1. Substance Abuse Problems in the Community

2. Drug Use – Costs to Society  160 billion dollars spent in 2000  Substance abuse treatment and prevention  Health care costs  Reduced job productivity/lost earnings  Crime and social welfare

3. Consequences of Drug Use  Drug related deaths – 1979 3.2/100,000, 1998 6.3/100,000  Drug related emergencies are increasing  Spreading of infectious diseases  Homelessness  Workplace productivity adversely affected

4. National Survey on Drug Use and Health Statistics  Primary source of statistical information on illicit drug use  12 years of age and older  Conducted periodically since 1971; annually since 1990  22 million Americans are classified with substance dependence or abuse (2002)

5. Marijuana Use  Perceiving marijuana as a great risk is associated with less marijuana use  Teens Partnership Attitude Tracking Study (PATS) teens are increasingly aware of dangers (2003) 19% compared to (1998) 16%  Trend of use has decreased showing us that education matters

6.  Thirteen states have passed legislation allowing the medical use of marijuana.

7. Monitoring the Future 2002-2003  Drug use among 8 th, 10 th, and 12 th graders is decreasing – marijuana, ecstasy, cigarettes, alcohol – some still remain high  Only significant increase was crack use – 10 th graders, and sedatives in 12 th graders  Heroin use is stable – 1%  Any illicit drug – past month use – 17.3%

8. Heroin Use  Heroin is replacing crack as drug of choice  80% pure and sells for $4 a bag  In Boston area, number of emergency room treatments doubled from 2002-2003  www.npr.org/featiresfeatire/[j[?wfld =1688762

9. Why be concerned? It’s just experimentation  Large percentage of student do remain drug users  60% of children who tried cocaine and LSD are still using drugs at graduation  Person who smokes marijuana is 85 times more likely to try cocaine  Earlier that you initiate drug use, more likely to develop a drug problem later in life

10. Identification of Risk and Protective Factors  Risk factors – the most crucial ones are those that influence a child’s early development within the family  Protective Factors – strong bonds and clear rules of conduct; strong bonds with family, schools, and religious institutions

11. National Drug Control Strategy Goals  Two year goals – 10% reduction in current use of illegal drugs by the 12-17 year old age group  10% reduction for those 18 and over  Five year goals – 15% reduction by adults and 12-17 year old age group

12. National Priorities  Stopping drug use before it starts  Healing America’s drug users  Disrupting the market

13. Stopping drug use before it starts  Student drug testing (new for 2004)  Media campaign  Drug-free communities program

14. Healing America’s Drug Users  Over 19 million Americans still use drugs on a monthly basis  Increase in treatment by 9.6% overall for 2005  Access to Recovery provide drug treatment to individuals otherwise unable to obtain access to services

15. Treatment Efficacy  10,000 clients in community bases programs in 11 cities compared before and after treatment  Reductions in weekly uise of heroin, cocaine, marijuana, illegal behavior, improvements in employment status  One year follow-up and five year drug treatment outcome study

16. Disrupting the Market  Attacking the economic basis of the drug trade  Availability at a low price does matter  Drop in availability may be a spur to enter drug treatment  Disrupting the markets at home  Disrupting the markets at the source country

17. Alcohol Impaired Driving  Alcohol-related motor vehicle crashes kill someone every 30 minutes and nonfatally injure someone every two minutes (NHTSA 2003)  During 2002, 17,419 people in the U.S. died in alcohol-related motor vehicle crashes, representing 41% of all traffic-related deaths (NHTSA,2003)  Drugs other than alcohol (e.g. marijuana and cocaine) have been identified as factors in 18% of motor vehicle driver deaths. Other drugs are generally used in combination with alcohol (NTHSAm2003

18. Legislative efforts to reduce alcohol impaired driving  National Minimum Drinking Age – all states have enacted age 21 (1998)  Reduce 700-1000 deaths each year for the past decade  Zero tolerance – limits of zero to.02 percent blood alcohol for persons under age 21  First 12 states adopted this – 20% decline in crashes of drivers under 21

19. Legislative efforts to reduce alcohol impaired driving cont’d  Administrative license revocation – police officer can confiscate a driver’s license if blood alcohol exceeds legal limit in 40 states – 5% decline in fatal crashes  Laws to deter repeat offenders – actions for treatment, probation

20. Alcohol Control Policies  Increases in beer taxes – associated with drop in fatality rates (.9%)  Server training – Oregon – helped to reduce amount of alcohol consumed – single vehicle, night time crashes likely to involve alcohol dropped by 23% after three years

21. Individual Actions  Designated drivers  Personal interventions (requests from friends, family members)  Safety belt laws

22. Effective measures to reduce fatalities  Promptly suspending drivers license of people who drive while intoxicated (DeJong, 1998)  Lowering the permissible levels of blood alcohol concentrations (BAC) for adults to.08% in all states  (Shults, 2001)  Zero tolerance laws for drivers younger than 21 years old in all states (Shults, 2001)  Sobriety checkpoints (Shults, 2001)  Multi-faceted community-based approaches to alcohol control in DUI prevention (Holder, 2000,DeJong, 1998)  Mandatory substance abuse assessment and treatment or driving under the influence offenders (Wells-Parker,1995)

23. What does it take to impact this problem area?  Comprehensive approaches that mobilize the community  Explain the research base to community  Use pre-existing community support and coalitions for rapid implementation of policy and interventions  Community leaders support  Use community events/media

24. Prevention Programs  Universal – reach the general population  Selective – target groups at risk or subsets of the general population (children of drug users or pool school achievers)  Indicated programs – designed for people who are already experimenting with drugs or exhibit other risk-related behavior

25. Prevention Principles  Enhance protective factors and reverse risk factors  Target all forms of drug abuse  Should be age specific, culturally sensitive  Family focused programs  Should include a component that equips parents to reinforce anti-drug norms  Should address specific problems in the local community (NIDA Notes, 2000)