Substance Abuse Prevention Briefing Community Anti-Drug Coalitions of America

1. Substance Abuse Prevention BriefingCommunity Anti-Drug Coalitions of America

2. 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/Infofacts/treatmeth.html 2U.S. Department of Health and Human Services and Education and SAMHSA’s 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.

3. 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.” 25:2.

4. 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

6. 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.nih.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 9:103-110, 1997. 3The National Household Survey on Drug Abuse (NHSDA) report. August 23, 2002. Available: http://oas.samhsa.gov/2k2/MJ&dependence/MJdependence.htm

7. Peer Drug Use and Lower Test Scores “Kids Count” Study—State 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 onstandardized 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_091200.pdf

8. 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.

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

10. 12th Graders’ Past Year Marijuana Use vs. Perceived Risk of Occasional Marijuana Use SOURCE: University of Michigan, 2008 Monitoring the Future Study SOURCE: University of Michigan, 2008 Monitoring the Future Study

11. When MTF data is disaggregated, disturbing trends are beginning, as attitudes are softening.

12. 2008 Monitoring the Future Study Key Findings- Attitudes (2008 cf. 2007) SOURCE: University of Michigan, 2008 Monitoring the Future Study SOURCE: University of Michigan, 2008 Monitoring the Future Study

13. Percent Perceiving Great Risk of Smoking Marijuana Regularly Denotes significant difference between 2007 and 2008. SOURCE: University of Michigan, 2008 Monitoring the Future Study SOURCE: University of Michigan, 2008 Monitoring the Future Study

14. Percent Perceiving Great Risk of Taking Inhalants Regularly Denotes significant difference between 2007 and 2008. SOURCE: University of Michigan, 2008 Monitoring the Future Study SOURCE: University of Michigan, 2008 Monitoring the Future Study

15. Softening attitudes generally precede an increase in drug use rates by approximately two years.

16. Among 8th and 12th graders, there was a decrease in disapprovalof LSD.

17. Concurrently, there has been an increase in past-year LSD use in 8th and 12th graders over the past three years.

18. Among 10th graders, past 30 day use of marijuana has already eclipsed that of tobacco.

19. 10th Grade, Past 30-Day Use 13.8% 12.3% Marijuana SOURCE: University of Michigan, 2008 Monitoring the Future Study www.pridesurveys.com

20. 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.

21. The community coalition model has proven successful in reducing drug use and underage drinking.

22. 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

23. 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.”

24. 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

25. 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)

26. 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

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

28. 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.

29. 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;

30. 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.

31. Strategies Implemented by Thomas County to Achieve Underage Drinking Outcomes • Developing and implementing a community–wide 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

32. 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 Institute’s 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.

33. 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

34. 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.

35. 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.

36. The CASE Coalition’s Outcomes -63% -80.2%

37. 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.

38. 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

39. Cheese Outcomes Achieved in Dallas The number of cheese related deaths was reduced from 22 between 2005 and 2007 to zerosince July, 2007.

40. 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)197–207. 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)307–315. 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. 27:187–196. 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):2341–2347. 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):84–90.

41. 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.

42. 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.