Transcript Prevention - Dr. Hoover

THE GOOD NEWS/ AOD USE IN YOUTH - 2013
• Cigarette and alcohol use among 8th,10th and 12th
graders, are at the lowest point since 1975.
• Five-year trends show significant decreases in
alcohol use among nearly all grades and across
all prevalence periods.
• Binge use of alcohol declined among 8th, 10th and
12 graders over the past year.
• In 2013, there was an increase in perceived risk
of smoking among 8th, 10th and 12th graders.
• The use of inhalants continued its decline among
individuals in 8th, 10th, and 12th grades.
THE BAD NEWS/ AOD USE IN YOUTH - 2012
• Alcohol & other drugs are readily available.
• One out of 2 seniors has tried an illicit drug; 7 out
of 10 have used alcohol at some time.
• Students as young as those in grades 3 and 4
have used alcohol and tobacco; many even
younger have been exposed to illicit drugs by
peers, older siblings and parents.
• Five-year trends show significant increases in
marijuana use, which now exceeds tobacco use.
• After marijuana, prescription OTC medications
account for most of the illicit drug use by teens.
Cumulative alcohol and marijuana initiation, by age:
Seattle Social Development Project, 1985-93.
Percent
Am J Pub Health, 90(3): 361, 2000
Alcohol use is a serious problem.
Prevention Works
It Takes A Village
What is Prevention?
Prevention is the sum of our
actions to ensure healthy, safe and
productive lives for all our children
and families. (CSAP)
• Universal
• Selective
• Indicated
Drinking Alcohol as a Function of Parental Monitoring
9th Graders: 5+ Drinks in a Row
Patterson, et al, Child Development 55: 1299, 1993
The Impact of Addiction on
Children and Families
National Longitudinal Alcohol
Epidemiologic Survey - 1992
• 7.4% of adults classified with DSM-IV
alcohol abuse or dependence in past
year.
• 18% of adults classified with lifetime
DSM-IV alcohol abuse or dependence
• 9.7 million children living in households
with 1 or more adults who were abusing
or dependent on alcohol
B F Grant, AJPH; 90 (1):112-115; 2000
National Longitudinal Alcohol
Epidemiologic Survey - 1992
• 1 in every 4 children in the US exposed to alcohol
abuse or dependence in the family.
• The number.. “defines one of today’s major
public health problems.”
• “Children exposed through no fault of their
own..are thrust into families and environments
that pose extraordinary risks to their immediate
and future well-being and threaten the
achievement of their fullest potential.
BF Grant, AJPH; 90 (1):112-115, 2000
Detection of Alcoholism in Hospitalized
Children and Their Families
Duggan AK, Adger H, McDonald
EM, Stokes EJ, Moore R
AJDC, 145:613-617, 1991
Comparison of Adolescents by
Household Screening Status
Despite feeling a responsibility to inquire about AOD in
patients and families there appears to be a cultural
ambivalence and a lack of skills in doing so.
• 0% Recognition by
housestaff
• 1 Positive case
identified by faculty
Why Care About Prevention, Screening,
Brief Intervention and Referral to Treatment ?
Adapted from Broadening the Base of Alcohol Treatment (IOM)
Primary Prevention (Intensive for High Risk)
Brief
Intervention
Specialized Treatment
Referral
Challenges
Drug Abuse is a preventable
behavior. Drug Addiction is a
treatable disease.
Partnership for a Drug-Free America