Ending the year on a good note

Earlier today, I wrote that I didn't want to end 2010 on a down note . . . so I won't.

Here is a Calvin and Hobbes comic that I have seen several times when attending presentations by researchers at SDRG.

In 2011, may we all have the foresight to look down the road to prevent being hit by a cement truck.

ER visits related to underage drinking spike on New Years Day

I don't want to end 2010 on a down note, but I do want to share a timely story I read on HealthDay this morning.

The number of emergency department visits that involved underage drinking jumped by more than 250 percent on New Year's Day two years ago, compared with other days of the year, a new U.S. study reveals.

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.

Compared with other national holidays, the number of admissions on New Year's Day linked to underage drinking was 191 percent higher than on Memorial Day and 110 percent higher than on the Fourth of July, the researchers explained.

The article ends with a link to Make a difference: Talk to your child about alcohol. Other parenting resources are linked on the Prevention WINS website.

Prevention message part of best 2010 campaign

In today's PI, Joel Connelly wrote about "2010: Who scored, who dropped the ball (besides the M's, Hawks)" and here is what he wrote under Best Campaign:

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.

School-based substance abuse prevention

I subscribe to a national substance abuse prevention listserv and when I read many posts it seems to me that there is a lot of misinformation out there regarding what substance abuse prevention is and is not.

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:

emotional awareness;
social problem-solving; and
academic support, especially in reading.

- Prevention programs for middle or junior high and high school students should increase academic and social competence with the following skills:

study habits and academic support;
peer relationships;
self-efficacy and assertiveness;
drug resistance skills;
reinforcement of anti-drug attitudes; and
strengthening of personal commitments against drug abuse.
Prevention WINS started an evidence-based substance abuse prevention program, Life Skills Training, at Eckstein Middle School. Thanks to the dedication of Eckstein staff, that program continues to be taught. This curriculum is part of a larger community prevention strategy that now includes other tested and effective activities like alcohol purchase surveys, a social norms campaign, and advocacy.

Teenagers driving safely

From a press release from the National Youth Anti-Drug Media Campaign:

As part of the National Drug Control Strategy, President Obama has made combating drugged driving a national priority and set a goal of reducing drugged driving prevalence by 10 percent by 2015.

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:

-- A New Driver's Kit: Tips, facts, quizzes, and more alerting parents and teens to the dangers of drugged, drunk, and distracted driving.

-- 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.

Teens, drinking and your parenting style

Call it the Goldilocks approach to parenting.

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.

Creating healthy communities

Two recent opinion pieces in the Seattle Times brought to mind what it means to live in a healthy community.

A mission to promote health and wellness -- a great example of a Seattle community coming together to "reduce chronic diseases such as hypertension and diabetes in children and youth through obesity prevention."

For city well being, money is not everything -- describes how strong communities are those that "build residents' attachment". This idea compliments the social development strategy that guides Prevention WINS -- if teenagers feel a sense of attachment to our community, their schools, and their families they are more likely to have healthy behaviors.

Coalitions making a difference

Since this is the season for celebrations, I decided to blog about hopeful things today. So, I am starting with an excerpt from a message sent by the DFC Administrator on the ONDCP list serv earlier this month:

At a time when many national surveys are showing increases in youth substance use, the past 30-day use of alcohol, tobacco, and marijuana have declined significantly and in all grade levels (middle school, high school) between DFC coalitions’ first and most recent data report. Additionally, perception of risk increased significantly for alcohol, tobacco, and marijuana use among youth in DFC-funded communities. Both markers are clear evidence of the success of your work and the effectiveness of this model.

I wanted to share that with you as a harbinger of hope. The Prevention WINS coalition accomplished quite a bit over the past 4+ years and now, with DFC support, we have the wonderful opportunity to accomplish even more, creating a safe and healthy community for our children.

A few things about what teens see on tv

Increased youth exposure to tv alcohol ads
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.

Affluence increases risk for young adult substance abuse

According to a study published in the August 2010 edition of Substance Abuse Treatment, Prevention and Policy, adolescents who come from higher socioeconomic status (SES) backgrounds, as measured by parental education and household income in adolescence, have higher rates of substance use, particularly binge drinking, marijuana use and cocaine use, in early adulthood.

The study concludes by saying: As much of the previous scientific literature often focuses on substance abuse in lower SES populations, it is possible that teachers and school administrators in wealthier schools may be less likely to recognize the need for substance abuse treatment programs, if the current policy focus is on lower SES populations. Likewise, administrators of drug abuse prevention programs may be less likely to focus their efforts in higher-income areas.

This study offers evidence that wealthier students may be at risk for substance use problems in the future, particularly for binge drinking, marijuana and cocaine use. As previous evidence shows that students with more spending money might be more likely to engage in substance use into adulthood, access to allowances and other forms of spending money may be issues that parents can address if they are concerned with the possibility of substance abuse among their children. School administrators seeking to identify substance use education policies in their schools can find a listing of programs shown to be effective on the website for the National Institute on Drug Abuse (NIDA). Examining the substance abuse problems facing students with higher SES can help teachers, school administrators, and parents recognize the needs that may be present in their schools and communities, and the need for programs to effectively address substance use.

In the news

State liquor laws in the news:

Monitoring the Future in the news:

Though I blogged about this before, here is a link to what appeared in the Seattle PI: Teen pot smoking at 30-year high. Someone who posted a comment after the PI article noted that nobody is talking about how youth alcohol and tobacco use rates have decreased. Considering I had blogged about accentuating the positive in communities right before I blogged about increasing rates of youth marijuana use, I took that comment to heart. Communities across the nation have focused quite a bit on preventing youth alcohol and tobacco use and these successes should be recognized and celebrated. Prevention does work!

National drug policy in the news:

Questions for the Drug Czar (The Nation) Here's an excerpt in which Gil Kerlikowke talks about prevention:

I do not underestimate people's frustrations or strong feelings about a lack of success in the war on drugs, whether in the US or worldwide. It's been going on forty-five years, yet people still know their child can get drugs in high school, that their neighborhood has drug dealing, or they have a friend or neighbor or co-worker impacted by drugs. Where we have so clearly failed is not helping people understand there are very cost-effective, basic ways of working through prevention, understanding treatment can be effective and it's half the cost of incarceration. We don't have to throw up our hands as a nation and say the war on drugs has failed and therefore we have to go for legalization. We should look at these other prevention and treatment issues.

Mental health in the news:

Serious mental health needs seen growing at colleges (New York Times) Alcohol and drug abuse are included in the mental health needs discussed in this article.

Good parenting practices can be a long-lasting gift

A coalition member recently shared the following with me:

Youth who are characterized as impulsive risk takers are known to be at increased risk for alcohol use and dependence over their lifetimes. For them, deliberate family management practices have been shown to disrupt the relationship between youth risk and adult alcohol use.

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.
-- Clear family rules.
-- Norms that guide social activities are understood and discussed calmly between parent and child.

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.
Note: Strengthening Families, a program the helps parents develop good parenting practices, will be offered at Eckstein Middle School in the new year. Information about the program will be posted on this blog and on the Prevention WINS website.

Teen brain development in the news

Here are a few interesting excerpts from an article in Newsweek entitled, The Kids Can’t Help It: What new research reveals about the adolescent brain—from why kids bully to how the teen years shape the rest of your life.

-- 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.

-- . . . the social and psychological dynamics that make adolescents susceptible to acting on the real or perceived pressure of their peers can also be a system for resisting those same pressures. Sometimes it is the adolescents who have been picked on, but have found compatriots, whose anticonformist attitude protects against both the harassment by, and the social pressure from, higher-status peers. And surprisingly, sometimes the teens most at risk are in the middle and upper range of social status, but not quite at the top.

Youth substance abuse prevention: a strategy for everyone

Earlier this week I blogged about environmental strategies for preventing youth substance abuse and shared handouts from the 2010 DFC New Grantee Training. One of the slides in the handout listed seven strategies for community change.

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 barriers exist in our community that get in the way of creating a safe and healthy environment for our children? What can you or your organization do, in collaboration with other coalition and community members, to eliminate those barriers?

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?

Where in our community do youth consume alcohol or smoke marijuana? Can anything in that environment be changed that would discourage drug use?

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.

Nartionwide increase in youth marijuana use

From a December 14 National Institute on Drug Abuse (NIDA) press release:

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."

Positive community norms

Jeff Linkenbach from Montana State University gave the opening plenary and provided a workshop about the Positive Community Norms Model for prevention during the DFC New Grantee Training last week. Below I touch on a few of the ideas he shared.

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 positive

Be present

Be perceptive

Be purposeful

Be perfected (learn from mistakes and share what was learned)

Be proactive

Be passionate.

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)

Embrace Life

Substance abuse prevention ads using positive social norms may be viewed on the Most of Us website.

Environmental prevention: policy

Earlier today my blog topic was environmental prevention. During the DFC New Grantee Training, I attended a workshop about promoting policies that are proven to reduce youth substance abuse. Policy advocacy is considered an environmental prevention strategy.

The session started off with the question, "What policies (at what level?) can help make the population-level change you want to make in your community?" There are many settings within a community in which policy can make a difference.

When planning to advocate for policy change, it's important for coalition's to also ask themselves:

-- Is this winnable?

-- Is there energy behind it?

-- Is it worth the effort?

At least in the beginning of policy advocacy work, it is essential that coalition's find success to keep and build momentum.

The workshop went on to discuss different policies to address different factors contributing to youth substance abuse. Below are two factors present in northeast Seattle.

The last part of the workshop dealt with the steps to take when advocating for policy.

Policy advocacy is best when many voices are heard. A high level of support behind a policy is extremely important and it needs to be seen and recognized by the community and policy-makers.
The entire handout from the workshop if available on the coalition's website.

What is environmental prevention?

During the DFC New Grantee Training last week, we learned more about environmental prevention strategies.

Environmental strategies address the place, settings, occasions and circumstances in which alcohol and other drug use and/or sales occur. Over the last four years, the Prevention WINS coalition mostly worked on individually focused prevention programs like Life Skills Training and Guiding Good Choices.
The DFC grant requires that we focus on environmental strategies.

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.

Sharing: DFC New Grantee Training

Earlier this week, I spent three days in Washington, DC participating in the 2010 Drug Free Communities New Grantee Training. The Prevention WINS coalition is one of 169 coalitions that were awarded DFC grants this year. Nationwide, 741 coalitions receive DFC funding and there are now 30 DFC coalitions in Washington!

In addition to the workshops about managing the grant, I was fortunate to participate in other sessions that are of interest to many coalition members. I will blog about them over the next few days.

Here are a few things I took away from the training:

-- 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.

-- Coalition coordinators are community facilitators and barrier removers whose job it is to support community members and their prevention activities.

-- Tell your community's story. Don't rely only on data but share with others what you see in our community.

-- Take advantage of CADCA materials and trainings.

-- Take advantage of the Above the Influence campaign materials.

-- Sugarland's Stand Up is catchy. Jack Claypool, the federal administrator for the DFC program, played it several times during the training and it didn't leave my head until I got on the plane back to Seattle.

King County Legislative Forum December 15

King County Legislative Forum: Issues for 2011 Related to Mental Health & Substance Abuse Prevention, Treatment, and Recovery
Wednesday, December 15, 2010
6:30 - 8:30 p.m.
St. Marks Cathedral, Bloedel Hall

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)

Show your support for reducing youth exposure to alcohol ads

Thanks in part to input from anti-drug coalitions, the Washington State Liquor Control Board adopted new alcohol advertising rules in April to reduce the amount of ads that young people are exposed to in our communities.

We can, once again, show our support for a reduction in alcohol advertising by signing a Let's Draw the Line Commitment Card. Print and sign a card, get other people you know to sign them, too, and send them to the Prevention WINS coordinator. Our cards will join cards signed by other advocates and raise awareness about alcohol advertising and youth.

For information about alcohol marketing and youth, visit http://www.camy.org/.

Drugged driving

From an ONDCP press release:

Earlier this week, Gil Kerlikowske, Director of National Drug Control Policy (ONDCP), called attention to the alarmingly high percentage of fatalities on our Nation's roadways involving drivers that had drugs in their system and called on communities to act immediately to prevent drug use before it starts in light of a new traffic fatality analysis released by the National Highway Transportation Safety Administration (NHTSA).

While national data focusing on the danger of driving under the influence of alcohol is readily available and often cited, less is known or discussed about drivers under the influence of other drugs. However, according to the first-ever analysis of drug involvement from NHTSA's Fatal Accident Reporting System (FARS) census, one in three motor vehicle fatalities (33 percent) with known drug test results tested positive for drugs in 2009. Additionally, according to the new analysis, the involvement of drugs in fatal crashes has increased by five percent over the past five years, even as the overall number of drivers killed in motor vehicle crashes in the United States has declined.

These new data from NHTSA's FARS census reports the presence of narcotics, depressants, stimulants, cannabinoids (marijuana), hallucinogens PCP, anabolic steroids, and inhalants among drivers fatally injured in car crashes over the past five years. Drugs recorded in FARS include illegal substances as well as over-the-counter and prescription medications, which may or may not have been misused. Alcohol, nicotine, aspirin, and drugs administered after the crash are excluded from these results. Additionally, drug involvement means that drugs were found in the driver's system and does not imply impairment or indicate that drug use was the cause of the crash. However, research shows that drugs have adverse effects on judgment, reaction time, motor skills, and memory—critical skills for safe and responsible driving.

The importance of providing youth with opportunities for pro-social involvement

The prevention strategies being implemented by the Prevention WINS coalition are based on risk and protective factors identified through community data. While we work to reduce risk factors such as easy access to alcohol and marijuana, favorable attitudes towards drugs, and families not monitoring their children, we strive to increase factors that protect our children from drug and alcohol use.

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.