Smoking cannabis is more harmful than cigarettes and more likely to
trigger cancer, according to a report.

Just three cannabis ‘joints’ a day can cause the same amount of damage to the lungs as an entire packet of 20 cigarettes.

The British Lung Foundation says that when cannabis and tobacco are
smoked together, the harmful effects are significantly worse.

Its research suggests young cannabis smokers may also be at greater risk of throat and gullet cancers.

The foundation found that tar from cannabis joints contains 50 per cent more cancer-causing toxins than cigarettes made from tobacco alone.

Eight million Britons are thought to smoke cannabis, which some experts believe is a ‘gateway’ to harder drugs such as heroin and cocaine.

Earlier this year, researchers found that 79 per cent of children
thought cannabis was safe while only 2 per cent recognised there are
health risks from smoking the drug.

Dame Helena Shovelton, chief executive of the British Lung Foundation, said the harmful effects of cannabis had been swept under the carpet.

‘People are under the illusion it is safe to smoke cannabis. Our report
shows it is very dangerous to lung health, at least as dangerous as tobacco.

‘It seems society is in the same position as when research first showed the harm caused by tobacco. It took 15 years for the Government to take notice but we don’t want to repeat the mistakes of the past.’

Dame Helena said cannabis available today is 15 times stronger than the drug smoked in the 1960s. ‘This means studies carried out at that time will probably have underestimated the effects of cannabis smoking,’ she explained.

‘Puff and inhalation volume with cannabis is up to four times higher
than with tobacco – in other words you inhale deeper and hold your
breath with the smoke for longer before exhaling.

‘This results in more poisonous carbon monoxide and tar entering into
the lungs,’ Dame Helena said.

The foundation’s report – A Smoking Gun? – analyses research from around the world.

It found cannabis smokers have a higher level of chronic and acute
respiratory-conditions such as coughingwheezing and bronchitis. ‘When cannabis is smoked together with tobacco then the effects are additive’, it says.

Some studies suggest cannabis smoking may trigger chronic obstructive pulmonary disease which kills 32,000 people in Britain every year, the foundation’s report adds.

‘Research linking cannabis smoking to the development of respiratory
cancer exists although there have also been conflicting findings.

‘Not only does the tar in a cannabis cigarette contain many of the same carcinogens as tobacco smoke, but the concentrations of these are up to 50 per cent higher in the smoke of a cannabis cigarette,’ it says.

Benzyprene, found in the tar of cannabis joints, can change the make-up of one of the genes which suppresses tumours and could therefore make cancer more likely for people who smoke joints.

There are also more than 75 case studies of young cannabis smokers with cancers of the throat and gullet – diseases usually rare in people under 60.

Source: Daily Mail
Monday 11 Nov 2002

Neuropharmacologists ran clinical trials to find that a drug called topiramate is an effective therapeutic medication for decreasing heavy drinking and diminishing the physical and psychosocial harm caused by alcohol dependence.

The drug works by blocking the right amount of the feel good effects of alcohol (brought on by increased levels of dopamine), making drinking less enjoyable and thus reducing cravings and helping to stop heavy drinking.

Topiramate was also found to lower blood pressure and cholesterol levels which may lead to a decrease in heart disease in alcohol dependent patients.

Alcoholism affects over 17 million people. Without proper treatment, it’s a devastating disease that can ruin lives and relationships. A new therapy that comes in a pill is bringing new hope to alcoholics.

There was a time in Christine Flemming’s life when alcohol came before her kids.
“I can’t remember when my daughter was very little, because I was drinking so much,” said Flemming. “That affected me a lot.”

Flemming needed help, but traditional treatment methods didn’t work. Now she’s on a new kind of therapy in the form of a pill called topiramate. It has changed her life. “I can tell you that it cuts my cravings, and I don’t feel like I have to drink,” Flemming said. “I don’t feel like that’s something I need in my life and I have to do.”

Alcohol increases levels of dopamine, a chemical in the brain that makes us feel good. The drug works by blocking the right amount of the feel-good effects from alcohol to reduce cravings and help stop heavy drinking. During clinical trials, neuropharmacologists were surprised to learn it also lowers blood pressure and cholesterol levels, which may lead to a decrease in heart disease in alcohol dependent patients.

“Most of the morbidity due to alcoholism is caused by secondary effects of all these other systems, so to have a drug that begins to correct all those other physical abnormalities is extremely helpful,” said Bankhole Johnson, Ph.D., a Neuropharmacologist at the University of Virginia in Charlottesville, Va.

The drug helped improve Fleming’s health and end her dependence on alcohol. She cut her drinking from 15 beers a day to just three, so time with her kids is now a priority.
“It’s made a big difference,” Flemming said. “It’s made a really big difference, and I feel like I’m actually there for my family.”

Qualifying patients can find out how to receive the drug by contacting their primary care doctors.

WHAT IS TOPIRAMATE? Topiramate is a drug originally discovered in 1979. It is prescribed as an epilepsy medication and for migraine headaches. It is also used for a number of other purposes, including as a treatment for people with alcoholism.

Researchers believe that topiramate works in two ways. First, it reduces the release of dopamine that follows the consumption of alcohol. This reduces the positive feeling that people receive from alcohol, and thus reduce the incentive to drink. Second, topiramate interferes with the protein glutamate which normally excites dopamine neurons and again, lessening the ýfeel goodý effect of dopamine from alcohol.

WHAT IS ALCOHOL? Alcohol is created through the natural process of fermentation. This happens when yeast and sugar from vegetables and grains change the sugar into alcohol. When you drink alcohol, it is absorbed into your bloodstream, where it can affect the central nervous system, which is the control center for your entire body.

Alcohol slows down this control center with its sedative effect. In moderation it can reduce anxiety, but it also blocks some of the commands the brain sends to other parts of the body, so it alters your senses. That’s why, when drunk, people often have trouble walking, talking, and some may even “black out,” forgetting what they said or did. Drinking an excessive amount of alcohol can even be fatal.

Source www.ScienceDaily June 2010

“This report summarises the key findings from a report exploring public attitudes towards illegal drugs and drug misuse in Scotland, based on data from the 2009 Scottish Social Attitudes survey. It focuses in particular on attitudes towards opiate misuse, and on views of potential policy responses to this. However, it also places such attitudes in the context of wider views and experiences of illegal drugs.”

Main Findings
■ Support for legalising cannabis – which increased in Scotland (as in the rest of the UK) in the late 1990s – has fallen considerably in more recent years, from 37% in 2001 to 24% in 2009. Attitudes towards prosecution for possession of cannabis for personal use also hardened between 2001 and 2009.

■ Most people said taking cocaine occasionally is wrong – 76% rated it as 4 or 5 on a scale where 5 meant ‘very seriously wrong’.

■ 45% of people agreed that ‘Most people who end up addicted to heroin have only themselves to blame’, while just 27% disagreed.

■ Around half (53%) disagreed that ‘most heroin users come from difficult backgrounds’ (29% agreed).

■ Among those in paid employment, around half (47%) said they would be ‘very’ or ‘fairly comfortable’ working alongside someone they knew had used heroin in the past, while around 1 in 5 would be uncomfortable.

■ Just a quarter (26%) said they would be comfortable with someone who was receiving help to stop using heroin moving near to them, while half (49%) would be uncomfortable.

■ There was no public consensus on what should be the top government priority for tackling heroin use in Scotland – 32% chose ‘tougher penalties for those who take heroin’, 32% ‘more help for people who want to stop using heroin’ and 28% ‘more education about drugs’.

■ Just 16% agreed that people who possess heroin for personal use should not be prosecuted (compared with 34% for cannabis).

■ Public support for providing clean needles to injecting drug users fell from 62% in 2001 to 50% in 2009.

■ Opinion on educating young people about safer drug use was split – 44% agreed that young people should be given information about how to use drugs more safely, but 40% disagreed.

■ Four out of five (80%) agreed that ‘the only real way of helping drug addicts is to get them to stop using drugs altogether’. However, 29% agreed that ‘most heroin users can never stop using drugs completely’, while 27% said they neither agreed nor disagreed or did not know.

■ 63% disagreed that ‘Someone who has been a heroin addict can never make a good parent, even if their drug problems are in the past’.

■ Around two thirds (64%) said that young children of heroin users should be placed into temporary foster care until the parents stop taking heroin. A further 1 in 5 believed the child should stay at home while the family receives help from social workers and just 8% said the child should be permanently adopted by another family.

The full report is also accessible online.

Source: http://uwsnealb.wordpress.com/2010/05/28/scottish-social-attitudes-survey-2009-public-attitudes-to-drugs-and-drug-use-in-scotland/ May 25 2010

Combining a randomised trial with a ‘real-world’ test, studies of the Dutch Drinking Less programme have gone further than any others to establish the beneficial impacts of web-based alcohol self-help interventions.

The study was a ‘real-world’ test of a promising Dutch internet-based self-help intervention for problem drinking.
A previous randomised trial employing the methodological safeguards possible in tightly controlled research (particularly the recruitment of a comparison group not given access to the intervention) had established that the intervention reduced drinking. At issue in the featured study was whether similar drinking reductions would be seen when the intervention was made freely available to the general public. If they were, then the assumption could be made that these too were caused by having access to the intervention.

Drinking Less is an on-line, interactive programme with no personal therapist input. Aimed at risky drinkers among the general adult population, the intervention is based on principles derived from motivational interviewing, cognitive-behavioural therapies and self-control training. Its home page offers links to alcohol-related information, treatment services, a discussion forum, and the

Drinking Less self-help programme, the core of the intervention. Over a recommended six weeks (though this is entirely up to the user) the programme guides visitors in preparing to change their drinking, setting goals , implementing change, and finally sustaining it, preferably by drinking within recommended limits.

The earlier trial had found that six months later, at least 17% of adult problem drinkers randomly allocated to this intervention had reduced their drinking to within Dutch guidelines, compared to just 5% allocated to an on-line alcohol education brochure. Before the study, both groups had averaged about 55 UK units a week.

At follow-up, the Drinking Less group had cut consumption to about 36 UK units a week, but the brochure group had barely changed.

The featured study monitored what happened when over 10 months spanning 2007 and 2008 the web site was advertised to the Dutch public. During this time round 27,500 people visited the site, of whom 1625 signed up for the self-help programme, accessing it on average 23 times.

Typically they were well educated, employed, middle-aged men. On average they drank about 50 UK units a week, and nearly all who completed the on-line AUDIT screening questionnaire scored in a range indicative of alcohol abuse or dependence.
During the first seven of the 10 months, 378 of site visitors who signed up to the Drinking Less programme also agreed to participate in research to assess its impact. On average they drank roughly the same amount (95% exceeded Dutch guidelines) as all 1625 who signed up and were also similar in age, sex, employment, and motivation to change.

Despite some statistically significant differences, they were also broadly similar to participants in the earlier randomised trial. Over 8 in 10 had never received professional help for their drinking. A few weeks later a survey suggested that after signing up, nearly 9 in 10 went on to use the programme, though generally only a few times.
Of the 378 in the baseline sample, 153 responded to an on-line follow-up survey six months later. Before signing up to the programme, just 4% had confined their drinking within Dutch guidelines; six month later, 39% did so. They had also nearly halved their average consumption from 50 UK units to 27. On the ‘fail-safe’ assumption that the intervention had no impact on people who were not followed up, still the drinking reductions were statistically significant; from 5%, the proportion drinking within guidelines rose to 19%, and consumption fell from 51 UK units to 42.

Next the analysts compared these results with those from the six-month follow-up in the randomised trial. Based only on respondents to the follow-up surveys, and adjusting for differences between the samples, in the ‘real-world’ test over twice as many (unadjusted figures 36% v. 19%) people moved to drinking within Dutch guidelines. When the assumption was made that in both trials the intervention had no impact on people not followed up, the figures still favoured the ‘real-world’ test (15% v. 10%), but the difference was no longer statistically significant.

The researchers concluded that the featured study had shown that the benefits established by the randomised controlled trial would be sustained when the intervention was made routinely and generally available to the public. The expected throughput of 3000 Drinking Less programme users a year would amount to nearly 3% of the country’s problem drinkers who would otherwise not have received professional help. Probably because they require the drinker to take the initiative and visit the site, such interventions reach people who, compared to the totality of problem drinkers, are more likely to be women, employed, highly educated, and motivated to change their drinking. Given its low cost per user, this type of intervention seems to have a worthwhile place in a public health approach to reducing alcohol-related problems.

Though only a minority of site visitors may sign up for web-based alcohol programmes, nevertheless the numbers engaged can be very large, and the risk-reductions seem of the order typical in studies of brief advice to drinkers identified in health care settings. In these settings screening programmes typically identify people who are not actually seeking help for drinking problems – ‘pushing’ them towards intervention and change – while web sites ‘pull’ in people already curious or concerned about their drinking. As such these two gateways can play complementary roles in improving public health and offering change opportunities to people who would not present to alcohol treatment services. However, in Britain and elsewhere, both tactics reach only small fractions of the population who drinking excessively, leaving the bulk of the public health work to be done by interventions which drinkers generally cannot avoid and do not have seek out, such as price increases and availability restrictions.

With its combination of a randomised trial and a ‘real-world’ test, the featured research programme has gone further than any other in establishing the beneficial impacts of web-based alcohol interventions. However, largely because many site users do not complete research surveys, it remains impossible to be sure that the results seen in such studies will be replicated across the entire usership of the sites. Details below.

Strengths and limitations of the featured study
The featured study’s combination of a randomised trial with all its methodological safeguards, and a ‘real-world’ trial approximating normal conditions, affords what seems to be the best indication to date of the contribution web-based self-help interventions could make to reducing heavy drinking and associated health risks. However, its twin pillars are weakened by the fact that many people either did not join the studies or did not supply follow-up data; those who did may not have been typical of all the people who might access such sites.

In the randomised trial, 40% of the baseline sample did not complete the six-month follow-up survey, and in the featured study, nearly 60%. Though on the measures taken by the study the respondents generally seemed typical of the baseline sample, clearly something was sufficiently different to cause them to respond while the others did not. In both studies this problem was catered for by assuming that non-responders were also non-changers. Though this almost certainly underestimated the impact of the intervention, still in both there remained significant and worthwhile improvements.

What could not be catered for in either study was the degree to which people who join such studies differ from the much greater number who would use the web sites, but decline participation in research. This problem was especially apparent in the featured study, in which it seems that around 6% of site visitors signed up for the self-help programme. Of these, perhaps a third or slightly more of the people who signed up for the programme during the relevant period also agreed to participate in the research. In some important ways (including amount drunk and motivation to change) they seemed similar to the bulk of programme sign-ups, though the researchers suspect they were more likely to have engaged with the programme.

Opening more doors to change for more people
A review of computer-based alcohol services for the general public has rehearsed the advantages: immediate, convenient access for people (the majority in developed nations) connected to the internet; consequently able to capitalise on what may be fleeting resolve; anonymous services sidestep the embarrassment or stigma which might deter help-seeking; such services are available to people unwilling or less able to talk about their problems to a stranger; generally they are free and entail no travel costs or lost income due to time off work; very low operating cost per user if widely accessed; easily updated.

In consumption terms, the drinking problems of web site users are comparable to those of drinkers who seek treatment, yet few have received professional help, perhaps partly because their higher socioeconomic status and greater resources have enabled them to restrict the consequential damage. People who actually engage with web-based assessments of their drinking problems have more severe problems than those who just visit and leave. Including the randomised trial which paved the way for the featured study, the review found eight studies which evaluated the effectiveness of computer-based interventions for the general public.

In all but one the users significantly improved on at least one of the alcohol-related measures recorded by the studies.
A particular role for alcohol self-help sites may be to offer an easy, quick and accessible way to for drinkers to actualise their desire to tackle their problems, especially when that desire is allied with the resources to implement and sustain improvements without face-to-face or comprehensive assistance. After conducting the Project MATCH trial, some of the world’s leading alcohol treatment researchers argued that “access to treatment may be as important as the type of treatment available”. The implication is that in cultures which accept ‘treatment’ as a route to resolving unhealthy and/or undesirable drinking, having convincing-looking and accessible ‘treatment doors’ to go through may be more important than what lies behind those doors, as long as this fulfils the expectations of the client or patient. This is likely to be especially the case for people who retain a stake in conventional society in the form of marriages, jobs, families, and a reputation to lose. These populations – the kind the featured study suggests are attracted to self-help alcohol therapy web sites – have more of the ‘recovery capital’ resources needed to themselves do most of the work in curbing their drinking.

The British Down Your Drink site
The best known British alcohol self-help web site is the Down Your Drink site run by a team based at University College London, an initiative originally funded by the Alcohol Education and Research Council and now by the Medical Research Council’s National Prevention Research Initiative. In 2007 this was revised to offer set programmes from a one-hour brief intervention to several weeks, but also to generally give the user greater control over the use they made of the site. The approach remained based on principles and techniques derived from motivational interviewing and cognitive-behavioural therapies.

The previous version had been structured as six consecutive modules to be accessed weekly. An analysis of data provided by the first 10,000 people who registered at the site after piloting ended in September 2003 revealed that most were in their 30s and 40s, half were women, nearly two-thirds were married or living with a partner, just 4% were unemployed, and most reported occupations from higher socioeconomic strata.

As an earlier study commented, site users were predominantly middle class, middle aged, white and European. Six in 10 either did not start the programme, or completed just the first week. About 17% completed the six weeks. Of these, 57% returned an outcome questionnaire. Compared to their pre-programme status, on average they were now at substantially lower risk, and functioning better and living much improved lives.
The sample had been recruited over about 27 months, a registration rate of about 4500 a year. By way of comparison, in England during 2008/09, around 100,000 adults were treated for their alcohol problems at conventional services. User profile and site usage had been similar during the earlier pilot phase. Results from surveys sent to pilot programme completers indicated that three quarters had never previously sought help for their drinking.

Source: Published in Findings 19 May 2010 Alcoholism: Clinical and Experimental Research: 2009, 33(8), p. 1401–1408

An Evaluation of the Kids, Adults Together Programme (KAT)

INTRODUCTION
A key influence on the timing of young people’s first alcohol use is the family (Spoth et al. 2002) and a number of substance misuse prevention programmes (mainly in the USA) have tried to influence families. Most are based in schools, which potentially provide an efficient way to reach large numbers of young people and their families (Bryan et al. 2006). However, in practice, school-based initiatives have not always managed to engage significant numbers of parents (Lloyd et al. 2000; Rothwell et al. 2009; Stead et al. 2007; Ward and Snow 2008).
This report describes the findings from an exploratory evaluation of a new school-based alcohol misuse prevention programme – Kids, Adults Together (KAT), which engaged with parents as well as children. The programme comprised a classroom component for children, a family fun evening, and a DVD. The research study evaluated the development and early implementation of KAT, and aimed to establish the theoretical basis for the programme. It explored implementation processes and acceptability, and identified plausible precursors of the intended long-term outcome which could be used as indicators of likely effectiveness.
METHODS
Mixed qualitative data-collection methods were used during two phases of evaluation. The first phase of the evaluation investigated how KAT had originated and developed; its relationship to existing evidence and theory; and its aims. Methods used were an analysis of thirty-two documents selected by the programme organizers and meant to provide an ‘audit trail’ of programme development up until the start of the evaluation; a literature search; and interviews with six members of the working group who had been involved in setting up the programme, the programme organiser and his assistant, the KAT DVD producer and the organiser of the Australian PAKT programme (on which KAT is based).
The second phase comprised observation of the classroom preparation and KAT family events in two pilot schools; focus groups with forty-one children; interviews with both head teachers and with teachers who delivered the classroom preparation; follow-up interviews with the programme organisers and six Working Group members; interviews with twelve parents who attended the KAT family events; and a questionnaire for parents of all 110 children who had been involved in the classroom preparation. There were two rounds of focus groups and parent interviews: the first as soon as possible after the KAT event at each school and the second months later.
Programme aims
The main aim of KAT was identified as reducing the number of children and young people who engaged in alcohol misuse. Exploration of the programme’s implementation suggested that family communication should be reaffirmed as its primary objective. This was consistent with the social development model (Catalano and Hawkins 1996) which links family communication with children’s alcohol-related behaviour later in life.
Acceptability
KAT achieved high levels of acceptability among pupils, parents and school staff. Parents enjoyed the fun evening, and thought it was delivered in an, engaging and non lecturing way. Participants thought it was good that the KAT programme had been run in the school setting, and felt that such work should be delivered to children at a young age. Staff in both pilot schools believed that the way in which the evening was promoted as an opportunity for parents to find out what their children had been working on helped avoid a perception that the fun evening was designed to lecture parents.
INITIAL IMPACT
Communication
The KAT programme’s most significant and persistent impact on communication was the effect on family conversations about parental drinking. Many children who thought their parents drank too much alcohol reported trying to change their (parents’) behaviour.
The classroom preparation was effective in promoting communication about alcohol issues amongst members of the class but outside the classroom, its effect was minimal, and until the work had culminated in the fun evening, few children said much at home about it. Most children were very keen to go to the fun evening, to show off their work, to see what it was like and to enjoy the refreshments and entertainment. Many put pressure on their parents to attend.
The fun evening acted as a catalyst for setting off conversations about what children had done in the classroom and activities during the evening. The DVD was effective in extending the influence of the programme beyond the school-based components.
Knowledge
Both children and parents reported having gained new knowledge about alcohol as a result of their involvement with the KAT programme.
Attitudes
There was little evidence that involvement in KAT (as a whole or its constituent components) had led to changes in parents’ or children’s attitudes to alcohol consumption. Overall the children held critical attitudes towards alcohol and the effects which its consumption might lead to. Most parents who were concerned about the dangers of alcohol and the use of alcohol by their children held pre-existing concerns or attitudes.
Awareness
KAT raised children’s and parents’ awareness of issues relating to alcohol and some parents had thought about their own drinking practices, particularly how drinking alcohol in front of their children could influence them.
Intention
Evidence from participants suggested that KAT had only a small effect on intentions regarding future behaviour. These intentions were often stimulated by specific aspects of the programme such as the DVD or leaflets in the goody bag.
Behaviour
There was evidence from some parents and children at both schools that drinking behaviour of parents and other family members had changed as a result of KAT. The effect was not confined to those who had attended the fun evening, suggesting that KAT was able to influence communication within wider networks of family and friends.
IMPLICATIONS
The report highlights five main findings from the evaluation of KAT:
1. KAT has demonstrated promise as an alcohol misuse prevention intervention through its short term impact on knowledge acquisition and pro-social communication with family networks
2. The interaction between the programme’s core components (classroom activities, family fun evening and the programme DVD/goody bag) appear to have been integral to the impact on knowledge acquisition and communication processes that occurred within participating families
3. The timing of KAT (its delivery to children In primary school Years 5 and 6) is appropriate both because it precedes the onset of drinking (or regular drinking), and because it engages families whilst they are still a key attachment and influence in young people’s lives
4. KAT achieved high levels of engagement and acceptability among parents, and this included some families with problems/support needs in relation to alcohol
5. Engagement levels among parents were higher among mothers than fathers. The research was not able to explore the in-depth experiences of those parents/carers who did not or could not attend the KAT fun evening
The following five recommendations are made for the future development and evaluation of KAT:
1. Further research is needed to refine and develop the theoretical model of how KAT works, whether short term changes in knowledge, communication and behaviour are sustained over the longer term, and how these processes might reduce alcohol misuse
2. KAT needs to be delivered and evaluated in different school contexts to further test its underpinning model, and explore the acceptability and local adaptation of the programme within these settings
Future research needs to explore in more detail the reach of the programme (including the engagement of fathers), examine what barriers to attendance might exist and put in place strategies to minimise them
3. Future stages of implementation should clarify if KAT specifically aims to reach families with problems/support needs in relation to alcohol, or whether it is intended as a primary prevention intervention for general school populations
4. It is important to address the support needs of children whose attempts to discuss issues raised by KAT (particularly around parental drinking) are rejected or not received positively by their parents

Source: http://www.aerc.org.uk/insightPages/libraryIns0070.html Alcohol Insight number 70

Research Summary
Frequent, long-term use of the club drug ketamine appears to cause significant impairment in short-term and visual memory, according to researchers from University College London.
Reuters reported Nov. 20 that researchers tracked 150 users of ketamine, a.k.a. “Special K,” for more than a year. They found that while occasional users of ketamine seemed to suffer few ill effects, frequent users of the anaesthetic drug experienced problems with memory and concentration as well as a decline in psychological well-being. Short-term and visual memory problems worsened over time, study author Celia J. A. Morgan and colleagues found.
“Despite the dramatic increase in ketamine use over the past decade, young people who use this drug are still largely unaware of its damaging health properties and its potential for dependency,” the study said. “Health education campaigns should target ketamine users to ensure that people are informed of the negative consequences of heavy ketamine use.”
Source: www.jointogether.org Nov.2009 The findings were published in the journal Addiction.

April 5, 2007

A new study finds that teaching teens ‘competence skills’ — such as good self-management and positive psychological characteristics — can effectively reduce adolescent alcohol and other drug use.
Health News Digest reported April 4 that the study from Weill Cornell Medical College researchers found competence skills can protect teens from social risk factors for substance abuse, including having friends who use alcohol, tobacco, or illicit drugs.
Researchers who studied a group of 1,500 (mostly Hispanic) adolescents from New York City over a period of three years found that those with high refusal-assertiveness marks and sound decision-making skills were less likely to smoke or use multiple substances, even when they had friends or siblings who did.
“The take-home message from these findings is that competence skills matter in our understanding of substance use,” says study author Jennifer A. Epstein of the Division of Prevention and Health Behavior at Weill Cornell. “They can combat powerful social influences from friends and siblings to use multiple substances, including cigarettes. Moreover, this research provides important support for drug-abuse prevention programs that include the teaching of competence skills, including refusal skills and decision-making skills.”
“Students need to be encouraged to develop competence skills to resist drugs, since social and other risk factors can never be entirely eliminated,” added Gilbert Botvin, senior author of the report and developer of the Life Skills Training prevention program.
The study was published in the issue of the journal

Source: journal: Addictive Behaviors. April 2007

Young men are three times more likely to die from alcohol-related injuries than females. To make matters worse, new research released today shows that they do not respond to school-based drug education as well as their female counterparts.
Delivery of a new school-based program has resulted in lower alcohol consumption, less binge drinking and less alcohol-related harms – but only in females.
CLIMATE Schools: Alcohol Module was developed and trialled by the National Drug and Alcohol Research Centre (NDARC) at the University of NSW. Researcher, Ms Laura Vogl, found that the findings were consistent with the results of many other school-based drug prevention programs.
“Males are a much harder group to reach,” Ms Vogl said. “It is common knowledge that alcohol use generally increases from the early to late teenage years. This program was effective in subduing this growth. Twelve months after the program was delivered it was clear that the CLIMATE program had subdued the growth of alcohol use and harm for females.”
After one year, students who did not get the CLIMATE program reported:
o Twice the increase in average weekly alcohol consumption compared with the students who received the CLIMATE program.
o A fives times greater increase in the frequency of binge drinking compared with the students who received the CLIMATE program.
o Twice the increase in the maximum number of drinks consumed during these binging occasions, and
o A five times greater increase in the number of alcohol-related harms experienced in the previous 12 months compared with the students who received the CLIMATE program

CLIMATE Schools: Alcohol Module was developed by NDARC in collaboration with the Clinical Research Unit for Anxiety and Depression and secondary school teachers. This program was trialled with over 1,500 Year 8 students in Catholic and Independent schools. This innovative program uses a computerised cartoon-based teenage drama to teach young people skills to minimise alcohol consumption and reduce the risk of harm.
The program was successful in teaching all young people, both males and females, the knowledge to minimise alcohol-related harm. It was also effective in moderating students’

beliefs regarding the positive benefits of alcohol. Students were far less likely to glamorise the effects of alcohol after they had completed the CLIMATE program.
However, when it came to behaviour change, it was only female students who changed their behaviour.
For the boys, the CLIMATE program was no more effective in changing alcohol use behaviour than the standard alcohol prevention education currently being delivered in the control schools.
Ms Vogl said that there could be a number of reasons to explain this result.
”The Australian Alcohol Guidelines were used in the program and these state that males can drink more alcohol than females to stay at low risk,” explained Ms Vogl. ”Currently, many young females drink similar amounts to their male counterparts. Pointing out to young women that they cannot actually drink as much alcohol for the same level of risk, may have been a shock for many and made them rethink their behaviour.“
Drinking and the experience of alcohol-related harm is often seen as a badge of honour or sign of manhood and could be a contributing factor to the gender differences.
“If a male student is involved in a fight, he may be viewed as a hero. Likewise, if a male has unplanned sex whilst under the influence of alcohol, he may be viewed as a stud. By contrast, if a female accidentally falls pregnant while under the influence of alcohol, she may be viewed as promiscuous. If she vomits in a public place as a result of drinking, the consequences can be dire.”
Traditionally, male socialisation and friendships also revolve more closely around alcohol than that of females. For alcohol prevention interventions to be effective with male students a broader range of alcohol related beliefs may need to be targeted.
Research has suggested that it may be necessary to focus on the negative sexual effects of alcohol, such as erectile dysfunction, to achieve success. The only obstacle to this is that it may be considered inappropriate to teach this in Year 7 and 8 of high school, when alcohol prevention education needs to be implemented.
“Alcohol-related harm is a major concern during adolescence, especially for males. Effective alcohol prevention programs do exist and in many cases are the ones implemented in schools. However, greater time needs to be given for more intensive interventions with the hope of more effectively changing the behaviour of young males.”
ends

Source: NDARC. Univ. of New South Wales. Australia February 25 2007

Background: Prevention interventions that focus on the impact of social influences, making healthy choices, and promoting anti-substance abusing norms have proven effective in reducing adolescent drug use. The school-based drug abuse prevention program Life Skills Training (LST) teaches a variety of cognitive-behavioral skills for problem-solving and decisionmaking, resisting media influences, managing stress and anxiety, communicating effectively, developing healthy personal relationships, and asserting one’s rights. Researchers wanted to know if these strategies may also be successfully applied to combat adolescent delinquency, verbal and physical aggression, and fighting.

Study Design: Researchers introduced LST to 2,374 students in 20 New York City public and parochial schools, and established a comparable control group. Sample composition was 39 percent African-American, 33 percent Hispanic, 10 percent White; 55 percent economically disadvantaged; and 30 percent living in mother-only households.

What They Found: After 15 school-based sessions, delinquency and frequent fighting were significantly reduced across the entire intervention group.

Comments from the Authors: This study supports the idea that multiple problem behaviors may have common causes. It further suggests that the development of comprehensive, integrated school-based approaches to prevention may more efficiently target an array of related behaviors, thereby reducing the burden on resources and increasing the likelihood for adoption and implementation.

What’s Next: More research is needed to test the durability of the LST approach. It would also be useful to determine if these strategies can prevent more serious forms of violence, such as assault and homicide.

Publication: The study, led by Dr. Gilbert J. Botvin of the Department of Public Health at Weill Cornell University Medical College, was published in volume 7, pages 403-408 (2006) of Prevention Science.

Source: NIDA 27th Aug.2007

The Texas Prevention Impact Index is a report showing statistics in the usage of drugs, alcohol, tobacco, and violence among students in the Amarillo independent school district.
The TPII look at risk and protective factors that lead students to or away from the various substances. They look at perceptions in the community towards alcohol, drugs, and tobacco use. The numbers also reflect the usage of these substances by the students that fill out the survey.
25 hundred surveys are filled out by a cross section of students in the Amarillo school district, ranging from the 6th grade up to seniors in high school.
Here a few noteworthy statistics you may find interesting from the data collected by Research and Educational services, a private evaluation and research firm based out of Houston. The company has done the surveys and completed the data for A.I.S.D. since 2002.
47.9% of students say they would go to parents if they had a question about alcohol or drugs, versus 20.7% say they would ask a friend their age.
The number of students who say it’s ok to have alcohol to have a good time is 26% down from 30% just 4 years ago.
The number of students who think schools do NOT enforce rules on drinking have gone down form 30% to 19%, which means more students are getting the idea that it’s not acceptable to use alcohol from the school district.
In the category of usage in the past 30 days here are some numbers that show improvement.
In the past 30 days, seniors are using alcohol 7% less, using tobacco 6% less, and nearly 14% less of the students serveyed say they have participated in binge drinking in the past 30 days. All are positive stats.
87% of all students across the board have NOT used Marijuana in the past 30 days.
Frequency of usage numbers also show decreases. Tobacco is down 12%, alcohol is down 6%, marijuana is down 11%, this means that those kids that do use these substances are not using as frequently.
Some statistics that show perception changes are the following: 93% of the students surveyed say that they are harming themselves by smoking. 79% of students, up from 69% say that they are harming themselves by smoking marijuana.
Switching gears to violence and safety issues.
15% of students say they have been bullied during the past 30 days.
12% say they’ve been involved with a group fight.
In the past year the percentage of students who have been in a fight at school was 15%.
33.4% of the students say they have discussed safety issues with family in the past 30 days.
All in all, some of the numbers shown are alarming and some show great improvement in prevention and awareness programs here in Amarillo. The Amarillo community should be proud that the students have made progress and the school district is working decrease these all important problems.
“It shows, basically that the efforts that are being conducted here are working, to be honest with you when you look at the rest of the state or other areas in the state, I don’t think you see the same kind of trends or same kind of change in those areas, it’s been very successful here,” said Dr. Robert Landry, Director of Research and Educational Services.
“We’re seeing some decreases in some types of drug use which we’re glad to see, we also know that we need to continue the education K-12 for our students and be able to share current information with them,” said Teresa Kenedy, A.I.S.D. Prevention Specialist.

Source: www.connectamarillo.com  31st March 2009

Marijuana use leads to difficulty in concentrating and thinking. It also decreases the user ability to memorize things. (1—4). In addition, user’s of marijuana have an increased tendency to ‘remember’ things that did not happen. (5,6) Most marijuana users do not realize that these effects of marijuana on mental ability persist for up to 6 hours after the last use of the drug. The user may not feel high, but his reaction times are slower and memory skills are decreased. These changes can decrease ability in sports, other physical activities, and in studies.

Marijuana may be more detrimental to memory function than is alcohol or cocaine. (7) This effect may be due to the presence of cannabinoid receptor sites (activation of these receptors interrupts normal brain motor and cognitive function) in the areas of the brain which control memory.
(8,9)

The results of a 1992 study of 48 adult male subjects who smoked marijuana then completed standardized, paper—and—pencil tests of educational development and ability, learning, associative processes, abstraction, and psychomotor performance indicate that all capabilities were impaired except abstraction and vocabulary. (10,11)

Referenses:
1. Andreasson S, Allebeck et al. Cannabis and schizophrenia; A longitudinal study of Swedish conscripts. Lancet 1987 Dec 26; :2483—6.
2. Schwartz RH. Heavy marijuana use and recent memory impairment. Psychiatric Annals 2992 Feb;21(2) :80—2.
3. Abood ME, Martin BR. Neurobiology of marijuana abuse. Trends In Pharmacological Sciences 1992 May; 13(5) :201—6.
4. Nahas G, Latour C. The human toxicity of marijuana. Medical Journal Of Australia 1992 Apr 6;156(7) :495-7
5. Pfefferbaum A, Darley CF, Tinklenberg JR, Roth NT, Kopell BS. Marijuana and memory intrusions. J Nerv Ment Dis
1977;l65(6) :381—6.
6. Block RI, Wittenborn JR. Marijuana effects on associative processes. Psychopharmacol 1985;85:426—30.
7. Brown J, Kranzler HR. Delboca FK. Self—reports by alcohol and drug abuse inpatients — factors affecting reliability and validity. British Journal Of Addiction 1992 Jul;87(7) :10]3—24.
8. Matsuda LA, Bonner TI, Lolait SJ. Localization of cannabinoid receptor messenger RNA in rat brain. Journal of Comparative Neurology 1993 Jan 22;327(4) :535—50.
9. Heyser CJ, Hampson RE, Deadwyler SA. Effects of delta—9—tetrahydrocannabinol on delayed match to sample performance in rats — alterations in short—term memory associated with changes in task specific firing of hippocampal cells. Journal Of Pharmacology And Experimental Therapeutics 1993 Jan;264 (1) 294-307.
10. Block RI, Farinpour 1k, Braverman K. Acute effects of marijuana on cognition — relationships to chronic effects and smoking techniques. Pharmacology Biochemistry And Behavior 2992 Nov;43(3) :907—17.
11. Azorlosa JL, Heishman SJ, Stitzer ML, Mahaffey JM. Marijuana smoking — effect of varying delta—9—tetrahydrocannabinol content and number of puffs. Journal Of Pharmacology.

Source:www.cesar.umd.edu/metnet, Nov 1998

“Drugs and sex are interrelated,” Dr. Porio stressed as the 2002 Young Adult Fertility and Sexuality Study 3 (YAFS 3) disclosed that the youngsters who indulge in drugs have the ‘gnawing desire’ for sex.

In fact, the YAFS 3 showed that there was a high incidence of drug use among females as it almost tripled from one percent in 1974 to 3.2 percent in 2002. The drug prevalence among females reached 19.7 percent in 2002 from 10.9 percent in 1994.

As these figures increased, Dr. Porio said that paying attention to reproductive health education is an important act that must be done right away asserting, “there’s a need to mainstream practical reproductive health education campaigns and activities.”

She also disclosed that drugs have parallel effects to the increase of crime index nowadays as 65 percent of prison inmates are in jail for drug-related crimes with 70% percent of drug-related cases filed in court.

The BMA has called on the UK government to develop a campaign to highlight that taking drugs—whether prescribed, over the counter, or illegal—can impair driving capacity in a similar way to alcohol.
The BMA has recommended that the government should coordinate scientific research to establish effective drug testing devices and should educate the public on the association between taking some drugs and impaired driving ability.
To help publicise the problem, the BMA has developed a website www.bma.org.uk that reviews trends in road traffic fatalities and injuries, as well as research on drugs and driving performance. The website highlights research from the Transport Research Laboratory showing that the number of people involved in fatal collisions who tested positive for illegal drugs increased sixfold between the periods 1985-87 and 1996-99

A revised version of the Drug Abuse Resistance Education (DARE) program is showing effective results in preliminary studies.
About 15,500 seventh graders in Detroit, Houston, Los Angeles, Newark, New Orleans, and St. Louis took part in early trials conducted by researchers at the Institute for Health and Social Policy at the University of Akron.The researchers found that the students given the new curriculum were more likely to refuse drugs and had fewer misconceptions about how many of their peers use drugs, compared to students in a control group.

“It shows us that the program is doing what it intended to do, and in a very significant way,” said Zili Sloboda, an epidemiologist at the Institute for Health and Social Policy and leader of the study.The findings could mean that the anti-drug program, which is most frequently taught to fifth-graders, could be administered in elementary through high school. “These kids are prepared now. Now we’ve got to reinforce that when they enter the ninth grade,” said Sloboda.

The researchers will continue to follow the students through their junior year in high school.The original DARE curriculum, which was implemented in 80 percent of school districts, has been criticized over the last few years for being ineffective or not sufficiently tested. A study last August supported those beliefs. The revised DARE curriculum, which will involve teachers rather than just police officers, includes more lifelike situations and helps students confront peer pressure more effectively. The study was funded by the Robert Wood Johnson Foundation.

Souce:Reported in Join Together Online 11.1.2002

The prevalence of marijuana use among young people has risen rapidly in recent years, causing concern over the potential impact on academic performance of such use. While recent studies have examined the effect of alcohol use on educational attainment, they have largely ignored the potential negative effects of other substances, such as marijuana. This paper examines whether the relationship between the initiation of marijuana use and the decision to drop out of high school varies with the age of dropout or with multiple substance use. Data are from a longitudinal survey of 1392 adolescents aged 16-18 years. The results suggest that marijuana initiation is positively related to dropping out of high school. Although the magnitude and significance of this relationship varies with age of dropout and with other substances used, it is concluded that the effect of marijuana in on the probability of subsequent high school dropout is relatively stable, with marijuana users odds of dropping out being about 2.3 times that of non-users. Implications of these conclusions are considered for both policy makers and researchers.
Source: Author Bray, Zarkin et al Research Triangle Institute NC USA July 1999

Two 11-year-olds in every classroom are using drugs, according to official figures which show a rise’ in cocaine use among school leavers. Amid controversy about David Blunkett’s drugs strategy, data published by the Government’s statistical service showed that six per cent of 11-year-olds used drugs during 2001. The figure rose to 39 per cent among 15-year-olds, while a fifth of 11- to 15-year-olds in England used drugs in 2001 Cannabis was the most frequent drug used, with 13 per cent of 11- to 15-year-olds smoking.
Peter Walker, adviser on drugs to the National Association of Head teachers, said, You show me a head teacher that says they haven’t got a drug problem and I will show you a liar. I mean infant schools, primary schools and secondary schools.
Source: Daily Telegraph, Womack, July 2002

What is preventive education for adolescents or children?
One of the most popular forms of ATOD (Alcohol, Tobacco and Other Drugs)prevention is preventive education for adolescents or children. Youth in classrooms or other community settings are presented with preventive lessons by a teacher, preventionist, trained police officer, or other authority. Often, trained teen volunteers may co-present a lesson. Lesson content may include ATOD information, life skills, or other components. (Note: Preventive education is just one way that schools play a prevention role. See the U.S. Dept. of Education’s list of “Characteristics of a Safe, Disciplined, and Drug-Free School,” in Appendix E of this Best Practices Handbook.)

Why does preventive education work?
Different kinds of curricula are based on different premises. Some seek to remedy a lack of drug information. Some seek to develop decision-making and resistance skills. Some seek to help adolescents counter pro-drug social influence as the youth establish their attitudes about ATOD. Research indicates that only some of these premises are valid.

How effective is preventive education for adolescents or children?
Preventionists have long been aware that preventive education alone is inferior to a more comprehensive approach that includes a focus on parents and community. Even so, preventive education as a sole approach has been one of the most heavily researched approaches to ATOD prevention. As a result of cumulative research, particularly in the 1980s and early 1990s, the evolving consensus of researchers in the field is that:

1. Given the correct curriculum, implementation support, and teaching approach, preventive education can have a significant positive effect in terms of delaying or preventing youth ATOD use.
2. Most currently used preventive education materials are NOT among the effective ones. But, they continue to be used due to political support, low cost, or other factors.
What else does research tell us about preventive education?
For adolescent education, two key research sources are Tobler and Stratton (1997) and Hansen (1996). Following earlier (1986 and 1992) meta-analysis studies of drug prevention programs, researcher Nancy S. Tobler conducted a meta-analysis of 120 experimental or quasi-experimental school-based adolescent drug prevention programs (5th-12th grade) that evaluated success on self-reported drug use measures. Each program was classified as either interactive (included guided discussion among students) or non-interactive (included only a lecture and discussion with the class facilitator).
Tobler found a tremendous difference in effectiveness, with non-interactive programs having little impact but the interactive programs having a substantial impact. Surprisingly, this impact on drug use occurred even when the average program length was only 10 contact hours.

Content categories of the various programs also played a role in effectiveness. Programs that focused only on intrapersonal skills such as decision-making, goal setting, and values clarification were ineffective. Effective programs may have had some intrapersonal skills, but included a strong interpersonal skill component focused on dealing with peer influence. Even with this content, programs delivered in a non-interactive way were substantially less effective, and frequently ineffective.

Another attribute, program size, was unexpectedly found to play a significant role in effectiveness. ‘Small” interactive programs did much better than “large” interactive programs, even though the latter did better than small non-interactive programs. The Tobler article does not define “small” and “large”, but a sub-analysis with “extremely large programs” may be used to infer a cutoff of about 1,000 students between the two categories.

Tobler’s meta-analysis used self-reported drug use as the sole measure of effectiveness, but “mediating variables” including knowledge and attitudes were also measured. An interesting point about the pattern of results on these measures is that interactive and non-interactive programs were approximately equal in producing knowledge gain, but interactive programs were superior in changing attitudes and decreasing use.

William Hansen’s summary of work in progress indicates that the three most powerful curricular elements in ATOD prevention are:

1. Normative Beliefs. Youth tend to greatly overestimate the percent of peers who use drugs. When given actual numbers, they apparently feel less deviant in their non-use.

2. Life Style Compatibility. In spite of hearing about the negative effects of drugs, many adolescents don’t necessarily see any threat by drug use to their desired lifestyle. When these connections are explicitly made, it has an impact.

3. Commitment. Opportunities for adolescents to make a personal, public commitment to avoiding ATOD use can lead to lower use rates.

For preventive education of younger (elementary school) children, the National Structured Evaluation indicates that a “Psychosocial Skill” approach is best. The approach is congruent with a “youth development” model, emphasizing affective, social, and other skills. It includes no didactic ATOD education. Examples of beneficial life skills for prevention include resistance skills, assertiveness, social problem solving, and decision-making.

Source: Best practices in ATOD prevention: US Dept. of Health & Human Services, National

Data from the past 20 years show that prevention has succeeded in substantially reducing the incidence and prevalence of illicit drug use. Successful substance abuse prevention also leads to reductions in traffic fatalities, violence, unwanted pregnancy, child abuse, sexually transmitted diseases, HIV/AIDS, injuries, cancer, heart disease and lost productivity.

Substance Abuse Prevention can be shown to be effective. In 1979, 25 million Americans used an illegal drug during the preceding month. (SAMHSA National Household Survey) In 1995, 12.8 million Americans used an illegal drug in the past month, a decrease of nearly 50 percent. In the 1980s, complete abstinence from drugs was claimed by fewer than one in thirteen high-school seniors. (NIDA–Monitoring the Future Survey) In 1995 nearly one out of five seniors reported complete abstinence, an increase of nearly 250 percent. Examples of Prevention Findings from CSAP national cross-site evaluations, CSAP grantee evaluations, and other programs.

FINDING:
Prevention programs can encourage change in youth behavior patterns which are indicative of eventual substance abuse.

Cornell University researchers in a study of 6,000 students in NY State found that the odds of drinking, smoking, and using marijuana were 40% lower among students who participated in a school-based substance abuse program in grades 7-9 than among their counterparts who did not.
Forty-two schools in Kansas City, MO reported less student use of alcohol, tobacco, and marijuana than control sites as a result of Project Star, a prevention program.
In Nashville, the proportion of students who achieved perfect attendance for 20-day attendance periods increased from 27% to 60% as a result of a CSAP-funded community partnership school incentive prevention program.
FINDING:
Substance abuse prevention programs can improve parenting skills and family relationships.
A CSAP-funded study at CO State University found significant and enduring enhancement of successful parenting skills including: increased parental satisfaction, decreased harsh punishments for children, increased positive attitudes towards parenting, and increased appropriate control techniques.
FINDING:
Drug abuse prevention programs are effective in changing individual characteristics which are predictive of later substance abuse.
In Oakland, CA and other sites across the country, the Child Development Project found significant decreases in incidents of weapons possession and gang fighting among program participants in comparison to control groups.
FINDING:
Substance abuse prevention programs reduce delinquent behaviors among youth which are frequently associated with substance abuse and drug-related crime.
The Mexican-American Unity Council found significantly fewer conduct problems, less hyperactive behavior, and reduced passivity among children participating in a CSAP-funded prevention program. A similar study in Denver, CO replicated these results.
The Safe Streets Prevention Partnership in Tacoma, WA has been instrumental in closing 600 drug selling locations since 1990 and in reducing crime by more than 40%.
The Miami Coalition Community Partnership program has spurred Dade County community officials to demolish more than 2000 crack houses. Crime in the area has been reduced 24% and annual drug use has decreased by more than 40%.
FINDING:
The transmission of generic life skills is associated with short-term reductions in substance abuse among adolescents.
In DE, the Diamond Deliveries program which targets pregnant adolescent alcohol and drug users resulted in a 60% lower incidence of low-birth-weight babies and significantly lower neonatal costs than a matched control group.
CSAP’s High Risk Youth projects confirm that prevention efforts incorporating “life skills” such as problem-solving, decision-making, resistance against adverse peer influences, and social and communication skills are associated with reduced incidence of substance abuse among adolescents.
Source: CSAP (Center for Substance Abuse Prevention) – www.health.org – Apr/1999

The federal government recently announced that the growing potency of America’s most popular illegal drug, marijuana, and the number of kids seeking help to get off the drug (one in five users) worried them so much that they were soliciting new marijuana-research proposals and urging local law enforcement to crack down on those who sell the drug.

The pro-marijuana lobby was furious and immediately charged the feds with fear-mongering and clamoring to protect their (not so glamorous, actually) jobs in Washington. Their cries rested on claims that more potent marijuana is not tantamount to more dangerous marijuana and that the rise in the number of treatment beds for marijuana users is due to criminal justice referrals, not the drug’s harmfulness.

But the evidence shows the government may indeed have it right. The pro-drug movement, fuelled with the motivation to legalize harmful substances and angry at the attack on its values of “drug use for all,” is putting kids at risk by downplaying the known dangers of marijuana.

Although not as destructive as shooting heroin or smoking crack, marijuana use is unquestionably damaging. Today’s more powerful marijuana probably leads to greater health consequences than the marijuana of the 1960s: Astonishingly, pot admissions to emergency rooms now exceed those of heroin. Visits to hospital emergency departments because of marijuana use have risen steadily, from an estimated 16,251 in 1991 to more than 119,472 in 2002. That has accompanied a rise in potency from 3.26 percent to 7.19 percent, according to the Potency Monitoring Project at the University of Mississippi.

More potent marijuana is also seen as more lucrative on the market. Customs reports claim that a dealer coming north with a pound of cocaine can make an even trade with a dealer traveling south with a pound of high-potency marijuana. It makes sense that people pay more for stronger pot because the high is better.

A flurry of very recent research studies – concerning withdrawal, schizophrenia and lung obstruction, for example – have also shown marijuana’s unfortunate consequences. These conclusions were not being reached in the ’70s and ’80s (legalizers often point to the Nixon-commissioned Shafer report, which said nice things about the drug as evidence of marijuana’s harmlessness), because marijuana from that era was weaker and less dangerous than today’s drug. The May 5 issue of the Journal of the American Medical Association reported that the number of marijuana users over the past 10 years stayed the same while the number dependent on the drug rose 20 percent – from 2.2 million to 3 million.

And although a majority of kids in treatment for marijuana are referred there by the criminal justice system, it still remains only a slight majority – about 54 percent. The rest is self-, school or doctor referral.To paint the picture that the reason marijuana dependence looks higher is because of the criminal justice system is disingenuous (especially because most people who use only marijuana never interact with law enforcement as a result of that use).

Some still argue that it’s wrong to arrest kids and force them into treatment. It seems like the government can never win: If it arrests and locks people up, legalizers kick and scream that we’re not giving users “alternatives to incarceration.” If it arrest kids as a way to get them help, and not as a punishment mechanism, all of a sudden the government is giving in to George Orwell.

It’s too bad that pot apologists don’t see what most parents do see: Marijuana is a harmful drug with serious consequences, and mechanisms – even a brush with the law to help a user realize that what he’s doing is harmful – to help stop the progression of use should be seen as a good thing. That’s not government propaganda. That’s common sense.And it may save a few lives.

Source: Kevin A. Sabet recently stepped down as senior speechwriter to America’s drug czar, John P. Walters. A Marshall Scholar, he is writing a book on drug policy and is also a Ph.D. candidate at Oxford University.

If state legislators wrote a bill outlawing a critical remedy to help kids avoid a disease like tuberculosis, there would probably be a major effort to boot every single one of them out of office. Recently, the state Senate did something just as asinine — except the condition in question was drug use by kids, far more prevalent than TB. Bowing to pro-drug interest groups, a bill is making its way to the governor’s desk that would stymie efforts by local schools to test students for drugs. Unlike lawmakers in other states, Sacramento bureaucrats would like to control the way schools drug-test students, making such testing voluntary and placing restrictions on how it is administered.

Drug testing sounds costly, unnecessary, uncompassionate, even unconstitutional. Those who want to legalize and legitimize drug use caricature drug testing as a draconian policy designed to catch kids using drugs and throw them into jail.

It’s time to set the record straight. At a time when drug abuse in California plagues many students, it makes sense to drug-test students as a part a comprehensive drug-prevention program (which includes after-school programs). Since addiction is spread from peer to peer, drug testing gives a student another more credible reason to say “no” when offered drugs by his or her friend.

Unfortunately, the sponsors of Senate Bill 1386 miss the point of random drug testing when they assume that the practice is unnecessary because it is already easy to detect drug use: “You come into class, your eyes are red, you’re falling asleep, and yesterday you weren’t like that,” argues Assemblywoman Jackie Goldberg, D-Los Angeles, who coauthored the bill with Sen. John Vasconcellos, D-Santa Clara.

But drug testing is not meant to catch the kid who “everyone knows” is using drugs. The purpose of testing is to get those kids who have yet to show symptoms of their drug use the help they need before their “recreational fun” turns into dependence or addiction. It’s meant to prevent the scenario described above so that the student and his or her peers don’t have to live with the consequences of their classmate coming to school on drugs.

Drug testing is also not intended to detect drug use for punitive purposes — in fact, the U.S. Supreme Court prohibited that in its recent landmark ruling defending random drug tests for kids involved in activities at school. No student goes to jail as a result of a positive drug test. Instead, the family’s privacy is respected and the child is referred to get help to stop his or her use. Consequences entail being denied involvement in sports or other extra curricular activities during the treatment period and until the child tests negative for drugs.

Employing this carrot-and-stick method works. For example: After two years of a drug testing program, Hunterdon Central High School in New Jersey saw significant reductions in 20 of 28 drug use categories, including a drop in cocaine use by seniors from 13 percent to 4 percent. The U.S. military saw drug-use rates drop from 27 percent in 1981 to 3 percent today, thanks to the introduction of random drug testing. Schools like St. Patrick’s High in Chicago are seeing a total change in the culture of education at their school as a result of drug testing.

Compared to other health interventions, drug testing is cheap. It costs roughly $10 to $50 per student, per year. Most parents would gladly pay that small fee in exchange for knowing that their child was safe. In addition, the federal government has proposed $25 million to help school districts offset the costs.

Unfortunately, opponents of random drug tests (many of whom carry mission statements dedicated to legalizing drugs) can claim some victories in our state. Already, schools such as Bret Harte Union High School in Angels Camp (Calaveras County) have said that they will pull their effective drug testing program if SB1386 passes.

Principals, teachers and parents who employ an effective drug-testing program at school realize it is a valuable tool to deter kids from delving into drug use in the first place and to refer troubled teens to help. Our elected officials should not make that tool harder to use with this misguided legislation.

Source: Kevin A. Sabet. Former chief speechwriter for the Bush administration’s drug czar. A Marshall scholar at Oxford University, Sabet and is writing on book on drug use.

Recently, the British Prime Minister Mr. Tony Blair gave an interview to the News of the World newspaper. In a paper more noted for salacious stories it was a sober affair. Reflecting on 6 years in power , he said “I’ve had lumps kicked out of me ….but I’m tougher than ever”. In the wide ranging interview, Mr. Blair introduced his newest plan -random drug testing in schools.

Mr. Blair’s government does not seem to know what to do about the drugs problem. They ignore evidence from other countries on what works to lower the incidence of drug use and rely instead upon advice from so-called experts – many of whom have been advocating the relaxation of drug laws for years.

Re-classifying Cannabis has sent out totally the wrong message to our youth who mostly now believe that cannabis is (a) legal and (b) harmless. The government rushes in to Spend £1 million on a campaign to tell people that cannabis is (a) not legal and (b) harmful.

More money is being spent on treatment – and with this we have no argument. People who have problems from drug use need all the help and treatment they can get to become drug free and contributory members of society again. Treatment is always expensive – and there is the ‘revolving door’ syndrome where users enter treatment for a few weeks or months, return to society and often begin using again – once the use results in a more chaotic lifestyle again the user returns to treatment. Relapse is common and costs money.

Mr. Blair’s new idea – random drug testing – has resulted in the inevitable dichotomy between those who approve of the plan and those who regard it as a great infringement of personal liberty. Some organizations who want drug laws relaxed are scaremongering by suggesting that pupils know that cannabis stays in the body for longer than many other drugs and so would stop using cannabis and instead turn to Ecstasy or Heroin. This is very unlikely since the majority of young people who do use cannabis whilst at school do so because they believe it is harmless – they do not use so-called ‘hard’ drugs because they know they are harmful. Understandably the teaching profession have expressed great concern about the time, costs and legal ramifications of testing. A large majority of parents think it is an excellent idea – and, surprisingly to some, most young people agree with it.

The NDPA have seen evidence of the success of drug testing in America and Australia and work closely with a Belgian colleage who has made a study of drug testing. One of our colleagues has also worked in Restorative Justice and this could be tied in with drug testing. Many companies in the USA and the UK have introduced random drug tests amongst their work force and this has cut down accident and absence rates and staff turnover . Therefore, our belief is that there is mileage in using random drug tests in schools – provided they are handled sensitively. It would need all schools and colleges to ‘opt in’ to be a total success – and schools would need financial help to cover the inevitable costs. And schools need to consider that random drug testing should not belinked to punishing or excluding pupils who test positive.

The article “Study: Jobs Don’t Prevent New Drug Offenses After Prison” is somewhat misleading and does not mention our most important findings. The former prisoners in our study were followed for only a few months after coming home to Baltimore, insufficient time to conclude that employment doesn’t prevent recidivism. Our more important, policy-relevant findings have to do with how released prisoners obtain jobs and stay off drugs.

The study documented that men and women who participated in work release programs while in prison were more likely to be employed after their release — despite poor job records, limited education, and few vocational skills — suggesting that much can be done to improve their employment prospects.

We also learned that those who made use of in-prison substance abuse treatment were less likely to take drugs after returning to Baltimore. In addition, former prisoners who received valuable housing, financial assistance, and emotional support from their families were more likely to get a job and stay off drugs.

The report’s implications are clear: expanding employment, substance abuse, and family reunification programs, both behind the prison walls and in the community, can make a difference. We encourage readers to view the full report, Baltimore Prisoners’ Experiences Returning Home.

Administered by Kentucky’s Council on Prevention and Education, CLC worked with five church communities to identify and recruit 11- to 15-year-olds. Over 131 ethnically diverse youths and their families living in rural, suburban, and inner-city areas in Kentucky participated in the program. CLC provided youths with 15 hours of training and parents/caregivers received 55 hours of training on substance abuse issues, communication skills, refusal skills, and family issues. CLC also provided referral services to families that required intervention or other social services. Evaluators found that both parents and children had increased involvement with the church community and an increase in resiliency as they learned about alcohol and drug issues. Youths increasingly declined drug and alcohol use and some inexperienced with drug use delayed initial experimentation with drugs. Participants also increasingly consulted community services for resolving family and personal problems and reported greater communication and bonding between parents and children.

Breeding ground for chemical dependence or for immunity against substance abuse?

Dr. Robert DuPont is a strong proponent of an “active commitment to observing and enforcing the drug and alcohol laws on college campuses, including in college dormitories.”

According to DuPont, the combination of vulnerable youth in an environment of almost non-existent social controls results in a uniquely threatening setting for substance abuse. Although many colleges and universities are beginning to reconsider their responsibilities with respect to the personal lives of their students, DuPont contends that numerous institutions of higher learning, especially many of “the most prestigious, continue to hide behind the concept that their students are responsible for their own decisions and behavior.” Moreover, he argues that these colleges and universities “treat drug and alcohol use as a personal matter, focusing on ‘responsible choices’ and the distinction between ‘use’ and ‘abuse” rather than the inherent dangers to the individual and to society.

To combat substance abuse in the college environment, DuPont believes that it is necessary to foster and develop a student commitment to lifestyles that reject the usage of what he terms “recreational pharmacology.” He stresses that before this ideology can produce positive behavioral changes, it needs to be “rooted in the deep and enduring values of colleges to promote the full physical, intellectual, and spiritual development of students.” DuPont contends that modern scientific research surrounding the processes and effects of drug addiction, and the many tragic drug-related incidents of the past two decades illustrate that the out-dated values of the 1960’s can no longer be accepted or applied to the present-day situation. Leaving drug usage decisions to the individual is no longer intellectually justifiable, and “reflects a reckless abdication of the principle of caring for one’s fellow human beings.” Finally, DuPont criticizes some university faculty and administrators for being reluctant to part with the more liberal values of earlier decades. Ironically, he believes that many college students are more willing to accept a less tolerant and more restrictive attitude to drug and alcohol usage than their educators.

Source: Dr. Robert L. DuPont, Georgetown University Medical School, President, Institute for Behavior and Health, 6191 Executive Blvd., Rockville, Maryland 20852 (301) 468-8980

In a workshop at the August 1997 10th Annual National Prevention Network (NPN) Research Conference, in Philadelphia, Nancy Chase and Fred Garcia defined the kinds of media reaching today’s youth. These include such obvious sources as television and movies and the Internet, as well as message delivery vehicles not always looked at as media, such as T-shirts, video games, and the lyrics of popular music. DHHS Secretary Donna Shalala responds to the question of why so many of today’s kids engage in substance abuse by pointing out that “…young people are bombarded with mixed messages about drugs, alcohol, and tobacco from the environment…” The reach and impact of media in the environment is growing daily. While the NPN members on hand were familiar with the issue generally, they were impressed by a collection of recent videotaped clips of commercials and news programs shown during the workshop. They also learned that the American Psychological Association estimates that the typical child sees about 10,000 acts of violence each year on television. And the workshop leaders pointed out that these same youth are exposed to music that “glamorizes illicit drug use, underage drinking, and violence.” A surprisingly long and varied list of products depicts the marijuana leaf, often with a pro-marijuana message.

Faced with the challenge of countering such powerful forces, media literacy offers opportunities to strengthen and add to other prevention efforts: Media campaigns and other prevention strategies are important steps in reducing substance abuse among adolescents. It is simply not possible to reach all young people with compelling and frequent enough messages about the dangers of alcohol, tobacco, and illicit drugs. Dollar for dollar, substance abuse prevention forces can never hope to match, much less outspend, corporate marketing in the media. But media literacy may adjust the balance in favor of prevention at relatively small cost by helping young people “analyze, evaluate, and understand the direct and subtle themes of a media message.”

To be media literate, in the workshop’s words, “is to understand that the message was produced by someone with an agenda to sell, persuade, or change attitudes or behaviors.” Thus, “media literacy is the skill to ‘deconstruct’ the message and understand the messenger’s motives.” In theory the idea of letting someone else pay to produce a message, which, through media literacy can become an effective prevention teaching tool, is bound to be appealing. But how well does it work? Garcia and Chase cited a 1996 study that found that students who have acquired media literacy skills will counter-argue alcohol ads months or years after exposure.

At the University of Washington, Erica Weintraub Austin reported that third graders had immediate as well as delayed effects from viewing and discussing a videotape about television advertising and looking at alcohol ads. The workshop presenters conclude from this and other studies that “teachers of media literacy may indeed be inoculating students against the appeals of sophisticated alcohol and tobacco advertising.” Garcia and Chase also emphasize that media literacy is not media bashing, but treats media as a tool that can be used, misused, and abused. Nor, they told the gathering of State prevention directors, is media literacy a silver bullet. But the media industries need to be seen as a part of the solution toward healthier, safer communities. And media literacy is a prevention strategy to address both public health and public safety concerns. It’s also an excellent alternative activity for youth, since it is involving, engaging and compelling.

Source: Workshop in Aug-1997 – 10th Annual National Prevention Network Research Conference – Philadelphia USA – Reported in Prevention Pipeline Nov/Dec 1997

A universal program, the Seattle project is a school-based intervention for grades one through six that seeks to reduce shared childhood risks for delinquency and drug abuse by enhancing protective factors. The multicomponent intervention trains elementary school teachers to use active classroom management, interactive teaching strategies, and cooperative learning in their classrooms. At the same time, as children progress from grades one through six, their parents are provided a training session called ‘How To Help Your Child Succeed in School’, a family management skills training curriculum called ‘Catch ‘Em Being Good’, and the ‘Preparing for the Drug-Free Years’ curriculum. The interventions are designed to enhance opportunities, skills, and rewards for children’s prosocial involvement in both school and family settings, thereby increasing their bonds to school and family and commitment to the norm of not using drugs. Long-term results indicate positive outcomes for students who participated in the program: reductions in antisocial behaviour, improved academic skills, greater commitment to school, reduced levels of alienation and better bonding to prosocial others, less misbehavior in school, and fewer incidents of drug use in school.

Source: Hawkins et al. 1992

Strengthening Families is a selective multicomponent, family-focused program that provides prevention programming for 6-10-year-old children of substance abusers. The program began as an effort to help substance-abusing parents improve their parenting skills and reduce their children’s risk factors. The program has been culturally modified and found effective (through independent evaluation) with African-American, Asian/Pacific Islander, and Hispanic families. The Strengthening Families program contains three elements: a parent training program, a children‘s skills training program, and a family skills training program. In each of the 14 weekly sessions, parents and children are trained separately in the first hour. During the second hour, parents and children come together in the family skills training portion. Afterward, the families share dinner and a film or other entertainment. Parent training improves parenting skills and reduces substance abuse by parents. Children‘s skills training decreases children’s negative behaviors and increases their socially acceptable behaviors through work with a program therapist. Family skills training improves the family environment by involving both generations in learning and practising their new behaviors. This intervention approach has been evaluated in a variety of settings and with several racial and ethnic groups. The primary outcomes of the program include reductions in family conflict, improvement in family communication and organization, and reductions in youth conduct disorders, aggressiveness, and substance abuse.

Source: Kumpfer et al. 1996

The follow-up results of a six-year study by the Institute for Prevention Research at Cornell University Medical College provide important new evidence that drug abuse prevention programs conducted in school classrooms work. In a large-scale study involving nearly 6,000 students from 58 schools in New York state, students who received a skills-based prevention program in junior high school were found to have significantly lower odds of smoking, drinking, and using marijuana at the end of high school. This is the first scientifically rigorous study to show conclusively that a school-based drug abuse prevention program can produce meaningful reductions in drug use lasting over the critical junior and senior high school years.

The study was conducted by researchers at Cornell University Medical College’s Institute for Prevention Research with funding from the National Institute on Drug Abuse. The research team was led by Dr. Gilbert J. Botvin, professor public health and psychiatry. Schools were first grouped according to their rates of drug use and then randomly assigned to either receive the prevention program or to serve as controls. The prevention program, called Life Skills Training, taught students self-management skills and general social skills as well as information and skills for resisting pro-drug use influences. Students received the prevention program during the 7th, 8th, and 9th grades. Final follow-up data were collected at the end of the 12th grade.

Students receiving the prevention program had less tobacco, alcohol, and drug use at the end of the study than control students who did not receive the prevention program. The odds of smoking, drinking immoderately, or using marijuana were significantly lower for the students who received the prevention program during grades seven, eight, and nine. For these students, the odds of smoking, drinking, or using marijuana were up to 40 percent lower than for controls. Not surprisingly, the prevention program was less effective for students whose teachers taught only part of the program. On the other hand the strongest prevention effects were found for students who received at least 60 per cent of the drug abuse prevention program.

In addition to assessing the long-term impact of the prevention program on the use of individual substances, the effectiveness of the program was also assessed in terms of polydrug use (defined as the use of two or more drugs by the same individual.) A criticism of previous prevention studies is that they have only demonstrated an impact on relatively low levels of drug involvement – for example, the occasional use of cigarettes. This study directly deals with this issue by looking at the impact of the prevention program on the regular (weekly or more) use of cigarettes, alcohol, and marijuana. The odds of using all three substances on a regular basis were up to 60 percent lower for the students who received the prevention program than for controls.

Two forms of the prevention program were tested. One involved providing teachers conducting the program with special training and feedback by project staff. The other gave teachers a videotaped version of the training and no feedback. All teachers assigned to teach the prevention program were given a teacher’s manual and student guides for each year of the program. The teacher’s manual contained 12 units designed to be taught in 15 class periods. Each unit included an overall goal and specific student objectives as well as detailed lesson plans spelling out the material that should be covered with step-by-step instructions. The student guide contained information related to each of the program units and classroom activities along with workbook assignments intended to supplement classroom material.

Teachers in the schools assigned to receive training and feedback attended a one-day workshop that taught them about the causes of drug abuse and the reasons for using this particular prevention method. They were also taught how each of the classroom sessions should be conducted. During the time they were teaching the prevention program, members of the project staff periodically watched the teachers conducting the program in the classroom and whenever necessary gave them feedback and advice on how to teach the prevention program more effectively. The teachers in the other group received the same prevention materials and videotapes for each year of the program offering the same material as the training workshops. Although teachers in this group were also periodically observed while teaching the prevention program, they did not receive any feedback or advice.

Both prevention groups had significantly lower odds of using drugs by the end of the study. However, when results were examined with respect to the most serious patterns of drug use – using two or three drugs once a week or more – as expected, the prevention program was more effective for the students whose teachers received the training workshop and ongoing support from the Cornell researchers.

The results of this study have several practical implications for developing more effective drug abuse prevention programs:

Prevention programs should contain components that make students aware of the actual rates of drug use and the fact that only a small percentage of adolescents use drugs in order to correct the misperception that “everybody’s doing it.”

Prevention programs should teach skills for resisting pro-drug use social influences.
They should also teach a variety of general life skills for helping adolescents deal with the challenges of adolescent life. These include self-improvement skills such as goal-setting and self-reinforcement, skills for making decisions and solving problems, skills for thinking critically and analyzing media messages, skills for coping with anxiety, skills for communicating effectively, skills for meeting people and making friends, and general assertiveness skills.

Even if a prevention program previously found to be effective is being taught, it will only be effective if it is properly implemented. Because there are many competing demands on the school schedule, it is sometimes difficult to teach drug abuse prevention programs in their entirety. However, this and other studies show that there is a direct relationship between how much of the prevention program is implemented and its effectiveness. If prevention programs are only partially implemented, they are not likely to reduce drug use or drug use risk. Similarly, changing a prevention program known to be effective by modifying program components or adding new ones that have not yet been tested can render the prevention program ineffective.

Drug abuse prevention programs must be taught over a prolonged period of time. Prevention programs that are only one year long or do not contain two or more years of booster sessions are not likely to produce lasting reductions in a drug use. In fact, evaluations of prevention programs not including booster sessions have shown that initial reductions in drug use decrease after about a year and disappear totally after about two or three years.

In order to have maximum effectiveness, training and support from prevention experts should be obtained whenever possible.

The prevention program tested in the Cornell study was effective whether teachers received a formal training workshop and ongoing consultation and support or only received a training videotape. However, with respect to more serious drug use, it was most effective when teachers received formal training and periodic consultation and support.

Researchers have been searching for effective prevention programs for more than two decades now. The goal of a prevention program that could actually produce measurable reductions in drug use behavior has been elusive. Prevention approaches that relied on teaching factual information about the dangers of drug use have consistently been shown to be ineffective, as have a variety of other prevention approaches. Prevention programs that teach students how to resist social influences to use drugs have produced short-term reductions in cigarette smoking and, to a lesser extent, alcohol and marijuana use. Several long-term follow-up studies have raised questions about the ability of these approaches to pro duce lasting reductions in drug use.

The results of the Cornell study provide important new information that prevention works. The right kind of program, when properly implemented with junior high school students and with four years of booster sessions, can produce prevention effects that last at least until the end of high school. A prevention program that teaches general skills for dealing with life as well as skills and information for resisting social influences to use drugs can significantly reduce the chances that junior high school students will experiment with drugs. It can also reduce the likelihood that these same students will develop more serious patterns of drug use by the end of high school . With this study, it is clear that drug abuse prevention has come of age.

Source: Western Center News – June 1994 – Western Regional Center for Drug-Free Schools and Communities – published in ‘The Challenge’ vol. 6 No.1.

The long term effectiveness of DARE was assessed by contrasting drug use and other DARE related attitudinal variables among 356 12th grade students who received the program in 6th grade with 264 others who did not receive it. There was a significant relationship between earlier participation in DARE and less use of illegal, more deviant drugs (e.g. inhalants, cocaine and LSD). This effect was significant for males. Long term effects of DARE that were not perceptible after 3 years appeared among the males after six years when they were senior in high school. A possible explanation for this ‘sleeper effect’ is that the effectiveness of DARE was ‘suppressed’ until after the follow-up in 9th grade. This effect may not have arisen for the young women due at least partially to the fact that so few of them in either the DARE or control condition were using these hard drugs.

Richard L. Dukes et. al., University of Colorado, 1996.

3,150 11th grade students participated in the survey; some had participated in the D.A.R.E. programme at elementary, junior and senior high school levels. 11th grade students were selected as the study population because they were old enough to have been confronted with opportunities to use alcohol, marijuana and hard drugs. This study found that D.A.R.E. did influence students attitudes and behaviours about substance abuse. The differences reported here were all statistically significant, and in a positive direction. All in all D.A.R.E. reduced substance use, increased peer resistance, encouraged communication with parents and other responsible adults, and increased positive views of the police.

J. Donnermeyer PhD and G. H. Phillips PhD, Ohio University.

Introduction
Several reviews of the substance abuse prevention literature have concluded that social-influence-based prevention programmes can significantly delay the onset of tobacco, alcohol, and other drug use and slow the rate of increase in substance use prevalence among entire populations of early adolescents. Less is known about the capacity of these and other primary prevention programmes to effect decreases in substance use. This is an important question, since some youth have already begun to experiment with drugs by the time that usual primary prevention programmes have reached them. Youth exhibiting early drug use relative to their peers are considered at higher risk for later drug use and abuse. The few studies that have investigated the effect of primary prevention programmes on those who have already begun using tobacco or other drugs have yielded equivocal results and have not systematically evaluated maintenance of decreases in use. The purpose of this study was to evaluate the secondary prevention effects of a primary prevention programme in reducing cigarette, alcohol, and marijuana use among baseline users.

Abstract
Objectives. This study investigated the secondary prevention effects of a substance abuse primary prevention programme.
Methods. Logistic regression analyses were conducted on 4 waves of follow-up data from sixth- and seventh-grade baseline users of cigarettes, alcohol, and marijuana taking part in a school-based programme in Indianapolis.
Results. The programme demonstrated significant reductions in cigarette use at the initial follow-up (6 months) and alcohol use at the first 2 follow-ups (up to 1.5 years). Models considering repeated measures also showed effects on all 3 substances.
Conclusions
Primary prevention programmes are able to reach and influence high-risk adolescents in a non-stigmatizing manner.
Discussion
Primary prevention programmes have been criticized for affecting future occasional users but not youth at the highest risk for drug abuse (e.g., current users). In this study, we reported 3.5-year follow-up effects of a primary prevention programme in decreasing drug use among adolescents who were users at either sixth or seventh grade. With a very conservative criterion to define decreased use, the results indicate that the programme did effect reductions in use, especially cigarette and alcohol use. These secondary prevention effects were significant for cigarette users at the 6-month follow-up and marginally significant at the 2.5-year follow-up. Effects were also found among baseline alcohol users through the 1.5-year follow-up. Consistent with other prevention studies, the effect sizes were small for cigarettes (range: .05-.31) and alcohol (range: .08-.24) and medium for marijuana (range: .38-.58). Although no significant effects were detected among baseline marijuana users, it is important to note that the programme group consistently demonstrated greater reductions in all 3 substances across all follow-ups, except marijuana at the 3.5-year follow-up. When the secular trend was also considered, the Midwestern Prevention Project consistently showed significant secondary prevention effects on cigarette, alcohol, and marijuana use.

There are several methodological limitations to this study. For example, a possible threat to the validity of the findings was the reliance on self-reported drug use. However, extensive research conducted on the validity of self-reported smoking dispels this concern, especially if a bogus pipeline activity is built into the procedures for data collection, as was done in the present study. Another possible limitation is that measurements were limited to a fixed point in time (previous month) from year to year, thus leaving open the possibility that the last reported use level may have been an under-estimate of actual normal use patterns. However, given that this study was fully randomized, the programme and control groups should have been equal in regard to their validity estimates of the point prevalence of drug use measured.

This research suggests that social-influence-based primary prevention programmes can have an impact on not only students who are nonusers at baseline but also those who have begun to use drugs. The advantage of such a primary prevention programme is that it may reach and affect a ‘silent’, not-yet-identified, high-risk population of early drug users in a nonstigmatizing , nonlabeling fashion at an age when youth are more easily persuaded (treating the young users, in effect, like nonusers contemplating use).

Source: Chih-Ping Chou, PhD, et al. American Journal of Public Health, June 1998, Vol.88, No6

There are a number of complex and inter-relating factors that predispose young people to smoke, and these vary among individuals and among populations. However, years of research have identified certain factors that commonly play a role in smoking initiation. These include high levels of social acceptability for tobacco products, exposure and vulnerability to tobacco marketing efforts, availability and ease of access, role modeling by parents and other adults, and peer group use.

Minimising of risk
Adolescents frequently experiment with new behaviours, but don’t often take into serious consideration the long-term consequences. Some youths who are exposed to tobacco messages from an early age come to accept the notion that tobacco provides certain psychological benefits which will help them through adolescence. For them, the risks of tobacco use, which are perceived to be remote, are outweighed by the immediate psychological benefits. Young people tend to underestimate the addictiveness of nicotine and the difficulties associated with quitting, tending to believe that it is easier for young people to quit than adults.

Exposure to tobacco advertising and promotion
The role of advertising is critical to the adolescent’s conditioning process. In advertisements, tobacco users are portrayed as glamorous, popular, independent, adventurous, and macho. By selecting brands that present these images, young people may feel that they are internalising these characteristics. Children’s attitudes and behaviour regarding tobacco are influenced by advertising. Thus, tobacco advertising subverts the understanding and ability of young people to make a free, informed choice whether or not to smoke. Advertising also leads teens to believe that smoking is more common than may actually be the case, particularly among their peers.

Modeling of adults
Children perceive smoking to be an adult behaviour and children may often take up smoking in an attempt to appear more grown-up. Studies show that young children are influenced by parents who smoke, forming more positive attitudes towards smoking than those living with non-smoking parents. This association was found in children as young as three years old; In one study, twice as many children of smokers say that they want to smoke compared to children of non-smokers. Adolescent children of parents who successfully quit smoking are also much less likely to smoke compared to those of parents who do smoke. Adults should be made aware of the impact of their own smoking behaviour on the future smoking behaviour of children. It is essential for adult smoking to be reduced and marginalised as part of comprehensive strategy to decrease smoking among young people.

Peer pressure
Exposure to peers who smoke increases the risk of adolescents starting to smoke. However, it appears that this influence is particularly important after the adolescent has already become susceptible to smoking. Indeed, the effect, of peers is most noticeable in the transition from experimental smoking to addiction.

(WHO – web site)

The Health Belief Model postulates that health and risk-taking decisions are based partially on individual perceptions of personal susceptibility to an adverse condition. Decisions also are based on beliefs regarding seriousness of the condition. The initial decision to accept the risk involved with tobacco use makes it easier to progress to the risk associated with illicit drug use. Psychologists refer to the progression of drug-taking involvement as a “developmental sequence.” The initial decision to use tobacco makes the risk involved with using other drugs seem less severe. For example. injecting heroin might be perceived as a near suicidal risk for a nonsmoker. However, for people who smoked cigarettes for years. despite knowledge of their harmful effects, using heroin may seem only slightly more dangerous than behaviours they currently engage in and have thus far survived. Therefore, tobacco may act as a risk perception stepping stone which reduces perceived severity of the dangers involved with illegal drug use.

Similarly, tobacco may undermine the “perception of personal susceptibility” portion of the Health Belief Model. Youthful users of tobacco who fail to see any immediate lethal consequences from their use likely conclude the purported dangers of tobacco as greatly exaggerated. They may conclude that the health warnings against illicit drug use are exaggerated or that they are somehow not susceptible to the adverse effects of drug use. This belief enhances the likelihood of using illegal drugs.

Issues of risk perception apply to legal risks as well as health risks. Adolescent purchase, possession, and use of tobacco is illegal in every state. In Social Learning Theory terminology, as teen-agers break tobacco-related laws they develop “self-efficacy perceptions” in their ability to break substance abuse laws. The Health Belief Model suggests these adolescents simultaneously are creating the belief that breaking substance abuse laws is not serious and their likelihood of punishment is low. These perceptions about tobacco laws may erode the deterrent effect of laws prohibiting use of illicit drugs.

One way to reconcile beliefs regarding severity and personal susceptibility of drug use involves rationalizing the behaviour. Decisions that violate personal beliefs regarding what is wise. right, and appropriate can create “cognitive dissonance”. Rationalization provides a psychological defense mechanism to justify the behaviour. Comments such as “We all got to go sometime.” “I could get killed in a car wreck tomorrow.” or “Grandpa smoked and lived to be 80” are examples of rationalizations, individuals who use these rationalizations to justify cigarette use might easily transfer these psychological defense mechanisms to legitimize use of illicit drugs.

Studies indicate nearly 90% of regular smokers get addicted to nicotine. Researchers show surprise at how rapidly nicotine addiction is acquired among teen smokers. Cigarettes represent teenagers’ first personal experience with the phenomenon of true drug addiction, and most teen smokers freely acknowledge being “hooked.” Adolescent nicotine addicts observe that life goes on despite their dependence on cigarettes. This situation causes adolescents to develop a lower risk perception of drug addiction in general. Addiction to a drug comes to be considered neither abnormal nor risky. Spending significant amounts of discretionary income for drugs also acquires a sense of normalcy.

No wonder so many people have trouble balancing checkbooks. Blame that pot smoking some of you did in school, suggests a new study by three economists who examined the relationship between standardized scores and marijuana use. These researchers collected survey data from about 20 000 people who were in the 10th and 12th grade early 1990s. The information included students’ scores on standardized math and verbal tests, as well as questions about drug use. They found that, controlling for other factors, the periodic use of marijuana “remains statistically associated a 15 percent reduction in performance on standardized math tests,” though verbal test scores did not seem to be affected, reported Rosalie Liccardo Pacula and Jeanne S. Ringel of the Rand Corp. and Karen E. R University of Michigan.

Source: www.washingtompost.com. Sep 2003

The European Commission has published a new directive to ban tobacco advertising Europe-wide. The directive covers TV, radio, internet and print advertising as well as sponsorship of sport and a ban on the promotion of cigarettes at sporting events. The new directive is designed to ban tobacco advertising that crosses borders and therefore excludes advertising in cinemas or on posters. It was the inclusion of the latter which lead to the previous directive being struck down by the European Court of Justice ASH said the new proposals were a “good start but could do better”. John Connolly of ASH said: “Tobacco advertising gets more people smoking, and persuades smokers to keep smoking. This directive is a promising first step towards controlling advertising across the EU. It’s a shame, though that they didn’t take this opportunity to publish something stronger.” ASH and other health groups are pressing for the directive to include ‘brand-stretching’ (indirect advertising) and direct mail.

Source: International Herald Tribune, Daily Express, E Independent, Wall St Journal, 31/5/01

“Youthful drug use violates both formal law and informal norms for conventional behaviour. Analyses of influences on permissive drug attitudes and behaviours among adolescents should, therefore, focus on both attitude towards the law and the informal normative climate of these youths. Legal attitude and norm qualities, however, can vary depending on the cultural and situational context. The authors examined the effect of legal attitude and norm qualities on drug permissiveness attitudes, as well as actual alcohol and cannabis use of 196 adolescents comprising three cultural groups: American Indian residents of a rural community, non-Indian residents of the same community, and transient Indians attending a job-training programme in the community. In general, for all three groups, legal attitude primarily affects permissiveness towards drug use, while norm qualities of peers and personal permissiveness influence actual substance use. However, the three cultural groups vary in the relative salience of these variables”.

With the No Child Left Behind Act increasingly focusing schools’ attention on test scores alone, programs that stress behavior, social development and commitment to school have sometimes gotten left behind.

But a new study indicates that schools adopting programs that target antisocial behavior are also likely to boost their students’ academic performance. The study of nearly 600 children by the University of Washington’s Social Development Research Group found that risk factors such as substance use, delinquency and violence that can be identified and counteracted in elementary school also are good predictors of later academic achievement.

“The implications are that prevention programs that address specific risk factors, curb antisocial behavior such as alcohol and cigarette use, stress a greater connection to school and promote social and emotional skills also contribute to academic achievement,” said Kevin Haggerty, a co-author of the study.

Haggerty also is director of the Raising Healthy Children Project, an intervention program that is following the progress of two groups of students in the Edmonds School District, a suburban area north of Seattle. One group received the intervention while the other did not.

The new study indicated that higher levels of school attachment and better social, emotional and decision-making skills in the seventh grade were related to higher grades and test scores on the Washington Assessment of Student Learning (WASL), given to 10th graders in 2002 and 2003. The WASL is a standardized test administered to students to comply with the No Child Left Behind Act.

The study, being published in the November issue of the Journal of School Health, also found that lower student test scores and grades were predicted by higher levels of attention problems, disruptive and aggressive behavior and negative behavior by peers. In addition, early use of alcohol and cigarettes predicted lower test scores.

“There is no stronger predictor of future problems than past ones,” said Charles Fleming, lead author of the study and a research analyst with the Social Development Research Group, which is part of the UW’s School of Social Work. “These findings show that if you make some difference in correcting negative behavior you can have a positive effect on school performance. This provides support, for instance, for programs being implemented in many elementary and middle schools to curb bullying behavior.”

Fleming noted that the researchers collected data from multiple sources – from the students and their parents and teachers – and that they got the same predictive outcomes from all of them. The researchers controlled for the students’ scores on a standardized test given in the fourth grade, parents’ level of education and socioeconomic level. “We wanted to see if the different behaviors that our prevention programs target also predict academic achievement, and they do,” he said.

The Raising Healthy Children program ran from the first or second grade through the 12th grade. The intervention included instructional workshops to help teachers become more effective in the classroom, workshops to teach parents better family management and monitoring skills and summer camps and study clubs for students.

“Targeted school-based prevention programs can contribute to student academic achievement,” Haggerty said. “We can’t eliminate these programs because of claims that ‘we don’t have time for them during the academic day in the classroom.’ These programs are important and they teach skills that children need to negotiate in the classroom and the school environment. When we teach them to children they are more successful academically.”

### Co-authors of the paper are Richard Catalano, director of the Social Development Research Group, and professor of social work; Tracy Harachi, UW associate professor of social work; James Mazza, UW associate professor of educational psychology, and Diana Gruman, an assistant professor of psychology at Western Washington University. The National Institute on Drug Abuse funded the research.

For more information, contact Fleming at (206) 685-8497 or cnbflem@u.washington.edu or Haggerty at (206) 543-3188 or haggerty@u.washington.edu
Source: Eurekalert. Nov.2005