2. THE GOOD NEWS/ AOD USE IN YOUTH - 2013 Cigarette and alcohol use among 8 th,10 th and 12 th graders, are at the lowest point since 1975. Five-year trends show significant decreases in alcohol use among nearly all grades and across all prevalence periods. Binge use of alcohol declined among 8 th, 10 th and 12 graders over the past year. In 2013, there was an increase in perceived risk of smoking among 8 th, 10 th and 12 th graders. The use of inhalants continued its decline among individuals in 8 th, 10 th, and 12 th grades.

3. THE BAD NEWS/ AOD USE IN YOUTH - 2012 Alcohol & other drugs are readily available. One out of 2 seniors has tried an illicit drug; 7 out of 10 have used alcohol at some time. Students as young as those in grades 3 and 4 have used alcohol and tobacco; many even younger have been exposed to illicit drugs by peers, older siblings and parents. Five-year trends show significant increases in marijuana use, which now exceeds tobacco use. After marijuana, prescription OTC medications account for most of the illicit drug use by teens.

8. Cumulative alcohol and marijuana initiation, by age: Seattle Social Development Project, 1985-93. Percent Am J Pub Health, 90(3): 361, 2000

9. Alcohol use is a serious problem.

10. Prevention Works It Takes A Village

11. What is Prevention? Prevention is the sum of our actions to ensure healthy, safe and productive lives for all our children and families. (CSAP) Universal Selective Indicated

16. Drinking Alcohol as a Function of Parental Monitoring 9th Graders: 5+ Drinks in a Row Patterson, et al, Child Development 55: 1299, 1993

17. The Impact of Addiction on Children and Families

18. National Longitudinal Alcohol Epidemiologic Survey - 1992 7.4% of adults classified with DSM-IV alcohol abuse or dependence in past year. 18% of adults classified with lifetime DSM-IV alcohol abuse or dependence 9.7 million children living in households with 1 or more adults who were abusing or dependent on alcohol B F Grant, AJPH; 90 (1):112-115; 2000

19. National Longitudinal Alcohol Epidemiologic Survey - 1992 1 in every 4 children in the US exposed to alcohol abuse or dependence in the family. The number.. “defines one of today’s major public health problems.” “Children exposed through no fault of their own..are thrust into families and environments that pose extraordinary risks to their immediate and future well-being and threaten the achievement of their fullest potential. BF Grant, AJPH; 90 (1):112-115, 2000

20. Detection of Alcoholism in Hospitalized Children and Their Families Duggan AK, Adger H, McDonald EM, Stokes EJ, Moore R AJDC, 145:613-617, 1991

21. Comparison of Adolescents by Household Screening Status

22. Despite feeling a responsibility to inquire about AOD in patients and families there appears to be a cultural ambivalence and a lack of skills in doing so. 0% Recognition by housestaff 1 Positive case identified by faculty

23. Why Care About Prevention, Screening, Brief Intervention and Referral to Treatment ? Adapted from Broadening the Base of Alcohol Treatment (IOM) Primary Prevention (Intensive for High Risk) Abstinence Infrequent use Problem users - Abuse Dependence Brief Intervention Specialized Treatment Referral Challenges Drug Involvement

24. Drug Abuse is a preventable behavior. Drug Addiction is a treatable disease. Partnership for a Drug-Free America