Substance Abuse Prevention Briefing Community Anti-Drug Coalitions of America

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Substance Abuse Prevention BriefingCommunity
Anti-Drug Coalitions of America
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Ignoring Drug and Alcohol Prevention Is Costly

• The economic cost of drug, alcohol and tobacco
  abuse in the United States is more than 500
  billion.1
• Drug, alcohol and tobacco use currently cost
  schools throughout the country an EXTRA 41
  billion per year in truancy, violence,
  disciplinary programs, school security and other
  expenses.2

1National Institute on Drug Abuse. (2006). NIDA
InfoFacts Treatment Approaches for Drug
Addiction. Available http//www.drugabuse.gov/Inf
ofacts/treatmeth.html 2U.S. Department of
Health and Human Services and Education and
SAMHSAs National Clearinghouse for Alcohol and
Drug Information. (2002). Prevention Alert.
Schools and Substance Abuse (I) It Costs 41
Billion. 5(10). Available http//www.health.org/
govpubs/prevalert/v5/5.aspx.
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Cost/Benefit For Prevention

• Prevention Yields Huge Savings
• Effective substance abuse prevention can yield
  major economic dividends. For every dollar
  invested in prevention between 2.00 to 20.00
  can be saved.1

1 Swisher, J.D., Scherer, J. and Yin, K.
(October, 2004). The Journal of Primary
Prevention. Cost-benefit estimates in prevention
research. 252.
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What the Research Shows To Support the Need For
Prevention

• Drug addiction is a developmental disorder that
  begins in adolescence, sometimes as early as
  childhood, for which effective prevention is
  critical.1
• 1 Quote by Dr. Nora Volkow, Director of the
  National Institute on Drug Abuse

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(No Transcript)
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Increasing the Age of Initiation is Key

• Adolescents who begin drinking before the age of
  15 are four times more likely to develop alcohol
  dependence. Each additional year of delayed
  drinking onset reduces the probability of alcohol
  dependence by 14.1
• Of youth who began drinking before age 15, 40
  were classified as dependent later in life. 2
• Children who first smoke marijuana under the age
  of 14 are more than five times as likely to abuse
  drugs as adults, than those who first use
  marijuana at age 18.3

1 National Institute on Alcohol Abuse and
Alcoholism. (2006). Underage Drinking A Growing
Healthcare Concern. Available http//pubs.niaaa.n
ih.gov/publications/PSA/underagepg2.htm. 2Grant,
B.F., and Dawson, D.A. Age at onset of alcohol
use and its association with DSM-IV alcohol abuse
and dependence Results from the National
Longitudinal Alcohol Epidemiologic Survey. J Sub
Abuse 9103-110, 1997. 3The National Household
Survey on Drug Abuse (NHSDA) report. August 23,
2002. Available http//oas.samhsa.gov/2k2/MJdep
endence/MJdependence.htm
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Peer Drug Use and Lower Test Scores

• Kids Count StudyState of WA1
• Findings link lower test scores to peer substance
  abuse - not to individual student use as one
  might expect.
• Students whose peers had little or no involvement
  with drinking or drugs scored higher on
  standardized tests, while those whose peers were
  involved with drinking or drugs failed to meet
  the requirements of the standardized tests.
• On average, students whose peers avoided
  substance use had test scores (measured by the
  Washington Assessment of Student Learning reading
  and math scores) that were 18 points higher for
  reading, and 45 points higher for math

1 Bence, M., Brandon, R., Lee, I., Tran, H.
University of Washington. (2000). Impact of peer
substance use on middle school performance in
Washington Summary. Washington Kids
Count/University of WA Seattle, WA. Available
http//www.hspc.org/wkc/special/pdf/peer_sub_09120
0.pdf
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According to the 2008 Monitoring the Future (MTF)
results, the number of 8th, 10th and 12th graders
reporting past month illicit drug use has
declined by 25 over the last seven years.
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Perception of Risk and Social Disapproval

• Research demonstrates that illegal drug use among
  youth declines as the perception of risk and
  social disapproval increases.

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12th Graders Past Year Marijuana Use vs.
Perceived Risk of Occasional Marijuana Use
SOURCE University of Michigan, 2008 Monitoring
the Future Study
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• When MTF data is disaggregated, disturbing trends
  are beginning, as attitudes are softening.

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SOURCE University of Michigan, 2008 Monitoring
the Future Study
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Percent Perceiving Great Risk of Smoking
Marijuana Regularly
SOURCE University of Michigan, 2008 Monitoring
the Future Study
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Percent Perceiving Great Risk of Taking Inhalants
Regularly
SOURCE University of Michigan, 2008 Monitoring
the Future Study
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• Softening attitudes generally precede an increase
  in drug use rates by approximately two years.

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Among 8th and 12th graders, there was a decrease
in disapproval of LSD.
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Concurrently, there has been an increase in
past-year LSD use in 8th and 12th graders over
the past three years.
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• Among 10th graders, past 30 day use of marijuana
  has already eclipsed that of tobacco.

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10th Grade, Past 30-Day Use
13.8
12.3
Marijuana
www.pridesurveys.com
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Effective Substance Abuse Prevention Is Unique

• It involves
• Reducing the availability of alcohol, tobacco and
  drugs
• Reducing access to alcohol, tobacco and drugs
• Enforcing consequences for alcohol and drug
  related offenses 
• Changing attitudes and perceptions about the
  dangers and acceptability of alcohol, tobacco
   and drugs
• Changing social norms about alcohol, tobacco and
  drugs
• Raising awareness about the costs and
  consequences of alcohol, tobacco and drugs and
• Building skills in youth, parents and communities
  to deal with these issues effectively.

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The community coalition model has proven
successful in reducing drug use and underage
drinking.
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  Key Players
Coalitions convene and combine talent and
resources to address local substance abuse
issues

• Faith based community
• Civic and volunteer groups
• Health care professionals
• State, local or tribal agencies
• Other organizations involved in reducing
  substance abuse

• Youth
• Parents
• Businesses
• Media
• Schools
• Youth serving organizations
• Law enforcement

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There Is No One Silver Bullet

• Coalitions achieve success when they
• Use local data to make local decisions and track
  outcomes over time and
• Implement comprehensive community plans to
  achieve population level decreases in substance
  use
• No one program or sector is a silver bullet.

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Effective Coalitions Are Data Driven

• Coalitions use the following types of local data
• Youth Surveys
• Police data (e.g., arrests for drug possession
  and trafficking, DUIs, alcohol related crashes
  and fatalities, etc.)
• Emergency room data
• Compliance check data
• Treatment admission data

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DFC Program

• National program, created by Congress in 1997
• Reauthorized in 2001 and again in 2006
• Recognizes the importance of multisector comunity
  coalitions in reducing substance abuse
• Establishes funding for local community
  coalitions (local coalitions can apply for up
  to 125,000 dollars per year for a period of up
  to five years - renewable)

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DFC Program Requirements

• To be eligible to compete for a DFC grant, a
  coalition must
• Have the reduction of substance abuse among youth
  as its principal mission, and must target
  multiple drugs
• Have been in existence for at least 6 months
• Have representation from the each of the 12
  sectors
• Be able to demonstrate through its meeting
  minutes that it functions as a unique entity and
  is more than a group of agency and organization
  representatives or a board of directors of a
  direct service delivery organization
• Coalitions are only eligible to receive as much
  federal funding as they can match, dollar for
  dollar, with non- Federal support, up to 125,000

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• Outcomes for communities with DFC funded
  coalitions are better than national MTF trends.

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Calloway County Alliance Outcomes
In this community, past 30 day use of marijuana
use among 10th graders decreased to 12 in 2006,
a 42.9 decrease since 2002, as measured by the
Kentucky Incentives for Prevention Student
Survey. During this same time frame, according to
MTF, the national rate dropped to 14.2, a 20.2
decrease since 2002.
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Strategies Implemented By Calloway County
Alliance to Achieve Marijuana Outcomes

• Implementing social marketing campaigns
• Implementing extensive local media campaigns in
  multiple venues
• Promoting parent education and
• Taking science-based programs to scale for all
  3rd 8th graders

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Thomas County Coalition Outcomes
?
?
47.5
44.4
2003 2007 ? National MTF Rate (2003)
? National MTF Rate (2007)
In this community, past 30 day use of alcohol
among 12th graders decreased to 33.7 in 2007, a
44.2 decrease since 2003, as measured by the
Kansas Communities That Care Student Survey.
During this same time frame, according to MTF,
the national rate dropped to 44.4, a 6.5
decrease since 2003.
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Strategies Implemented by Thomas County to
Achieve Underage Drinking Outcomes

• Developing and implementing a communitywide
  social norms campaign
• Developing and disseminating educational and
  informational materials throughout the community
• Providing cross-age prevention activities
  throughout the community and
• Implementing a comprehensive youth component to
  address underage drinking

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Old Saybrook Local Prevention Council Outcomes
In this DFC community, annual prevalence of
inhalant use among 10th graders decreased to 5
in 2007, a 68.8 decrease since 1997, as measured
by the Search Institutes Profile of Student
Life Attitudes and Behaviors. During this same
time frame, according to MTF, the national rate
dropped to 6.6, a 24.1 decrease since 1997.
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Strategies Implemented by Old Saybrook Prevention
Council to Achieve Inhalant Outcomes

• Increasing parent training and education
• Developing and implementing public awareness and
  media campaigns and
• Promoting meaningful opportunities for youth
  participation

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Environmental Strategies Are Effective

• The most effective substance abuse prevention is
  comprehensive and community-wide and includes
  environmental and population level strategies
  that are designed to change or strengthen norms
  against alcohol and drug use.
• Environmental strategies involve changes in
  legislation, policy and enforcement throughout an
  entire community.

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Examples of Successful Environmental Strategies
to Deal With Meth

• The CASE Coalition, Bonifay, Florida
• Implemented comprehensive, data driven
  strategies, including
• Providing community-wide meth awareness and
  education presentations
• Initiating anti-meth forums, press releases and
  direct mailings to key business and community
  leaders
• Establishing a local anti-meth advertising
  campaign
• Creating and disseminating a Meth Awareness
  Neighborhood Resource Guide to all households
  within the county
• Establishing and providing support for
  neighborhood watch groups that the Holmes County
  Sheriffs Department identified as the highest
  crime/arrest areas for methamphetamine.

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The CASE Coalitions Outcomes
-63
-80.2
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Cheese An Emerging Drug Trend

• Cheese is a dangerous combination of black tar
  heroin with crushed cold medicine, such as
  Tylenol PM.
• Between 2005 and 2007, approximately 22 youth in
  Dallas, TX died by overdosing on cheese.

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Strategies to Deal With Cheese

• The Greater Dallas Council on Alcohol and Drug
  Abuse, Dallas, TX implemented the following
• Holding conferences to educate students, parents,
  and community professionals about cheese
• Supporting teenager town hall meetings
• Increasing code enforcement and police patrols in
  affected neighborhoods
• Coordinating with treatment providers and police
  to distribute prevention resources
• Working with media outlets to air public service
  announcements and
• Distributing public information bulletins in both
  English and Spanish

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Cheese Outcomes Achieved in Dallas

• The number of cheese related deaths was reduced
  from 22 between 2005 and 2007 to zero since July,
  2007.

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Prevention Efforts Should Continue to Focus on
Environmental and Population Based Strategies

• Effective prevention hinges on the extent to
  which schools, parents, law enforcement,
  business, media, the faith community, the
  recovery community and other community groups
  work comprehensively and collaboratively through
  communitywide efforts to implement a full array
  of education, prevention, enforcement, treatment
  and recovery initiatives, as coalitions do.1

1Treno, A.J. Gruenewald, P.J. Lee, J.P. et al.
(2007). The Sacramento neighborhood alcohol
prevention project outcomes from a community
prevention trial. Journal of Studies on Alcohol
and Drugs. (68)197207. Wagenaar, A.C. Erickson,
D.J. Harwood, E.M. et al. (2006). Effects of
state coalitions to reduce underage drinking A
national evaluation. American Journal of
Preventive Medicine. 31(4)307315. Weitzman,
E.R. Nelson, T.F. Lee, H. and Wechsler,
H.(2004). Reducing drinking and related harms in
college Evaluation of the A Matter of Degree
program. American Journal of Preventive
Medicine. 27187196. Holder HD, Gruenewald PJ,
Ponicki WR, Treno AJ, Grube JW, Saltz RF, Voas
RB, Reynolds R, Davis J, Sanchez L, Gaumont G,
Roeper P. (2000). Effect of community-based
interventions on high-risk drinking and
alcohol-related injuries. Journal of the
American Medical Association, 284(18)23412347.
Hingson, R.W. Zakocs, R.C. Heeren, T. et al.
(2005). Effects on alcohol related fatal crashes
of a community based initiative to increase
substance abuse treatment and reduce alcohol
availability. Injury Prevention. 11(2)8490.
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Sober Truth on Preventing Underage Drinking Act

• The Center for Substance Abuse Prevention (CSAP)
  has built upon the pre-existing infrastructure of
  coalitions by funding community based enhancement
  grants for current and past Drug Free Communities
  (DFC) grantees.

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Why Is This Effective?

• It builds on existing infrastructures with proven
  results that include all of the relevant sectors
  needed to address and decrease underage drinking.
• It is the most cost effective way to leverage
  resources and deal with underage drinking at the
  community level.