Critical Aspects of Vermont ATOD Data John S. Searles, Ph.D. Substance Abuse Research and Policy Analyst

State Epidemiological Workgroup (SEW): Data-Driven Prevention Kelly Hale LaMonda, Chair

x = {q + [q 2 + (r-p 2 ) 3 ] 1/2 } 1/3 + {q - [q 2 + (r-p 2 ) 3 ] 1/2 } 1/3 + p where p = -b/(3a), q = p 3 + (bc-3ad)/(6a 2 ), r = c/(3a) And The Mathematical Basis of Data Analysis

The Mathematical Basis of Data Analysis - Explained "Reports that say that something hasn't happened are always interesting to me, because as we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns -- the ones we don't know we don’t know.” –Donald Rumsfeld, Feburary 12, 2002

State Epidemiological Data Systems (SEDS) Key constructs (e.g., mortality) and indicators (e.g., motor vehicle crash deaths) related to substance use and consequences by type (alcohol, tobacco, illicit drugs) Contains data available from national sources only (at lowest level available) (e.g., YRBSS, FARS, UCR, NVSS, NSDUH) Downloadable zip files of State data

Using Epidemiological Data Some Problems State Epidemiological Data Systems (SEDS) [From CSAP] –Not up-to-date –Not complete –Sometimes not relevant to Vermont

Using Epidemiological Data Other State Sources Distribution of population (geographic, age) Local crime data (DUI by County) Treatment data Hospital discharge data OMG Factor ICD-9/10 Codes No standard or uniform coding procedures $ not #

“Drill Down” Data Sources BRFSS –Data Limitations for year olds YRBS –County –SU –School –Limited to students in school

Gaps year olds –Students –Non Students –BRFSS does not sample cell phone users –10% of all households are now wireless Prescription Drug Abuse Data Lags –Looking at “Rapid Response” options

TOBACCO

Current Smokers in Vermont (BRFSS)

Current Smokers in Vermont YRBS

Binge Drinking in VT BRFSS by County and Age Group

ALCOHOL

Past 30-Day Use of Alcohol YRBS

Past 30-Day Binge YRBS

MARIJUANA

Past 30-Day Marijuana Use YRBS

Past 30-Day Mja Use by Grade and Gender - YRBS

OTHER DRUGS ( Including Prescription Drugs of Abuse)

YRBS Drug Use

CocaineHeroinMethamphetamineHallucinogens County Addison Bennington Caledonia Chittenden Essex Franklin Grand Isle Lamoille Orange Orleans Rutland Washington Windham Windsor

Illicit Drug Use National Survey on Drug Use and Health

Treatment for Opiate Addiction (Other than Heroin)

Surrogate Indicators

DOC by Age and County

Robbery Crime Rate

Prescription Drug Abuse I

Prescription Drug Abuse II

Prescription Drug Abuse III

Indicator of Increasing Problems with Potential Drugs of Abuse FACT: From 2001 to 2005, DEA drug arrests in Vermont went from 15 to 56 INTERPRETATION: There is an increasing problem with prescription drugs in Vermont

DEA Arrests in Vermont

$400 $600 $800 $1000 $200 $400 $600 $800 $1000 $200 $400 $600 $800 $1000 $200 $400 $600 $800 $1000 $200 $400 $600 $800 $1000 $200 Torturing the Data History of VDH Obscure Milwaukee Brewers Evidence- Based Prevention Programs Intervening Variables

“I’ll take ‘Torturing the Data’ for $1000, Alex”

DEA Arrests in Vermont

Phase 1 Prioritization Process- Phase 1 – Identify consequence and consumption data – Analyze & interpret according to certain dimensions Size/Magnitude (numbers/frequencies, rates) Impact (depth of problem across dimensions; social costs are high) – Determine epidemiological data priorities

Assessing Burden and Determining Substance-Related Problems Use criteria of burden to describe features of the data such as –What is the size of the problem? –What do rates of the problem look like? –Who is affected? –What is the geographic distribution? –What do trends over time look like? –How serious is the problem?

Assessing Burden and Determining Substance-Related Problems The most influential criteria used by the SEW to identify statewide priorities were: Vermont’s ranking relative to other states Relative prevalence within Vermont Trends

Consumption and Consequences Alcohol Illicit Drugs Tobacco

2005 Youth Risk Behavior Survey Ever Used Among 9-12th Graders

Past Month Binge Alcohol Use

Past Month Use of Marijuana

Percent of Vermont 12th Graders Who Rode or Drove Under the Influence of Alcohol or Marijuana Vermont Youth Risk Behavior Survey

Recommendations The most influential criteria used by the SEW to identify statewide priorities were: Vermont’s ranking relative to other states Relative prevalence within Vermont Trends

Epi Workgroup Preliminary Recommendations Workgroup decided to recommend that the Advisory Council focus on: Alcohol misuse across the lifespan Driving under the influence of marijuana

SES by County Less than HSHSAttended College Addison6.0%28.3%65.7% Bennington9.4%26.2%64.4% Caledonia9.4%31.5%59.1% Chittenden5.7%20.2%74.2% Essex12.6%51.4%36.0% Franklin7.9%37.1%55.0% Grand Isle10.3%33.9%55.7% Lamoille9.7%29.1%61.1% Orange7.8%29.0%63.2% Orleans8.6%38.3%53.0% Rutland8.8%30.3%61.0% Washington6.5%23.8%69.6% Windham8.0%28.4%63.6% Windsor7.1%24.8%68.0% From 2005 YRBS

Surrogate SES and Consumption YRBS

DOC Census 10/06

Parental Attitude and Drinking

Grades and Drinking

Binge Drinking Year Olds

DUI Among Year Olds in VT

Heavy Drinking in VT

Calculations for CIs

Calculating CIs

Final Recommendations Reduce underage drinking Reduce high-risk drinking among persons under 25 Reduce marijuana use among persons under age 25 Build prevention capacity and infra- structure at the state and community levels, including a sustainable evaluation system for prevention grantees.

THE END

Questions?