Courts, Judicial Independence, And Underage Drinking OJJDP National EUDL Leadership Conference

1. Courts, Judicial Independence, And Underage Drinking OJJDP National EUDL Leadership Conference Anaheim, California

2. Role of the Court Public Health Crisis or Rite of Passage

3. “On the surface people would say that kids “having a few beers” is no big deal, but that’s not what we’re seeing on the law enforcement side.” Deputy Chief Gordon Dibble, Batavia, NY

4. “No amount of law enforcement can solve a problem that goes back to the family.” J. Edgar Hoover, former Director, FBI

5. Factoid 95% of problem adult drinkers began drinking as teens.

6. Sobering Statistics Alcohol – a frequent Partner in Crime and High-Risk Behaviors

7. Alcohol is a factor in nearly 50% of all violent crime and 40% of all fatal motor vehicle crashes. United States Department of Justice

8. Alcohol is a leading factor • 67% of domestic violence • 62% of assaults • 54% of murders/attempted murder • 48% of robberies • 44% of burglaries • 66% of child abuse • 75% of date rape • 90% of sexual assaults on coeds

9. Criminal Justice Underage Drinking Costs • Youth Violence - $31.1 billion • Youth Traffic Crashes - $14.9 billion • Youth Property Crimes - $3.1 billion Pacific Institute for Research & Evaluation (PIRE) 2007

10. “I don’t believe the problem behind risky teen behavior is a lack of knowledge. The programs do a good job in teaching kids the facts. Education alone doesn’t work. It doesn’t seem to affect their behavior.” Dr. Laurence Steinberg Temple University

11. Community Strategy Use of the justice community to prevent underage drinking, not to criminalize mistakes of youth, but as a genuine public health intervention

12. Justice System Triumvirate “From the Cop on the Street to the Judge’s Seat”

13. National “Call to Action” “We can no longer ignore what alcohol is doing to our children.” RADM Kenneth Moritsugu, M.D. U.S. Surgeon General March 6, 2007

14. National Goals (Goal 1) Foster Change in American Society • Uniform enforcement of law and policies against underage use and widely publicize these efforts. • Gain public support for enforcement by working with stakeholders • Work with State, tribal and local coalitions to reduce underage drinking.

15. National Goals (Goal 2) Engage parents, other organizations and all levels of government that interface with youth to prevent underage drinking. • Increase knowledge of judges and others • Require intervention for parents with disorders • Provide screenings and interventions • Enforce underage drinking laws and hold adults accountable • Decrease availability

16. National Goals (Goal 3) Promote understanding of underage alcohol consumption in context of human maturation and development • Provide for violations to be developmentally appropriate and avoid unintended outcomes.

17. National Goals (Goal 6) Work to ensure policies at all levels are consistent with the national goal to prevent underage drinking. • Uniform and consistent enforcement of law • Enforce graduated license laws for novice drivers to include restrictions • Enforce zero-tolerance laws and laws related to driving after drinking

18. Judicial Independence Can you work with judges?

19. Need for Judicial Leadership • Judges occupy a unique position, one that allows them to speak to the growing problems associated with underage drinking. • Judges hold the ethical obligation to ensure the effective administration of justice. • Judges represent a respected and venerable institution. • Judges promote effective citizen involvement. • Judges serve as convenors and facilitators, bringing together diverse parties and interests to forge solutions.

20. Contact Information Ronald E. Bogle Superior Court Judge (Retired) Community Strategy Group 154 Lake Ellen Drive Chapel Hill, NC 27514 (919) 931-0164 robojudge@earthlink.net

21. Judicial Innovation • Goals can be achieved at little or no cost to judicial budget. • Innovation relies on both traditional and non-traditional collaborations. This involves partnerships and an open judiciary. You may not have to reinvent the wheel. • Obtain high quality data on your local population. Research can be more specific than program evaluations. Research can provide objective data, direct policy, and provide free services. Explore key collaborations with local universities, professors, graduate level students, hospitals, and/or progressive treatment providers. This approach will move your judiciary to highly attuned and specialized services.

22. Beginnings • Formation of the RI Alcohol Calendar began in 2007. • Several high profile cases involving underage drinking. • Although RI has a unified court system, there was a lack of uniformity throughout cities and towns in handling underage drinking. Additionally, reporting interventions and outcomes was insufficient. • Increasing awareness that family involvement is a necessary requirement for effective intervention.

23. The Relationship between the Alcohol Calendar and Problem Solving Courts • Complimentary • Similar: voluntary, employ a range of incentives and sanctions; petitions will be dismissed if successful; focus on treatment; incorporates a team approach. • Different: The Alcohol Calendar is more diversionary in nature; shorter in duration (approximately 3 months); employs greater use of random breathalyzers/alcohol screens; less dependent on funding issues. • For juveniles on the Alcohol Calendar that demonstrate the need for more individualized interventions, cases can be referred to the Juvenile Drug Court for longer supervision and additional mental health services.

24. Targeted Research into existing court programs and populations served. • Identify high risk behavior and contributing factors. • Incorporate families into research. • Research can offer services. • Make sure research is attuned to the timelines of the judiciary.

25. PATH Alcohol studyNIDA R21DA19245; Tolou-Shams, Brown, Houck et al. Baseline data from 52 male juvenile drug court offenders who participated in an adolescent-only HIV prevention program Examined self-reported rates of past 30 days alcohol use, past 30 days marijuana use and recent (past 90 days) sexual activity

26. PATH Alcohol study • 52% (n=27) reported drinking any alcohol in past 30 days • 36% (n=19) reported using marijuana at least once in past 30 days • 29% (n=15) reported using both substances in past 30 days • At time of data reporting, average length of time in drug court was 3.94 months (suggesting that youth are using while in drug court program)

27. PATH Alcohol studyComparing drinkers to non-drinkers • As compared to non-drinkers, drinkers were: • older in age (no other demographic differences) • more likely to have vaginal/anal sex in the past 90 days • higher on a measure of sexual sensation-seeking • more likely to use marijuana recently • more likely to have used alcohol prior to entering drug court

28. PATH Alcohol studyComparing marijuana users to non-users • As compared to non-marijuana users, users • were not demographically different • showed no statistically significant sexual risk differences (only a trend toward having had vaginal/anal sex in past 90 days) • were higher on a measure of sexual sensation-seeking • were more likely to have used alcohol prior to entering drug court and to have used alcohol in past 30 days

29. PATH Alcohol studyWhat is the relationship between alcohol, marijuana use and HIV/sexual risk? • Examined the relationship between recent alcohol, marijuana use and vaginal or anal sex in the past 90 days to determine the relative weight of alcohol versus marijuana use in driving sexual risk RESULTS: • Even when accounting for marijuana use, the odds that a youth recently using alcohol has recent vaginal or anal sex is 6 times that of their non-drinking peers. • Marijuana use does not increase the odds of sexual activity in this sample.

30. PATH Alcohol studyImplications • Juvenile drug court programs need to address interventions specifically for alcohol use (which differ in content and approach from marijuana and other drug use interventions) • Additional integration of HIV/STI and pregnancy prevention interventions is warranted given the relationship between alcohol use and sexual activity.

31. Court –University Cooperation • Services in the community may be difficult to access • Treatment research studies provide free services to families • Although they are research studies, these studies , especially those funded by NIH grants, typically provide high quality, cutting edge treatments • In some studies, like the ones I will describe, families may also be compensated for taking part in the evaluation component of the project

32. University Research and the Courts • Adolescents seen in Family Court are referred to Brown University’s Center for Alcohol and Addiction Studies (CAAS) where they receive a brief family counseling session (the Family Check-Up) as part of an NIH-funded research study conducted by Dr. Spirito. • Families choose to take part in the research. If they are unwilling to do so, they receive brief family counseling as a service.

33. Brief Counseling • The research being conducted involves only brief counseling because it is difficult to get these teens and families to attend an extended number of sessions, not all need intensive treatment, and research shows that for many teens brief treatment can be as effective as more extended treatment. • In all cases, families are offered referrals to additional treatment if they desire.

34. Counseling Approach Family Check –up • Goal is to enhance parental recognition of teen risk factors • Motivate parents to take action – especially with regard to monitoring, limit-setting, and communicating with their teen

35. Two Sessions • The Family Check-Up is only two sessions: • 1st session- parents and teens are interviewed, they complete questionnaires on substance use and other problem behaviors and the parents and teen are videotaped discussing family issues including curfew and rules about substance use • 2nd session- parent returns to receive feedback based on the data collected at the first session

36. Rationale for the Family Check –up • Dr. Spirito recently completed a study of adolescents seen in the emergency room after a drinking incident that demonstrated that the Family Check-Up resulted in lower alcohol and marijuana use over a 12 month period compared to interviewing the teen alone

37. Outcomes

38. Court Referred Teens and Their Teen Siblings • In Dr. Spirito’s current grant funded by the National Institute on Alcohol Abuse and Alcoholism, teens/parents in Family Court for a substance use violation are receiving the Family Check-up and parents are asked to bring their other teenage siblings to the session. The goal is to have a broader effect on family functioning beyond just the court-referred teen.

39. Truancy Court • Dr. Spirito received a new grant from the National Institute of Drug Abuse to test the effects of the 2-session Family Check-up plus a 2-session individual motivational counseling session with the teen on substance using teens seen in our Truancy Courts.

40. Truancy Court • For these teens, the Family Check-up will address not only substance use but also school attendance. In addition, because data shows these teens are at high risk to engage in unprotected sex, the family and individual sessions also address risky sexual behavior. This study starts this Fall.

42. Problem Areas • 26 % of the teen drivers who died in motor vehicle crashes between 2004 and 2008 had been drinking and 38% of the teen passengers who died had also been drinking. (FARS, RI Department of Health 2010) • According to the 2009 Rhode Island Youth Behavior Survey, 23% of RI public high school students reported that during the month before the survey they rode in a vehicle driven by someone who had been drinking. (2009 RI Youth Risk Behavior Survey) Source: RI KIDS COUNT

43. 4 Reducing Youthful Dangerous Decisions ’ • Injury Prevention Center, Rhode Island Hospital & Brown University • & • Rhode Island Family, District, and Traffic Courts

44. Reducing Youthful Dangerous Decisions • Meet the Team • Ted Nirenberg, PhD: Principal Investigator • Janette Baird, PhD: Co-Investigator • Melody Los, MS: Clinical Coordinator • Megan Corbett BS: Data Coordinator • Andrea Cheli BS: Enrollment Coordinator

45. CDC RYDD 2005-2008 • November 2005 – IPC received funding from Center for Disease Control (CDC) • 16 hour program • 2 group model- Educational Programming and: • Community service as an observer in RIH Trauma Center • OR • Community service at a non-profit organization in greater RI area • 84% of participants referred to RYDD successfully completed the program

46. CDC RYDD 2005-2008 • Over 500 young people were referred to the RYDD Program • Average age was 17 years • 82% of participants were male • 55% of participants had a driving related offense (Driving Without a License, Reckless Driving, Speeding) • 45% of participants had a substance related offense (Possession Alcohol, Possession Marijuana, DUI, Breathalyzer refusal)

47. CDC RYDD 2005-2008 Breakdown of Referring Agencies 68% of participants were referred from the Family Court 20% of participants were referred from the District Court 5% of participants were referred from the Traffic Tribunal 4% of participants were referred from a Juvenile Hearing Board 3% of participants were referred from other agencies (municipal courts, local and state police)

48. NIH RYDD 2008-Present • April 2007 – IPC received funding from National Institutes of Health • 20 hour program • 3 group model: • Educational Programming + RIH Trauma Center Observation • Educational Programming + Enhanced Community Service • Educational Programming + Community Service • To date: 87% of participants referred to RYDD successfully completed the program

49. NIH RYDD 2008-Present • Over 1100 young people were referred to the RYDD program • Average age was 18 years • 74% of participants were male • 49% of participants had a driving related offense (driving without a license, reckless driving, speeding) • 51% of participants had an substance related offense (Possession Alcohol, Possession Marijuana, DUI, Breathalyzer refusal, transportation of alcohol)

50. NIH RYDD 2005-2008 Breakdown of Referring Agencies 23% of participants were referred from the Family Court 42% of participants were referred from the District Court 32% of participants were referred from the Traffic Tribunal 1% of participants were referred from a Juvenile Hearing Board 2% of participants were referred from other agencies (municipal courts, local and state police)