Transcript Binge Drinking Presentation to Safe and Healthy Kids

Adolescent Binge Drinking:
Trends, Implications, and
New Directions for Schools
Presented by:
Joël Phillips
Community Prevention Institute (CPI)
Colusa County Office of Education
February 16, 2005
Issues
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What constitutes excessive alcohol consumption?
Is there a problem with excessive alcohol use among
California adolescents?
If so, to what extent?
Are there disparities to address?
What are the consequences of excessive alcohol
consumption?
What can we do?
What is Excessive Alcohol
Consumption (Binge Drinking)?
General
Binge (high risk) drinking is the consumption of alcohol to
the extent that harmful consequences – health,
academic, legal and others – may be expected.
Specific (Recent NIAAA definition)
A “binge” is a pattern of drinking alcohol that brings the
blood alcohol level concentration (BAC) to 0.08 or above.
For the typical adult, this pattern corresponds to
consuming 5 or more drinks (male), or 4 or more drinks
(female), in about 2 hours.
A “drink” refers to half an ounce of alcohol (e.g., one 12oz. beer, one 5 oz. glass of wine, or one 1.5 oz. shot of
distilled spirits.)
Dimensions of the Problem
Table 1. High Risk Drug Use & Excessive Alcohol Use
91-92*
(%)
93-94
95-96
97-98
99-00
01-02
02-03
Grade 9
Excessive Alcohol Users (EAU)
18.5
21.0
23.3
19.4
16.4
17.1
14.3
High-Risk Drug Users (HRU) a
11.4
21.2
20.2
20.3
11.0
10.4
9.3
Total EAU or HRU
22.0
29.1
28.5
29.5
19.4
20.0
17.4
Excessive Alcohol Users (EAU)
27.5
29.2
31.3
30.8
33.9
32.4
29.9
High-Risk Drug Users (HRU) a,
17.6
26.6
26.8
26.9
20.7
21.3
17.3
Total EAU or HRU
32.5
37.8
38.4
38.6
37.6
35.7
33.6
Grade 11
a
Refers to drug use in the past six months only. *Passive parent consent required for participation; starting in 1995, active (written)
consent was required.
Excessive Alcohol & High-Risk Drug Users
Grade 11
60
50
40
30
20
10
0
199192
199394
199596
199798
199920
200102
200203
Excessive Alcohol Users (EAU)
High-Risk Drug Users (HRU)
Trend Data Results
The trend data in Table 1 supports several conclusions:
1. High rate use of alcohol or drugs by California students
increases significantly in the middle and high school years.
2. Despite the emphasis on alcohol and drug prevention in
schools, the percentage of students who report high use rates
for alcohol or other drugs has been relatively constant over the
last decade; 2002-2003 EAU and HRU rates are nearly the
same as the 1991-1992 rates.
3. Excessive alcohol use is more prevalent than high risk drug
use.
4. A substantial percentage of California secondary school
students report that they are high rate users.
Binge Drinking
Table 2. Frequency Consumed Five or More Drinks in a Row, Past 30 Days
Grade 7
Never
Grade 9
Grade 11
19992000
20012002
20032004
19992000
20012002
20032004
19992000
20012002
20032004
(%)
(%)
(%)
(%)
(%)
(%)
(%)
(%)
(%)
94.2
97.2
96.3
86.7
86.6
88.5
73.8
73.7
76.7
1+ days
5.8
2.8
3.7
13.3
13.4
11.5
26.2
26.3
23.3
3+ days
1.7
1.0
1.3
6.1
7.2
5.1
14.2
14.0
12.2
10+ days
0.9
0.6
0.6
2.5
2.4
1.9
4.5
5.1
4.2
• By the 11th grade, approximately one fourth of the student sample reported
binge drinking at least once in the last 30 days.
• Approximately 12 percent of 11th graders binged 3 or more days in the past
month.
Binge Drinkers and Problem Behavior
Table 3. Other Alcohol-use Correlates of Binge Drinking, 11th Graders, 2003 CSS
Total
Sample
Binge Drank,
Past 30
Days
Non-binge
Drinker, 30
Days
No Alcohol,
30 Days
7.0
21.2
4.1
2.2
Was drunk 3 or more times
19.6
56.8
20.9
6.2
Drink/drive episode, 3 or more
12.5
32.4
14.6
5.8
Fight between groups, year
17.7
29.5
20.4
12.7
Used weapon to threaten, year
8.6
17.1
11.3
5.9
Been in a gang, ever
9.2
15.8
10.4
7.5
Relationship violence, year
8.2
14.9
7.9
6.4
Likes to get really drunk
• Binge drinkers are much more likely to put themselves and others in harm’s way through being
intoxicated and through drinking and driving.
• Binge drinkers are more likely to be involved in gangs and potential violence than students
who do not binge.
• Binge drinkers are more likely to be involved in relationship violence, an issue of particular
relevance to Student Assistance Programs (SAPs).
Binge Drinkers and School Behavior
Table 4: Binge Drinking and School Behaviors
Non-binge
Drinker, 30
Days
Total Sample
Binge Drank, Past
30 Days
No Alcohol,
30 Days
Used alcohol at school, past 30 days
8.0
23.6
5.9
2.8
Drunk/high at school, 3 or more times
12.1
30.4
11.5
5.7
Physical fight at school
20.5
32.2
30.6
14.7
Taken a weapon to school
13.0
23.1
13.6
9.2
Damaged school property
17.8
31.2
20.1
13.2
Skip school/cut class (ever)
60.3
82.9
54.2
50.9
Skip school/cut class (“few times” or
more)
39.3
60.7
33.0
29.8
Low school connectedness
21.0
26.3
19.4
19.3
School-related Alcohol Use
School Violence (Year)
School Behavior
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Much more likely to use substances at or before school, and to be under the influence of substances at school;
Somewhat more likely to engage in violent or destructive behavior at school;
Much more likely to skip school or cut class; and
Tend to have lower connectedness to school.
Other Behaviors that Go Hand-in-Hand with
Excessive Alcohol Consumption
Youth with serious alcohol problems (approximately 9% of CA males and females
ages16 to 17):
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11 times more likely to have serious problems with other drugs
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10 times more likely to drink and drive
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4 times more likely to be arrested
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2 times more likely to have a C average or lower and are likely to miss twice as
much school
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2 times more likely to smoke
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1.5 times more likely to require hospital emergency care
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5 times more likely to commit suicide
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4 times more likely to get into a serious fight
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3.5 more times more likely to carry a weapon
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3 times more likely to have a conduct disorder
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3 times more likely to be hospitalized with a mental health problem
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2 times more likely to get into an accident, injure another person or themselves
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Almost twice as likely to have multiple sex partners
(Source: George Washington University Medical Center)
Other Consequences
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Binge drinking in high school, especially
among males, is strongly predictive of binge
drinking in college. (NIAAA)
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Young persons who begin drinking before
age 13 are four times as likely to develop
alcohol dependence and twice as likely to
develop alcohol abuse as those who begin
drinking at age 21. (National Longitudinal
Alcohol Epidemiologic Survey)
Long-Term, Heavy Use of Alcohol
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Significant shrinking of the brain
50-70% show cognitive impairment
Effects remain even after detoxification and
abstinence
Alcohol dementia is the 2nd leading cause of
adult dementia
Alcohol Hijacks the Brain’s Reward
Circuitry
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Continued use of alcohol reduces the brain’s
dopamine production.
Because dopamine is part of the reward
system, the brain is “fooled” that alcohol has
survival value for the organism.
The reward system responds with “drug
seeking behaviors.”
Craving occurs and, eventually, dependence.
Adolescents with a History of
Extensive Alcohol Use
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Decrease in hippocampus by 50%
(hippocampus converts information to
memory).
Decrease in brain activity during memory
tasks.
Increase in brain activation when shown
alcohol images (trigger for relapse).
Adolescents Are More Susceptible to
Alcohol Than Adults
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Reduced sensitivity to intoxication
Increased sensitivity to social disinhibitions
Greater adverse effects to cognitive
functioning
Medicates “excitability”
Gender Discrepancies
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Underage youth saw more alcohol advertising than
adults, on a per capita basis, in magazines in 2002.
Girls were even more overexposed to this
advertising than boys (Archives of Pediatrics &
Adolescent Medicine, 2004).
In 2002, MTF found that eighth- and 10th-grade girls
surpassed boys for the first time as current drinkers.
In 2003, CDC found that more girls consume alcohol
than boys and they binge drink more often.
An AMA poll found that the average age of a girl’s
first drink is now 13.
Why Worry About Girls?
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Girls tend to feel the impairing effects of alcohol
much faster than males.
Effects include liver, brain and heart damage as well
as gender-specific complications such as increased
chances of breast cancer, osteoporosis, menstrual
disorders and pregnancy.
Relationship violence.
Sexual assault and date rape.
Unplanned and unprotected sex.
Fetal alcohol syndrome.
What Can We Do?
1.
Recognize there is a serious problem with binge drinking in our
schools and communities.
2.
Increase awareness/knowledge of consequences of underage
binge drinking by sharing information with health care providers
and educators, teachers, administrators, business leaders, public
officials, community advocates, parents, and students. Utilize
existing infrastructure of local coalitions if possible.
3.
Examine local prevention/intervention services for alignment with
best practice strategies.
4.
Modify existing services as needed. CPI can provide no-cost
technical assistance and training.
Paradigm Shift Away from Blaming
Youth
Youth are not the primary producers,
promoters, distributors, sellers, or users
of alcohol
...ADULTS AND ADULT BUSINESSES ARE
[adult drinkers / brewers, distillers & wine
producers / bars, taverns, restaurants / mass
media / advertising / merchants / etc.]
Journal of Adolescent Health
(Oct. 2004)
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Reports on a study that concludes parents strongly
influence their children’s drinking behavior.
Teens were twice as likely to binge drink and use
alcohol within a 30-day period if their parents or
friends’ parents provided alcohol at their homes for a
party.
Parents who set strict consequences for breaking
the house rules regarding drinking can help prevent
underage drinking.
Student Assistance Programs
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A recognized, school-based approach to providing
focused services to students needing interventions
for substance abuse or other problems.
Few studies, but with promising results.
SAPs are uniquely tailored to local needs.
Selective participation.
Collaboration.
Screening and assessment.
Multiple services.
Potential SAP Services
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Academic support
Counseling services
After-school activities
Substance use education
Violence prevention and conflict mediation
Peer support and mentoring programs
Career services
Common Characteristics
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Support groups
Individual counseling
Community involvement
Supportive environments
Collaboration
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Facilitate accessibility
Avoid duplication
Support groups
Health clinics
Health care providers
Cessation programs
Law enforcement agencies
Social service organizations
Identification
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Teachers
Counselors
Administrators
Other school personnel
Law enforcement
Disciplinary referrals
Parents
Peers
Self
Common Challenges
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Funding
Staffing
Program awareness
Buy-in
Complementary Model Programming:
Project Toward No Drug Abuse
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Recommended for indicated and selective high school youth.
Originally developed to work with youth in alternative high
schools with higher risk youth, but has since been adopted by
many traditional high schools.
Targets ATOD by encouraging youth to participate in lower-risk
activities, to appreciate the risks of drugs on the body, and to
develop positive decision-making skills.
40- to 50-minute interactive curriculum designed to be
presented in 12 lessons.
Good fit for a pullout group format.
Complementary Model Programming:
Too Good For Drugs
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Recommended for selective middle and high school youth.
Middle school curriculum is grade-specific; high school is not.
Designed to reduce the intention to use ATOD during the middle and
high school years.
Relies on small group activities, role play and group discussions
regarding appropriate attitudes toward ATOD use, knowledge of
ATOD’s negative consequences, the benefits of a drug-free lifestyle,
and positive peer norms.
Also meets the needs of sites seeking to prevent conflict and violence
on their campuses.
Pullout structure okay as long as the same students are served
throughout the program.
10-lesson curriculum once a week for 14 lessons.
Optional home workouts for parents and infusion lessons are included
Complementary Model Programming:
LifeSkills Training
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Recommended for indicated and selective middle
school youth.
Flexibility to be used with a universal or elevated risk
middle school population, and to be used in a
classroom or support group setting.
Drug Resistance Skills.
Personal Self-Management Skills.
General Social Skills.
Interactive skills-based curriculum with follow-up
boosters.
CPI Services
Prevention Extension Workshop:
Community Action to Reduce Binge Drinking
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Profile population needs, resources, and readiness to
address the problems and gaps in service delivery.
Mobilize and/or build capacity to address needs.
Develop a comprehensive strategic plan.
Implement evidence-based prevention programs and
infrastructure development activities.
Monitor process, evaluate effectiveness, sustain effective
programs/activities, and improve or replace those that fail.
On-Line Resources
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www.ca-cpi.org
www.jointogether.org
www.marininstitute.org
www.saddonline.com
www.westcapt.org
www.camy.org
http://modelprograms.samhsa.gov
Local and State Data Sources
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California Healthy Kids Survey (CHK)
ASIPS/GIS mapping
Place of Last Drink (POLD)
SWITRS—California Highway Patrol
Police Department
Emergency Medical Services
Hospital Discharge Data
National Data Sources
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Monitoring the Future
National Survey on Drug Use and Health
NIAAA—College Drinking Prevention
Harvard School of Public Health, College
Alcohol Study
SAMHSA—Clearinghouse
www.ca-cpi.org
771 Oak Avenue Parkway, Suite 3
Folsom, CA 95630
916-983-8929-MAIN
916-983-5738-FAX