Researchers with the U.S. Substance Abuse and Mental Health Services Administration found that an estimated 1,980 emergency visits on Jan. 1, 2009, had something to do with underage drinking. The national average for such visits during the year as a whole was 546 per day.
Facing a public dissatisfied with the state's hard liquor monopoly, opponents of Initiatives 1100 and 1105 blanketed the airwaves with TV spots of teens buying booze at a convenience store and then driving off.
The campaign created just enough doubt about privatization to turn back both measures.
If what he says is true, that the image of teenagers buying alcohol is what turned the tide against the initiatives, then those of us involved in youth substance abuse prevention should take note. The citizens of Washington support what we do and the health and safety of our children takes precedence over convenience and getting government out of the liquor business.
The Washington Association for Substance Abuse and Violence Prevention (WASAVP) played a key role in the coalition that campaigned against the initiatives. WASAVP is a volunteer-run organization with the mission of uniting prevention advocates from around the state.
With that in mind, I decided to start blogging again about principles of youth substance abuse prevention. Last month I blogged about general prevention principles and community-based prevention principles. Today, I blog about school-based prevention principles.
- Prevention programs can be designed to intervene as early as preschool to address risk factors for drug abuse, such as aggressive behavior, poor social skills, and academic difficulties.
- Prevention programs for elementary school children should target improving academic and social-emotional learning to address risk factors for drug abuse, such as early aggression, academic failure, and school dropout. Education should focus on the following skills:
social problem-solving; and
academic support, especially in reading.
self-efficacy and assertiveness;
drug resistance skills;
reinforcement of anti-drug attitudes; and
strengthening of personal commitments against drug abuse.
As teens take to the roads, you can take action by talking about the dangers of drugged and drunk driving. Parents are the most important influence on their teen when it comes to risky behaviors, including substance abuse and driving. Teens who report having conversations with their parents about alcohol and drug use are more likely to stay drug-free, compared to teens who do not talk about substance abuse with their parents.
Free online resources for community leaders and parents of teen drivers to help start the conversation about the dangers of driving under the influence are available at: http://www.theantidrug.com/resources/impaired-driving.aspx. Resources available include:
-- Parent-Teen Driving Contract: Students Against Destructive Decisions (SADD) designed this contract to help facilitate communication between teens and parents about potentially destructive decisions related to risky behaviors and driving.
-- Top 10 Tips for Preventing Teen Accidents: Tips for preventing teen accidents.
New research shows which parenting style works best to keep a teenager away from the most dangerous type of alcohol use. Scientists surveyed 5,000 teens, ranging from 7th- to 12th-grade, on their drinking habits and their home life.
Results show a parenting style that isn't too strict or too permissive works best to prevent binge drinking. Why? Teens have boundaries and consequences and have opportunities to use own judgment.
Story on NPR.
According to a report by the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health, youth exposure to alcohol advertising increased 71% between 2001-2009. The report goes on to say:
Despite efforts of alcohol companies to strengthen their self-regulatory standards, the average number of ads seen by youth watching television increased from 217 in 2001 to 366 in 2009, or one alcohol ad per day.
In 2003, the trade associations representing beer and distilled spirits companies joined the wine industry in committing to place ads only when the underage audience composition is 30 percent or less. Their previous threshold had been 50 percent.
The report shows that the rise of distilled spirits advertising on cable television is driving the increase. Youth exposure to distilled spirits advertising grew by nearly 3,000 percent from 2001 to 2009, primarily on cable. The majority of youth exposure to alcoholic beverage advertising on cable occurred on programming that youth ages 12 to 20 were more likely to be watching than adults 21 and above.
What can parents do?
The Too Smart to Start website contains information for parents about media literacy and helping teenagers decipher what they see and hear so that they can resist pressures from advertising.
Alcohol ads during the Super Bowl
In an effort to increase awareness of this issue, the Marin Institute is hosting its annual Free the Bowl video contest for youth. The campaign is in response to the many alcohol ads broadcast during the Super Bowl, an event watched by an estimated 30 million underage youth.
The effects of media on teenagers
Earlier this year, Dr. Victor Strausburger spoke at Children's Hospital about "What every pediatrician and parent SHOULD know about the effects of media on adolescents."
Exposure to alcohol ads a risk factor for underage and binge drinking
A recent study, published in Preventive Medicine, bolsters the findings of previous research that show that there is an association between youth exposure to alcohol ads and alcohol use among teens, including binge drinking.
Research conducted by the Social Development Research Group of over 800 youth and reported in Drug and Alcohol Dependence (2010) shows that specific family management practices in early adolescence protect against the effects of impulsive risk taking on alcohol abuse and dependence in adulthood.
Good family management is expressed in multiple ways:
-- Consistent parental monitoring to know where and whom the adolescent child is with.
These findings support the use of interventions that strengthen family management in early adolescence, particularly for youth who are prone to impulsive, risk-taking behavior. Read the research brief, Family Management Matters: Adolescent Risk Taking and the Development of Adult Alcohol Use Disorders.
-- One of the most important discoveries in this area of study, says Dr. Frances Jensen, a neuroscientist at Harvard, is that our brains are not finished maturing by adolescence, as was previously thought. Adolescent brains “are only about 80 percent of the way to maturity,” she said at the annual meeting of the Society for Neuroscience in November. It takes until the mid-20s, and possibly later, for a brain to become fully developed.
-- . . . a Harvard study found that kids who smoked pot before age 16 had more lifelong cognitive problems than those who started smoking after 16. The tests were done on subjects with an average age of 22, and those who smoked pot earlier had problems remembering details, making decisions, and responding quickly when directions changed.
As a coalition, Prevention WINS members understand that each and every one of us has a role to play when it comes to creating a safe and healthy community which includes preventing youth substance abuse. To put that idea into practice, each individual and organization can do one or more of the strategies listed above.
CADCA's Handbook for Community Coalitions goes into more detail about how individuals and organizations can incorporate these strategies into what they already do.
Does your organization integrate substance abuse prevention messages into informational programs dealing with healthy youth, community safety, parenting, and other related topics?
Do you talk to your children, family, or friends about how to prevent youth substance abuse? If your organization works with children and/or families, do you share with them information about prevention or programs that will help them avoid drugs?
Do you provide opportunities for youth involvement in pro-social activities? Do you provide them with the skills needed to be successful in those activities? Do you recognize them for their involvement in activities that reduce risk and enhance protection?
What consequences do youth in our community face if they use drugs and alcohol? What recognition do they receive for leading healthy lives? What do we do to reduce the likelihood that youth can buy alcohol?
Does your organization have anti-drug policies and are youth aware of them? How do our local laws and policies affect youth substance use? Are laws and policies actually enforced?
As you can see, there are many opportunities to do things to prevent youth substance abuse. Some can be done individually, in the home, some can be done within your organization, and others need the full coalition and community behind them. What is clear is that each and every community member can play a role in prevention.
Fueled by increases in marijuana use, the rate of eighth-graders saying they have used an illicit drug in the past year jumped to 16 percent, up from last year's 14.5 percent, with daily marijuana use up in all grades surveyed, according to the 2010 Monitoring the Future Survey (MTF).
For 12th-graders, declines in cigarette use accompanied by recent increases in marijuana use have put marijuana ahead of cigarette smoking by some measures. In 2010, 21.4 percent of high school seniors used marijuana in the past 30 days, while 19.2 percent smoked cigarettes.
The survey . . . also shows significant increases in use of Ecstasy. In addition, nonmedical use of prescription drugs remains high. MTF is an annual series of classroom surveys of eighth, 10th, and 12th-graders conducted by researchers at the University of Michigan, Ann Arbor, under a grant from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.
Most measures of marijuana use increased among eighth-graders, and daily marijuana use increased significantly among all three grades.
"These high rates of marijuana use during the teen and pre-teen years, when the brain continues to develop, place our young people at particular risk," said NIDA Director Nora D. Volkow, M.D. "Not only does marijuana affect learning, judgment, and motor skills, but research tells us that about 1 in 6 people who start using it as adolescents become addicted."
"The increases in youth drug use reflected in the Monitoring the Future Study are disappointing," said Gil Kerlikowske, director of the White House Office of National Drug Control Policy. "Mixed messages about drug legalization, particularly marijuana, may be to blame. Such messages certainly don't help parents who are trying to prevent kids from using drugs."
At the beginning of both sessions, Dr. Linkenbach asked everyone, "Are we busy or are we effective?" Are we changing our communities or are we transforming them?
He talked about prevention as an act of leadership and presented seven core actions of positive leadership:
Be perfected (learn from mistakes and share what was learned)
Dr. Linkenbach is well-known for the Most of Us campaigns using the Positive Community Norms Model. A message that these campaigns promote is: most kids make healthy choices but exceptions do exist.
He also spoke about bringing together spirit, science, and action when communities work to reduce youth substance abuse. Together, they create synergy that can lead to community transformation.He provided several examples of "spirit" and shared the following negative ad:
Though they are not videos for substance abuse prevention, he shared the following with us to provide examples of spirit:
Where is Matt? (as an example that good already exists in all of our communities)
Substance abuse prevention ads using positive social norms may be viewed on the Most of Us website.
The last part of the workshop dealt with the steps to take when advocating for policy.
While the coalition's DFC strategies will focus on environmental prevention, we will continue to work with and support community organizations that offer individual prevention programs.
Copies of this presentation and others from the New Grantee Training are available on the coalition's website.
-- Coalitions across the nation have been successful in reducing youth substance abuse. Coalitions that include all community sectors are the most successful. Everyone has a role to play. Help individuals and organizations recognize their role.
-- Infuse prevention into all conversations about public health and safety.
1. Light refreshments followed by program to begin promptly at 7 p.m.
2. Keynote from King County Executive Dow Constantine (Invited)
3. Presentations by Consumers and Family Members
4. Legislative Priorities for Mental Health and Substance Abuse Prevention, Community Organizing, Treatment and Recovery
5. Legislative Roundtable with King County Legislators and United States Congress Representatives (Invited)
According to the Social Development Research Group at the University of Washington, two key protective factors are
(1) bonding to pro-social family, school and peers, and
(2) clear standards or norms for behavior.
Families, schools, community organizations, neighbors, and others can promote these protective factors by providing "opportunities for involvement in productive pro-social roles, skills to be successfully involved in these roles, and consistent systems of recognition and reinforcement for pro-social involvement. These factors protect against the development of conduct problems, school misbehavior, truancy, and drug abuse."
Be a part of creating a community that provides opportunities and teaches skills for pro-social involvement and then rewards young people for their involvement. Everyone in the community has a role to play.
The article goes on to say, "In 2007, one of out every nine teens . . . received prescriptions for medication such as pain killers, sedatives and stimulants that could potentially be abused, the study, led by Robert Fortuna at the University of Rochester in New York, warned."
While the column goes on to discuss the huge amount of alcohol ads that minors are exposed to, I would add that there are multiple factors that influence underage and binge drinking, including advertising and alcoholic beverages that are attractive to young people. Factors such as local laws and their enforcement; parental and community attitudes and actions; and opportunities for youth to play meaningful roles in their communities and to be recognized for their positive contributions.
While banning certain alcohol products and reducing alcohol advertising will reduce underage and binge drinking, there are more strategies that communities need to consider when acting to prevent youth substance abuse.
- perceived strength of coalition leadership;
- task-oriented coalitions;
- positive relationships among members, staff, and community organizations.
December 2, 2010
12:00 noon - 1:30 p.m.
Gain new tools to address tobacco policy and smoking cessation.
Understand the role and effectiveness of quit lines.
Learn about the available resources to help reduce smoking in your community.
Hear from local communities about their successes.
To register, visit www.CADCA.org.
- providing structured time with adults through mentoring;
- increasing positive attitudes though community service;
- communicating clear policies on substance abuse;
- supporting a large number of prevention strategies or integrating strategies into already existing activities.
It reminded me of something I had read recently about the younger a person starts smoking marijuana the higher the likelihood of addiction. The effects of marijuana on youth differ from the effects on adults.
It also reminded me that I wanted to create a link to the presentation that Stephen Bogan gave at this year's Prevention Summit: Getting High to Not Be Low - Adolescent Marijuana Abuse, Addiction, and Mental Health.
As we continue our discussion about the legal status of marijuana, it's important we include conversations about youth substance abuse prevention and treatment.
The National Institute on Drug Abuse has identified several Prevention Principles intended to help people deliver research-based prevention programs at the community level. The first four principles cover risk and protective factors.
Principle 1: Prevention programs should enhance protective factors and reverse or reduce risk factors.
Risk and protective factors differ from community to community. The Prevention WINS coalition identified the following risk factors in our community:
- Favorable attitudes towards drug use among high school students (individual/peer domain);
- Poor family management -- parents monitor their children less and less as the get older (family domain);
- Youth who use are not caught and when they are very few consequences exist (community domain).
The tested and effective prevention programs implemented by Prevention WINS over the past four years include Life Skills Training and Guiding Good Choices. Both of these programs address all forms of drug abuse. In the future, the coalition will continue to address all forms of substance abuse using environmental strategies.
Principle 3: Prevention programs should address the type of drug abuse problem in the local community.
In northeast Seattle, the top two drugs used by teenagers are alcohol and marijuana according to the Healthy Youth Survey. The coalition's action plan addresses both.
Principle 4: Prevention programs should be tailored to address risks specific to audience characteristics such as age, gender, and ethnicity.
This will especially be true as the coalition develops a social norms campaign and works on local advocacy issues as part of the DFC grant.
With these four principles in mind, community organizations are encouraged to:
- Develop integrated, comprehensive prevention strategies rather than one-time community-based events.
- Provide young people with structured time with adults through mentoring.
- Increase positive opportunities, skills, and recognition through community service and other activities.
- Communicate and enforce clear policies.
- Organize at the neighborhood level.