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Epidemiology Update SPF-SIG Advisory Council

Epidemiology Update SPF-SIG Advisory Council. September 2014 Elizabeth Eustis Turf, Ph.D. Outcomes-Based Prevention. Use of data to identify high levels of a substance-related consequence – AKA Outcome Our outcome is MVCs with drinking drivers within the 15-24 year age range

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Epidemiology Update SPF-SIG Advisory Council

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  1. Epidemiology UpdateSPF-SIG Advisory Council September 2014 Elizabeth Eustis Turf, Ph.D.

  2. Outcomes-Based Prevention • Use of data to identify high levels of a substance-related consequence – AKA Outcome • Our outcome is MVCs with drinking drivers within the 15-24 year age range • All locations identified18-24 year olds as target • Change in level of outcome over time determines success of prevention activities

  3. Phase II • 11 jurisdictions completed Steps 1-3 • Assessment • Capacity • Planning • 10 Working on Steps 4 & 5 • Implementation and • Evaluation

  4. Group 2 • Hampton • Newport News • Montgomery County • Stafford • Spotsylvania

  5. Jurisdiction Prevention • Allprevention activities evidence-based and approved by SPF-SIG Evidence-Based Workgroup (EBW) • All jurisdictions implementing environmental strategies • One jurisdiction has included an individually-focused strategy • High risk college students • Brief intervention • Several strategies selected for ~3 prioritized factors

  6. Alcohol-Specific IVs • Based on research – shown on Holder model • Seven (7) key community Intervening Variables • Retail Availability • Social Availability • Enforcement • Community Norms • Promotion • Price • Perceived Risk

  7. Harold Holder, Environmental Prevention: Achieving High Quality Implementation to Best Outcomes, SAMHSA, November 2011

  8. Update • Number of motor vehicle crashes (MVCs) down • Number of alcohol-related MVCs also down • But – proportion remains same • Still – 36% of fatalities in alcohol-related crashes • Evaluate change in rates • Statewide • Funded jurisdictions

  9. Trend in Alcohol-Related Crashes BAC 0.08 or higher http://www.dmvnow.com/safety/#crash_data/index.asp

  10. Persons Killed in Crashes Any BAC>0 http://www-fars.nhtsa.dot.gov/States/StatesAlcohol.aspx

  11. Drinking Drivers 15-24 • Number / rate of all MVCs downward trend • Rate of MVCs w/ drinking drivers 15-24 • Any alcohol • 37% drop since project baseline • 2006-2008 rate = 32.1/10,000 population 15-24 • 2013 rate = 20.1/10,000 • Alcohol is consistently involved in 7-8% of all MVCs

  12. Rate of MVCs – Drivers 15-24 37% drop

  13. Where Do Crashes Occur MVCs w/ drinking drivers 15-24 / 10,000 pop 15-24

  14. 2006-08 to 2013 MVCs w/ drinking drivers 15-24 / 10,000 pop 15-24

  15. Statewide -- Who’s At Risk? • Overall, males ~ 2.5-4 times more likely to be the driver • 28.9 MVCs/10,000 males vs 10.8 MVCs/10,000 females • For 15-17 year group – gap increased in 2013 • 21-24 year olds - highest rate • 49.6MVCs/ 10,000 males 21-24 vs19.7/ 10,000 females • 23.0MVCs/ 10,000 males 18-20 vs8.0/ 10,000 females • 4.6 MVCs/10,000 males 15-17 vs0.8/ 10,000 females

  16. Trend Drinking Drivers 15 to 24 Rates / 10,000

  17. Trend – 15 to 24 Year Olds • All rates dropped • Except 21-24 yo females

  18. Specifics -- Fundees • Change in rate over time • Goal - decrease of at least 10% from baseline • Country-wide seeing decrease in rates • Compare to statewide decrease

  19. Specifics -- Fundees • Assessment activities began in 2012 • Interventions began early 2013 • Local data collected in late 2013 • Change in usage-related behaviors • Awareness of prevention activities • MVC data -- 2006-08 baseline thru 2013

  20. Trend in Rates – Funded JurisdictionsRates / 10,000

  21. Trend in Rates 15-24

  22. Funded vs Non-funded No difference in percent change: Mean rates / funded vs non-funded. But – still early – will check 2014

  23. Statewide Update • 5-year report • Review use of all substances by all age groups • National Survey on Drug Use and Health • Young Adult Survey – limited • Youth Risk Behavioral Survey • Review consequence data • Alcohol-related • Drug-related • Consider changes

  24. Statewide Update • Benchmarking • Compare current VA rates to US rates • Determine if VA has higher prevalence • Compute Rate Ratio – Rate 1 / Rate 2 • Change over time • Compute the percent change over past 5 years • Determine if rates have gone up • Look for key differences in patterns

  25. Statewide Update in Usage • National Survey on Drug Use and Health (NSDUH), 2008-2012 • Past month use of substances decreased overall from 2008-2012 in both 12-17 year olds and 18-25 year olds • Exception --- alcohol use and binge drinking among 18-25 year olds

  26. Trend in Alcohol Use NSDUH, 2008-2012

  27. Trend in Binge Drinking

  28. Illicit Drug Use NSDUH, 2008-2012

  29. Trend in Prescription Drug Use

  30. Benchmarking: VA to US

  31. Benchmarking: VA to US *Perception of risk should go up over time not down

  32. Benchmarking: VA to US

  33. Change Over Time: 2008-2012

  34. Change Over Time: 2008-2012 *Perception of risk should go up over time not down

  35. Change Over Time: 2008-2012

  36. Summary • Virginia rates better then the US except: • Alcohol use in 18-25 year olds and 26+ • 5% greater prevalence rates in VA • Perception of risk of binge drinking lower in VA then in US among 12-17 and 26+ • Perception of marijuana use once/month lower in all three age groups • Rates have improved over past 5 years except: • Perception of risk of use of marijuana

  37. SA-Related Consequences SA-related consequences examined • Deaths • Drug overdose • Cirrhosis • DUIs • Drug-related arrests • Drug dependence or abuse

  38. Overdose Deaths • Erratic • 2011-2012 slight decrease • 25-64 – highest rate • Statewide – no more recent data

  39. Cirrhosis Deaths • 65+ highest rate • 20% increase over 5 years • Total rate – also increase

  40. DUIs • 15-24 – highest rate • 21-24 biggest proportion • Decreasing 2011-2012 • Why? • 65+ rate – stable over time

  41. DUI Convictions

  42. DUI Dispositions • Proportion guilty increases with age • Not guilty ~1.6%

  43. Drug Arrests • <25 years – highest rate and increasing • 25-64 also increased • 65+ stable

  44. Alcohol Abuse or Dependence • Drop in rates since 2010 • 12-17= -39.9% • 18-25= -26.2% • 26+= -19.4%

  45. Drug Abuse or Dependence • Drop in rates for all ages • 12-17 = -2.3% • 18-25 = -5.4% • 26+ = -1.2%

  46. Benchmarking - Alcohol

  47. Benchmarking - Drugs

  48. Change Over Time *Increase in DUIs difficult to categorize

  49. Change Over Time *Increase in arrests difficult to categorize

  50. Treatment • TEDS • Publicly funded only • Only those in treatment • Idea of frequently used substances • Intakes – considers “primary drug of choice”

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