Lessons from tobacco prevention (part 2): dedicated funds diverted to general fund

As our state starts implementing I-1183 (privatization of liquor sales and further deregulation of liquor and wine) and considers changing laws regarding illegal drugs, with proponents stating that tax revenue generated from these changes will fund prevention and other social services, it is interesting to consider lessons learned from similar promises made regarding tobacco prevention. 

From the Campaign for Tobacco-Free Kids:

Historically, Washington funded tobacco prevention largely through the Tobacco Prevention and Control Account, which included a portion of the revenue raised by a 2001 voter-approved 60-cent per pack cigarette tax increase. The ballot initiative dedicated the new revenue to the state’s Basic Health Plan, to tobacco prevention and cessation, and other existing programs that were already funded with tobacco tax revenue. The initiative required the state to spend at least $26.24 million a year on tobacco prevention and cessation beginning July 1, 2002. In the 2009 legislative session, the Washington State Legislature changed this law and diverted tobacco tax money to the general fund. After June 30, 2011, the Tobacco Prevention and Control Account had no remaining funds to sustain the program.

In FY2012, the state’s tobacco prevention program was essentially eliminated as the state will spend only $750,000 on tobacco prevention efforts.

As a result of the dramatic funding cut, Washington will no longer fund anti-tobacco media campaigns or local tobacco prevention and cessation programs in schools or through local governments or community organizations.

Washington is spending almost nothing on tobacco prevention despite the fact that the state is receiving more tobacco-generated revenue than ever before as a result of a $1.00 per pack cigarette tax increase, to $3.025 per pack, and increases in the tax rates on other tobacco products effective May 2010.

Lessons from tobacco prevention: well-funded programs work

According to a story I heard on the radio yesterday: States will rake in over $25 billion this year from tobacco taxes and tobacco settlement money.  However, less and less of that money will go toward prevention activities. 

One lesson we have learned from tobacco settlement dollars and tax revenue that have gone to fund tobacco prevention programs is that, when well-funded and comprehensive, prevention works.

Washington's success
Our state has had much success in preventing tobacco use among youth when our prevention programs were well funded.  In a report from the Campaign for Tobacco-Free Kids:

The Washington State Tobacco Prevention and Control program was implemented in 1999 after the state Legislature set aside money from the Master Settlement Agreement to create a Tobacco Prevention and Control Account.  Tobacco prevention and control received additional funds in 2011 when the state's voters passed a cigarette tax that dedicated a portion of the new revenue to tobacco prevention and cessation.

• Since the tobacco control program was implemented, Washington has reduced the adult smoking rate by one-third, from 22.4 percent in 1999 to 15.2 percent in 2010.  Washington's tobacco prevention efforts have also reduce youth smoking rates in half, saving additional lives and dollars. 

An earlier study in the CDC's peer-reviewed journal, Preventing Chronic Disease, found that although Washington made progress in implementing tobacco control policies between 1990 and 2000, smoking prevalence did not decline significantly until after substantial investment was made in the state's comprehensive tobacco control program. 

The following chart, from the Washington State Department of Health's most recent tobacco prevention progress report, shows the decline in youth smoking rates since 1999.  The chart indicates that while our state has seen a significant reduction in use rates, progress has stalled since funding for prevention has been reduced.

What does an effective prevention program include?
The U.S. Centers for Disease Control and Prevention has established Best Practices that recommend key elements of tobacco prevention and cessation programs.

Key elements include:

• Hard-hitting education and media campaigns;
• Community and school-based programs;
• Effective enforcement of laws prohibiting tobacco sales to minors;
• Affordable, accessible assistance for smokers trying to quit;
• Rigorous evaluation to ensure these programs are delivering results.

While these reports focus on tobacco prevention, the lessons learned may be applied to all youth substance abuse prevention programs.

How parents can prevent teen drug use

Here is a roundup of parenting-related information that has been sitting in my Inbox . . .

Arguing with mom preps teens for peer pressure (TODAY!Moms)

New report shows that adolescents are far more likely to drive under the influence of alcohol or drugs if they live with a parent that drives under the influence (Substance Abuse and Mental Health Services Administration)

Adult-supervised Alcohol Use and Harmful Consequences among American and Australian Teens (Underage Drinking Enforcement Training Center)

From the CDC:

• Positive Parenting Tips -- Young Teens (12 to 14 years)
• Positive Parenting Tips -- Teenagers (15-17 years)
• "Parents Are the Key" -- CDC offers parents tools and proven steps for reducing teen driving injuries and deaths.

Marijuana in the news . . .

Room for Debate: Should Teenagers Get High Instead of Drunk? (New York Times)

Marijuana measure headed for ballot? (Seattle PI)

Another marijuana dispensary on Lake City (Maple Leaf Life)

Gregoire to DEA: Make marijuana a legal drug (Seattle Times)

Lawsuit filed over Seattle's medical-marijuana ordinance (Seattle Times)
 
Where Selling Pot is No Longer a Backroom Deal (New York Times)
 
Anti-Drug Leaders Respond to Study on Medical Marijuana and Traffic Deaths (Join Together)
 
Legalization of Marijuana and the Impact on Children (Join Together)

Underage drinking rates decline, teen marijuana use rates increase

Last week, results from the nationwide Monitoring the Future (MTF) survey were released and the findings include:

~ Marijuana use among teens rose in 2011 for the fourth straight year -- a sharp contrast to the considerable decline that had occurred in the preceding decade.  Daily marijuana use is now at a 30-year peak level among high school seniors.

~ Underage drinking -- and, importantly, occasions of heavy drinking -- continued a long-term gradual decline among teens, reaching historically low levels in 2011. 

Why is teen marijuana use increasing?
The MTF report states: One possible explanation for the resurgence of marijuana use is that in recent years fewer teens report seeing much danger associated with its use, even with regular use.  "Perceived risk", as the investigators call it -- which the study has shown is often a harbinger of changes to come in the use of a drug -- has been falling rather sharply for marijuana in the past five years or so . . .

How do local use rates compare to national rates?
Here are the 10th grade current (30-day) marijuana use rates from MTF and local Healthy Youth Survey data:

• MTF: 18%
• Washington State: 20%
• King County: 18%
• Seattle Schools: 22%
• Nathan Hale High School: 21%
• Roosevelt High School: 23%

Among Hale 10th grade students, use rates have declined since 2008 when 29% of them reported currently using marijuana.  Like the nation, Roosevelt 10th grade marijuana use rates have steadily increased over the past few years -- 18% in 2006, 20% in 2008 and 23% in 2010.

Detailed Healthy Youth Survey data for Nathan Hale, Roosevelt and Seattle Schools may be accessed through the Prevention WINS website.  Other Healthy Youth Survey data may be accessed through AskHYS.net. 

Science-based information about marijuana, including a fact sheet about Adolescents and Marijuana, is available through the University of Washington's Alcohol & Drug Abuse Institute. 

Prevention Specialist Training to be offered in Renton

Substance Abuse Prevention Specialist Training (SAPST): a comprehensive training on the science and application of prevention

February 29, March 1, 7 & 8 (4-day training)
8:30 a.m. - 5:00 p.m.
Blackriver Training & Conference Center
800 Oakesdale Ave, SW in Renton

Training topics:

• The history of prevention
• Research and planning
• Evaluation
• Media
• Human development/culture
• Prevention ethics

Cost: $25

More information is available on the Prevention Specialists Certification Board's website. 

2012 general coalition meeting dates

Prevention WINS 2012 General Coalition Meetings

Thursday, March 15, 2012
8-9:30 a.m.
Seattle Children's, G-1026
4800 Sand Point Way NE

Friday, June 22, 2012
8-9:30 a.m.
Seattle Children's, SDR-3
4800 Sand Point Way NE

Thursday, September 20, 2012
8-9:30 a.m.
Eckstein Middle School
3003 NE 75th Street

Thursday, December 20, 2012
8-9:30 a.m.
Seattle Children's, G-1026
4800 Sand Point Way NE

All coalition meetings are open to the public.  Everyone who is interested in preventing youth substance abuse in NE Seattle is welcome! 

Transitioning to private liquor sales in WA

The Liquor Control Board's (LCB) website now contains information about the work being done in response to the passage of Initiative 1183.  The LCB will cease state liquor store and liquor distribution operations by June 1, 2012. The Seattle Distribution Center - which supplies state and contract liquor stores with liquor - and its assets will be sold.  The private sector will be allowed to sell and distribute liquor with the proper liquor licenses.

Several laws related to the three-tier system will also change, including:

• Uniform pricing is repealed for liquor and wine.
• Ban on quantity discounts is repealed for liquor and wine.

Repealing these policies will enable retailers to sell liquor and wine at lower prices.  These are of particular concern to underage drinking prevention advocates because lower alcohol prices are associated with higher alcohol consumption among teenagers.

Learn about substance abuse prevention online for free

During tomorrow's general coalition meeting, Prevention WINS members will discuss how to educate the community about public policy related to preventing youth substance abuse.  Working on public policy issues is one example of an "environmental" prevention strategy.

As part of their Pathways to Prevention program, the Center for Substance Abuse Prevention (CSAP) has a good, free online course that provides an overview of environmental prevention strategies.  According to CSAP, types of environmental strategies include:

• Policy
• Enforcement
• Education
• Communication
• Collaboration

Why prevent youth substance use?

The American Academy of Pediatrics recently released a policy statement regarding the role of primary care providers in screening for drug use, brief intervention and referral to treatment.  The introduction provides a good summary of why those of us working to prevent youth substance abuse do what we do.

Although it is common for adolescents and young adults to try mood-altering chemicals, including nicotine, it is important that this experimentation not be condoned, facilitated, or trivialized by adults including parents, teachers, and health care providers.  Use of alcohol and other drugs remains a leading cause of morbidity and mortality (disease/injury and death) for young people in the United States.  Even the first use of alcohol or another drug can result in tragic consequences such as unintentional injury or death.  All substance use involves health risks that can occur long before there is drug addiction, and teenagers seem to be particularly susceptible to health risk-taking behaviors and injuries related to alcohol, tobacco, and other drug use.  In addition, research has established that adolescence is a period of neurodevelopmental vulnerability for developing addictions; age of first use is inversely correlated with lifetime incidence of developing a substance use disorder. 

I-1183: How NE Seattle voted

The Seattle Times posted maps that show precinct by precinct election results for I-1183, the initiative for privatizing liquor sales and further deregulating alcohol in general.  Below is a snapshot of how NE Seattle voted. 

Mercer Island passes state's first social host law

From the Mercer Island Patch:

Mercer Island City Council approved an ordinance Monday night intended to prevent underage drinking by fining local homeowners — with few exceptions — where teens 18 and younger were found drinking alcohol. The civil ordinance is the first of its kind in the state.

The council voted 6-1 to hold persons responsible by having to pay a fine for failing to prevent underage drinking at gatherings on property they own or otherwise control. The civil fines of $250 per infraction would be levied if police find evidence of drinking by minors 18 years old and under — even if the drinking occurred without their knowledge.

In some places, social host laws include criminal penalties.  NBC's Today Show recently covered a story about a California father who may face jail time for underage drinking that occurred in his home. 

General coalition meeting on December 15

Prevention Works in Seattle General Coalition Meeting
Thursday, December 15, 2011
9:00 - 10:30 a.m.
Seattle Children's Hospital
4800 Sand Point Way NE

All coalition meetings are open to anyone interested in preventing youth substance abuse in NE Seattle.  For more information please contact the coalition coordinator.   

Town hall meeting on youth substance abuse in NE Seattle

Save the date!

Town Hall Meeting
Topic: youth substance abuse & what parents can do to prevent it

January 31, 2012
6:00 - 8:00 p.m.
Eckstein Middle School

Free pizza!
Free childcare! 

More information will soon be posted on the Prevention WINS website.

WASAVP 2012 legislative priorities

After surveying members, the Washington Association for Substance Abuse and Violence Prevention (WASAVP) Board of Directors identified the following issues as top priorities for their work during the 2012 state legislative session.

1. Prevent liquor privatization and further deregulation.

2. Support designation of all ATOD (alcohol, tobacco and other drugs) fees and taxes to go toward enforcement, prevention and treatment in communities, not the general fund. 

3. Reclassify medical marijuana so that it may be regulated and sold in pharmacies like other prescription medications.

4. Oppose state and federal budget cuts to community and school-based prevention programs.

The Board also identified several issues that will be monitored.

Free webinar: social marketing, social norms, social media and substance abuse prevention

The Substance Abuse and Mental Health Services Administration is offering a free webinar as part of their series on environmental strategies for substance abuse prevention:

Social Marketing, Social Norms, Social Media, Social What?
December 13, 2011
3:30-5:00 p.m.

The strategies and evidence that support different prevention practices often get confused, severely limiting the effective implementation of these approaches. Learn about the differences between some of the more common and evidence-based prevention strategies, including social marketing and social norms, as well as how new tools like social media fit in to the mix. This webinar will leave you with new tools, a better understanding of your prevention arsenal and the energy to make positive behavior change a reality.

Key topics will include:
-Social Marketing, including branding strategies
-Social Norms
-How to select the right approach
-Differentiating between a tool and an approach
-How to select the right tools for your approach
-How Social Media fits in most effectively

To register, click here. 

911 Good Samaritan Law: making a difference?

From UW's ADAI:

Drug users and bystanders who witness a drug overdose are often reluctant to call 911 out of fear that they might be arrested for drug possession. Initial results from an evaluation of Washington State's 911 Good Samaritan Law show that 88% of opiate users are now likely to call 911 to get emergency help for drug overdose victims, knowing that they are protected by the state’s Good Samaritan laws.

The study's early findings also indicated that 62% of police surveyed said the law would not change their behavior during a future overdose because they would not have made an arrest for possession anyway, 20% were unsure what they would do, and 14% said they would be less likely to make such an arrest.

Providing parents with tips on how to support healthy decision-making among teens

One of the Prevention WINS coalition's strategies to prevent youth substance abuse in NE Seattle is outreach and education among parents.  The coalition's campaign to help parents support healthy decision-making among their children includes postcards containing parenting tips.  These tips echo what parents learn through tested and effective prevention programs like Guiding Good Choices and Strengthening Families, which is offered to Eckstein Middle School families twice a year.

The first round of postcards are in the mail and will go to all families of students attending Eckstein Middle School, Nathan Hale High School and Roosevelt High School. 

The coalition's Social Marketing Workgroup, which is developing the campaign, will meet again on Tuesday, December 6 at 6:30 p.m.  Contact the Prevention WINS coordinator for more information.

Hospital visits involving energy drinks increased tenfold in four years

Nationwide, the number of hospital emergency department (ED) visits involving energy drinks increased tenfold between 2005 and 2009, according to a recent report from the Substance Abuse and Mental Health Services Administration. 

Forty-five percent of energy drink related ED visits were made by young adults aged 18 to 25 and 11% were made by adolescents aged 12 to 17. 

Most teenagers who visited the ED suffered adverse effects from the energy drink alone.  The rest suffered adverse effects from combining the energy drinks with alcohol (5%) or pharmaceuticals (20%) such as Ritalin.

Funding available for local underage drinking prevention activities

The Washington State Coalition to Reduce Underage Drinking (RUaD) is offering stipends for community organizations that want to conduct a Let's Draw the Line Between Youth & Alcohol campaign and/or a town hall meeting about underage drinking. 

RUaD has been asked by the Substance Abuse and Mental Health Services Administration (SAMHSA) to submit the names of 100 Washington communities that would like to host town hall meetings.  Participants will receive a $500 stipend to underwrite costs of the meetings.  Contact RUaD by December 2 if your organization is interested. 

Groups can receive a $1000 stipend for conducting a Let's Draw the Line campaign.  Groups may sign up on December 1 by visiting http://www.letsdrawtheline.org/. 

Changing attitudes about substance abuse takes time

In an interview, the author of a book about the history of drunk driving makes some interesting comments about attitudes concerning alcohol use in the United States. 

Here are a few excerpts from the interview:

When Barron Lerner was writing his book on the history of drunk driving in America — and efforts to control it — he carried out an experiment at home that involved a bottle of vodka, a shot glass and a Breathalyzer. He was the guinea pig.

"I was trying to figure out just how drunk you had to be in order to not drive safely," says Lerner, a professor of medicine and public health at Columbia University, who wrote One for the Road. He decided to drink and test his levels — but he didn't actually get into a car.

"And, as I suspected after doing my research, one can drink an awful lot and be pretty buzzed and still legally drive in the United States."

He goes on to talk about how attitudes about drunk driving have changed significantly in the last sixty years.

One of the things Lerner writes about is the history of public attitudes toward drunk driving. He uses the example of Margaret Mitchell, the author of Gone with the Wind, who was crossing the street with her husband in Atlanta in 1949 when she was hit by a drunk driver and died.

According to Lerner, people initially reacted with horror, but then attitudes shifted and there started to be more sympathy for the driver — who had had 22 previous arrests for driving violations, including speeding and drunk driving — than for Mitchell.

"This is such an instructive case about drunk driving in this country," Lerner says. "For years and years, back in that era, people who were killed or victimized by a drunk driver were seen as being in the wrong place at the wrong time — that these things happen. And that was very much the case with Margaret Mitchell. After the initial outrage, people started to say, 'Well, it was her time to go.' I read so many stories like that, and every one was almost more shocking than the next — that we could have had a society that was so passive to a crime that was killing 25,000 people a year for so long."

This is a good lesson for those of us working to prevent youth substance abuse to remember.  It may take a long time, but if we are vigilant, attitudes can change.  Drunk driving attitudes are a good example.  So are attitudes around smoking.  Even if people now say "kids will be kids" and that there is nothing we can do to prevent youth substance abuse, those attitudes can change.

Attorneys general urge FTC to limit alcohol content in Four Loko

Yesterday, 34 state attorneys general, including Washington's, and the San Francisco city attorney, filed comments responding to the Federal Trade Commission (FTC)'s proposed settlement with the makers of Four Loko regarding deceptive marketing of the flavored malt beverage.

The FTC was commended for recognizing that the marketing of these super-sized drinks as single servings is misleading because one can contains the alcohol equivalent of almost five beers. The FTC was also called on to adopt additional measures to address the safety risks presented by Four Loko, such as limiting its alcohol content to no more than two servings of alcohol per can.

Mercer Island considering social host ordinance

Thanks to Mercer Island's Communities That Care Coalition, the Mercer Island City Council is considering an ordinance that would fine adults who host underage drinking parties in their homes.  These types of laws, called social host ordinances, are an effective method for preventing underage drinking in communities where house parties are a problem.  As with most youth substance abuse prevention-related policies, they are especially effective in communities where multiple prevention activities are happening. 

For those of you who would like to be present for the second reading and vote on the proposed ordinance, the Mercer Island City Council will take up the matter again during its December 5, 2011 meeting.  

City of Seattle proposal to keep bars open past 2 a.m.

In October, the Washington State Liquor Control Board (LCB) agreed to the City of Seattle's request to open rule-making regarding the hours of alcohol service.  The City of Seattle is asking the LCB to consider changing its policy that states that alcohol cannot be served between the hours of 2-6:00 a.m. 

To be clear, the petition submitted by Seattle Mayor McGinn asks the LCB to allow "for on-premises liquor service after 2 a.m." in "extended service hours service areas".  The proposed rule change would permit certain establishments within those areas to serve alcohol "between the hours of 2 a.m. and 6 a.m.".  This means that some bars could be open 24 hours per day.  The City's petition and supporting documentation may be accessed online.

The Citywide Police Advisory Committee is speaking out against increasing hours of alcohol sales.  In a recent message from the group, they say, ". . . three of us from the Citywide PAC had an informal coffee with two (of the three) members of the Washington State Liquor Control Board.  The perception of the Board was that the City Council's support of this petition was reflective of the community's position.  This perception is completely incorrect, for the vast majority of Seattle citizens are against the proposal . . . We do know that the Mayor's Office has not publicized anything about the (LCB) community input process/opportunity."

The LCB is accepting initial comments about the potential rule change until December 1.  To do so, contact them at:
Rules Coordinator
Liquor Control Board
P.O. Box 43080
Olympia, WA  98504-3080
rules@liq.wa.gov

After the December 1 deadline, community members can still make comments until January 18, when a public hearing will be held. 

Small grocery stores want in on the liquor business

And so it starts . . . just days after I-1183, the initiative to privatize liquor sales in our state, passed, Publicola reports that small grocers are preparing to ask legislators to reduce the required size of stores selling hard alcohol. 

People can call me and other pro-regulation advocates a nanny or a liar all that they want, but the research is clear: increased access to alcohol increases consumption, including consumption among minors.  I blogged about it on October 24 and August 18.  The coalition website contains links to lessons learned about private liquor sales and public health consequences in the UK.  AlcoholPolicyMD.com is one of many great online resources about how public policy can be used to prevent underage drinking. 

People can also say that "kids will be kids" and that there is nothing we can do to stop them from drinking but, again, we have research that shows otherwise.  Not to mention that our northeast Seattle community has worked together to reduce underage drinking rates over the past five years. 

Will strong regulations and policy limiting alcohol marketing and availability alone prevent underage drinking?  No.  However, it is one tool for communities to use to prevent underage drinking.  When one part of an already beleaguered substance abuse prevention system is eliminated, it makes a significant difference in a community's ability to keep kids safe and healthy. 

Easing regulations to raise money

Earlier today, I went through my "to read" folder and posted a bunch of drug and alcohol-related links in the blog entry below.  I was going to include one from the New York Times entitled "States Putting Hopes in ‘Bottoms Up’ to Help the Bottom Line" but I thought it deserved its own entry considering all of our local/state initiatives that would ease regulations on alcohol.

Here's an excerpt:

With cities across the country facing their fifth straight year of declining revenues and states cutting services and laying off workers, raising money from people who enjoy a cocktail is becoming an increasingly attractive option.

Since the recession started in earnest in 2008, dozens of states and cities have tinkered with laws that regulate alcohol sales as a way to build up their budgets.

Although some drinkers and government budget writers might like the changes, not everyone is happy.

“Lawmakers are taking a very short-sided view,” said David Jernigan, director of the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health. “What they gain in short-term tax revenue they are losing in long-term police costs, emergency room costs and work-force readiness costs in terms of the Monday morning effect.”

Like many public health officials, Mr. Jernigan does not support government efforts that increase the availability of alcohol, but he does support raising sales tax as a way to make people drink less.

As I have noted in previous blog entries, stringent alcohol regulations are one tool communities rely upon to prevent underage drinking.  So, as our local and state governments propose increasing access to alcohol as a way to raise tax revenue, communities should consider the costs associated with increased access .  At the same time, communities may want to consider advocating for an increase in taxes on alcohol -- a policy that has proven to prevent underage drinking. 

In the news . . .

Community effort brings lasting drop in smoking, delinquency, drug use  (Science Daily)

Are today's parents going too soft on kids' using marijuana?  (USA Today)

A chance to safely clean out medicine cabinets (Seattle Times)

Teens hear 34 references to brand-name liquor a day in rap and hip-hop (ABC News)

Prohibition's real lessons for drug policy (LA Times)

Councilman: Why so many drug dealers in the morning (Seattle PI)

Friends of teen’s romantic partner can influence drinking habits (American Sociological Association)

Insufficient sleep among high school students associated with drinking, smoking and smoking marijuana (Preventive Medicine)
 
Liquor store density linked to youth homicides, U.S. studies find (Science Daily)
 
Alcohol isn’t worth the trouble for some chain restaurants (New York Times)
 
Teens who eat at family dinners less likely to drink, smoke and use marijuana (CASA Columbia)
 
NIH study finds hospitalization increase for alcohol and drug overdoses (NIH News)

NIH release clinicians guide to screen for underage drinking

From a recent NIH news release:

Based on just two questions from a newly released guide, health care professionals could spot children and teenagers at risk for alcohol-related problems.  Alcohol Screening and Brief Intervention for Youth: A Practitioner's Guide is now available from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health. 

We know that alcohol is by far the drug of choice among youth,” says NIAAA acting director Kenneth R. Warren, Ph.D. “Underage drinking is also a marker for other unhealthy behaviors and it often goes undetected. This new tool was designed to allow busy practitioners who manage the health and well-being of children and adolescents to conduct fast, effective alcohol screens and brief interventions.”

The American Academy of Pediatrics (AAP) says doctors should routinely screen their teenage patients for drug and alcohol use at every visit, and look for signs of dependence or addiction.  In a new policy statement, the group provides a guide to help doctors ask adolescents about substance abuse issues.

CDC: drug overdoses may soon overtake car crashes as leading cause of fatal injury

From the Centers for Disease Control and Prevention (CDC):

Deaths from prescription painkillers have reached epidemic levels in the past decade. The number of overdose deaths is now greater than those of deaths from heroin and cocaine combined. A big part of the problem is nonmedical use of prescription painkillers—using drugs without a prescription, or using drugs just for the "high" they cause.

November 17: annual King County legislative forum on substance abuse and mental health

Everyone is welcome to attend . . .

15th Annual King County Community Legislative Forum: Mental Health and Substance Abuse Prevention, Treatment and Recovery and Preparing for Health Care Reform

Thursday, November 17, 2011
6:30 p.m. - 8:30 p.m.
St. Mark’s Cathedral, Bloedel Hall
1245 10th Avenue East, Seattle

Learn about local successes and hear from legislators about priorities and perspectives on the upcoming legislative session. 

Learn about the relationship between alcohol and crime from the comfort of your own desk

Alcohol and Crime: FREE National Electronic Seminar
Thursday, November 17, 2011
Noon - 1:15 p.m.
Visit www.udetc.org/audioconfregistration.asp to register.

How many crimes are committed in this country where alcohol is a causal factor? If you are a cop on the street you don’t have to be a scientist to figure that out. Cops know the answer based on experience -- it’s a huge percentage. How do we really prove it?

In the spring of 2005, the Wyoming Association of Sheriffs and Chiefs of Police received grant funding from the Wyoming Department of Transportation – Highway Safety Program to collect and evaluate alcohol-related arrest data in ten counties in Wyoming.  During this free electronic presentation, a researcher in the field of criminal justice will discuss his conclusions of the study and what can be done to reduce alcohol related crime.

Strong alcohol regulations save us money

While researchers continue to find that substance abuse prevention saves money (see yesterday's post), a Centers for Disease Control and Prevention (CDC) study adds to what we know about the high cost of excessive alcohol consumption. 

Underage drinking is included in the definition of excessive alcohol consumption.  According to the study, 12% of the economic costs of excessive consumption were related to underage drinking.  The largest share of underage drinking costs were related to "lost productivity" due to premature death. 

Here is part of CADCA's summary of the findings:

Excessive alcohol consumption is responsible for an average of 79,000 deaths and 2.3 million years of potential life lost in the United States each year, said CDC Director Thomas R. Frieden, M.D., M.P.H., in a press conference held Monday.

Researchers found the costs largely resulted from losses in workplace productivity (72 percent of the total cost), health care expenses for problems caused by excessive drinking (11 percent of the total cost), law enforcement and other criminal justice expenses related to excessive alcohol consumption (9 percent of the total cost), and motor vehicle crash costs from impaired driving (6 percent of the total cost). The study did not consider a number of other costs such as those due to pain and suffering by the excessive drinker or others who were affected by the drinking, and thus may be an underestimate. Researchers estimated that excessive drinking cost $746 per person in the United States in 2006.

“This research captures the reality that binge drinking means binge spending, not just for the person who drinks but for families, communities, and society,” Dr. Frieden said. “There are substantial costs to all of us in health care, the workplace, and criminal justice systems. Responsible individual behavior combined with the effective policies can decrease unhealthy drinking, reduce health care and other costs, and increase productivity.”

The authors of the study (published in the American Journal of Preventive Medicine, November 2011) conclude by saying, ". . . this study shows that the economic impact of excessive alcohol consumption is quite comparable to the economic impact of other leading health-risk behaviors, such as smoking and physical inactivity."  Among the policies they cite as being effective in preventing excessive consumption are increasing the price of alcohol, limiting alcohol outlet density, and keeping the legal drinking age of 21.  In other words, strong alcohol regulations can save us money.

Prevention Summit: holistic prevention saves money

Every year, the Washington State Prevention Summit provides youth and adults from around the state with resources and information about substance abuse and violence prevention.  Handouts from some of the 2011 presentations are now available online.  

From my perspective, a common theme among many of the speakers was the importance of prevention activities that address the whole person and the whole community.  For example: 

• During his presentation, Anthony Biglan discussed different strategies for developing nurturing communities including nurturing schools and families.
• Heather Larkin discussed a whole person approach to addressing Adverse Childhood Experiences (ACES).
• Harold Holder described his research around implementing environmental prevention strategies as part of a comprehensive, community-wide approach. 
• Children's own Leslie Walker talked about creating health equity by reducing the fragmentation of services and considering the family, social, and community issues of each teenager needing help.

 Another theme that emerged during the Summit was that, in the long run, prevention saves money.  This is an especially important message during these difficult economic times.  Stephanie Lee from the Washington State Institute for Public Policy provided specific examples during her presentation.  One of the prevention programs she highlighted is Life Skills Training, the prevention curriculum offered at Eckstein Middle School.  Here is the slide from her presentation:

 

 

I-1183, liquor in our grocery stores and underage drinking

Don't know what to think about Initiative 1183? 

Before I get into all of the studies that show a correlation between alcohol availability and underage drinking, just imagine what our community will look like if stores that are 10,000 square feet or larger can sell hard alcohol.  Imagine the large QFC, Safeway, Bartell Drug and Rite Aid stores in our community (most of them) with shelves of hard alcohol.  In several stores, I already feel bombarded with wine displays.  When we go shopping with our kids, do we want to see vodka and rum displays throughout some stores?  Is that what we want in our community?

Now on to the research.  When it comes to underage drinking, we know that:

-- a growing number of youth who drink prefer liquor to other forms of alcohol. According to a recent report from the U.S. Department of Health and Human Services, “distilled spirits” are the #1 choice among 12th grade girls who drink and the #2 choice among 12th grade boys who drink.

-- when it comes to minors accessing alcohol, Washington State liquor stores have a 94% no-sale-to-minors compliance rate, the nation’s highest. Private sector compliance rates range from 76% - 84%.

-- there is a correlation between alcohol outlet density (the number of places where people can buy alcohol) and youth alcohol consumption.  One of the studies cited in the ADAI fact sheet regarding last year's privatization initiatives found that, "more comprehensive and stringent alcohol control policies, particularly those affecting availability and marketing, are associated with lower prevalence/frequency of adolescent consumption and age of first use."

More information about privatizing/deregulating the sale of alcohol and public health and safety can be viewed on the WASAVP website, the Marin Institute website and the Campaign for a Healthy Alcohol Marketplace website.

More on how underage drinkers access alcohol

In July, I posted data about how underage drinkers in our community get alcohol.  The top two ways are "got it from friends" and "got it at a party".  While the Prevention WINS coalition is working to figure out exactly where the alcohol comes from, national statistics indicate that high school youth (ages 15-17) get alcohol from:

1. someone under the age of 21 (22%)
2. someone not related and over the age of 21 (20%)
3. giving someone else money to purchase alcohol (19%).

Source: Report to Congress on the Prevention and Reduction of Underage Drinking, U.S. Department of Health and Human Services, May 2011

National Prescription Drug Take Back Day October 29

Law enforcement, public health, and environmental professionals stand united in support of medication take-back programs, such as the DEA’s take-back event on Saturday, October 29, as the safest and most responsible way to dispose of old and leftover medicines.  Take-back programs are one way to prevent youth prescription drug abuse.

In our community, the North Precinct will be collecting unused medications on October 29, 10:00 a.m to 2:00 p.m. as part of the DEA's national take-back day.  Other Seattle Police precincts are also participating.  In addition to these one-day drop-off sites, local Bartell Drugs and Group Health sites take back medicines all of the time.


In Washington State, the Take Back Your Meds Coalition is advocating for a permanent, state-wide take-back program.  Drug manufacturers are in a unique position to take responsibility and pay for take-back programs as a cost of doing business, just as they already do in other countries. For a couple of pennies per prescription or bottle of cold pills, drug companies could finance and provide a safe ongoing medicine take-back system for our state.

In Olympia, big PHARMA has worked hard to dodge taking responsibility. Sadly, pressure from PHARMA stalled action in the WA Legislature last year. Luckily, this year our representatives again have a chance to pass a bill to create a state wide medicine take-back system by requiring companies selling medicines in the state to provide the program as part of doing business.

Photos from "Celebrate Healthy Youth"

Thanks to coalition member Christine Milton, here are a few photos from our October 10 event celebrating the reduction in local underage drinking rates.

 RADD members

 Jill Hudson and Chris Cronas

Denise Espania 

Kipp Strong and Kelly Kerby 

Carolyn Bernhard and Cherylynne Crowther 

Ray Hsiao and panel 

Gary Hothi

Underage drinking rates decline thanks to community-wide prevention activities

More than 50 people attended Monday's Celebrate Healthy Youth at Nathan Hale High School and learned about how the community in northeast Seattle came together to reduce underage drinking rates.  Following are links to media coverage of the event. 

How alcohol use was cut at two Seattle schools (Seattle Times)

Finding: North Seattle teens are drinking less (KOMO)

More about underage drinking in public parks . . .

From the West Seattle Blog: Teacher’s disturbing discovery in West Seattle park: Hazing.  Though the incident took place in West Seattle, it apparently involved Roosevelt and Garfield High School students. 

How can a community reduce underage drinking rates?

You are invited to . . .

 
View the Celebrate Healthy Youth flyer for more information.

National Geographic: "Beautiful Teenage Brains"

The October edition of National Geographic magazine contains a fascinating article about the teenage brain.  For those of us who are working to prevent youth substance abuse and/or for those of us who have teenage children, the following paragraph reminds us of the importance of parenting. 

Yet we [parents] can and do help. We can ward off some of the world's worst hazards and nudge adolescents toward appropriate responses to the rest. Studies show that when parents engage and guide their teens with a light but steady hand, staying connected but allowing independence, their kids generally do much better in life. Adolescents want to learn primarily, but not entirely, from their friends. At some level and at some times (and it's the parent's job to spot when), the teen recognizes that the parent can offer certain kernels of wisdom—knowledge valued not because it comes from parental authority but because it comes from the parent's own struggles to learn how the world turns. The teen rightly perceives that she must understand not just her parents' world but also the one she is entering. Yet if allowed to, she can appreciate that her parents once faced the same problems and may remember a few things worth knowing.

Stop overdoses by calling 911

Recently, the 911 Good Samaritan Law was passed in Washington, providing legal immunity to people who call for medical assistance for drug users who overdose.

If you think you're witnessing a drug overdose and seek medical help, call 911.  If you are in possession of drugs at the time that you call, you will receive immunity from criminal charges of drug possession. The overdose victim you're helping is protected, too.

More Washingtonians die every year from overdoses than from car crashes. Most drug overdoses involve a prescription medication used with other drugs or alcohol. Most of these deaths can be prevented with fast medical help.

Webcast about preventing youth marijuana use available online

During last week's general coalition meeting, a few people asked for the link to the recently broadcast webcast, The Blunt Truth: Communities Dealing with Marijuana.  It is available "on demand" through the CADCA website. 

One of the panelists is Jim Cooper, the president of the Washington Association for Substance Abuse and Violence Prevention (WASAVP).  One of the goals of WASAVP is to increase awareness about how marijuana policy effects use among youth. 

Prevention WINS awarded AMA Foundation grant

In partnership with Seattle Children’s Hospital, Prevention WINS was awarded a grant from the American Medical Association (AMA) Foundation’s Healthy Living Program.  The $5,000 grant will be used to expand the Prevention WINS social marketing campaign and parent education program for Eckstein Middle School families. The project’s goal is to provide parents with the support they need to prevent substance abuse, including prescription drug abuse, among their children.

The AMA Foundation's Healthy Living Program addresses critical healthy lifestyle issues by providing mini-grants to grassroots community organizations.  This year, the foundation is funding projects targeting youth and addressing the topics of nutrition and physical fitness, prescription drug safety and violence prevention. Prevention WINS is one of 37 nonprofits across the country that received this grant this year.  

CADCA gathering signatures in support of continued DFC funding

Community Anti-Drug Coalitions of America (CADCA) is asking substance abuse prevention advocates to help them ensure that the Congressional “super committee,” charged with determining $1.5 million in federal budget cuts by November 23, does not cut funding for the Drug Free Communities (DFC) program for FY 2012.

The super committee is made up of 12 Congressional members, one of which is Senator Patty Murray. As a result, Senator Murray has a significant say in the final recommendations concerning what should be cut. CADCA is asking people to sign a letter to Senator Murray that outlines the DFC program's successes and makes the case to continue funding for the program.  Prevention WINS is funded by a DFC grant. 

For more information about the letter and how to sign on to it, contact CADCA's Director of Public Policy by September 12.

Washington now has 31 coalitions funded by Drug Free Communities grants

Yesterday, the recipients of the 2011 Drug Free Communities (DFC) continuation, mentoring, and new grants were announced. 

Twenty-eight Washington State Drug Free Communities continuation grantees, including Prevention WINS, were awarded ongoing funding.  Additionally, three new DFC grants were awarded in Washington State. Congratulations to the following new grantee coalitions:

1. Kittitas County Community Network Coalition (fiscal agent Kittitas Valley Community Hospital)

2. Pend Oreille County Youth Task Force (fiscal agent Pend Oreille County Counseling Services)

3. Citizens for Safer Yakima Communities (fiscal agent Educational Service District 105)

A mentoring grant was awarded to Prevent! The Substance Abuse Coalition of Clark County (fiscal agent Educational Service District 112).

Across the country, 87 new grants were awarded which brings the total of DFC grants awarded for 2011 to 694, including continuation grants.

Odyssey magazine focuses on addiction

The September edition of Odyssey, a science magazine for middle school students, focuses on addiction.  Among the many articles are:

-- Facing Up to Underage Drinking

-- Bad Bet with the Brain: The Neuroscience of Addiction

-- Are Cell Phones Addictive?

-- Pain Pills?

Youth drug abuse a "big problem" according to adults

Adults rate drug abuse and obesity as the top health concerns for children, according to a recent study. 

After drug abuse and obesity, tobacco use is ranked third and alcohol abuse is ranked eighth. 

The report goes on to state, "Drug abuse rises to the top of the list of child health concerns in 2011, with one-third of adults overall rating drug abuse as a big problem . . . Whether this increased concern translates to greater support for drug prevention and/or drug treatment programs remains to be seen."

Prevention news from around the state

The latest edition of FOCUS, the Washington State Division of Behavioral Health and Recovery's e-newsletter, is now available online.  It includes stories about:

-- Washington teenagers advocating for prevention,

-- student prevention groups and their activities,

-- 2010 Healthy Youth Survey results,

-- local campaigns to limit alcohol advertising targeting young people. 

Volunteers needed for 2011 Prevention Summit

Volunteer for the Washington State Prevention Summit and take advantage of the following perks:

• Free conference registration (valued at more than $200)

• Conference meals and beverages (valued at more than $75)

• Participation with colleagues and community leaders

• Access to more than 25 workshops and keynote presentations

To receive free registration, individuals must volunteer for ten or more hours. 

Volunteer applications are due by September 1.  The 2011 Summit will take place October 27-29 at the Yakima Convention Center. 

Prescription drug take-back campaign notes

The local Take Back Your Meds campaign holds monthly coordinating conference calls and here are my notes from today's call --

-- The DEA is hosting another prescription drug take-back event on October 29.  This will probably be the last or second-to-last nationwide event, with the last one possibly to be held in early 2012, since new federal legislation will allow for take-back programs without DEA involvement. 

-- "Extended producer responsibility", including the responsibility of pharmaceutical companies to be stewards of their products after they are sold, was the topic of a panel discussion during the National Conference of State Legislators earlier this month.  The only non-industry panelist was from the Product Policy Institute and he blogged about his experience. 

Liquor privatization: public health costs

While the Seattle Times "cheers Initiative 1183" because it would generate additional revenue for state and local governments, the Washington State Budget & Policy Center questions whether the additional revenue would offset costs associated with increased public health, safety, and economic implications. 

In a recent post to their Schmudget blog, the Budget & Policy Center states that the Washington State Office of Financial Management's (OFM) analysis "does not account for future costs associated with greater consumption of hard liquor.  They estimate that hard liquor sales (consumption) would increase by about five percent under I-1183.  However, a 2010 report from the State Auditor's Office estimated that consumption of hard liquor could increase by as much as 15 percent under a privatized liquor system similar to that proposed by I-1183.  Either way, our state could face increased public health and safety costs under the initiative -- due to higher rates of drunk driving and other alcohol-related crimes." 

An increase in underage drinking is one of those public health and safety costs.  Increased availability of alcohol through stores means increased problems with underage drinking, according to many research articles (which may be found in the ADAI Library Resource Brief about Privatization of Alcohol Sales, page 4).

"Let's Draw the Line" materials still available for free

The Washington State Coalition to Reduce Underage Drinking (RUaD) still has free materials available for community's that want to continue activities in support of the Let's Draw the Line campaign.  Free materials include window clings like the ones shown below.  (Wrist bands are no longer available.)  Order forms are available on the campaign website.   

Wine & beer at farmers markets

From the Washington State Liquor Control Board --

The agency on July 27 selected the 10 farmers markets that are invited to participate in a pilot program that allows wine and beer tastings at farmers markets.

As directed in Substitute House Bill 1172, which created the pilot, the markets were selected in a manner to ensure geographic representation.

The pilot runs from Sept. 1, 2011 to Nov. 1, 2012.

The following list (of Seattle markets that will host tastings) is tentative, pending verification that the markets are able to meet the pilot requirements. A confirmed list will be posted on the WSLCB website.

-- West Seattle Farmers Market, 4400 S.W. Alaska St. in Seattle

-- Magnolia Farmers Market, 2550 34th Ave. W. in Seattle

-- Pike Place Market; Street Farmers Market, Pike Place, between Pine and Steward Streets, in Seattle

The Washington Association for Substance Abuse & Violence Prevention opposed the legislation that allows for beer and wine tastings at farmers markets:  Consuming beer and wine while running errands (such as grocery shopping) sets a bad example for children as parents and other adults model the causal use of alcohol.  If the legislature does not draw the line at this form of three-dimensional advertising, the negative effects are likely to compound over time . . .  we wonder what venues will be next. 

There are many ways the alcohol industry can promote its products.  The open use of alcohol in public markets does not need to be one of them.   

Counselor Camp 2011

From a Prevention WINS coalition member --

Counselor Camp is back and here to stay! Join us this fall at Cispus Learning Center in Randle, WA for an inspiring weekend of seminars and activities for professionals that work with Adolescent Prevention, Intervention, Counseling and Treatment Systems. 

This event (September 16-18) is designed to offer the best evidence-based theory and time-tested practice from a variety of professionals from our own backyard.

Opiate use in Washington State

Washington State, like much of the United States, has seen a tremendous increase in the use and negative consequences of prescription-type opiates over the last 10-15 years, according to a Research Brief released this month by the University of Washington's Alcohol and Drug Abuse Institute.  The brief goes on to state: Prescription-type opiates appear to be a pathway to heroin for many users . . .

The maps below are from the brief and show the increases in the Washington State opiate problem between 2000-2009.  (Rx = prescription)