When Lynnfield took a step to proactively address the opioid epidemic and formed its Substance Abuse Prevention Coalition, known as A Healthy Lynnfield (AHL), the town hired Margaret “Peg” Sallade, a designated substance-abuse prevention coordinator.
With her knowledge and years of experience with public-health campaigns, community partnerships and substance-use prevention, Sallade is the engine and the glue behind AHL. That said, she is very modest and strictly business when it comes to describing her role in the coalition.
“Selectman [Phil] Crawford gets the credit for originally convening the group. He looked around and understood that many coalitions on the North Shore had community-health partnerships and Lynnfield did not and really called the community together initially to address the opiate crisis,” said Sallade. “And then, to keep the group going and to really put together a local plan, they brought me in, and we did some grant writing and some convening and building of the partnership with people around the table to address substance-use prevention in Lynnfield.”
Sallade grew up in a very small rural town in the Catskills in New York.
“I think that’s shaped my sense of community and really working to give back to the community throughout my life,” she said.
She went to the Pennsylvania State University and earned a degree in health education. Sallade spent the first years after college doing work-site health promotion with a company in Boston. Her job included cholesterol screenings, blood-pressure screenings, and work-site wellness-program offerings.
After six years in corporate-health promotion, she decided to move to community-based health. Sallade attributes her interest in substance-use prevention to a course on alcoholism she took in college. That course was based on research by E.M. Jellinek, who was responsible for looking at the disease model of substance use.
Sallade remembers going to Alcoholics Anonymous (AA) meetings as a part of her class curriculum. She was struck by a realization of how misframed alcoholism was in the public because it was not known as a disease. That sparked her interest in being able to help individuals that had a substance-use disorder.
In the early 1990s, Sallade started working for the Center for Addictive Behaviors in Salem, which is now known as Beth Israel Lahey Health Behavioral Services. Her work at the center was funded under the Massachusetts tobacco-control program.
“My role really was to help communities form local partnerships, and to look at how to shape local health policies to reduce smoking,” said Sallade. “I learned a lot in that role, both in terms of how public funding and mass media and policy can really make an impact on the health of the public.”
The Massachusetts tobacco-control program was one of the most successful public-health campaigns that really did reduce smoking rates, Sallade said. She worked with local boards of health encouraging them to support tobacco policies to protect the health of the public.
“It was really my first experience in understanding how many different facets of a community can really make an impact on public health,” said Sallade.
She worked with young people to show them how they can talk to their boards of health and advocate to make restaurants smoke-free. Sallade believes that local communities can absolutely use their voice in making the change.
“And now, you know, years later we see a lot of those repeat strategies with flavored-tobacco products,” said Sallade.
The industry came up with a different product, but the strategy to protect the health of the public is the same.
“It really depends on local communities having a voice in making that change,” said Sallade.
Sallade’s career saw her work for the Reading Coalition for Prevention and Support, Healthy Waltham and Danvers Cares, which are all examples of community partnerships. She said that all of these organizations have evolved over the years. They have been reshaped by different people, different funding sources, sometimes different topics, but they still exist as a local group of community people that have expertise and want to make changes to impact health in their community.
“My role is really sort of a convener and a guide to leverage the skills that exist within a community to shape change. Change is a word we often use,” said Sallade.
She joined AHL in 2018.
Sallade’s approach to substance-use prevention is focused on helping young people make healthy decisions.
“If young people delay their first use, they’re less likely to experience any issues with addiction,” Sallade said. “Any use before age 25 is not healthy for a growing brain.”
And it is not always directly about drug education. Sallade said that prevention is very multifaceted. To be resilient and healthy, youths need to have strong connections with adults, opportunities to engage and give back to the community, and ability to use their voices in decisions for things that impact them.
“It’s really about how we build supports in the community for young people,” she said.
Sallade thinks that the real strength of Lynnfield as a community is that the town already has a lot of good programs and services for youth. AHL has also started a youth-leadership program, coordinated by Julie Greene, and formed a Youth Council that will plan and implement prevention strategies among adults through civic engagement, education, media campaigns, and volunteerism.
The council has 10 paid positions for Lynnfield youth and about 35 high-school students in total meets twice a month. There is also a youth group for Lynnfield Middle School students.
One of the examples of how youth can promote and model good decision-making for their peers was the “Above the influence” campaign with a subtitle “21 reasons to stay above the influence.” Lynnfield high schoolers created a video with reasons they would choose not to use substances.
As part of that campaign, AHL invited businesses that are licensed to sell or serve alcohol to pledge not to sell alcohol to underage kids, Sallade said. All such businesses chose to get involved, and the coalition thanked them for not selling to minors with a certificate.
“It really does take a village. Everybody plays a different role in supporting youth in the community in a different role in substance-use prevention,” said Sallade, including community residents, town employees and businesses.
At the same time, part of Sallade’s approach when working in a new community is to do an assessment of current conditions and needs of the community and to find gaps. In Lynnfield, such a gap was a mental-health referral and resource line. AHL contracted William James College to provide Lynnfield residents with access to its Interface help line.
Interface is staffed by clinical professionals who can help community members access various outpatient resources, including mental-health counseling.
“This is one-stop shopping,” Sallade said. “You can make a phone call, provide information and they help match your insurance and your availability and your need with someone who’s able to provide counseling.”
Interface services are paid by the town through the two federal grants that AHL has received. One grant, A Drug Free Communities Grant, comes from the Substance Use Mental Health Services Administration. The other one is a Partnerships for Success Grant from the Centers for Disease Control.
AHL holds public meetings once a month that bring various people from the community with different expertise together.
“That’s what coalition, that’s what partnership work is,” said Sallade. “We have treatment agencies, we have the faith community, we have the YMCA, we have so many different experts at the table to work on this issue together. That’s a big piece of coalition work and that’s new for Lynnfield.”
Sallade said that the town has been very supportive.
“And we really would not be here without the leadership of Phil Crawford, who founded the organization,” she added.