Adolescent health care providers call for binge drinking prevention activities

The Society for Adolescent Health and Medicine (SAHM) is hosting their annual meeting in Seattle this week and I was looking at their website and came across their October 2010 press release about binge drinking.  Following are a few excerpts:

In light of the Centers for Disease Control and Prevention’s (CDC) recently released report on binge drinking among high school students and adults in the United States in 2009, the Society for Adolescent Health and Medicine (SAHM) called today for strong and directed action by health care professionals, community and policy leaders, local officials, schools, religious groups and community members to develop and implement programs and policies to curb the rise in binge drinking among adolescents and young adults in the United States.

“This report reaffirms,” said Dr. William Adelman, Chair of SAHM’s Alcohol and Drug subcommittee, “that binge drinking is a particularly serious problem for adolescents as well as adults in the United States but that the majority of underage drinkers are apparently learning to drink alcohol with the expressed goal of intoxication. It is no surprise then, that binge drinking disproportionately affects those in high school and then through age 25, too often with tragic outcomes.”

. . . community-based interventions such as those recommended in the Guide to Community Preventive Services are recommended resources for broader efforts.

Among the interventions recommended in the guide are:
-- Increasing alcohol taxes
-- Maintaining limits on days of sale
-- Maintaining limits on hours of sale
-- Regulation of alcohol outlet density
-- Enhanced enforcement of laws prohibiting sales to minors

What is youth substance abuse prevention?

Earlier today, I blogged about risk and protective factors.  These factors are the primary targets of effective prevention strategies used in family, school, and community settings. The goal of these strategies is to build new and strengthen existing protective factors and reverse or reduce risk factors in youth.

How do prevention strategies increase protection and decrease risk? 

In the Family - Prevention strategies can strengthen protective factors among children by teaching parents better family communication skills, appropriate discipline styles, firm and consistent rule enforcement, and other family management approaches including monitoring skills. 

In northeast Seattle, the Strengthening Families program at Eckstein Middle School is one tested and effective program that helps parents learn these skills.  Soon, the Prevention WINS coalition will launch a social norms campaign to support positive parenting behaviors. 

In School - Prevention programs in schools focus on children’s social and academic skills, including enhancing peer relationships, self-control, coping, and drug-refusal skills. 

In northeast Seattle, Eckstein Middle School has integrated Life Skills Training, a tested and effective prevention curriculum, into 6th grade health and other classes.

In the Community - Prevention programs work at the community level with civic, religious, law enforcement, and other government organizations to enhance anti-drug norms and pro-social behaviors. Many programs coordinate prevention efforts across settings to communicate consistent messages through school, work, religious institutions, and the media. 

In northeast Seattle, the Prevention WINS coalition is composed of more than thirty community members dedicated to working together for this purpose.  Within the next year, the coalition will increase activities to reduce sales of alcohol to minors.  The coalition will also launch activities to advocate for the enforcement of youth-related drug and alcohol laws and for legislation that would reduce drug and alcohol access among minors.

More information about substance abuse prevention is available on the National Institute on Drug Abuse's website.

What is youth substance abuse prevention? Start with risk & protective factors . . .

What is substance abuse prevention?  Understanding risk and protective factors is one place to start to gain an understanding of what substance abuse prevention is and is not.

Communities working together to prevent youth substance abuse can look at what factors increase risk of substance abuse and what factors protect against substance abuse in their communities.  Risk factors can increase a person’s chances for drug abuse while protective factors can reduce the risk.  Prevention strategies work towards decreasing risk factors and increasing protective factors.

Above is a chart displaying risk factors for substance abuse as well as delinquency, teen pregnancy, school drop-out and violence.  Risk factors that the Prevention WINS coalition has identified in northeast Seattle are family management problems (regarding monitoring youth and setting consequences) and youth favorable attitudes towards drugs and alcohol.  In other communities risk factors may include low neighborhood attachment, lack of commitment to school, or early and persistent anti-social behavior.  Each community is different and, therefore, prevention strategies may vary community to community.

Protective factors include individual traits such as a resilient temperament and a pro-social orientation.  Community protective factors include opportunities for youth to be involved in pro-social activities and being recognized for those activities.  At home, families can bolster protection by increasing family bonds, reinforcing healthy beliefs and setting clear standards.

In the news . . .

Should parents give alcohol to their kids? (CBS News)

Private liquor sales pitched as way to help state budget (Seattle Times)

Liquor sales: business interests wake up to sober truth (Seattle Times)

A sensible approach to marijuana legalization that protects young people (Seattle Times)

Every member of Seattle's legislative delegation goes on record in favor of legalizing pot (The Stranger's Slog)

Legalizing marijuana could hurt young people (Seattle Times)

Marijuana use in high school (The New York Times' Well blog)

April coalition meetings

Retail Outreach Workgroup Meeting
Monday, April 4, 2011
10-11:30 a.m.
Place TBA - check the coalition's website for updated information



Youth Engagement Committee
Tuesday, April 5, 2011
8-9:30 a.m.
Eckstein Middle School, 3003 NE 75th Street


Parenting Social Norms Workgroup Meeting
Tuesday, April 26, 2011
7-8:30 p.m.
Seattle Children's Hospital, 4800 Sand Point Way NE

See a full list of upcoming Prevention WINS meetings on the coalition's website.

Student testimony illustrates why school-based prevention & intervention services are needed

In NE Seattle, high school students have little to no access to school-based drug/alcohol prevention intervention services.  Why are these services important?  Check out what a Garfield High School student says during his testimony in favor of HB 2014.  His testimony starts at about 19 minutes into the session.  Testimony from students from another school district starts at about 44 minutes. 

Thanks in part to student's testimony, HB 2014 passed the House State Government and Tribal Affairs Committee with a 7-4 vote!  The bill moves on to the House Ways & Means Committee, yet to be scheduled.  Northeast Seattle Representative Kenney is a member of this committee.

With a 10% increase in alcohol licensing fees, HB2014 would generate approximately $1.2 million in revenue to go towards preventing youth substance abuse and providing needed school-based intervention services. For more information, the Washington Association for Substance Abuse and Violence Prevention has created a HB2014 Fact Sheet.

Social norms workgroup identifies goals

The coalition's Parenting Social Norms Workgroup met on Tuesday and participated in a readiness assessment exercise. Some of the decisions made include our target audience and goals of the social norms campaign.

Target audience: Northeast Seattle parents of children in grades K-12

Goals:

 -- To reduce youth substance abuse.
 -- To decrease favorable attitudes about drugs.
 -- To increase parenting behaviors that have been proven to prevent youth substance abuse:

1. Talk to your children about drugs.
2. Set specific consequences.
3. Monitor your children.

The next Workgroup meeting is scheduled for April 26, 7:00 p.m., at Seattle Children's.

Here is an example of a social norms message developed in in Illinois.

  

What teenagers think adults think about youth alcohol, tobacco and marijuana use

These charts show the percent of King County and Washington State 6th, 8th, 10th, and 12th grade students who report that adults in their neighborhoods think youth alcohol, tobacco, and marijuana use is "very wrong".  As you see, the older children get, the less likely they are to think adults disapprove of drug use.  

Source: 2010 Healthy Youth Survey.  King County results are posted on the Prevention WINS website.

Youth substance abuse prevention legislation

From WASAVP:

The cumulative effects of recent Washington State legislation regarding alcohol promotion and advertising, coupled with the pre-existing pervasiveness of such marketing, must be considered from a youngster’s perspective. Many of these enactments permit a casual approach to alcohol use (just before driving a car and running errands, e.g.), others contribute to the overall normalization of alcohol use, and some allow promotions that will have an intended or unintended impact on youth.

2011 Legislation

SHB 1172 creates a pilot project for beer and wine tasting at farmers markets.

SSB 5788:
• Allows restaurants and hotels that sell spirits, beer and wine to sell beer in a sanitary container brought to the premises by the purchaser or furnished by the restaurant/hotel and filled at the tap at the time of sale (e.g., growlers).
• Allows special occasion licensees to pay for beer and wine immediately following the end of an event and allows wineries and breweries to pay reasonable special occasion table fees.
• Allows branded promotional items to include the logo of a professional sports team.
• Removes the 40 per year limit on nonclub, member-sponsored events by private club licensees.

SHB 1202 creates a pilot project for spirits sampling in state and contract liquor stores.

SSB 5156 creates a liquor license allowing VIP airport lounge operators to serve spirits, beer, and wine for on premises consumption.

HB 1244 allows a spirits, beer, and wine restaurant to sell beer in a sanitary container brought to the premises by the purchaser or furnished by the restaurant and filled at the tap by the restaurant at the time of sale (e.g., growlers).

2009-2010 Legislation

SSB 6329: A grocery store licensed to sell beer and/or wine may obtain an endorsement to offer beer and wine tasting.

ESHB 5110: Wedding boutiques and art galleries may offer one glass of wine or beer without charge to customers at least 21 years of age for on-premise consumption

EHB 2040:
• Permits financial interests between liquor manufacturers, distributors, and retailers under certain conditions.
• Allows liquor manufacturers and distributors to provide branded promotional items to retailers.
• Eliminates the mandatory 10 percent minimum mark-up for beer and wine manufacturers to charge distributors and for distributors to charge retailers.

SHB 1415: Allows the Legislative Gift Center to sell wine produced in Washington to persons 21 years of age or older for off-premises consumption.

2007-2008 Legislation

SHB 1047: Allows grocery stores licensed by the Liquor Control Board that have a snack bar license to sell confections with up to 10 percent alcohol to persons 21 or older.

SSB 5721: Allows a liquor manufacturer, importer, or distributor to enter into an arrangement with a sports/entertainment facility licensee or an affiliated business for brand advertising at the licensed facility or promoting events held at the facility.


Current legislation to support substance abuse prevention and intervention
HB 2014:  The Washington Association for Substance Abuse and Violence Prevention is now asking the legislature to help balance this situation by replacing some of the cuts to community and school based prevention services that have been simultaneously imposed over this same time period, due to revenue shortfalls.  In hopes of achieving this balance, HB 2012 has been introduced in the House Committee on State Government and Tribal Affairs. 

Youth perceive risk of harm from tobacco and use it at lower rates than alcohol and marijuana

These charts show the percent of King County and Washington State students in grades 6, 8, 10 and 12 who report great risk of harm from using different substances.  (Source: 2010 Healthy Youth Survey -- HYS.)  Results from the 2010 HYS also show that tobacco use rates among youth are much lower than the rates of youth alcohol and marijuana use.

Coalition's Parenting Social Norms Workgroup to meet March 22

This poster is part of the social norms campaign for parents developed by the Kelso STOP coalition.  It reflects their true community norm that most parents talk to their children about not drinking alcohol.

The Prevention WINS Parenting Social Norms Workgroup will meet tomorrow, Tuesday, March 22, 7PM at Seattle Children's Hospital.  Anyone who is interested in developing a social norms campaign for northeast Seattle parents to prevent youth substance abuse is welcome to participate.

Want more information about what the social norms approach to youth substance abuse prevention is all about?  Check out this video of Dr. Wesley Perkins explaining the social norms approach.

Teenagers find it easy to get alcohol

State and King County results from the 2010 Healthy Youth Survey (HYS) were recently released.  Among the questions that students in grades 6, 8, 10 and 12 were asked is how difficult it would be to get alcohol, cigarettes and marijuana.  As is shown in the charts above,  perceived availability declines significantly for all substances as children get older.  HYS results also show that adolescents find it easier to get alcohol and cigarettes, both legal and regulated, than it is to get marijuana.

Young artists raise awareness about substance abuse

WAPI Presents : TRUTH BE TOLD: Substance Abuse


Open Mic: Youth spreading awareness about their experiences with substance abuse through poetry, art, music in partnership with the King County "Lets Draw the Line Between Youth and Alcohol" Arts Contest. Come see Seattle’s young artists perform their poetry, songs, dance and visual arts!

When: Saturday March 26, 6-9 PM

Where: The Dungeon: WAPI - Washington Asian Pacific Islander Community Services

Columbia City Location: 3722 S. Hudson St. 98118 (Rainier Avenue and Henderson Downstairs)

Youth and community members are invited to attend.  The purpose of this event is to inform the community and youth about substance abuse. 

Youth substance abuse treatment: need outweighs availability

In Washington State, 13,375 adolescents (ages 12-17) who were eligible for state-funded substance abuse treatment did not receive treatment.  This means that 67% of young teenagers who qualify, both clinically and financially, for publicly-funded substance abuse treatment did not get the services they needed because of limits of available funding.  (Source: 2010 Tobacco, Alcohol, and Other Drug Abuse Trends in Washington State, page 222)

Youth substance abuse treatment admissions: meth down, marijuana up

Though alcohol is the drug most commonly abused by adolescents, marijuana is, by far, the primary reason youth in Washington enter state-funded treatment.  (Source: 2010 Tobacco, Alcohol, and Other Drug Abuse Trends in Washington State, page 259)  The chart above shows that marijuana treatment admissions have increased over the past few years while meth-related admissions have decreased significantly.

Marijuana use rates among WA high school seniors increases, higher than national average

Though the rates of marijuana use among Washington State high school seniors dropped between 2000-2003, it has steadily increased since then.  (Source: 2010 Tobacco, Alcohol, and Other Drug Abuse Trends in Washington State, page 41.)

As I posted yesterday about 2010 Healthy Youth Survey results, fewer Washington State students perceive that it is risky to use marijuana.  Research has shown that as perceptions of risk decrease, use increases.

I don't want to suggest that Seattle policy affects the rest of the state, but I do want to point out that I-75, the Seattle initiative that made marijuana the city's lowest law-enforcement priority, was passed in 2003.  Last year, Washington legalized marijuana for medical purposes. Currently, our state is in the midst of a debate about marijuana legalization.  A research-based risk factor for youth substance abuse is community norms favorable to drugs.  As we continue our conversations about marijuana policy, it behooves us to consider what messages our children are getting from them. 

2010 Healthy Youth Survey results available online

Statewide results from the 2010 Healthy Youth Survey are now available on the Department of Health website. 

According to the survey, given in October to all 6th, 8th, 10th, and 12th graders in Washington, more students are making healthier choices by avoiding alcohol. In the past 20 years, there’s been a big drop in 8th and 10th graders who report drinking alcohol in the past 30 days. Since 1990, youth drinking is down for 8th graders by over half, from 29 to 14 percent in 2010. Drinking among 10th graders has dropped from 44 to 28 percent. Since 2008, about 20,000 more youth in 8th, 10th, and 12th grade report that their parents talked to them about not drinking alcohol.


While our state has made gains in preventing underage drinking, the same cannot be said for youth marijuana use. 

-- Marijuana use among 12th graders increased from 23% to 26% (compared to 20% of 12th graders who smoke cigarettes).

-- Fewer students believe regular use of marijuana is a great risk: down from 63% to 59% among 8th graders; from 52% to 46% among 10th th graders.   As perception of harm goes down, drug use increases.


Statewide data is available online.  Seattle Public Schools anticipates releasing school-level data in April. 

Parents can prevent underage drinking

Yesterday, the Today Show hosted a discussion about parents letting their teenagers drink at home.  This is a common discussion among parents -- following is some information to add to the conversation.

European Drinking Myth
It is often stated that European families teach their children how to drink by allowing them to have wine with dinner.  I often hear people say that France and Italy don't have problems with youth binge drinking because of this type of parenting.  This is a myth!  European countries, including France and Italy, are having increasing problems with teen binge drinking. 

Most Teenagers Do Not Drink
During the Today Show, one of the guests stated that kids are going to drink, no matter what.  This is another myth.  Most teenagers do not drink.  In Washington State, 58% of high school seniors and 67% of high school sophomores do not drink, according to the Healthy Youth Survey.

Parents Can Prevent Underage Drinking
Parents are the #1 influence on adolescents and there are proven strategies parents can use to prevent their teenagers from drinking.

1. Talk to your children early about alcohol and your family's rules about underage drinking.  Set clear and specific guidelines.

2. Monitor your children.  Know where they are going and with whom.  Network with other parents, especially the parents of your child's friends. 

3. Set consequences and follow through on them.

The high cost of underage drinking in Washington State

The Washington State Division of Behavioral Health and Recovery recently released its 2010 Report on Tobacco, Alcohol and Other Drug Abuse Trends in Washington State.  Included is this chart (on page 179) about the costs of underage drinking in our state.  The report states:

Underage drinking in Washington State is associated with substantial harm resulting from traffic crashes, violent crime, unintentional injury, and risky sexual behavior.

-- In 2007, it is estimated that there were 32 traffic fatalities and 2,200 nonfatal traffic injuries involving underage drinking and driving.

-- In 2006, it is estimated that there were 21 homicides, 17,700 nonfatal violent crimes such as rape, robbery, and assault and 50,200 property crimes including burglary, larceny, and car theft perpetrated by underage drinkers.

-- In 2006, it is estimated that there were 12 fatalities from burns, drowning, and suicide involving underage drinking.

-- In 2006, an estimated 2,500 teen pregnancies and 11,500 risky sexual acts by teens involved the use of alcohol.

This all from a substance that is illegal for those under the age 21 and that is regulated. 

What is a coalition?

Last week, a Prevention WINS coalition member and I participated in week one of a three-week National Coalition Academy training.  During the week, we learned about the Strategic Prevention Framework (SPF), how to develop a community assessment, and how to create a logic model. 

One of the topics on the first day of the training was defining a coalition.  A coalition is a voluntary, strategic alliance to enhance our ability to achieve a common purpose by sharing risks, responsibilities, resources, and rewards. 

In the substance abuse prevention field, much of the work we have done is through programs.  A coalition is not a program.  Here are a few differences between programs and coalitions.

Long-term Outcomes
Coalitions measure success by examining community-level indicators for substance abuse.  Instead of measuring outcomes by the number of people who participate in a program, coalitions measure longer term outcomes such as rates of use among people who were part of the prevention strategy.

Multiple Causes
Coalitions seek to address multiple causes of substance abuse.  Coalitions look at root causes and address more than personal risk factors or single strategies.

Multiple Actors
Coalition actions are diffused and taken by all members with staff playing a coordinating and supportive role.

Free online teleconference: Court's capacity to process underage drinking cases

Free online audio-teleconference: How have budget cuts influenced the Court’s capacity to process underage alcohol cases?

Thursday, March 17, 2011, 12:00 - 1:15 p.m.

States across the country are responding to the current budget crisis by implementing a number of cost-saving measures and state courts are called upon to assume part of the burden of these reductions. Responses range from personnel layoffs to a curtailed docket as well as the elimination of programming.  Multnomah County Courts and the Multnomah County Department of Community Justice (Adult and Juvenile Divisions) have embraced prevention as an effective response to the underage drinking cases that come before the court. The effective data driven strategies developed by the county to address underage alcohol cases have been curtailed or eliminated due to budget cuts.  Teleconference panelists will explore how the Courts and Department of Community Justice of Multnomah County have responded to their budget cuts and measure the impact of the cuts on their underage alcohol strategy.

Register on line at:  http://www.udetc.org/audioconf_judicialregistration.asp

Talking to your children about alcohol and other drugs

Talking with teens about alcohol and drinking can be difficult for parents -- but emergency room doctors and MADD just made it a little easier.

The American College of Emergency Physicians (ACEP) teamed up with MADD to create and release a new, free handbook as part of MADD's "Power of Parents, It's Your Influence" campaign.

The handbook is part of the lead-up to PowerTalk 21 Day, scheduled for April 21, a national day for parents to talk to their teens about alcohol.

Other online resources for parents are Parents - The Anti-Drug and Start Talking Now.

April 30 National Prescription Take-Back Day

On Saturday, April 30th, from 10 a.m. to 2 p.m., the Drug Enforcement Administration and its national and community partners will hold the second National Prescription Drug Take-Back Day at sites nationwide.  The event will give the public an opportunity to prevent pill abuse and theft by ridding their homes of potentially dangerous expired, unused, and unwanted prescription drugs.
This service is free and anonymous, no questions asked. To find a local medicine return site, visit http://www.dea.gov/ and click on the “Got Drugs?” icon.

Secure medicine take-back bill fails in WA Senate

On March 7, the Washington State Senate failed to vote on and pass Substitute Senate Bill 5234, the Secure Medicine Take-Back Bill. The proposed legislation would have required drug manufacturers selling medicines in Washington state to provide and finance a secure take-back and disposal program for left-over or expired medicines from residents. Over 140 organizations statewide supported the proposed legislation, including sheriffs, public health leaders, substance abuse professionals, and water quality experts.


“While many Senators were strongly in favor of this bill, pressure from the pharmaceutical industry managed to derail a good piece of legislation that would help protect our families and the environment from left-over medicines. It’s unfortunate that common sense and innovation were left on the sidelines in favor of backroom politics. Washington desperately needs a secure system to safely dispose of leftover medicines from homes without hurting the environment. It’s time to put our families first, not the pharmaceutical companies,” said Karen Bowman, RN, Washington State Nurses Association.

Gearing up for next year . . . Secure medicine return bills are NOT dead for all time. The Legislature works in two-year cycles - this is year one of the 2011-2012 biennium.  Every bill introduced this year is automatically re-introduced next year.


At the start of the 2012 session, SSB 5234 will start in the Senate Rules committee. If we can encourage more Senators to support the bill between now and then, SSB 5234 could be pulled straight out for a floor vote.


HB 1370 will also be reintroduced in the House.

Drug policy and youth substance abuse

Within the past few years, there has been a call for the public to engage in a conversation about legalizing marijuana.  The conversation includes the impact marijuana legalization would have on adolescents. 

Today's Seattle Times includes an opinion piece about how marijuana legalization could affect adolescents. 

A few years ago, the American Academy of Pediatrics published an article entitled, Legalization of Marijuana: Potential Impact on Youth.

Resources from CADCA National Leadership Forum

Last month, CADCA hosted its annual National Leadership Forum during which substance abuse prevention coalitions from around the nation came together to network, learn more about effective prevention strategies, and advocate for prevention policies.  CADCA's website includes links to many of the Forum's presentations.  Some require a password to access: nlf2011. 

The following videos are also posted:

Federal Town Hall Meeting featuring leaders from the National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, and the Center for Substance Abuse Prevention, 

Plenary Session featuring ONDCP Director Gil Kerlikowske,

A second Federal Town Hall Meeting featuring leaders from the Substance Abuse and Mental Health Services Administration, the Department of Education, and others. 

Advocacy workgroup identifies focus areas

The Prevention WINS Advocacy Workgroup met for the first time yesterday and decided to focus advocacy activities on:

1. Increasing enforcement of current laws regarding underage drinking and youth drug use.

2. Increasing youth prevention and intervention services in schools and the community.

3. Opposing legislation that would increase youth access to alcohol and drugs and supporting legislation and that would decrease youth access to alcohol and drugs.

While currently debated legislation, such as the establishment of a safe medicine return program and the legalization of marijuana, could effect youth access to drugs, the Workgroup suggested that the full coalition first needs to define a process for taking stances on issues. 

The next Advocacy Workgroup meeting will take place Tuesday, May 2, noon, at Seattle Children's Hospital.