Transcript IPRC, ATOD monograph, 2007. - Indiana Prevention Resource Center

The Dilemma of Underage
Drinking in Indiana
Barbara Seitz de Martinez, PhD, MLS, CPP
Deputy Director,
Indiana Prevention Resource Center
Safe & Drug Free Schools Workshop
Spring 2008
The Indiana Prevention Resource Center is funded, in part, by a contract with the Indiana Family
and Social Services Administration, Division of Mental Health and Addiction, financially
supported through HHS/Substance Abuse Mental Health Services Administration, Center for
Substance Abuse Prevention, Substance Abuse Prevention and Treatment Block Grant. The
IPRC is operated by the Indiana University Department of Applied Health Science and School of
Health, Physical Education and Recreation. It is affiliated with the Department's Institute of Drug
Abuse Prevention.
Gateway Drugs
Research has shown that the majority of
individuals' illicit drug use occurs only after
they use cigarettes, alcohol, or marijuana.
These three are known as the "gateway
drugs." (Bailey, 1992; Donovan & Jessor,
1983; Fleming, Leventhal, Glynn, &
Ershler, 1989; Golub & Johnson, 2001;
Kandel & Yamaguchi, 1993).
Alcohol and Rx Drugs
Males and females with alcohol dependence are 18x more likely to
abuse prescription drugs than are those who abstain from alcohol
use. Youth under age 25 are especially vulnerable to abusing both
alcohol and prescription drugs.
Source: Elizabeth Ashton, “Alcohol Abuse Makes Prescription Drug
Abuse More Likely,” NIDA Notes 21/5 (March 2008):8-9.
Note: Preventing or delaying use of alcohol will reduce the likelihood of drug use and of other
associated problem behaviors.
IPRC: Call 800 – 346-3077
www.drugs.indiana.edu
We need to remember that alcohol is a gateway drug.
When new drug trends emerge we must remember that alcohol, along with tobacco,
is a primary drug of abuse and must be addressed aggressively .
ATOD Survey, p. 112
ATOD Survey, p. 112
ATOD Survey, p. 112
ATOD Survey, p. 112
•
ATOD Survey, p. 122
ATOD Survey, p. 112
Indiana Students’ Use
3-10+ times in last 2 wks. 1.3%
2.3%
IPRC, ATOD Survey Monograph, 2007
4.2%
5.5%
7.7%
8.3%
10.8%
Drugs and Driving by American
High School Seniors, 2001-2006
• In 2006, 30% of HS seniors reported
exposure to a drugged or drinking driver in
the past 2 weeks
• This was down from 35% in 2001
• Exposure was widespread
• Individual lifestyle factors were associated
with outcome behaviors
Source: Patrick M. O’Malley, “Drugs and Driving by Am HS Sr, 2001-2006,” Jrnl
of Studies on Alcohol and Drugs 68/6 (November 2007):834-842.
Individual Lifestyle Factors
Associated with Drugs and Driving
•
•
•
•
•
Religiosity
Grade point average
Truancy
Frequency of evenings out for fun
Hours of work
Source: Patrick M. O’Malley, “Drugs and Driving by Am HS Sr, 2001-2006,” Jrnl
of Studies on Alcohol and Drugs 68/6 (November 2007):834-842.
IPRC: Call 800 – 346-3077
www.drugs.indiana.edu
Age of 1st Use
. . . the younger a person is when she or he begins using alcohol, the more
likely the person is to experience alcohol dependence and abuse
(Grant, Stinson, & Harford, 2001; Warner & White, 2003).
A recent study found that compared to persons who began drinking at age 21 or
older, those who began drinking before age 14 were more likely to experience
alcohol dependence later in life (R. W. Hingson, Heeren, & Winter, 2006).
Note: Preventing or delaying use of alcohol will reduce the likelihood of other drug use and of
other associated problem behaviors.
Age of 1st Use – Alcohol (IN)
IPRC, ATOD Survey Monograph, 2007
Age of 1st Use
IPRC, ATOD Monograph, p. 14
Perceived Risk of Harm
and Annual Prevalence
IPRC, ATOD Monograph, p. 15
Perceived Risk of Harm
and Monthly Prevalence
IPRC, ATOD Monograph, p. 16
Perceived Peer Approval
and Annual Prevalence
IPRC, ATOD Monograph, p. 17
Perceived Peer Approval
and Monthly Prevalence
IPRC, ATOD Monograph, p. 18
Perceived Parental Approval
and Annual Prevalence
IPRC, ATOD Monograph, p. 18.
Perceived Parental Approval
and Monthly Prevalence
IPRC, ATOD Monograph, p. 18
The Importance of Norms
Promoting and maintaining a culture or
environment where the perception of risk
of harm from alcohol use and the
perception of parental and peer
disapproval of alcohol use is greater will
reduce the likelihood of drug use and
associated problems.
After-School Activities
and Annual Prevalence
IPRC, ATOD Monograph, p. 18
After-School Activities
and Monthly Prevalence
IPRC, ATOD Monograph, p. 18
Indiana Students’ Use
IPRC, ATOD Survey Monograph, 2007
Importance of Monitoring
Parental monitoring of their child’s
activities and involvement in those
activities are powerful tools in reducing the
likelihood of drug use. The hours from 36 p.m. are particularly important because
this is a time when many parents are
working and the child may be presented
with temptations to initiate drug use.
Survey of Alcohol Compliance
•April 16, 2008
•new program initiated by State Excise
Police
•evaluates the sale of alcohol to persons
under 21
•attempts to mirror success of TRIP
Source: Aaron Jones,
http://www.drugs.indiana.edu/news-featured_detail.aspx?seq=12
SAC Inspections
State Excise Police SAC Inspections
•collaboration -- State Excise Officers and
18-20 year-olds
•primary goal -- to reduce access and
availability
•one of many strategies
IPRC Role
•recruiting and hiring youth
•other administrative duties
Source: Aaron Jones,
http://www.drugs.indiana.edu/news-featured_detail.aspx?seq=12
New Knowledge:
Alcohol and the Alcoholic Lung
Alcohol abuse increases the risk of acute
lung injury, e.g., following:
• major trauma, such as a serious motor
vehicle accident, gunshot,
• other event requiring hospitalization,
• the spread of bacteria attributed to
infection.
• …can occur even in young and otherwise
healthy individuals
Source: Corey D. Kershaw and David Guidot, “Alcoholic Lung
Disease,” Alcohol Research & Health 31/1 (2008):66-75.
IPRC Activities
•Survey of Alcohol Compliance
•Drug Information Portal
•ATOD Survey of ATOD Use by IN Children and Adolescents
•PREV-STAT GIS Data and Mapping Resources
•After School Prevention Programs – R.O.C.K.
•Grant-Writing and Evaluation Support
•Strategic Prevention Framework approach and SIG support
•School Prevention Curricula
•Library – Literature, Reference Services, AV loans
•Problem Gambling Prevention
IPRC Activities
Preventing or delaying use of alcohol will reduce the likelihood of
drug use and of other associated problem behaviors.
The greater the perception of risk of harm from alcohol use and the
greater the perception of parental and peer disapproval of alcohol
use the less likely it is that youth will use alcohol and other drugs or
experience associated problems. Promote or maintain such a culture
in your family and environment.
Parental monitoring of their child’s activities and involvement in those
activities are powerful tools in reducing the likelihood of drug use.
The hours from 3-6 p.m. are particularly important because this is a
time when many parents are working and the child may be presented
with temptations to initiate drug use.
We need to remember that alcohol is a gateway drug.
When new drug trends emerge we must remember that
alcohol, along with tobacco, is a primary drug of abuse
and must be addressed aggressively.
Tobacco Use
By School Students in Indiana
Barbara Seitz de Martinez, PhD, MLS, CPP
Deputy Director,
Indiana Prevention Resource Center
Safe & Drug Free Schools Workshop
Spring 2008
The Indiana Prevention Resource Center is funded, in part, by a contract with the Indiana Family
and Social Services Administration, Division of Mental Health and Addiction, financially
supported through HHS/Substance Abuse Mental Health Services Administration, Center for
Substance Abuse Prevention, Substance Abuse Prevention and Treatment Block Grant. The
IPRC is operated by the Indiana University Department of Applied Health Science and School of
Health, Physical Education and Recreation. It is affiliated with the Department's Institute of Drug
Abuse Prevention.
IPRC, ATOD Survey Monograph, 2007
IPRC, ATOD Survey Monograph, 2007
Indiana Students’ Use
IPRC, ATOD Survey Monograph, 2007
Indiana Students’ Use
IPRC, ATOD Survey Monograph, 2007
IPRC, ATOD Survey Monograph, 2007
IPRC, ATOD Survey Monograph, 2007
Age of 1st Use – Cigarettes (IN)
IPRC, ATOD Survey Monograph, 2007
Marijuana Use
among School Students
in Indiana
Barbara Seitz de Martinez, PhD, MLS, CPP
Deputy Director,
Indiana Prevention Resource Center
Safe & Drug Free Schools Workshop
Spring 2008
The Indiana Prevention Resource Center is funded, in part, by a contract with the Indiana Family
and Social Services Administration, Division of Mental Health and Addiction, financially
supported through HHS/Substance Abuse Mental Health Services Administration, Center for
Substance Abuse Prevention, Substance Abuse Prevention and Treatment Block Grant. The
IPRC is operated by the Indiana University Department of Applied Health Science and School of
Health, Physical Education and Recreation. It is affiliated with the Department's Institute of Drug
Abuse Prevention.
Marijuana
• Most widely used illicit drug (US/EU) – 4 million in US
• Most widely used secondary drug for stimulant or opiate
dependence (p.9)
• Marijuana dependence exists
• Very similar to other substances
• Adults seeking treatment (10 yrs/6 serious quit attempts)
• Withdrawal creates real symptoms
• Dependence 2x as prevalent as any other illicit drug
• About 50% of heavy marijuana users also smoke
tobacco
Source: Budney, Alan J., et al., “Marijuana
Dependence and Its Treatment, Addiction Science &
Clinical Practice (December 2007):4-16.
IPRC, ATOD Survey Monograph, 2007
IPRC, ATOD Survey Monograph, 2007
Indiana Students’ Use
IPRC, ATOD Survey Monograph, 2007
IPRC, ATOD Survey Monograph, 2007
Indiana Students’ Use
IPRC, ATOD Survey Monograph, 2007
IPRC, ATOD Survey Monograph, 2007
Marijuana Impaired Driving
• 5% of persons 12+ (NSDUH)
• 15-18% of 18-21 yr. olds (illicit -- NSDUH)
• 20% of HS drivers in Canada
High School Seniors DUI
25
18.2%
20
Marijuana
Illicit Not Marij
Alcohol
Heavy Drinking
Any of Above
15
10
5
0
2001
2005
2006
Source: Patrick M. O’Malley, “Drugs
and Driving by Am HS Sr, 2001-2006,”
Jrnl of Studies on Alcohol and Drugs
68/6 (November 2007):834-842.
High School Seniors
Riding with an Impaired Driver
30
24.4%
25
Marijuana
Illicit not Marij
Alcohol
Heavy Drinking
Any of Above
20
15
10
5
0
2001
2005
2006
Source: Patrick M. O’Malley, “Drugs
and Driving by Am HS Sr, 2001-2006,”
Jrnl of Studies on Alcohol and Drugs
68/6 (November 2007):834-842.
High School Seniors DUI or
Riding with an Impaired Driver
35
29.6%
30
25
Marijuana
Illicit not Marij
Alcohol
Heavy Drinking
Any of Above
20
15
10
5
0
2001
2005
2006
Source: Patrick M. O’Malley, “Drugs
and Driving by Am HS Sr, 2001-2006,”
Jrnl of Studies on Alcohol and Drugs
68/6 (November 2007):834-842.
Withdrawal Symptoms
•
•
•
•
•
•
•
•
Cravings
Anxiety
Depression -- feelings of misery
Difficulty sleeping
Chills and muscle pain
Irritability
Predictable (timeframe)
Mild compared to heroin or severe alcohol
Budney et al, 2004; Budney and Hughes, 2006. Cited
in “Research Review – Marijuana Dependence and Its
Treatment, Addiction Science & Clinical Practice 4/1
(December 2007):10.
Percent of SA Treatment
Admissions due to Marijuana
60
50
40
1993
2005
30
20
10
0
Alcohol Cocaine Heroin Marijuana
Source: SAMHSA, 2006. Cited by Budney, Alan J., et al.,
“Marijuana Dependence and Its Treatment, Addiction
Science & Clinical Practice (December 2007):4-16.
Marijuana
admissions
nearly doubled
1993-2005
Adolescent Drug Treatment
70
60
50
Marijuana
Cocaine
Heroin
Alcohol
40
Marijuana –
the most
adolescent
admissions
30
20
10
0
'12-17
18-20
21-34
35-55
Source: SAMHSA, 2006. Cited by Budney, Alan J., et al.,
“Marijuana Dependence and Its Treatment, Addiction
Science & Clinical Practice (December 2007):4-16.
Why the Rise in Youth Use?
• Higher potency marijuana
• Initiation of use at younger age
• Rise in use among young adult AfricanAmerican and Hispanic men and AfricanAmerican women
Source: Compton, 2004 JAMA 291/17. Cited by Budney,
Alan J., et al., “Marijuana Dependence and Its Treatment,
Addiction Science & Clinical Practice (December 2007):416.
Why the Rise among Minorities?
•
•
•
•
Effects of acculturation on Hispanic youth
More minority youth attending college
Environmental and economic factors
Higher prices and stricter government policies
for other drugs
Source: Budney, Alan J., et al., “Marijuana
Dependence and Its Treatment, Addiction Science &
Clinical Practice (December 2007):4-16.
Adolescent Risks
•
•
•
•
•
•
•
Adverse health and psychosocial consequences
Sexually transmitted diseases and pregnancy
Early school dropout
Delinquency
Legal problems
Lowered educational and occupational aspirations
Typically “forced” into treatment (Diamond et al, ’06)
Source: Budney, Alan J., et al., “Marijuana Dependence
and Its Treatment, Addiction Science & Clinical Practice
(December 2007):4-16.
The Dilemma of Rx and OTC
Drug Abuse in Indiana
Barbara Seitz de Martinez, PhD, MLS, CPP
Deputy Director,
Indiana Prevention Resource Center
Safe & Drug Free Schools Workshop
Spring 2008
The Indiana Prevention Resource Center is funded, in part, by a contract with the Indiana Family
and Social Services Administration, Division of Mental Health and Addiction, financially
supported through HHS/Substance Abuse Mental Health Services Administration, Center for
Substance Abuse Prevention, Substance Abuse Prevention and Treatment Block Grant. The
IPRC is operated by the Indiana University Department of Applied Health Science and School of
Health, Physical Education and Recreation. It is affiliated with the Department's Institute of Drug
Abuse Prevention.
Recommended web site:
www.theantidrug.com
The Family Medicine Cabinet
•
•
•
•
Pain Killers (e.g., post-surgical Rx)
Depressants (e.g., sleeping, anti-anxiety)
Stimulants (e.g., for ADHD)
OTC (e.g., cough and cold remedies)
www.theantidrug.com
Danger:
• Pain Meds and Depressants: breathing
failure
• Stimulants: heart system failure, seizures
• OTC: blurred vision, nausea, vomiting,
coma, death
• Combining the above risks respiratory
failure and death.
www.theantidrug.com
Upsetting Trend: Pain Meds
Every day
2500 teens ages 12-17
abuse a pain medication
for the 1st time.
Many don’t realize the danger.
www.theantidrug.com
Upsetting Trend: Pain Meds
Nearly 1 in 5 teens (18% or 4.3 million) report
abusing Vicodin®
1 in 10 teens (10% or 2.3 million) report
abusing OxyContin®
Partnership for a Drug-Free
America, www.drugfree.org
Upsetting Trend: Stimulants
1 in 10 teens (10% or 2.3 million) report trying
Ritalin® and/or Adderall® without a doctor’s
order.
1 in 11 teens (9% or 2.2 million) has abused
OTC cough meds to get high (contains
dextromethorphan).
Partnership for a Drug-Free
America, www.drugfree.org
Upsetting Trend: Rx Drugs
• Of illicit drugs, only marijuana has more teen
abusers
• More than 2.1 million teens reported
abusing Rx drugs
• The Drug of Choice for 12-13 year olds
www.theantidrug.com
Multiple Drug Use
“Individuals who report using Oxycontin®
typically have a history of multiple drug use
including non-medical use of other
prescription medications such as
tranquilizers, sedatives and stimulants.”
(Sees et al, 2005)
IPRC, ATOD monograph, 2007.
Indiana Stats: Rx Drugs
ATOD Survey of 6th-12th graders asks about:
• Amphetamines
• Methamphetamines
• Ritalin or Adderall
• Tranquilizers
• Rohypnol
• Over the Counter Drugs
Indiana Stats: Rx Drugs
6th
Drug
8th
10th
12th
IN
US IN US IN US IN US
Amphetamines
0.3
2.3 4.7 5.7 7.9 5.4 8.1
Methamphetamine
0.2
1.2 1.8 1.9 1.8 1.9 2.5
Tranquilizers
2.8
6.7 2.6 9.5 5.2 8.3 6.6
Ritalin or Adderall
0.7
3.3 2.6 7.4 3.6 7.0 4.4
Rohypnol
0.1
0.8 0.5 1.1 0.5 1.0 1.1
OTC
3.8
8.0
10.3
8.5
What to do if you suspect:
•
•
•
•
•
•
•
•
•
Get educated
Have the talk – Let them know you know
Be specific about your concerns
Don’t make excuses
Try to remain calm and connect with him/her
Be prepared – practice what you’ll say
Act now – monitor your child, get involved
Be available to listen
Set and enforce rules
www.theantidrug.com
Prevention: What You Can Do
•
•
•
•
•
•
•
•
Keep all drugs at home. Monitor and control meds.
Set clear rules about all drugs
Teach child to follow doctor’s advise and dosage
Teach child to not share medications
Be a good role model
Properly conceal and dispose of unused meds
Ask friends and family to control their Rx and OTC
Talk to your teen
www.theantidrug.com
Methamphetamine Impact on
Indiana School Children
Barbara Seitz de Martinez, PhD, MLS, CPP
Deputy Director,
Indiana Prevention Resource Center
Safe & Drug Free Schools Workshop
Spring 2008
The Indiana Prevention Resource Center is funded, in part, by a contract with the Indiana Family
and Social Services Administration, Division of Mental Health and Addiction, financially
supported through HHS/Substance Abuse Mental Health Services Administration, Center for
Substance Abuse Prevention, Substance Abuse Prevention and Treatment Block Grant. The
IPRC is operated by the Indiana University Department of Applied Health Science and School of
Health, Physical Education and Recreation. It is affiliated with the Department's Institute of Drug
Abuse Prevention.
Vigo County Profile, 6.5
Methamphetamine Laboratory Seizures, 1998-2005
(ISP, 2006)
Vigo
Indiana
1998 (Any Agency)
1
43
1999 (Any Agency)
18
129
2000 (Any Agency)
52
314
2001 (Any Agency)
66
542
2002 (Any Agency)
105
988
2003 (Any Agency)
108
1,278
2004 (Any Agency)
166
1,549
2005 (IPS)
19
989
2005 (Any Agency)
83
1,303
Table 6.5:
Clandestine
Methampheta
mine Lab
Seizures,
(ISP,
2007)(ATC,
Indiana State
Excise
Police, 2006)
Map: Meth Lab Busts (prism)
Source: IN State Police, 2007
Total lab busts in 2006, 993
Indiana Prevention Resource Center
Meth Impact on Parenting
• Inconsistent and inappropriate emotional
responsiveness to children
• Unpredictable and impulsive
• Paranoid and delusional
• Disorganized lifestyle
• Experience interpersonal violence
Source: Brown, Julie A. and Melinda Hohman, “The
Impact of Methamphetmine Use on Parenting,” in The
Impact of Substance Abuse on Children and Families:
Research and Practice Implications, Shulamith Lala
Ashenberg Straussner and ChristineHuff Fewell, eds.
New York: Haworth Press, 2006, pp. 63-88.
Themes: Impact on Parenting
•
•
•
•
•
•
Polar Parenting
Drug Management
The Separate Life
Domestic Violence
Effects on Children
Retrospective Ambivalence
Source: Brown, Julie A. and Melinda Hohman, “The
Impact of Methamphetmine Use on Parenting,” in The
Impact of Substance Abuse on Children and Families:
Research and Practice Implications, Shulamith Lala
Ashenberg Straussner and ChristineHuff Fewell, eds.
New York: Haworth Press, 2006, pp. 63-88.
Themes RE: Impacts on Parenting
Polar Parenting
Extreme feelings of anger or apathy, not balanced
by positive expressions
Drug Management The logistics of using meth as a parent of young
children
The Separate Life
Parents removing themselves, and their drug use
from their children
Domestic Violence Violence between marital and live-in partners;
violent crimes against family members in the
home – a side effect of use
Effects on
Children
Physical, environmental, emotional, and
psychological impacts.
Retrospective
Ambivalence
Differing opinions and beliefs about whether or
not they were able to handle their parental role
while using meth
Source: Julie A Brown and Melinda Hohman, Impact
of SA on Children and Families: Research and
Practice Implications. Haworth Press, 2006:70+
Child Experience in Meth Home
•
•
•
•
•
•
•
Neglect (due to use and binge/crash cycle)
Often exposed to home manufacturing
Exposure to toxic chemicals and fumes
Exposed to violent, aggressive behavior
Parent’s multiple sex partners
Withdrawal – intense depression/irritability
Very similar to other substances
Source: Brown, Julie A. and Melinda Hohman, “The Impact of
Methamphetmine Use on Parenting,” in The Impact of Substance
Abuse on Children and Families: Research and Practice Implications,
Shulamith Lala Ashenberg Straussner and ChristineHuff Fewell, eds.
New York: Haworth Press, 2006, pp. 63-88.
IPRC Activities
Preventing or delaying use of gateway drugs will reduce the
likelihood of drug use and of other associated problem behaviors.
The greater the perception of risk of harm from drug use and the
greater the perception of parental and peer disapproval of alcohol
use the less likely it is that youth will use alcohol or other drugs or
experience associated problems. Promote or maintain such a culture
in your family and environment.
Parental monitoring of their child’s activities and involvement in those
activities are powerful tools in reducing the likelihood of drug use.
The hours from 3-6 p.m. are particularly important because this is a
time when many parents are working and the child may be presented
with temptations to initiate drug use.
Remember the gateway drugs. When new drug trends
emerge we must remember that alcohol and/or tobacco
are usually the 1st drugs used. Don’t forget the
importance of addressing these aggressively, as well as
enhancing protective factors.
Protective Factors
IPRC, ATOD Survey Monograph, 2007
Protective Factors
IPRC, ATOD Survey Monograph, 2007
Promote a healthy lifestyle, strong values, bonding w/ family, school, community.
IPRC, ATOD Survey Monograph, 2007
Thank you!
• Call: 327 / 855-0851
• E-mail: [email protected]
• www.drugs.indiana.edu