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Prepared by David S. Anderson, Ph.D. Professor of Education and Human Development George Mason University Fairfax, Virginia 703-993-3698

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Presentation on theme: "Prepared by David S. Anderson, Ph.D. Professor of Education and Human Development George Mason University Fairfax, Virginia 703-993-3698"— Presentation transcript:

1 Prepared by David S. Anderson, Ph.D. Professor of Education and Human Development George Mason University Fairfax, Virginia caph.gmu.edu

2  General Usage Patterns

3 Alcohol-Related Fatalities National Highway Traffic Safety Administration

4 Source: U.S. Fatality Analysis Reporting System, 2009; U.S. Census Bureau, 2009 U.S. MLDA Age 21 law MLDA 21 in all 50 states Ages ↓ 60% Ages ↓ 44% (n=4,733) (n=2,583) (n=1,520) (n=3,867) Data in initial NIAAA college report

5 "Although statistics on drug use in the United States are not fully reliable, the numbers available indicate that US consumption of cocaine and marijuana has been essentially stable for many years— although considerably reduced from its peak in the 1970s and 1980s. The data also show that, today, the United States consumes illegal substances at a rate some three times that of Europe—although the use of drugs in the EU continues to grow rapidly and a few countries actually consume more per capita than the United States. In both the United States and Europe, the wholesale and street prices of cannabis and cocaine have declined in the past several years, although reportedly their potency has increased and demand remains steady. Across the world, illicit drugs appear to be available at stable or declining prices. A recent EU Commission study concluded that global drug production and use remained largely unchanged during the period from 1998 through 2007.“ Source: Hakim, Peter, "Rethinking US Drug Policy," Inter-American Dialogue (Washington, DC: The Beckley Foundation, February, 2010), p. 4.

6 Percentage Change in Lifetime and Monthly Substance Use (ages 12 and older) Percent Change Lifetime Eight- Year %chg Lifetime Five-Year %chg Monthly Eight-Year %chg Monthly Five-Year %chg ILLICIT DRUGS - ALL+9.7%+3.3%+11.7%+4.3% Marijuana+10.0%+3.0%+14.6%+1.6% Cocaine+7.9%+4.1%-19.0%+19.9% Crack-0.5%+1.8%-13.2%+23.8% Heroin+0.4%+3.2%+17.5%+103.6% Hallucinogens+8.6%+2.8%+5.2%-15.9% Ecstasy+40.2%+20.8%+12.4%-21.9% Psychotherapeutics+8.0%+6.3%+10.6%+12.9% Pain Relievers+18.4%+13.0%+20.1%+19.3% Methamphetamine-16.5%-7.5%-26.5%+7.0% Illicit-other-than- marijuana +7.8%+3.7%+4.3%+9.5% Alcohol+6.7%+4.1%+9.0%+4.6% Alcohol – Heavy %+6.8% Tobacco+1.3%+1.2%-2.5%+1.9%

7 Percentage Change in Monthly Substance Use (ages 12 and older) Percent Change Monthly Eight-Year %chg Monthly Five-Year %chg ILLICIT DRUGS - ALL +11.7%+4.3% Marijuana +14.6%+1.6% Cocaine -19.0%+19.9% Crack -13.2%+23.8% Heroin +17.5%+103.6% Hallucinogens +5.2%-15.9% Ecstasy +12.4%-21.9% Psychotherapeutics +10.6%+12.9% Pain Relievers +20.1%+19.3% Methamphetamine -26.5%+7.0% Illicit-other-than-marijuana +4.3%+9.5% Alcohol +9.0%+4.6% Alcohol – Heavy +8.0%+6.8% Tobacco -2.5%+1.9%

8 Treatment Episode Data Set - Admissions (TEDS-A), 2008

9 Treatment Episode Data Set - Admissions (TEDS-A), 2008

10  Patterns Linked to Start of Use  Use Linked to Homework Checked by Parents  Use Linked to Involvement in Activities

11 Alcohol is the Substance of Choice Among Adolescents Source: Monitoring the Future

12 Source: SAMHSA National Survey on Drug Use and Health, 2002 (12-17)(26 and older)

13 A number of information sources are used to quantify America’s drug problem and to monitor drug abuse trends. Foremost among these sources are the Monitoring the Future (MTF) survey* and the National Survey on Drug Use and Health** (NSDUH). Since 1975, the MTF survey has measured drug, alcohol, and cigarette use as well as related attitudes among adolescent students nationwide. For the 2010 survey, 46,482 students in 8th, 10th, and 12th grades from 396 public and private schools participated. Funded by NIDA, the MTF survey is conducted by investigators at the University of Michigan. The NSDUH is an annual survey on the nationwide prevalence and incidence of illicit drug, alcohol, and tobacco use, abuse, and dependence among Americans aged 12 years and older, conducted by the Substance Abuse and Mental Health Services Administration. Approximately 67,500 people are included in this survey. Because of differences in the timing of administration of the surveys, reported NSDUH data are 1 year behind those of MTF. In MTF and NSDUH, there are three primary prevalence periods for which data are reported: lifetime, past year, and past month (also referred to as “current”). It is generally believed that past year and past month are the better indicators of actual use. However, some analyses are done for only one specific prevalence period.

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16 High School and Middle School Youth: 5 or more drinks in a row in last 2 weeks

17 High School and Middle School Youth: 30 Day Tobacco Use

18 High School and Middle School Youth: Any illicit drug in last 30 days

19 High School and Middle School Youth: Any illicit drug other than marijuana High School and Middle School Youth: Any illicit drug other than marijuana in last 30 days

20 High School and Middle School Youth: 30 Day Marijuana Use

21 High School and Middle School Youth: 30 Day Ecstasy Use

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27 National Survey on Drug Use and Health, 2009

28 National Survey on Drug Use and Health, 2009

29 National Survey on Drug Use and Health, 2009

30 National Survey on Drug Use and Health, 2009

31 National Survey on Drug Use and Health, 2009

32 National Survey on Drug Use and Health, 2009

33 National Survey on Drug Use and Health, 2009

34 National Survey on Drug Use and Health, 2009

35 National Survey on Drug Use and Health, 2009

36 National Survey on Drug Use and Health, 2009

37 National Survey on Drug Use and Health, 2009

38 According to NSDUH, overall prevalence of underage (ages 12–20) alcohol use and binge drinking has shown a gradual decline across all prevalence periods. In 2009, an estimated 30.2 million people (12.0 percent) aged 12 or older reported driving under the influence of alcohol at least once in the past year. Although this reflects a downward trend from 14.2 percent in 2002, it remains a cause for concern. The decline in illicit drug use by the Nation’s adolescents since the mid- to late-1990s has leveled off. Among 8th, 10th, and 12th graders, most measures of illicit drug use remained unchanged from 2009 to Marijuana use rose this year—a sharp contrast to the considerable decline of the preceding decade. The downward trend in ecstasy use has been reversed as well, with significant increases this year following a considerable and recent decline in the belief that its use is dangerous.

39 Prescription and over-the-counter (OTC) medications accounted for most of the top drugs abused by 12th graders in the past year. Among 12th graders, past-year nonmedical use of Vicodin decreased from 9.7 percent to 8.0 percent. However, past-year nonmedical use of Oxycontin remained unchanged across the three grades and has increased among 10th graders over the past 5 years. Moreover, past-year nonmedical use of Adderall and OTC cough and cold medicines among 12th graders remained high at 6.5 percent and 6.6 percent, respectively. Complete NSDUH findings are available at

40 The Partnership at Drugfree.org alcohol-use-headed-in-wrong-direction

41 Underage Drinking in Europe Austria Belgium Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Farce Islands Finland France Germany Greece Greenland Hungary Iceland Ireland Isle of Man Italy Latvia Lithuania Malta Netherlands Norway Poland Portugal Romania Russia Slovak Republic Slovenia Sweden Switzerland Turkey Ukraine UK USA Austria Belgium Bulgaria Croatia Cyprus Czech Republic Denmark Estonia France Germany Greece Greenland Iceland Ireland Isle of Man Italy Latvia Lithuania Malta Netherlands Norway Poland Portugal Romania Russia Slovak Republic Sweden Switzerland Turkey Ukraine UK Spain USA Slovenia Percent of 15-Year Olds Who Drank to Intoxication in the Past 12 Months Percent of 15-Year Olds Who Consumed an Alcoholic Beverage in the Past 12 Months ESPAD 2003 Farce Islands Finland Hungary

42 Percent Drunk in Past Year, Students Ages 15-16, ESPAD 2007

43 Source: Grant and Dawson (1997) J. Substance Abuse

44  General Usage Patterns  Student-Athletes

45 TRADITIONAL-AGE COLLEGE STUDENTS: ALCOHOL USE IN LAST 30 DAYS

46 TRADITIONAL-AGE COLLEGE STUDENTS: DRUNK IN LAST 30 DAYS

47 USE OF ALCOHOL BY TRADITIONAL-AGE COLLEGE STUDENTS: 5+ Drinks at a Setting in the Last Two Weeks

48 TRADITIONAL-AGE COLLEGE STUDENTS: 30 DAY USE OF MARIJUANA

49 TRADITIONAL-AGE COLLEGE STUDENTS: 30 DAY USE OF ECSTASY

50 TRADITIONAL-AGE COLLEGE STUDENTS: 30 DAY USE OF NARCOTICS OTHER THAN HEROIN

51 TRADITIONAL-AGE COLLEGE STUDENTS: 30 DAY USE OF COCAINE

52 TRADITIONAL-AGE COLLEGE STUDENTS: 30 DAY USE OF INHALANTS

53 TRADITIONAL-AGE COLLEGE STUDENTS: 30 DAY USE OF LSD

54 TRADITIONAL-AGE COLLEGE STUDENTS: 30 DAY USE OF AMPHETAMINES

55 Source: Core Institute

56 AthleteNon-Athlete Regretted behavior46.4%37.2% Missed a class39.4%31.6% Blackout36.0%27.6% Had unplanned sexual activity 31.0%22.7% 5 or more neg. consequences 29.5%20.1% Harvard College Alcohol Study, 2001

57 82.6%Recreational or social purposes 13.6%Because it makes me feel good 3.3%Helps me deal with the stresses of college life and college athletics 0.0%Improves my athletic performance Source: NCAA Study of Substance Use Habits of College Student-Athletes, 2005

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64 AthleteNonathlete Driving 90.9%91.7% Studying 78.4%74.5% Interferes with athletics 61.2%18.3% On a date 46.4%40.8% Fattening 30.2%26.3% Afraid of getting caught 22.7%18.5% Source: Harvard College Alcohol Study, 2001

65 Anderson and Gadaleto, 2009 College Alcohol Survey

66 Alcohol's Involvement with Campus Behavior: 2009 Anderson and Gadaleto, 2009 College Alcohol Survey

67 Alcohol’s Involvement in Academic Issues: 2009 Anderson and Gadaleto, 2009 College Alcohol Survey

68  High School Youth  Parents  Community Leaders

69 http.teenalcoholcultures.gmu.edu

70  Literature Review  250 articles, 59 dissertations/theses, 34 government/non-profit reports, 19 books, 19 data sets  Telephone Polling  1623 interviews [1014 parents and 609 teens]  522 are matched pairs [parent and teen]  Key Informant and Individual Interviews  58 completed [blend of community, school, law, and health]  Expert Interviews  28 completed [includes university, research, government, medical, and authors] The methodology incorporated a blend of approaches, and involves the use of a national Advisory Panel.

71  Focus Groups [N=71]  59 with youth [47 high school, 6 middle school, 6 college]  8 with parents  4 with community leaders  513 youth were involved in focus groups  396 high school and 35 middle school youth  High school youth were balanced with boys/girls and white/non- white  No notable differences were found based on race/ethnicity  Few differences were found based on gender  Sites included Northern Virginia, Bucks County (PA), Orange County (FL), Minneapolis, Santa Fe (NM), Northern New Jersey, and rural Georgia.  No notable differences were found based on setting (urban/rural/suburban)

72  Inadequacy of Current Knowledge  Much current knowledge is based on survey research.  Limited conversational research is found with teens, parents or other front line personnel.  Current expert knowledge is often limited.  Disjunction Between Formal and Informal Rules  Teens and parents have their own practices and beliefs about what is practical and appropriate.  These practices and beliefs often diverge sharply from legal codes.

73  Differences Between Parent and Teen Views  Teens cite academic challenges more often than parents.  Teens are more likely to cite emotional or social reasons for drinking and for getting drunk.  Parents attach more importance to family relationships as motivators for teens’ drinking or not drinking.  Extreme Teen Behavior  Teens engage in high risk drinking behaviors on a frequent basis.  Teens who drink do so for emotional and social reasons.

74  Lack of Helpful Information  Teens have minimal knowledge of alcohol’s effects (beyond drinking and driving consequences).  Teens and parents are unaware of helpful resources.  Teens and parents lack skills for meaningful dialogue on alcohol.  Not Sure What to Do  Parents and community leaders are unsure how to address teen drinking.  Parents and community leaders focus primarily on policy or law enforcement approaches.

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83  Teens report that obtaining alcohol is quite easy, through relationships (older siblings, friends, co- workers), places of purchase, theft or party settings.  Unlike other studies, our middle school teens report having few to no experiences with alcohol.  Boys are typically expected to provide alcohol for girls.

84  Teens drink primarily to get drunk; drinking for taste or mild effects is rare.  Teens drink to deal with stress, to facilitate group membership, and to feel better.  Teens’ transition to high school is a high-risk time.

85  Early drinking experiences are frequently dangerous “trials by fire” where teens learn by experimentation.  While youth are aware of family and legal consequences, they are often confident that they will not get caught.

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87  Parents are often unsure how to talk to their teens and to other parents about teen alcohol consumption.  Parents feel a lack of information and guidance.  Parents are aware of the divergence between legal codes and informal practices.  Public moralism and zero tolerance laws make frank conversation with their teen(s) and other parents difficult.

88  Parents are four times as likely as teens to think that alcohol education programs, such as those at school, are effective.  Parents believe that schools emphasize informational and legal messages, including  don’t drink  alcohol affects your health  don’t drink and drive  alcohol use is illegal under 21  Teens report limited to no conversations on alcohol with parents during teen years.

89  Teens want more information about alcohol.  Teens want judgment-free information about alcohol from sources they can trust; they do not trust school-based education programs.  Most teens report that alcohol is talked about by school authorities, and report informational, legal and proscriptive messages.  Whatever their actual behavior, teens report hearing and respecting messages about not drinking and driving.

90  Teens typically don’t see drinking as a problem, unless they get in trouble with those in authority.  Teens see other teens’ drinking as more of a problem than their own, even if the behavior is essentially the same.  Teens overwhelmingly deny the importance of peer pressure in decisions to consume or not consume alcohol.  However, teens have a poorly developed concept of peer pressure.  Teens see drinking as pleasurable and often essential to socializing with other teens.  For many teens, drinking is a primary extracurricular activity.

91 Underlying or Core Factors Intrinsic or Vital FactorsExtrinsic FactorsContextual Factors *Strong core values *Feel connected to past and future *Has a sense of purpose *Family bonds *Feeling loved and listened to *Feeling capable (confidence) *Aware of areas of concern *Knows where to turn for assistance *Feels supported *Has balance in life *Good coping skills to deal with anxiety, stress, high expectations *Friends provide support *Friends encourage behavior change as needed *Spend family time together *Healthy family *Has open communication / conversation with parents *Has meals with families *Has good sense of personal boundaries *Feels affirmation *Has clear and reasonable expectations *Skills to interact with others *Sees parents as partners and guides *Reflect on self *Has positive role models *Engaged in activities, clubs *Has opportunity to learn by doing, experiment, make mistakes *Is encouraged to stretch and extend comfort zone The Teen’s WorldThe Role of Alcohol

92 Underlying Causes Intrinsic FactorsExtrinsic FactorsContextual Factors *Stress *Feel pressure *Discouragement *Disenfranchised *Lonely *Seeking own identity *Insecure *Hopelessness *Lack coping skills *Boredom (nothing to do) *Not comfortable being alone *Lack of goals or mission *Escape *To experience things themselves *No reflection *To fit in *To be older *To rebel *Unrealistic expectations (life, situations) *Lack knowledge and information *Lack meaningful conversation with parents *Lack of role models *Allure (TV, songs, ads) *No substantive, consistent legal consequences *Conflicting messages (adults drink) * Educational dishonesty, inadequacy, mistrust *Peer acceptability *Peers’ encouragement *Ease of access *Party availability *Alcohol is readily available *Societal acceptability The Teen’s WorldThe Role of Alcohol

93 FRAMEWORK FOR YOUTH RISKY ALCOHOL DECISIONS Underlying Causes Intrinsic Factors Extrinsic Factors Contextual Factors

94 FRAMEWORK FOR YOUTH RISKY ALCOHOL DECISIONS Underlying Causes Intrinsic Factors Extrinsic Factors Contextual Factors

95 FRAMEWORK FOR YOUTH RISKY ALCOHOL DECISIONS Underlying Causes Intrinsic Factors Extrinsic Factors Contextual Factors

96 FRAMEWORK FOR YOUTH RISKY ALCOHOL DECISIONS Underlying Causes Intrinsic Factors Extrinsic Factors Contextual Factors

97 FRAMEWORK FOR YOUTH RISKY ALCOHOL DECISIONS Underlying Causes Intrinsic Factors Extrinsic Factors Contextual Factors

98 FRAMEWORK FOR YOUTH RISKY ALCOHOL DECISIONS Underlying Causes Intrinsic Factors Extrinsic Factors Contextual Factors

99 TYPE OF EFFORT PolicyProgramTrainingEnvironment GROUP OR ORGANIZATION Schools Consistently implemented rules and regulations Standards for school employees and visitors Curriculum that is meaningful Clubs and organizations After school activities Personnel preparation with identification and referral School bonding and community-building activities Recognition for positive contributions Law Enforcement Laws and policies throughout the community Enforcement of laws Sponsor local events Participate in community activities Mentoring youth Community resource officers in school and community settings Health Services Services available for teens Public awareness materials Community forum and dialog How to identify problematic use How to be supportive Promote as trusted source Spokespersons Community Standards and guidelines Community forum and dialog Prepare adults and community leaders to understand today’s youth needs Group meeting behavior Volunteering for community events Public awareness activities Youth-Serving Organizations Engage in establishing community policies Community-wide activities Mentoring opportunities for older teens Provide awards for positive contributions

100 Focus groups: Difficulty identifying site coordinators to provide leadership and handle logistics with coordinating multiple focus groups and interviews. Access to Youth: Reaching youth faces roadblocks from gatekeepers. Human Subjects Review Board: Requests for protocols require reworking design (e.g., Initial refusal to allow recruitment through schools, need for approval from each school for focus groups, concern about use of incentives, need for approval of each referring organization for on-line polling, limits on certain open-ended questions with telephone polling, initial requirement for written consent from parent for telephone polling) Timelines: Changing standards and delayed reviews from HSRB affects schedules and plans. Multiple approaches: More sequential scheduling of strategies would assist ongoing refinement of research questions; difficult within limited time frame.

101 Recommendations are prepared within each of the following areas of emphasis:  Youth  Parents and Families  Communities and Schools  Future Research  Overall

102  Engage youth in a meaningful way in planning extracurricular activities, information needs, learning experiences.  Address the core needs of youth, with attention to underlying causes and intrinsic factors.  Provide opportunities for youth to discuss their needs, concerns, and other issues.  Provide teens with factual information about alcohol and its interaction with the body.  Enroll older siblings as part of the solution.

103  Provide opportunities for parent-to-parent discussion of dilemmas and challenges.  Promote trust and ongoing dialog with teens about their lives.  Provide parents and older siblings with current, accurate information and resource assistance.  Enhance parents’ skills and confidence for having ongoing conversations with teens about alcohol, consequences, and underlying causes.  Encourage parents’ and older siblings’ skills and responsibilities.

104  Community leaders should prepare a community-wide strategy that engages all partners through a systems approach, and incorporates appropriate benchmarks to monitor progress.  Community leaders should seek heightened priority of teen alcohol issues and underlying causes, with increased visibility and attention.  Communities and schools should provide a range of positive outlets for youth involvement and engagement.  Community leaders should identify modes of access to alcohol used by youth and implement consistent standards and consequences.

105  Engage various individuals and groups as communicators or sponsors of teen alcohol abuse prevention messages.  Establish opportunities for dialog about teen drinking.  Schools should provide curriculum material or extra- curricular programming on alcohol that is honest, provocative, engaging.  Incorporate content on alcohol and related issues in a range of courses offered in school.  Host life skills development sessions for youth and parents.  Identify partnership opportunities.

106  Facilitate additional qualitative research on teen alcohol cultures by a range of individuals/groups.  Review community-based efforts, organizing strategies, monitoring approaches.  Examine curricular materials and methods.  Examine messages youth hear on drinking alcohol.  Explore the role of athletics, service activities, and other extracurricular activities in youth decisions about alcohol.

107  Research in more detail the four categories of teen alcohol behavior.  Better understand the role of and opportunities with older siblings in youth decisions.  Conduct a detailed systems analysis of one or more communities regarding alcohol culture.  Gain more detailed understanding of youth knowledge about alcohol, its effects, and decision-making factors.

108  Investigate the relationship between teen drinking and religious affiliation.  Further investigate social hosting practices.  Examine consistency regarding alcohol issues within households.  Better understand teens’ use of alcohol with prescription drugs.

109  Maintain a perspective that understanding youth alcohol decisions is very complex, based on both the Youth Alcohol Decision Frameworks.  Engage key influencers of youth, particularly those who could be mentors.  Embrace affirming and fact-based approaches.  Maintain a perspective that changing teen drinking cultures is attainable and appropriate.


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