Scott Caldwell & Connie Bettin Presentation to the recently formed Coalition Madison, WI January 5, 2009 Dane Co. Youth and Drinking: What the Data Shows and What We Should Do About It

1.Adolescence is a unique and powerful developmental period 2.Alcohol use impacts teens differently than adults 3.There are multiple pathways to effective prevention and intervention Three considerations: 2

The “Health Paradox” of Adolescence Source: Dahl (2005) On one hand… Measures of most abilities show that adolescence is the healthiest and most resilient period of the lifespan But on the other hand… Clinical problems and mortality rates increase 200 to 300 percent 3

Primary causes of clinical problems and mortality during adolescence are related to difficulties with control of behavior and emotion 4

New science Insights into teen behaviors Implications for parents, counselors, educators, policy makers Adolescent Neuroscience

General findings: Adolescence is a period of unique and profound brain maturation Remodeling of structure The brain maturation process is not complete until about age 24!! 6

amygdala Research: These areas are still developing during adolescence CEO: judgment, decision making, planning ahead Directs motivation Regulates emotion 7

Teen Brain Teen Behavior Limits to motivation: Limits to emotional regulation: Limits to judgments: preferences for low effort, high excitement activities moodiness, quick to anger increased risk taking, decreased planning ahead 8

Why should we be concerned about teen drinking? Alcohol use amplifies the vulnerabilities. 9

On-going survey of students 7 th – 12 th grade 189 items 23,542 students participated (66% HS) Voluntary and anonymous HS alcohol groups examined: Abstainers (≈ 49%) = No past year drinking vs. Current drinkers (≈ 27%) = At least one drink during the past 30 days Analysis of Dane Co. youth Brian Koenig, Principal Investigator 10

Teen drinking is associated with: Reduced sensitivity to intoxication 11

Of current high school drinkers, percentage who reported binge drinking: Source: DCYA (2005) 77%

Reduced sensitivity to intoxication Involvement with other drugs Teen drinking is associated with: 13

Current drinking is strongly associated with past year drug use Source: DCYA (2005)

Reduced sensitivity to intoxication Involvement with other drug use Risk taking Teen drinking is associated with: 15

Current drinking is strongly associated with current risk behaviors Source: DCYA (2005)

Reduced sensitivity to intoxication Involvement with other drug use Risk taking Risk for cognitive deficits Teen drinking is associated with: 17

Binge drinking and the teen brain 15 year old male non-drinker 15 year old male heavy drinker 18

Reduced sensitivity to intoxication Involvement with other drug use Risk taking Risk for cognitive deficits School difficulties Teen drinking is associated with: 19

Current drinking corresponds with decreased school connection, attendance, and grades Source: DCYA (2005)

Reduced sensitivity to intoxication Involvement with other drug use Risk taking Risk for cognitive deficits School difficulties Co-occurring problems Teen drinking is associated with: 21

Drinking among HS students is linked to co-occurring problems Any past year delinquency Source: DCYA (2005)

Reduced sensitivity to intoxication Involvement with other drug use Risk taking Risk for cognitive deficits School difficulties Co-occurring problems Risk for long-term alcohol problems Teen drinking is associated with: 23

Percentages of Past Year Alcohol Problems among Adults Aged 21 or Older, by Age of First Use Source: SAMHSA (2005) Age Started Drinking Early age drinking increases future risk by 6 times 24

The very same brain areas developing during adolescence are implicated in addiction 25

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Summary of the Data Adolescents are not “mini adults” Teens are particularly vulnerable to the harmful effects of alcohol Potential risks can be immediate as well as long-term 27

What to do? Directions for this Coalition to consider…. 28

Selected Principles of Effective Prevention Source: NIDA (2003) Start early (preschool, K-6) Target key risk and protective factors Target developmental transitions Utilize multiple strategies, across multiple levels and settings Deliver consistent, community- wide messages

Five areas to consider: 1.Involve parents and families 30

My parents think it’s wrong to drink alcohol (% strongly agree) Source: DCYA (2005) AVE = 42%

My parents know what I’m doing after school (% very often) Source: DCYA (2005) AVE = 54%

Five areas to consider: 1.Involve parents and families 2.Increase youth perception of risk for alcohol effects (demand) 3.Address alcohol accessibility (supply) 4.Address alcohol marketing to youth 5.Screening, brief intervention, and referral for treatment (SBIRT) in “opportunistic” settings 33

What does not work: Education Scare tactics Messages to “drink responsibly” Confrontational interventions 34

Questions and Discussion