1 Teens, Young Adults, Substance Abuse and Employment 2009 National Youth Build Learning Exchange Atlanta, Ga. Travis Fretwell, MAC, NCACII, CCS TCJA Resolutions Lilburn, Georgia

2 Social Use is: Using to the point of increased interaction. Easy to limit use Not about drinking to get drunk

3 Drug Abuse is: physical, psychological, economic, legal, or social harm to the individual user or to others affected by the drug users behavior.

4 Drug Intoxication is: A consequence of excessive consumption of a drug Usually disruptive changes in physical and psychological functioning, mood and cognitive functioning.

5 Addiction is : Addiction is : A chronic brain disease Expressed as compulsive behavior Expressed within a social context Prone to relapse Treatable

6 What the Research Tells Us - Epidemiological Knowledge Consequences go up as severity increases from use to multiple substance use, abuse, and dependence. Substance use disorders typically on-set during adolescence and last for decades. The earlier the age of onset, the longer the course of substance use The earlier treatment is received, the shorter the course of substance use Marijuana has become the leading substance problem Less than 1 in 10 adolescents with substance abuse or dependence problems receive treatment Over 88% are treated in the public system Source: Michael Dennis, Ph.D., Chestnut Health Systems, November 2005

7 Age of First Use Predicts Dependence an Average of 22 years Later Source: Dennis, Babor, Roebuck & Donaldson (2002) and 1998 NHSDA Tobacco, OR=1.3*, Pop.=151,442,082 Alcohol, OR=1.9*, Pop.=176,188,916 Marijuana, OR=1.5*, Pop.=71,704,012 Other, OR=1.5*, Pop.=38,997,916 % with 1+ Past Year Symptoms Under Age 15 Aged Aged 18 or older Tobacco: Pop.=151,442,082 OR=1.49* Alcohol: Pop.=176,188,916 OR=2.74* * p<.05 Marijuana: Pop.=71,704,012 OR=2.45* Other Drugs: Pop.=38,997,916 OR=2.65*

8 Common Drugs of Abuse/Dep. Marijuana Alcohol Cocaine Methamphetamine Opioids Prescription Meds Inhalants

9 Why Family history Environmental factors Socialization- peer group does it Trauma Don’t recognize the use as a problem Addiction

10 Working With Young People Requires Patience Empathy Staying inform Creativity A sense of humor Ability to motivate while, instilling a since of respect and accomplishment

11 The Stages of Change Model Permanent Exit? Pre-contemplation Contemplation Determination Action Maintenance Relapse?

12 Stages of Change Stage 1 Pre-Contemplation Youth: Not yet considering possibility of change Surprised, not defensive Tasks: Raise doubt; provide information

13 Stages of Change Stage 2 Contemplation Youth: Ambivalent “Yes, but…” considers & rejects change Tasks: Tip the balance in favor of change Build motivation: elicit self-motivational statements

14 Stages of Change Stage 3 Determination Youth: “I’ve got to do something about this?” “What can I do?” Tasks: Take advantage of the window of opportunity Strengthen commitment to change Match to change strategies that is acceptable, accessible, appropriate, effective

15 Stages of Change Stage 4 Action Youth: Engages in particular actions intended to bring about a change Task: Help client take steps toward change

16 Stages of Change Stage 5 Maintenance Youth: Makes broader changes in life to sustain desired changes Tasks: Identify and develop strategies and skills needed to maintain change

17 Stages of Change Stage 6 Relapse Youth: Return to unwanted behaviors Tasks: Help avoid discouragement Initiate renewal of processes of contemplation, determination and action, without becoming stuck

18 Culture of Addiction Social group where heavy use of drugs is the norm, fun often centers around drug use Dress is: Overly focused on grooming, apperance or not focused on it at all Language is: Grandiose, Drug, Hustling and Cop Related

19 Culture of Addiction Values: Excitement through risk Avoid responsibility Drug first Don’t trust Don’t feel

20 Substance Abuse, Retention and Work Process Improvement Policy/Non-Policy Integrate SA and work Start efforts before the work begins Screen for SA/MH issues and refer to treatment It is about the relationship Use rewards/incentives Sanctions- treatment is not a sanction Be creative Identify what matters Engage community- i.e. churches, Schools, leaders

21 Employed vs. Unemployed Youth An estimated 33.7 percent of youths aged 15 to 17 were employed either part or full time during the past week Employed youths were more likely than youths who were not employed to have used alcohol (35.9 vs percent), to have engaged in binge alcohol use (24.6 vs percent), and to have used an illicit drug (19.4 vs percent) during the past month Youths working 20 or more hours per week were more likely than those working 19 or fewer hours per week to have drunk alcohol (41.1 vs percent), to have binged on alcohol (29.0 vs percent), and to have used any illicit drug (22.3 vs percent) during the past month Source: NSDUH Report SA Use & Employment Youth 15-17, 2006

22 Hours of Youth Employment Source: NSDUH Report SA Use & Employment Youth 15-17, 2006

23 The Big Picture

24 It takes a Village Involve the community Work collaboratively with other agencies Find out what has worked in the past Share information with other locations Be creative when working with and dealing with families and peers Families are the greatest natural support

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26 Effectiveness of Treatment 40-60% Drug UseCrimeEmployment 40-60% 40% Source: National Institute on Drug Abuse July 2006

27 Teens, SA & Employment Q&A