Changing attitudes about substance abuse takes time

In an interview, the author of a book about the history of drunk driving makes some interesting comments about attitudes concerning alcohol use in the United States. 

Here are a few excerpts from the interview:

When Barron Lerner was writing his book on the history of drunk driving in America — and efforts to control it — he carried out an experiment at home that involved a bottle of vodka, a shot glass and a Breathalyzer. He was the guinea pig.

"I was trying to figure out just how drunk you had to be in order to not drive safely," says Lerner, a professor of medicine and public health at Columbia University, who wrote One for the Road. He decided to drink and test his levels — but he didn't actually get into a car.

"And, as I suspected after doing my research, one can drink an awful lot and be pretty buzzed and still legally drive in the United States."

He goes on to talk about how attitudes about drunk driving have changed significantly in the last sixty years.

One of the things Lerner writes about is the history of public attitudes toward drunk driving. He uses the example of Margaret Mitchell, the author of Gone with the Wind, who was crossing the street with her husband in Atlanta in 1949 when she was hit by a drunk driver and died.

According to Lerner, people initially reacted with horror, but then attitudes shifted and there started to be more sympathy for the driver — who had had 22 previous arrests for driving violations, including speeding and drunk driving — than for Mitchell.

"This is such an instructive case about drunk driving in this country," Lerner says. "For years and years, back in that era, people who were killed or victimized by a drunk driver were seen as being in the wrong place at the wrong time — that these things happen. And that was very much the case with Margaret Mitchell. After the initial outrage, people started to say, 'Well, it was her time to go.' I read so many stories like that, and every one was almost more shocking than the next — that we could have had a society that was so passive to a crime that was killing 25,000 people a year for so long."

This is a good lesson for those of us working to prevent youth substance abuse to remember.  It may take a long time, but if we are vigilant, attitudes can change.  Drunk driving attitudes are a good example.  So are attitudes around smoking.  Even if people now say "kids will be kids" and that there is nothing we can do to prevent youth substance abuse, those attitudes can change.

Reports on drug use and health available online

The Substance Abuse and Mental Health Services Administration (SAMHSA) has many downloadable reports about drug use and health.  One that recently caught my eye was about State Estimates of Drunk and Drugged Driving.  According to the report, Washington has a relatively low rate of drunk driving that has decreased since 2006 but has a relatively high rate of drugged driving. 

Other reports include:

Substance Abuse Treatment Admissions Aged 12-14

A Day in the Life of American Adolescents: Substance Use Facts Update

SAMHSA News: Preventing Suicide on College Campuses

Freakonomics on prevention

A recent post on the Freakonomics blog questions the effectiveness of substance abuse prevention programs.

Do school-based prevention programs work?
The author begins with, "A large body of research has shown that the vast majority of [school-based] programs have largely been ineffective . . . only six of 52 high-quality programs have been able to show results." Though stated in the negative, this means that we know of six school-based programs that are effective, Life Skills Training being one of them. Thomas Edison is quoted as saying, "I have not failed. I just found 10,000 ways that won't work," when discussing his many attempts to create a working light-bulb. We can use what we know does work by implementing tested and effective programs and building on them.

The same goes for the author's pronouncement that only a few parenting programs and social norms marketing campaigns work.

What about alcohol advertising?
On the positive side, the author notes, " . . . some studies, particularly those that track subjects over time, have shown that less [alcohol] advertising does work, particularly for the young . . . " He goes on to state, "However, we are unlikely to see less advertising, particularly if we wait for the alcohol industry to take the lead; self-regulation initiatives have not led to results in the past. Ironically, responsible drinking education programs produced by the alcohol industry have been shown to sometimes have the exact opposite of the (presumably) intended effect: they actually promote positive views about alcohol and its makers."

Reducing drunk driving deaths

The National Highway Traffic Safety Administration has published "Lives Saved in 2007 by Restraint Use and Minimum Drinking Age Laws." The report's findings indicate that the 21-year-old minimum drinking age laws have prevented an estimated 4,441 drunken driving deaths in the last 5 years alone. (Office of Juvenile Justice and Delinquency Prevention)