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Perspectives on ATOD Prevention

Perspectives on ATOD Prevention. Robert I. Reynolds, Director Center for Policy Analysis and Training Pacific Institute for Research and Evaluation. Drug “Capture” Rate. Percent of Users Who Become Clinically Dependent Tobacco 31.9% Heroin 23.1% Cocaine 16.7%

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Perspectives on ATOD Prevention

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  1. Perspectives on ATOD Prevention Robert I. Reynolds, Director Center for Policy Analysis and Training Pacific Institute for Research and Evaluation

  2. Drug “Capture” Rate Percent of Users Who Become Clinically Dependent Tobacco 31.9% Heroin 23.1% Cocaine 16.7% Alcohol 15.4% Stimulants 11.2% Marijuana 9.1% Source: National Comorbidity Survey Anthony, Warner, and Kessler

  3. U.S. Economic Costs of ATOD Use, 1995 Total Costs = $415 Billion Sources: Harwood, Fountain, & Livermore, NIDA & NIAAA, 1998 Rice (unpublished) Institute for Health and Aging, UCSF, 1995

  4. Question: ATOD Problems in the United States are: • At epidemic proportions • Steadily declining • Both of the above

  5. ATOD consumption in the U.S has declined over the past 20 years. Alcohol consumption is down. Tobacco consumption is down. Other Drug use is down.

  6. Tobacco use has declined. Percent reductions in monthly tobacco use by age group (1985 to 2000)

  7. Illicit drug use has decreased. Percent reductions in monthly illicit drug use by age group (1979 to 2000)

  8. Alcohol consumption has decreased in the past 20 years... Reduction in per capita consumption1980-1999 (gallons of pure ethanol)

  9. …and fewer youth are drinking now versus twenty years ago. Percent Reduction: Monthly Alcohol Use, 1979-2000

  10. In particular, fewer fatalities are alcohol-related. Percentage traffic fatalities related to alcohol(1982-2000)

  11. What these successes have in common: • changes in Social Norms • policy interventions • deterrence and enforcement

  12. Changes in Social Norms Media Advocacy: • “If you’re not in the news, you don’t exist” • Media Advocacy is the strategic use of media to advance a social or public policy goal • Media Advocacy is “Earned Media”

  13. Policy Interventions • To prevent ATOD problems, policy interventions must focus on the Availability of alcohol, tobacco, and other drugs. • Effective policies address the • Price • Place • Product • Promotion… …of ATOD products

  14. Deterrence and Enforcement • Effective Deterrence requires the Perception of • Certainty • Swiftness • Severity • Active Enforcement is a Requirement for Effective Deterrence.

  15. Essential Elements of Effective Prevention of ATOD Problems Policies and Laws Enforcement Preven-tion Public Support

  16. Alcohol Markets and Problems: 2003

  17. Country Case Volume China 725 million cases Russia 350 India 249 Brazil 195 Japan 176 United States 135 Korea 79 Thailand 76 Germany 60 France 37 Source: Mark Brown, President Sazerac Company, Inc. March 4, 2003 Global Market – Alcohol SpiritsSales Exceed 2 Billion Cases Annually

  18. Product Categories – Alcohol Spirits Product Category Case Volume Baijiu 725 million cases Vodka 400 Whisky 205 Cachaca 200 Rum 115 Brandy 82 Shochu 70 Soju 70 Liqueurs 51 Source: Mark Brown, President Sazerac Company, Inc. March 4, 2003

  19. Global Burden of Disease(Disability-Adjusted Life Years) Attribution Tobacco Alcohol Illicit Drugs Worldwide 4.1% 4.0% 0.8% North America 8 - 15.9% 4 - 7.9% 2 - 3.9% South America 8 - 15.9% 2 - 3.9% 1 - 1.9% Source: World Health Report 2002 World Health Organization

  20. Myths about alcohol suggest alcohol is an “integral part of American life”. From an industry website: “…the vast majority of consumers drink responsibly and in moderation…” CEUDL

  21. The real picture of “Drinking in America” is much different. Adults: Most adults do not drink or drink infrequently. Youth: Most young people do not drink. Prevention Policy: There is widespread support for policies to reduce alcohol-related harm. CEUDL

  22. Most adults do not drink or drink infrequently. Frequency of Drinking Among U.S. Adults 21 and Older, 2000 (past 30 days) CEUDL

  23. Most adults do not drink at a hazardous level. Drinking Patterns among U.S. Adults 21 and Older, 2000(past 30 days) CEUDL

  24. Alcohol sales depend on the heaviest drinkers. Alcohol Consumed by Drinking Pattern Among Adult Drinkers, 2000 (past 30 days) CEUDL

  25. Binge drinkers are 20% of the population, but consume 80% of the alcohol. Binge Drinkers, 2000 CEUDL

  26. Most young people do not drink. Drinking Among Youth, 2000(past 30 days) 12- to 14-year-olds 15- to 17-year-olds 18- to 20-year-olds 8% 23% 17% 52% 94% 75% 25% Drinking occasions 0 1 to 4 5 or more CEUDL

  27. Young drinkers tend to drink more heavily than adult drinkers. Comparison of drinking patterns for adult and underage drinkers, 2000 (past 30 days) Nonbingers Bingers CEUDL

  28. Young bingers consume the majority of the alcohol for their age group. Percentage of Drinks Consumed by Drinking Pattern Among Underage Drinkers, 2000 12- to 14-year-olds 12- to 14-year-olds 15- to 17-year-olds 18- to 20-year-olds 4% 4% 8% 26% 34% 45% 70% 47% 62% 94% Nonbingers InfrequentBingers Frequent Bingers CEUDL

  29. What is the REAL message in “Designated Driver” programs?

  30. Binge Drinking: Adverse Health Effects Suicide Alcohol Poisoning Hypertension Acute Myocardial Infarction Gastritis Pancreatitis Sexually Transmitted Diseases Meningitis Poor Control of Diabetes Interpersonal Violence (homicide, assault, domestic violence, rape, & child abuse

  31. Binge Drinking is Increasing1995 - 2001 Rate of Binge-Drinking Episodes (Episodes/Person/Year among US Adults) Age 1995 2001 % Increase 18-20 8.8 15.3 74 21-25 11.6 18.0 55 26-34 7.6 9.2 21 35-54 5.1 6.7 31 55 + 1.9 2.7 42 All Ages 35 Source: Timothy Naimi, et.al JAMA, 1/1/03

  32. Binge Drinking is Increasing… • Binge drinking episodes increased by 35% • Binge drinkers reported impaired-driving 14 times more frequently than non-bingers. • The majority of binge-drinking episodes (70%) occurred among those 26 or older. • Moderate drinkers (average 1-2 drinks/day) accounted for almost as many binge drinking occasions as did heavy drinkers. • Underage drinkers had the largest increase (74%) in the rate of binge-drinking. Source: Timothy Naimi, et.al JAMA, 1/1/03

  33. Prevention Policy: There is widespread support for policies to reduce alcohol-related harm. CEUDL

  34. In Order to Continue Our Progress and to Confront Our Challenges We Must: • Change Social Norms. • Adopt Policies impacting the Price, Place, Product and Promotion of ATOD availability. • Increase Deterrence and Enforcement.

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