Teens and drugs: Drug use statistics and treatment that works

Here are some drug use statistics:

  • Over 80% of teens engage in some form of deviant behavior (1).
  • Over 50% of high-school seniors admit to having used drugs (2).
  • Only 10%-15% of the population develop drug addiction problems related to their drug use (1).

The question is:

If the majority of teens experiment with drug use, and so few eventually develop drug addiction problems, should we be focusing on something other than stopping kids from trying drugs? Continue reading “Teens and drugs: Drug use statistics and treatment that works”

DARE – Drug Abuse Prevention that doesn’t work

  • DARE (Drug Abuse Resistance Education) is the largest school-based drug abuse prevention program in the United States.
  • 80% of school districts across the country teach the DARE curriculum, reaching an estimated 26 million children (1).
  • Every year, over $1 billion goes into keeping the program running. A billion dollars may be a small price to pay to keep America’s children drug-free, but there is plenty of evidence to suggest that DARE isn’t doing what it’s supposed to.

What is DARE?

dareFounded in 1983, DARE began as a 17 week long course taught to 5th and 6th graders. The course is taught by a uniformed police officer who teaches the students about drug use and gang violence. The DARE curriculum includes role-playing, written assignments, presentations, and group discussions.

DARE uses a zero tolerance policy towards drug use. Students are told to adopt mottoes like “Drug free is the way to be” and “Just say no to drugs!” Pictures of blackened lungs and drunk driving accidents are methods used to discourage experimentation. The focus of the program is clearly flat out refusal. Students are not taught what to do if they are already experiencing problems with drugs.

Is DARE effective?

The effectiveness of DARE has been called into question since the early 90s. A meta-analysis of 11 studies conducted from 1991-2002 shows no significant effect of DARE in reducing drug use (1). Several studies have even reported an opposite effect, with DARE leading to higher rates of drug use later on in life. Reports from the California Department of Education, American Psychological Association, and U.S. Surgeon General all label DARE as ineffective.

The results seem clear, but statistics don’t seem to be enough to convince concerned parents and policy makers to shut down any drug abuse prevention program. With drug use on the rise, it seems that DARE is here to stay. But perhaps getting rid of DARE isn’t the best option. The framework and funding already exist for a potentially successful prevention program. Maybe all we need to do is apply some science and develop new techniques that will provide results.

*It should be noted that in 2001, DARE made substantial revisions to its program under the title “New DARE.” The effects of these revisions have yet to be measured, so we’ll wait and see.

 

Citation:

1. West, S.L., O’Neal, K.K. (2004) Project D.A.R.E. Outcome Effectiveness Revisited. American Journal of Public Health. 94(6)

West Cost Symposium on Addictive Disorders – Addiction education with A3 discount

You already know how much of a supporter of addiction education and training I am. I think that there are thousands of ways to treat any given addict and unless those of us in the addiction treatment profession keep up with information, we’re neglecting our clients and giving them less than a full chance at getting better.

What is that you say? Constantly keeping up with new information is hard! Well we might just have a solution for you – and A3 even got you a discount on it (read below)!

The West Coast Symposium on Addictive Disorders (WCSAD) – Is a three-day conference (June 3-5) taking place in La Quinta California at the La Quinta Resort & Club. You get to learn and network at the same time while getting to hear presentations on some of the most important, relevant, and current topics in addiction and addiction treatment:

At the end of the three days you should be much better educated on addiction in general and on any specific topic you feel really passionate about or interested in. You can also earn Continuing Education credits and come by and meet us at our booth too!

If you want to register, make sure to use our special VIP code – AAAVIP – it’ll get you in to the pre-conference for free AND save you $50 off the registration fee. If you have any questions you can feel free to email me or Dee McGraw at deemcgraw@ameritech.net

Hope to see you there!!!

Does current smoking among health care providers limit their ability to dissuade smoking to the general public?

By Christopher Russell

In 2003, the US Department of Health and Human Services (USDHHS) set a goal of reducing cigarette smoking among US adults (18 years +) to 12% by 2010, which if achieved would halve the adult smoking prevalence rate reported in 1998 (24%). Achieving this current smoking reduction may depend on the extent to which health care providers (doctors, nurses, and such), who are charged with promoting smoking cessation and dissuading the uptake of smoking among to the general public, are themselves current smokers. For example, health care providers’ anti-smoking and pro-quit messages will likely be more persuasive and credible to the smoking public when the messengers practice what they preach about smoking. Such messages may also better motivate quit efforts if the health care providers have had personal success in quitting smoking using the methods and information they are now endorsing. Conversely, smokers may intuit that when health care providers advise quitting but continue to smoke themselves despite enjoying ready access to all the resources, information, and tools which should facilitate quitting, then smokers, without this luxury of access to education and resources, will be even less likely to successfully stop smoking.

Therefore, significant strides in increasing the number of quit smokers and never smokers in the general population may somewhat depend on reducing current smoking among the health care providers who act as both educators and trusted role models to the general public. It is therefore important to know how the prevalence of smoking among health care providers compares to the prevalence of smoking in the general population, which health care providers are charged to reduce.

Current smoking among health care providers

Using US population survey data, a recent study published in Nicotine and Tobacco Research reports estimated changes in the prevalence of current smokers, former smokers, and never smokers among eight groups of health care provider  – physician, physicians assistant, registered nurse (RN), licensed practical nurse (LPN), pharmacist, respiratory therapist, dentist, and dental hygienist – between 2003 and 2006/07. While the majority of these health care providers have never smoked a single cigarette, the authors report that, in 2006/07, approximately one in every five licensed practical nurse (20.55%) and respiratory therapist (19.28%) was a current smoker. Current smoking rates among LPNs and respiratory therapists were marginally higher than the rate of current smoking in the general population (18.01%) and near double the Healthy People 2010 goal of 12% current smoking in the general population. Four groups of health care provider – physicians (2.31%), dentists (3.01%), pharmacists (3.25%), and registered nurses (RNs) (10.73%) were all on course to be below the 12% prevalence goal. Furthermore, seven of these eight health care groups in 2006/07 showed higher quit rates than was found in the general population (52%) – only LPNs had a lower quit rate (46%). However, the concern from a public health perspective, is that while current smoking rates among these health care groups and in the general population have dropped considerably when compared to data reported in a similar cohort study in 1990/91, these decreases in current smoking appear to have leveled off in recent years; current smoking did not significantly decrease in any health care profession or in the general population between 2003 and 2006/07.

An important methodological note about this study is that results reflect weighted population estimates (WPE), not actual data. WPEs allow researchers to make inferences about an entire population group given only some data for that group simply by scaling up the actual data, (i.e. data reported by around 4000 health care providers in each collection year were used to estimate smoking statuses for over 2 million actual individuals). Of course, this technique likely overgeneralizes behavior in the sampling group, but is nonetheless a standard, valuable tool of health epidemiologists when they want to make inferences about how entire populations are behaving. Indeed, many of our health policies have derived from WPEs.

Current smoking among licensed practical nurses

Among the most important findings of this study is that one in five licensed practical nurses in the US is currently smoking. Of the estimated 754,000 LPNs in the US, this equates to roughly 155,000 current smokers in this profession, illustrating that health campaigns designed to depict smoking as socially unacceptable, readily available access to education and empirical research on the health consequences of smoking, working in smoke-free health care campuses, and being charged with task of persuading clients to stop smoking, all appear insufficient to reduce current smoking among LPNs and respiratory therapists to below the rate of current smoking in the general population.

In contrast, 10.73% of registered nurses are current smokers. The discrepancy between LPNs and RNs begs two questions: why are LPNs nearly twice as likely as RNs to be current smokers, and should we expect RNs will be better able than LPNs to persuade current smokers to quit and dissuade smoking to would-be smokers? Certainly, researchers should now ask whether a health care provider’s smoking status is related to his ability to produce cessation in health care recipients. If we assume that health care workers have a central role to play in producing mass behaviour change of whatever kind, then it is plausible to reason that reducing smoking prevalence at the national level will significantly depend on first reducing smoking prevalence among health care providers, our first responders to public health concerns. Testing this hypothesis seems the logical extension to capitalise on these smoking prevalence data.

Why are licensed practical nurses twice as likely as registered nurses to be currently smoking?

If one’s smoking status is important for persuading change in others, we need to know why smoking is more prevalent among LPNs than RNs, why LPNs have a lower quit ratio than the general population, and so, which factors should be addressed to reduce current smoking among LPNs to below the 12% level. The authors of this study suggested that LPNs’ fewer years in education and lower annual income may be associated with their current smoking status since they mirror socioeconomic factors known to associate with higher smoking rates. Comparably large proportions of LPNs and RNs are female, thus ruling out an important effect of gender. In my opinion, given that nicotine produces positively reinforcing psychoactive effects and that smokers commonly report smoking to alleviate affective distress, another consideration may be that LPNs and RNs differ in their exposure to stressful work events and environments, and/or differ in their emotional reactivity and sensitivity to these events, and/or differ in their bias to perceive work events as stressful. Furthermore, as smoking staus is known to be associated with socioeconomic status and socioeconomic status is known to be associated with many health and wellbeing factors including stress, then stress may be important both as a direct influence on smoking behavior and indirectly as a mediator of the effects of socioeconomic variables on smoking behavior. A good start to exploring these hypotheses would be to simply ask LPNs and RNs of their main reasons for smoking in short open-ended interviews; if reliable differences in smoking attributions emerge then we may begin the harder task of counseling LPNs to think of smoking in ways which alter their reasons to smoke, the reasons which may currently be maintaining smoking in one in five LPNs.

Questions for the reader; please give your comments below

1)      Why do you think current smoking is more prevalent among licensed practical nurses than in the general population?

2)      Does a health care provider’s status as a current smoker make him/her more or less able to persuade smoking cessation in others?

3)      Will reducing current smoking nationally depend on reducing current smoking among health care providers?

References:

U.S. Department of Health and Human Services. (2003). Healthy People 2010, Retrieved from http://www.healthypeople.gov/

This report is free to download at: http://www.healthypeople.gov/document/pdf/uih/2010uih.pdf

Sarna, L., Bialous, S. A., Sinha, K., Yang, Q., & Wewers, M. E. (in press). Are health care providers still smoking? Data from the 2003 and 2006/2007 Tobacco Use Supplement-Current Population Surveys. Nicotine and Tobacco Research.

Understanding addiction research will require us to argue our corner but be flexible to change corners.

Hello everyone,

My name is Christopher Russell, I am a doctoral student in psychology at the University of Strathclyde in Glasgow, UK. My addiction research interests are wide and varied, but my core interests are in addiction theory (“why people do what they do”), the issue of freedom to control when using drugs, interpretations of addiction research evidence, and the use of licit and illicit drugs in the law.

Respect and rational debate of addiction research

Dr Adi Jaffe has very generously asked me to become a contributor to A3 and after reading about what A3 stood for (the mission and the abbreviation) and what Dr Jaffe is trying to achieve through A3, I am delighted to be a part of A3. Adi noted in a previous post that we do hold some different opinions about the nature and course of addiction. Above our differences, however, I respect that Dr Jaffe and I are able to debate addiction research rationally, respectfully, and vigorously without either of us resorting to ideological proclamations, disrespect for the alternative view, claiming a moral high ground or attacking each other’s moral character, or worst of all, name calling! Such people are hard to find in the academic world! The truth is that I, like Dr Jaffe, am still learning about addiction, and I’m not foolish enough to believe that my way is the way! If addiction research over the past 100 years has shown anything it is that a researcher would be foolish to hang his hat on any interpretation and proclaim it as fact – for example, for the past 200 years, masturbation was considered the most prevalent psychiatric disorder until it was replaced by drug use, and up until 1973, homosexuality was still diagnosed and treated as a form of mental illness! We must be willing to bend with the wind, to accept when addiction research evidence invalidates our beliefs, and to respond to falsifications by constructing models which stand up to our efforts to falsify them.

A3 and the fluid landscape of addiction research

The landscape of addiction research changes by about 50% each decade, as do many scientific ideas, so it is important that we all hold our beliefs about addiction lightly and be willing to consider that some dearly held addiction “truths” may not be as truthful as we had thought, perhaps hoped. Scientists are constantly revising what they thought they knew, changing their approach to measuring and conceptualising the problem, disseminating the latest findings to the public; like any good scientist, those who are involved with addiction, either personally or professionally, should always try to update their model, and sometimes, evidence can arise which causes us to question everything we thought we knew about the nature of a problem. Such evidence may require us to not merely adapt our exisitng models of the problem, but if called for, to abandon them in favour of more potent models which need not necessarily be liked or fully understood.

Hearing what addiction research is telling us, not what we want to hear

However, despite our pledges to be good scientists, our basic ways of thinking tend to get in the way of building better models of a problem. For example, a classic contribution of psychology research has been the finding that people prefer to try to discredit a new piece of evidence about a concept which doesn’t fit with their existing understanding of that concept rather than assimilate the new evidence into our understanding because it is cognitively easier to leave our belief structure as it is. This phenomenon is quite common in the addiction research community; some people just refuse to believe that addiction could be something other than what they had long thought it to be, and no amount of validated, replicable evidence to the contrary will move them to revise their beliefs. It is regrettably common that, for some, beliefs about addiction are based on an unwavering ideology rather than a science-grounded conclusion. Addiction researchers cannot afford to be this pompous, lazy, or inflexible; too many people are counting us to get the right answers to them, no matter who they come from or what form they come in. I know that my contributions to A3 are only useful to the extent to which they help get people from where they are to where they want to be. To achieve this, I must argue my corner but be willing to bend when the wind blows. We all must.

In the hope that I can be both teacher and student of A3, I believe that the value of my arguments will be measured by how well they hold up in the face of your most passionate, insightful criticism. Therefore, I invite all those who read my contributions to criticize, refute or support any of my arguments when you feel it is warranted. I will always try to give an intelligent answer and I swear to never resort to clichéd answers, bumper sticker answers, or the “it just is because it is” answer, which is in effect, no answer. And I will never resort to name calling (except when you really deserve it!).

I look forward to providing you with thought pieces, philosophical contributions, reviews of evidence, and most of all, interacting with you the readers, the lifeblood of A3.

Christopher

About Addiction: Your brain, smoking, alcohol and drugs

Some new, different areas of addiction and some old favorites.  Read on to learn more!

Check out this USA Today story about President Obama’s public health fight and goals of reducing drug usage.  He said prevention and education are really what we need.

Your Brain and Addiction

Science Daily: A genetic variant of a receptor in the brain’s reward circuitry plays an important role in determining whether the neurotransmitter dopamine is released in the brain following alcohol intake.

Health Day: Children who experience psychological disorders such as depression and substance abuse appear to be headed for a financially depressed adulthood.

Science Daily: This article investigates separate and joint effects of alcohol and tobacco on the nucleus accumbens. A new study has found that alcohol abuse elevated the expression of a distinct set of genes in the NAC and VTA while nicotine blunted this effect in the VTA.

Alcohol

APP: This article talks about a new study on alcohol use of teens. The Partnership for a Drug Free America found in a study released in March an 11 percent increase among students in grades 9-12 who reported drinking alcohol in the past month, up to 39 percent in 2009, or 6.5 million students.

Science Daily: This article suggests that frequent alcohol use is linked to faster HIV disease progression. According to the article, HIV disease tends to progress at a faster rate in infected individuals who consume two or more alcoholic drinks a day.

Associated Press: This is a link to a short text which states that the World Health Organization endorsed a global strategy to reduce alcohol abuse. This text calls alcohol use one of the leading causes of sickness and death.

Smoking

Physorg.com: In a new study was found that treatment for smoking dependence is as effective among people with severe mental illnesses as it is for the general population.

Cesar Fax: This  states that cigarette excise tax increased in fifteen states in 2009. Four states have not increased cigarette taxes in more than a decade.

Other Drugs

Reuters: Prescription drug use of US children has risen. Children were the leading growth demographic for the pharmaceutical industry in 2009, with the increase of prescription drug use among youngsters nearly four times higher than in the overall population.

Medical News Today: There are significant changes in substance use treatment admissions patterns that have occurred over the past decade. The co-abuse of alcohol and drugs has declined gradually yet significantly.

Weeding out your significant other? The effect of marijuana on relationships

contributing co-author: Gacia Tachejian

Michael Phelps smoking weed

Being young involves quite a bit of exciting change. There’s the end of high-school, the start of college and some measure of independence, and a whole slew of new experiences.

A recent study conducted by Judith Brooks at NYU School of Medicine has revealed that one of those experiences, smoking marijuana (weed) may be associated with more relationship conflict later in life. What’s amazing about this study is that the drug use here occurred earlier in life for most of the 534 participants, while the relationship trouble was assessed around their mid- to late-twenties.

Could other factors explain this finding?!

Now you may be thinking to yourself that there are a whole lot of other aspects of a person’s life that can affect their relationship quality and their probability of smoking weed in adolescence. You’d be right, but here’s what the researchers in this study ruled out as possible confounds (the scientific name for variables that obscure findings):

  • Relationship with parents
  • Aggressive tendencies
  • adjustment difficulty
  • gender
  • education

Even after controlling for all of these things, smoking marijuana as a teen still predicted having less harmonious relationships later on in life.

Limitations

All humor aside, this research is not saying that if you smoke weed you will definitely have a lower quality relationship later. What it does point out is that, on average, given a person with similar social skills, aggressive personality, and education, the one who smoked marijuana around their mid-teens is likely to have a less satisfying relationship.

UPDATE: Before you leave another angry comment about how wrong this article is to suggest that marijuana can cause any problems ever, please read my article on the difference between causality and association; this article is talking about an association, not causality.

Citation:

Brook, J. S., Pahl, K., and Cohen, P. (2008). Associations between marijuana use during emerging adulthood and aspects of significant other relationship in young adulthood. Journal of Child and Family Studies, Vol 17, pg. 1-12.