1. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Current Substance Use Among California Secondary Students Results of the 2007/08 12 th Biennial California Student Survey Drug, Alcohol and Tobacco Use Greg Austin, PhD, and Rod Skager, PhD WestEd January 23, 2009, Governor’s Prevention Advisory Council

2. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 What is the CSS? Biennial survey of substance use and other risk behaviors among California secondary students, since 1985 Office of Attorney General legislatively mandated to conduct (1991) Co-sponsored by Dept. of Alcohol and Drug Programs and California Dept. of Education Controlled administration (by contractor) Representative state sample; random schools/classrooms School/student participation voluntary, with parent consent Approved by state Committee for Protection Human Subjects

3. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 What is the CSS? Source of items on the California Healthy Kids Survey Fully integrated with other CHKS content in 1999 (aka “The biennial statewide CHKS”), to provide state norms for local comparison — Enabled joint administration by 43% of schools, nearly same as 2005 (40%) — Has improved recruitment efforts.

4. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Sample 13,930 students, grades 7, 9, & 11 48 middle and 68 high schools (including 10 continuation) Race/ethnicity consistent with prior surveys % males increased, gender controlled by weighting

5. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Consent Passive parental consent allowed since 2005 if required policies adopted by school board* — 78% of school adopted, vs. 56% in vs. 58 and 62% previously Evident Effects — Increased student response rate: 78%, same as 2005-06 vs. 58 and 62% previously — Increased participation by males — No meaningful differences in 2005, written vs. passive schools *Ed Code 519381b — applies only to grade 7 and above

6. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Content – 2007 Modifications Modified to comply with SAMHSA requirements for collecting National Outcome Measures (NOMs) — Entailed significant content changes, including: (1) deleting questions to make room; and (2) replacing/modifying similar questions Expanded frequency options to better identify experimenters vs. heavy users Expanded gambling questions for ADP Office Reduced 7th grade instrument, based on feedback

7. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 NOM’s Changes — Perceived HARM (frequent, occasional) deleted and replaced by NOM’s question on perceived risk — Friends’ disapproval of respondent AOD use replaced w/ respondent disapproval of friends’ use — Same change made for disapproval of possession of weapons Additions — Likelihood would work for employer that conducts drug tests — Talked w/ parents about dangers of ATOD use — Exposure to messages about ATOD use — Age of onset of alcohol, cigarettes, smokeless tobacco, marijuana, other drug (Added 2006)

8. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Changes - Lifetime ATOD Use Expanded substances and made separate question on recreational use of pharmaceuticals (high school only) — Based on 2004 data showing almost 15% of 11 th graders had used prescription painkillers — Added cold/cough medicines, diet pills, and Ritalin/Adderal Use frequency options increased from 4+ to 7+ times — To better identify regular users Deleted use of cocaine, LSD, and ecstasy in 7th grade because so low

9. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Issues in Interpreting Results Ability to assess 2005-07 trends severely restricted by changes to instrument: — NOMs — 6-month alcohol use vs. specific beverage — Expansion of frequency options appears to have increased prevalence rates. Did not occur in unchanged items. Report focuses on implications of current data rather than between-survey differences. — Changed items treated with extreme caution. Differences do not necessarily reflect change in actual behavior.

10. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Summary of 2005 Results General leveling-off of previous declining trends across grades and substances Most changes small and often inconsistent by grade. — 7th: Slight-to-marginal increases in several indicators — 9th/11th: Changes few and small; most in negative direction, continuing previous declining trend. Rise in drinking/driving one exception *Binge drinking, drunk/sick from drinking, drinking and driving, high on drugs & drunk/high at school, weekly use of alcohol or marijuana

11. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Summary of 2007 Results Prescription pain killers 2 nd to marijuana in 11th & 3 rd in 9 th, just after inhalants All non-mj drugs exceeded by recreational use of cold/cough medicine (“to get high”), and equal to mj in 9 th. Previous levels of substance use underestimated by under-assessing “medicinal” drugs Prevalence rates for unchanged questions stable. No meaningful declines on any measure with exception of methamphetamines in 11 th. Some increases in indicators of heavy/risky use in 11 th

12. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Overall Lifetime Prevalence of Drug Use Lifetime Prevalence *to get high – not for medicinal reasons

13. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Overall Lifetime Prevalence of Drug Use Aggregated Lifetime Categories

14. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Heavy Use Two point percentage increases for experiencing 2 or more AOD dependency-related indicators — 7% for 9 th and 16% for 11 th Three point increases for experiencing 2 or more problems caused by AOD use — 10% for 9 th and 18% for 11 th Lifetime drinking and driving involvement increased in both 9 th and 11 th to the highest levels in past 6 years — 23% for 9 th and 32% for 11 th

15. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 2 Plus Problem and Dependency Indicators* *Of 11 Social, Personal, and Educational Problems and 7 Indicators based on DSM-IV Dependency Criteria

16. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08

17. Analysis Using DSM Criteria DSM DEPENDENCY CRITERIA (Meets 3): Evidence of Tolerance to Use [1 question] Lack of Use Control [1 of 2 questions] Time-consuming Substance Use Lifestyle [1 question] Important Activities Given Up/Reduced [1 question] Persistent or Recurrent Physical or Psychological Problems [1 of 2 questions] Use Cessation or Reduction Efforts [1 of 4 questions]

18. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Two Positive Findings Increases for students (1) attempting to stop drinking and (2) believing school would provide help to stop use

19. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Conclusions Despite problems with trend assessment, confirms 2005 conclusion that previous declining trend is over. — Prevention efforts may be bottoming-out Heavy use persistent problem. Early identification and intervention with high-risk students essential. — In an average 11th-grade classroom of 35 students: 5-6 students may be in need of some intervention 3 need counseling or even treatment

20. 12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Conclusions (cont.) New data on prescription and OTC drug use red-flag for targeted prevention efforts and warning that may be underestimating drug use among adolescents. Reversal of previous declines in drinking and driving another warning against complacency.