1. Presented by: Marvis Doster, RN CARN

2. Objectives 1) Understand the correlation between abuse of alcohol and risky sexual behavior 2) Utilize assessment skills and tools to identify problem drinking 3) Develop awareness of referral sources available to address alcohol abuse

3. How prevalent is alcohol use? Adolescents 44% of middle school and 73% of high school students have had at least 1 drink sometime in their life 30% of high school students report binge drinking in the past 30 days Low perceived risk of harm in binge drinking(12.5% -none, 27% - slight, 33.8%- moderate, 26.7%- great)

4. How prevalent is alcohol use? Adults ND is #1 among all states for binge drinking among individuals 18 and over College age venues: Fraternity residences, dormitories reported the highest rates of binge drinking. What if you DON’T Drink? Second-hand effects – insulted humiliated pushed, hit or assaulted unwanted sexual advances sleep or study time interrupted caring for a drunken student

5. Drinking Contexts Adolescents: Homes of friends or acquaintances Outdoor settings like parks, beaches or sport stadiums In moving cars or trucks At school or work Own home Bars or restaurants

6. Sexual Abuse and Unsafe Sex 97,000 students between 18 and 24 are victims of sexual assault or date rape 400,000 students engaged in unprotected sex as a direct result of their drinking Over 100,000 students have reported being too drunk to know whether or not they consented to having sex

7. How does alcohol affect the brain and the choices we make? Alcohol acts directly on the brain to: 1)Reduce inhibitions 2)Diminish risk perception 3)Exaggerate sexual performance expectations 4)Provides an excuse for socially unacceptable behavior

8. Conservative estimates of sexual assault prevalence suggest that 25% of American women have experienced sexual assault, including rape. Approximately ½ of those cases involve alcohol consumption by the perpetrator, the victim or both

9. Effect of alcohol on sexual behavior People under the influence of alcohol are more likely to: Have multiple sex partners Engage in unprotected sex Select high-risk partners Exchange sex for money, drugs and alcohol More likely to engage the services of a prostitute

10. Other effects of alcohol on sexual behavior Increased incidence of Sexual Assault Distorted accounts of the events because both the perpetrator and the victim have been drinking heavily Increases likelihood for date rape while excusing the perpetrator from responsibility for their behavior in their own perception

11. Perpetrators Victims Distal FactorsGeneral, heavy alcohol consumption Alcohol expectancies about sex, aggression, and disinhibition Childhood sexual abuse Stereotypes about drinking women being sexually available and appropriate targets Situational Factors Heavy drinkers spend time in bars and at parties Drinking is used as an excuse for socially unacceptable behavior Alcohol’s cognitive impairments reduce ability to evaluate risk Alcohol’s cognitive impairments enhance misperception of the woman’s friendly cues as sexual Alcohol’s motor impairments reduce ability to resist effectively Alcohol’s cognitive impairments facilitate an aggressive response if the man feels he has been “led on”

12. Music and Media: Effects on Sexual Expectations “Alcohol” – Brad Paisley http://www.youtube.com/watch?v=JhEBgnwDH9A “Blame it” – Jamie Foxx http://www.youtube.com/watch?v=rfjtpp90lu8&a=o5K_ 2ptay0U&playnext_from=ML http://www.youtube.com/watch?v=rfjtpp90lu8&a=o5K_ 2ptay0U&playnext_from=ML “Why don’t we get drunk” – Jimmy Buffet http://www.youtube.com/watch?v=9wFpvRMIIEM “Baby it’s cold outside” – Rod Stewart and Dolly Parton http://www.youtube.com/watch?v=9frFggnz4P0

13. Assessment tools Rethinking Drinking (handout) What are symptoms of an alcohol use disorder? Pamphlet available online in PDF format at http://rethinkingdrinking.niaaa.nih.gov/

14. Assessment tools C.A.G.E. Assessment C=Cut down Have you ever felt that you should cut down on your drinking? A=Annoyed Have people annoyed you by criticizing your drinking? G=Guilty Have you ever felt bad or guilty about your drinking? E=Eye opener Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

15. Prevention www.highriskhigh.org Developed in ND – resources for prevention for parents, teachers, and youth. Testimonials included. http://www.nd.gov/dhs/services/mentalhealth/preventi on.html ND Resources for prevention.

16. Resources www.niaaa.org National Institute on Alcohol Abuse and Alcoholism www.niaaa.org www.samhsa.org Substance Abuse and Mental Health Services Administration www.samhsa.org www.collegedrinkingprevention.gov/ rgerhardt@btinet.net Rebecca Gerhardt, Safe Communities Coordinator Dacotah Foundation, Bismarck ND rgerhardt@btinet.net www.childtrends.org Publication: What works for older youth during the transition to adulthood, Hadley, et al www.childtrends.org

17. Guilt-Based Anti-Alcohol Ads Can Backfire “ A better approach might be to educate the public about the negatives associated with drinking but link that message to one of empowerment. If you’re going to communicate a frightening scenario, temper it with the idea that it’s avoidable.” --Adam Duhachek www.jointogether.org