk for the development of substance use and misuse problems and vice

versa.60 High school and college completion, or the lack thereof, play a key role in income inequality in

Region 6. In the Gulf Coast, specifically, local jobs requiring a bachelor’s degree pay on average $28

dollars more per hour than other regional jobs.61 Table 18 displays dropout rates for each county in

Region 6, for 2014, 2015, and 2016.62 As of 2016, Walker County had the highest high school dropout

rate at 10.3 percent and Chambers County had the lowest high school dropout rate at .2 percent.

School Discipline and Alcohol and Drugs on School Property In the Surgeon General’s report on addiction, the lack of commitment to school is described as a

breakdown in the student’s ability to see his or her role as meaningful and rewarding. Table 19 shows

county-level school expulsion and suspension counts for 2015, 2016, and 2017 in Region 6.

Two indicators on the TSS provide some insight into the possible behaviors associated with such a lack

of investment or commitment to school. The first indicator consists of questions that elicit self-reports

of conduct problems and absenteeism in students who identify as users and non-users of alcohol and

marijuana (see Table 20). The second indicator, alcohol and drugs on school property, can be inferred

from students’ self-reports regarding the number of days they attended classes while drunk on alcohol,

high from marijuana use, or high from some other drug (see Figure 9).Table 21 displays county-level

school alcohol and drug violation data, as well, for the 2016-2017 school year.

60 U.S. Department of Health and Human Services. Facing addiction in America: the surgeon general’s report on alcohol, drugs, and health. https://addiction.surgeongeneral.gov/. Published 2017. Accessed July 30, 2017. 61 Texas Comptroller of Public Accounts. Regional Snapshot: Gulf Coast Region. https://comptroller.texas.gov/economy/docs/regions/region-5.pdf. Published 2015. Accessed July 30, 2017. 62Texas Education Agency. Completion, Graduation, and Dropouts. https://tea.texas.gov/acctres/dropcomp/years.html. Published December 14, 2017. Accessed April 24, 2018.


https://comptroller.texas.gov/economy/docs/regions/region-5.pdf


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Table 18. Region 6 county-level dropout rates: 2014, 2015, 201663

2014 2015 2016

Graduate %

Drop Out %

Graduate %

Drop Out %

Graduate %

Drop Out %

Austin 95.7% 2.5% 95.7% 3.3% 94.1% 4.7%

Brazoria 92.8% 2.8% 93.2% 2.8% 93.7% 2.2%

Chambers 99% 0.2%* 98.2% 0.2%* 98.4% 0.2%*

Colorado 93.3% 3.6% 92.6% 3% 85.9% 6.7%

Fort Bend 92.1% 4.1% 93.2% 3.4% 92.9% 3.8%

Galveston 91.4% 4.8% 91.9% 4% 91.7% 3.9%

Harris 86.3% 8% 87% 7.8% 86.7% 8%

Liberty 92% 4.1% 90.8% 5.5% 91.6% 5.6%

Matagorda 92.5% 5.9% 92.9% 5.6% 91.6% 4.7%

Montgomery 91.4% 4.2% 92.4% 3.6% 91.5% 3.8%

Walker 74.9% 9.9%** 79.3% 7.9%** 77.1% 10.3%**

Waller 95.8% 2.6% 94.2% 2.9% 94.7% 2.4%

Wharton 95.6% 2.6% 95.0% 3.1% 96.3% 1.7%

Region 6 91.8% 4.3% 88.9% 6.3% 88.5% 6.5%

Texas 93.4% 6.6% 93.7% 6.3% 93.8% 6.2%

Note. Graduate % only includes information on graduates, continued education programs, and those

students holding General Education Diplomas (GED).

*Lowest dropout rate

**Highest dropout rate

63Texas Education Agency. Completion, Graduation, and Dropouts. https://tea.texas.gov/acctres/dropcomp/years.html. Published December 14, 2017. Accessed April 24, 2018.

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Table 19. Region 6 county-level school expulsion and suspension counts: 2015, 2016, 201764

2015 2016 2017

Year-End Enrollment

Expulsion Count

Suspension Count

Year-End Enrollment

Expulsion Count

Suspension Count

Year-End Enrollment

Expulsion Count

Suspension Count

Austin 6,136 -- 1,004 6,265 -- 1,005 6,289 -- 1,025

Brazoria 69,672 63 9,225 71,862 73 8,866 74,124 78 8,949

Chambers 8,007 -- 777 8,260 -- 795 8,528 -- 715*

Colorado 3,766* -- 733* 3,861* -- 622* 3,977* -- 683

Fort Bend 111,943 102 12,414 114,787 51 10,340 117,345 35 11,045

Galveston 85,444 83 12,919 86,367 60 12,607 86,750 83 13,268

Harris 924,742** 562 147,544** 938,217** 590 140,971** 947,982** 562 141,322**

Liberty 16,425 6 3,418 17,001 6 3,116 17,937 15 2,964

Matagorda 7,669 -- 1,558 7,808 -- 1,645 7,786 -- 1,725

Montgomery 106,749 233 12,741 110,511 192 12,204 113,495 184 12,362

Walker 8,741 6 1,768 9,067 -- 1,641 9,562 -- 1,635

Waller 10,727 -- 1,638 11,314 -- 2,084 11,620 21 2,155

Wharton 8,800 1,597 8,849 -- 1,703 8,936 -- 1,840

Region 6 1,368,821 207,336 1,394,169 197,599 1,414,331 199,688

Note. Suspension Count = In-School Suspension and Out-of-School Suspension Counts Combined; No highest and lowest count indicated for

Expulsion Counts due to masked or unreported data; -- = masked or unreported data; Data is masked when n>5.

*Lowest count

**Highest count

64 Texas Education Agency. Year-end enrollment, homelessness enrollment, expulsions, in-school suspensions, and out-of-school suspensions. 2017. Report generated July 5, 2018.

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Table 20. Region 5/6 and Texas comparisons of conduct problems at and absences from school, Grades

7-12: TSS, 201665

Average number of days conduct problems reported

Average number of days absent

Students Region 5/6 Texas Region 5/6 Texas Non-alcohol users 0.8 0.8 3.2 3.5

Alcohol users 2.3 2.4 4.1 4.5

Non-marijuana users 1.2 1.1 3.4 3.7

Marijuana users 3.2 3.7 4.5 4.9

Note. Please note that attendance and conduct data are only available for alcohol and marijuana;

prescription drugs are not included in these particular survey questions.

Figure 9. Regions 5 and 6 and Texas, Grades 7-12 report of class attendance while drunk or high, Grades

7-12:TSS,201666

Note. Y axis maximum is 10%, not 100%.

65 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report. http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018. 66 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report. http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018.

3.0%

0.6%0.6%

3.1%

1.0%1.4% 1.6%

0.6% 0.6%

2.9%

0.5% 0.4%

3.6%

1.2%1.7%

1.9%

0.6%0.6%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

10.0%

Per

cen

t r

esp

on

ses

Since school began in the fall, on how many days (if any) have you attended class while drunk on alcohol, high from marijuana use, or high from use of some other

drug?

Region 5/6 Texas

http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf


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Table 21. Region 6 county-level school alcohol and controlled substance violation data: 2016-201767

Alcohol Violation Controlled Substance Violation

Student Count Incident Count Student Count Incident Count

Austin 0 0 16 12

Brazoria 68 39 211 190

Chambers -- -- -- --

Colorado -- -- -- --

Fort Bend 72 62 392 379

Galveston -- -- 370 354

Harris 488 338 3,819 3,439

Liberty 36 21 98 74

Matagorda -- -- 26 24

Montgomery 143 90 387 344

Walker -- -- 28 28

Waller -- 22 -- --

Wharton -- -- 33 31

Note. -- = Masked or missing data.

67Texas Education Agency. County-level alcohol and controlled substance violation data, 2016-2017. http://tea.texas.gov . Report

generated July 17, 2018.

http://tea.texas.gov/

PRC 6 RNA 2018

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Family Domain

Parental Approval of Consumption One of the strongest predictors of substance use and misuse in youth is favorable parental attitudes to

drug use and approval of drinking and drug use. Figures 10-12 display the breakdown of students’

perceptions of their parents’ approval of consuming alcohol, marijuana, and tobacco products.

Figure 10. Region 5/6 and Texas comparisons of students’ perceptions of parental attitudes toward

consumption of alcohol, Grades 7-12: TSS, 201668

68 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report. http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018.

61.4%

13.4% 12.0%4.0%

1.2%

8.0%

64.9%

13.7% 10.7%3.3% 1.1%

6.3%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

StronglyDisapprove

MildlyDisapprove

Neither Mildly Approve StronglyApprove

Do Not Know

Per

cen

t r

esp

on

ses

How do your parents feel about kids your age drinking alcohol?

Region 5/6 Texas


PRC 6 RNA 2018

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Figure 11. Region 5/6 and Texas comparisons of students’ perceptions of parental attitudes toward use

of marijuana, Grades 7-12: TSS, 201669


of tobacco, Grades 7-12: TSS, 201670


78.1%

5.8% 5.4%1.3% 1.8%

7.6%

79.0%

6.1% 5.9% 1.4% 1.5%6.2%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

StronglyDisapprove

MildlyDisapprove


Do Not Know

Per

cen

t r

esp

on

ses

How do your parents feel about kids your age using marijuana?

Region 5/6 Texas

75.8%

7.5% 6.5%1.1%

0.9%

8.1%

78.4%

7.4% 5.9%1.0% 0.8%

6.5%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

StronglyDisapprove

MildlyDisapprove


Do Not Know

Per

cen

t r

esp

on

ses

How do your parents feel about kids your age using tobacco?

Region 5/6 Texas



PRC 6 RNA 2018

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Peer Domain

Cultural Norm and Youth Perceptions of Peer Consumption When evaluating the risk factors that contribute to certain risky behaviors (in this case, substance misuse

behaviors), there are many factors external to an individual that can increase the likelihood that

individual would engage in those risky behaviors, one of those risk factors being cultural or social norm.

Although many risk factors impose a predisposition to substance use and misuse, perceptions of one’s

peers’ engagement in such risky behaviors can be quite influential on that individual’s inclination to do

the same. Figures 13-15 display students’ perceptions of how many of their close friends use alcohol,

marijuana, and tobacco.

Figure 13. Regions 5/6 and Texas, perception of peer consumption of alcohol, Grades 7-12: TSS, 201671

Figure 14. Regions 5/6 and Texas, perception of peer consumption of marijuana, Grades 7-12: TSS, 201672


47.7%

23.2%13.7% 11.5%

4.0%

49.5%

23.3%13.8%

10.3%3.1%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

None Few Some Most All

Pe

rce

nt

Re

spo

nse

s

How many of your close friends use alcohol ?

Region 5/6 Texas

58.8%

20.0%

10.6% 7.6%2.9%

58.6%

19.0%10.9% 8.5%

3.0%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%


Pe

rce

nt

Re

spo

nse

s

How many of your close friends use marijuana?

Region 5/6 Texas



PRC 6 RNA 2018

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Figure 15. Regions 5/6 and Texas, perception of peer consumption of tobacco, Grades 7-12: TSS, 201673

Perceived Access to Alcohol, Marijuana, Prescription Drugs, and Tobacco SAMHSA specifically cites norms and laws favorable to substance use as a key risk factor for potential

substance use and misuse. Figure 16 displays adolescents’ perceptions of how easy it is for them to obtain

alcohol, tobacco, and marijuana.

Figure 16. Region 5/6 and Texas comparisons, perceived accessibility to alcohol, tobacco, and marijuana,

Grades 7-12: 201674


66.0%

20.2%

8.4%4.2% 1.2%

68.4%

19.1%7.8%

3.7% 1.0%0.0%

20.0%

40.0%

60.0%

80.0%

100.0%


Pe

rce

nt

Re

spo

nse

s

How many of your close friends use tobacco ?

Region 5/6 Texas

24.… 21.4%29.1% 26.2% 28.9% 25.4%

13.4% 14.5%

20.3% 21.8%22.8%

24.1%5.4… 6.1%

5.7% 7.4%7.0% 7.7%

10.2% 11.1%

8.7% 9.8%9.0% 9.4%16.0% 18.3%

13.8% 14.1% 12.0% 12.6%

30.8% 28.6%22.3% 20.7% 20.2% 20.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Alcohol,Region 5/6

Alcohol,Texas

Tobacco,Region 5/6

Tobacco,Texas

Marijuana,Region 5/6

Marijuana,Texas

% R

esp

on

ses

per

Cat

ego

ry o

f E

ase

If you wanted some, how easy would it be to get alcohol? tobacco?

marijuana?

Very Easy

Somewhat Easy

Somewhat Difficult

Very Difficult

Impossible

Never



PRC 6 RNA 2018

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Social Hosting and Parties Figure 17 shows that 24.3 percent of adolescents questioned about their sources for obtaining alcohol in

Region 5/6 indicated they get alcohol from home and 30.6 percent reported obtaining alcohol from

parties (both percentages are slightly higher than the state-level percentages). Less than 10 percent of

adolescents report getting alcohol from the store, according to the TSS. When looking at the Youth Risk

Behavior Survey 2017 data, about 38 percent of the Texas high school aged adolescents surveyed,

indicated that they got their alcohol from someone else.75 When combined with the percentages of

students who reported that alcohol was used at parties half of the time, most of the time, and always

(6.3%, 7.9%, 10.9%, respectively; 25.1% total), the topic of social hosting is a persistent concern (see

Figure 18). Figure 19 displays students’ perceived prevalence of marijuana and/or other drugs at parties

they have reported attending. Figure 20 displays accessible sources of prescription pain relievers for

youth, ages 12-17. Fifty-eight percent of youth ages 12-17 report getting prescription pain relievers from

friends or family.

Figure 17. Regions 5/6 and Texas comparisons of accessible sources of alcoholic beverages, Grades 7-12:

201676

75 Texas Department of State Health Services. 2001 - 2017 High School Youth Risk Behavior Survey Data. http://healthdata.dshs.texas.gov/HealthRisks/YRBS/. Accessed on April 27, 2018. 76 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report. http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018.

24.3% 26.0%

9.1%

30.6%

17.3%22.4% 24.2%

7.8%

27.8%

15.8%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Home Friends Store Parties Other

Per

cen

t R

esp

on

ses

How often, if ever, do you get alcoholic beverages from home? friends? store? parties? other?

Region 5/6 Texas


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Figure 18. Regions 5/6 and Texas, reports of presence of alcohol at parties, Grades 7-12: TSS, 201677

Figure 19. Regions 5/ 6 and Texas, reports of presence of marijuana and/or other drugs at parties, Grades

7-12: TSS, 201678


49.1%

7.9% 6.3% 7.9%10.9%

17.9%

51.0%

7.5% 5.4%8.1% 10.3%

17.7%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Never Seldom Half Time Most Time Always Did notKnow/Attend

Pe

rce

nt

Re

spo

nse

s

Thinking of the parties you attended this school year, how often was alcohol used?

Region 5/6 Texas

60.9%

6.4% 4.5% 5.2% 5.3%

17.8%

60.9%

5.8% 4.2%5.4% 5.9%

17.8%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Never Seldom Half Time Most Time Always Did notKnow/Attend

Pe

rce

nt

Re

spo

nse

s

Thinking of the parties you attended this school year, how often was marijuana and/or other drugs used?

Region 5/6

Texas



PRC 6 RNA 2018

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Figure 20. National, youth reports of where they obtain prescription drugs not prescribed to them, Ages

12-17: NSDUH, 201679

Individual Domain

Mental Health Early and persistent problem behavior, possibly indicative of emotional distress is an important risk

factor once attention is focused toward the individual/peer domain. Suicide is the leading cause of

death in individuals with SUDs. Comorbidity of mental illness and SUDs increase the risk of suicide even

further. According to epidemiological research in the areas of SUDs and suicide, the two phenomena

share many of the same risk factors, as well as well as many of the same protective factors, when

prevention is the goal. Interestingly, some of those shared individual/relationship (or peer) risk factors

are discussed in this RNA, and one such instance is in the presentation of general socioeconomics which

included information on employment rates. Table 22 displays suicide rates for Region 6 by county for

2012, 2013, and 2014. As of 2014, Matagorda and Austin counties had the highest suicide rates at 24.5

and 23.2 suicides per 100,000 population, respectively. Chambers and Colorado counties had the lowest

rate of suicides with total counts of four and two suicides, respectively (the counts were not high

enough in order for the rates per 100,000 to be calculated).

79 Substance Abuse and Mental Health Services Administration. Results from the 2016 National Survey on Drug Use and Health: detailed tables. https://www.samhsa.gov/samhsa-data-outcomes-quality/major-data-collections/reports-detailed-tables-2016-NSDUH. Published September 7, 2017. Accessed July 15, 2018.

From Friend or

Relative for Free

38%

Bought from Friend

or Relative

9%Stole from Friend or

Relative

10%

Bought from Drug

Dealer or other

Stranger

10%

Prescription

from One

Doctor

Prescriptions from

More than One

Doctor

4%

Stole from Doctor's

Office, Clinic, or

Pharmacy

2%

Some Other Way

7%

https://www.samhsa.gov/samhsa-data-outcomes-quality/major-data-collections/reports-detailed-tables-2016-NSDUH


PRC 6 RNA 2018

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Suicide Table 22. Region 6 county-level incidents of death by suicide per 100,000: 2013, 2014, 201580

2013 2014 2015

County

Total Population

Suicide Rate per 100,000

Total Population


Total Population


Austin 8 27.4 7 23.2** 30,446 -- Brazoria 44 13.3 50 14.8 345,717 44 12.7 Chambers 15 40.8 4 -- 39,041 -- -- Colorado 4 -- 2 -- 21,848 -- -- Fort Bend 49 7.5 49 7.1 716,491 75 10.5 Galveston 36 11.8 43 13.7 320,926 64 19.9 Harris 411 9.5 421 9.5 4,530,268 461 10.2 Liberty 11 13.9 15 18.9 79,746 15 Matagorda 3 -- 9 24.5 36,643 -- -- Montgomery 74 14.9 80 15.4 539,335 89 16.5 Walker 13 18.7 8 11.3 71,485 19 Waller 10 22.1 7 14.9 48,349 -- Wharton 7 16.9 7 16.9 11,251 -- -- Region 6 Texas 3,047 11.5 3,225 12 27,469,114 3,368

*Lowest incidents of death by suicide per 100,000

**Highest incidents of death by suicide per 100,000

80 Texas Department of State Health Services. Texas Health Data Center for Health Statistics. Deaths from intentional self-harm (suicide) for 2013, 2014, 2015.

http://healthdata.dshs.texas.gov/VitalStatistics/Death. Accessed July 25, 2018.

http://healthdata.dshs.texas.gov/VitalStatistics/Death

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Regional Consumption Patterns Alcohol

Early Initiation Age of initiation, particularly early age of initiation to a substance, is a highly significant risk factor for

developing a substance use disorder later in life. In fact, as it was mentioned in the front matter of this

RNA, about 90 percent of individuals who develop substance use disorders, first tried a substance

before the age of 18. In the 2017 administration of the Youth Behavioral Risk Surveillance System

(YRBSS) data collection wave with their Texas sample, about 17 percent of adolescents in Grades 9

through 12 reported trying alcohol for the first time before the age of 13 years old.81

Current use, Lifetime Use, and Current High-risk Use Of those students who have reported using alcohol during the 2016 TSS data collection, Figure 21

displays the percentages of current use and lifetime use, as reported by the students. In Region 5/6, 31.7

percent of students reported using alcohol within the past 30 days, 56.7 percent of students reported

using alcohol at least once in their lifetime, and 43.3 percent reported never using alcohol at all.

In measuring frequency and quantity of alcohol use in the aforementioned students who reported using

alcohol within the past 30 days, Figure 22 displays the percentage of that particular group of students

who engaged in the behavior of consuming five or more drinks in a two hour period and how many days

(times) they did so during the course of those 30 days.

Figure 21. Region 5/6 and Texas comparisons of indicators of current use and lifetime use of alcohol: TSS

Grades 7-12, Texas and Regions 5/6, 2016; YRBS Grades 9-12, Texas, 20178283

81 Texas Department of State Health Services. 2001 - 2017 High School Youth Risk Behavior Survey Data. http://healthdata.dshs.texas.gov/HealthRisks/YRBS/. Accessed April 27, 2018. 82 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report. http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018. 83 Center for Disease Control and Prevention. High School Youth Risk Behavior Surveillance System (YRBSS). 2017. http://healthdata.dshs.texas.gov/HealthRisks/YRBS. Accessed July 25, 2018.

31.7%

56.7%

28.6%

53.0%

26.80%

67.20%

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

Current Use (last 30 days) Lifetime Use (ever used)

Per

cen

t R

esp

on

ses

How recently, if ever, have you used alcohol?

Region 5/6, TSS (2016)

Texas, TSS (2016)

Texas, YRBS (2017)



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Figure 22. Region 5/6 and Texas comparisons of high-risk alcohol consumption behaviors, Grades 7-12:

TSS, 201684

Marijuana

Early Initiation In the 2017 administration of the YRBSS data collection wave with their Texas sample, about 7.9

percent of adolescents in Grades 9 through 12 reported trying marijuana for the first time before the

age of 13 years old.85

Current Use, Lifetime Use, and Current High-risk Use Of those students who have reported using marijuana during the 2016 TSS data collection, Figure 23

displays the percentages of current use and lifetime use, as reported by the students. In Region 5/6, 12.3

percent of students reported using marijuana within the past 30 days, 14.9 percent reported using

marijuana during the current school year, 21.5 percent of students reported using marijuana at least once

in their lifetime, and 51.3 percent reported never using marijuana at all. In measuring frequency of

marijuana use, Figure 24 displays the percentage of those students, who did report using marijuana, who

also reported high-risk consumption behaviors for marijuana.

84 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report. http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018. 85 Texas Department of State Health Services. 2001 - 2017 High School Youth Risk Behavior Survey Data. http://healthdata.dshs.texas.gov/HealthRisks/YRBS/. Accessed April 27, 2018.

5.0%

2.9%2.4%

0.8%

1.8%

4.3%

2.6%2.2%

0.8%1.5%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

10.0%

One Day Two Days 3-5 Days 6-9 Days 10+

Per

cen

t r

esp

on

ses

During the past 30 days, on how many days have you had five or more drinks of alcohol in a two hour period?

Region 5/6

Texas


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Figure 23. Region 5/6 and Texas comparisons of indicators of current use and lifetime use of marijuana:

TSS Grades 7-12, Texas and Regions 5/6, 2016; YRBS Grades 9-12, Texas, 20178687

Figure 24. Regions 5 and 6 and Texas comparisons of high-risk marijuana consumption behaviors, Grades

7-12: TSS, 201688

86 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report. http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018. 87 Center for Disease Control and Prevention. High School Youth Risk Behavior Surveillance System (YRBSS). 2017. http://healthdata.dshs.texas.gov/HealthRisks/YRBS. Accessed July 25, 2018. 88 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report. http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018.

12.3%21.5%

12.2%

21.0%17.0%

34.4%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Current Use (last 30 days) Lifetime Use (ever used)

Per

cen

t R

esp

on

ses

How recently, if ever, have you used marijuana?

Region 5/6, TSS (2016)

Texas, TSS (2016)

Texas, YRBS (2017)

0.7%0.4% 0.3% 0.3% 0.1% 0.1%

0.7%0.5% 0.4% 0.2% 0.1% 0.1%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

10.0%

Less than Once aYear

About Once aYear

About Once aMonth

Several Times aMonth

Several Times aWeek

Every Day

Per

cen

t r

esp

on

ses

How often do you normally use marijuana?

Region 5/6 Texas




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Prescription Drugs

Current Use and Lifetime Use Of those students who reported using prescription medications not prescribed to them, with the intent

of getting high, during the 2016 TSS data collection year, Figure 25 displays the percentages of current

use and lifetime use, as reported by those students. In Region 5/6, 11.6 percent of students reported

using prescription medications within the past 30 days, 15 percent reported using prescription

medications during the current school year, 20 percent of those students reported using prescription

medications at least once in their lifetime, and 80 percent reported never using prescription drugs at all.

Figure 25. Region 5/6 and Texas comparisons of indicators of current use and lifetime use of

prescription drugs, Grades 7-12: TSS, 201689

Tobacco

Early Initiation In the 2017 administration of the YRBSS data collection wave with their Texas sample, about 11.9

percent of adolescents in Grades 9 through 12 reported trying tobacco for the first time before the age

of 13 years old.90

Current Use and Lifetime Use Of those students who have reported using marijuana during the 2016 TSS data collection, Figure 26

displays the percentages of current use and lifetime use, as reported by the students. In Region 5/6,

15.6 percent of students reported using tobacco within the past 30 days, 19.9 percent reported using

tobacco during the current school year, 32.7 percent of students reported using tobacco at least once in

their lifetime, and 67.6 percent reported never using tobacco at all.

89 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report. http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018. 90 Texas Department of State Health Services. 2001 - 2017 High School Youth Risk Behavior Survey Data. http://healthdata.dshs.texas.gov/HealthRisks/YRBS/. Accessed on April 27, 2018.

11.6%20.0%

10.3%

18.5%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Current Use (last 30 days) Lifetime Use (ever)

Per

cen

t R

esp

on

ses

Region 5/6 Texas

PRC 6 RNA 2018

P a g e 52 | 140

Figure 26. Region 5/6 and Texas comparisons of indicators of current use and lifetime use of tobacco: TSS

Grades 7-12, Texas and Regions 5/6, 2016; YRBS Grades 9-12, Texas, 20179192

91 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report.

http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018. 92 Center for Disease Control and Prevention. High School Youth Risk Behavior Surveillance System (YRBSS). 2017.

http://healthdata.dshs.texas.gov/HealthRisks/YRBS. Accessed July 25, 2018.

15.6%

32.7%

14.5%

30.5%

10.40%

30%

10.30%

41%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Current Use (last 30 days) Lifetime Use (ever)

Per

cen

t R

esp

on

ses

Region 5/6 TSS Tobacco (2016)

Texas TSS Tobacco (2016)

Texas YRBS Cigarettes (2017)

Texas YRBS E-Cig (2017)


PRC 6 RNA 2018

P a g e 53 | 140

Emerging Trends

Texas School Survey (TSS), Statewide Longitudinal Trends Figure 27.Texas trends in adolescents’ alcohol consumption, Grades 7-12: TSS 2008, 2010, 2012, 2014,

201693

Figure 28. Texas trends in adolescents’ tobacco consumption, Grades 7-12: TSS 2008, 2010, 2012, 2014,

201694


http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018. 94 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report.

http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018.

0

10

20

30

40

50

60

70

80

90

100

2008 2010 2012 2014 2016

PER

CEN

T R

ESP

ON

SES

YEAR

Current Use

Lifetime Use

High Risk Use

0

10

20

30

40

50

60

70

80

90

100

2008 2010 2012 2014 2016

PER

CEN

T R

ESP

ON

SES

YEAR

Current Use

Lifetime Use

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P a g e 54 | 140

Figure 29. Texas trends in adolescents’ marijuana consumption, Grades 7-12: TSS 2008, 2010, 2012,

2014, 201695

Figure 30. Texas trends in adolescents’ illicit drug consumption, Grades 7-12: TSS 2008, 2010, 2012,

2014, 201696


http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018. 96 Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report.

http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018.

0

10

20

30

40

50

60

70

80

90

100

2008 2010 2012 2014 2016

PER

CEN

T R

ESP

ON

SES

YEAR

Current Use

Lifetime Use

0

10

20

30

40

50

60

70

80

90

100

2008 2010 2012 2014 2016

PER

CEN

T R

ESP

ON

SES

YEAR

Current Use

Lifetime Use

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Figure 31. Texas trends in adolescents’ prescription drug consumption, Grades 7-12: TSS, 2008, 2010,

2012, 2014, 201697

Youth Behavior Surveillance System (YRBSS) Statewide Longitudinal Trends

Figure 32. Texas trends in adolescents’ alcohol consumption, Grades 9-12: YRBS, 2001, 2005, 2007,

2009, 2011, 2013, 201798


http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018. 98 Center for Disease Control and Prevention. High School Youth Risk Behavior Surveillance System (YRBSS). 2017.


0

10

20

30

40

50

60

70

80

90

100

2008 2010 2012 2014 2016

PER

CEN

T R

ESP

ON

SES

YEAR

Current Use

Lifetime Use

0

10

20

30

40

50

60

70

80

90

100

2001 2005 2007 2009 2011 2013 2017

PER

CEN

T R

ESP

ON

SES

YEAR

Current Use

Lifetime Use

Binge Drinking

Extreme Binge Drinking


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P a g e 56 | 140

Figure 33. Texas trends in adolescents’ marijuana consumption, Grades 9-12: YRBS, 2001, 2005, 2007,

2009, 2011, 2013, 201799

Figure 34. Texas trends in adolescents’ life time use of substances, Grades 9-12: YRBS, 2001, 2005,

2007, 2009, 2011, 2013, 2017100

99 Center for Disease Control and Prevention. High School Youth Risk Behavior Surveillance System (YRBSS). 2017.

http://healthdata.dshs.texas.gov/HealthRisks/YRBS. Accessed July 25, 2018. 100 Center for Disease Control and Prevention. High School Youth Risk Behavior Surveillance System (YRBSS). 2017.


0

10

20

30

40

50

60

70

80

90

100

2001 2005 2007 2009 2011 2013 2017

PER

CEN

T R

ESP

ON

SES

YEAR

Current Use

Lifetime Use

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

2001 2005 2007 2009 2011 2013 2017

Pe

rce

nt

of

Life

Tim

e U

se

Year

Alcohol Marijuana InhalantsCocaine Heroin InjectedMethamphetamines Steroids



PRC 6 RNA 2018

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Consequences Mortality

Overdose Deaths Table 23 shows the counts and rates of drug- and alcohol-induced deaths by county in Region 6, 1999-

2015. In just about every county (with the exception of Austin county), the number of drug induced

deaths outweighed the number of alcohol-induced deaths. In the last column, which displays the total

count of all substance-induced deaths (drug- and alcohol-induced), Galveston and Liberty counties had

the highest substance-induced death rates at 21.4 and 21.3 per 100,000 population. Fort Bend County

had the lowest substance-induced death rate at 7 deaths per 100,000 population. Figure 34 displays

opioid overdose deaths by county in 2015 in which Harris County reported the highest opioid overdose

rate at 239 deaths.

Table 23. Region 6 county-level drug and alcohol-induced deaths per 100,000: 2012-2016101

Drug-Induced

Deaths

Alcohol-Induced

Deaths

Drugs- and Alcohol-Induced

Deaths Combined

County

Total Pop

Count

Rate per 100,000

Count

Rate per 100,000

Count

Rate per 100,000

Austin 145,900 12 -- 12 -- 24 16.4

Brazoria 1,693,642 159 9.4 85 5 244 14.4

Chambers 189,915 23 12.1 -- -- 28 14.7

Colorado 104,056 -- -- -- -- 12 11.5

Fort Bend 3,422,327 159 4.6 106 3.1 265 7.7*

Galveston 1,573,120 233 14.8 141 9 374 23.8*

Harris 22,159,879 2,248 10.1 1,379 6.2 3,627 16.4

Liberty 392,953 55 14 20 5.1 75 19.1

Matagorda 51,015 -- -- -- -- 11 21.6

Montgomery 2,596,893 282 10.9 169 6.5 451 17.4

Walker 349,197 19 -- -- -- 28 8

Waller 235,161 18 -- 17 -- 35 14.9

Wharton 206,890 12 -- -- -- 21 10.2

Texas 134,796,064 13,576 10.1 9,639 7.2 23,215 17.2

Note. -- = Suppressed or unreliable data

*Lowest combined drug- and alcohol-induced deaths per 100,000

**Highest combined drug- and alcohol-induced deaths per 100,000

101 CDC Wonder. Drug- and Alcohol-Induced Deaths. https://wonder.cdc.gov/wonder/help/mcd.html. Accessed July 30, 2018.

https://wonder.cdc.gov/wonder/help/mcd.html

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Figure 35 .Texas opioid overdose deaths by county: 2015102

102 Texas Department of State Health Services. Texas Health Data Center for Health Statistics. Opioid related deaths. 2015.

http://healthdata.dshs.texas.gov/Opioids/Deaths. Accessed July 25, 2018.

http://healthdata.dshs.texas.gov/Opioids/Deaths

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Drug and Alcohol Related Fatalities Table 24 displays DUI related fatalities by county for 2014, 2015, and 2016. As of 2016, the highest count

for total fatalities was in Harris County. 103

Table 24. Region 6 county-level DUI alcohol related fatalities: 2014, 2015, and 2016104

2014 2015 2016

County

Driver Fatalities

Total Fatalities

Driver Fatalities

Total Fatalities

Driver Fatalities

Total Fatalities

Austin 1 1 0 0 0 0

Brazoria 7 9 13 16 10 19

Chambers 5 5 0 2 1 2

Colorado 0 0 3 4 0 0

Fort Bend 9 9 8 12 7 12

Galveston 6 15 9 10 9 14

Harris 98 178 78 112 100 159

Liberty 4 5 1 5 2 5

Matagorda 1 2 5 7 2 3

Montgomery 17 20 10 15 14 21

Walker 6 9 2 2 4 7

Waller 0 0 0 0 1 1

Wharton 1 2 2 3 1 2

Region 6 155 255 131 188 151 245

Texas 711 1,086 639 960 638 987

Legal

Substance Use, Driving Under the Influence, and Criminal Charges Many of the legal consequences associated with alcohol and drugs start with offences of drinking and

then getting behind the wheel of a car and driving. Accordingly, the TSS has provided some insight into

the percentages of students who report driving while drunk or high on drugs (see Figures 36 and 37).

Table 25 displays offences of record for counties in Region 6.

103 Texas Department of Transportation. Report for DUI Driver Fatalities and DUI Total Fatalities, 2014, 2015, 2016. http://www.txdot.gov/government/enforcement/annual-summary.html. Accessed July 30, 2017. 104 Texas Department of Transportation. Report for DUI Driver Fatalities and DUI Total Fatalities, 2014, 2015, 2016.

http://www.txdot.gov/government/enforcement/annual-summary.html. Accessed July 14, 2018.

http://www.txdot.gov/government/enforcement/annual-summary.html


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Figure 36. Region 5/6 and Texas comparisons of students’ self-reports of driving while under the influence

of alcohol, Grades 9-12: TSS, 2016105

Figure 37. Region 5/6 and Texas comparisons of students’ self-reports of driving while under the influence

of drugs, Grades 7-12: TSS, 2016106


95.5%

3.6% 0.4% 0.5%

95.6%

3.5%0.4% 0.4%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

None 1-3 Times 4-9 Times 10+ Times

Per

cen

t r

esp

on

ses

During the past 12 months, how many times (if any) have you driven a car when you have had a good bit to drink?

Region 5/6 Texas

95.0%

3.4% 0.4% 0.5%

94.0%

3.6%0.8% 1.5%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

None 1-3 Times 4-9 Times 10+ Times

Per

cen

t r

esp

on

ses

During the past 12 months, how many times (if any) have you driven a car when you have felt high from drugs?

Region 5/6

Texas

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Table 25. Region 6 county-level counts of offenses of record: 2015, 2016, and 2017107

2015 2016 2017

County Drug-Delivery

Drug-Possession

Drug- Other DWI

Drug- Delivery

Drug-Possession

Drug-Other

DWI

Drug- Delivery

Drug- Possession

Drug- Other

DWI

Austin 4 18 0 2 0 13 0 4 6 21 0 2 Brazoria 42 148 30 126 58 167 13 116 49 187 7 107 Chambers 12 22 0 12 10 19 0 7 11 29 0 10 Colorado 11 23 0 11 8 23 0 5 12 21 0 6 Fort Bend 75 59 0 23 85 56 0 24 75 70 0 36 Galveston 93 120 0 79 94 162 1 83 95 170 0 95 Harris 1,292 2157 3 684 1,379 1,981 1 666 1328 1728 1 667 Liberty 38 100 0 41 44 106 0 35 51 96 0 35 Matagorda 34 22 0 10 29 19 0 7 22 20 0 5 Montgomery 212 194 0 266 231 220 1 284 242 236 0 273 Walker 15 17 0 9 14 23 0 12 16 21 0 10 Waller 9 21 0 6 13 18 0 7 12 21 0 5 Wharton 21 26 0 15 15 24 0 13 14 19 0 13 Region 6 1858 2927 33 1284 1980 2831 16 1263 1933 2639 8 1264 Texas 9,514 14,008 55 7,171 9,686 13,841 31 7,044 9,686 13,917 28 6,643

107 Texas Department of Criminal Justice. Texas Incarcerations, Drug and Alcohol Offenders on Hand, 2014-2017. Report generated July 1, 2018.

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Hospitalization and Treatment

Hospital Use Due to AOD

Table 26. Texas and national admissions for substance misuse and SUDs: 2013, 2014, and 2015108

2013 2014 2015

Area

Total Admissions

Juvenile

Adult

Total Admissions

Juvenile

Adult

Total Admissions

Juvenile

Adult

Texas 39,676 8.9% 91.1% 39,485 10.2% 89.8% 37,370 8.1% 91.9% United States 1,740, 321

6%

94% 1,805,999

8.1%

91.9%

--

--

--

Note. -- = Missing data or suppressed data. Juvenile = Ages 12-17.

Figure 38. Texas adolescent treatment episodes by substance, Ages 12-17: 2016109

108 Center for Behavioral Health Statistics. Treatment Episode Data Set (TEDS). 2013, 2014, 2015.

https://wwwdasis.samhsa.gov/webt/quicklink/TX17.htm. Substance Abuse and Mental Health Services Administration. Accessed July 25, 2018. 109 Center for Behavioral Health Statistics. Treatment Episode Data Set (TEDS). 2016. https://wwwdasis.samhsa.gov/webt/quicklink/TX17.htm. Substance Abuse and Mental Health Services Administration. Accessed July 25, 2018.

Alcohol only, 5,357,

14%

Alcohol with

secondary drug,

4,329, 11%

Heroin, 6,165, 16%

Other opiates,

1,793, 5%Cocaine (smoked),

1,346, 4%

Cocaine (other route),

1,467, 4%

Marijuana, 9,142, 24%

Amphetamines, 7,444,

19%

Other stimulants, 12,

0%

Tranquilizers, 661, 2% Sedatives, 52, 0%

Hallucinogens, 44, 0% PCP , 278, 1% Inhalants, 17, 0%

Other/Unknown, 64,

0%

https://wwwdasis.samhsa.gov/webt/quicklink/TX17.htm


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Table 27. Region 6 county-level counts of exposures for which the reason was intentional abuse: 2010-

2017110

County 2010 2011 2012 2013 2014 2015 2016 2017

Austin -- 5 -- -- 6 -- -- --

Brazoria 39 50 37 30 34 39 25 26

Chambers 5 -- 6 -- -- -- -- 5

Colorado -- -- -- 0 -- -- 6 --

Fort Bend 70 74 65 57 64 74 54 47

Galveston 48 59 44 50 38 45 35 31

Harris 569 654 656 487 421 467 344 374

Liberty 23 24 19 11 11 10 9 8

Matagorda 6 -- 7 7 -- 9 -- 10

Montgomery 81 69 74 66 57 59 49 46

Walker 10 7 8 5 10 15 7 14

Waller -- -- 19 -- 0 -- 0 0

Wharton 5 6 8 -- 5 6 6 9

Region 6 856 948 943 713 646 724 535 570 Texas 4,292 4,358 3,918 3,431 3,273 3,250 2,975 2,759

Note. -- = Missing data or suppressed data.

110 Southeast Texas Poison Center. Exposures reported to the Texas Poison Center Network during January 2000-June 2018 where the exposure reason was intentional abuse. Report generated on July 3, 2018.

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Emergency Room Admissions due to Alcohol and Other Drugs

Table 28.Region 6 county-level counts of EMS runs with primary symptom of overdose from alcohol or

drugs: 2010-2014, 2016111

Note. -- = Missing data or suppressed data. Texas EMS and Trauma Registries did not report 2015 data.

111 Texas Department of State Health Services. Texas EMS and Trauma Registries Portal. http://www.dshs.texas.gov/injury/. Accessed July 3, 2018.

County 2010 2011 2012 2013 2014 2016

Austin 13 19 18 6 21 7

Brazoria 404 433 397 242 389 185

Chambers 6 -- 5 -- -- --

Colorado 23 21 24 10 7 6

Fort Bend 222 162 211 297 490 208

Galveston 216 256 296 272 328 210

Harris 1636 1511 1648 1318 1116 1111

Liberty 45 54 105 55 27 6

Matagorda 65 -- -- -- -- 294

Montgomery 463 680 740 261 157 95

Walker 10 21 17 86 84 59

Waller 13 40 20 -- 12 20

Wharton 5 32 19 22 22 10

Region 6 3121 3229 3500 2569 2653 2211

http://www.dshs.texas.gov/injury/

PRC 6 RNA 2018

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Protective Factors Much of the information provided up until this point in this RNA, such as the risk factors, consumption,

and consequences data, seem to paint a grim picture for parts of Region 6. However, the inclusion of

this information is important and necessary in order to make educated decisions about the allocation of

resources in order to make the highest impact for those areas most in need. Hopefully, this section on

Protective Factors will highlight the great strides that have been made through prevention efforts in

Region 6 during FY2018. Once again, in following with the framework presented in Figure 2. Risk and

protective factors for alcohol and other drug use that was introduced on p. xii, protective factors will be

discussed within the context of the domains of Society, Community, School, Family, Peer, and

Individual.


Society Domain In their chapter in the Oxford Handbook of Substance Use and Substance Use Disorders on the policies

and programs regulating impaired driving, Voas and Fell discuss some of the most successful efforts in

this arena which include many that fall under the Society Domain of Protective Factors. Some of these

PRC 6 RNA 2018

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efforts include minimum drinking age laws, limiting alcohol availability, laws against serving obviously

intoxicated persons, and alcohol excise taxes. However, some of the evidence-based environmental

strategies that are funded for and implemented by the HHSC-funded prevention coalitions in Region 6

also fall under the Society Domain of Protective Factors as described by Voas and Fell, as many of the

coalitions are involved in implementing strategies such as counteradvertising, influencing community

norms, and promoting citizen activism, and the implementation of these strategies has been very

evident among Region 6 prevention coalitions during the FY2018.112

Counteradvertising PRC6 and all of the state-funded substance abuse prevention coalitions are constantly involved in

media literacy projects throughout the year. During the FY2018, PRC6 has extended HHSC-sponsored,

Drug Free Texas, SAMHSA, CDC, Get Smart Smart About Drugs, media literacy messages on alcohol,

drugs, and tobacco use through social media outlets such as Facebook and maintenance of coalition

websites. The PRC6 develops, posts, and disseminates fact sheets with the latest TSS consumption

data on each of the four priority substances, as well (visit www.prc6.org).

Influencing Community Norms Bi-annual prescription drug take-back efforts now occur across the United States and are orchestrated

through partnerships between the Drug Enforcement Agency (DEA) and countless coalitions,

businesses, and law enforcement across the country. These concerted efforts prevent youth substance

use and misuse by reducing the amount of prescription drugs available from family and friends’

medicine cabinets, which is important since about 57 percent of youth ages 12-17 reported getting

drugs not prescribed to them from a friend or family member.113 Hundreds of thousands of pounds of

unused, expired, and unwanted prescription drugs are collected on a bi-annual basis at community drug

takeback events. In fact, National Prescription Drug Take-Back Day has become an annual event

through which coalition leaders, law enforcement agencies, and community partners work together in

partnerships to ensure widespread success for this event, and also, to provide permanent drop-boxes at

police stations, sheriffs’ departments, and certain pharmacies.114 One example of the progress made by

a Region 6 prevention coalition, Brazoria Community Coalition with the Bay Area Council on Drugs and

Alcohol, can be seen in Appendix F where it is detailed that nine prescription drug drop boxes are now

housed in Brazoria County and partnerships with local and federal law enforcement agencies has

yielded the collection and incineration of over 2,000 pounds of prescription drugs a year.

According to a recent report by the American Medical Association, opioid prescriptions are decreasing

nationwide as opioid prescription data between 2013 and 2016 show negative correlations with the

increase effectiveness of Prescription Drug Monitoring Programs (PDMP), which is good.115 As lack of

use has been cited as a major barrier to physicians effectively using PDMPs, Figure 39 shows the

percent increase of physicians’ queries in their respective states’ PDMPs. For the most part, each state

112 Voas, RB, Fell, JC. Programs and policies designed to reduce impaired driving. In: KJ Sher ed. The Oxford Handbook of Substance Use and Substance Use Disorders. Vol. 2.New York, NY: Oxford University Press; 2016:621-674. 113 Substance Abuse and Mental Health Services Administration. Results from the 2016 National Survey on Drug Use and Health: detailed tables. https://www.samhsa.gov/samhsa-data-outcomes-quality/major-data-collections/reports-detailed-tables-2016-NSDUH. Published September 7, 2017. Accessed July 15, 2018. 114 To find prescription drug drop-off locations near you, or to list your agency’s drop-box, see RxDrugDropBox.org. 115 American Medical Association Opioid Task Force. Physicians’ progress to reverse the nation’s opioid epidemic. American Medical Association Opioid Task Force Progress Report 2018. American Medical Association. 2018. https://www.end-opioid-epidemic.org/wp-content/uploads/2018/05/AMA2018-OpioidReport-FINAL-updated.pdf. Accessed July 25, 2018.




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shows an increase in the number of physician queries made in the PDMP system. For some states, the

increase in queries from one year to the other is even astronomical, increasing by more than 2,000

percent. For example, North Carolina saw an increase of physician queries of 2,054 percent. Texas

physicians demonstrated a 283 percent increase in queries in the PDMP system from 2016 to 2017.

Figure 39. Percent increase in physicians’ Prescription Drug Monitoring Program queries from 2016 to

2017116

Note. States for which there were missing data (CO, CT, DC, HI, IN, IA, ME, MD, MA, MO, MT, NE, UT)

or a decrease in physicians’ queries (OK,-8.1%; NH, -88.7%) were not included in this analysis.

Promoting Community Activism One Region 6 community prevention coalition promotes opportunities for youth to participate in community activism by operating a program through which youth are recruited for sting operations with the Texas Alcoholic Beverage Commission (TABC). The Coalition for Substance Abuse Prevention (CoSAP) and Phoenix House elevate prevention efforts to involving youth at the community level in which operations target alcohol retail establishments. High school students are recruited and ultimately interviewed and selected by the TABC agents in charge of the sting operation. Students are selected according to specific psychological and emotional criteria. An actual sting operation consist of a student, under the close supervision of an undercover agent, entering a retail establishment and attempting to purchase alcohol. If the sale is successful, the officers immediately take custody of the alcohol and return to the store to take adequate legal action.

Community Domain

Community Partners and Community Coalitions In order for prevention efforts against substance use and misuse to be effective with youth, there are

protective factors within the community domain that can be fortified through actions such as the

provision of positive opportunities for social involvement, recognition of youth for positive behaviors,

116 American Medical Association Opioid Task Force. Physicians’ progress to reverse the nation’s opioid epidemic. American Medical Association Opioid Task Force Progress Report 2018. American Medical Association. 2018. https://www.end-opioid-epidemic.org/wp-content/uploads/2018/05/AMA2018-OpioidReport-FINAL-updated.pdf. Accessed July 25, 2018.



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and reinforcement and fostering of standard for behaviors.117 Well supported scientific evidence shows

that communities are an important organizing force for bringing effective evidence-based interventions

to scale. Accordingly, the Gulf Coast Region is home to several robust community coalitions for

prevention of substance misuse and SUDs in youth. Coalitions work in partnership with many

organizations in order to educate the public, schools, law enforcement, parents, and teens about the

risks of youth substance misuse, as well as the benefits of healthy alternatives (see Table 29 for a listing

of community partners and community coalitions in Region 6). These community partners are not

limited to the state-funded prevention coalitions in Region 6, but also include universities, treatment

facilities, school districts, professional organizations, law enforcement and crime prevention

organizations. One of the state-funded prevention coalitions in Region 6, the Brazoria Community

Coalition at the Bay Area Council on Drugs and Alcohol, volunteered to compile a mini-report of their

first-quarter work for FY2018 in order to give the public an idea of what their substance abuse

prevention work consists (see Appendix F).

Table 29. Region 6 PRC community partners and community coalitions: FY2018

117 U.S. Department of Health and Human Services. Facing addiction in America: the surgeon general’s report on alcohol, drugs, and health. https://addiction.surgeongeneral.gov/. Published 2017. Accessed July 30, 2017.

The Baker Institute Drug Policy Program

Advocates of Healthy Minds

Tri-County Behavioral Healthcare Behavioral Health Alliance of Texas

Harris County Constable Precinct 8 Cenikor Foundation

Spring Outreach Services City of LA Porte Municipal Court

Jacinto City ES Community Family Centers

Family Houston DePelchin Children’s Center

Coalition of Behavioral Health Services Lee College-Baytown

Center for Neurobehavioral Research on Addiction (CNRA)

Drug Enforcement Agency (DEA)

Phoenix House Julie Stevens

Pasadena Community Coalition Serenity Light Recovery

Galveston Community Coalition Cynthia Hill

Santa Maria Hostel Texas A&M Health Science Center COP

Community Family Centers Baker Ripley-Cleveland

North Harris County Substance Abuse Prevention Coalition

IMPACT Collaborative

Southeast Harris Community Coalition Alvin Police Department-Victim Assistance Program


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Fort Bend Council Harris County District Attorney's Office

Gulf Coast Center La Porte Victim Assistance Office

Brazoria County Community Coalition The Lovett Center

Clear Creek ISD/Bay Area Alliance for Youth & Family

Texas Gulf Coast Crime Prevention Association

Change Happens Pearland Police Department

Harris County Sheriff's Office Behavioral Hospital of Bellaire

Kemah Palms Recovery REACH Coalition UTMB Galveston

National Cinemedia, LLC Monahay ES (Alief)

Texas Overdose Naloxone Initiative Lorna May

Harris County Labs Multi-County Interagency Coalition against Sexual Assault

Teen and Family Services Chambers ES (Alief)

Fortis Academy Tri-County Behavioral Healthcare

Center for Success United Way of Greater Baytown Area and Chambers County

Harris County Juvenile Probation Department UT Health Center for Neurobehavioral Research on Addiction

Klentzman IS (Alief) Sienna Crossing ES (Fort Bend)

Petrosky (Alief) Rosa Parks ES (Fort Bend)

Owens-CIS (Alief) Armstrong ES (Fort Bend)

Killough MS (Alief) Briargate ES (Fort Bend)

Reece Academy (Aldine) Madden ES (Fort Bend)

Magrill ES (Aldine) Barrington Place ES (Fort Bend)

Grantham Academy (Aldine) Sugar Mill ES (Fort Bend)

Shotwell Academy (Aldine) Hunters Glen ES (Fort Bend)

Kujawa ES (Aldine) Sammons ES (Aldine)

Calvert ES (Aldine) DeZevala ES (Channelview)

de Santiago EC/PK (Aldine) Quail Valley MS (Fort Bend)

Reed Academy (Aldine) Escamilla IS (Aldine)

Hinojosa EC/PK (Aldine) Woodland MS

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Treatment/Intervention Providers The Recovery Oriented Systems of Care (ROSC) community, particularly of the Greater Houston Area,

rivals that of very few other recovery communities in the United States. The Houston Recovery Initiative

(HRI) ROSC meetings are held the third Friday of every month and yield a significant monthly gathering

of service providers from all across the Gulf Coast Region 6 area. These meetings have brought in

attendees and speakers from the Houston Mayors Office, as well as from around the state of Texas and

the country (see Appendix G for a comprehensive list of substance abuse and mental health treatment

providers in Region 6).

School Domain Essentially, some of the most important protective factors in the School Domain are the provision of

ample prosocial opportunities, positive instructional climate, clear standards set for behavior, and

healthy attitudes and beliefs taught in a caring and compassionate way.118

Youth Prevention Programs There are three types of youth prevention programs: universal prevention interventions (YPU), selective

interventions (YPS), and indicated interventions (YPI). School-level YPU interventions are designed to

address social and emotional competencies in the overall and have the greatest overall impact on

reducing substance use and misuse compared to more individually-focused interventions. In many cases,

an entire population of students on a school campus might be enrolled in a universal intervention

program and many universal programs are designed to be implemented with elementary populations, as

well as adolescent populations. The far-reaching nature of universal intervention programs is what gives

these programs results that yield more bang for the buck, so to speak.119

Selective youth prevention interventions (YPS) are designed for youth who come to the table already at

increased risk of developing substance misuse problems. Although more limited in their reach, compared

to population-based interventions, YPS programs and services are purposefully designed for a specific

high-risk group with the goal of reducing identified risk factors, increasing protective factors, or both.

118 D’Amico, EJ, Osilla, KC. Prevention and intervention in the school setting. In: KJ Sher ed. The Oxford Handbook of Substance Use and Substance Use Disorders. Vol. 2.New York, NY: Oxford University Press; 2016:675-723. 119 Source: U.S. Department of Health and Human Services. Facing addiction in America: the surgeon general’s report on alcohol, drugs, and health. https://addiction.surgeongeneral.gov/. Published 2017. Accessed July 30, 2017.

North Shore Sr HS (Galena Park) San Jacinto ES (Deer Park)

Settlers Way ES (Fort Bend) Purple Sage ES

Rita Drabek ES (Fort Bend) Fairmont ES (Deer Park)

Jensen ES (Pasadena) Hearne ES

Deepwater ES (Deer Park) Liestman (Alief)

Parkwood ES (Deer Park) Matthys ES (Pasadena)

Chancellor ES (Alief)


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YPS programs do have some advantages over universal intervention programs in that greater levels of

resources and efforts are allocated to individuals who are at high risk for developing behavioral health

difficulties.

Indicated youth prevention interventions are designed for those youth who are identified as already

being involved in risky behavior. As many of the TSS data points for 2016 have shown, the percentages

of students already involved in such risky behavior are quite small. However, it is this population of youth

who require the most intensive and individualized prevention interventions and resources available.

Given the likelihood of developing SUDs without intensive intervention, which imposes a much larger

financial burden than the higher cost of the YPI intervention (in comparison with YPUs and YPSs), the

benefits of the YPI for this population of youth far outweigh any negatives associated with such a cost.

See Appendix H for a listing of youth prevent programs in Region 6 for FY2018.

Alcohol, Tobacco, and Other Drugs Education in School The next two tables present indicators from the TSS (2016) regarding how information about alcohol and

drugs is given to students, as well as who students would seek help from should they find themselves in

having substance misuse or substance use disorder problems. Table 30 displays the school-based

individuals or departments from which students report receiving information on alcohol and other drugs

at school, as per the TSS (2016). Other than Any School Source, School Health classes were the highest

reported source from which students reported getting information about alcohol and drugs, which was

44.7 percent of students in Region 5/6 who filled out the TSS.

Table 30. Region 5/6 and Texas comparisons of student reports on sources from which they received

information on alcohol and drugs, Grades 7-12: TSS, 2016

Since school began in the Fall, have you gotten any information on drugs or alcohol

from the following?

School Personnel Region 5/6 Texas

School Health 44.7% 43.9%

Assembly Program 34.9% 44.7%

Guidance Counselor 21.3% 27.9%

School Nurse 14.3% 17.2%

Science or Social Studies Class 23.0% 27.3%

Student Group or Club 13.4% 14.4%

Invited Guest 22.2% 31.6%

Another Source at School 26.0% 28.9%

Any School Source 63.2% 68.9%

No Prevention Education on Drugs or Alcohol 36.8% 31.1%

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Alternative Peer Groups and Recovery High Schools The Alternative Peer Group (APG) has emerged as a comprehensive model for recovery from SUDs in

adolescents, and has a rich history in Region 6, particularly the Houston area.120 Research has shown that

peers can have as much, or even more, of a positive influence on successful recovery as a negative impact

on substance misuse. 121 The use of the APG model is particularly important when considering the

environment and organizational structure within many sober or recovery schools, the students of which

tend to support and engage one another in positive emotional, informational, and affiliational ways. This

positive peer support tends to be integral in recovery schools that are based on the APG model, and

provides a means through which students can celebrate their journey of recovery alongside peers who

are also in recovery. Such positive peer pressure, as well as the high expectations of the school culture

that foster empathy and encouragement toward recovery and sobriety, has been shown to positively

impact the recovery journeys of many youth.122

At the present time, Region 6 is home to three recovery high schools. Archway Academy and Cates

Academy are private recovery high schools and the Harris County Department of Education recently their

first public recovery high school, Fortis Academy.

120 Collier, C., Hilliker, R., & Onwuegbuzie, A. Alternative peer group: a model for youth recovery. Journal of Groups in Addiction and Recovery. 2014; v. 9 (1). 121 Center for Substance Abuse Treatment. What are peer recovery support services?: Recovery Community Services Program; Rockville, MD: 2009. http://store.samhsa.gov/shin/content//SMA09-4454/.pdf, Accessed July 30, 2017. 122 Karakos, H. Positive peer support or negative peer influence? The role of peers among adolescents in recovery high schools. Peabody Journal of Education. January 1, 2014; 89(2): 214-228. Doi: 10.1080/0161956X.2014.897094.

http://store.samhsa.gov/shin/content/SMA09-4454/.pdf

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High School Completion and Graduation Rates

Table 31. Region 6 county-level graduation and dropout rates: 2014, 2015, 2016123

2014 2015 2016

Graduate %

Drop Out %

Graduate %

Drop Out %

Graduate %

Drop Out %

Austin 95.7 2.5 95.7 3.3 94.1 4.7

Brazoria 92.8 2.8 93.2 2.8 93.7 2.2

Chambers 99 0.2* 98.2 0.2* 98.4 0.2*

Colorado 93.3 3.6 92.6 3 85.9 6.7

Fort Bend 92.1 4.1 93.2 3.4 92.9 3.8

Galveston 91.4 4.8 91.9 4 91.7 3.9

Harris 86.3 8 87 7.8 86.7 8

Liberty 92 4.1 90.8 5.5 91.6 5.6

Matagorda 92.5 5.9 92.9 5.6 91.6 4.7

Montgomery 91.4 4.2 92.4 3.6 91.5 3.8

Walker 74.9 9.9** 79.3 7.9** 77.1 10.3**

Waller 95.8 2.6 94.2 2.9 94.7 2.4

Wharton 95.6 2.6 95.0 3.1 96.3 1.7

Region 6 91.8 4.3 88.9 6.3 88.5 6.5

Texas 93.4 6.6 93.7 6.3 93.8 6.2

Note. Graduate % only includes information on graduates, continued education programs, and those

students holding General Education Diplomas (GED).

*Lowest dropout rate

**Highest dropout rate

123 Texas Education Agency. Completion, Graduation, and Dropouts. https://tea.texas.gov/acctres/dropcomp/years.html. Published December 14, 2017. Accessed April 24, 2018.

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Family Domain The protective factors discussed below are clear indicators of what one might expect in the Family

Domain of youth where there are positive attachments, healthy attitudes and beliefs and clear standards

for behavior, high parental expectations, a sense of basic trust, and positive family dynamics.

Communication between Parent and Child Regarding Alcohol, Tobacco, and

other Drugs As can be seen in Figure 40, the highest percentage of student reports indicating to whom they would go

for help if they were having difficulties with drugs or alcohol, 68 percent (the highest percentage of all

choices provided) indicated they would go to their parents.

Figure 40. Region 5/6 and Texas comparisons of student reports of individuals to whom they would reach

out for help if they had a drug or alcohol problem.124

Parental Attitudes toward Alcohol and Drug Consumption Just as favorable parental attitudes toward substance consumption is a risk factor for youths’ use and

misuse of substances, so too are parents’ negative attitudes toward substance use and misuse a

protective factor from such behaviors. Furthermore, parental involvement with adolescent children,

which is also a protective factor, includes providing clear expectations of behavior. Figures 41 and 42

display students’ perceptions of parental attitudes toward alcohol and drug use.


38.2%

22.6%

39.4%

68.2%

39.2%

54.8%

62.8% 61.4%

40.3%

24.0%

42.9%

70.7%

40.9%

56.2%64.2%

62.1%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

SchoolCounselor

School Nurse AnotherAdult inSchool

Parents Program orCounselor

OutsideSchool

MedicalDoctor

Friends AnotherAdult

Per

cen

t r

esp

on

ses

If you had a drug or alcohol problem and needed help, who would you go to?

Region 5/6 Texas

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Figure 41. Region 5/6 and Texas comparisons of students’ perceptions of parental attitudes toward

consumption of alcohol, Grades 7-12: TSS, 2016125


of marijuana, Grades 7-12: TSS, 2016126


61.4%

13.4% 12.0%4.0%

1.2%

8.0%

64.9%

13.7% 10.7%3.3% 1.1%

6.3%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

StronglyDisapprove

MildlyDisapprove


Do Not Know

Per

cen

t r

esp

on

ses

How do your parents feel about kids your age drinking alcohol?

Region 5/6 Texas

78.1%

5.8% 5.4%1.3% 1.8%

7.6%

79.0%

6.1% 5.9% 1.4% 1.5%6.2%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

StronglyDisapprove

MildlyDisapprove


Do Not Know

Per

cen

t r

esp

on

ses

How do your parents feel about kids your age using marijuana?

Region 5/6 Texas

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Peer Domain Some of the protective factors that are particularly important at the Peer Domain would have much to

do with facilitating environments where youth are positively involved with peers, where they are not

easily influenced by the negative behaviors of their peers, and involved in organized activities. 127

Adolescent Recovery Oriented Systems of Care The Adolescent Recovery Oriented Systems of Care (AROSC) subcommittee of the Houston Recovery

Initiative Recovery Oriented Systems of Care (HRI/ROSC) is one example of the organization of various

agencies in Region 6 that provide positive recovery-centered events for adolescents and their families.

The mission statement of the AROSC is as follows: The mission of the AROSC is to come together as a

team to fulfill the vision of promoting pathways to recovery for our children, families, and community.

The Houston AROSC works closely with Fortis Academy, the first public recovery high school in

Houston, is gearing up for its second annual Recovery in the Park event on September 1, 2018, and

dedicates its organizational efforts to ensuring best practices for youth and their families who are

seeking treatment and recovery services. The important take-away from these efforts, particularly for

the participating youth, is the positive peer pressure culture of recovery and facilitation of multiple

opportunities to experience and engage in effective and adaptive life skills, untainted by addictive

substances.

Perception of Peer Consumption versus Actual Peer Consumption One important contradiction between perception of peer consumption and actual consumption data is

that youth tend to perceive that their friends are using or misusing substances at quite a higher level

than what youth, in general, actually report using. Figures 43-45 demonstrate this phenomenon for

alcohol, marijuana, and tobacco as perception of peer consumption and actual consumption was

measured on the TSS.

127 D’Amico, EJ, Osilla, KC. Prevention and intervention in the school setting. In: KJ Sher ed. The Oxford Handbook of Substance Use and Substance Use Disorders. Vol. 2.New York, NY: Oxford University Press; 2016:675-723.

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Figure 43. Regions 5/6 and Texas youth perception of peer consumption versus actual consumption of

alcohol, Grades 7-12: TSS, 2016128


marijuana, Grades 7-12: TSS, 2016129


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tobacco, Grades 7-12: TSS, 2016130

Individual Domain

Life Skills Learned in Youth Prevention Programs According to epidemiological investigations on the protective factors in reducing risky behaviors in

youth, the social, emotional, behavioral, cognitive, and moral competence in the individual is key.

Therefore the evidence based interventions that are approved for use with youth in prevention programs

focus on building skills of increased self-efficacy, spirituality, resiliency, and good decision making in

these youth. Additionally, Chapter 3 of the U.S. Surgeon General’s report on addiction specifically

discusses the step-by-step process for improving the dissemination and implementation of evidence-

based interventions and programs that focus on strengthening all the aforementioned individually-

geared skills.

Youth Perception of Risk and Harm of Alcohol, Marijuana, Prescription Drugs,

and Tobacco High perception of risk or negative feelings towards alcohol or drug use is a major protective factor

against substance use and misuse, which was also captured with students’ responses to questions about

perception of harm on the TSS. Figure 46 illustrates students’ perception of harm in response to

questions about alcohol, tobacco, marijuana, and prescription drugs, which are actually high. Particularly

impressive are youth’s increased perception of harm about the illicit substances in Figures 47 and 48. The

one substance that leaves the reader with a lingering concern is marijuana, considering what is already

know from the short-term negative consequences that have emerged in the four states that have

legalized marijuana.


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Figure 46. Region 5/6 and Texas, perceived risk of harm from alcohol, tobacco, marijuana, and

prescription drugs, Grades 7-12: TSS, 2016131

Figure 47. Region 5/6 and Texas perceived risk of harm from cocaine, crack, ecstasy, and steroids,

Grades 7-12: TSS, 2016132


81.3%

14.8%

3.9%

84.0%

11.3%

4.6%

71.5%

24.2%

4.5%

87.6%

5.8%

6.5%

82.4%

14.2%

3.3%

85.8%

9.9%4.3%

71.6%

24.4%

3.9%

88.2%

5.4%6.3%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Per

cen

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ses

How dangerous do you think it is for kids your age to use...?

Region 5/6

Texas

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Figure 48. Region 5/6 and Texas perceived risk of harm from heroin, methamphetamines, and synthetic

cannabinoids, Grades 7-12: TSS, 2016133

Region in Focus Gaps in Services Although the availability of Medication Assisted Treatment (MAT) providers has significantly increased

in Region 6 over the past year, inhabitants of rural counties in Region 6 continue to have limited access

to services. MAT, it seems, has created a unique landscape where it appears that physicians with already

established practices have heeded the need for increased availability of MAT locations and followed the

appropriate licensure protocol for registration for Buprenorphine treatment, hence the dramatic increase

in Buprenorphine registered treatment providers over the past year. Unfortunately, just as the most rural

counties in Region 6 see little to no mental health nor substance abuse provider services in their areas

(typically Austin, Colorado, Chambers, Liberty, Matagorda, Walker, Waller, Wharton), these counties

continue to see little to no MAT services. A few counties actually now have a registered Buprenorphine

treatment provider, but no other mental health nor substance abuse provider services. It will be

interesting to see if the increase of MAT providers will have an effect on the increase of mental health

and substance abuse treatment providers in those counties in the future.

Gaps in Data All TSS data presented in this RNA was collected in 2016. Where new Texas YRBS data collected in 2017

were available for consumption data and information on long-term state-wide trends, those data were

presented. For this RNA for 2017, an effort was made in obtaining longitudinal data where it was available

and appropriate. PRC evaluators across the state followed the same guidelines in obtaining this

longitudinal data with a focus on the presentation of county-level data, with the exception of TSS data.


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The longitudinal data was collected and presented here in order for the reader to use it as a resource or

reference material, and hopefully allowing for a narrower view on variables that pertain to individual

counties as opposed to having to make region-based generalizations for individual counties, which has

been the protocol in past years. As far as the TSS data is concerned, only 2016 data for the combined

Regions 5 and 6, with the exception of tables displaying state-level consumption data from 2008 through

to 2016, are provided in this RNA. Additionally, due to the lack of participating campuses in Region 6 in

the administration of the TSS, which is fairly typical, all TSS data are presented for Regions 5 and 6,

combined.

The TSS was used in presenting much of the consumption data. If there was a construct for which the

TSS did not provide data, then data from the YRBS was used to discuss that construct. In such a case

where the same construct was measured by both instruments, the TSS data were used over the YRBS

data simply due to the fact that the sample size for the TSS Texas level data was substantially larger than

that used for the YRBS Texas level data. The 2016 TSS data did not provide early initiation data and used

YRBS data to compensate, but only available as state-level data, with a substantially smaller sample size,

and only grade levels 9-12. The YRBS Trends data is also not completely comparable to the TSS trends

data – sample size is substantially smaller, YRBS is only grade levels 9-12, data collection waves are not

quite as consistent (every two years like the TSS).

Particularly with regard of reporting out on educational data and in accordance with FERPA laws, and the

same goes for HIPPA laws as well, prevalence and incidence numbers below at the county level are often

missing, masked, or not publicly reported out at the county level. There appeared to be more missing or

masked data, or more instances where no counts were provided when there were less than 10 persons in

a county who met criteria for inclusion in a dataset (particularly for sensitive variables like death by

suicide), in the fulfilment of the present year’s data requests. For example, Texas Department of State

Health Services did not report any county-level counts of EMS runs with primary symptom of overdose

from alcohol or drugs for 2015 due to what was deemed by the agency to be an overabundance of masked

or missing data (see Table 28).

Regional Successes On July 25-27, 2018, the PRC6 and The Council on Recovery combined efforts to host the high profile 2018 Houston Opioid Summit: Creating Awareness and Taking Action to Save Lives. The Summit brought together leaders from the prevention, treatment, legal, medical, pharmacology, law enforcement, media, and legislative communities to increase awareness and education about the opioid crisis facing Region 6, but more specifically, the Houston area. The Summit opened with a showing of the documentary film Do No Harm: The Opioid Epidemic, immediately followed by a panel discussion. Topics ranged from the impact of PDMPs on the medical community, to prevention strategies and challenges, to the role of media in raising awareness about the opioid crisis, and addiction, in general. The Harris County Opioid litigation, the actual lawsuit that Harris County is filing against Perdue Pharmaceuticals for its role in the opioid crisis in Houston, was presented and discussed. The need for strong advocacy against the stigma of substance use disorders, for the education about substance use disorder as a disease of the brain, and for the enforcement of parity laws regarding health insurance were passionately voiced. The range of speakers spanned high-level researchers from local universities and federal, state, and county agencies such as the Substance Abuse and Mental Health Services Administration, Facing

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Addiction/National Council on Alcoholism and Drug Dependence, Texas Targeted Opioid Response/Texas Health and Human Services Commission, University of Houston, Texas A&M, Pasadena Community Coalition/Bay Area Council On Drugs and Alcohol, Texas Association of Addiction Providers (TAAP), TAAP Advocacy, Harris County District Attorney’s Office, Houston High Intensity Drug Trafficking Area Division, Houston Police Department, Memorial Hermann Prevention and Recovery Center, Texas Children’s Hospital, and even Representative Alvarado addressed the audience with some words of encouragement. The Summit culminated with personal stories and journeys of loss, substance use disorder, recovery, and advocacy.

Conclusion

Key Findings

1. The counties that make up Region 6 range from large and densely populated (Harris County at

1,704.9 square miles with 2,601 estimated population per square mile) to smaller and less

densely populated (Colorado County at 960.3 square miles of total land area with 21.7

estimated population per square mile). From a county rankings perspective, Matagorda County

tended to rank highest on variables such as unemployment rates, percentages of children from

single-parent households, and rates of Supplemental Nutrition Assistance Program (SNAP)

recipients per 100,000 population. Conversely, Fort Bend ranked highest out of the 13 Region 6

counties on per capita income and lowest on variables such as SNAP recipients per 100,000

population, percentage of children eligible for free or reduced cost lunch, and percentage of

children without health insurance. Harris County law enforcement officials report the highest

level of violent and property crime out of all counties in Region 6 and also has the highest

alcohol sales permit density in Region 6 at 6.4 retailers per square mile.

2. Alcohol consumption remains the largest issue among youth, but multi-year statewide trends

show slight decreases in consumption. The RNA 2018 included consumption trends from the

latest round of data from the Youth Risk Behavior Surveillance System (YRBSS, 2017) and the

resulting trends for Texas youth in Grades 9-12 seem promising. However, one theme common

to the treatment episode data, perception of harm, and perception of parental approval is that

all of these sources of data demonstrate increasingly lenient perceptions and consumption data

patterns of marijuana, albeit minor at the present time. There is much still to be learned about

the long-term consequences of the legalization of marijuana through future research. However,

current research on the short-term consequences of recently-passed legislation legalizing

marijuana in Alaska, Colorado, Oregon, and Washington, and has already demonstrated a

plethora of issues that are particularly concerning from a substance abuse prevention

perspective – many of the social and legal consequences that are increasing with the

legalization of marijuana are similar to the consequences seen with alcohol. For example,

consequences occurring in Colorado since the legalization of marijuana in 2012 include a 65

percent increase in first-time use in youth, an 8 percent increase in alcohol consumption, a 210

percent increase in four-year averages to poison control, and a crime rate that has increased 11

times faster than the rest of the United States. Also, 33.8 percent of persons who received

treatment in Texas in 2017 for misuse of any substance of any kind were youth ages 12-17 who

sought treatment for marijuana use disorder. This subcategory of youth make up the largest

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subcategory, according to Center for Behavioral Health Statistics and Quality (2016),

Treatment Episode Data Set (TEDS), substantially more so than alcohol or any other substance

use disorder.

3. Particularly regarding the national opioid crisis and how the state of Texas and Region 6 is

addressing this crisis, there are a few points of significant progress that are definitely worth

mentioning as a key finding, here. The first has to do with the American Medical Association’s

(AMA) tracking of the effectiveness of Prescription Drug Monitoring Programs (PDMP), which

found that Texas’ physicians’ PDMP system queries increased by 283 percent between 2016

(1,086,373) and 2017 (4,163,058). Also noteworthy of recognition is the increasing awareness

and availability of Naloxone with a standing order at many pharmacies in Texas, particularly

Walgreens, Walmart, and CVS Pharmacies, which have publicly committed at the corporate

level to honor the Texas standing order and stock Naloxone rescue kits. Finally, Appendix F

contains a list of all of the Buprenorphine treatment providers in Region 6. The increase in

Buprenorphine Medication Assisted Treatment (MAT) registered treatment providers and

increased PDMP use by physicians demonstrates positive changes resulting from the

implementation of protective factors, including recent Texas Targeted Opioid Response

(TTOR) funding, a $24.7 million grant to combat opioid addiction in Texas. Harris County,

alone, has 190 Buprenorphine treatment providers and Region 6 has 283.

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Appendix A References 1. Smart Approaches to Marijuana. Lessons learned from marijuana legalization in four U.S. states and

D.C. March, 2018. https://learnaboutsam.org/wp-content/uploads/2018/04/SAM-Lessons-Learned-From-Marijuana-Legalization-Digital.pdf. Accessed July 30, 2018.

2. Center for Behavioral Health Statistics. Treatment Episode Data Set (TEDS). 2016. https://wwwdasis.samhsa.gov/webt/quicklink/TX17.htm. Substance Abuse and Mental Health Services Administration. Accessed July 25, 2018.

3. American Medical Association Opioid Task Force. Physicians’ progress to reverse the nation’s opioid epidemic. American Medical Association Opioid Task Force Progress Report 2018. American Medical Association. 2018. https://www.end-opioid-epidemic.org/wp-content/uploads/2018/05/AMA2018-OpioidReport-FINAL-updated.pdf. Accessed July 25, 2018.

4. Substance Abuse and Mental Health Services Administration Behavioral Health Treatment Locator. https://findtreatment.samhsa.gov/. Accessed July 25, 2018.

5. Center on Addiction. CASA analysis of the National Survey on Drug Use and Health, 2009 [Data file]. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. https://www.centeronaddiction.org/addiction-prevention/teenage-addiction. Accessed July 18, 2018.

6. D’Amico, EJ, Chan Osilla, K, Stern, SA. Prevention and Intervention in the School Setting. In Sher, KJ, ed. The Oxford Handbook of Substance Use and Substance Use Disorders, Volume 2. New York, NY: Oxford University Press; 2016: 675-723.

7. Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 State Report. 2016. http://www.texasschoolsurvey.org/Documents/Reports/State/16State712.pdf. Accessed May 30, 2018.

8. Texas Department of State Health Services. 2001-2017 High School Youth Risk Behavior Surveillance System Data. 2017. http://healthdata.dshs.texas.gov/HealthRisks/YRBS. Accessed April 27, 2018.

9. Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health. 2016. https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf. Accessed May 30, 2018.

10. Substance Abuse and Mental Health Services Administration. Substance use disorders. https://www.samhsa.gov/disorders/substance-use. Updated October 27, 2015. Accessed May 29, 2018.

11. National Institute for Alcohol Abuse and Alcoholism. What is a “standard” drink? https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/What-counts-as-a-drink/Whats-A-Standard-Drink.aspx. Accessed May 24, 2018.

12. National Institute on Drug Abuse. 2016-2020 NIDA Strategic Plan. 2016. https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/nida_2016strategicplan_032316.pdf. Accessed May 29, 2018.

13. Martin, CS., Langenbucher, JW, Chung, Sher, KJ. Truth or consequences in the diagnosis of substance use disorders. Addiction. 2014; 109(11): 1773-1778.





https://findtreatment.samhsa.gov/



http://www.texasschoolsurvey.org/Documents/Reports/State/16State712.pdf






https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/nida_2016strategicplan_032316.pdf

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14. Substance Abuse and Mental Health Services Administration. Strategic Prevention Framework. https://www.samhsa.gov/capt/applying-strategic-prevention-framework. Last updated June 5, 2017.Accessed July 30, 2017.

15. Hegar, G. Fiscal notes: Port of Houston. Texas Comptroller of Public Accounts. file:///C:/Users/mromain-harrott/Downloads/fn.pdf. Published April, 2017. Accessed July 30, 2017.

16. Coronado, G. How Houston has become the most diverse place in America. Los Angeles Times. http://www.latimes.com/nation/la-na-houston-diversity-2017-htmlstory.html. Published May 9, 2017. Accessed July 24, 2017.

17. Texas Demographic Center, Population Estimates and Projections Program. Preliminary Estimates of the Total Populations of Counties in Texas for July 1, 2016. http://demographics.texas.gov/Resources/TPEPP/Estimates/2016/Preliminary_2016_txpopest_county.pdf. 2016. Accessed June 5, 2018.

18. U.S. Census Bureau. Map of Texas Counties by Land Area. 2010. http://www.texascounties.net/statistics/landarea.htm. Accessed June 5, 2018.

19. U.S. Department of Health and Human Services. Facing addiction in America: the surgeon general’s report on alcohol, drugs, and health. https://addiction.surgeongeneral.gov/. Published 2017. Accessed July 30, 2017.

20. US Census Bureau, American Community Survey. 5-Year Population Totals and Density Estimates by Regions and Counties 2012-2016. https://assessment.communitycommons.org/CHNA/SelectArea?reporttype=libraryCHNA. Accessed June 6, 2018.

21. U.S. Department of Health and Human Services. Federal poverty level guidelines. https://aspe.hhs.gov/poverty-guidelines. Accessed June 18, 2018.

22. U.S. Bureau of Labor Statistics, Local Area Unemployment Statistics Information and Analysis. Labor Force Data by County, 2017 Annual Averages. 2017. https://www.bls.gov/lau/#tables. Accessed June 28, 2018.

23. Texas Health and Human Services Commission. Temporary Assistance for Needy Families (TANF). https://hhs.texas.gov/about-hhs/records-statistics/data-statistics/data/statistics/temporary-assistance-needy-familites-tanf-statistics. Accessed June 29, 2018.

24. US Census Bureau, American Fact Finder. Annual Estimates of the Annual Population: April 1, 2010 to July 1, 2017. https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk. Accessed July 1, 2018.

25. United States Department of Agriculture Food and Nutrition Service. Child Nutrition Programs – Income Eligibility Guideline – (July 1, 2018 – June 30, 2019). Last published May 8, 2018. https://www.fns.usda.gov/school-meals/fr-050818. Accessed July 20, 2018.

26. Stevens, J., Harman, J.S., & Kelleher, J.K. Race/ethnicity and insurance status as factors associated with ADHD treatment patterns. Journal of Child and Adolescent Psychopharmacology. 2005; 15 (1) 88-96.

27. County Health Rankings and Roadmaps. Texas Data. 2018. http://www.countyhealthrankings.org/app/texas//compare/snapshot.Accessed June 18, 2018.



http://www.texascounties.net/statistics/landarea.htm




https://www.bls.gov/lau/#tables






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28. US Census Bureau, American Fact Finder. Annual Estimates of the Annual Population: April 1, 2010 to July 1, 2017. https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk. Accessed July 1, 2018.

29. Texas Health and Human Services. Supplemental Nutritional Assistance Program (SNAP) Statistics. https://hhs.texas.gov/about-hhs/records-statistics/data-statistics/supplemental-nutritional-assistance-program-snap-statistics. Accessed July 20, 2018.

30. U.S. Department of Education, National Center for Education Statistics: Common Core Data. ELSI-Elementary and Secondary Information System. https://nces.ed.gov/ccd/elsi/tableGenerator.aspx. Accessed April 24, 2018.

31. U.S. Census Bureau. 2008-2016 Small Area Health Insurance Estimates (SAHIE) Using the American Community Survey (ACS). Model-Based SAHIE Estimates for Counties and States: 2016. https://www.census.gov/data/datasets/time-series/demo/sahie/estimates-acs.html. Accessed June 28, 2018.

32. Embleton L, Mwangi A, Vreeman R, Ayuku D, Braitstein P. The epidemiology of substance use among street children in resource-constrained settings: a systematic review and meta-analysis. Journal of Addiction. 2013.

33. U.S. Department of Housing and Urban Development, Office of Community Planning and Development. The 2016 Annual Homeless Assessment Report (AHAR) to Congress. https://www.hudexchange.info/resources/documents/2016-AHAR-Part-1.pdf, Published November, 2016. Accessed July 30, 2017.

34. Texas Education Agency. Year-end enrollment, homelessness enrollment, expulsions, in-school suspensions, and out-of-school suspensions. 2017. Report generated July 5, 2018.

35. Texas Education Agency. County-level homelessness and year-end enrollment rates. 2015, 2016. http://tea.texas.gov/acctres/enroll_index.html. Accessed April, 2017.

36. Texas Department of Public Safety. Texas crime report for 2014, 2015, 2016.: http://www.dps.texas.gov/crimereports/13/citCh2.pdf. Accessed July 10, 2018.

37. Houston Investigative Support center. 2018 Houston High Intensity Drug Trafficking Area (HIDTA) Threat Assessment. Office of National Drug Control Policy. 2018.

38. Texas Department of Public Safety. Crime in Texas Online. Drugs seized reports. https://txucr.nibrs.com/Report/DrugSeized. Accessed July 25, 2017.

39. Texas Alcoholic Beverage Commission. 2018. https://www.tabc.texas.gov/public_information/license_public_information.asp. Accessed July 2, 2018.

40. Texas Comptroller of Public Accounts. Regional Snapshot: Gulf Coast Region. https://comptroller.texas.gov/economy/docs/regions/region-5.pdf. Published 2015. Accessed July 30, 2017.

41. Texas Education Agency. Completion, Graduation, and Dropouts. https://tea.texas.gov/acctres/dropcomp/years.html. Published December 14, 2017. Accessed April 24, 2018.




https://nces.ed.gov/ccd/elsi/tableGenerator.aspx

https://www.census.gov/data/datasets/time-series/demo/sahie/estimates-acs.html

https://www.hudexchange.info/resources/documents/2016-AHAR-Part-1.pdf

http://tea.texas.gov/acctres/enroll_index.html



https://www.tabc.texas.gov/public_information/license_public_information.asp


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42. Texas A&M University. Texas School Survey of Drug and Alcohol Use: 2016 HHSC Region 5 and 6 Report. http://www.texasschoolsurvey.org/Documents/Reports/Region/16Region5-6.pdf. Accessed July 25, 2018.

43. Texas Education Agency. County-level alcohol and controlled substance violation data, 2016-2017. http://tea.texas.gov . Report generated July 17, 2018.

44. Center for Substance Abuse Treatment. Substance Abuse and suicide prevention: Evidence and Implications – A White Paper. DHHS Pub. No. SMA-08-4352. Rockville, MD: Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/shin/content/SMA08-4352/SMA08-4352.pdf. Published 2008. Accessed July 30, 2017.

45. Texas Department of State Health Services. Texas Health Data Center for Health Statistics. Deaths from intentional self-harm (suicide) for 2013, 2014, 2015. http://healthdata.dshs.texas.gov/VitalStatistics/Death. Accessed July 25, 2018.

46. Center for Disease Control and Prevention. High School Youth Risk Behavior Surveillance System (YRBSS). 2017. http://healthdata.dshs.texas.gov/HealthRisks/YRBS. Accessed July 25, 2018.

47. Texas Department of Transportation. Report for DUI Driver Fatalities and DUI Total Fatalities, 2014, 2015, 2016. http://www.txdot.gov/government/enforcement/annual-summary.html. Accessed July 30, 2017.

48. CDC Wonder. Drug- and Alcohol-Induced Deaths. https://wonder.cdc.gov/wonder/help/mcd.html. Accessed July 30, 2018.

49. Texas Department of State Health Services. Texas Health Data Center for Health Statistics. Opioid related deaths. 2015. http://healthdata.dshs.texas.gov/Opioids/Deaths. Accessed July 25, 2018.

50. Texas Department of Criminal Justice. Texas Incarcerations, Drug and Alcohol Offenders on Hand, 2014-2017. Report generated July 1, 2018.

51. Center for Behavioral Health Statistics. Treatment Episode Data Set (TEDS). 2013, 2014, 2015. https://wwwdasis.samhsa.gov/webt/quicklink/TX17.htm. Substance Abuse and Mental Health Services Administration. Accessed July 25, 2018.

52. Southeast Texas Poison Center. Exposures reported to the Texas Poison Center Network during January 2000-June 2018 where the exposure reason was intentional abuse. Report generated on July 3, 2018.

53. Texas Department of State Health Services. Texas EMS and Trauma Registries Portal. http://www.dshs.texas.gov/injury/. Accessed July 3, 2018.

54. Voas, RB, Fell, JC. Programs and policies designed to reduce impaired driving. In: KJ Sher ed. The Oxford Handbook of Substance Use and Substance Use Disorders. Vol. 2.New York, NY: Oxford University Press; 2016:621-674.

55. Substance Abuse and Mental Health Services Administration. Results from the 2016 National Survey on Drug Use and Health: detailed tables. https://www.samhsa.gov/samhsa-data-outcomes-quality/major-data-collections/reports-detailed-tables-2016-NSDUH. Published September 7, 2017. Accessed July 15, 2018.


http://tea.texas.gov/

https://store.samhsa.gov/shin/content/SMA08-4352/SMA08-4352.pdf

https://store.samhsa.gov/shin/content/SMA08-4352/SMA08-4352.pdf

http://healthdata.dshs.texas.gov/VitalStatistics/Death



https://wonder.cdc.gov/wonder/help/mcd.html

http://healthdata.dshs.texas.gov/Opioids/Deaths


http://www.dshs.texas.gov/injury/



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Appendix B Glossary of Terms

ACS American Community Survey

Adolescent An individual between the ages of 12 and 17 years (SAMHSA)

APA American Psychological Association

ATOD Alcohol, tobacco, and other drugs

BAC Blood Alcohol Concentration

BLS U.S. Bureau of Labor Statistics

BRFSS Behavioral Risk Factor Surveillance System

CAPT Southwest Regional Center for Applied Prevention Technologies

CBD Cannabinoid

CDC Centers for Disease Control and Prevention

CHR County Health Rankings

CSAP SAMHSA's Center for Substance Abuse Prevention

Current Use Misuse of a substance in the 30 days before participation in survey

DEA Drug Enforcement Agency

Epidemiology Epidemiology is concerned with the distribution and determinants of health and diseases, sickness, injuries, disabilities, and death in populations

Evaluation Systematic application of scientific and statistical procedures for measuring program conceptualization, design, implementation, and utility; making comparisons based on these measurements; and the use of the resulting information to optimize program outcomes.

EWG Epidemiological Work Group

FBI UCR Federal Bureau-Investigation Uniform Crime Reporting

HHSC Health and Human Services Commission

HIDTA High Intensity Drug Trafficking Area

Incidence Incidence refers to the occurrence of new cases of disease or injury in a population over a specified period of time. (CDC)

IOM Institute of Medicine

Lifetime Use Any misuse of a substance, even just once, in one’s lifetime

NCES National Center for Education Statistics

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NIAAA National Institute on Alcohol Abuse and Alcoholism

NCLB No Child Left Behind

NIDA National Institute on Drug Abuse

NREPP National Registry of Evidence-based Programs and Practices

OCA Texas Office of Court Administration

PDAP Palmer Substance Abuse Program

PMP Prescription Monitoring Program

PPRI Public Policy Research Institute

PRC Prevention Resource Center

Prevalence Prevalence is the proportion of persons in a population who have a particular disease or attribute at a specified point in time or over a specified period of time. Prevalence differs from incidence in that prevalence includes all cases, both new and preexisting, in the population at the specified time, whereas incidence is limited to new cases only. (CDC)

Protective Factor Protective factors are characteristics associated with a lower likelihood of negative outcomes or that reduce a risk factor’s impact. Protective factors may be seen as positive countering events. (SAMHSA)

Risk Factor Risk factors are characteristics at the biological, psychological, family, community, or cultural level that precede and are associated with a higher likelihood of negative outcomes. (SAMHSA)

RNA Regional Needs Assessment

SAMHSA Substance Abuse and Mental Health Services Administration

SNAP Supplemental Nutrition Assistance Program

Substance Misuse The use of a substance for a purpose not consistent with legal or medical guidelines. This term often describes the use of a prescription drug in a way that varies from the medical direction, such as taking more than the prescribed amount of a drug or using someone else's prescribed drug for medical or recreational use.

Substance Use The consumption of low and/or infrequent doses of alcohol and other drugs such that damaging consequences may be rare or minor. Substance use might include an occasional glass of wine or beer with dinner, or the legal use of prescription medication as directed by a doctor to relieve pain or to treat a behavioral health disorder.

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SPF Strategic Prevention Framework. SAMHSA’s SPF is a planning process for preventing substance use and misuse. The five steps and two guiding principles of the SPF offer prevention professionals a comprehensive process for addressing the substance misuse and related behavioral health problems facing their communities. (SAMHSA)

SUD Substance Use Disorder. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), no longer uses the terms substance abuse and substance dependence, rather it refers to substance use disorders, which are defined as mild, moderate, or severe to indicate the level of severity, which is determined by the number of diagnostic criteria met by an individual. Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. According to the DSM-5, a diagnosis of substance use disorder is based on evidence of impaired control, social impairment, risky use, and pharmacological criteria. Disorders include: Alcohol Use Disorder (AUD), Tobacco Use Disorder, Cannabis Use Disorder, Stimulant Use Disorder, Hallucinogen Use Disorder, and Opioid Use Disorder. (SAMHSA)

TANF Temporary Assistance for Needy Families

TDC Texas Demographic Center

TEA Texas Education Agency

TJJD Texas Juvenile Justice Department

TSS Texas School Survey

TxDOT Texas Department of Transportation

TxDPS Texas Department of Public Safety

USCB U.S. Census Bureau

WHO World Health Organization

YRBSS Youth Risk Behavior Surveillance System

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Appendix C List of Tables

Table 1. Region 6 county-level total population and population density estimates: 2012-2016 6

Table 2. Region 6 county-level population estimates and percentages by age category, Age 0-34: 2012-2016 7

Table 3. Region 6 county-level population estimates and percentages by age category, Ages 35-65+: 2012-2016 8

Table 4. Region 6 county-level limited English proficient population estimates: 2012-2016 14

Table 5. Region 6 county-level per capita income: 2012-2016 17

Table 6. Region 6 county-level labor force totals and percent unemployment: 2015, 2016, 2017 18

Table 7. Region 6 county-level totals and percentages of children from single-parent households, five year estimates: 2010-2014, 2011-2015, 2012-2016 20

Table 8. Region 6 county-level Temporary Assistance to Needy Families (TANF) recipients per 100,000: 2015, 2016, 2017 21

Table 9. Region 6 county-level Supplemental Nutrition Assistance Program (SNAP) recipients per 100,000: 2014, 2015, 2016 22

Table 10. Region 6 county-level percentages of children eligible for free or reduced cost lunch: 2014, 2015, 2016 23

Table 11. Region 6 county-level counts and percentages for uninsured children: 2014, 2015, 2016 24

Table 12. Region 6 county-level child homelessness and year-end enrollment rates: 2015, 2016, 2017 26

Table 13. Table 13. Region 6 county-level indices of property crime per 100,000: 2014, 2015, 2016 28

Table 14. Region 6 county-level indices of property crime subcategories of burglary, grand larceny, and auto theft per 100,000: 2016 29

Table 15. Region 6 county-level indices of violent crime per 100,000: 2014, 2015, 2016 30

Table 16. Region 6 county-level indices of violent crime subcategories of murder, rape, robbery, and assault per 100,000: 2016 31

Table 17. Region 6 county-level counts of active alcohol sales permits and permit density per square mile: 2017 34

Table 18. Region 6 county-level dropout rates: 2014, 2015, 2016 33

Table 19. Region 6 county-level school expulsion and suspension counts: 2015, 2016, 2017 37

Table 20. Region 5/6 and Texas comparisons of conduct problems at and absences from school, Grades 7-12: TSS, 2016 38

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Table 21. Region 6 county-level school alcohol and controlled substance violation data: 2016-2017 39

Table 22. Region 6 county-level incidents of death by suicide per 100,000: 2013, 2014, 2015 47

Table 23. Region 6 county-level drug and alcohol-induced deaths per 100,000: 2012-2016 57

Table 24. Region 6 county-level DUI alcohol related fatalities: 2014, 2015, 2016 59

Table 25. Region 6 county-level counts of offenses of record: 2015, 2016, and 2017 61

Table 26. Texas and national treatment admissions for substance misuse and SUDs: 2013, 2014, 2015 62

Table 27. Region 6 county-level counts of exposures for which the reason was intentional abuse: 2010-2017 63

Table 28.Region 6 county-level counts of EMS runs with primary symptom of overdose from alcohol or drugs: 2010-2014, 2016 64

Table 29. Region 6 PRC community partners and community coalitions: FY2018 68

Table 30. Region 5/6 and Texas comparisons of student reports on sources from which they received information on alcohol and drugs, Grades 7-12: TSS, 2016 71

Table 31. Region 6 county-level graduation and dropout rates: 2014, 2015, 2016 73

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Appendix D List of Figures

Figure 1. Current areas serviced by Prevention Resource Centers in Texas vii

Figure 2. Risk and protective factors for alcohol and other drug use x

Figure 3. NIAAA (2004) rubric for operationalizing alcohol consumption into unit of measurement across beverage type xii

Figure 4. Strategic Prevention Framework (SPF) 2

Figure 5. Location and 13 counties of Region 6 in Texas 3

Figure 6. Region 6 county-level population estimate totals, density and percentages by race and ethnicity, 2012-2016 9

Figure 7. Federal Poverty Level: 2018 16

Figure 8. Houston HIDTA designated counties 32

Figure 9. Regions 5 and 6 and Texas, Grades 7-12 report of class attendance while drunk or high, Grades 7-12:TSS,2016 38

Figure 10. Region 5/6 and Texas comparisons of students’ perceptions of parental attitudes toward consumption of alcohol, Grades 7-12: TSS, 2016 40

Figure 11. Region 5/6 and Texas comparisons of students’ perceptions of parental attitudes toward use of marijuana, Grades 7-12: TSS, 2016 41

Figure 12. Region 5/6 and Texas comparisons of students’ perceptions of parental attitudes toward use of tobacco, Grades 7-12: TSS, 2016 41

Figure 13. Regions 5/6 and Texas, perception of peer consumption of alcohol, Grades 7-12: TSS, 2016 42

Figure 14. Regions 5/6 and Texas, perception of peer consumption of marijuana, Grades 7-12: TSS, 2016 42

Figure 15. Regions 5/6 and Texas, perception of peer consumption of tobacco, Grades 7-12: TSS, 2016 43

Figure 16. Region 5/6 and Texas comparisons, perceived accessibility to alcohol, tobacco, and marijuana, Grades 7-12: 2016 43

Figure 17. Regions 5/6 and Texas comparisons of accessible sources of alcoholic beverages, Grades 7-12: 2016 44

Figure 18. Regions 5/6 and Texas, reports of presence of alcohol at parties, Grades 7-12: TSS, 2016 45

Figure 19. Regions 5/ 6 and Texas, reports of presence of marijuana and/or other drugs at parties, Grades 7-12: TSS, 2016 45

Figure 20. National, youth reports on where they obtain prescription drugs not prescribed to them, Ages 12-17: NSDUH, 2016 46

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Figure 21. Region 5/6 and Texas comparisons of indicators of current use and lifetime use of alcohol, TSS Grades 7-12: 2016 48

Figure 22. Region 5/6 and Texas comparisons of high-risk alcohol consumption behaviors, Grades 7-12: TSS, 2016 49

Figure 23. Region 5/6 and Texas comparisons of indicators of current use and lifetime use of marijuana, Grades 7-12: TSS, 2016 50

Figure 24. Regions 5 and 6 and Texas comparisons of high-risk marijuana consumption

behaviors, Grades 7-12: TSS, 2016 50

Figure 25. Region 5/6 and Texas comparisons of indicators of current use and lifetime use of

prescription drugs, Grades 7-12: TSS, 2016 51

Figure 26. Region 5/6 and Texas comparisons of indicators of current use and lifetime use of tobacco, Grades 7-12: TSS, 2016 52

Figure 27 .Texas trends in adolescents’ alcohol consumption, Grades 7-12: TSS 2008, 2010, 2012, 2014, 2016 53

Figure 28. Texas trends in adolescents’ tobacco consumption, Grades 7-12: TSS 2008, 2010, 2012, 2014, 2016 53

Figure 29. Texas trends in adolescents’ marijuana consumption, Grades 7-12: TSS 2008, 2010, 2012, 2014, 2016 54

Figure 30. Texas trends in adolescents’ illicit drug consumption, Grades 7-12: TSS 2008, 2010, 2012, 2014, 2016 54

Figure 31. Texas trends in adolescents’ prescription drug consumption, Grades 7-12: TSS, 2008, 2010, 2012, 2014, 2016 55

Figure 32. Texas trends in adolescents’ alcohol consumption, Grades 9-12: YRBS, 2001, 2005, 2007, 2009, 2011, 2013, 2017 55

Figure 33. Texas trends in adolescents’ marijuana consumption, Grades 9-12: YRBS, 2001,

2005, 2007, 2009, 2011, 2013, 2017 56

Figure 34. Texas trends in adolescents’ life time use of substances, Grades 9-12: YRBS, 2001,

2005, 2007, 2009, 2011, 2013, 2017 56

Figure 35.Texas opioid overdose deaths by county: 2015 58

Figure 36. Region 5/6 and Texas comparisons of students’ self-reports of driving while under

the influence of alcohol, Grades 9-12: TSS, 2016 60

Figure 37. Region 5/6 and Texas comparisons of students’ self-reports of driving while under

the influence of drugs, Grades 7-12: TSS, 2016 60

Figure 38. Texas adolescent treatment episodes by substance, Ages 12-17: 2016 62

Figure 39. Percent increase in physicians’ Prescription Drug Monitoring Program queries from

2016 to 2017 67

Figure 40. Region 5/6 and Texas comparisons of student reports of individuals to whom they

would reach out for help if they had a drug or alcohol problem. 74

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Figure 41. Region 5/6 and Texas comparisons of students’ perceptions of parental attitudes

toward consumption of alcohol, Grades 7-12: TSS, 2016 75

Figure 42. Region 5/6 and Texas comparisons of students’ perceptions of parental attitudes

toward use of marijuana, Grades 7-12: TSS, 2016 75

Figure 43. Regions 5/6 and Texas youth perception of peer consumption versus actual consumption of alcohol, Grades 7-12: TSS, 2016

77

Figure 44. Regions 5/6 and Texas youth perception of peer consumption versus actual

consumption of marijuana, Grades 7-12: TSS, 2016 77

Figure 45. Regions 5/6 and Texas youth perception of peer consumption versus actual

consumption of tobacco, Grades 7-12: TSS, 2016 78

Figure 46. Region 5/6 and Texas, perceived risk of harm from alcohol, tobacco, marijuana, and

prescription drugs, Grades 7-12: TSS, 2016 79

Figure 47. Region 5/6 and Texas perceived risk of harm from cocaine, crack, ecstasy, and

steroids, Grades 7-12: TSS, 2016 79

Figure 48. Region 5/6 and Texas perceived risk of harm from heroin, methamphetamines, and

synthetic cannabinoids, Grades 7-12: TSS, 2016 80

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Appendix E Texas Department of Public Safety, Houston Police Department Drug

Seizures, June 2017-June 2018

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Appendix F Sample of Region 6 HHSC-Funded Substance Abuse Prevention

Coalition Work Quarterly Work – 1st Quarter, FY2018

Brazoria Community Coalition/Bay Area Council on Drugs and

Alcohol

Fiscal Year 2018 Dates covered: September 1 – November 30, 2017

Coalition Director/Coordinator: Dannielle Meyer Email: [email protected]

Phone: 832-330-5898 Website: www.bacoda.org

Physical Address: 2911 South Shore Blvd. League City

Circle one: HHSC Funded or Non-HHSC Funded

1. Describe your coalition’s service area (e.g., county, counties, zip codes, etc.) Populations

330,242, 18 cities/towns, 2 junior colleges, 8 school districts, 4 state highways, 1,597 Square

miles.

2. Treatment/Intervention providers in your coalition’s service area with whom you work.

Brazos Place, Pathway to Recovery, ADAPT, Serenity Light, PaRC Pearland, Gulf Coast Center

3. Please list and describe each activity/event, as well as its outcome, in which your coalition

has been involved during the indicated fiscal quarter. Please list under the appropriate

categories, below.

a) Youth: Brazosport BISD: Prom Promise at Brazosport HS Student Council/Coalition

Members & Brazowood HS PALS Program. Safe Retail Practices Campaign to local limo

companies and retailers with liquor licenses & Underage Drinking and Driving campaign on

campus.

b) Parents: Parent Education at Lighthouse Learning Center (Disciplinary school in BISD).

Part of an entire process each student (and their guardian) must complete before student

can return back to their home campus.

c) Business Community: Collaboration with local Pharmacy to supply Deterra Bags to the

community, pharmacist received naloxone training so she can make it available to the

community, supporter of proper Rx disposal and opioid abuse prevention. Partnering with

Dow to allow all collected Rx to be incinerated on their site.

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d) Media: The Facts supports our coalition with numerous articles. I’ve been a guest columnist

and front page articles. I proposed an article on CVS and Walgreens lack of knowledge with

naloxone and the reporter wrote it. Our incineration objective was featured in a magazine

sponsored by The Facts called Gulf Coast Giants.

e) Schools: Alvin ISD: continued collaboration on a Project Graduation objective to prevent

drinking and driving during graduation weekend. Educated their counselors on drug trends

and presented the movie “Why Me” including the movie’s creator as the guest speaker.

BISD: Ongoing collaboration on numerous objectives (Prom Promise, Underage Drinking

Synthetic Drugs, Marijuana prevention, National Chat Facts Day, Responsible Retailer

Campaign, Parent Education, Town Halls, Naloxone presentation to Nurses & Counselors,

Opioid/RX presentations to staff, faculty, coaches.)

f) Youth-serving organizations: Collaborate with both local colleges to support Safe Spring

Break, Alcohol Prevention Week and Fall Festival.

g) Law enforcement agencies: 9 law enforcement agencies are coalition members.

Numerous objectives with LE. Example: 9 Rx drop boxes collecting and incinerating over

2,000lbs per year. Each agency changed policy in regards to collecting and disposing of Rx

within the field. Two agencies now carry naloxone with several others to follow. Officers

attend our trainings, town halls.

h) Religious or fraternal organizations

i) Civic and Volunteer groups

j) Healthcare Professionals

k) State, local, or tribal agencies with expertise in the field of substance abuse

l) Other organizations involved in reducing substance misuse and SUDs

4. Please list any upcoming activities/events and/or data collection efforts that you would like

your fellow coalitions, constituents, and stakeholders to know about.

My coalition has been in the forefront of Rx prevention. Our Rx Task Force began in 2013

starting with the proper disposal and incineration objective (we had an objectives within Policy,

Enforcement, Education, Communication & Collaboration Strategies.) By June 2014, we had 4

working drop boxes. We now house 9 within Brazoria County. We have a signed MOU with

Dow Chemical to provide all of our incineration (in-kind.) Both objectives completed way

before other coalitions even began discussing it. We have collaborated with other coalitions

within the state to assist with their own Rx Disposal Campaigns. At one point, we had more

information than our stakeholders. (Only one of our boxes were purchased. The rest were

provided via a grant from NADDI. We also assisted with 4 other law enforcement agencies

outside our county to receive granted NADDI boxes.)

My coalition has sponsored The National Rx Take Backs since 2012. At one point we had 10

drop off locations throughout the county and the DEA asked us to limit the locations due to the

lack of officers! And, a U-Haul truck was needed to pick up our collections.

We started the naloxone dialogue over 2 years ago. We began the discussion with law

enforcement with the objective to place naloxone in each car. We began teaching our

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community the importance of having it in their first-aid kits. We investigated and found out

CVS and Walgreens were not following through with their promises before anyone else knew of

this issue. We reported it to our stakeholders.

We are currently working on:

The objective to increase education to our local medical staff on prescribing, using PMP and

addiction. Also encouraging our local pharmacist to take the class required to distribute

naloxone and education on the standing order.

Continued collaboration with Winning The Fight and Kathy O’Keefe (Flowermound, Tx.)

National Rx Take Back on April 28th (3 locations)

ANNOUNCEMENT:

Collaboration with BISD, Gulf Coast Center, Serenity Light and Brazosport College to bring the

documentary The Last High to Brazoria County on April 26th, 6:30pam-8:30pm @ Brazosport

College.

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Appendix G Young Adult and Adult Mental Health and Substance Abuse Treatment Providers in Region 6

Adult/Young Adult Providers Address City Zip Phone Website

MH/ SA

Brazoria County

Sweeny Community Hospital

305 North McKinney Street Sweeny 77480 979-548-1500 x1550 http://www.sweeneyhospital.org MH

Gulf Coast Center 101 Brennen Lane Alvin 77511 281-331-4502 http://www.gulfcoastcenter.org MH

Santa Maria 713 West Adoue Street Alvin 77511 713-691-0900 http://santamariahostel.org SA

Pathway to Recovery 135 West Locust Street Angleton 77515 979-549-0385 http://www.pathwaytorecovery.com SA

Gulf Coast Center 101 Tigner Street Angleton 77515 979-848-0933 http://www.GulfCoastCenter.org MH

Saint Genevieve 141 North Brazosport Boulevard Clute 77531 979-265-0705 http://stgenevieve.weebly.com SA

Fort Bend

Westpark Springs Hospital 6902 South Peek Road Richmond 77407 832-535-2770 http://www.westparksprings.com MH

Turning Point Inc 117 Lane Drive Rosenberg 77471 346-702-4670 http://TTPI.NET SA

Fort Bend Regional Council on 3926 Avenue H Rosenberg 77471 281-342-8828 http://www.fortbendcouncil.org/ SA

Fort Bend District Office 12300 Parc Crest Drive Stafford 77477 713-861-4849 http://www.familyhouston.org MH

TRS Behavioral Care Inc

403 West Grand Parkway South Katy 77494 281-465-4500 http://www.rightstep.com SA

Galveston County

Bay Area Recovery Center 3111 Yupon Street Dickinson 77539 281-337-3322 http://www.bayarearecovery.com SA

Excel Center at Friendswood

111 East Edgewood Drive

Friendswood 77546 281-648-1200 http://www.westoakshospital.com MH

Gulf Coast Center 123 Rosenberg Street Galveston 77550 409-763-2373 http://www.gulfcoastcenter.org MH

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Alcohol Drug Abuse Womens Center 201 First Street Galveston 77550 409-763-5516 x7 http://www.adawomenscenter.org SA

UTMB Outpatient Clinic 400 Harborside Drive Galveston 77555 409-772-0770 http://www.utmb.edu/psychiatry MH

University of TX Med Branch Hosp

301 University Boulevard Galveston 77555 409-772-1011 http://www.utmb.edu MH

Toxicology Associates Inc 2411 Franklin Street La Marque 77568 409-935-3749

http://www.toxicologyassociates.com SA

Gulf Coast Center 7510 FM 1765 Texas City 77591 409-935-6083 http://www.gulfcoastcenter.org MH

Bay Area Recovery Center 4316 Washington Street Dickinson 77539 281-337-1343 http://www.bayarearecovery.com SA

Bay Area Recovery Center 2523 44th Street Dickinson 77539 281-337-1343 http://www.bayarearecovery.com SA

Kemah Palms Recovery 1013 Delesandri Lane Kemah 77565 713-568-1210 http://www.kemahpalms.com SA

Harris County

Houston Maintenance Clinic Inc 4608 Main Street Houston 77002 713-527-0064 http:// SA

Saint Joseph Medical Center

1404 Saint Joseph Parkway Houston 77002 713-757-7512 http://sjmctx.org MH

Career and Recovery Resources Inc 2525 San Jacinto Street Houston 77002 713-754-7000 http://www.careerandrecovery.org SA

Set Free DAT Center 3333 Fannin Street Houston 77004 713-520-8042 http:// SA

Harris Center for Mental Health and 1215 Dennis Street Houston 77004 713-658-0972 http://www.mhmraharris.org MH

Toxicology Associates Inc 4405 Caroline Street Houston 77004 713-528-2071


Montrose Counseling Center Inc 401 Branard Street Houston 77006 713-529-0037

http://www.montrosecenter.org/hub/services/way-out-recovery-program/ SA

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Family Services of Greater Houston 4625 Lillian Street Houston 77007 713-861-4849 http://Familyhouston.org MH

Center for Recovering Families at 303 Jackson Hill Street Houston 77007 713-914-0556 http://www.councilonrecovery.org SA

Institute of Chem Dependency Studies 1235 North Loop West Houston 77008 866-523-2669 http://www.cdstudies.com SA

Assoc for the Adv of Mex Amer Inc 204 Clifton Street Houston 77011 713-926-2450 http://www.aama.org SA

Texas Alcoholism Foundation Inc 2208 West 34th Street Houston 77018 713-956-6337 x12 http://www.texas-house.org SA

David and Ivory Ministries Inc 4728 Gunter Street Houston 77020 713-675-3823 http://www.davidivoryministries.org SA

Harris County Psychiatric Center

2800 South MacGregor Way Houston 77021 713-741-5000 http://www.hcpc.uth.tmc.edu MH

Texas Clinic 6311 Fulton Street Houston 77022 713-694-8100 http://www.texasclinic.com SA

Unlimited Visions Aftercare Inc 5527 Lawndale Street Houston 77023 713-921-2276

http://www.unlimitedvisionsaftercare.org SA

Michael E DeBakey VAMC

2002 Holcombe Boulevard Houston 77030

713-791-1414 x28907 http://www.mentalhealth.va.gov MH

Houston Treatment Center Inc 1050 Edgebrook Drive Houston 77034 713-947-1773 http:// SA

Post Oak Care Center 1147 Brittmoore Road Houston 77043 713-960-0344 http://www.postoakscarecenter.com MH

UTHealth CNRA 1941 East Road Houston 77054 713-486-2800 http://med.uth.edu/psychiatry/research/addiction SA

Texas Clinic 9320 Westview Drive Houston 77055 713-468-0536 http://www.texasclinic.com SA

Santa Maria Hostel Inc 2005 Jacquelyn Street Houston 77055 713-957-2413 x113 http://www.santamariahostel.org SA

Passages Inc 7722 Westview Drive Houston 77055 713-957-4910 http://www.passagesforwomen.com SA

Lifestream Behavioral Health 123 Northpoint Drive Houston 77060 281-445-9700 http:// SA

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West Oaks Hospital 6612 Hornwood Drive Houston 77074 713-774-0606 http://www.westoakshospital.com MH

Harris Center for Mental Health and 9401 SW Freeway Houston 77074 713-970-7000 http://mhmraharris.org MH

Adult Rehabilitation Services Inc 6624 Hornwood Street Houston 77074 713-541-4422 http://www.Adult-Rehab.com SA


Behavioral Hospital of Bellaire 5314 Dashwood Drive Houston 77081 713-600-9500 http://www.bhbhospital.com/ MH

Texas American Medical Consultants

7428 Park Place Boulevard Houston 77087 713-645-6303

http://www.americanhealthservices.org SA

Counseling and Recovery Services 705 Malone Street Tomball 77375 281-351-8585

http://www.counselingandrecoveryservices.com SA

Lone Star Behavioral Health Cypress 16303 Grant Road Cypress 77429 281-516-6200 http://lonestarbehavioralhealth.com MH

Unlimited Visions Aftercare Inc 313 Highway 146 South Baytown 77520 281-427-8786

http://www.unlimitedvisionsaftercare.org SA

Harris Center for Mental Health and 2627 Caroline Street Houston 77004 713-970-7413 http:// MH

El Dorado Texas Community Services 1213 Durham Drive Houston 77007 713-636-9138 http://americanhealthservices.org SA

Jewish Family Service

4131 South Braeswood Boulevard Houston 77025 713-667-9336 http://www.jfshouston.org MH

Innerwisdom Inc 10777 Stella Link Road Houston 77025 713-592-9292 http://www.innerwisdom.com MH

Best Recovery Healthcare Inc 9211 South Main Street Houston 77025 713-661-0971 http:// SA

LH Transitional Center Inc 2410 Caplin Street Houston 77026 713-692-1728 http:// SA

Ben Taub Hospital 1502 Taub Loop Houston 77030 713-873-5130 http:// MH

New Dimensions Day Trt Centers 1345 Space Park Drive Houston 77058 281-333-2284 http://www.nddtreatment.com MH

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Into Action Recovery Center Inc 17337 El Camino Real Houston 77058 844-694-3576 http://intoactionrecovery.com SA

Family Houston 1300 Bay Area Boulevard Houston 77058 281-282-6045 http://www.familyhouston.org MH

Into Action Recovery Center Inc 17250 El Camino Real Houston 77058 844-694-3576 http://intoactionrecovery.com SA

Toxicology Associates Inc 530 North Belt Street Houston 77060 281-847-2093 x7


Toxicology Associates Inc 6910 Bellaire Boulevard Houston 77074 713-271-0067


Harris Center 5901 Long Drive Houston 77087 713-970-4300 http://www.mhmraharris.org/ MH

Alliance Risk Group LLC

7445 Park Place Boulevard Houston 77087 832-767-1560 http://www.gatewaysobriety.com SA

Cypress Creek Hospital Inc 17750 Cali Drive Houston 77090 281-586-7600 x7600

http://www.cypresscreekhospital.com SA

Cypress Creek Hospital 17750 Cali Drive Houston 77090 281-586-7600

http://www.cypresscreekhospital.com MH

Intracare North Hospital

1120 Cypress Station Drive Houston 77090 281-893-7200 http://www.intracare.org MH

Texas Treatment Centers Inc 4800 West 34th Street Houston 77092 713-956-7712 http:// SA

MH/MR Authority of Harris County 3737 Dacoma Street Houston 77092 713-970-8400 http://www.mhmraharris.org MH

Santa Maria Hostel Inc 2605 Parker Road Houston 77093 713-691-0900 http://www.santamariahostel.org SA

Road to Recovery 9400 Lomax Street Houston 77093 713-742-6514 http://www.rtrtx.com SA

Cheyenne Center Inc 10525 Eastex Freeway Houston 77093 713-691-4898 http://www.cheyennecenter.com SA

Pasadena Substance Abuse Clinic

1645 Pasadena Boulevard Pasadena 77502 713-473-1405

http://www.pasadena-substance-abuse-clinic.com SA

San Jacinto Methodist Hospital 1700 James Bowie Drive Baytown 77520 281-420-6736 http://houstonmethodist.org MH

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Memorial Hermann Prevention and 3722 North Main Street Baytown 77521 281-837-7373 http://parc.memorialhermann.org/ SA

Bay Area Recovery Center

506 West NASA Parkway Webster 77598 281-332-5428 http://www.bayarearecovery.com SA

Watershed at Clear Lake Inc

20 Professional Park Drive Webster 77598 281-724-6162 http://www.thewatershed.com SA

UTMB Psychiatry 400 Texas Avenue Webster 77598 281-338-2798 http:// MH

Tri County Behavioral Healthcare 2000 Panther Lane Liberty 77575 936-334-3299 http://www.TCBHC.org MH

Tri County Behavioral Healthcare 2004 Truman Street Cleveland 77327 281-432-3000 http://www.TCBHC.org MH

Matagorda County

MEHOP Behavioral Health Clinic 1700 Golden Avenue Bay City 77414 979-245-2008

http://mehop.org/services/behavioral-health MH

Montgomery County

Woodlands District Office 1600 Lake Front Circle Spring 77380 713-861-4849 http://www.familyhouston.org MH

Conroe Treatment and Recovery Ctr 501 Everett Street Conroe 77301 936-441-9172 http://www.huntsvilleclinicinc.com SA

Aspire Hospital LLC 2006 South Loop 336 West Conroe 77304 936-647-3500 http://www.aspirehealthcorp.com MH

TRS Behavioral Care Inc 5452 Highway 105 Conroe 77304 936-828-3908 http://www.rightstep.com SA

New Dimensions Day Trt Centers 25511 Budde Road Spring 77380 800-685-9796 http://www.nddtreatment.com MH

Walker County

Tri County Behavioral Healthcare

7045 State Highway 75 South Huntsville 77340 936-291-5800 http://www.tcbhc.org MH

Huntsville Clinic Inc 829 10th Street Huntsville 77320 936-291-9172 http://www.huntsvilleclinicinc.com SA

Waller County

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Career and Recovery Resources Inc 531 FM 359 South Brookshire 77423 832-563-6756 http://www.careerandrecovery.org SA

Career and Recovery Resources Inc 925 5th Street Hempstead 77445 832-563-6756 http://www.careerandrecovery.org SA

Wharton County

Straightway Inc FM 1161 and County Road 218 Hungerford 77448 979-532-5613 http://www.straightway.org SA

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Child and Adolescent Mental Health and Substance Abuse Treatment Providers in Region 6 Child and Adolescent Facilities

Address City Zip Phone Website MH/ SA

Brazoria County

Sweeny Community Hospital

305 North McKinney Street

Sweeny 77480 979-548-1500 x1550 http://www.sweeneyhospital.org MH

Adapt Programs LLC 2512 North Velasco Angleton 77515 979-480-3327 http://www.adaptprograms.com SA

Adapt Programs LLC 210 West 1st Street Freeport 77541 979-480-3327 http:// SA

Adapt Programs LLC 20514 Highway 6 Manvel 77578 832-457-3540 http://www.adaptprograms.com SA

Fort Bend

Westpark Springs Hospital

6902 South Peek Road Richmond 77407 832-535-2770 http://www.westparksprings.com SA

Fort Bend Regional Council on

10435 Greenbough Street

Stafford 77477 281-207-2400 http://www.fortbendcouncil.org/ SA

Westpark Springs Hospital

6902 South Peek Road Richmond 77407 832-535-2770 http://www.westparksprings.com MH

DePelchin Childrens Center

710 South 7th Street Richmond 77469 281-342-4906 http://www.depelchin.org MH

Fort Bend District Office

12300 Parc Crest Drive Stafford 77477 713-861-4849 http://www.familyhouston.org MH

Galveston County

Excel Center at Friendswood

111 East Edgewood Drive

Friendswood

77546 281-648-1200 http://www.westoakshospital.com MH

UTMB Outpatient Clinic

400 Harborside Drive Galveston 77555 409-772-0770 http://www.utmb.edu/psychiatry MH

University of TX Med Branch Hosp

301 University Boulevard

Galveston 77555 409-772-1011 http://www.utmb.edu MH

Adapt Programs LLC 1228 North Logan Street

Texas City 77590 409-908-3004 http:// SA

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Pathway to Recovery 1224 Linton Street La Marque 77568 409-933-1437 http://www.pathwaytorecovery.com SA

Pathway to Recovery 2119 Oak Street La Marque 77568 409-933-4366 http://www.pathwaytorecovery.com SA

Harris County

DePelchin Childrens Center

4950 Memorial Drive Houston 77007 713-730-2335 http://www.depelchin.org/ MH

Jewish Family Service

4131 South Braeswood Boulevard

Houston 77025 713-667-9336 http://www.jfshouston.org MH

Innerwisdom Inc 10777 Stella Link Road Houston 77025 713-592-9292 http://www.innerwisdom.com MH

Ben Taub Hospital 1502 Taub Loop Houston 77030 713-873-5130 http:// MH

New Dimensions Day Trt Centers

1345 Space Park Drive Houston 77058 281-333-2284 http://www.nddtreatment.com MH

Family Houston 1300 Bay Area Boulevard

Houston 77058 281-282-6045 http://www.familyhouston.org MH

New Dimensions Day Treatment Ctr

1345 Space Park Drive Houston 77058 281-333-2284 x1307 http://www.newdimensionsdayhospital.com

SA

Guardian Angels I Residential

9530 West Montgomery Road

Houston 77088 281-447-1812 http:// MH

Cypress Creek Hospital

17750 Cali Drive Houston 77090 281-586-7600 http://www.cypresscreekhospital.com

MH

Intracare North Hospital

1120 Cypress Station Drive

Houston 77090 281-893-7200 http://www.intracare.org MH

Turning Point Inc 5815 Antoine Street Houston 77091 713-602-3459 http:// SA

Houston Serenity Place Inc

6509 Morrow Street Houston 77091 713-691-5453 http://www.serenityrtc.com MH

Turning Point Inc 9111 Eastex Freeway Houston 77093 713-884-2642 http:// SA

Texas Prevention Network Inc

10103 Fondren Road Houston 77096 713-981-6063 http:// SA

Kingwood Pines Hospital

2001 Ladbrook Drive Kingwood 77339 281-404-1001 http://www.kingwoodpines.com SA

UTMB Psychiatry 400 Texas Avenue Webster 77598 281-338-2798 http:// MH

Harris Center for Mental Health and

2525 Murworth Drive Houston 77054 713-394-4494 http://www.mhmraharris.org MH

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Shamar Hope Haven 2719 Truxillo Street Houston 77004 713-942-8009 http://www.shamarhopehaven.org SA


902 West Alabama Street

Houston 77006 713-528-3709 http://www.rightstep.com SA

Family Services of Greater Houston

4625 Lillian Street Houston 77007 713-861-4849 http://Familyhouston.org MH

Assoc for the Adv of Mex Amer Inc

204 Clifton Street Houston 77011 713-926-9491 x3101 http://www.aama.org SA

Northshore Treatment Center

176 Uvalde Road Houston 77015 713-455-7008 http:// SA

Phoenix House of Texas

501 Garden Oaks Boulevard

Houston 77018 844-748-3927 http://www.phoenixhouse.org SA

Center for Success and Independence

3722 Pinemont Drive Houston 77018 713-426-4545 http://tcsi.org/programs/residential-treatment-program/

SA

Harris County Psychiatric Center

2800 South MacGregor Way

Houston 77021 713-741-5000 http://www.hcpc.uth.tmc.edu MH

Assoc for the Adv of Mex Amer Inc

6001 Gulf Freeway Houston 77023 713-929-2450 http://aama.org SA

Turning Point Inc 10175 Harwin Drive Houston 77036 713-773-3280 http://www.ttpi.net/ SA


17398 Northwest Freeway

Houston 77040 281-465-4500 http://www.rightstep.com SA

Post Oak Care Center

1147 Brittmoore Road Houston 77043 713-960-0344 http://www.postoakscarecenter.com MH

Unity Childrens Home

11805 Trickey Road Houston 77067 281-537-6148 http://www.unitychildrenshome.com MH

Spirit Mind and Body 6776 SW Freeway Houston 77074 713-988-4878 http:// SA


West Oaks Hospital Inc

6500 Hornwood Drive Houston 77074 713-778-5250 http://www.westoakshospital.com SA


Memorial Hermann Prev/Rec Ctr

3043 Gessner Street Houston 77080 713-939-7272 http://www.mhparc.org SA

Behavioral Hospital of Bellaire

5314 Dashwood Drive Houston 77081 713-600-9500 http://www.bhbhospital.com SA

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Behavioral Hospital of Bellaire

5314 Dashwood Drive Houston 77081 713-600-9500 http://www.bhbhospital.com/ MH

Sheltering Harbour 17803 West Strack Drive

Spring 77379 281-379-4578 http://shelteringharbour.org MH

Unlimited Visions Aftercare Inc

907 Preston Street Pasadena 77503 713-534-8191 http://www.unlimitedvisions.org SA

Cease Addiction Now Inc

401 West Texas Avenue

Baytown 77520 281-427-4226 http://www.ceaseaddictionnow.org SA

Lutheran Soc Servs of the South Inc

25752 Kingsland Boulevard

Katy 77494 281-392-7505 http://www.upbring.org MH


403 West Grand Parkway South

Katy 77494 281-465-4500 http://www.rightstep.com SA

Liberty County


2004 Truman Street Cleveland 77327 281-432-3000 http://www.TCBHC.org MH


2000 Panther Lane Liberty 77575 936-334-3299 http://www.TCBHC.org MH

Adapt Programs LLC 2800 Beaumont Avenue

Liberty 77575 979-480-3327 http:// SA

Matagorda County

MEHOP Behavioral Health Clinic

1700 Golden Avenue Bay City 77414 979-245-2008 http://mehop.org/services/behavioral-health

MH

Montgomery County


233 Sargent Ed Holcomb Boulevard South

Conroe 77304 800-550-8408 http://www.tcbhc.org SA

New Dimensions Day Trt Centers

25511 Budde Road Spring 77380 800-685-9796 http://www.nddtreatment.com MH

Woodlands District Office

1600 Lake Front Circle Spring 77380 713-861-4849 http://www.familyhouston.org MH

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New Dimensions Day Treatment Centers

25511 Budde Road Spring 77380 800-685-9796 http://www.newdimensionsdayhospital.com

SA

Houston Wee Care Shelter Inc

28915 South Plum Creek Drive

Spring 77386 281-363-4020 http://wecaretreatmentcenter.com/ MH

Walker County

ADAPT Programs 1523 Normal Park Drive

Huntsville 77340 936-303-0808 x1028 http:// SA

Bayes Achievement Center

7517 Highway 75 South Huntsville 77340 936-291-3391 http://www.bayescenter.com MH


7045 State Highway 75 South

Huntsville 77340 936-291-5800 http://www.tcbhc.org MH

Source: SAMHSA

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Buprenorphine Treatment Providers in Region 6 Buprenorphine Treatment Providers

Address Address 2 City State Zip Phone

Brazoria County

Dr. Syed S. Zaidi, M.D. 110 South Gordon Street Alvin TX 77511 281-968-7568

Dr. Hugh Michael Ogburn, M.D. Serenity Light Recovery 1820 East County Road 36

Angleton TX 77515 832-654-7280

Dr. Manjit Randhawa, D.O. 1980 East Mulberry Street Angleton TX 77515 979-848-3068

Dr. Larry Keith Parker, Sr. 2315 East Mulberry Angleton TX 77515 832-551-9945

Dr. Thuy-Khanh Ha Bui, D.O. 101A Parking Way Lake Jackson TX 77566 979-297-2441

Dr. Nilesh J. Patel, M.D. 201 Oak Drive South Unit 204 Lake Jackson TX 77566 979-299-0012

Dr. Ashok Jain, M.D. 3203 East Broadway Street Currently at sugar Land location

Pearland TX 77581 281-302-6636

Dr. Riaz Ul Haque, M.D. 2404 Smith Ranch Road Suite 200 Pearland TX 77584 713-436-4333

Dr. Chiyyarath V. Sathees, M.D. 2225 CR 90 Unit 215 Pearland TX 77584 832-654-4390

Dr. George W. DeLeon, M.D. 2734 Sunrise Boulevard Suite 402 Pearland TX 77584 713-482-3977

Dr. Dale Leonard Messer, M.D. 711 Sidnor Alvin TX 77511 281-331-5953

Dr. Shakeel Raza, M.D. 13912 Morgan Bay Dr Pearland TX 77584 713-429-5325

Chambers County

Dr. Hossein Yazdani, M.D. 105 South Kansas PO Drawer C Anahuac TX 77514 409-267-3118

Fort Bend County

Dr. Zaki Moin, M.D. 7790 West Grand Parkway South

Suite 103 Richmond TX 77406 281-242-5400

Dr. Ateka Zaki, M.D. 7790 West Grand Parkway South

Suite 103 Richmond TX 77406 281-242-5400

Dr. Prashant Gajwani, M.D. 4502 Riverstone Boulevard Sugar LAnd TX 77459 281-778-9530

Dr. Javier R. Canon, M.D. 1517 Thompson Highway Richmond TX 77469 281-344-1715

Dr. Madhu Rao, M.D. 4910 Airport Avenue Building A Rosenberg TX 77471 281-342-6384

Dr. Vaishnavi N. Reddy, M.D. 2525 B.F. Terry Boulevard Fm 2218 Rosenberg TX 77471 281-342-6006

Dr. William Henry Reading, M.D. 12603 Southwest Freeway, Suite 510

Stafford TX 77477 281-494-4471

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Dr. Nilesh J. Patel, M.D. 13017 Jess Pirtle Blvd. Suite 100 Sugar TX 77478 281-566-1151

Dr. Carl Roger Meisner, M.D. 2225 Willaims Trace Boulevard

Unit 110 Sugar Land TX 77478 281-491-1911

Monica Agbro, NP 14825 Southwest Freeway Sugar Land TX 77478 832-532-7068

Dr. Deena Gandhi, M.D. 56 Sugar Creek Center Boulevard

Unit #350 Sugar Land TX 77478 281-277-9137

Dr. Ashok Jain, M.D. 1201 Creekway Drive, Suite C

Psychiatric Solutions Sugar Land TX 77478 281-302-6636

Dr. Christopher ChiYong Kwon, M.D.

16000 Southwest Freeway Sugar Land TX 77479 281-277-0911

Dr. Liza H. Leal, M.D. 4655 Sweetwater Boulevard Suite 500 Sugar Land TX 77479 281-265-6565

Dr. Gabriella Ribarne Pasztor, M.D.

3531 Town Center Boulevard South

Suite #101 Sugar Land TX 77479 281-201-2656

Dr. Irfan Lalani, M.D. 16605 SW Fwy, MOB 3, Suite 320

Sugar Land TX 77479 281-265-0225

Dr. Mudassar Tariq, M.D. 2245 Texas Drive Suite 300 Sugar Land TX 77479 832-919-6667

Dr. Nilesh J. Patel, M.D. 3533 Town Center Boulevard South

Suite 300 Sugar Land TX 77479 281-313-4666

Dr. Dilawar Ajani, M.D. Katy Family Physicians PA 550 S. Katy Fort Bend Road Ste 300

Katy TX 77494 281-344-2335

HORTENSE MBWENZE NGOE, NP

14629 BEECHNUT HOUSTON TX 77083 281-933-4447

Dama Alexander Ziworitin, 14629 Beechnut Street HOUSTON TX 77083 281-933-4447

Dr. Rachel Chundenu Kientcha -Tita, MD;RPH.

14629 Beechnut Street Houston TX 77083 281-933-4447

Dr. Shahnaz Amin Karim, M.D. 1201 Creekway Drive Suite B Sugarland TX 77074 713-668-6000

Dr. Homayoun Ataei, M.D. 9701 Richmond Avenue Suite 250 Houston TX 77479 713-523-6700

Dr. Marco A. Renazco, M.D. 24215 Kingsland Boulevard Katy TX 77494 281-599-3313

Galveston County

Dr. Dorothy F. Merritt, M.D. 676 FM 517 RD W Dickinson TX 77539 713-482-4535

Dr. John R. Sebok, D.O. 308 West Parkwood Avenue Suite 106 Friendswood TX 77546 713-943-7246

Dr. Jerry M. Keepers, M.D. 308 West Parkwood Avenue Suite 106 Friendswood TX 77546 713-943-7246

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Dr. Mohsin Qayyum, M.D. 341 East Parkwood Avenue Friendswood TX 77546 281-993-3733

Dr. Michael Alan Fuller, M.D. 301 University Boulevard Galveston TX 77555 409-747-8342

Dr. Edythe Pennal Harvey, M.D. 301 University Boulevard Galveston TX 77555 409-747-9722

Dr. Michael O'Boyle, M.D. UTMB, Department of Psychiatry

301 University Galveston TX 77555 409-747-9722

Dr. Warren T. Longmire Jr., MD 6801 Delaney Road Hitchcock TX 77563 409-986-5521

Syed Ahmed, 1301 West Highway 96 League City TX 77573 281-333-3540

Dr. Gerard Lawrence Guderian, M.D.

1108 Gulf Freeway South Suite 230 League City TX 77573 281-557-4404

Dr. Houshmand Tirandaz, M.D. 109 Marshall Street League City TX 77573 281-557-1414

Dr. Kokab Saeed, M.D. 2360 South Gulf Freeway League City TX 77573 281-554-0123

Dr. Mohammad Akhtar Saeed, M.D.

2360 South Gulf Freeway Suite 100B League City TX 77573 281-554-0123

Dr. Sonia Sood, M.D. Calder Urgent Care and Family Practice

1108 South Gulf Freeway

League City TX 77573 281-557-4404

Dr. Theresa D. Bui, D.O. 1150 Devereux Drive League City TX 77573 281-335-1000

Dr. Chiachin Lin, 1711 6th Street North Texas City TX 77590 409-965-0077

Dr. Nancy Beth Rubio, M.D. Texas City VA Clinic 9300 Emmett F. Lowry, Suite 206

Texas City TX 77591 409-986-2900

Dr. Sheena R. Wydermyer, M.D. 9300 Emmett F. Lowry Expressway

Suite 206 Texas City TX 77591 832-506-1278

Dr. Fan Li, 6807 Emmett F. Lowry Expressway

Suite 300 Texas City TX 77591 409-935-8400

Dr. Fan Li, 7111 MEDICAL CENTER DR. SUITE 200 TEXAS CITY TX 77591 409-948-8521

Dr. Harrison Keith Pinchot, 3750 Medical Park Drive Suite 200 Dickinson TX 77539 281-534-1133

Dr. Ruth Ellen Allbritton, M.D. 1560 West Bay Area Boulevard

Suite 309 Friendswood TX 77546 832-726-0720

Dr. Karen Quintavell Radcliffe, M.D.

201 Enterprise Avenue Suite 800 League City TX 77573 832-848-0444

Harris County

Dr. Sourial Morris Sourial, D.O. 250 Blossom St Suite 120 Webster TX 77498 917-940-7644

Dr. Gary H. Lew, D.O., F.A.A.F.A. 1111 Highway 6 South Suite 225 Sugar Land TX 77401 281-277-4600

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Dr. Asra Oberoi, M.D. 4801 Woodway Ste 150W Houston TX 77056 713-443-9611

Dr. Kimberly Henderson, M.D. 1315 St. Joseph Parkway Suite 1003 Houston TX 77002 713-659-2666

Dr. Jia Wang, MD 1200 Binz Street Suite 520 Houston TX 77004 832-930-1275

Rodney Bretain Trimble, 2342 quenby street houston texas 77005 houston TX 77005 281-797-6749

Dr. Charles Lucey, M.D., MPH 515 Avondale Street Houston TX 77006 202-509-7126

Dr. Wafaa Y. Farag, 1648 Richmond Avenue Houston TX 77006 832-754-2092

Dr. Zaid Bin Hussain Malik, M.D. 5225 Katy Freeway Unit 105 Houston TX 77007 713-802-9799

Dr. Robert J. Bacon, Jr., M.D. 5225 Katy Freeway Unit 215 Houston TX 77007 713-655-9410

Eduardo Roberto Chavez Ruiz, 2150 West 18th street suite 300 Houston TX 77008 713-426-0027

Dr. Jason Z.W. Powers, M.D. 1010 WAVERLY ST Houston TX 77008 832-856-2156

Dr. William Z. Cohen, M.D. 4000 Fulton Street Suite A Houston TX 77009 713-931-4040

Dr. John L. Mohney, D.O. 2304 Fulton Street Houston TX 77009 713-228-4505

Dr. Jorge Guerrero, M.D 6710 Capitol Street Houston TX 77011 713-921-7176

Dr. Novarro Stafford, M.D. 14405 Walters Road Suite 1016 Houston TX 77014 832-401-9407

Dr. Gouher Wali, M.D. 14511 Falling Creek Ste 302 Houston TX 77014 832-777-7581

Dr. Thomas Ouyjuung Kim, M.D. 1100 West 34th Street Houston TX 77018 713-861-3939

Dr. Dominick Steven D'Aunno, M.D.

1708 Elmen Street Houston TX 77019 832-704-6500

Ramachandra Malya, 212 E. Crosstimbers St #170 Houston TX 77022 713-692-0518

Dr. Manazir Shamsi, M.D. 6311 Fulton Street Houston TX 77022 713-694-8100

Dr. George Atallah, D.O. Modern Pain Management 902 Frostwood, Suite 232

Houston TX 77024 713-298-0120

Dr. Hussamaddin Al-Khadour, M.D.

902 Frostwood Drive Suite 106 Houston TX 77024 832-649-5000

Dr. Azim Amin Karim, M.D. 10019 South Main Street Houston TX 77025 713-668-6000

Dr. Ronald R. Buescher, M.D. 10021 South Main Suite B3 Houston TX 77025 713-668-1166

Dr. Ivan C. Spector, M.D. 3100 Weslayan Suite 350 Houston TX 77027 713-963-0769

Dr. John L. Mohney, D.O. 4742 W Alabama Houston TX 77027 713-626-0312

Dr. Long Nguyen, M.D. 4151 Southwest Freeway Suite 410 Houston TX 77027 713-222-7246

Dr. Melinda Min Gu, M.D. 3400 Edloe Street Suite 1604 Houston TX 77027 617-820-1056

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Dr. Sara Elizabeth Allison, Michael E. DeBakey VA Medical Center

2002 Holcombe Blvd. 116A

Houston TX 77030 713-791-1414

Dr. Wendy L. Smitherman, M.D. Department of Psychiatry One Baylor Plaza, BCM 350

Houston TX 77030 713-791-1414

Dr. Poonam K Thandi, M.D. 2002 Holcombe Boulevard Houston TX 77030 713-791-1414

Dr. Thomas R. Kosten, M.D. 2002 Holcombe Boulevard Houston TX 77030 713-794-7032

Dr. John Victor Ibeas Fermo, M.D.

MEDVAMC 116SDTP 2002 Holcombe Boulevard

Houston TX 77030 713-791-1414

Dr. Ali Abbas Asghar-Ali, M.D. 2002 Holcombe Boulevard Houston TX 77030 713-791-1414

Dr. Sarah Elizabeth Ramos, M.D. 1502 Taub Loop Houston TX 77030 713-873-4900

Dr. Tso M. Chen, M.D. 2002 Holocombe Boulevard Houston TX 77030 713-791-1414

Dr. Elisabeth Ware Netherton, M.D.

1977 Butler Boulevard Houston TX 77030 713-798-4857

Dr. Claudine Daniela Johnson, M.D.

2002 Holcombe Boulevard Houston TX 77030 713-791-1414

Dr. Emilio Rene Cardona, M.D. Green Park One 7515 South Main, Suite 600

Houston TX 77030 713-796-9993

Dr. Corinna Maria Keenmon, M.D.

6560 Fannin St. Scurlock Tower Ste. 900

Houston TX 77030 713-441-3800

Dr. James J. Ireland, M.D. 2002 Holocombe Boulevard Houston TX 77030 713-794-7101

Andres Arturo Avellaneda Ojeda,

1504 Taub Loop Houston TX 77030 713-873-4900

Dr. Junaid Kamal, M.D. 2002 Holcombe Boulevard VAMC, Dept of Anesthesiology 145

Houston TX 77030 713-791-1414

Dr. Mehran Rahbar, M.D. VAMC 2002 Holcombe Boulevard

Houston TX 77030 713-794-7689

Dr. Benjamin T. Li, M.D. 1502 Taub Loop 2nd Floor, Room 2.216

Houston TX 77030 713-873-4900

Dr. Charles DeJohn, M.D. VA Hospital, Rm. 6B-115, MHCL

2002 Holcombe Boulevard

Houston TX 77030 713-794-8709

Dr. Martha Anne Lederer, M.D. Michael E. DeBakey Veterans Affairs

Medical Center in Houston

Houston TX 77030 713-859-3898

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Dr. Utpal Ghosh, M.D. 2002 Holocombe Boulevard Mail code 111 PC Houston TX 77030 713-791-1414

Dr. Robert Mark Gerber, M.D. Michael E. DeBakey VA Medical Center


Houston TX 77030 713-794-8700

Dr. Bengi B. Melton, M.D. VA Medical Center 2002 Holocombe Boulevard

Houston TX 77030 713-791-1414

Dr. Andrea Gail Stolar, M.D. MICHAEL E. DEBAKERY VAMC


Houston TX 77030 713-791-1414

David Boaz Berman, 2002 Holcombe Boulevard PC 111 Houston TX 77030 713-794-7228

Dr. Nicholas M. Masozera, M.D. 2002 Holocombe Boulevard Pc 111 Houston TX 77030 713-791-1414

Dr. Roham Darvishi, M.D. VA Hospital 2002 Holocombe Boulevard

Houston TX 77030 713-791-1414

Dr. Yaw Boamah Frimpong-Badu, M.D.

2002 Holcombe Boulevard Houston TX 77030 713-791-1414

Dr. Pilar Laborde-Lahoz, M.D. VA de BAKEY 2002 Holcombe Boulevard

Houston TX 77030 713-791-1414

Dr. Jennie F. Hall, M.D. MEDVAMC 2002 Holcombe Boulevard

Houston TX 77030 713-791-1414

Dr. Nidal Moukaddam, M.D. Harris Health Systems/Baylor

1504 Taub Loop Houston TX 77030 713-873-4900

Dr. James G. Pullano, M.D. 12555 Gulf Freeway Suite B Houston TX 77034 713-322-6060

Dr. Marcel Dwaine Thompson, M.D.

5600 South Willow Drive Suite 101 Houston TX 77035 713-729-5934

Dr. Michael Lewis McClam, M.D. 12301 Main Street Houston TX 77035 713-275-5212

Jonathan Robert Stevens, The Menninger Clinic 12301 Main Street Houston TX 77035 713-275-5178

Dr. James Edward McCrary, D.O. 6201 Bonhomme Road Suite 354-N Houston TX 77036 832-767-0357

Dr. Rusti T. Hauge, M.D. 5500 Guhn Road Suite 100 Houston TX 77040 713-783-8889

Dr. Jason D. Baron, M.D. 5500 Guhn Road Suite 100 Houston TX 77040 713-783-8889

Dr. Jaime Ganc, M.D. 5500 Guhn Road Suite 100 Houston TX 77040 713-783-8889

Dr. Edward C. Fallick, D.O. 2901 Wilcrest Dr Suite 520 Houston TX 77042 713-400-7400

Dr. James C. Lai, M.D. 1140 Business Center Drive Suite 580 Houston TX 77043 713-467-6200

Dr. Balbir S. Chahal, M.D. 21212 NW Freeway Suite 425 Cypress TX 77049 281-357-0661

Dr. Jerry M. Keepers, M.D. 7400 Fannin Suite 1160 Houston TX 77054 713-808-9595

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Dr. Ramesh R. Parikh, M.D. 7707 Fannin Street Suite 205 Houston TX 77054 713-790-0745

Dr. Demetris Allen Green, Sr., M.D.

2646 South Loop West Suite 220 Houston TX 77054 713-808-9658

Dr. Michael Weaver, M.D. 1941 East Road Suite 2100 Houston TX 77054 713-486-2525

Dr. Uchenna Kennedy Ojiaku, M.D.

2626 South Loop West Suite 300 Houston TX 77054 202-390-7520

Kairav R Shah, UT PSYCHIATRY- BBSB 1941 EAST ROAD HOUSTON TX 77054 713-486-2700

Dr. Frederick Gerard Moeller, M.D.

UTHSC at Houston Texas Research Clinic

1941 East Road Houston TX 77054 713-486-2800

Dr. Greg S. Burzynski, M.D. 9432 Katy Freeway Suite 400 Houston TX 77055 713-333-6464

Dr. Arif M. Shoaib, M.D. 2411 Fountain View Suite 217 Houston TX 77057 713-660-8877

Dr. Tayfun Karakoc, M.D. 6260 Westpark Suite 300 Houston TX 77057 713-783-8889

Dr. Larry Michael Nahmias, M.D. 17555 El Camino Real Houston TX 77058 281-333-2278

Dr. James Incalcaterra, Jr., M.D. 1322 Space Park Drive, East Suite B150 Houston TX 77058 281-333-1213

Dr. Rehan Memon, M.D. 2020 NASA Parkway suite 220 Houston TX 77058 713-369-1969

Dr. Patricia P. Corke, M.D. 18333 Egret Bay Boulevard Suite 305 Houston TX 77058 281-333-5740

Dr. Woodrow William Coppedge, M.D.

1002 Gemini Suite 205 Houston TX 77058 281-218-8181

Dr. Hubert Neil Williston, M.D. 11452 Space Center Blvd Suite 400 Houston TX 77059 713-486-6200

Dr. Russell Neil McDonald, D.O. 414-A North Sam Houston Parkway East

Houston TX 77060 281-260-0308

Dr. Caroline Njeri Mbogua, M.D. 8121 Broadway Street Suite 103 Houston TX 77061 713-668-1166

Dr. Hansa B. Medley, M.D. 3920 Braxton Drive Suite 108 Houston TX 77063 713-782-2156

Dr. Cynthia A. Pham, D.O. 10028 West Road Unit 102 Houston TX 77064 281-500-8900

Dr. Anand Balsubramanian, M.D.

11302 Fallbrook Ste 306 Houston TX 77065 281-893-8100

Dr. Ghada A. Saqer, M.D. 11037 FM 1960 W SUITE B1 Houston TX 77065 832-237-9400

Dr. Ifeoma Arene, M.D. 12828 Willow Center Drive Suite E Houston TX 77066 281-893-3656

Dr. Robert J. Bacon, Jr., M.D. 19500 State Highway 249 Suite 240 Houston TX 77070 713-655-9410

Dr. Bernadette Uche Iguh, M.D. 12660 Beechnut Suite 110 Houston TX 77072 281-564-2242

Mauricio Daniel Garcia Jacques, 7324 Southwest Freeway Suite 325 Houston TX 77074 832-930-3589

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Dr. Warren B. Dailey, M.D. 6624 Hornwood Houston TX 77074 713-541-4422

Dr. Obianuju C. Okeke, M.D. 7500 Beechnut Street, Suite 290

Houston TX 77074 713-790-7800

Dr. Festus Ikechukwu Uzokwe, 9100 Southwest Freeway Suite 121 Houston TX 77074 713-360-7972

Dr. Jorge A. Raichman, M.D. 7500 Beechnut Unit 214 Houston TX 77074 713-772-6519

Dr. Albert Oguejiofor, M .D. 7737 Beechnut Street Suite 200 Houston TX 77074 713-777-6606

Dr. Anjali Jain, M.D. 6776 Southwest Freeway Suite 400 Houston TX 77074 713-272-8884

Dr. Prabhu B. Patil, M.D. 150 West Parker Road Suite 206 Houston TX 77076 713-697-0776

Dr. Bao Thang Ngoc Pham, M.D. 1570 South Dairy Ashford Drive

Suite 120 Houston TX 77077 281-531-5293

Dr. Matthew Thompson, M.D. 2990 Richmond Suite 310 Houston TX 77078 713-385-2112

Dr. Cynthia Lee Ketterer, M.D. 14770 Memorial drive #100 Houston TX 77079 281-496-7333

Dr. Paulo R. Bettega, M.D. Menninger Clinic 2801 Gessner Houston TX 77080 713-275-5400

Dr. Jamal Rafique, M.D. 5314 Dashwood Drive Houston TX 77081 713-600-9550

Dr. Gerald Busch, M.D. 6550 Mapleridge St. Suite 210 Houstont TX 77081 713-665-9000

Dr. Gurdip Singh Buttar, M.D. 6006 Bellaire Boulevard Suite 230 Houston TX 77081 713-272-9297

Dr. Robert Lee Woodham, M.D. 4888 Loop Central Suite 510 Houston TX 77081 713-349-1100

Dr. Guruswami Kesavalu Ravichandran, M.D.

6420 Hillcroft Street Suite 411 Houston TX 77081 713-988-9911

Dr. Benjamin E. Wowo, M.D. 16225 Park Ten Place Suite 500 Houston TX 77084 281-665-8546

Dr. Alan D. Tran, M.D. 13734 State Highway 249, Suite B

Houston TX 77086 281-591-0500

Dr. Hilary Chukwudolue Akpudo, M.D.

Houston Behavioral Health Care

11920 Astoria Boulevard, Suite 110

Houston TX 77089 281-481-4646

Dr. Aaron M. Levine, M.D. 11914 Astoria Boulevard Suite 540 Houston TX 77089 281-484-8123

Dr. Gunther Groning, M.D. 837 Cypress Creek Parkway Suite 105 Houston TX 77090 281-586-3888

Dr. Santosh Kale, M.D. Lone Star Medical Management, Llc

830 FM 1960 West, Suite 10

Houston TX 77090 832-260-0996

Dr. Larry Flowers, M.D. 1125 Cypress Station Drive Building B1 Houston TX 77090 281-586-7880

Dr. Gicele Urrutibeheity, D.O. 845 FM 1960 West Suite 104 Houston TX 77090 281-444-9898

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P O Box 90967 Houston TX 77090 281-893-8100


17400 Red Oak Drive Houston TX 77090 281-893-8100


511 W. Tidwell Road Houston TX 77091 281-893-8100

Dr. Alicia Ann Kowalchuk, D.O. 3701 Kirby Drive Suite 600 Houston TX 77098 713-873-5180

Dr. Maria C Mejia de Grubb, M.D. 3701 Kirby Drive Suite 600 Houston TX 77098 713-798-4735

Dr. Kathleen Anne Gallentine, M.D.

3100 Richmond Avenue Suite #410 Houston TX 77098 713-528-9430

Dr. Marsha Kaye Wheatley, M.D. 2990 Richmond Avenue Suite 660 Houston TX 77098 713-824-1184

Dr. Scott Ellis Sprabery, M.D. 3701 Kirby Drive Suite 570 Houston TX 77098 713-527-8448

Dr. Ralph Franklin Coleman, M.D.

11732 Wilcrest Houston TX 77099 281-498-4357

Dr. Austin A. Orette, M.D. P.O. Box 420711 Houston TX 77242 281-962-0777

Dr. William Frederick Fisher, M.D.

P.O. Box 58312 Houston TX 77258 713-530-4530

Dr. Mohsin Qayyum, M.D. P.O. Box 890708 Houston TX 77289 281-993-3733

Dr. Ashok Khushalani, M.D. 210 S.Ave C Suite 10 HUMBLE TX 77338 281-446-9216

Dr. Ashok Khushalani, M.D. 210 S.Ave C HUMBLE TX 77338 281-446-9216

Dr. Ashok Khushalani, M.D. 210 S.Ave C Humble TX 77338 281-446-9216

Dr. Fernando S. Gallegos, M.D. 2601 West Lake Houston Parkway

Kingwood TX 77339 281-360-7502

Dr. Pradeep K. Roy, M.D. 2527 Chestnut Ridge Kingwood TX 77339 281-358-4747

Dr. Jyothi Achi, M.D. 22999 US Highway 59 North

Suite 232 Kingwood TX 77339 281-852-7500

Dr. Balbir S. Chahal, M.D. 455 School Street Suite 44 Tomball TX 77375 281-357-0661

Dr. Vanessa Moore, M.D. 30903 Quinn Road Tomball TX 77375 281-351-6644

Dr. Candice Martin DeMattia, M.D.

506 Graham Street Suite 200 Tomball TX 77375 281-255-3838

Dr. Jason Kelly DeMattia, M.D. 506 Graham Drive Suite 200 Tomball TX 77375 281-255-3838

Dr. Eugene Allen Degner, 6565 West Loop South Suite 525 Bellaire TX 77401 713-661-7888

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Dr. William Clay Brown, M.D. 6565 West Loop South Suite 525 Bellaire TX 77401 713-661-7888

Dr. Karen Dee Snyder, M .D. 5959 West Loop South Suite 600 Bellaire TX 77401 713-669-0303

Dr. Mobeen N. Choudhri, M.D. 4747 Bellaire Boulevard Suite 101 Bellaire TX 77401 713-622-1700

Dr. Bo Jonathan Allaire, M.D. 6565 West Loop South Suite 525 Bellaire TX 77401 713-661-7888

Dr. Donald Edwin Hauser, M.D. 5959 West Loop South Suite 600 Bellaire TX 77401 713-669-0303

Dr. Omar D. Vidal, M.D. 6750 West Loop South Suite 830 Bellaire TX 77401 713-751-0631

Dr. Jaime Robledo, M.D. 21380 Kingsland Boulevard Suite 102 Katy TX 77450 281-717-4902

Dr. Dilawar Ajani, M.D. 21406 Provincial Blvd Katy TX 77450 281-344-2335

Dr. Suchmor Thomas, M.D. Pasadena Health Center 908 East Southmore Avenue, Suite 100

Pasadena TX 77502 713-554-1091

Dr. Syed N Mujeeb, M.D. 3950 Spencer Highway Pasadena TX 77504 832-925-7600

Dr. Kimberly Henderson, M.D. 4002 Burke Road Suite 300A Pasadena TX 77504 281-998-2611

Dr. Thomas R. Synek, 5150 Crenshaw Suite B100 Pasadena TX 77505 281-419-5993

Daniel Cardin Hatmaker, NP 5010 Crenshaw Road Suite 130 Pasadena TX 77505 281-991-2200

Dr. Joseph Gerard Valdez, M.D. 5413 Crenshaw Road Suite 200 Pasadena TX 77505 281-998-3500

Dr. Durga P. Sunkara, M.D. 4802 East Sam Houston Tollway South

Suite 150 Pasadena TX 77505 281-487-3111

Philip Brian Seabolt, PA 5010 Crenshaw Road Suite 130 Pasadena TX 77505 218-991-2200

Dr. Chris Taigo Fuke, M.D. 5010 Crenshaw Road Suite #130 Pasadena TX 77505 281-991-2200

Dr. Peter Stanfield, M.D. 923 Pasadena Freeway Pasadena TX 77506 713-475-8686

Terri Brooke Swisher, NP 923 Pasadena Freeway Suite 100 Pasadena TX 77506 713-475-8686

Dr. Allen Ray Dorsett, D.O. 923 Pasadena Freeway Pasadena TX 77506 713-475-8686

Dr. Michael Manish Sheth, M.D. 923 Pasadena Freeway Pasadena TX 77506 713-475-8686

Dr. Kimberly Henderson, M.D. 1610 James Bowie Suite B109 Baytown TX 77520 281-442-3619

Dr. Ghyasuddin Syed, M.D. 2802 Garth Road Suite 101 Baytown TX 77521 281-422-5500

Dr. Ricardo Rafael Pardo, M.D. 2800 Garth Road Baytown TX 77521 281-428-1141

Dr. Gary R Burman, 15035 East Freeway Ste D Channelview TX 77530 281-457-0477

Dr. David W. Spinks, M.D. 321 West San Augustine Deer Park TX 77536 281-476-0780

Ashley Michelle Gilbert, PA 11006 Spencer Highway La Porte TX 77571 281-470-2100

Dr. Robert David Johnston, M.D. 11006 Spencer Highway La Porte TX 77571 281-470-2100

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Susanne Danielle Bailey, NP 11006 Spencer Hwighway La porte TX 77571 281-470-2100

James Monroe Dieter, NP 250 Blossom suite 270 Webster TX 77598 832-524-5355

Mai Nguyen, 720 West NASA Parkway Webster TX 77598 832-932-5990

Dr. Janis Jean Fowler-Gulde, M.D.

525 Blossom Street Webster TX 77598 832-915-2454

Dr. Pranav H Bhakta, M.D. 17448 Highway 3 Suite 160 Webster TX 77598 281-332-6650

Dr. Pamela Denise Dugano-Daphnis, M.D.

333 N. Texas Avenue STE 4100 Webster TX 77598 281-317-1261

Dr. Mikhail Fukshansky, M.D. 250 Blossom Street Suite 285 Webster TX 77598 713-790-1400

Dr. Sourial Morris Sourial, D.O. US Pain and Spine Institute 250 Webster TX 77598 713-973-7246

Dr. Arturo Antonio Martinez, M.D.

5413 Crenshaw Rd. Ste 200 Pasadena TX 78246 281-998-3500

Dr. Novarro Stafford, M.D. 1405 Walters Road Houston TX 77014 832-401-9407

Dr. Kenneth John Krajewski, M.D.

2800 South MacGregor Way Houston TX 77021 713-741-3830

Dr. Priya Kachhwaha, 20822 Kerby Place Cypress TX 77433 281-408-5942

Dr. Jerry M. Keepers, M.D. 24044 Highway 59 North Kingwood TX 77339 713-943-7246

Dr. Athi P. Venkatesh, M.D. 19701 Kingwood Drive Bldg 3 Kingwood TX 77339 281-358-5701

Dr. Claudel Jean-Pierre, M.D. 19701 Kingwood Drive Building 8 Kingwood TX 77339 832-615-1107

Dr. Sheri Gaines, M.D. 7517 Highway 755 Huntsville TX 77342 936-435-1201

Liberty County

Dr. Barbara Doyle Marino, M.D. 705 EAST HOUSTON STREET

Cleveland TX 77327 281-592-1115

Dr. Gonzalo Ramos, 403 East Dallas Street Cleveland TX 77327 281-659-9533

Matagorda County

Dr. Ajay Aggarwal, M.D. 600 Hospital Circle Suite 201 Bay City TX 77414 979-245-2777

Montgomery County

Nora Lee Bailey, VA Clinic Conroe 690 S Loop 336 W, 3rd Floor

Conroe TX 77304 936-522-4000

Dr. Larry Flowers, M.D. 100 Medical Center Boulevard

Suite 106 Conroe TX 77304 936-441-7555

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Dr. Robert Jeremy Laningham, M.D.

4015 I-45 North Suite 220 Conroe TX 77304 936-441-1122

Dr. Debra Martin Emmite, M.D. 690 S. Loop 336 W Conroe TX 77304 832-563-7880

Dr. Kenneth G. Davis, M.D. 605 South Conroe Medical Drive

Conroe TX 77304 936-539-4004

Dr. Shazia Billal, M.D. 920 Medical Complex Drive Suite 450 The Woodlands

TX 77380 281-364-1700

Dr. Ashley M. Chin, M.D. 6318 FM 1488 Suite 100 Magnolia TX 77354 936-321-3110

Dr. Robert Gale Woodrome, M.D.

13817 US Highway 59 Suite C Splendora TX 77372 281-689-6901

Dr. Benny J. Sanchez, M.D. 25329 Interstate 45 North Suite B The Woodlands

TX 77380 713-697-6884

Dr. Chinasa Paul Anugwom, M.D. 920 Medical Plaza Drive Suite 370 The Woodlands

TX 77380 832-246-8935

Dr. Fadi G Ghanem, 1111 Medical Plaza Drive Suite #230 Spring TX 77380 281-419-1599

Dr. Michael Phillip Sprintz, D.O. 9303 Pinecroft Drive Suite 320 The Woodlands

TX 77380 713-714-1399

Dr. Sheri Gaines, M.D. New Dimensions Hospital 4840 West Panther Creek

The Woodlands

TX 77381 800-685-9796

Dr. Wayne F. Keller, M.D. 8701 New Trails Drive Suite 150 The Woodlands

TX 77381 281-367-1015

Dr. Lourdes R. Bosquez, M.D. 9006 Forest Crossing Drive Suite C Spring TX 77381 281-364-9884

Dr. Athi P. Venkatesh, M.D. 150 Pine Forest Dr. Suite 202

The Woodlands

TX 77384 281-358-5701

Dr. Rafael J. DelaFlor-Weiss, M.D.

26222 I45 North Freeway Suite #A Spring TX 77386 281-292-1310

Dr. Jeffrey Alan Klem, M.D. 26222 I 45 North Suite A Spring TX 77386 281-292-1310

Walker Counter

Dr. Darrel Richard Wells, M.D. Independent Clinic of Texas 152 State Highway 75 North

Huntsville TX 77320 936-295-8392

Dr. Hung T. Dao, M.D. 829 10th Street Huntsville TX 77320 936-291-9172

Wharton County

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Dr. Ashok Jain, M.D. 10119 US 59 Highway Suite 300 Wharton TX 77488 281-302-6636

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Appendix H HHSC-Funded Prevention Programs, Region 6, Fiscal Year 2018 This table provides detail about the school district, campus, and type of regional prevention programs.

YPU: Youth Prevention-Universal. Curriculum designed for all students.

YPS: Youth Prevention-Selected. Curriculum designed for students selected to receive preventative information based on risk factors.

YPI: Youth Prevention-Indicated. Curriculum designed for students who have an indicated high risk for substance abuse.

District Campus Program

Aldine ISD Escamilla Intermediate YPS YPU Alief ISD Alief Taylor YPI Alief ISD Budewig Intermediate School YPS YPU Alief ISD Bush Elementary School YPU Aleif ISD Crossroads YPI Aleif ISD Owens Intermidate YPI Alief ISD Klentzman Intermediate School YPS YPU Alief ISD O'Donnell Middle School YPS YPU Alief ISD Olle Middle School YPS Alief ISD Youens Elementary School YPU Alvin ISD Walt Disney Elementary School YPS

Alvin ISD ADAPT (Alternative Program) (Junior High and High School) YPS

Angleton ISD CATS Academy YPS Bay City ISD Christian Life Academy YPS Brazosport ISD Clute Intermediate School YPS Brazosport ISD Rasco Middle School YPS Brazosport ISD Lighthouse Learning Center YPS Brazosport ISD R. O'Hara Lanier Middle School YPS Brazosport ISD Stephen F. Austin STEM Academy YPS Charter A+ YPS Charter YES Prep - Brays Oaks Campus YPI YPS YPU Charter YES Prep - Hoffman YPS Charter YES Prep - North line YPS Charter YES Prep - Northside YPS Charter YES Prep – West 9th Grade YPI Clear Creek ISD Clear Path Alternative School YPS

Clear Creek ISD Clear View High School YPS Cleveland ISD Eastside Elementary School YPS Cleveland ISD Northside Elementary School YPS Cleveland ISD Southside Primary School YPS Community Org Bessie Swindle Park YPU Community Org CH Program YPU Community Org Change Happens AS YPS Community Org Crestmon Park YPU

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Community Org Edgewood Park YPU Community Org Emancipation Park YPU Community Org fifth ward enrichment YPI Community Org Holy Name YPU Community Org Judson Robinson Jr Park YPU Community Org Judspon Robinson SR Park YPU Community Org Salvation Army YPU Community Org Sw glen YPU Community Org Sw glen greenpoint YPU Community Org Town wood park YPU Community Org TSU YPS Community Org Wesley YPU Conroe ISD Hailey Elementary School YPS Conroe ISD Wilkerson Intermediate School YPS Dickinson ISD Adams Junior High School YPS Dickinson ISD Dickinson Continuation Center (HS students) YPS Dickinson ISD Dickinson High School YPS YPU Dickinson ISD Dunbar Middle School YPS Dickinson ISD Hughes Elementary School YPS Dickinson ISD Juvenile Justice Center levels 4 and 5 YPS Fort Bend ISD Austin High School YPI Fort Bend ISD Blue Ridge Elementary School YPU Fort Bend ISD Burton Elementary School YPU Fort Bend ISD Commonwealth Elementary School YPU Fort Bend ISD Crockett Middle School YPS Fort Bend ISD Ferndell Henry CFL YPI Fort Bend ISD Goodman Elementary School YPU Fort Bend ISD Heritage Rose Elementary School YPU Fort Bend ISD Hodges Bend Middle School YPS Fort Bend ISD Jones Elementary School YPU Fort Bend ISD Lake Olympia MS YPI Fort Bend ISD McAuliffe Middle School YPS Fort Bend ISD Mission Glen Elementary School YPU Fort Bend ISD Mission West Elementary School YPU Fort Bend ISD Missouri City Middle School YPS Fort Bend ISD Quail Valley Middle School YPS Fort Bend ISD Ridge Point High School YPI Fort Bend ISD Seguin Elementary School YPU Fort Bend ISD Sugar Land Middle School YPS Fort Bend ISD Willowridge High School YPI Galena Park ISD Cimmaron Elementary School YPU Galena Park ISD Cobb 6th Grade Campus YPU Galena Park ISD Purple Sage Elementary School YPU Houston ISD Alcott YPU Houston ISD Cook Elementary School YPU Houston ISD Cullen Middle School YPS Houston ISD Forest Brook Middle School YPI YPS

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Houston ISD Foster YPU Houston ISD Kashmere High School YPI Houston ISD Kashmere Gardens Elementary School YPU Houston ISD Kelso Elementary School YPU Houston ISD Key Middle School YPI Houston ISD Lawson Middle School YPS Houston ISD McGowen Elementary School YPI YPS Houston ISD McNamara Elementary School YPU Houston ISD Patrick Henry Middle School YPS Houston ISD Peck Elementary School YPU Houston ISD Sterling YPI YPS Houston ISD Stevens Elementary School YPU Houston ISD Thompson YPU Houston ISD Westbury YPI Houston ISD Whidby YPU Houston ISD Woodson K-8 YPS Houston ISD Yates High School YPI Lamar CISD Alternative Learning Center YPI Lamar CISD Beasley Elementary School YPU Lamar CISD Briscoe Junior High School YPI Lamar CISD Foster High School YPI Lamar CISD Fulshear High School YPI Lamar CISD George Junior High School YPI Lamar CISD George Ranch High School YPI Lamar CISD Lamar Junior High School YPI Lamar CISD Leaman Junior High School YPI Lamar CISD Navarro Middle School YPS Lamar CISD Pink Elementary School YPU Lamar CISD Reading Junior High School YPI Lamar CISD Terry High School YPI Lamar CISD Thomas Elementary School YPU Lamar CISD Travis Elementary School YPU Lamar CISD Wessendorf Middle School YPS La Porte ISD Baker 6th Grade Campus YPS New Caney ISD New Caney Elementary YPS New Waverly ISD New Waverly Intermediate School YPS New Waverly ISD New Waverly Junior High School YPS Pasadena ISD McMasters Elementary School YPU Pasadena ISD Robert Turner College and Career HS YPS

Santa Fe ISD Coastal Alternative Program-Santa Fe (Junior High and High School)

Spring ISD Burchett Elementary School YPU Spring ISD Edwin M Wells Middle School YPS Stafford MSD Stafford HS YPI Stafford MSD Stafford SEAC YPI Texas City ISD Texas City Early Childhoold YPS Texas City ISD Texas City DAEP YPS

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Appendix I

Suggested Citation

If you would like to reference this report, please use this citation information:

Prevention Resource Center 6. Regional Needs Assessment 2018: Epidemiological Profile, Youth

Substance Use and Misuse Trends, and Prevention Efforts in the Texas Gulf Coast Region.

Houston, TX: The Council on Recovery; July, 2018. www.prc6.org/data.

Author

Melissa Romain-Harrott, Ph.D., Regional Evaluator, Prevention Resource Center 6

Contributors

Whitney Weathersby, Regional Liaison, Prevention Resource Center 6

Dannielle Meyer, Coalition Coordinator, Brazoria Community Coalition, Bay Area Council on Drugs and

Alcohol

Carlos Rangel, Coalition Coordinator, Coalition on Substance Abuse Prevention

Joy P Alonzo, M. Eng., PharmD., Clinical Assistant Professor, Department of Pharmacy Practice, Texas

A&M Health Science Center Rangel College of Pharmacy

Acknowledgements

Thank you to the dynamic coalition leaders and community partners of Region 6 who tirelessly make it

their business to build capacity for evidence-based prevention, treatment, and recovery services across

the Gulf Coast Region. The past year has been particularly difficult due to the devastation Hurricane

Harvey left behind almost a year ago and everyone has gone above and beyond the call of duty in order

to best serve their local communities in need. Special thanks to Cynthia Sequeiros, Director of

Prevention Resources and Services at The Council on Recovery, for support through the data collection

and assessment process. Lastly, thank you to Mary Beck, CSO of The Council on Recovery, for

supporting the PRC6’s growth into a regionally-recognized source of data and evidence-based

prevention support.

http://www.prc6.org/data

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