Circles of San Antonio Community Coalition Bexar County Needs Assessment September 2014

www.circlesofsa.org 1 COSA Needs Assessment September 2014
Circles of San Antonio Community
Coalition
Needs Assessment
September 2014
For information about the Circles of San Antonio Community Coalition
or this Needs Assessment contact Vickie B. Adams or Charles Villafranca
coalition@sacada.org

www.sacada.org 2 COSA Needs Assessment June 2014
Table of Contents
Introduction.....................................................................................................................................4
Part I – Geographic / Target Population.......................................................................... 6
Part II – Prevention Resource, Capacities and Gaps............................................................10
a. Prevention Resource Center.....................................................................................................10
b. Other Coalitions...........................................................................................................................10
c. Other State and Federally Funded Programs.........................................................................11
d. School Programs.........................................................................................................................12
Community Programs and Services..................................................................................................13
e. Parent Programs .........................................................................................................................13
f. Direct Prevention Service Providers ........................................................................................14
g. Treatment Providers ...................................................................................................................14
h. Healthcare Providers ..................................................................................................................15
i. Higher Education Prevention.....................................................................................................15
j. Law Enforcement ........................................................................................................................16
Gaps in Service ....................................................................................................................................17
Part III – Consequences and Consumption Patterns of the Community............................18
a. DWI Rates.........................................................................................................................18
b. Alcohol Related Vehicular Fatalities...................................................................................21
c. Violent Crimes ...................................................................................................................25
d. Possession of illicit drugs (arrests) ....................................................................................27
e. Public Intoxications............................................................................................................28
f. Suicide Rates .....................................................................................................................29
g. Homicide Rates .................................................................................................................29
j. Underage binge drinking rates............................................................................................30
k. College age binge drinking ................................................................................................31
l. Current 30 day drinking rates..............................................................................................35
m. Current 30 day illicit drug use rates...................................................................................37
n. Perceptions of harmfulness of use (alcohol and other substances).........................................38
o. HIV infection rates and transmission route..................................................................................43

q. Treatment episode admission data....................................................................................45
s. Truancy data / drop out rates.............................................................................................49
t. Texas School Survey Data .................................................................................................52
v. Tobacco sales to minors....................................................................................................53
x. Other data sources ............................................................................................................56
Colleges and Universities...................................................................................60
Military ...............................................................................................................65
Public Health......................................................................................................66
Part IV – Intervening Variables ......................................................................................72
Part V – Community Readiness.....................................................................................74
Part VI – Putting it all together .......................................................................................75
Target Population ..................................................................................................................75
Primary Substance use behaviors .........................................................................................75
Secondary Substance use behavior ......................................................................................75
Strategic Planning Process....................................................................................................75
References....................................................................................................................76

Introduction
As a Community Coalition Partnership grantee the San Antonio Council on Alcohol and Drug
Abuse (SACADA) and the Circles of San Antonio (COSA) Community Coalition have been
tasked by Department of State Health Services (DSHS) with developing a needs assessment as
part of an overall strategic plan that will be implemented over the next two years. This
community needs assessment is a fluid document and subject to revision as our understanding
of the data develops, further data becomes available or conditions within the community
change.
It is evident that the misuse of alcohol and the manufacture, sale and use of illicit drugs have a
far reaching and negative impact on most communities. We observe many of the social
problems in our neighborhoods, such as economic deprivation and crime, and we intuitively
know that drugs and alcohol play some role in creating these problems, sustaining them, or
making them worse. From a social point of view, substance abuse hinders the ability of all
individuals affected by it to reach their full potential. Economically, almost all individuals and
institutions in society are impacted by drug addiction and alcoholism. In the United States, in
2007 the cost of drug abuse to society – health care costs, productivity losses and other costs -
was $193.8 billion (ONDCP Update, June 2011). Furthermore, substance abuse creates a strain
on, and limits the effectiveness of those institutions, which are designed to help people, such as
hospitals and mental health care facilities. Bexar County is not unlike most other large
metropolitan areas in that drugs and alcohol are a significant problem.
This needs assessment should serve as a comprehensive snapshot of Bexar County and as a
tool for substance use prevention. The purpose is to describe demographic characteristics,
identify both risk and protective factors, and to discover substance use consumption patterns

and consequences. The coalition needs assessment also aims to document gaps and
resources so we can better shape prevention in our community and capitalize on existing
efforts. While the information contained within provides us with baseline data which serves to
aid COSA in prioritizing problem areas so that we can strategically target prevention efforts, we
also encourage community stakeholders in drug and alcohol prevention to use this needs
assessment in their own work and to help us to improve it if needed.

Part I – Geographic / Target Population
Bexar County is the 4th
largest county in Texas with a population of over 1.785 million. Bexar
County consists of 27 cities and municipalities of which San Antonio is the county seat. The
2012 population estimate of San Antonio is 1,382,951, (a 4.2% increase between April 1, 2010
and July 1, 2012 compared to only a 3.6% increase for the state of Texas during that same time
period) and is the largest metropolitan area in Bexar County. As the central region of the San
Antonio Metropolitan Statistical Area (MSA), Bexar County serves as an area of social and
economic integration for its adjacent counties – Kendall, Bandera, Medina, Atascosa, Wilson,
Guadalupe and Comal.
Table 1 shows 2009-2011 general demographic figures for Bexar County, from the Census

Census Bureau’s 3-Year American Community Survey estimates.
DP05: ACS DEMOGRAPHIC AND HOUSING ESTIMATES
2010-2012 American Community Survey 3-Year Estimates
Subject
Texas Bexar
County,
Texas
San
Antonio
city, Texas
Estimate Estimate Estimate
SEX AND AGE
Total population 25,644,550 1,754,058 1,358,143
Male 12,729,073 861,044 661,308
Female 12,915,477 893,014 696,835
Under 5 years 1,933,935 130,982 100,588
5 to 9 years 1,954,052 131,499 100,506
10 to 14 years 1,915,750 130,776 98,675
15 to 19 years 1,884,763 132,316 101,206
20 to 24 years 1,875,333 137,960 111,418
25 to 34 years 3,686,704 261,870 206,401
35 to 44 years 3,506,544 234,263 176,115
45 to 54 years 3,445,849 229,520 177,643
55 to 59 years 1,468,038 96,875 75,374
60 to 64 years 1,251,062 84,289 63,694
65 to 74 years 1,555,124 101,742 80,386
75 to 84 years 845,579 57,709 46,479
85 years and over 321,817 24,257 19,658
Median age (years) 33.8 33.0 32.8
18 years and over 18,716,209 1,283,988 999,364
21 years and over 17,555,099 1,200,073 934,600
62 years and over 3,449,337 232,554 183,421
65 years and over 2,722,520 183,708 146,523
18 years and over 18,716,209 1,283,988 999,364
Male 9,188,796 621,552 477,603
Female 9,527,413 662,436 521,761
65 years and over 2,722,520 183,708 146,523
Male 1,193,661 78,155 61,271
Female 1,528,859 105,553 85,252
RACE
One race 25,063,369 1,702,180 1,322,402
Two or more races 581,181 51,878 35,741
One race 25,063,369 1,702,180 1,322,402
White 19,116,593 1,315,323 1,020,761
Black or African American 3,030,320 127,092 90,907

American Indian and Alaska Native 129,874 13,540 11,031
Cherokee tribal grouping 16,338 891 696
Chippewa tribal grouping 1,192 134 116
Navajo tribal grouping 2,881 582 447
Sioux tribal grouping 2,575 523 272
Asian 1,010,831 42,698 30,501
Asian Indian 263,050 9,475 7,227
Chinese 166,908 6,010 4,582
Filipino 103,685 8,734 5,331
Japanese 19,116 2,205 1,922
Korean 75,450 4,030 2,721
Vietnamese 225,925 5,131 4,495
Other Asian 156,697 7,113 4,223
Native Hawaiian and Other Pacific Islander 21,954 2,378 1,719
Native Hawaiian 7,234 553 420
Guamanian or Chamorro 6,609 1,100 939
Samoan 2,598 324 231
Other Pacific Islander 5,513 401 129
Some other race 1,753,797 201,149 167,483
Two or more races 581,181 51,878 35,741
White and Black or African American 132,433 10,637 6,911
White and American Indian and Alaska Native 116,914 7,110 4,743
White and Asian 95,639 8,800 6,039
Black or African American and American Indian and
Alaska Native
19,609 885 550
Race alone or in combination with one or more other races
White 19,611,359 1,357,565 1,050,382
Black or African American 3,232,576 146,078 103,098
American Indian and Alaska Native 296,040 24,884 19,122
Asian 1,158,983 57,714 40,272
Native Hawaiian and Other Pacific Islander 46,585 4,821 3,192
Some other race 1,915,405 218,451 180,720
HISPANIC OR LATINO AND RACE
Hispanic or Latino (of any race) 9,741,366 1,034,687 859,533
Mexican 8,543,694 932,457 779,605
Puerto Rican 140,745 20,780 14,803
Cuban 52,920 3,838 3,026
Other Hispanic or Latino 1,004,007 77,612 62,099
Not Hispanic or Latino 15,903,184 719,371 498,610
White alone 11,481,091 524,036 361,500
Black or African American alone 2,956,974 120,864 86,267
American Indian and Alaska Native alone 68,615 3,668 2,616
Asian alone 996,546 40,995 29,275
Native Hawaiian and Other Pacific Islander alone 18,402 1,649 1,082
Some other race alone 33,049 2,664 1,933
Two or more races 348,507 25,495 15,937

Two races including Some other race 18,975 1,478 972
Two races excluding Some other race, and Three or more
races
329,532 24,017 14,965
Total housing units 10,073,268 667,117 529,614
Of the population 16 and over in Bexar County, 65.3% were in the labor force in 2011 according
to the American Community Survey. Table 2 illustrates employment by sector for the greater
San Antonio Area. Between August 2012 and August 2013, in the San Antonio Metropolitan
Statistical Area, there modest increases or no change in employment, with only the Financial
Activities and the Professional, Business & Other Services sectors showing decreases.
According to the 2009-2011 American Community Survey, the number of Armed Forces
personnel that reside in Bexar County is estimated to be 1.9% of the labor force or 363,238
persons. The remainder of San Antonio’s Department of Defense workforce is civil servants
and subcontractors.
Table 2 San Antonio Employment by Sector
Industry May ‘14 Apr '14 May '13
Change
Education and Health Services 135,300 135,400 134,700
From
May '13
Education Services 142,200 140,800 138,900 2.38%
Leisure and hospitality Services 124,900 121,400 119,000 4.96%
Financial Activities 76,700 75,700 75,700 1.32%
Retail Trade 102,800 102,500 99,500 3.32%
Government 162,500 163,000 162,200 0.18%
Professional, Business & Other Svcs. 113,500 114,500 109,600 3.56%
Transportation, Warehousing and Utilities 23,500 23,300 22,700 3.52%
Source: Texas Labor Market Review May 2014

Part II – Prevention Resource, Capacities and Gaps
a. Prevention Resource Center
In July 2014, the San Antonio Council on Alcohol and Drug Abuse was awarded a DSHS
Prevention Resource Center (PRC) grant to be a clearing house of Substance Abuse data and
resources for Region 8. The data the coalition has already obtained will be shared with the
PRC and will work on promoting the use of the Texas School
b. Other Coalitions
The city of San Antonio is home to four Drug Free Communities Grantees. Bethel Community
Development Corporation was awarded in 2013, Circles of San Antonio Community Coalition
was awarded in 2014 along with East Point Promise Prevention Coalition and George Gervin
Youth Center-project alert.
The DSHS funding for the San Antonio Tobacco Prevention and Control Coalition (SATPCC)
ended in August 2013. As a result of strategic planning conducted during FY-13 the SATPCC
has scaled back their goals to continue serving the community. SATPCC provides technical
assistance for implementing the Teens Against Tobacco Use curriculum in five area high
schools through Family Service Association and in youth community centers across Bexar
County through SACADA their youth component HYPE. SATPCC will also continue to work with
local law enforcement to reduce tobacco sales to minors. COSA maintains an active
membership status in the SATPCC and the former SATPCC Coordinator is now the COSA
Coalition Specialist. In summer 2014 TATU training was facilitated to train new instructors in the
schools. American Lung Association coordinated the training.
The San Antonio Police Department has implanted the SA Team DWI as a combined law
enforcement effort to reduce DWI rates and fatalities associated with alcohol use. SA Team
DWI matches current data related to DWI and motor vehicle incidences to strategically place

DWI saturation patrols and Texas Alcoholic Beverage Commission seller-server compliance
checks. The Bexar County District Attorney’s office has implemented a full time year round no-
refusal initiative for alcohol intoxication checks across Bexar County. COSA maintains an active
partnership with SA TEAM DWI.
A number of community-based coalitions exist within Bexar County and most have a stake in
addressing alcohol and other drugs. Four coalitions exist in Bexar County for reducing alcohol
related motor vehicle fatalities: COSA, the Shattered Dreams Coalition, the Bexar County DWI
Taskforce and The Texas Department of Transportation Traffic Jam Coalition. Other coalitions
that are an important part of prevention in Bexar County are the Healthy Futures Alliance and
the Men’s Health Coalition. The Healthy Futures Alliance serves to prevent teen pregnancy, and
unplanned pregnancy among young adults in San Antonio. The Men’s Health Coalition
addresses issues surrounding access to medical services. The San Antonio Coalition for
Veterans and Families provides networking with Veterans Service Agencies and addresses
gaps.
c. Other State and Federally Funded Programs
COSA maintains an active member of Texans Standing Tall (TST), a statewide coalition and is
an active member on the TST statewide strategy team. COSA utilizes Texans Standing Tall as
their technical assistance provider for strategic planning and environmental strategy process to
reduce underage alcohol access and use and replicates the same strategies that are currently
being implemented in communities across the state.
In 2014 the Texas Counter Drug Task Force-National Guard conducted a Kaizan Model self-
assessment of our coalition and results will be available in Fall 2014.

d. School Programs
Communities in Schools of San Antonio (CIS-SA), a non-profit organization, provides on
campus Case Managers and Social Workers to operate programs in 74 schools across Bexar
County covering 7 School Districts and additionally the Bexar County Juvenile Justice Academy
at the Bexar County Juvenile Detention Center and 1 IDEA campus to work directly with at risk
students and families with the goal of increasing retention and graduation rates of students. The
identified districts are San Antonio ISD, Edgewood ISD, Harlandale ISD, Northeast ISD,
Northside ISD, South San ISD, and Somerset ISD. All of these districts have been identifies
through a process of evaluating socio-economic status, risk and protective factors, and past
year graduation rates. COSA and SACADA maintain a current Memorandum of Understanding
with CIS-SA and are available to provide ATOD information directly to students and parents
through their site offices.
Family Service Association (FSA) is funded by DSHS to conduct Youth Prevention for 2
Indicated populations with Project Towards No Drug Abuse ages 14-19 and Curriculum Based
Support Group for ages 11-17 and one Youth Prevention for a Selective Population using the
Positive Curriculum. COSA is currently discussing the ability of FSA to expand the outreach of
ZAYC program to make it available for their High School and campus groups. In addition FSA is
implementing the Teens Against Tobacco Use (TATU) as part of the Youth Against Gang
Activity (YAGA) activities on the High School Campuses they service.
Family Violence and Prevention Services is funded by DSHS to conduct Reconnecting Youth
Curriculum with a Indicated Populations ages 14-19.
JOVEN is funded by DSHS to conduct Youth Prevention for a Selective Population Postive
Action with 6-9 year olds and 9-18 year olds

San Antonio Council on Alcohol and Drug Abuse is funded by DSHS to provide Youth
Prevention to three Universal Populations utilizing Life Skills Training Curriculum with ages 8-9
and 9-12 year olds, Too Good For Drugs with 9-18 year olds, and Project Toward No Drug
Abuse with 14-19 year olds. SACADA also serves a Selective population with Curriculum Based
Support Group with 6-9 and 9-17 year olds. With the Indicated Population Project Toward No
Drug Abuse is also used serving ages 14-19 year olds.
COSA and Texans Standing Tall are currently in dialogue with Claudia Taylor Johnson HS to
implement the Zero Alcohol for Youth Campaign on their campus through the Winner’s Club.
Johnson High School is located in the northern most area of San Antonio and is one of the
newest High Schools in Bexar County. The same geographic area has been identified by the
SAPD as a consistent hot spot for DWI related incidences and school district personnel have
identified their biggest problem to be underage access to alcohol.
Most Colleges and universities in San Antonio have alcohol awareness and prevention
resources and programs in place that encompass some form of the CSAP six prevention
strategies. The University of Texas is working on Environmental strategies as well as
information dissemination.
Community Programs and Services
e. Parent Programs
The Circles of San Antonio will maintain their collaboration with Communities in Schools of San
Antonio. Through CIS-SA campus operations, COSA will be available as a resource to provide
ATOD awareness and community education to their parent support network. COSA is available
to PTA groups for ATOD presentations for awareness and under-age alcohol use prevention.

f. Direct Prevention Service Providers
In Bexar County there are four agencies that are funded by DSHS to conduct prevention
programing- Family Service Association, Family Violence Prevention Services, JOVEN, and the
San Antonio Council on Alcohol and Drug Abuse. These are listed in the School Based
Providers section.
g. Treatment Providers
In 2013, the Recovery Systems of Care (ROSC) was awarded a grant initiative to form a
Recovery Web Portal and enlist recovery coaches for one on one service to the recovery
community. The group is starting a adolescent ROSC.
COSA serves as an active partner on the Alamo Area Recovery Initiative. COSA is also a
partner with the San Antonio Addiction to Recovery Coalition and assists the organization of the
3-5K Recovery Walk. The mission of the 3-5K Recovery Walk is to raise awareness of Recovery
Support Services available in the community.
The University of Health Science Center San Antonio received a 1115 Waiver to provide
substance abuse treatment with adolescents, they completed their Problem Identification and
Community Needs Assessment of Youth Substance Use Treatment in August 2014. One of the
key finding is that Bexar County would benefit from increased data collection on youth
substance use. Currently, nine facilities offer youth substance use treatment in Bexar County,
and six offer substance use-specific programs. The table below shows the nine existing
programs and whether they (a) have a specific youth substance use program; (b) offer
residential and/or outpatient programs; and (c) offer individual, family, and/or group therapy,
and/or (d) offer continued care.
Table 24. Existing Youth Substance Use Treatment Programs

Max # of
Patients
Substance-
Use Spec.
Prog
Residential
(R) or
Outpatient
(OP)
Individual
(I),
Family
(F), or
Group
(G)
Continued
Care (CC)
Alpha Home 47 R & OP I & G
Center for Health Care Services N/A Y OP G
Elite Counseling N/A Y OP I & G
Family Services (Keeping It Real) 33 Y OP I &F CC
Laurel Ridge N/A R & OP I, F, & G
Palmer Drug Abuse Program N/A Y OP I & G
Project Tejas 50 Y OP I, F, & G
SA Counseling & Beh Center 50 OP I & F
Selena Center for Youth Potential 16 Y R I, F, & G
h. Healthcare Providers
COSA has met with the epidemiology team of the San Antonio Metropolitan Health District
(SAMHD). Through this partnership COSA is able to work with the SAMHD on data sharing and
strategic alignment of service initiatives that correlate with health disparities.
COSA is a member of the Bexar County Health Collaborative, a combined collaborative effort to
identify and direct services for the most needed health services of Bexar County residents.
i. Higher Education Prevention
Most Colleges and universities in San Antonio have alcohol awareness and prevention
resources and programs in place.
COSA has a well-established working relationship with several Higher Educational Institutions
and active membership from UTSA, University of Incarnate Word, St, Mary’s University, and
Alamo Community College District. COSA will continue to work with local colleges and
universities to provide prevention and educational support to the campuses.

The University of Texas at San Antonio (UTSA) is the newest higher education campus to adopt
a smoke-free campus wide policy. This policy has been in a phase in status beginning on June
1, 2013 and will take full effect on June 1, 2014 for the main campus and the downtown campus
as well as any satellite campus. In addition, UTSA Student Activities Department and Be A
Responsible Roadrunner student organization host Alcohol Awareness Week Programs and
other student led initiatives that have become staple events with the purpose of educating
students about campus policy and state law regarding alcohol, reducing alcohol violations on
campus and reducing high risk drinking among college students.
The University Of Incarnate Word Office Of Student Health Services conducts alcohol
awareness activities on campus and hosts “SOBER Roads” a yearly campus wide health fair.
Several of the professors require their students to attend the health fair and complete a
research study on alcohol use and consequences utilizing information form the resource
providers attending the health fair.
j. Law Enforcement
COSA has a well-established working relationship with local law enforcement agencies. COSA’s
extensive network of relationships involves the San Antonio Police Department, San Antonio
Team DWI, Bexar County DWI Task Force, Alamo Area Council of Governments Law
Enforcement Academy, Texas Comptroller’s Office Criminal Investigations Division, The
University of Texas at San Antonio Police Department, local school district police and municipal
police departments. In Bexar County, there are 25 municipal city jurisdictions and COSA is
continually trying to network with these smaller departments such as Alamo Heights, Leon
Valley, and Balcones Heights just to name a few. In 2012 the Bexar County voters elected a
new Sheriff and this change resulted in an administrative and structure change to the operations
of the Bexar County Sheriff’s Office. COSA is currently working to strengthen the relationship

with the Sheriff’s Office and has plans for meeting with the Sheriff to discuss environmental
strategies that are currently being work on.
Gaps in Service
We feel that a priority for prevention is continuum of care. In order to address risk factors and
maximize protective factors, ideally there should be a continuum of care which includes a
network of providers. Not only does this prevent duplication of services, but it makes for a more
cost effective and efficient use of resources. However, in order to even consider what gaps in
service there are, there first must be recognition that a problem exists and risk factors need to
be prioritized.
A continuum of prevention across the life span is a gap that prevents co-morbidity, relapse,
disability and the consequences of severe mental illness. In addition, it is commonly accepted
that individuals are most at risk for substance use and abuse at “transition” points in their life
and at key stages across the life span cycle.
We also know that drug use and alcohol abuse exists within the workplace and is costly to
employers and the community alike. Having prevention programs for the workplace is a good
use of prevention resources that can have a greater economic and social impact.
San Antonio Metropolitan Health Collaborative has identified four areas of priority that currently
are not being addressed: 1) Lack of public health resources to study substance-exposed infants.
2) Lack of hospital data on the type of substance abuse and cost. 3) Lack of consistent
standards in substance abuse treatment programs that treat pregnant women. 4) Harm
reduction programs to help prevent infectious diseases such as needle exchange programs.
Texas eliminated the Safe and Drug Free Communities grants to schools. We feel that many of
the schools in San Antonio are reluctant to implement DSHS funded programs on their

campuses because it might attach a stigma that their schools have a drug and alcohol problem.
Educating the educators is something that needs to take place in all communities because the
objective evidence shows that no community, regardless of socio-economic stature, is immune
from the destructive influence of alcohol and drugs.
One of our biggest concerns is lack of data needed to help us understand the entire scope of
drug and alcohol use in Bexar County. Having a more comprehensive, data-driven, picture of
prevention needs in the community would enable us to better target prevention efforts. It is
important to emphasize that Bexar County lacks a local infrastructure for collaborating on data
collection and analysis; this includes the sharing of data between agencies.
Bexar County is home to eleven colleges and universities. In order to address risky behavior
among college students in Bexar County, we need uniform data across all campuses. The Core
Survey is one such tool that would make uniform data available. A short term goal for COSA is
to motivate colleges in Bexar County to administer the Core Survey. Additionally, since armed
forces personnel are represented in significant numbers in Bexar County, greater collaboration
with the military for prevention and data would be equally as beneficial.
From our own experience, SACADA envisions a culture of prevention where agencies are not
operating so much in silos, but collaborating and sharing resources. Even though there has
been much headway in this direction, there is still a lot of work to do
Part III – Consequences and Consumption Patterns of the Community
a. DWI Rates
The graphs that follow on the next several pages highlight pertinent data points taken from the
San Antonio Police Department and the Bexar County Sherriff’s Office. These graphs show DWI
trends and patterns in San Antonio and Bexar County. DWI arrests have increased in recent

years and there has also been a increase in enforcement by SAPD. Still, a priority intervening
variable to be considered for prevention interventions in Bexar County should be low
enforcement.
Thirty-eight is the mean age for persons arrested for DWI in Bexar County and that the average
BAC (Blood Alcohol Concentration) of those arrested is .151, nearly twice the legal limit (Bexar
County Sherriff’s Office). Most arrestees are by far, first time offenders (Graph 3).
Graph 3
Source: Bexar County Sheriff’s Office
68%
14%
7%
7%
4%
Bexar County DWI Disposition 2007-2011
Five Year Average
DWI-1ST
DWI-2ND
DWI-3RD
DUI-MINOR
UNKNOWN

Graph 5
Source: San Antonio District Attorney’s office
Source: San Antonio Police Department
2009 2010 2011 2012 2013
Arrests 6095 6872 6873 7517 7712
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
AxisTitle
DWI Arrest Data by Year

b. Alcohol Related Vehicular Fatalities
In 2011, Bexar County was in the lower third of counties within the state for number of alcohol-
related crash fatalities, with a rate of 4.50 fatalities per 100,000 residents. The following graphs
illustrate Bexar County’s alcohol-related crash fatality trend compared to that of Texas and the
United States. The data was collected from the National Highway Traffic Safety Administration
and “alcohol-related crash fatality” is defined as a fatality that resulted from a crash that involved
at least one driver or motorcycle rider with a BAC (Blood Alcohol Concentration) of .08 or above.
Although Bexar County had shown a 10% decrease in fatalities between 2007 and 2009, it has
since spiked well above the state and national average in 2010.
Source: National Highway Traffic Safety Administration
2008 2009 2010 2011 2012
Bexar County 46% 42% 53% 53% 48%
Texas 38% 41% 42% 40% 38%
United States 31% 32% 31% 30% 31%
0%
10%
20%
30%
40%
50%
60%
% Alcohol Related Motor Vehicle Fatalities

2012 Bexar County Alcohol Related Crash Fatalities
Source: NHTSA FARS Data (Bexar County, BAC >.08, Fatalities)

2008 2009 2010 2011 2012
Bexar 74 64 80 80 78
Cameron 18 14 16 17 16
Dallas 99 73 82 71 84
El Paso 27 33 33 46 30
Harris 168 162 182 172 166
Tarrant 67 62 68 63 50
0
20
40
60
80
100
120
140
160
180
200
Texas Vehicular Alcohol Fatalities by County

2008 2009 2010 2011 2012
Bexar 4.48 3.8 4.64 4.56 4.37
Cameron 4.58 3.5 3.92 4.12 3.85
Dallas 4.28 3.11 3.45 2.95 3.42
El Paso 3.51 4.19 4.11 5.62 3.63
Harris 4.27 4.02 4.43 4.12 3.9
Tarrant 3.84 3.48 3.74 3.41 2.66
2
2.5
3
3.5
4
4.5
5
5.5
6
Texas Vehicular Alcohol Fatalities by County Per
100,000

c. Violent Crimes
Source: Bexar County Juvenile Probation
Source: Bexar County Juvenile Probation
2009 2010 2011 2012 2013
Murder/Manslaughter 5 3 2 4 3
Attempted Murder 0 1 0 0 0
0
1
2
3
4
5
6
Bexar County Juvenile Probation Violent
Referrals
2009 2010 2011 2012 2013
Sexual Assault, related 82 92 88 87 89
Robbery 58 56 50 42 34
Aggravated Assault 203 198 197 152 147
0
50
100
150
200
250
Bexar County Juvenile Probation Violent
Referrals cont.

Source: UCR Crime Data FBI.gov
Violent
crime
Murder
and
nonnegl
igent
manslau
ghter
Forcible
rape
Robbery
Aggrava
ted
assault
Propert
y
crime
Burglary
Larceny-
theft
Motor
vehicle
theft
Arson
Bexar 487 10 70 99 308 6,398 2,081 3,865 452 80
Cameron 143 4 15 19 105 1,732 619 1,027 86 19
Dallas 51 0 2 6 43 296 91 181 24 0
El Paso 250 5 28 23 194 1,260 303 829 128 13
Harris 7,416 77 295 2,744 4,300 52,551 13,848 32,259 6,444 331
Tarrant 126 1 17 12 96 1,246 411 746 89 15
0
10,000
20,000
30,000
40,000
50,000
60,000
2012 Offenses Known to Law Enforcement

www.circlesofsa.org 27 COSA Needs Assessment September
2014
TEXAS
Full-time Law Enforcement
Employees
2012
County
Total law
enforcement
employees
Total
officers
Total
civilians
Bexar 1,627 527 1,100
Cameron 502 112 390
Denton 583 234 349
El Paso 1,126 258 868
Source: FBI.gov
d. Possession of illicit drugs (arrests)
Source: Texas Department of Public Safety (2012 Crime in Texas)
Synthetic
Narcotics
52%
Marijuana
12%
Other
11%
Opium or
Cocaine
25%
Drug Sale & Manufacturing Arrests by
Drug Type

Source: Texas Department of Public Safety (2012 Crime in Texas)
e. Public Intoxications
Source: Texas Department of Public Safety
Sythetic Narcotics
8%
Opium or Cocaine
19%
Other
15%
Marijuana
58%
Drug Possession Arrests by Drug Type
2008 2009 2010 2011 2012
Drunkeness 145184 142631 131565 118451 114436
Liquor Laws 31366 29292 26797 24062 22889
Driving Under the Influence 94248 96350 94440 87644 89256
Texas Arrest Data for Alcohol Involved Crimes

f. Suicide Rates
Suicides - Drugs Alcohol
2007 2008 2009 2010 2011 2012 2013
Alcohol Only 18 27 34 * * * *
Drugs Only 64 59 75 * * * *
Drugs and Alcohol 27 31 32 19 27 23 27
Total Tests
Performed
163 172 204 199 194 206 198
*The M.E. no longer reports on Alcohol Only or Drugs Only, instead they classify as Drug(s)/Chemical(s).
g. Homicide Rates
Homicides - Drugs Alcohol
2007 2008 2009 2010 2011 2012 2013
Total Performed 159 175 151 124 118 136 137
Source: Bexar County Medical Examiner Annual Reports
2008 2009 2010 2011 2012 2013
Homicide 175 151 124 118 136 137
Suicide 172 204 119 194 206 198
0
50
100
150
200
250
Manner of Death - Bexar County

j. Underage binge drinking rates
Combined school district data taken from the Texas Education Agencies (TEA) Public Education
Information Management System (PEIMS) data shows that there was a decrease in controlled
substance violations during the 2010-2011 school year (See Graph 10).
Additionally controlled substance violations are markedly more common an offense than either
alcohol or tobacco. Alcohol violations, also from PEIMS, showed a 6% increase from 08-09 to
09-10, at its highest since 05-06 but dropped off during 10-11 (See Graph 11). Tobacco
violations showed an 11% increase from 08-09 to 09-10 but dropped off during 10-11 nearing
the 08-09 levels (See Graph 12). Submission of PEIMS data to the TEA is required by all school
districts in the state of Texas and the reporting requirements are uniform. Furthermore, for the
graphs below, yearly rates were adjusted for school enrollment growth which has increased by
10% since the 05-06 school year.

TEXAS EDUCATION AGENCY
PEIMS Discipline Data for 2012-2013
04-CONTROLLED
SUBSTANCE/DRUGS
05-ALCOHOL
VIOLATION 33-TOBACCO
Alamo Heights ISD 20 25 n/a
Boerne ISD 39 9 n/a
East Central ISD 64 n/a 8
Edgewood ISD 127 n/a 8
Ft. Sam Houston ISD n/a not reported n/a
Harlandale ISD 133 n/a n/a
Judson ISD 203 11 n/a
Lackland ISD n/a not reported not reported
North East ISD 463 54 61
Northside ISD 633 40 68
San Antonio ISD 621 18 132
Somerset ISD 17 9 n/a
South San Antonio
ISD 73 n/a not reported
Southside ISD 42 n/a n/a
Southwest ISD 104 6 5
Counts less than 5 and greater than 0, and, when necessary, other associated counts
are masked with the value "N/A" to comply with FERPA.
Source: http://ritter.tea.state.tx.us/adhocrpt/Disciplinary_Data_Products/Download_District_Summaries.html
k. College age binge drinking
The Behavioral Risk Factor Surveillance System (BRFSS) data for the San Antonio MSA
(Metropolitan Statistical Area – See demographics section) shows that from 2005 to 2010 the
binge drinking rates for adults 18 and over were higher than both the state and national rates.
While the state and national binge drinking rates follow each other almost exactly and have
remained relatively constant since 2005 (between 14% and 15%), the local rate started to show

a decline from 19% in 2006 to 16.9% in 2008, but then sharply increased in 2009 to 21% (a 4%
increase). Though there was a drop in 2010 numbers, the rate is still higher than in 2006 and
could rebound again as the trend line indicates. As with binge drinking, state and national
heavy drinking rates since 2006 have remained more or less constant at about five percent.
Like binge drinking, heavy drinking remains higher, but not remarkably so, than the state and
national rates. In 2010 the San Antonio heavy drinking rate was 8.2% while the state and
national rates were 4.9% and 6.7%, respectively. In 2010, 57.4% of adults twenty-one and over
in Bexar and surrounding counties reported having consumed alcohol within the past thirty days.
As a SAMHSA grantee, the University of Texas San Antonio conducted a survey in 2014 with
395 students from undergraduate classes. (Sociology, political science, history, biology). 235
were ages 18-20 and of this number 48% reported drinking within the past 30 days. 32% of all
participants said they used marijuana in the past year and 55/9% said it was easy to obtain
drugs and alcohol in the community.
Graph 2, shows Behavioral Risk Factor Surveillance system (BRFSS) results for respondents
18 years and older who reported having 5 or more drinks on one occasion in the past 30 days
and Graph 2.1 shows heavy drinking behavior in the last 30 days for respondents 18 years and
older.

Source: Behavioral Risk Factor Surveillance System (BRFSS)
10.0%
15.0%
20.0%
25.0%
2005 2006 2007 2008 2009 2010
Nationwide
Texas
San Antonio
Trend Line (San Antonio)
Past 30 Day Binge Drinking
At
Risk

2014
Prevalence of Binge Drinking
San Antonio MSA
Adults Ages 18 Years and Over
Texas BRFSS, 2011
Area Groups Demographics
Sample
Size
Percent Not at
Risk
(95% CI)
Percent At Risk
(95% CI)
San Antonio MSA Totals Totals 1116 77.5 (72.3-81.9) 22.5 (18.1-27.7)
Gender Male 420 72.2 (65.0-78.4) 27.8 (21.6-35.0)
Female 696 82.6 (74.4-88.6) 17.4 (11.4-25.6)
Race/Ethnicit
y White 635 74.7 (66.1-81.7) 25.3 (18.3-33.9)
Black 77 89.7 (74.0-96.4) 10.3 (3.6-26.0)
Hispanic 360 77.8 (70.2-83.9) 22.2 (16.1-29.8)
Other < 50 0.0 (-) 0.0 (-)
Age Group 18-29 Years 85 56.5 (42.4-69.6) 43.5 (30.4-57.6)
30-44 Years 221 78.2 (70.0-84.6) 21.8 (15.4-30.0)
45-64 Years 413 83.9 (77.9-88.5) 16.1 (11.5-22.1)
65+ Years 390 94.7 (88.6-97.6) 5.3 (2.4-11.4)
Education < High School 96 77.2 (61.4-87.8) 22.8 (12.2-38.6)
High School Grad 259 85.0 (76.6-90.7) 15.0 (9.3-23.4)
Some College 333 71.1 (60.0-80.1) 28.9 (19.9-40.0)
College Grad 424 78.3 (71.3-84.1) 21.7 (15.9-28.7)
Income < $25,000 293 80.3 (71.1-87.1) 19.7 (12.9-28.9)
$25,000-$49,999 244 73.8 (64.3-81.5) 26.2 (18.5-35.7)
$50,000 + 450 81.7 (75.1-86.8) 18.3 (13.2-24.9)

2014
l. Current 30 day drinking rates
Source: Behavioral Risk Factor Surveillance System (BRFSS)
0.00%
1.00%
2.00%
3.00%
4.00%
5.00%
6.00%
7.00%
8.00%
9.00%
10.00%
2004 2005 2006 2007 2008 2009 2010
Past 30 Day Heavy Drinking
Nationwide
Texas
San Antonio

2010 Youth Risk Behavior Survey Results
Percentage of students who had at least one drink of alcohol on one or more days during their life
CPPW: San Antonio, TX High School Survey
Percentage of students who had at least one drink of alcohol on one or more of the past 30 days
72.6
68.9
76.4
61.4
75.3
78.2 80.5
62.9
74.2 72.7
0
20
40
60
80
100
Total Male Female 9th 10th 11th 12th Black*Hispanic/…White*
37.7 34.7
41.0
29.2
38.0
42.5
45.3
22.2
40.1 37.5
0
20
40
60
80
100

m. Current 30 day illicit drug use rates
Percentage of students who used marijuana one or more times during the past 30 days
Percentage of students who were offered, sold, or given an illegal drug by someone on school
property during the past 12 months
23.5
27.0
19.9 17.7
23.7
27.5 28.2
15.3 25.7
19.9
0
20
40
60
80
100
29.7 29.3 30.1 26.6
29.8
32.7 30.7
19.1
32.4 26.1
0
20
40
60
80
100

2014
n. Perceptions of harmfulness of use (alcohol and other substances)
How dangerous do you think it is for kids your age to use...
Never
heard of
Very
dangerous Dangerous
Not at all
dangerous
Do not
know
Any tobacco
product?
All 1.70% 78.00% 16.60% 0.50% 3.20%
Grade 4 3.80% 82.00% 11.30% 0% 3.00%
Grade 5 0.70% 82.80% 14.90% 0% 1.50%
Grade 6 0.50% 69.30% 23.70% 1.50% 5.00%
Cigarettes?
All 2.70% 67.70% 24.70% 0.80% 4.10%
Grade 4 5.30% 73.50% 18.20% * 3.00%
Grade 5 1.50% 71.40% 24.10% * 3.00%
Grade 6 1.30% 58.10% 31.90% 2.30% 6.30%
Smokeless
tobacco?
All 9.40% 65.80% 17.60% 0.90% 6.30%
Grade 4 21.70% 62.80% 10.10% 0.80% 4.70%
Grade 5 3.80% 74.80% 16.00% * 5.30%
Grade 6 2.80% 59.80% 26.60% 2.00% 8.80%
Source: San Antonio, TX NISD Texas School Survey 2012
How dangerous do you think it is for kids your age
to use tobacco?
Very
dangerous
Somewhat
dangerous
Not very
dangerous
Not at all
dangerous
Do not
know
All 56.10% 26.80% 9.10% 2.90% 5.20%
Grade 7 71.80% 18.30% 2.80% 1.40% 5.60%
Grade 8 65.80% 15.20% 6.30% 1.30% 11.40%
Grade 9 54.70% 28.10% 9.00% 2.30% 5.80%
Grade 10 52.10% 30.60% 10.70% 5.00% 1.70%
Grade 11 49.70% 33.30% 10.50% 2.90% 3.50%
Grade 12 43.00% 35.50% 14.70% 4.30% 2.40%

Never
heard of
Very
dangerous Dangerous
Not at all
dangerous
Do not
know
Any alcohol
product?
All 1.10% 70% 21.60% 2.50% 4.80%
Grade 4 2.30% 80% 12.90% * 5.30%
Grade 5 0.70% 71.10% 22.20% 2.20% 3.70%
Grade 6 0.40% 59.40% 29.60% 5.20% 5.30%
Beer?
All 0.90% 50.40% 33.70% 5.90% 9.10%
Grade 4 2.40% 60.30% 27.80% 0.80% 8.70%
Grade 5 0.00% 51.90% 32.60% 6.20% 9.30%
Grade 6 0.40% 39.10% 40.60% 10.60% 9.30%
Wine coolers?
All 15.00% 43.90% 23.50% 4.80% 12.80%
Grade 4 20.00% 52.30% 16.90% 0.80% 10.00%
Grade 5 16.20% 43.10% 23.10% 3.10% 14.60%
Grade 6 8.80% 36.30% 30.60% 10.50% 13.70%
Wine?
All 2.00% 47.80% 29.30% 10.40% 10.50%
Grade 4 4.60% 58.50% 25.40% 6.20% 5.40%
Grade 5 0.80% 49.25% 27.30% 9.40% 13.30%
Grade 6 0.60% 35.80% 35.00% 15.60% 13.00%
Liquor?
All 6.70% 61.80% 22.90% 2.50% 6.20%
Grade 4 13.20% 64.30% 16.30% 0.00% 6.20%
Grade 5 4.70% 66.70% 22.50% 2.30% 3.90%
Grade 6 2.20% 54.50% 29.80% 5.20% 8.40%
How dangerous do you think it is for kids your age to use alcohol?
Very
dangerous
Somewhat
dangerous
Not very
dangerous
Not at all
dangerous Do not know
All 47.90% 31.40% 14.00% 3.20% 3.50%
Grade 7 67.60% 11.30% 11.30% 4.20% 5.60%
Grade 8 48.70% 28.90% 10.50% 3.90% 7.90%
Grade 9 43.10% 32.60% 17.50% 3.00% 3.80%
Grade 10 43.80% 33.10% 18.20% 4.10% 0.80%
Grade 11 44.30% 39.50% 12.60% 1.80% 1.80%
Grade 12 42.30% 42.10% 12.70% 1.60% 1.20%

How dangerous do you think it is for kids your age to use
marijuana
Never
heard of
Very
dangerous Dangerous
Not at all
dangerous
Do not
know
All 15.50% 67% 9.10% 1.60% 6.60%
Grade 4 27.00% 59% 6.30% * 7.90%
Grade 5 15.60% 71.10% 7.80% 0.00% 5.50%
Grade 6 4.30% 71.50% 12.90% 4.80% 6.50%

Very
dangerou
s
Somewhat
dangerous
Not very
dangerous
Not at all
dangerous
Do not
know
Marijuana?
All 47.60% 17.20% 14.80% 17.70% 2.70%
Grade 7 74.60% 11.30% 4.20% 5.60% 4.20%
Grade 8 49.30% 19.20% 9.60% 19.20% 2.70%
Grade 9 49.60% 15.80% 14.80% 16.30% 3.50%
Grade 10 40.70% 16.30% 17.10% 24.40% 1.60%
Grade 11 38.50% 20.70% 20.10% 18.30% 2.40%
Grade 12 34.50% 20.10% 22.80% 20.90% 1.60%
Cocaine?
All 84.20% 8.40% 1.80% 1.10% 4.50%
Grade 7 81.20% 5.80% 2.90% 2.90% 7.20%
Grade 8 83.30% 9.70% 1.40% 0.00% 5.60%
Grade 9 83.40% 9.20% 1.60% 0.70% 5.10%
Grade 10 82.50% 10.80% 3.30% 1.70% 1.70%
Grade 11 87.30% 6.70% 0.60% 0.60% 4.80%
Grade 12 88.10% 7.40% 1.10% 0.70% 2.60%
Crack?
All 85.50% 7.60% 1.20% 0.70% 5.00%
Grade 7 80.90% 10.30% 1.50% 1.50% 5.90%
Grade 8 84.50% 5.60% 1.40% 0.00% 8.50%
Grade 9 85.40% 7.10% 1.40% 0.90% 5.20%
Grade 10 83.10% 11.90% 1.70% 0.80% 2.50%
Grade 11 88.90% 4.90% 0.60% 0.60% 4.90%
Grade 12 90.50% 5.40% 0.70% 0.50% 2.90%
Ecstasy?
All 74.80% 12.20% 3.20% 1.40% 8.40%
Grade 7 81.80% 4.50% 3.00% 0.00% 10.60%
Grade 8 76.40% 9.70% 0.00% 1.40% 12.50%
Grade 9 73.40% 10.80% 4.20% 1.70% 9.80%
Grade 10 68.10% 20.40% 3.50% 1.80% 6.20%
Grade 11 74.40% 13.80% 3.10% 1.90% 6.90%
Grade 12 75.80% 13.30% 5.10% 1.50% 4.30%
Continued on next page…

Very
dangerous
Somewhat
dangerous
Not very
dangerous
Not at all
dangerous
Do not
know
Steroids?
All 74.00% 14.60% 4.30% 1.40% 8.40%
Grade 7 80.30% 7.60% 6.10% 0.00% 10.60%
Grade 8 77.50% 12.70% 0.00% 1.40% 12.50%
Grade 9 71.60% 15.70% 4.60% 1.70% 9.80%
Grade 10 72.20% 21.70% 2.60% 1.80% 6.20%
Grade 11 69.90% 12.90% 8.00% 1.90% 6.90%
Grade 12 73.70% 15.90% 5.10% 1.50% 4.30%
Heroin?
All 87.10% 5.40% 1.00% 0.90% 5.70%
Grade 7 86.60% 3.00% 1.50% 1.50% 7.50%
Grade 8 84.70% 6.90% 1.40% 0.00% 6.90%
Grade 9 85.50% 5.58% 1.20% 0.70% 7.20%
Grade 10 85.50% 9.40% 0.90% 1.70% 2.60%
Grade 11 89.00% 3.70% 0.60% 0.60% 6.10%
Grade 12 91.80% 3.50% 0.30% 0.70% 3.70%
2012 was the most recent year in which the Texas School Survey (TSS) of Drug and Alcohol
Use was conducted in Bexar County. Only one school district was surveyed in 2012.

o. HIV infection rates and transmission route
2005 2006 2007 2008 2009 2010
Sexually Transmitted
Diseases Cases
Rate
per
100k Cases
Rate
per
100k Cases
Rate
per
100k Cases
Rate
per
100k Cases
Rate
per
100k Cases
Rate
per
100k
Chlamydia 7,400 501.2 7,594 488.2 8,054 505.1 8,849 545.3 10,440 632.2 11,455 668
Gonorrhea 2,184 147.9 2,562 164.7 2,465 154.6 2,898 178.6 3,401 205.9 3,520 205.3
Syphilis 422 28.6 438 28.2 384 24.1 550 33.9 705 42.7 670 39.1
HIV (not AIDS) Reports * 330 22.4 208 13.4 223 14 205 12.6 * *
AIDS Reports ** 205 13.9 207 13.3 226 14.2 198 12.2 ** **
HIV Infection Diagnoses *** *** *** *** *** 312 18.9 253 14.8
AIDS Diagnoses **** **** **** **** **** 200 12.1 165 9.6
* HIV (not AIDS) cases were not tracked before 1999 in Texas
** AIDS cases are no longer presented by year of report as of 2009
*** Diagnoses of HIV infection regardless of disease satus (either HIV or AIDS) are presented by year
****Diagnoses of AIDS are presented by year of diagnosis as of 2009
Source: Bexar County Health Profiles 2010 (courtesy of Dr. Anil Mangla and John Berlanga

2014
Primary and Secondary Syphilis Rates by Race/Ethnicity, United States,
2002–2011
Source: Syphilis in Bexar County (courtesy of Dr. Anil Mangla), Aug 14, 2013
Primary and Secondary Syphilis Rates, 2000-2012*
Source: Syphilis in Bexar County (courtesy of Dr. Anil Mangla), Aug 14, 2013

*2012 Local Preliminary Data 2-15-13
q. Treatment episode admission data
Cannabis was the primary problem for 23 percent of admissions to treatment programs in 2012
compared with 8 percent in 1995. While 43 percent of cannabis admissions in 2012 reported no
second substance abuse problem, 29 percent had a problem with alcohol. The average age of
cannabis clients was 23. Approximately 43 percent were Hispanic, 25 percent were White, and
26 percent were Black; 72 percent were male. Seventy-eight percent were involved with the
criminal justice system and only 13 percent were employed fulltime. (Source: Substance Abuse
Trends in Texas: June 2013, Maxwell )
Source: Substance Abuse Trends in Texas: June 2013, Maxwell
Texas Poison Center Network abuse and misuse calls involving the use of cocaine increased from 497 in
1998 to 1410 in 2008 and then declined to 552 in 2012 (exhibit 7). Sixty-five percent of the cocaine cases
in 2012 were male and average age was 33. (Source: Substance Abuse Trends in Texas: June 2013, Maxwell )

Calls to the Texas Poison Center Network involving confirmed exposures to heroin ranged from 181 in
1998 to 268 in 2012 (exhibit 11). Heroin was the primary drug of abuse for 13 percent of clients admitted
to treatment in 2012 (Appendix 1). The characteristics of these users vary by route of administration, as
exhibit 12 illustrates. Most heroin addicts entering treatment inject the drug, but the proportion inhaling
heroin increased from 4 percent of all heroin admissions in 1996 to 18 percent in 2012. Smoking black tar
heroin is very rare in Texas because the chemical composition tends to flare and burn rather than
smolder. (Source: Substance Abuse Trends in Texas: June 2013, Maxwell )
Exhibit 14 shows the changes in race/ethnicity over the years. In 2011 and 2012, the proportion of White
admissions increased and the proportion of Hispanic admissions decreased. (Source: Substance Abuse
Trends in Texas: June 2013, Maxwell )

The increase in young persons entering treatment for dependence on heroin is a concern. The proportion
of heroin clients under age 30 increased from 40 percent in 2005 to 48 percent in 2012, while the
proportion of older admissions decreased correspondingly (exhibit 13). The proportion of teenagers
entering treatment remained low, but given the lag between first use and dependence, many of the
admissions in their twenties began their heroin use as teenagers. (Source: Substance Abuse Trends in Texas:
June 2013, Maxwell )
In 2012, there were 354 heroin poisoning deaths in Texas (exhibit 15). The decline in average age of the
decedents from 40 in 2008 to 36 in 2012 is evidence of the increasing use by young adults. Of these
deaths, 51 percent involved only heroin and 24 percent also involved cocaine. Of these decedents, 85
percent were male; 52 were White, 90 percent were Hispanic, and 8 percent were Black. (Source:
Substance Abuse Trends in Texas: June 2013, Maxwell )

s. Truancy data / drop out rates
In Bexar County there are 14 school districts. In 2011, the average number of students that
were determined by the Texas Education Agency (TEA) to be disadvantaged was sixty-six
percent for a total of 219,165 students. Five school districts – Edgewood, Harlandale, San
Antonio ISD, South San Antonio ISD and Southwest ISD - had on average, 90% of their
students classified as economically disadvantaged. Also according to the TEA, in 2010 these
same five school districts were among the top seven with the highest enrollment of Hispanic
students (averaging collectively over 95%). In San Antonio, 2011, for the population
represented by those 25 and older, only 15% attained a Bachelor’s degree, less than 7%
earned an Associates or equivalent, 25% graduated from high school only with either a diploma
or GED equivalent while 20% of that population never completed high school. These rates were
nearly the same as those for Texas. For both African Americans (13%) and Hispanics (29%)
the dropout rate, and the mean SAT score for those in high school were considerably worse
than they were for Whites.

Source TEA Website http://loving1.tea.state.tx.us/lonestar/selectdist.aspx?level=district
Bexar County is home to 11 universities and colleges with a combined student population of
over 371,000.
AHISD BISD ECISD EISD
FtSHI
SD
HISD JISD LISD NEISD NISD SAISD
Some
rISD
SSanI
SD
SouSI
SD
SWIS
D
2005-06 1.1% 0.3% 3.5% 8.4% 0.3% 2.7% 4.0% 0.0% 1.2% 3.3% 8.5% 4.6% 6.2% 4.8% 5.2%
2006-07 1.1% 0.2% 4.5% 4.8% 1.1% 3.5% 4.3% 0.6% 0.8% 3.2% 8.1% 6.7% 6.7% 5.7% 4.1%
2007-08 0.6% 0.2% 2.8% 4.0% 0.3% 2.5% 4.6% 0.0% 1.2% 1.7% 6.8% 2.1% 6.8% 6.7% 4.3%
2008-09 0.4% 0.0% 3.7% 5.8% 0.0% 4.5% 3.3% 0.5% 1.7% 1.0% 6.3% 3.7% 5.7% 4.8% 3.8%
2009-10 0.7% 0.1% 2.0% 5.3% 0.5% 3.2% 3.5% 1.2% 1.8% 1.0% 5.9% 4.6% 3.9% 3.8% 3.9%
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
9.0%
Drop Out Rates Grades 9 - 12

Education Statistics by Bexar County School Districts 2011
Source: Bexar County Health Profiles 2011 (courtesy of Dr. Anil Mangla and John Berlanga

t. Texas School Survey Data
Long Term Trends of Use by Texas Youth Grades 7-12
Texas SAISD NISD NISD
Ever Used 2000 2010
% of
Change
2000 -
2010 2012
% of
Change
2010 -
2012 2010
% of
Change
2010
State 2010
% of
Change
2010
State 2012
% of
Change
2010
State
Alcohol 70.7% 61.8% -12.6% 58.0% -6.1% 59.0% -4.5% 68.0% 10.0% 62.0% 6.9%
Tobacco 51.1% 30.5% -40.3% 28.0% -8.2% 23.0% -24.6% 34.0% 11.5% 26.0% -7.1%
Marijuana 32.2% 26.2% -18.6% 15.0% -42.7% 13.0% -50.4% 19.0% -27.5% 24.0% 60.0%
Texas SAISD NISD NISD
Past Month
Use 2000 2010
% of
Change
2000 -
2010 2012
% of
Change
2010 -
2012 2010
% of
Change
2010
State 2010
% of
Change
2010
State 2012
% of
Change
2010
State
Alcohol 36.1% 29.0% -19.7% 25.0% -13.8% 31.0% 6.9% 35.0% 20.7% 27.0% 8.0%
Tobacco 22.4% 12.5% -44.2% 11.0% -12.0% 9.0% -28.0% 14.0% 12.0% 9.0% -18.2%
Marijuana 13.7% 11.4% -16.8% 5.0% -56.1% 4.0% -64.9% 8.0% -29.8% 9.0% 80.0%

2014
v. Tobacco sales to minors
Total state minor tobacco stings recorded for the September 2012, through August 2013, period was
262. There are only two agencies, Precinct 3 Constable’s office and Bexar County Sheriff’s department,
in Bexar County funded to do tobacco compliance stings in the county. Precinct 3 only covers one
quarter of the county. The Sheriff’s department only focuses on stings outside the city limits, within the
county.
Source: San Antonio Police Department, Lt, R. Phelan
Amarillo Austin Bay City Bexar Dallas Denton El Paso
Fort
Worth
Harris Houston
Incidents 8 12 3 15 35 4 15 9 7 10
0
5
10
15
20
25
30
35
40
Texas Minor Tobacco Stings
Sep 2012 - Aug 2013

FY08 FY09 FY10 FY11 FY12 FY13
Q1-Q2
Number of controlled buys 990 717 661 1,865 4851
2432
87
% youth whose age not questioned in
successful buy
80% 93.8% 33.3% 23.9% 25%1
20%2
NA
% tobacco sales to minors in controlled
buy
0.51% 2.2% 2.7% 3.8% 1.6%1
2.1%2
0%
Source: Texas Comptroller of Public Accounts, Tobacco Compliance Grant
Program
1. FY12 CPA
2. FY12 DSHS TEP
Source: SATPCC Community Needs Assessment
Current Adult Cigarette Use
2012 Population 18+
years old
Extrapolation of
Current # of Adult
Smokers in 2012**‘04-07 ‘11
All Adults 18+ 18.3% 15.7% 1,228,450 192,867
Gender
Males 23.2% 15.7% 592,579 93,506
Females 13.6% 15.6% 635,871 99,196
Source: BRFSS [≥100 cigarettes in lifetime and still smoke every day or some days]; 2012 Census
Comments: 2012 ACS population http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk
*Current smokers = 2012 smoking rate x 2012 population 18+.

2014
Past 30-day Youth Overall Tobacco Use
Cigarette Use (%) Any Tobacco Use (%) Smokeless Tobacco Use (%)
‘08 ‘12 ‘08 ‘12 ‘08 ‘12
16.1% 13.6% 22.7% 18.7% 7% 3.8%
Source: Texas Youth Tobacco Survey
Past 30-day Youth Cigarette Use by Grade Level and Gender
Grade Level and Gender ‘08 ‘12
Middle School Males 10.2% 11.3%
Females 4.7% 3.8%
High School Males 26.7% 23%
Females 17.9% 11.8%
Source: Texas Youth Tobacco Survey

x. Other data sources
Mexican American and Latino Population
The Core of San Antonio’s population consists primarily of first, second and third generation
Mexican Americans. People of Mexican descent account for 91% of the Latino population in
San Antonio and people of Hispanic or Latino origin account for 63% of the entire San Antonio
population (US Census Bureau). Compared to the United States, where only 16% of the
population is of Hispanic or Latino decent, in San Antonio there is a clear need for a culturally
appropriate response to issues surrounding healthcare and substance use prevention.
Number and proportion of all quality measures for which members of selected groups experienced
better, same, or worse quality of care compared with reference group
2012 Nat'l Healthcare Disparities Report 1

Regardless of the actual population numbers, Latinos are in many ways at a distinct
disadvantage. As displayed in the
above graph, Hispanics received
worse care than non-Hispanic Whites
for about 40% of quality measures.
Compared to their non-white
counterparts “Latinos are more likely
to experience disparities across a
wide spectrum of social indicators
such as education, income and
health care”. (Ramirez, Chalela,
Gallion, 2011). Remaining true since
the publishing of the 2011 National
Healthcare Report from the Agency
for Healthcare Research and Quality,
health disparities in quality of care are becoming larger for Latinos “Hispanics had worse access
to care than non-Hispanic Whites”.
In 2011, 26.0% of the Latino population in Bexar County was uninsured, compared to 20.4% of
the Anglo population (American Factfinder). In addition, Latinos living in Bexar County account
for 82% of the population that resides within 10 zip codes which the San Antonio Metropolitan
Health District has identified as high-risk areas. Due to the high concentration of poverty in
these zip codes and health problems resulting from high numbers of births to both single and
school-age mothers, children in these areas are more likely to experience problems which may
serve as barriers to success.
The 10 Zip Codes – San Antonio Metropolitan Health District

Levels of acculturation and assimilation among Mexican Americans are contrasted by a
generational divide. While first and many second generation Latinos linguistically adhere to their
native tongue and traditional value systems, more and more young people from this group are
adopting many of the values and culture of mainstream America. For example, older
generations tend to hold traditional views on gender roles and have been forced, based upon
poor economic upbringing, to choose work before education. In contrast, younger generations,
both male and female, tend to value a more progressive cultural identity where the opportunity
for success and education supersede more traditional role distinctions. It should be highlighted,
however, that regardless of generational differences there are still strong cultural ties to
traditional Mexican mores and customs. For instance, values placed on strong family bonds
and deep-seated religious ties, traditions and practices are vitally important to understand when
developing social programs and prevention messages.
A downside to reaching higher levels of acculturation among Hispanics, and other immigrant
groups for that matter, is that as these groups become more acculturated the more likely it is
that they will adopt substance abuse and binge drinking behavior in addition to experiencing
other public health concerns. This phenomenon is known as the Latino paradox and data from a
wide range of sources including academic literature, and The National Survey on Drug Use
2010 and Health (NSDSU) support this conclusion. “Hispanic adults who were born in the
United States had higher rates of past month substance use than Hispanic adults who were not
born in the United States, regardless of age. Among Hispanic adolescents, those who were
born in the United States had higher rates of past month cigarette use, alcohol use, and
marijuana use than those who were not born in the United States.” The data shown on Graph
1, is statistically significant and the .05 level.

Graph 1
Source: The National Survey on Drug Use and Health (NSDSU) “ ”
Most current data available
57.7
32.6
11.3
37.2
21.6
3
0
10
20
30
40
50
60
70
Alcohol Use Binge Alcohol Use Illicit Drug Use
Past Month Substance Use among Hispanic Adults, by Nativity:
2004 to 2008
Born in the United States Not Born in the United States

Colleges and Universities
San Antonio is home to 11 colleges and universities with a combined student population of over
one hundred thousand. Two of the four-year universities are public and four are private. Alcohol
is permitted on campus at all four of the private universities and is sold on-campus at two of
these schools. In 2007, according to data obtained from each school though the Clery Act,
there were a combined 732 alcohol-related incidences on all campuses.
Having a detailed picture of alcohol, drug use and related issues on college campuses is
important so that prevention efforts can be strategically targeted. The most comprehensive
instrument for gathering data that allows comparison to national level data is the Core Survey,
which was developed by the Core Institute and is considered to be the standard survey
instrument for higher education. As of 2011 we have Core Survey data for two of our most
prominent universities. The following are key demographics of survey respondents:
Table 3
24.4% Freshmen 64.6% Typical college age range of 18-22
17.0% Sophomores 64.1% Female
23.7% Juniors 78.6% Live off campus
19.3% Seniors 55.4% Work full time or part time
3.8% Graduates 90.7% Full-time students
1.9% Other 28.2% 5 hours per month in volunteer work
For comparison purposes data collected nationally from 74,481 students at 169 institutions was
aggregated from 2008 findings and then compared to local data. A side by side comparison
shows that the two surveyed schools in San Antonio reported lower rates of past 30 day use for
every category of licit and illicit substances than what was reported at the national level. The
following graph describes 30 day prevalence rates.

Graph 16
Source Core Survey of College Students: San Antonio, 2010
The annual prevalence rate for use of alcohol among survey respondents is 78.4% and past
month use was reported to be 61.3%. Lending credence to Social Norms Theory that most
college students overestimate their peers attitudes of levels of alcohol consumption, only 18.1%
of students participating in the Core reported that they use alcohol once a week, compared to
the perception that 28.6% of other students use alcohol once a week. Graph 16 shows data
from the Core Survey on the perceived effects of alcohol on college social life.
Graph 17
Source: Core Survey of College Students: San Antonio, 2010
0.0%
20.0%
40.0%
60.0%
80.0% Alcohol
Tobacco
Marijuana
Ampheta…
Sedatives
Cocaine
Hallucino…
Opiates
Designer…
Steroids
Other…
Inhalants
30 Day Local/National Prevalence Comparison
Bexar County Colleges
National
15.4%
40.9%
42.7%
45.9%
52.7%
54.4%
57.2%
57.3%
62.5%
67.1%
67.7%
Makes Food Taste Better
Makes it Easier to Deal With Stress
Facilitates Female Bonding
Facilitates Sexual Opportunity
Facilitates Male Bonding
Facilitates Connection with Peers
Allows People to Have More Fun
Give People Something to Talk…
Gives People Something to Do
Breaks the Ice
Enhances Social Activity
Perceived Effects of Alcohol
CORE Survey 2010

Graph 18
Knowing where students obtain or use alcohol most frequently is important for prevention. The
graph below indicates “social access” categories and associated percentages.
Graph 19
19.2%
36.4%
51.8%
62.7%
71.9%
77.4%
79.6%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Faculty/Staff
Alumni
Athelets
Female Students
Sororities
Male Students
Fraternities
Percentages of students who see drinking as a central part of
social life, by affiliation
Core Survey 2010
4.6%
7.3%
10.0%
10.4%
17.8%
18.1%
50.2%
59.6%
60.7%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%
On Campus Events
Frat/Soroity
Residence Hall
In a car
Other
Never Used
Bar/retaurant
Private Parties
Where Lived
Access to Alcohol
CORE Survey 2010

Most students reported “Where Lived” as the place where they get and consume alcohol and of
those surveyed 78% live off campus.
Students who responded to the Core were asked to rank the following variables by degree of
perceived risk. These percentages indicate the distribution of students who feel that there is
“great risk” associated with the following behaviors:
 15.7% Try marijuana once or twice
 22.0% Smoke marijuana occasionally
 48.5% Smoke marijuana regularly
 52.6% Try amphetamines once or twice
 47.6% Try cocaine once or twice
 56.8% Try LSD once or twice
 62.4% Have five or more drinks in one setting
 50.0% Consume alcohol prior to being sexually active
 49.1% Regularly engage in sexual activity with a single partner
 87.9% Regularly engage in unprotected sex with multiple partners
Students are considerably more permissive about marijuana use than binge drinking or use of
other drugs. Only 49.1% of students felt that there is great risk in “regularly engaging in
unprotected sex with a single partner”. Driving under the influence, another high risk behavior,
was reported to be similar for both males (29.4%) and females (24.2%).
As for consequences of engaging in risky behavior (for example, “been in trouble with police…”,
“performed poorly on a test or project”, or “done something later regretted”), our universities
ranked lower than the national averages in nearly every category. The comparative table below
describes a whole array negative experiences that can result from substance use.

Table 4
Bexar County National
Been Arrested for DWI/DUI 0.8 1.2
Been in trouble with police, residence hall, college
authorities 6.4 13.3
Damaged property 2.8 5.6
Driven a car while under the influence 26.1 22.3
Got into an argument or fight 20.8 31.2
Tried to commit suicide 1.1 1.1
Seriously thought about suicide 3.8 4.2
Been hurt or injured 9.6 16.3
Been taken advantaged of sexually 6.5 9.5
Taken advantage of another sexually 2.4 2.5
Tried unsuccessfully to stop using 4.2 4.9
Thought I might have a drinking or drug problem 6.8 10.8
Performed poorly on a test or important project 15.3 20.8
Done something I later regretted 22.7 36.0
Missed class 18.2 28.1
Been criticized by someone I know 22.6 29.7
Had memory loss 22.3 34.7
Got nauseated or vomited 43.2 54.0
Had a hang over 51.3 62.0
Source: Core Survey of College Students: San Antonio, 2010
Following are some key findings on opinions about the campus environment:
 81.5% of students said the campus has alcohol or drug policies
 17.8% said they “don’t know”
 0.8% said there wasn’t a policy
 51.3% said the campus has an alcohol and drug prevention program
 1.2% said there wasn’t a program
 78.7% of students said the campus is concerned about the prevention of drug and
alcohol use
 5.2% said the campus is not concerned

Military
Because there has been a lack of research in recent years on the negative consequences of
drinking within the Armed Forces, a study that was published in 2009 – “Binge Drinking Among
U.S. Active-Duty Military Personnel” - is currently our only source of information on ADMP for
episodes of binge drinking, characteristics of ADMP who binge drink, and the relationship
between binge drinking and related harms.
According to the study, half of all ADMP reported at least one episode of past-month binge
drinking and two-thirds of binge-drinking episodes involved personnel aged seventeen to
twenty-five. Furthermore, age specific rates are higher for ADMP than for the civilian population
(44% for ADMP aged 17-70 versus 26.1% for comparably aged civilians). The prevalence of
binge drinking is higher among males who are in the Army, followed, in order, by the Marines,
Navy and Air Force. However, the per-capita rate of binge drinking for women in the military is
higher than that of women in the civilian population. More than half of all ADMP who binge drink
reported alcohol related problems such as drinking and driving, job performance and criminal
activity. A notable consequence for women is that half of all pregnancies in the military are
unintended and there is usually a delay in recognition of pregnancy, so unborn children are at a
higher risk for fetal alcohol syndrome.
Traditionally, the military has focused less on prevention than on individual identification of
problem drinkers. However, this approach is unlikely to be as successful as environmental
strategies because only a small minority of ADMP meets the diagnostic criteria for alcohol
dependence. The military has been successful in reducing smoking rates using a

comprehensive public health approach and there has been an increase in small, base-specific
environmental strategy programs targeted at binge drinking that are showing positive results.
Because 13.3% of U.S. adults report having served in the military, binge drinking by ADMP has
an impact that reaches beyond active service and into the civilian population. Working toward
developing and implementing sound prevention practices is therefore crucial not only for ADMP,
but can have an impact on reducing drinking behavior in the general population.
Public Health
Juvenile Treatment
Juvenile admissions data for DSHS funded drug and alcohol treatment facilities is more or less
consistent with juvenile probation drug and alcohol probation referrals and UCR data for
offences in that most admissions are for marijuana. From 2003 to 2010, marijuana, alcohol,
heroin, sedative and cocaine accounted for the highest number of youth admissions to DSHS
funded treatment programs. The most number of admissions by far were for marijuana; 414 in
2010 compared to the next highest which was 28 admissions for heroin. Marijuana admissions
declined by 38% since 2008. However, this could be because of a shortage of beds in
treatment centers. On the other hand juvenile probation also showed a decline in referrals.
Juvenile Treatment Facts (DSHS, 2010):
 Admits for cannabis (85.37%) and opioid (76.19%) were largely male whereas females
were more likely to be admitted for alcohol (52%) and sedative (58.33%)
 IV drug use was mostly in the opioid category (76.19%). All IV drug users for opioids were
male (this is a turnaround from last year where most were female).
 Criminal Justice referrals were more evenly distributed: Sedative (83.33%), Alcohol (80%),
Cannabis (78.90%), Opioid (76.19%)

 The average level of education for all categories was roughly 9th grade: High (9.89) and
Low (9.33%)
Adult Treatment
For adults, heroin, alcohol, marijuana, cocaine and amphetamines accounted for the most
number of DSHS funded treatment center admissions between 2003 and 2010. Not
surprisingly, alcohol and marijuana had the lowest age of first use (under the age of 17)
compared to all other drugs (21 or over). Between 2003 and 2010, heroin and alcohol, followed
by marijuana accounted for the most treatment admissions for adults 18 and over.
Adult Treatment Facts (DSHS, 2010):
 Only 35.47% of admits for amphetamines were male
 69.26% of admits for alcohol were men
 Users of opioids had the lowest rate of employment (6.47%)
 Users of alcohol were most likely to be homeless (23.93%), followed by opioids (8.03%)
 Users of opioids were more likely to use needles (58.64%) followed by amphetamines
(26.74%).
 Only 12.19% of opioid users were criminal justice referred compared to amphetamine
(37.79%), cannabis (39.31%) and sedative (31.03%).
 Users of sedative and amphetamine had the most education (13 years)

Graph 21
Source: Department of State Health Services (DSHS) Treatment Episode Data (TEDS)
Substance abuse treatment rates vary by the class or type of drug causing impairment. Alcohol
is the most common drug leading to entry to substance abuse treatment in Texas. Alcohol
treatment occurs 2.4 times the rate of cocaine treatment and 2.9 times the rate of opioid
treatment in Texas in 2013.
1225 1249
613
492
189
38 11
0
200
400
600
800
1000
1200
1400
Opioid Alcohol Cannabis Cocaine Amphetamine Sedative Other
Adult Admissions to DSHS Funded Treatment Facilities
Bexar County, 2011

Only eleven of the thirty drug and alcohol treatment facilities in Bexar County are DSHS funded.
If a large number of the people in Bexar County needing or seeking substance abuse treatment
are either uninsured or indigent, then a comparative lack of subsidized treatment centers means
that a significant portion of the population is underserved. Of adults treated at DSHS funded
treatment centers between 2003 and 2008 the highest annual income of patients being treated
was less than $10,000, and less than half were employed. According to the Center for Health
Care Services, lack of detoxification resources for the indigent, uninsured or underinsured has
created a community wide crisis in Bexar County, and at the root of the problem is lack of state
and federal funding for treatment services Health insurance rates among Bexar County adults
with DWI are much lower than the general population.
DWI Offender Health Insurance Rates
.

Juvenile Adult
DSHS Funded Treatment
Centers In-Patient
Out-
Patient Male Female Co-ed Male Female Co-ed
A Turning Point x x
Alpha Home x x x
Army Substance Abuse
Program x x
Association for
Advancement of
Mexican Americans x x
Family Service
Association x x x x
Lifetime Recovery x male x co-ed x
Palmer Drug Abuse x x x
The Right Step x x x x
Volunteers of America x x
Center for Health Care
Services x x x x
Ripple Recovery Ranch x x

Since 2010 the City of San Antonio Municipal Court handles the alcohol law violations instead of
Juvenile Probation. The Municipal Court reported 1,954 Minor in Possession citations by youth
ages 12 to 20 between October, 2011 and November, 2012. During that same period, they also
reported 1,293 citations for Minor in Consumption of Alcohol for the same age group. (San
Antonio Municipal Court Clerk 2012)
DSHS reports that there is an estimated 47,824 youth in Bexar County who have been
diagnosed with mental illness, and an additional 81,058 have been identified as being at-risk of
being significantly impaired due to a mental disorder. In its Community Plan, the Alamo Area
Council of Governments cited a national study which concluded that 70.4% of children in the
juvenile justice system meet the criteria for at least one mental disorder, and 27% had a mental
disorder severe enough to require immediate treatment. Only five of Bexar County’s 28
residential psychiatric facilities provide inpatient psychiatric services to adolescents, and of
these five, only two offer hospitalizations for indigent youth.
Because mental illness is more often than not co-occurring with substance abuse, Bexar County
has recognized the need for integrated treatment and a continuum of care through the
coordination of existing mental health and substance abuse treatment services. Bexar County
has a drug court that aims to divert non-violent offenders into treatment; and programs such as
the Mental Health Advocacy Initiative aim to reduce the recidivism of mentally ill inmates by
providing access to support and treatment services.
Another figure that stands out is deaths caused by motor vehicle crashes, which is a leading
cause of death for every age group. Since nearly half of all fatal motor vehicle crashes involve a
legally impaired driver, drinking and driving is both a serious and preventable public health
issue.

Part IV – Intervening Variables
Contributors to Alcohol Use. Alcohol availability (social access) is a primary contributor to
alcohol use among community youth. 53.8% of Bexar County 8th
grade students and 59.5% of
Bexar County 9h
grade students report that it is somewhat easy to very easy to access alcohol
(TSS, 2010). Among the Bexar County youth who drank in the past month, 26.7% report they
get alcohol at parties always or most of the time, 15.2% report they get alcohol from friends, and
6.6% report they get alcohol from home. 29.5% of students report that alcohol was used “most
of the time” or “always” at parties they attended this school year. The presence of eleven
universities increases social access for underage youth in our community. Alcohol is permitted
on campus at all four of the private universities in our area and alcohol is sold on-campus at two
of these schools. 60.7% of college students report “where lived” as the place where the get and
consume alcohol, and of those surveyed 78% live off of campus. 59.6% of college students
report accessing and consuming alcohol at private parties.
COSA as well as other coalitions throughout the state of Texas recognize that alcohol pricing
contributes to too many youth consuming alcohol in our community. “A substantial body of
research has shown that higher prices or taxes on alcoholic beverages are associated with
lower levels of alcohol consumption and alcohol related problems, especially in young people”‐
National Institute of Alcohol Abuse and Alcoholism. According to research, Texans pay less in
taxes for beer, wine and spirit than residents in neighboring states and pay significantly less in
alcohol taxes than the US State average. Texas Alcohol excise tax has not been raised since
1984. In addition to youth access, another factor contributing to high rates of youth alcohol use
is social norms in the community that are favorable to alcohol use.

Inconsistent Enforcement or Low Enforcement also contributes to alcohol use by youth
in our community. Informant interviews and some local data indicate that local youth perceive
the probability of being caught as very low. Additionally, if youth are caught, the consequences
are not consistently enforced. While there were 1,954 MIP citations issued last year, only a
fraction of these youth attended a mandated prevention/intervention program. Initial evaluation
indicates that consequences vary in both the number of hours mandated and the type of
restitution required. In contrast, consistently-enforced consequences resulting from a citation
would be a substantial deterrent to local youth and adults.
Contributors to Marijuana Use. Social access is a major concern for marijuana use in Bexar
County, with only 41% of students reporting it is “very difficult” or “impossible” to get marijuana.
As a contrast, 78% of youth report cocaine would be difficult to obtain (TSS, 2010). Of those
that use marijuana, more than a quarter (26%) of students state that it was available at some or
all of the parties they attended (TSS, 2010).
Social norms also contribute to marijuana use among Bexar County youth. Data shows that
Bexar County students are considerably more permissive about marijuana use than binge
drinking or use of other drugs. Twenty-seven percent of students reported most or all of their
close friends smoke marijuana. Fifty-six percent of students believe that marijuana use is "very
dangerous" compared to 79 percent of students who feel that use of ecstasy is "very
dangerous" and 83 percent who believe that powdered cocaine use is "very dangerous."
Contributors to Prescription Drug Use. The coalition lacks sufficient data to state definitively
what contributes to youth prescription drug use. However, based on national data, it is likely

that a lack of perception of harm and the availability of prescription drugs lead to their use. The
coalition will work over the coming year to gather data to identify the contributors to prescription
drug use in our community.
Part V – Community Readiness
The coalition conducted on line community readiness survey of coalition members in September
2013 with only 16 responses. Responses show that coalition members that answered are
aware of programs and see a need for prevention programs. The coalition will continue to
collect survey responses from coalition members and reach out the non-coalition members for
responses. Based on coalition participation the coalition has created plans to reach out to the
youth community and recruit members to be more involved with prevention planning. The
challenge has been school and some state programs believe effective prevention is provision of
direct prevention programs and alternative activities.

Part VI – Putting it all together
Target Population
The coalition has determined the target population is Bexar County. Bexar County has many
municipalities that are encompassed within the city limits of San Antonio Residents commute
through several city limits to attend school, work or leisure activities.
Primary Substance use behaviors
The coalition has selected alcohol as it primary substance due to the data showing it is the
number one drug of choice for youth.
Secondary Substance use behavior
The coalition has selected marijuana as the secondary substance as data shows it is a concern
in Bexar County. National trends show increases in prescription drugs on the rise, and we have
seen abuse with college youth (CORE 2010).
Strategic Planning Process
The coalition members will review the needs assessment results at the October Meeting and
participate in a strategic planning meeting the following week. The coalition provides training on
evidenced based strategies on a annual basis. The coalition will discuss which strategies would
fit the community and what the capacity is for the coalition to implement these strategies.

References
Alamo Area Council of Governments (AACOG), 2010. Bexar County Community Plan.
http://www.aacog.com/criminaljustice/communityplanning/commplan2008_2009/2008-
2009BexarCountyCommunityPlan.pdf.
Bexar County Juvenile Probation, 2004-2012. Monthly Trend Report.
Bexar County Medical Examiners Office, 2009, 2012. Annual Report.
http://www.bexar.org/medicalexaminer/BCSD_MedExaminer_T102_R15.html.
Bexar County Sherriff’s Office, 2005-2010. DWI Arrests (Unpublished Raw Data).
Bexar County Sherriff’s Office, 2005-2011. Juvenile Arrests.
Core Survey, 2010. San Antonio Council on Alcohol and Drug Abuse
Center for Disease Control, 2004-2009. Behavioral Risk Factor Surveillance System
SMART Local Health Risk Prevalence Data Query System.
http://apps.nccd.cdc.gov/BRFSS-SMART/SelMMSAPrevData.asp
Centers for Disease Control, 2010. “Liver Disease – 12th
Most Common Cause of Death in US:
Study”. http://www.medindia.net/news/Liver-Disease-12th-Most-Common-Cause-Of-
Deaths-in-US-Study-76136-1.htm
Cheung, Ramsey, MD. 2006. “Chronic Hepatitis C in the Hispanic Population”. The HCV
Advocate. http://www.hcvadvocate.org/hcsp/hcsp_pdf/hispanics.pdf
Circles of San Antonio Community Coalition, 2008. SPF Needs Assessment ESI Data.
City of San Antonio, 2008. San Antonio, Texas Economic Indicators and Demographics.
http://www.sanantonio.gov/edd/pdfs/Economic%20report%207-8%2008%20abridged.pdf.
DSHS, 2008. DSHS Substance Abuse Services – Funded Treatment Providers (As of
11/20/2008).http://www.tcada.state.tx.us/treatment/ProfRes8.asp.
DSHS, 2003-2011. DSHS Substance Abuse Treatment Episode Data, Youth and Adult
[Raw Data]
DSHS, 2002-2008 Substance Abuse Treatment (TCADA Funded Programs). [Raw Data]
Mathias, C.W., Ryan, S.R., Mullen, J., Lake, S.L., Brown, P.C., Adams, V,. Villafranca, C., and
Dougherty, D.M. (2014). Problem identification and community assessment of DWI needs for
Bexar County, Texas (Center for Medicare & Medicaid Services report 085144601,2,6).
University of Texas Health Science Center San Antonio.
http://issuu.com/cosasacada/docs/nrlc_dwi_needs_assessment_03-31-201/1

National Highway Traffic Safety Administration (NHTSA), 2004-2011. Fatality Analysis
Reporting System (FARS). http://www-fars.nhtsa.dot.gov/Main/index.aspx
National Survey on Drug Use and Health, 2010. “Substance use Among Hispanic Adults”
Office of National Drug Control Policy (ONDCP), 2011. Economic Costs of Substance Abuse.
http://www.whitehouse.gov/sites/default/files/ondcp/newsletters/ondcp_update_june_2011.p
df
http://www.justice.gov/archive/ndic/pubs44/44731/44731p.pdf
Office of the State Demographer, Statistics on Uninsured, 2005. http://txsdc.utsa.edu/.
Presley, Cheryel A., Meilman, Philip, Leichliter, Jami; College Factors That Influence Binge
Drinking. Journal of Alcohol Studies, 14:2002.
Ryan, S.R., Friedman, C.K., Mathias, C.W., Mullen,, Dougherty, D.M., Adams, V, and
Villafranca, C.. (2014) Problem Identification and community assessment of youth substance
use treatment needs for Bexar County, Texas (Center for Medicare & Medicaid Services report
085144601.2.101). University of Texas Health Science Center San Antonio
SAMHSA, 2008. List of Treatment Centers in Bexar County.
http://findtreatment.samhsa.gov/ufds/listsearch_00.print?seq_num=561759.
San Antonio Metropolitan Health, Engaging Public Awareness of Health Disparities
http://www.sanantonio.gov/health/pdf/NACCHO%2010%20Zip%20Codes.pdf
San Antonio Metropolitan Health, 2004-2011. Health Profiles
http://www.sanantonio.gov/health/Healthprofiles-Main.html
San Antonio Metropolitan Health District. 2001-2010. Death Data.
http://www.sanantonio.gov/health/pdf/hp2008/deaths/Deaths.htm
San Antonio Police Department, 2003-2012. DWI Arrests [Raw Data].
Texas College Survey, 2005. Texas survey of Substance Use Among College Students Main
Findings Report.
www.dshs.state.tx.us/sa/Research/college/2005/2005_CollegeSurvey_lliu043007.pdf.
Texas Department of Public Safety, 2008. Uniform Crime Reports. [Raw Data].
Texas Education Agency, 2011. Region 20 District Level Annual Discipline Summary PEIMS
Discipline Data for 2010-2012.
Texas Education Agency, 2011. Selected AEIS Campus Data, A Multi-Year History
2003-2012.
Texas Education Agency, 2008. Longitudinal Completion Rates, Grades 9-12, by County and
Student Group, Texas Public Schools, Class of 2007.

Texas Labor Market Review, 2013. http://www.tracer2.com/?PAGEID=133
Texas School Survey, 2012. Texas School Survey of Drug and Alcohol Use.
U.S. Census Bureau, 2009-2011 American Community Survey. http://www.census.gov.
U.S. Census Bureau, 2009-2011 American Fact Finder. http://www.census.gov.
U.S. Census Bureau: State and County QuickFacts. http://quickfacts.census.gov/qfd/states/48/48029.html

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