Rhode Island Launches Underage Drinking Prevention Website
…The website and billboard campaign come just before prom season, graduation season, and the summer vacation months when many youth experiment with alcohol for the first time.

“We live in a fast-paced society that exposes our children to unhealthy messages and distractions, a fact that puts them at high risk for underage drinking and substance abuse. Parents have to be more vigilant and informed than ever to protect their children,” said Mrs. Carcieri, a mother of four and grandmother to fourteen. “Information is a powerful prevention tool, and I want our families, schools, youth, and community to know that there are user-friendly resources on a State website that can help keep our children safe.”

The website www.substancefreekids.ri.gov is tailored to parents, community members, educators, and youth, with sections devoted to each group. Read more…

Teen Drinking: Statistics Show Many TTUSD Students Have Been Drunk, High
Trevor Schlesinger didn’t need to hear statistics to know underage drinking and drug abuse is a problem within the Tahoe Truckee region.

Schlesinger, a 28-year old Truckee High School alumnus, said he experienced it firsthand since being exposed to alcohol and marijuana at the young age of 12.

Public education is the best way to combat the problem, said Schlesinger, who spoke recently as a panelist at Truckee’s recent Town Hall Meeting on Underage Drinking, along with law enforcement officials, counselors and members of Truckee VICE, a teen anti-drug advocacy group standing for Vision, Integrity, Courage and Excellence.

“When I was in high school, any drug was easy to get. I’ve seen friends pass away for driving drunk and watch friends get arrested,” Schlesinger said.

Schlesinger, who recently launched an Alcoholics Anonymous group for teens, said today’s teens are struggling with many of the same difficult challenges he had to overcome growing up.

Citing examples, he said marijuana and ecstasy are major problems — but alcohol is the biggest. Read more…

by Lisa Frederiksen

Alcohol use and heavy drinking are common during adolescence and
young adulthood, although the minimum legal drinking age across the
United States is 21 years. Some individuals may start hazardous alcohol
consumption earlier in childhood. The prevalence of problematic
alcohol use continues to escalate into the late adolescent and young adult
age range of 18 to 20 years. Drinking by college-aged students
remains a major issue. Results of recent research that have demonstrated
that brain development continues well into early adulthood1
and that alcohol consumption can interfere with such development2,3
indicate that alcohol use by youth is an even greater pediatric health
concern.

The above is a quote from the American Academy of Pediatrics Committee on Substance Abuse’s, April 12, 2010, “Policy Statement Alcohol Use by Youth and Adolescents: A Pediatric Concern,” published online and available for download. I urge parents, community leaders, policy makers, teachers and school administrators to read this article. It presents the new brain research and study findings as the reasons for Pediatricians to take an ongoing, proactive approach to consulting with their patients about underage drinking. Below are the 16 recommendations Pediatricians and other health care providers who work with children and adolescents are encouraged to do:
1. Become knowledgeable about all aspects of adolescent alcohol, tobacco, and other substance use through participation in training program curricula and/or continuing medical education that provide current best-practices training, including media-literacy training.
2. Obtain a complete family medical and social history at prenatal and health supervision visits to explore potential genetic and family influences regarding alcohol and other substance use.
3. Recognize risk factors for alcohol (as well as other drug) use among youth and be aware of coexisting mental health problems, such as depression, that may occur in this age group.
4. Regularly screen for current alcohol (as well as other drug) use by adolescents and young adults by using nonjudgmental, validated screening methods and appropriate
confidentiality assurances.
5. Assess patients whose screening results are positive for alcohol use to determine the appropriate level of intervention.
6. Use brief intervention techniques in the clinical setting and be familiar with motivational interviewing techniques to work with patients who use alcohol but do not meet criteria for immediate referral. Offer referral to treatment when indicated.
7. Discuss the hazards of alcohol and other substance use with patients as part of anticipatory guidance and patient/parent education at health supervision visits as well as when relevant at acute-problem visits. Anticipatory guidance aligned with key school calendar events, such as proms and graduation, may be especially meaningful.
8. Strongly advise against the use of alcohol, tobacco, and other illicit drugs by youth.
9. Encourage parents to be good role models for healthy life choices and never allow underaged drinking at their home or other property. Empower parents with the realization that their involvement with their adolescents is a powerful deterrent of substance abuse.
10. Be familiar with local resources to which various pediatric-aged patients with alcohol use disorders, their parents, and other family members can be referred for developmentally appropriate treatment.
11. Support adolescents with substance use disorders throughout and after their treatment.
12. Serve as a resource and support for school and other community-based alcohol use prevention programs.
13. Support advocacy efforts to promote appropriate media modeling of alcohol consumption and consequences, including print media, television, film, and the Internet.
14. Support advocacy efforts to promote legislation that reduces alcohol-related morbidity and mortality, such as graduated driver licensing; treatment parity from third-party payers; legal ramifications for parent sponsorship of adolescent drinking; increased alcohol excise taxes; and other prevention and treatment policies recommended in the Surgeon General’s call to action.
15. Support continuation of the age of 21 as the minimum legal drinking age, and support enforcement that decreases access to alcohol for minors.
16. Support further research into prevention, evidence-based screening and identification, brief intervention, and management and treatment of alcohol and other substance use by adolescents.

To better understand what problematic underage drinking is, the following is the CRAFFT Questions suggested for use by Pediatricians.

CRAFFT Questions: A Brief Screening Test of Adolescent Substance Abuse
C Have you ever ridden in a car driven by someone (including yourself) who was “high” or had been using alcohol or drugs?
R Do you ever use alcohol or drugs to relax, feel better about yourself, or fit in?
A Do you ever use alcohol or drugs while you are by yourself, alone?
F Do you ever forget things you did while using alcohol or drugs?
F Do your family or friends ever tell you that you should cut down on your drinking or drug use?
T Have you ever gotten into trouble while you were using alcohol or drugs?
Two or more yes answers suggest a significant problem, abuse, or dependence. The CRAFFT questions were developed with grant support from the Robert Wood Johnson Foundation, the National Institute on Alcohol Abuse and Alcoholism, and the Substance Abuse and Mental Health Services Administration.
Source for all of the above:  THE AMERICAN ACADEMY OF PEDIATRICS PEDIATRICS® Volume 125, Number 5, May 2010 1083 Downloaded from www.pediatrics.org on May 11, 2010.

Parents Who Host Teen Drinking Parties Face Serious Legal Action
…In the following brief video clips, John Knight, MD, director at the Center for Adolescent Substance Abuse Research(CeASAR) at Children’s Hospital Boston talks about why some parents buy alcohol for their kids, the effect of parents who allow teen drinking or willingly turn a blind eye to it, and the potential legal ramifications for adults who choose to break the law by providing alcohol for underage drinkers. View Video and Read More…

Finished Drug Rehab? 7 Quick Tips to Maintain Sobriety and Enter Recovery
Sometimes leaving a drug rehab can fell like a graduation. The danger is believing that you have ‘done the recovery thing’ and can get on with life.

While you can certainly start getting on with life, you have entered the recovery process, not completed recovery as an event. Chances are that you experienced one-on-one counseling, group therapy, as well as a variety of other experiences. Those are the growth and education experiences that you should continue throughout your addiction and recovery process. Read more…

For a Safe Prom Night: Parents, Please Don’t Serve Alcohol to Teens
As we move into the prom season, many parents and school officials worry about the safety of their children.  An internet search for “Safe Prom” turns up hundreds of websites that focus on encouraging students to make safe and healthy choices, and schools conducting pre-prom events showing the dangers of drinking and driving. However, there are few websites encouraging or guiding parents to take a leadership role in creating a safe prom night. Read more…

by Lisa Frederiksen

Irene, Jessica and I spent two hours today hosting a table at Laney College’s Wellness Fair in Oakland, CA. It was a wonderful opportunity to talk with students about their views on the common myths about drinking.

Below you will find the T/F Quiz students could take, and we had a poster board to draw students into the discussion. One one side was a picture of several different drinks – wine, a shot of vodka, straight bourbon, champagne, beer, vodka on the rocks – with the Question, “Which drink contains the most alcohol (not liquid but alcohol)?” On the other side was a picture of a various containers – bottle of champagne, bottle of table wine, 24 ounce beer, 750 ml bottle of vodka, a bottle of Mike’s Hard Lemonade and the common 20 ounce Red Cup used at most parties – with the question, “How many standard drinks are in each container?”

The photos and the answers to the quiz questions provided great opportunities to sort the myths from the realities as the three of us talked with students who stopped by.

1. Alcohol is a stimulant. ___ T ___ F
2. Putting a penny under your tongue will allow you to pass a breathalyzer test. ___ T ___ F
3. “Beer before liquor, never been sicker – liquor before beer, you’re in the clear.” ___ T ___ F
4. The best thing for a drunk friend is to let them sleep it off. ___ T ___ F
5. All college students drink. ___ T ___ F
6. Alcohol is not as harmful as other drugs, such as marijuana, cocaine or heroin. ___ T ___ F
7. Follow the BAC (blood alcohol content) charts, and you’re good to drive. ___ T ___ F
8. If you drink a lot of water, you dilute the alcohol and won’t get as drunk. ___ T ___ F
9. The impact of alcohol on the brain under 21 is no different than the impact on the brain of an adult over 25. ___ T ___ F
10. Throwing up, drinking coffee, taking a cold shower or walking around the block will sober you up. ___ T ___ F

by Lisa Frederiksen

For anyone working to reduce underage drinking, one of the keys to helping coalitions, parents, and young people better understand the “reasons” is to share the new science — the science-based answers now possible due to new imaging technologies that allow neuroscientists and medical professionals to study the live human brain like never before.

Below you will find excerpts from a Fact Sheet by Jack O’Connell, State Superintendent of Public Schools, California Department of Education, issued in January 2009, titled, “The Adolescent Brain and Substance Use.” It is relatively short but has so much important, well-explained information for anyone whose life or career intersects with teens and alcohol use.

Recent research findings on brain development call the adolescent brain “a work in progress.”1 Contrary to earlier wisdom, the brain continues to develop until we reach our early twenties. The areas of the brain that are last to develop are those responsible for decision making, impulse control, learning, and memory. Because teen brains are not yet mature, teens are especially vulnerable to the harmful consequences of substance use.2

A Brief Explanation of Brain Development
Until recently, many believed that the human brain develops by the age of three and matures by around age ten. However, advanced brain imaging techniques now show that brain development is not completed until around age twenty-four.

Between the ages of six and twelve, the brain’s nerve cells that are responsible for thinking and information processing multiply and develop new communication pathways. After this growth in nerve cells, a process of “pruning” occurs in the early twenties, where connections between neurons that are not used die away, and those that are used remain—a “use it or lose it” process.3 At the same time, there is a thickening of the brain’s myelin (a white fatty material that covers parts of the nerve cell and makes transmission of nerve signals faster and more efficient).

Click here to download the PDF of this article and learn more about the timing of various brain regions and their functions, the role puberty plays and how alcohol can hijack the brain of an adolescent.

by Lisa Frederiksen

I like to post stories about collaborative efforts to reduce underage drinking. Here is one on a statewide effort by South Carolina. Quoting from News Channel 7 WSPA  Staff Report, “Statewide Campaign Blitzes Underage Drinking,” appearing on their website, www2.wspa.com:

An “enforcement and education blitz” coordinated by the S.C. Department of Alcohol and Other Drug Abuse Services (DAODAS) resulted in an unprecedented number of activities by local law enforcement and prevention teams that focused attention on the dangers of underage alcohol use.

Through the statewide campaign, South Carolina’s Alcohol Enforcement Teams (AETs) helped direct activities aimed at limiting access to alcohol by young people under the age of 21. The increased enforcement and public education efforts promoted a safe end to the school year and a safe prom season. The campaign – called “Out of Their Hands” – emphasized that it is against the law for anyone under 21 to purchase, possess, or consume alcoholic beverages.

The campaign, which ran April 2-11, resulted in:

32 party-dispersal operations (compared to 3 during the same period in 2009);

759 compliance checks (compared to 115 during the same period in 2009);

71 public safety checkpoints (compared to 14 during the same period in 2009); and

95 “shoulder tap” operations (compared to 0 during the same period in 2009).

These various operations led to 452 cases of charges being filed. During the period of April 2-11, 2009, only 125 cases resulted from similar operations.

To read the rest of the article – click here…

by Lisa Frederiksen

I wanted to draw your attention specifically to two new articles included in recent SAMHSA (Substance Abuse and Mental Health Services Administration) newsletters. The first is on the new parity legislation to end discrimination in many health insurance plans against consumers of mental health and substance abuse treatment services, and the second is a game to play with younger children as a method for  exploring the issues surrounding underage drinking.

Parity: Landmark Legislation Takes Effect. What Are the Implications for Millions of Americans? Quoting from the article by Rebecca A. Clay, “In the past, health plans have often treated mental health and substance abuse treatment services differently than they have medical and surgical benefits. The new parity law ends that practice in group health plans offered by employers with more than 50 employees.”

Games Help Parents and Children Talk About Alcohol Quoting from the article, “Ready, Set, Listen!, developed by SAMHSA’s Center for Substance Abuse Prevention (CSAP), offers a fun and interactive experience that introduces and reinforces the importance of family discussion on an important subject. The game has two goals:

• To increase the number of conversations that parents and caregivers have with children age 9 to 13 about the harms of underage alcohol use.
• To increase the percentage of children, parents, and caregivers who see underage alcohol use as harmful.”

by Lisa Frederiksen

• Among young adults approaching their 21st birthdays (i.e., persons surveyed in the 30 days prior to their 21st birthdays), 86.1 percent had used alcohol in their lifetime, including 62.8 percent who had initiated use before their 18th birthdays
• Rates of past month and binge alcohol use were higher among young adults who had recently turned 21 than among those who were still 20 years old
• Rates of past month and binge alcohol use among 21 year olds declined and then stabilized in the months following their 21st birthdays, but their rates still remained higher than those for 20 year olds

To learn  more about alcohol use before and after the 21st birthday, check out he National Drug Use and Health (NSDUH) Report, “Alcohol Use Before and After the 21st Birthday.”  According to this report, “there is an ongoing debate among legislators, educators, and public health officials concerning the optimal age at which young adults should be given the right to purchase and possess alcohol. The National Minimum Drinking Age Act of 1984 (23 U.S.C. § 158) required all States to set that age at 21. Recent research examining alcohol use behaviors among young adults in the weeks leading up to and following their 21st birthdays … may further inform this line of research.”

by Lisa Frederiksen

If you work with children or have children, this site is for YOU! It was/is created and maintained by SAMHSA, NIAAA and the ADCouncil.

To help you better understand what you’ll find, here is a cut and past of just two portions of the site — the “HOME” page and the “Talk Early, Talk Often, Get Others Involved” page.

You will be able to customize a Talk early, Often, Get others Involved ACTION plan for a child based on gender and age of a child. This is truly an amazing resource for parents, teachers, community organizers — anyone who works with, loves or lives with children.

Real talk starts here.

Real kids are curious about alcohol. 40% have tried it by the time they reach eighth grade.¹ Talking with your children early and often can make a difference. Get the facts, the tools, and the advice you need to start talking real.

____________________________________________________________________________

Talk EARLY    Talk OFTEN   Get others INVOLVED

Short, frequent discussions can have a real impact on your child’s decisions about alcohol.

Talking to your child at an early age about drinking is the first step toward keeping them alcohol-free. But as they enter junior high and high school, the pressure to try alcohol increases.¹ It’s important to continue the conversation throughout adolescence.

Talking often builds an open, trusting relationship with your child.

Children are more likely to avoid drinking when they have a strong, trusting relationship with their parents.² Get into the habit of chatting with your child every day. It will make it easier to have serious conversations about things like alcohol, and will make your child more comfortable coming to you for advice.

Lots of little talks are more effective than one “big talk.”

Sitting down for the “big talk” about alcohol can be intimidating for both you and your child. Try using everyday opportunities to talk – in the car, during dinner, or while you and your child are watching TV. Having lots of little talks takes the pressure off trying to get all of the information out in one lengthy discussion, and your child will be less likely to tune you out.

When you do talk about alcohol, make your views and rules clear.

Take the time to discuss your beliefs and opinions about alcohol with your child. Be honest and express a clear, consistent message that underage drinking is unacceptable. When they feel that you’re being real and honest with them, they’ll be more likely to respect your rules about underage drinking.³

As children get older, the conversation changes.

What you say to a 9-year-old about alcohol is different from what you say to a 15-year-old. Children also can’t learn all they need to know from a single discussion. Make sure that the information you offer your child fits their age. As they get older, you can give them more information and reinforce your rules.

Create your personalized Action Plan to get age-appropriate tips.

Remember that the conversation goes both ways.

Although talking to your child about your thoughts about alcohol is essential, it’s also important to hear their point of view. Give your child the opportunity to ask you questions, and listen to what they have to say. Children who have parents who listen to their feelings and concerns are more likely to say “no” to alcohol.⁴

What you do is just as important as what you say.

In addition to talking often with your child about alcohol, it’s important to set a good example. If you choose to drink, you can positively influence your child by drinking in moderation and NEVER driving when you’ve been drinking. Be aware of where you keep your alcohol, and always remind your child that the alcohol in your house is off-limits.

by Lisa Frederiksen

We read and hear about the cost savings of prevention programs, but sometimes it’s important to assess for a specific program and/or collaborative effort.

Quoting the Executive Summary, Section 1, of SAMHSA (Substance Abuse and Mental Health Services Administration) report, “Substance Abuse Prevention Dollars and Cents: A Cost-Benefit Analysis:”

Policymakers and other stakeholders can use cost-benefit analysis as an informative tool for decision making for substance abuse prevention. This report reveals the importance of supporting effective prevention programs as part of a comprehensive substance abuse prevention strategy. The following patterns of use, their attendant costs, and the potential cost savings are analyzed:
-  Extent of substance abuse among youth;
- Costs of substance abuse to the Nation and to States;
- Cost savings that could be gained if effective prevention policies, programs, and services were implemented nationwide;
- Programs and policies that are most cost beneficial.

1.1. Costs of Substance Abuse
Studies have shown the annual cost of substance abuse to the Nation to be $510.8 billion in 1999 (Harwood, 2000). More specifically,
- Alcohol abuse cost the Nation $191.6 billion;
- Tobacco use cost the Nation $167.8 billion;
- Drug abuse cost the Nation $151.4 billion.
Substance abuse clearly is among the most costly health problems in the United States. Among national estimates of the costs of illness for 33 diseases and conditions, alcohol ranked second, tobacco ranked sixth, and drug disorders ranked seventh (National Institutes of Health [NIH], 2000). This report shows that programs designed to prevent substance abuse can reduce these costs.

1.2. Savings From Effective School-Based Substance Abuse Prevention
If effective prevention programs were implemented nationwide, substance abuse initiation would decline for 1.5 million youth and be delayed for 2 years on average. It has been well established that a delay in onset reduces subsequent problems later in life (Grant & Dawson, 1997; Lynskey et al., 2003). In 2003, an estimated:
- 5.6 percent fewer youth ages 13–15 would have engaged in drinking;
- 10.2 percent fewer youth would have used marijuana;
- 30.2 percent fewer youth would have used cocaine;
- 8.0 percent fewer youth would have smoked regularly.
The average effective school-based program in 2002 costs $220 per pupil including materials and teacher training, and these programs could save an estimated $18 per $1 invested if implemented nationwide. Nationwide, full implementation of school-based effective programming in 2002 would have had the following fiscal impact:

Substance Abuse Prevention Dollars and Cents: A Cost-Benefit Analysis
- Saved State and local governments $1.3 billion, including $1.05 billion in educational costs within 2 years;
- Reduced social costs of substance-abuse-related medical care, other resources, and lost productivity over a lifetime by an estimated $33.7 billion;
- Preserved the quality of life over a lifetime valued at $65 billion.
Although 80 percent of American youth reported participation in school-based prevention in 2005 (SAMHSA, 2004), only 20 percent were exposed to effective prevention programs (Flewelling et al., 2005). Given this level of participation, it is possible that some expected benefits already exist for these students, and the estimates in this paper are adjusted for these probable benefits. These cost-benefit estimates show that effective school-based programs could save $18 for every $1 spent on these programs.

1.3. Conclusion
The cost of substance abuse could be offset by a nationwide implementation of effective prevention policies and programs. SAMHSA’s Strategic Prevention Framework should include a planning step that considers cost-benefit ratios. Communities should consider a comprehensive prevention strategy based on their unique needs and characteristics and use cost-benefit ratios to help guide their decisions. Model programs should include data on costs and estimated cost-benefit ratios to help guide prevention planning.

To download a free copy of this report, click here.