Tuesday, September 16, 2014

Marijuana paraphernalia and foods confiscated in public schools last year

For the first time ever, last school year Seattle Public Schools filled the safe in which they keep drug-related items confiscated from students.  And they filled one new cabinet.

As of mid-May 2014, Seattle Public Schools data show that 758 drug/alcohol violations were reported.  Violations increased between mid-May and the end of the school year, especially around prom and graduation.  (Data for the entire 2013-14 school year is not yet available.)  Among the violations, 107 were alcohol offenses and 651 were drug offenses -- 98% of which involved marijuana, mostly alone but some in combination with other drugs.  Violations took place at all three levels: 3 were in elementary school, 204 were in middle school, and 551 were in high school.

Another first: last school year was the first time that vaporizing devices for nicotine and/or THC were confiscated.  Edible marijuana products that were bought, not baked at home, also were confiscated.  Marijuana-infused items included lollipops and candy bars likely produced for the medical marijuana market.  Some students who ate marijuana-infused foods overdosed on them while at school.  

Below are some of the "vape pens" and edibles confiscated.

Friday, September 12, 2014

General coalition meeting next week

Prevention WINS will meet:

Tuesday, September 16, 2014
8:00 a.m.
Eckstein Middle School

Agenda items include:

  • Drafted community adolescent substance use prevention plan
  • 2014-15 action plan
  • Show & Tell: Marijuana products & paraphernalia confiscated by schools last year

Everyone concerned about youth drug use in NE Seattle is welcome to attend.  For more information please email us!

Tuesday, September 9, 2014

New federal rules can make prescription drug disposal more convenient

Until this week, the federal Controlled Substances Act restricted who can dispose of unwanted prescription drugs/controlled substances.  People who wanted to rid themselves of unwanted pharmaceutical controlled substances could give them to law enforcement.  Most people flushed their unused drugs down the toilet, threw them in the trash, or kept them in the household medicine cabinet.  Pharmacies, doctors’ offices, and hospitals were banned from accepting them. 

These limitations made it difficult for people to get rid of their prescription medications in a way that is both safe for people and the environment often resulting in the accumulation of the substances in home medicine cabinets.  Since home medicine cabinets are easily accessible to teenagers, these drugs can be easily obtained for abuse, diversion (sharing, selling), and accidental poisoning. 

To make it easier for people to safely rid their homes of unwanted prescription drugs, the Secure and Responsible Drug Disposal Act was enacted in 2010.  Between then and now, the Drug Enforcement Agency has been developing rules to guide the Act’s implementation.  Their rules were released this week and include the following:

1. People may get rid of unwanted prescription drugs through:
  • Take-back events;
  • Mail-back programs;
  • Collection receptacles. 

2. In addition to law enforcement agencies, the following organizations can collect prescription drugs:
  • Drug manufacturers and distributors;
  • Narcotic treatment programs;
  • Hospitals/clinics with on-site pharmacies;
  • Retail pharmacies.

The rules define how these organizations can collect and dispose of the drugs they collect.  The rules do not mandate any of these options so organizations and communities will need to take the lead in establishing programs voluntarily.  

This is good news for King County’s secure medicine return program which calls for retail pharmacies to have collection receptacles placed in their businesses, allowing for people to dispose of their medications where they likely obtained them.  This is also good news for communities that want to establish take-back programs locally in partnership with organizations other than law enforcement.  

More information about the new rules, including a fact sheet for the general public, is available through the DEA website.

Wednesday, September 3, 2014

Parenting risk factors decrease as community risk factors increase

Last week, a reporter from the LA Times interviewed three members of the Adolescent Substance Abuse Program (ASAP) here at Seattle Children’s Hospital, including me.   The main article focuses on marijuana legalization and how parents in Washington are talking to their kids about it.  Two other articles focus on what parents and teenagers should know. 

The main article points out that there has been an increase in youth marijuana use among NE Seattle teenagers.  Though the article mostly focuses on parenting, the risk factors associated with parenting and youth drug use have gotten better in NE Seattle since 2006.  Most of the Prevention WINS coalition’s work focuses on increasing parenting skills proven to prevent teen drug use.

Source: WA Healthy Youth Survey
Despite parenting risk factors decreasing in NE Seattle, marijuana use rates have steadily increased.  Why?  The Healthy Youth Survey tells us that community-related risk factors have increased during the same time period. 

Source: WA Healthy Youth Survey
While parent education remains a priority for Prevention WINS, and evidence-based prevention programs will continue to be offered to middle school students, the need to address community risk factors is evident.  When the larger community discusses youth marijuana use prevention, they often focus on parenting.  However, as our local data seem to indicate, prevention needs to include the wider community. 

Access to marijuana needs to be addressed.  Community norms need to be addressed.  Enforcement of underage laws needs to be addressed.  The Prevention WINS coalition cannot address the multiple risk factors associated with youth drug use alone.  Individuals and organizations throughout Seattle need to step up and address the factors they influence.  

Tuesday, September 2, 2014

Parents connecting with parents important for preventing teen drug use

Most people know that teaching parents how to guide their children so that they make healthy decisions is part of a multi-pronged strategy for preventing adolescent drug use.  But what does that mean?  What can parents actually do?

One thing that parents can do is connect with other parents.  Making connections with the parents of your child's friends opens up opportunities to discuss views on teen drug use.  Many parents are surprised to find out that the vast majority of parents think that teen drug use is unacceptable, even in high school.  In fact, when Prevention WINS conducts surveys among NE Seattle parents, more than 90% agree that teenagers should not use drugs, including alcohol.

Connecting with other parents also makes it easier to monitor your child.  It makes it easier to call another parent to make sure your child is at a friend's house and that there are no drugs, including alcohol, available.

In the video below, Dr. Leslie R. Walker from Seattle Children's Hospital talks about why connecting with other parents is important.


The beginning of a school year provides many opportunities for parents to connect with one another.  Curriculum nights, PTSA-sponsored socials, and sporting events are just a few opportunities during which parents can easily connect with others.  

Friday, August 29, 2014

Safely dispose of unwanted medications September 27

Clean out your medicine cabinet and safely dispose of medications:

September 27, 2014
10:00 a.m. to 2:00 p.m. 

To publicize the event, posters and flyers are available online.  Please consider spreading the word at your workplace and in your community.  One way to prevent teenagers from getting medications for abuse is to get rid of unused medications in the home.  

Until King County is able to launch their secure medicine return policy, these semi-annual collection days are one of only a few ways to get rid of unused and unwanted medications with the least amount of harm to our local environment.  Some Group Health and Bartell pharmacies take back unused medications.  

King County's program is on hold as a result of an agreement in a lawsuit challenging the regulations.  The lawsuit, filed by Pharmaceutical Research and Manufacturers of America and others, is similar to a lawsuit already underway against Alameda County in California.  The Alameda County lawsuit is currently under review by the federal 9th Circuit Court of Appeals and their decision is likely to affect the King County lawsuit.  King County agreed, therefore, to delay implementation until after the court's decision.  

Tuesday, August 26, 2014

Why preventing prescription drug abuse is important

Over the past week, a few posts focused on what coalitions can do to prevent teen medicine abuse.  Since I realize I may have put the cart before the horse, today's post will explain why preventing teen prescription painkiller abuse is important.  

Prescription medicine abuse is the intentional use of a medication without a prescription; in a way other than as prescribed; or for the experience or feeling it causes.  According to the National Institutes on Drug Abuse, the medications most commonly abused are pain relievers/opioids.  

Prescription opioids act on the brain like heroin does and can be highly addictive.  As a 2013 report on the problem in WA states, "For some, abuse of prescription-type opiates . . . leads to heroin use so preventing inappropriate use of prescription opiates is important." 

Abuse of opioids, alone or with other drugs including alcohol, can depress breathing and lead to death. In King County, the Poison Center reports that oxycodone and hydrocodone (both opiods) are the most common drugs mentioned in prescription drug-related overdose reports.  Prescription opiates and heroin are the top two causes of drug-related deaths in King County.  Since 2009, as prescription opiate-related deaths decreased heroin-related deaths increased.  

Source: Alcohol and Drug Abuse Institute's 2013 report on King County drug trends.  

Monday, August 25, 2014

Different communities will have different prevention activities to address teen medicine abuse

Last week, two posts told the stories of community coalitions that conducted successful campaigns to prevent teen medicine abuse.  Well, I have one more.

I share this last one as an example of how prevention campaigns are different depending on the local community.  The coalition profiled in the video below implemented prevention activities that are different from the coalitions profiled in the other videos.  The stories highlight that every community is going to have different responses to teen medicine abuse, and other teen drug abuse problems, depending on what their local data tell them, who is involved in the coalition, and the capacity of coalition members to do something.

Friday, August 22, 2014

Using social media for outreach and education

The information about blogging that Dr. Yolanda Evans from Seattle Children's Hospital shares in the following video can help people concerned about youth substance use understand how they can use social media for outreach and education.

Dr. Evans blogs at Teenology 101.

Thursday, August 21, 2014

Everyone has a role to play in preventing teen medicine abuse

On Wednesday, I blogged about the importance of a community response to teen medicine abuse.  Below is another example of how community members can incorporate prevention activities into their work as part of a multi-pronged coalition strategy.  The video highlights how prevention activities can be sustained when community partners take ownership of them.

Wednesday, August 20, 2014

Preventing teen medicine abuse at the local level

The abuse of prescription drugs among NE Seattle teenagers increased steadily over the past few years.

Source: Washington State Healthy Youth Survey
During the 2012-13 school year, Prevention WINS members advocated for the King County Board of Health to adopt a countywide medicine return program.  It was adopted in June 2013 but is not yet up and running because pharmaceutical companies are suing to stop it.  The program will be one way to reduce the amount of unused prescription medicines in homes and therefore reduce youth access to them.

Prevention WINS members also promote the twice-yearly national Prescription Drug Take-Back Day.  The next one is Saturday, September 27 from 10:00 a.m. to 2:00 p.m..  All Seattle Police Department precincts will accept unused medications.  Materials for promoting the day are available on the King County Take Back Your Meds website.

Since substance abuse prevention activities are most effective when multiple community sectors address specific local problems, coalitions can be especially important for reducing teen medicine abuse.  The following video tells the story of one community coalition that is using a variety of approaches, guided by local data, to prevent medicine abuse.

Prevention WINS will plan for additional prevention activities during the September 16 general meeting. Please contact coalition staff for more information.  

Friday, August 15, 2014

"Just say no" is old news

Recently, Colorado launched a media campaign with the goal of preventing teen marijuana use.  Called "Don't be a lab rat", the campaign seems to take a similar tact as the anti-tobacco "truth" campaign.  Response to the campaign seems to be mixed with some people comparing it to the ineffective "This is your brain on drugs" campaign from the 1980's.

Prevention science has evolved quite a bit over the past thirty years and we know that scare tactics about health impacts don't work for preventing teen drug use.  We also know what does work and most are programs and policies implemented at the community level.     

Programs that work
Programs are usually activities, including school-based curricula, in which children and/or their parents participate that provide education and support for preventing teen drug use. The National Registry of Evidence Based Programs and Practices is an online database that provides an extensive list of programs that are proven to be effective.

In NE Seattle, Eckstein Middle School provides three programs proven to prevent teen drug use: 
Seattle Public Schools recently was awarded a grant to implement Project Alert in middle schools. 

If you take a look at them you will notice that the programs mostly teach social-emotional skills and parenting skills.  They provide basic information about drugs but as a science teacher I worked with once noted, the curricula don't necessarily fit into a science class.  They are filled with information about how to deal with social and emotional situations that may increase a teenager's likelihood for trying drugs.  They are filled with information to help parents support healthy decision-making among their children.  That's what works.

Community-based activities that work
Communities have a role to play in preventing teen drug use, too.  Policies that reduce availability, increase prices, and support the enforcement of laws are proven to reduce youth alcohol and tobacco use.  Community laws and norms that support healthy adolescent development amplify the messages that teens receive from programs and from their parents.

Examples of community-based prevention activities conducted by Prevention WINS include:
  • A media awareness and advocacy campaign focusing on underage drinking parties in parks.  A video appearing on the coalition homepage is part of the awareness campaign.
  • An advocacy campaign for the adoption of a secure medicine return program by the King County Board of Health.  
  • Letters to the Liquor Control Board about alcohol and marijuana regulations.  Most recently, Prevention WINS provided prevention-related advice regarding marijuana regulations.  In the past, the coalition advocated for restrictions on alcohol advertising and the removal of a liquor license from a NE Seattle convenience store selling beer to minors.  
Of course, I would be remiss if I didn't write: community-based coalitions work.  Prevention WINS is such a coalition.  When individuals and organizations come together to identify risk factors specific to their community and implement programs and policies that address those risk factors, teen drug use rates drop.  In 2011, Prevention WINS celebrated a drop in NE Seattle underage drinking rates.


Despite what is prolifically reported through media, prevention efforts have not used scare tactics to prevent youth drug use for many years.  Instead, parents have been encouraged to talk with their children about avoiding drugs and making healthy decisions.  Middle school students have learned how to deal with social situations and emotions that may put them at risk for trying drugs.  Communities have been encouraged to adopt policies that prevent teen access to drugs and support healthy youth development.

Tuesday, August 5, 2014

The first marijuana-infused foods to hit stores will be . . .

Today, the Liquor Control Board released the first list of marijuana-infused products that they approved for sale in recreational marijuana shops in our state.  The list includes the following marijuana-infused products:

Rainier Cherry Soda
Pomegranate Soda
Lemon Ginger Soda
Cannabis Infused Single Shots - Tart Cherry
Cannabis Infused Lemongrass Nuggets
Cannabis Infused Chili Cinnamon Fire Nuggets
420 Party Mix
Assorted Cookies
Cookies & Cream Bar
Crazy Carnival Nuts
Dark Chocolate Bar
Twisted Trail Mix

Prevention Summit registration now open

Registration for the annual Washington State Prevention Summit is now open!

30th Annual 
WA State Prevention Summit
October 20 - 21, 2014 
Yakima Convention Center

Convening since the 1980’s, initial conferences were held at Central Washington University in Ellensburg. The conferences were known as “family focus” meetings and soon became known as the annual “Building a Vision” conference.  In 1999, the conference began to be called the Washington State Prevention Summit.  It is the one time during the year when people working to prevent substance abuse, violence, and other destructive behaviors come together, reflect on the past year’s successes, learn new strategies, and network.  People who participate in the Summit include parents, children, teachers, law enforcement officials, prevention professionals, treatment providers, policy makers, college faculty, students, and dedicated volunteers who are all interested in preventing alcohol, tobacco and other drug abuse in Washington.

Wednesday, July 30, 2014

How public marijuana use impacts children

Community norms are among the strongest predictors of youth marijuana use according to research conducted by the University of Washington’s Social Development Research Group.  Community norms are communicated to children through social practices, policies, and adult expectations.  An example of a social practice that is not uncommon in Seattle is the public use of marijuana. 

An opinion piece in today’s Seattle Times discusses concerns from parents about this norm.  The piece starts with a description of what recently happened to a parent at one of our city’s parks:

She took three kids — two 8-year-olds and a 7-year-old — for a quick mid-afternoon trip to Golden Gardens on Sunday. Pails, shovels and ice cream in hand, they set up camp… and were enveloped in a cloud of marijuana smoke from three adults sitting upwind just a few feet away.

He then goes on to share a personal experience:

Last winter, my son’s middle-school ultimate frisbee match at Cal Anderson Park came to a sudden halt when the kids turned their noses to the marijuana smoke wafting from the nearby skateboard park. I yelled at the tokers to put it out, and was ignored. I support Initiative 502 for the same reasons as Natalie, but left the park wondering what we’d actually done.

People who don’t see a problem with public marijuana use are going to say that parents need to tell their kids that marijuana use is for adults only.   They are right.  But as prevention science tells us, it takes a village to raise a child.  Parents alone cannot prevent adolescent marijuana use – they need the support of other adults who model healthy and responsible behaviors.  They need the support of policies that prevent the public use of marijuana.  They need community norms to support healthy youth development.   

Tuesday, July 29, 2014

Community costs of underage drinking

Underage drinking parties in our parks is a problem the Prevention WINS coalition has been raising awareness about since 2006.  Today, Q13-FOX reported on an underage drinking party at Gas Works Park during which teenagers plastered it with graffiti.

Photo from Q13FOX, July 29, 2014
Cleaning up graffiti and trash left behind by underage drinkers costs Seattle Parks and Recreation money they would probably prefer to use for other purposes.  Other costs include personal ones associated with driving drunk as well as first responder and medical costs associated with injuries from drunk driving crashes.  View a video produced by Prevention WINS on this very subject at www.PreventionWorksInSeattle.org

Update (11:55 a.m.):  A reporter from KIRO said that it was a "huge party" of more than 100 minors that did not appear to be homeless.  

Friday, July 25, 2014

Seattle City Council hopes state will license medical marijuana businesses

When the Seattle City Council last year adopted a marijuana business zoning ordinance, it included a stipulation that all medical marijuana businesses be licensed by the state by January 2015.  The stipulation was included because the Council thought that the state legislature would establish a medical marijuana licensing system during their 2014 session.  The legislature did not.

Since there is no way that Seattle's 200+ medical marijuana businesses can be in compliance with the City's zoning ordinance, the Council is now considering extending the deadline believing, again, that the state legislature will adopt a medical marijuana licensing system during their next session.  While originally considering extending the deadline to July 1, 2015, during Wednesday's public hearing about the extension Councilmember Nick Licata indicated that they will move the deadline to January 1, 2016.  He recognized that the state would need time to establish rules if the legislature passes a licensing bill.  

Before the public hearing started, Councilmember Tim Burgess asked about the legality of the 67 medical marijuana businesses that opened after the ordinance was adopted.  Licata confirmed that these businesses are illegal.  The Department of Planning and Development enforces the ordinance based on complaints they receive.  To date, about 12 complaints were received, mostly about marijuana growing.

The Finance and Culture Committee will review the proposed changes to the ordinance during their meeting on August 13.  

Wednesday, July 23, 2014

Local conference to focus on social media and health

Using social media to improve adolescent health is the topic of a conference being held in Seattle next week. One way that social media can improve health is by providing easy access to information about health-related topics, such as teen drug use.  In the video below, Dr. Megan Moreno talks about how parents can guide their children in accessing online health information.

Similar videos are available on the SMAHRT YouTube page, providing a good example of how social media can be used to share health-related information.  Prevention WINS shares information through YouTube, Facebook, this blog, and Twitter.

The conference takes place July 31 through August 2 and information is available on the SMAHRT website.  Registration costs $10 per day - a bargain!

Tuesday, July 22, 2014

Tweeting for teen drug use prevention

Prevention WINS is on Twitter!  Here is the latest tweet:

Wednesday, July 16, 2014

City Councilmembers talk about marijuana

Right off the bat, City Councilmembers Burgess, Godden, and Licata answer questions about marijuana during this week's City Inside/Out: Council Edition.

Jean Godden says she wants the city to get some marijuana tax revenue to pay for enforcement costs and costs associated with potential downsides of marijuana use.

Nick Licata discusses the two marijuana systems -- medical and recreational.

Tim Burgess thinks that the city is looking for trouble with two marijuana distribution systems in place.  He advocates for one system.

Monday, July 14, 2014

City Council to host public hearing about medical marijuana licensing July 23

Last year, the Seattle City Council adopted a zoning ordinance regarding where marijuana businesses can be located within the city.  The ordinance includes a stipulation that all medical marijuana businesses be licensed by the state by January 2015.  At the time the ordinance was adopted, the state only planned to license recreational (I-502) marijuana businesses.

The City Council is now considering a change to the ordinance to extend until July 1, 2015 the deadline for lots, business establishments, and dwelling units where the production, processing, selling, or delivery of marijuana was being conducted prior to November 16, 2013.

The intent of the January 2015 deadline was to provide time for implementation of medical marijuana legislation, including the licensing of businesses selling medical marijuana, that was to be created by the Washington legislature in 2014.  However, the state did not adopt new medical marijuana regulations in 2014.  The newly proposed city legislation includes a six-month extension of the original deadline to July 1, 2015.  The hope is that the legislature will adopt legislation during their 2015 session that will license businesses that sell medical marijuana.

The Council’s Finance and Culture Committee  will hold a public hearing on the proposed legislation:
July 23, 2014
2:00 p.m.
Seattle City Hall
600 Fourth Avenue

A few facts about the marijuana market:
  • Seattle is currently home to more than 200 medical marijuana retail businesses and an unknown amount of businesses that produce or process medical marijuana.  
  • The Liquor Control Board allocated 21 recreational (I-502) retail marijuana business licenses for Seattle, similar to the number of liquor outlets in the city prior to privatization (I-1183).  
  • About 10% of people over the age of 12 in King County used marijuana within the last month, according to research conducted for the Liquor Control Board last year.  
  • About one quarter of the state's marijuana consumers are people under the age of 21 according to research conducted for the Liquor Control Board last year.
  • Medical marijuana may be sold to people under the age of 21, recreational marijuana cannot.
  • This past spring, a Washington State Court of Appeals ruled that medical marijuana businesses are illegal under state law.  

Adolescent medicine doctor provides tips for parents about preventing underage marijuana use

From the Teenology 101 blog:

This week the first recreational marijuana stores opened in Washington State. Initiative 502 was passed in 2012 to legalize marijuana in the state without a physician’s recommendation, but it was just yesterday that recreational stores could legally sell it. One store opened in Seattle, the others were in Bellingham, Prosser, and Spokane. It remains illegal for anyone under age 21 to use or possess marijuana, but legalizing recreational use does send a message to those who aren’t yet adults: it’s legal now, so it must be ok, right? We’ve had posts on marijuana legalization and teen marijuana use in the past, but here we wanted to highlight the importance of parents in preventing underage use.What can parents do?

Click here to

Wednesday, July 9, 2014

King County drug abuse trends 2013

The annual King County Drug Trends report was released last month by the King County Drug Trends Workgroup.  Among their major findings is that heroin use continues to increase in King County and statewide; young adults are a major population of concern.  Heroin involved deaths among those under 30 has increased from 7 deaths (14%) in 2009 to 34 deaths (34%) in 2013, the numbers for all ages increased from 49 to 99 respectively.

The report includes information about drug treatment admissions and for adolescents (under 18 years old) marijuana remains the primary reason for entering treatment.  For young adults (under 30 years old) heroin is the primary reason for entering treatment and alcohol is the primary reason for all other adults. 

A complete copy of the report is available at http://adai.uw.edu/pubs/cewg/CEWG_Seattle_June2014.pdf.

Teenagers and marijuana-infused foods, beverages

In this news story, Lisa Sharp from Seattle Public Schools and Yolanda Evans from Seattle Children's Hospital discuss the consumption of marijuana-infused foods among adolescents.  The story highlights the need to educate parents about marijuana-infused products and marijuana concentrates.

Wednesday, July 2, 2014

How do teenagers get marijuana and alcohol?

Marijuana retail stores are expected to start opening in our state next week.  As an adolescent drug use prevention coalition, Prevention WINS is interested in how youth access drugs, including marijuana.  What we know is that minors who use alcohol and marijuana mostly get the drugs from their friends.

Results from the 2012 Seattle Public Schools Youth Risk Behavior Survey (YRBS) indicate that most high school students who use marijuana get it from friends.  This is true for alcohol, as well.  Most Seattle high school students who use alcohol report getting it from a friend or at a party, according to the Washington State Healthy Youth Survey.

When marijuana stores open, it is expected that teenagers will get marijuana like they currently get alcohol: socially, including through family.  Increased access among adults who are willing to sell or give marijuana to teenagers leads to increased distribution to teenagers.  Increased parental use means more marijuana in the home for teenagers to take with or without permission.    

The YRBS results support this.  When high school marijuana users were asked if they ever used marijuana that came from of dispensary, 39% said yes and 23% were not sure, despite only 6% buying it from a dispensary.  Among those who said yes, it is likely that an adult or friend with a medical marijuana authorization provided the drug to them after purchasing it at a dispensary.  

Will marijuana stores sell to minors?  Likely not, at least as this new market gets up and running.  If the legal recreational market is to be successful, businesses need to show that they are responsible.  But adults who have easy access to marijuana, and teenagers who have medical marijuana authorizations, need to be held responsible, too, if distribution to minors is to be prevented.  

Policies that reduce drug availability are part of a comprehensive approach to drug prevention

Drug overdose deaths, particularly those caused by prescription painkillers, declined in Florida after state policy changes were made, according to the Centers for Disease Control and Prevention (CDC).

Their success provides a perfect example of how drug prevention is not only about school-based programs and parenting, it’s also about adopting policies that reduce the availability of drugs and enforcing those policies. 

From a New York Times article about the decline in deaths:

"Dr. Thomas Frieden, director of the C.D.C., said the pattern provided a hopeful example of the effect that policy could have on one of this country’s most entrenched public health problems, one that takes the lives of more than 20,000 Americans a year."

“This tells us that policies and enforcement work,” Dr. Frieden said."

From the CDC's report on the decline in drug-related deaths:

“. . . policy changes in Florida were followed by declines in the prescribing of drugs, especially those favored by Florida prescribing dispensers and pain clinics, as well as by declines in overdose deaths involving those drugs. Florida has reported that approximately 250 pain clinics were closed by 2013, and the number of high-volume oxycodone dispensing prescribers declined from 98 in 2010 to 13 in 2012 and zero in 2013. Law enforcement agencies in Florida also reported that rates of drug diversion (i.e., channeling of prescription drugs to illicit markets) declined during 2010–2012.

Like the most effective substance use prevention strategies, Florida took a multi-pronged approach to preventing drug-related deaths.  The approach relied heavily on policies that reduce access to prescription painkillers and the enforcement of those policies.  

Communities need to support parents with a "no drug use" message for teens

Yesterday, KING 5 broadcast a story about how parents can talk to their children about not using marijuana.


Parents need the support of other adults in the community so that teenagers get consistent messages that support healthy youth development.  In the KING 5 story, Dr. Leslie Walker says, "Just like parents should be doing with alcohol.  This is not a safe for you at this stage in your life.  It can possibly cause permanent damage to you as an adolescent with a developing brain.  I do not want you to use marijuana at this time."  People and institutions in our community need to express this message, too.

Prevention research evolved a great deal since the "just say no" days and we now know that we must provide teenagers with the tools they need to be able to follow through on family rules against drug use.  Adults can coach children:

  • Role play situations where they are offered drugs, including marijuana, by a peer.
  • Help them to find the right words to express their intention not to use.
  • Help them suggest an alternative to drug use.  (This is why it is important for communities to have alternative activities readily available.)
  • Tell them that is fine to walk away from someone, including a friend, who is offering drugs and, if needed, to call for a ride home.  

More about preventing underage marijuana use is available here.

Tuesday, July 1, 2014

Teen marijuana use prevention: It takes a community

Legislature should find the will to fund teenage marijuana use prevention” reads a recent Seattle Times editorial headline. 

The editorial states: “Just Say No” messages won’t work in this era."

Adolescent substance abuse prevention has evolved a great deal over the past twenty years thanks to prevention research and has not been about “Just Say No” for quite a while.   What does research tell use about how to effectively prevent adolescent substance use, including marijuana use?

For parents:

Prevention needs to start early.  Parents should start talking to their children about not using drugs by the end of elementary school and at the latest by the end of middle school.  A locally-developed parent guide can provide parents with information on what to say.  Among the research-backed strategies: 
  • A “no use” attitude is important.  Children whose parents have a positive attitude toward marijuana use are five times more likely to use marijuana by 8th grade. 
  •  Be clear about family rules against using drugs, including marijuana, and set clear guidelines.
  • Make sure those guidelines are followed and follow through on reasonable consequences if rules are broken.  
  • Monitor your own behavior – parents are role models for their children. 

For lawmakers:

As the editorial states: “With other budget pressures, Olympia will be tempted to tap into future marijuana tax revenues that I-502 specifically dedicated to prevention.”  In recent years, the legislature cut and then eliminated funding for the statewide Community Mobilization program, an evidence-based prevention program.  Most prevention funding now comes from the federal government and they, too, are always looking to cut expenditures. 

In addition to funding, lawmakers can be a part of a comprehensive prevention strategy.  Examples of policies that prevent teen drug use include: 
  • Enforcing marijuana laws, both medical and recreational.  Seattle drug use prevention coalitions have heard from kids that they can get marijuana easily through retail dispensaries.  Among Seattle high school students who use marijuana, 39% report using marijuana that came from a dispensary, likely through friends who bought it legally (with a recommendation) or illegally (without a recommendation.) 
  • Enacting and enforcing social host laws for both marijuana and alcohol to prevent parents from providing teenagers with the drugs. 

For communities:

Adolescent substance use prevention is most effective when multiple sectors of the community implement a variety of strategies.  To guide the selection of prevention strategies, communities can look at their local Healthy Youth Survey (HYS) data which not only provides data on use rates but information about risk factors that are specific to their community. 

For instance, the Prevention WINS coalition recently started planning to address the risk factor of “decreasing perception of risk” associated with marijuana use.  Since 2006 the coalition has tracked risk and protective factors specific to NE Seattle and every two years HYS data indicated that perceptions of risk decreased.  Data-driven decisions worked in NE Seattle in the past and continue to guide future prevention activities. 

The video below, featuring Dr. J. David Hawkins from the University of Washington, provides more information about what communities can do when working together and guided by local data.  

The Communities That Care system is very similar to the Strategic Prevention Framework used by most WA communities that have a drug use prevention coalitions.  

Wednesday, June 25, 2014

Liquor Control Board to limit marijuana-infused products appealing to children

Today, the Washington State Liquor Control Board adopted emergency rules adding a requirement that all marijuana-infused products, packaging, and labeling be approved by them.  The rules are to clarify the types of marijuana-infused products the board will allow to be produced and sold.  The board's issue paper on the emergency rules states:

"Many marijuana-infused products on the medical marijuana market today are appealing to children.  Products such as lollipops, gummy bears, and cotton candy are very appealing to children too young to read a label."

To gain approval from the board, marijuana processors must submit a picture of the product, its label, and packaging to them.  The board will not approve products that appeal to children.

Marijuana-infused products that look like foods and beverages that children commonly eat and drink have been a concern for Prevention WINS members even prior to the I-502 vote.  Concerns were expressed to the Liquor Control Board during their rule-making process and as they developed recommendations for reconciling the recreational and medical marijuana systems.  During rule-making, Prevention WINS included the following in our letter to the board:

Recently, a report published in the Journal of the American Medical Association – Pediatrics discussed the increase in unintentional ingestion of marijuana among children in Colorado.

As the Board knows from experience, many flavored malt beverages are fruit flavored and particularly attractive to minors. In one survey about underage drinking, when asked what one type of alcohol drink they would most prefer, 30% of teens said “alcopops” (the term used to describe these flavored alcoholic beverages – a combination of “alcohol” and “pop”).

In the past, the Board has banned the sale of certain alcohol products because of the high likelihood that the products are attractive to minors. A similar ban should be placed on marijuana-infused products that are attractive to minors and resemble products primarily consumed by children. Examples of such products, many of which currently may be sold in medical marijuana access points, include but are not limited to:
  • Snow-cones,
  • Hard candy, lollipops, and cookies shaped like animals, people, cartoon and other characters, Christmas trees, snowmen, stars, etc.,
  • Soda-pop,
  • Juice,
  • Candy bars,
  • Pop-Tarts,
  • “Gummy” candies shaped like worms, bears, etc.

Some flavored tobacco and alcohol products are also banned because of their potential to attract young people. The Board should ban marijuana products containing flavorings such as fruit, candy, and vanilla.

The emergency rules also include guidelines regarding serving sizes.  The new rules read:

"Marijuana-infused products in solid form that contain more than one serving must be scored to indicate individual serving sizes, and labeled so that the serving size is prominently displayed on the packaging."

"Marijuana-infused products must be homogenized to ensure uniform disbursement of cannabinoids throughout the product."  

Tuesday, June 24, 2014

Prevent teen drug use, prevent teen DUIs

Earlier this year, the Washington State Toxicologist reported that the primary drug, including alcohol, detected in DUI cases among people under the age of 21 is marijuana.  A recent study confirms that marijuana-related driving crashes are a significant problem among younger drivers. From the Robert Wood Johnson Foundation: 

The profile of a drugged driver has changed substantially since 1993, according to a new study released today in the journal Public Health Reports, which shows that more drivers are now testing positive for prescription drugs, marijuana and multiple drugs.

. . . The study examines trends in the characteristics of U.S. drivers who were involved in fatal crashes between 1993 and 2010 and tested positive for drugs.

. . . Almost 60 percent of cannabis-only users were younger than 30 years.  (About 36% of meth users and 25% of prescription drug and cocaine users were younger than 30.) 

We see that cocaine and methamphetamine are becoming less and less prevalent. Drugged drivers now would be much more likely to be using marijuana and prescription drugs, and they would probably be more likely to be mixing those drugs with alcohol. We see that overall fatalities are going down, perhaps because people are more likely to be in seat belts, but the mixing of alcohol with drugs is not trending down. It’s becoming more of a problem. 

The author notes that “these trends are likely to continue into the future given . . . increasing initiatives to legalize marijuana.”   

One way to prevent DUIs among people under the age of 21 is to prevent drug use, including marijuana and alcohol, among adolescents. Young drivers who do not use drugs don't drive under the influence.