Education

Submitted by Livia Edegger on  – 14:25

One of the most widely used school-based prevention programmes has proven to be effective in reducing drug use among adolescents in yet another country. After a team of researchers translated the programme known as Botvin LifeSkills Training into Italian, it was launched in around 180 schools in Lombardy, a region of Northern Italy. Within those schools the programme reached approximately 30,000 students and involved 1,800 teachers. The programme was found to reduce teenage smoking rates by 40% while boosting students’ self-esteem and equipping them with the relevant skills to deal with stressful situations. Following the success of the programme in Northern Italy, the Regional Observatory on Drug Addiction of Lombardy would like to see the programme implemented in schools across the country.

Links:

Source:

http://preventionhub.org/en/prevention-update/another-success-story-italy-adapts-botvin-lifeskills-training

17th June 2014

Colorado middle schools reported a 24 percent increase in drug-related incidents last year, according to USA Today. School-based experts tell the newspaper they believe the jump is directly related to marijuana legalization. Recreational sales of marijuana began on January 1, 2014.

Schools do not report which kinds of drugs are involved in the incidents, the article notes. State legislators are now asking school districts to keep track of which drugs they are finding.

John Simmons, the Denver Public Schools’ Executive Director of Student Services, says schools in his city saw a 7 percent increase in drug incidents, from 452 to 482. Almost all of the incidents were related to marijuana, he said.

Middle schools across the state reported a total of 951 drug violations, the highest number in a decade. School officials say while marijuana use has long been a problem, more students are trying it now that it is more easily available and socially accepted.

“We have seen parents come in and say, ‘Oh that’s mine, they just took it out of my room,’ and that sort of thing,” said school resource officer Judy Lutkin of the Aurora Police Department. “Parents have it in their houses more often, and the kids just can take it from home.”

“Middle schoolers are most vulnerable to being confused about marijuana,” said Dr. Christian Thurstone, attending physician for the Denver Health Adolescent Substance Abuse Treatment program. “They think, ‘Well, it’s legal so it must not be a problem.’”

Meg Sanders, owner of MiNDFUL, a marijuana company that operates in Colorado, says her business is very careful not to market to children. “We feel it’s our responsibility as a responsible business to card not just once but twice for any recreational customer, and medical patients have to show several documents before they can purchase marijuana,” she said.

Source: http://www.drugfree.org/join-together/jump-colorado-school-drug-cases  19th Feb.  2015

The Rocky Mountain High Intensity Drug Trafficking Area released its third annual report this week. The organization has been tracking the impact of marijuana legalization in Colorado since the state first legalized the drug for medical use in 2000, passed legislation to allow dispensaries beginning in 2009–which spawned a commercial marijuana industry–and legalized pot for recreational use in 2012. The 2015 report shows that by 2013, Colorado marijuana use was nearly double the national usage rate. The state ranked 3rd in the nation for youth use in 2013, up from 14th in 2006; 2nd in the nation for young adult use in 2013, up from 8th in 2006; and 5th in the nation for adults, up from 8th in 2006.

Drug-related school expulsions, most of which are marijuana-related, far exceed school expulsions for alcohol use. Note the sudden jump in drug expulsions that began in 2009 when Colorado allowed a commercial marijuana industry to emerge. Total school suspensions and expulsions rose from 3,736 by the end of the 2008-2009 school year to 5,249 by the end of the 2013-2014 school year.

Marijuana-related traffic fatalities in Colorado also began rising with the introduction and growth of the commercial marijuana industry in 2009. While total State wide fatalities decreased between 2006 and 2014, marijuana-related fatalities increased over that time.

Colorado marijuana-related emergency room visits increased to 18,255 in in 2014.

Marijuana-related hospitalizations have nearly quintupled since Colorado first legalized marijuana for medical use. Again, note the surge starting in 2009 when growers, processors, and dispensaries were first authorized, and a commercial industry began developing extensive marijuana products such as edibles, vape pens, and butane hash oils (BHO) to attract new customers. BHO has elevated THC levels to the highest seen in the nation; some contain 75 percent to 100 percent THC.

Although there is no data to document whether the increase in homelessness in Denver and other Colorado cities is marijuana-related, those who provide services to the homeless report that many say they relocated to Colorado because of marijuana’s legality.

In Colorado, marijuana is not available in about three-fourths of the state. Of a total 321 local jurisdictions, 228 (71 percent) ban all forms of marijuana businesses; 67 (21 percent) allow both medical and recreational marijuana businesses; and 26 (8 percent) allow only medical or recreational marijuana businesses.

Read report here.
Source: www.themarijuanareport.org  16th September 2015

One in five Canadians between 15 and 24 years of age reports daily or almost daily use of cannabis prior to legalization. They see it as “much safer than alcohol and tobacco” and “not as dangerous as drunk driving.”

Author 1. Paul W Bennett

Research Associate in Education, Saint Mary’s University

Disclosure statement

Paul W Bennett does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Partners

The Conversation UK receives funding from Hefce, Hefcw, SAGE, SFC, RCUK, The Nuffield Foundation, The Ogden Trust, The Royal Society, The Wellcome Trust, Esmée Fairbairn Foundation and The Alliance for Useful Evidence, as well as sixty five university members.

One of the enduring myths about marijuana is that it is “harmless” and can be safely used by teens.

Many high school teachers would beg to disagree, and consider the legalization of marijuana to be the biggest upcoming challenge in and around schools. And the evidence is on their side.

As an education researcher, I have visited hundreds of schools over four decades, conducting research into both education policy and teen mental health. I’ve come to recognize when policy changes are going awry and bound to have unintended effects. As Canadian provinces scramble to establish their implementation policies before the promised marijuana legalization date of July 2018, I believe three major education policy concerns remain unaddressed.

These are that marijuana use by children and youth is harmful to brain development, that it impacts negatively upon academic success and that legalization is likely to increase the number of teen users.

‘Much safer than alcohol’

Across Canada, province after province has been announcing its marijuana implementation policy, focusing almost exclusively on the control and regulation of the previously illegal substance. This has provoked fierce debates over who will reap most of the excise tax windfall and whether cannabis will be sold in government stores or delegated to heavily regulated private vendors.

All of the provincial pronouncements claim that their policy will be designed to protect “public health and safety” and safeguard “children and youth” from “harmful effects.”

Still, one in five young people between 15 and 24 years of age, according to a recent national study, report daily or almost daily use of cannabis.

They also see marijuana as “much safer than alcohol and tobacco” and “not as dangerous as drunk driving.”

Few either know about or seem concerned over the clear linkage between heavy use and early-onset psychosis.

Early-onset paranoid psychosis

So what does the evidence say? First, heavy marijuana use can, and does, damage brain development in youth aged 13 to 18. A 2015 Canadian Centre on Substance Abuse study confirmed the direct link between cannabis use and loss of concentration and memory, jumbled thinking and early onset paranoid psychosis.

One of the leaders in the medical field, Dr. Phil Tibbo, initiator of Nova Scotia’s Weed Myths campaign targeting teens, has seen the evidence, first hand, of what heavy use can do as director of Nova Scotia’s Early Psychosis Program. His brain research shows that regular marijuana use leads to an increased risk of developing psychosis and schizophrenia and effectively explodes popular and rather blasé notions that marijuana is “harmless” to teens and “recreational use” is simply “fun” and “healthy.”

Damaging to academic performance Second, marijuana negatively impacts neurocognitive performance in teens and users perform more poorly in quantitative subjects requiring precision — like mathematics and senior science.

In 2017, Dutch researchers Olivier Marie and Ulf Zolitz found that the academic performance of Maastricht University students increased substantially when they were no longer legally permitted to buy cannabis. The effects were stronger for women and low performers and academic gains were larger for courses needing numerical or mathematical skills.

Third, legalization of marijuana is likely to increase the number of teen users. Research from Oregon Research Institute conducted in 2017 showed that teenagers who were already using marijuana prior to legalization increased their frequency of use significantly afterwards. Research from New York University, published in 2014, indicated that many high school students normally at low risk for marijuana use (e.g., non-cigarette-smokers, religious students, those with friends who disapprove of use) reported an intention to use marijuana if it were legal. Medical researchers and practitioners have warned us that legalization carries great dangers, particularly for vulnerable and at-risk youth between 15 and 24 years of age.

Age of restriction

Marijuana legalization policy across Canada is a top-down federal initiative driven largely by changing public attitudes and conditioned by the current realities of the widespread use of marijuana, purchased though illicit means.

Setting the age of restriction, guided by the proposed federal policy framework, has turned out to be an exercise in “compromise” rather than one focused on heeding the advice of leading medical experts and the Canadian Medical Association (CMA). In a 2016 submission to the government, the CMA argued that 25 would be the ideal age for legal access to marijuana, as the brain is still developing until then, but that a lower minimum age of 21 should be considered — to discourage children from purchasing marijuana from organized crime groups.

The report argued that: “Marijuana use is linked to several adverse health outcomes, including addiction, cardiovascular and pulmonary effects (e.g., chronic bronchitis), mental illness, and other problems, including cognitive impairment and reduced educational attainment. There seems to be an increased risk of chronic psychosis disorders, including schizophrenia, in persons with a predisposition to such disorders.” In fact, the minimum age for purchasing and possessing marijuana is going to be age 18 in Alberta and Quebec, and 19 in most other provinces. Getting it “out of high schools” was a critical factor in bumping it up to age 19 in most provinces.

Every Canadian province is complying with the federal legislation, but — in our federal system – it’s “customized” for each jurisdiction.

The Canadian Western provinces — Alberta, British Columbia and Saskatchewan —have opted for regulating private retail stores, while Ontario and the Maritime provinces (Nova Scotia, New Brunswick and P.E.I.) are expanding their liquor control commissions to accommodate retail sales of cannabis. High school teachers, as of September 2018, may be battling a spike in marijuana use and greater peer pressure to smoke pot on the mistaken assumption that it is “harmless” at any age.

Clamping down in schools

For high school principals and staff, this will be a real test.

By September 2018, the old line of defence that using marijuana is illegal will have disappeared. Recreational marijuana will be more socially acceptable. The cannabis industry will be openly marketing its products. High school students who drive to school will likely get caught under new laws prohibiting motor vehicle use while impaired by drugs or alcohol. Fewer students are likely to abstain when it is perfectly legal to smoke pot when you reach university, college or the workplace. We have utterly failed, so far, in getting through to the current generation of teens, so a much more robust approach is in order.

“Be firm at the beginning” is the most common sage advice given to beginner teachers. Clamping down on teen marijuana use during and after school hours will require clarity and firm resolve in the year ahead — and the support of engaged and responsible parents.

Legalization of recreational marijuana is bound to complicate matters for Canadian high schools everywhere. Busting the “Weed Myths” should not be left to doctors and health practitioners. Pursuing research-based, evidence-informed policy and practice means getting behind those on the front lines of high school education.

Source: https://theconversation.com/marijuana-at-school-loss-of-concentration-risk-of-psychosis-90374 January 25th 2018

A new study provides credible evidence that marijuana legalization will lead to decreased academic success. (Elaine Thompson/AP)

The most rigorous study yet of the effects of marijuana legalization has identified a disturbing result: College students with access to recreational cannabis on average earn worse grades and fail classes at a higher rate. Economists Olivier Marie and Ulf Zölitz took advantage of a decision by Maastricht, a city in the Netherlands, to change the rules for “cannabis cafes,” which legally sell recreational marijuana. Because Maastricht is very close to the border of multiple European countries (Belgium, France and Germany), drug tourism was posing difficulties for the city. Hoping to address this, the city barred noncitizens of the Netherlands from buying from the cafes.

This policy change created an intriguing natural experiment at Maastricht University, because students there from neighboring countries suddenly were unable to access legal pot, while students from the Netherlands continued.

The research on more than 4,000 students, published in the Review of Economic Studies, found that those who lost access to legal marijuana showed substantial improvement in their grades. Specifically, those banned from cannabis cafes had a more than 5 percent increase in their odds of passing their courses. Low performing students benefited even more, which the researchers noted is particularly important because these students are at high-risk of dropping out. The researchers attribute their results to the students who were denied legal access to marijuana being less likely to use it and to suffer cognitive impairments (e.g., in concentration and memory) as a result.

Other studies have tried to estimate the impact of marijuana legalization by studying those U.S. states that legalized medicinal or recreational marijuana. But marijuana policy researcher Rosalie Pacula of RAND Corporation noted that the Maastricht study provide evidence that “is much better than anything done so far in the United States.”

States differ in countless ways that are hard for researchers to adjust for in their data analysis, but the Maastricht study examined similar people in the same location — some of them even side by side in the same classrooms — making it easier to isolate the effect of marijuana legalization. Also, Pacula pointed out that since voters in U.S. states are the ones who approve marijuana legalization, it creates a chicken and egg problem for researchers (i.e. does legalization make people smoke more pot, or do pot smokers tend to vote for legalization?). This methodological problem was resolved in the Maastricht study because the marijuana policy change was imposed without input from those whom it affected.

Although this is the strongest study to date on how people are affected by marijuana legalization, no research can ultimately tell us whether legalization is a good or bad decision: That’s a political question and not a scientific one. But what the Maastricht study can do is provides highly credible evidence that marijuana legalization will lead to decreased academic success — perhaps particularly so for struggling students — and that is a concern that both proponents and opponents of legalization should keep in mind.

Source:https://www.washingtonpost.com/news/wonk/wp/2017/07/25/these-       college-students-lost-access-to-legal-pot-and-started-getting-better-grades/?   

As the U.S. is facing its most challenging drug epidemic in history, the need to prevent adolescence drug misuse is imperative. For the past two years, Mentor Foundation USA and George Washington University have piloted an innovative drug prevention peer-to-peer initiative at three high schools in Columbia County, NY. The program, which engages youth through social media is showing some promising results in terms of shifts in attitudes towards drugs and intent to use.

The interactive “multi-media” initiative is called Living the Example (LTE), a program that incorporates messages for prevention specifically designed to counteract the misinformation adolescents have about drugs and alcohol.  Messages are framed to promote the benefits of prevention behaviors. “This approach to branding, an alternative, healthy behavior, or ‘counter-marketing’ as it has been termed in tobacco control, has been highly effective and is recognized as one of the main elements in successful prevention programs, such as in tobacco control,” says Principal Investigator, Dr. Doug Evans, a pioneer in the use of this strategy. Dr. Evans is a Professor of Prevention and Community Health & Global Health, with Milken Institute School of Public Health at George Washington University.

Youth Ambassadors are trained to create LTE branded prevention messages, disseminate them via social media platforms, and engage peers in their preferred social networks, with the intention of increasing peer interaction around the brand’s core messaging.  Positive receptivity to LTE messages was associated with some evidence of reduced self-reported drug use intentions, specifically for marijuana use, and reports of intent to use any drug. Among youth who reported exposure and receptivity to LTE, they reported a significant decrease in marijuana use intentions. The most common overall reason for drug use among all respondents was family stress (81.3%), boredom (40%) and academic stress (40%).

“Findings from the study suggest that peer-to-peer substance use prevention via social media is a promising strategy, especially given the low cost and low burden as an intervention channel, which schools, communities, and prevention programs can use as an approach, even in low resource settings,” says Michaela Pratt, President of Mentor Foundation USA. “Through our international network, Mentor Foundation shares over 20 years of global experience in best prevention practices, and Mentor Foundation USA has always been a pioneer in empowering young people to become their own advocates for drug prevention.”

This program was generously supported by The Conrad N. Hilton Foundation, Rip Van Winkle Foundation, among local foundations in Columbia County. Mentor Foundation USA is a member affiliate of Mentor International, which was founded in 1994 by Her Majesty Queen Silvia of Sweden and the World Health Organization and is the largest network of its kind for evidence based programs that prevent drug abuse among youth. Collectively, Mentor has implemented projects in over 80 countries impacting more than 6 million youth.  Mentor Foundation USA is a Delaware registered 501(c)3 non-profit organization.

SOURCE http://www.prnewswire.com/news-releases/200-dc-high-school-students-shatter-the-myths-around-substance-abuse-in-an-innovative-proven

Researchers at Canada’s Waterloo University studied what happens to academic goals, engagement, preparedness, and performance when high school students shift from no marijuana use to marijuana use. Their sample included 26,475 students in grades 9-12 in the COMPASS study, Canada’s largest survey of youth substance use. The researchers found that compared to students who do not use marijuana, those who use it at least once a month were:

· four times more likely to skip class,

· two to four times less likely to complete homework,

· two to four times less likely to value getting good grades, and

· half as likely to actually get good grades.

Moreover, half of those who smoked marijuana daily were less likely to report plans to attend college compared to nonusers. “We found that the more frequently students started using the drug, the greater their risk for poor school performance and engagement,” says Karen Patte, lead author of the study. Read more here.

Source: srusche@nationalfamilies.org  National Families in Action’s The Marijuana Report 17TH May 2017

The surrender of more than 2,000 minors involved in drugs in Cebu shows the need to step up efforts to educate the youth on the ill effects of illegal drugs. The Cebu Provincial Anti-Drug Abuse Office has produced a module on this for integration in Grades 7 to 9 classes starting this school year.

Jane Gurrea, Education Supervisor I of the Department of Education’s Division of Cebu Province, says anti-drug activities in schools have been strengthened by a memorandum issued by the department mandating the establishment of Barkada Kontra Droga chapters in schools.

Barkada Kontra Droga is a preventive education and information program to counter the dangers of drug abuse. HALF of the 2,203 minors rounded up under Project Tokhang were out-of-school youth, according to data collected by the Police Regional Office 7 from July 1, 2016 to Feb. 2, 2017.

Tokhang is the Philippine National Police’s program to knock on the doors of homes to persuade those suspected of involvement in illegal drugs to surrender. Some 2,166 of the minors in Cebu were drug users, 28 were sellers, while nine were mules. Could the rampant involvement of out-of-school youth in drugs have been prevented if Section 46 of the Comprehensive Dangerous Drugs Act of 2002 had been implemented?

Section 46 requires the establishment of a Special Drug Education Center (SDEC) for out-of-school youth and street children in every province to implement drug abuse prevention programs and activities. The SDEC should be led by the Provincial Social Welfare Officer. “Cebu Province still has to establish one,” however, said Grace Yana, social welfare officer  in charge of social technology unit of the Department of Social Welfare and Development (DSWD) . But areas in Cebu with active Pag-Asa Youth Association of the Philippines (PYAP) chapters, like Talisay, Naga, Danao and Mandaue cities, already have SDECs, she said. PYAP is the organization of out-of-school youth organized by the local government units.

“When the local government units hear the word center, they think they will need a building, and it needs a budget. So we tell them, even if it’s just a corner,” Yana said of the challenges of setting up the SDEC. Cebu Province may not have an SDEC, but the Cebu Provincial Anti-Drug Abuse Office (Cpadao) unveiled last November Project YMAD (Youth Making a Difference) that aims to provide out-of-school youth with socio-economic, physical, psychological, cultural and spiritual support through the PYAP.

Barkada Kontra Droga For in-school youth, the Cpadao is facilitating the implementation of the Barkada Kontra Droga drug prevention program, said Cpadao executive director Carmen Remedios Durano-Meca. Dangerous Drugs Board (DDB) Regulation 5, Series of 2007 calls for the institutionalization of the Barkada Kontra Droga (BKD), a preventive education and information program to counter the dangers and disastrous effects of drug abuse. It empowers the individual to be the catalyst in his peer groups in advocating healthy and drug-free lifestyles, the regulation says. “Cpadao is the one facilitating that this be implemented in every school,” Meca said. “We tap the Supreme Student Government officers. We have a Student Assistance Program (SAP) designed to help children who get into trouble with drugs in the school setting.”

SAP includes an intervention program to reduce substance abuse and behavioral problems by having the parent-teacher association take up school and home concerns. Under SAP, which will be established through the guidance office, the school will establish drug policies and regulations.

In addition, Cpadao made a module, which it has given to the Department of Education (DepEd) to distribute to schools. “It’s been agreed to be integrated in the Grades 7, 8 and 9 classes starting school year 2017. It will be one hour a week from MAPEH (Music, Arts, Physical Education and Health) for the whole school year. Later, we plan to teach it to the younger children, like Grade 4,” she said. “We’ve had a review of the module,” Jane Gurrea, Education Supervisor I of DepEd’s Division of Cebu Province, said last month. “If we receive that module, this will be integrated initially for public schools as additional reference materials.”

The DepEd Division of Cebu Province covers the 44 towns in Cebu. This month, the division will have a training of teachers for the integration of drug abuse prevention education, which will include a discussion of the Cpadao module. But even now, under the present K to 12 curriculum, basic concepts on illegal drugs can already be tackled as early as in Grade 4, as teachers could integrate these concepts in subjects like Health, when the subject of medicine use and abuse is discussed, she said. Gurrea, who is also the National Drug Education Program coordinator in the Division, said drug prevention education can be taught in subjects dealing with values education, social studies or MAPEH. “For music, students can write a poem or song on drug use prevention. They can have role playing. In art, they can do drawing (on drugs).”

Additionally, under Section 42 of the Dangerous Drugs Act, all student councils and campus organizations in elementary and secondary schools should include in their activities “a program for the prevention of and deterrence in the use of dangerous drugs, and referral for treatment and rehabilitation of students for drug dependence.” It is unclear how actively these student groups have campaigned against illegal drugs, but Gurrea said that every third week of November, students join the celebration of Drug Abuse Prevention and Control Week under the Supreme Student Government.

“The officers have to campaign room to room to talk about issues related to prevention of drug use. In the public schools in rural areas, you can see signs on fences or pergolas saying, ‘Get high on grades, not on drugs.’ They invite speakers for drug symposiums, like the police,” she said. The Supreme Student Government is for high school, while the Supreme Pupil Government is for elementary school. “In every town, we have a federated Supreme Student Government (SSG) and Supreme Pupil Government (SPG), and also a Division Federation of SSG and SPG. One of the programs is drug education,” Gurrea said. The Department of Education mandates all schools to have a student council organization strengthened. Gurrea said the anti-drug activities in schools were already there, but the term Barkada Kontra Droga was not used then. It was only when the DepEd coordinated with Cpadao that the term BKD was used. With the assistance of Cpadao that spent for resource speakers and meals of the students last year, BKD was institutionalized. BKD was strengthened further by DepEd Memorandum 200, Series of 2016 issued on Nov. 23, 2016 mandating the establishment of BKD chapters in schools, Gurrea said. “With this institutionalization, on the part of the budget for activities, students now have access through the Municipal Anti-Drug Abuse Councils (Madac).

So instead of spending their SSG funds for their activities, they can present their planned activities to the Madac, from which they can seek financial or other assistance (like for speakers),” she said. With the memo, the SSG has been recognized as an entity, enabling it to connect with the community, such as with agencies and non-government organizations for anti-drug activities, she said. “We have continuous advocacy and awareness programs. Some schools have a walk for a cause or caravan,” Gurrea said. The public schools in the division also have their student handbook. “One thing stipulated there is that no student is allowed to be involved in illegal drugs. There are schools that let students sign that piece of paper containing the rules and regulations, for their commitment to follow the rules in that handbook,” she said.

So if awareness of the dangers of illegal drugs is not the problem, what accounts for the high number of minors involved in drugs? “We are looking at peer pressure or circumstances in the family,” Gurrea said.

Source:  http://www.sunstar.com.ph/cebu/local-news/2017/03/04/who-watching-children-529169

Abstract

BACKGROUND:

There is concern that medical marijuana laws (MMLs) could negatively affect adolescents. To better understand these policies, we assess how adolescent exposure to MMLs is related to educational attainment.

METHODS:

Data from the 2000 Census and 2001-2014 American Community Surveys were restricted to individuals who were of high school age (14-18) between 1990 and 2012 (n=5,483,715). MML exposure was coded as: (i) a dichotomous “any MML” indicator, and (ii) number of years of high school age exposure. We used logistic regression to model whether MMLs affected: (a) completing high school by age 19; (b) beginning college, irrespective of completion; and (c) obtaining any degree after beginning college. A similar dataset based on the Youth Risk Behavior Survey (YRBS) was also constructed for confirmatory analyses assessing marijuana use.

RESULTS:

MMLs were associated with a 0.40 percentage point increase in the probability of not earning a high school diploma or GED after completing the 12th grade (from 3.99% to 4.39%). High school MML exposure was also associated with a 1.84 and 0.85 percentage point increase in the probability of college non-enrollment and degree non-completion, respectively (from 31.12% to 32.96% and 45.30% to 46.15%, respectively). Years of MML exposure exhibited a consistent dose response relationship for all outcomes. MMLs were also associated with 0.85 percentage point increase in daily marijuana use among 12th graders (up from 1.26%).

CONCLUSIONS:

Medical marijuana law exposure between age 14 to 18 likely has a delayed effect on use and education that persists over time.

Source:  https://www.ncbi.nlm.nih.gov/pubmed/27742490 Drug Alcohol Depend. 2016 Nov 1;168:320-327. doi: 10.1016/j.drugalcdep.2016.09.002. Epub 2016 Oct 11.

BRIDGEPORT — A drug-prevention organization uses reverse peer pressure to persuade teenagers to steer clear of controlled substances, Bridgeport City Council learned Monday night. Angie Ferguson, executive director of Drug Free Clubs of America, said teens who join the organization agree to undergo random drug testing and receive rewards for being members.

The rewards range from school field trips to special deals at local businesses, Ferguson told city council during a work session that preceded the regular meeting at Bridgeport City Hall. “That makes the other kids jealous, and they want to join,” she added.

Drug testing is the centrepiece of the organization’s drug-prevention efforts, Ferguson said.

Teens who agree to join consent to an initial drug screen and receive a photo identification card upon passing the test, Ferguson said. They also know they could be randomly tested throughout the year, Ferguson said. “If somebody offers you something, you can say, ‘I can’t because I might be drug-tested,’” she said. “And there’s no comeback for that.”

Ferguson said Drug-Free Clubs was started by her father, a retired Cincinnati firefighter.

He and another firefighter were brainstorming how to reverse the devastation that drugs were wreaking on their community, Ferguson said. They settled on drug testing, with those testing negative receiving recognition and positive reinforcement, Ferguson said.

Drug testing is seen as something punitive and heavy-handed, but it doesn’t have to be leveraged like that,” she said. “Drug testing works all the time. That’s why we do it in business.”

Forming a local Drug Free Club requires a buy-in by the schools, students, parents and the community, said Ferguson, who also gave a presentation during the council meeting.

Drug test results are shared only with the parent, with membership at stake should a test return positive, Ferguson said.

The cost to join is $67 per student per year, Ferguson said.

Councilwoman Melissa Matheny expressed concerns about students whose parents might not have the means to pay the membership fee. The organization never launches a chapter without a plan for those who can’t afford the fee, Ferguson replied.

Source: theet.com 13th May 2015

This is a good example of positive prevention. When local businesses agree to be involved, more teens agree to sign up. Offers of free cinema tickets, entry to skating rinks, meals at McDonald’s and similar encourage drug free youngsters to remain clean.

Whilst students already using heavily might not want to join, the school would then be able to keep a watchful eye on those refusing membership and identify users early on; this would enable helping strategies to be used for such pupils. Fewer users in an area results in safer communities, better academic results in schools and would be a win-win situation all round. NDPA

April 30, 2015 Special Reports, Addiction, Substance Use Disorder

By Robin M. Murray, MD

Attitudes toward cannabis are changing. Uruguay has legalized its use as have 4 American states; Jamaica is in the process of following suit. In addition, 17 US states have decriminalized cannabis, while 23 others have passed medical marijuana laws.

In many ways, cannabis is similar to alcohol; most of those who use it do so moderately, enjoy it, and suffer few if any adverse effects. However, in a minority of heavy users, problems develop. Given the likelihood that cannabis will become more available, it is important to establish any harms its use may cause so clinicians can identify and treat these. The main psychological harms that have been reported are dependence, cognitive impairment, and psychosis.

Why do people enjoy smoking cannabis?

The cannabis plant produces compounds known as cannabinoids in glandular trichomes, mostly around the flowering tops of the plant. Recreational cannabis is derived from these and has been traditionally available as herb (marijuana, grass, weed) or resin (hashish, hash). The cannabis plant produces more than 70 cannabinoids, but the one responsible for the “high” that users enjoy is tetrahydrocannabinol (THC). This activates the CB1 receptor, part of the endocannabinoid system, which, in turn, affects the dopaminergic reward system that is altered by all drugs of abuse.

Psychological dependence and tolerance can occur with cannabis. It remains in the body for several weeks, so withdrawal is very gradual but anxiety, insomnia, appetite disturbance, and depression can develop. Some reports claim that in 10% of persons who use cannabis and in 25% of daily users, dependence develops.1 Cannabis dependence is an increasingly common reason why patients seek help from drug treatment clinics.

Cognitive impairment

Many studies implicate adolescent cannabis use with poor subsequent educational achievement. Silins and colleagues2 observed more than 2500 young people in Australia and New Zealand. Their findings suggest that daily cannabis use before age 17 was associated with “clear reductions” in the likelihood of completing high school and obtaining a university degree.

THC disrupts the function of the hippocampus, a structure crucial to memory, and when it is given to volunteers, transient cognitive impairment is seen. Such impairment likely is why drivers under the influence of cannabis are at double the risk for traffic accidents.2 Long-term users show more obvious deficits, but questions remain about what happens when they stop. Some studies suggest they can recover fully, while others indicate that only partial recovery is possible.3

Risk of psychosis

It has long been known that persons with schizophrenia are more likely to smoke cannabis than is the rest of the population. Until recently, the general view was that they must be smoking to self-medicate or otherwise help them to cope with their illness. If this were so, then one might expect psychotic cannabis users to have a better outcome than non-users. However, the opposite is the case; the patients who continue to use cannabis are much more likely to continue to have delusions and hallucinations.4

However, this does not prove that cannabis use causes the poor outcomes. The possible causal role of cannabis can only be answered by prospective epidemiological studies. In the first of these, 45,750 young men were asked about their drug use when they were conscripted into the Swedish army.5 Those who had used cannabis more than 50 times when conscripted, were 6 times more likely to receive a diagnosis of schizophrenia over the next 15 years(Figure 1). Since 2002, a series of prospective studies have confirmed that individuals who used cannabis at the baseline evaluation had a great-er risk of subsequently developing psychotic symptoms or full-blown schizophrenia than non-users.4-7

Some skeptics have suggested that perhaps those who are predisposed to schizophrenia are especially likely to use cannabis. However, in the Dunedin birth cohort study, the subjects were intensively studied since childhood, so those who had already appeared psychosis-prone at age 11 were excluded.6 The researchers found a link between cannabis use and later schizophrenia, even when the effects of other drugs known to increase risk of psychosis were excluded (Figure 2). Another criticism was that some individuals might have been using cannabis in an attempt to ameliorate symptoms of psychosis or its precursors. However, a second New Zealand study, this time from Christchurch, showed that once minor psychotic symptoms developed, individuals tended to smoke less.7

Anyone familiar with the effects of alcohol would immediately accept that the frequency of drinking is relevant to its adverse effects. The same is true with cannabis; long-term daily users are most at risk. Nevertheless, the majority of daily users will not become psychotic. Indeed, when a young man in whom schizophrenia has developed after years of smoking cannabis is asked whether he thinks his habit may have contributed to the disorder, he might answer, “No, my friends smoke as much as I do, and they’re fine.” It seems that some people are especially vulnerable.

Individuals with a paranoid personality are at greatest risk, along with those who have a family history of psychosis. Inheriting certain variants of genes that influence the dopamine system, which is implicated in psychosis, may also make some users especially susceptible; examples include AKT1, DRD2, and possibly COMT.8,9

Changes in potency

In 1845, French psychiatrist Jacques-Joseph Moreau used cannabis and gave it to some of his students and patients. He concluded that cannabis could precipitate “acute psychotic reactions, generally lasting but a few hours, but occasionally as long as a week.”10 Modern experimental studies confirm that intravenous administration of THC in healthy volunteers can produce acute psychotic symptoms in a dose-dependent manner.8

The proportion of THC in traditional marijuana and resin in the 1960s was approximately 1% to 3%. Potency began to rise in the 1980s, when cannabis growers such as David Watson, commonly known as “Sam the Skunkman,” fled the Reagan-inspired “War on Drugs” and brought cannabis seeds to Amsterdam, where cannabis could be sold legally in “coffee shops.” Together with Dutch enthusiasts, they bred more potent plants, setting the scene for a slow but steady increase in new varieties of marijuana, including sensimilla (often called “skunk” because of its strong smell) harvested from unpollinated female flowers. The proportion of THC in sensimilla has risen to between 16% and 20% in England and Holland, respectively, and high-potency varieties have taken over much of the traditional market9,11; the same trend, although lagging a few years behind, has occurred in the US.12

Traditional cannabis often contained not only THC but an equivalent amount of cannabidiol. This has been shown in experimental studies to ameliorate the psychotomimetic effects of THC, and possibly to have antipsychotic properties (Figure 3).13 However, plants bred to produce a high concentration of THC cannot also produce much cannabidiol, so the high THC types of cannabis contain little or no cannabidiol. Such varieties are more psychotogenic; one study showed that persons who used high-THC–low-cannabidiol cannabis on a daily basis were 5 times more likely than non-users to suffer from a psychotic disorder.14 Another study that tested hair for cannabinoids showed that users with both detectable THC and cannabidiol in their hair had fewer psychotic symptoms than those with only THC.15

The increasing availability of high-potency cannabis explains why psychiatrists are more concerned about cannabis now than they were in the 1960s and 1970s. The trend toward greater potency continues: new forms of resin oil reportedly contain up to 60% of THC.11 These very potent forms remain unusual, but synthetic cannabinoids, often termed “spice” or “K2,” are now commonly advertised and sold on Web sites that keep within the law by labeling their products as incense—or adding “not for human consumption.” While THC only partially activates the CB1 receptor, most spice/K2 molecules fully activate the receptor and, consequently, acute adverse reactions are more common. A survey of 80,000 drug users showed that those who used synthetic cannabinoids were 30 times more likely to end up in an emergency department than users of traditional cannabis.16

Cannabis and the developing brain

It seems that starting cannabis use in early adolescence increases the likelihood of problems. For example, in the Dunedin study, those starting at 18 years or later showed only a nonsignificant increase in the risk of psychosis by age 26, but among those starting at age 15 or earlier, risk was increased 4-fold (Figure 2).6

Those starting cannabis use early also appear more likely to develop cognitive impairment. Pope and colleagues17 found that long-term heavy cannabis users who began smoking before age 17 had lower verbal IQ scores than those who began smoking at age 17 or older. Meier and colleagues18 followed a birth cohort in Dunedin, New Zealand, up to age 38 years. Their findings suggest that persistent cannabis use over several decades causes a decline of up to 8 points in IQ; such dramatic findings need to be replicated before they can be accepted.

The results from animal studies also show that THC administration produces a greater effect on cognitive function in juvenile rats than in adult rats. Moreover, imaging studies in persons with long-term, very heavy cannabis use indicate detectable brain changes, especially in those who started smoking in adolescence.19 Although the studies remain contentious, a possible explanation is that beginning cannabis use at an age when the brain is still developing might permanently impair the endocannabinoid system; this may affect other neurotransmitters, such as dopamine—known to be implicated in both learning and in psychosis.

Implications

Cannabis is now generally recognized as a contributory cause of schizophrenia. Although psychosis develops in only a small minority of cannabis users, when you consider that almost 200 million people worldwide use cannabis, the number of people who suffer cannabis-induced psychosis is likely to be in the millions, and the impact on mental health services is significant. The proportion of psychosis that has been attributed to cannabis use in different countries ranges from 8% to 24%, depending, in part, on the prevalence of use and the potency of the cannabis.16

Politicians have the difficult job of balancing the enjoyment that many people get from cannabis against the harm that afflicts some people. Furthermore, cannabis can alleviate chronic pain or symptoms associated with chemotherapy. Medical marijuana may be largely a cover used by the increasingly powerful marijuana industry to introduce recreational use, but research into the numerous components of cannabis should be encouraged, since it may produce drugs with important therapeutic uses.

Current trends are toward relaxing laws on cannabis, but no one knows the likely outcome. Will legalization mean an increase in consumption? Early reports from Colorado and Washington suggest an increase. Will this have knock-on effects on use by those in their early teens who seem most susceptible to adverse effects? Will the mental health and addiction services be able to cope? How effective will educational campaigns regarding the risks of regular use of high-potency cannabis or synthetic cannabinoids be? Might a simple genetic test reveal who is most likely to suffer adverse mental effects?

Many questions remain to be answered. In the meantime, as cannabis use continues to win acceptance, psychiatrists are likely to see more of the casualties.

Summary

The 2012/13 New Zealand Health Survey (NZHS) provides valuable information about cannabis use by adults aged 15 years and over. It builds upon and adds value to the findings of the 2007/08 New Zealand Alcohol and Drug Use Survey report on cannabis.

This report presents information on cannabis use in New Zealand, including patterns of use, drug-driving, harms from use (productivity and learning, and mental health), legal problems, and cutting down and seeking help. Information on the medicinal use of cannabis is also presented.

Patterns of cannabis use

Eleven percent of adults aged 15 years and over reported using cannabis in the last 12 months (defined here as cannabis users). Cannabis was used by 15% of men and 8.0% of women. Māori adults and adults living in the most deprived areas were more likely to report using cannabis in the last 12 months. Thirty-four percent of cannabis users reported using cannabis at least weekly in the last 12 months. Male cannabis users were more likely to report using cannabis at least weekly in the last 12 months.

Cannabis and driving

Thirty-six percent of cannabis users who drove in the past year reported driving under the influence of cannabis in the last 12 months. Men were more likely to have done so.

Cannabis-related learning and productivity harms

Six percent of cannabis users reported harmful effects on work, studies or employment opportunities, 4.9% reported difficulty learning, and 1.7% reported absence from work or school in the last 12 months due to cannabis use.

Cannabis and mental health harms

Eight percent of cannabis users reported a time in the last 12 months that cannabis use had a harmful effect on their mental health. Younger cannabis users (aged 25–34 years) were most affected, with reported harm to mental health decreasing markedly by age 55+ years.

Cannabis and legal problems

Two percent (2.1%) of cannabis users reported experiencing legal problems because of their use in the last 12 months.

Cutting down and help to reduce cannabis use

Most cannabis users (87%) did not report any concerns from others about their use. Seven percent of cannabis users reported that others had expressed concern about their drug use or had suggested cutting down drug use within the last 12 months. Of cannabis users, 1.2% had received help to reduce their level of drug use in the last 12 months. Few cannabis users who wanted help did not get it (3.6%).

Cannabis use for medicinal purposes

Forty-two percent of cannabis users reported medicinal use (ie, to treat pain or another medical condition) in the last 12 months. Rates were similar for men and women. Older cannabis users (aged 55+ years) reported higher rates of medicinal use.

An  infographic (PDF, 174 KB)  provides a short overview of these findings.

The methodology report for the 2012/13 New Zealand Health Survey is also available on this website.

If you have any queries please email hdi@moh.govt.nz

Downloads

Source:  Ministry of Health. 2015. Cannabis Use 2012/13: New Zealand Health Survey. Wellington: Ministry of Health. Published online:  28 May 2015

http://www.health.govt.nz/publication/cannabis-use-2012-13-new-zealand-health-survey

Students demonstrating better prosocial behavior were more likely to have graduated college, to be gainfully employed and to not have been arrested than students with lesser prosocial skills. Image: © iStock Photo Christopher Futcher

UNIVERSITY PARK, Pa. — Kindergarteners’ social-emotional skills are a significant predictor of their future education, employment and criminal activity, among other outcomes, according to Penn State researchers.

In a study spanning nearly 20 years, kindergarten teachers were surveyed on their students’ social competence. Once the kindergarteners reached their 20s, researchers followed up to see how the students were faring, socially and occupationally. Students demonstrating better prosocial behavior were more likely to have graduated college, to be gainfully employed and to not have been arrested than students with lesser prosocial skills.

“This research by itself doesn’t prove that higher social competence can lead to better outcomes later on,” said Damon Jones, senior research associate, Bennett Pierce Prevention Research Center. “But when combined with other research, it is clear that helping children develop these skills increases their chances of success in school, work and life.”

Jones and colleagues analyzed data collected from more than 700 students who were participating in the Fast Track Project, a study conducted by four universities — Penn State, Duke University, Vanderbilt University and the University of Washington. The Fast Track Project is a prevention program for children at high risk for long-term behavioral problems. The individuals studied for this research were part of the control group and did not receive any preventive services. Overall, the sample was representative of children living in lower socio-economic status neighborhoods.

Kindergarten teachers rated students on eight items using a five-point scale assessing how each child interacted socially with other children. Items included statements such as “is helpful to others,” “shares materials” and “resolves peer problems on own.”

The researchers compared the teachers’ assessments to the students’ outcomes in five areas during late adolescence through age 25 — including education and employment, public assistance, criminal activity, substance abuse, and mental health. Jones and colleagues report their results online and in a future issue of the American Journal of Public Health.

Overall, the researchers found that a higher rating for social competency as a kindergartener was significantly associated with all five of the outcome domains studied. For every one-point increase in a student’s social competency score, he or she was twice as likely to graduate from college and 46 percent more likely to have a full-time job by the age of 25.

For every one-point decrease in the child’s score, he or she had a 67 percent higher chance of having been arrested and an 82 percent higher chance of being in or on a waiting list for public housing at age 25. The study controlled for the effects of poverty, race, having teenage parents, family stress and neighborhood crime, and for the children’s aggression and reading levels in kindergarten.

“The good news is that social and emotional skills can improve, and this shows that we can inexpensively and efficiently measure these competencies at an early age,” said Jones. Evidence from numerous intervention studies indicate that social and emotional learning skills can be improved throughout childhood and adolescence.

Jones and colleagues plan to continue this work in order to further understand how social competency can predict future life outcomes, and further understand intermediary developmental processes whereby early social-emotional skills influence long-term adult outcomes.

Jones is also a research assistant professor of health and human development at Penn State. Mark Greenberg, the Bennett Endowed Chair in Prevention Research, founding director of the Bennett Pierce Prevention Research Center and professor of human development and family studies; and Max Crowley, assistant professor of human development and family studies, both at Penn State, also worked on this research.

The Robert Wood Johnson Foundation supported this research. The Fast Track Study also received grant support from the National Institute of Mental Health, the National Institute on Drug Abuse, the U.S. Department of Education and the Center for Substance Abuse Prevention.

Source: http://news.psu.edu/

ABSTRACT

Background:

This analysis examines decriminalization as a risk factor for future increases in youth marijuana acceptance and use. Specifically, we examine marijuana-related behaviors and attitudes of 8th, 10th, and 12th graders in California as compared to other U.S. states during the years before and after California passed legislation in 2010 to decriminalize marijuana.

Methods:

Data come from Monitoring the Future, an annual, nationally representative survey of 8th, 10th, and 12th grade students. Results: In 2012 and afterwards California 12th graders as compared to their peers in other states became (a) 25% more likely to have used marijuana in the past 30 days, (b) 20% less likely to perceive regular marijuana use as a great health risk, (c) 20% less likely to strongly disapprove of regular marijuana use, and (d) about 60% more likely to expect to be using marijuana five years in the future. Analysis of 10th graders raises the possibility that the findings among 12th graders may reflect a cohort effect that was set into place two years earlier. Conclusion: These results provide empirical evidence to support concerns that decriminalization may be a risk factor for future increases in youth marijuana use and acceptance.

Conclusion

The results of this study support decriminalization as a risk factor for increases in both marijuana acceptance and use among 12thgraders. Following decriminalization both marijuana acceptance and use significantly increased among California 12th graders as compared to their peers in other states. Policymakers and voters should consider the possibility that decriminalization sends a signal that encourages youth marijuana use. The study results both justify and motivate future work to determine whether decriminalization continues to exert an influence on future cohorts of California 12th graders, as well as an examination of intervening mechanisms that are amenable to policy and interventions.

Source:  International Journal of Drug Policy 26 (2015) 336–344 International Journal of Drug Policy 26 (2015) 336–

A recently published study sheds new light on how to prevent teen drug abuse. It also provides new evidence that the conventional wisdom regarding the timing of prevention efforts may be wrong. The current study shows that, with the right program, it’s possible to cut high school drug abuse in half.

The results of this study are especially important because they challenge the prevailing wisdom that high school is too late a time to start prevention programs. This program offers a successful approach to helping teens not exposed to an effective prevention program at an earlier age.

The new study, published in the World Journal of Preventive Medicine, shows that an approach proven effective with elementary and middle school students also works with high school students. The study compared students attending schools assigned at random to either receive or not receive the Botvin LifeSkills Training (LST) high school program, which was adapted from the evidence-based LST Middle School program. The LST program prevents tobacco, alcohol, and illicit drug use by teaching students skills for coping with the challenges of life, reducing motivations to use drugs and engaging in unhealthy behaviors, and fostering overall resilience.

Researchers found that the LST high school program reduced drug abuse in teens. Compared to the non-LST control group, there were 52% fewer daily substance users in the LST group. The study shows that dramatic reductions in drug abuse are possible with high school students across different racial/ethnic groups and different parts of the country.

“These are very exciting findings. This study not only shows that it’s possible to cut drug abuse in half among high school students. It also shows that you can do so with a program delivered by classroom teachers who only need minimal specialized training. Since this kind of program is inexpensive and can be widely disseminated to schools across the country, it offers tremendous potential as a cost-effective approach to a major public health problem,” said Dr. Gilbert J. Botvin, developer of the LifeSkills Training program and professor emeritus of Cornell University’s Weill Medical College.

The LifeSkills Training high school program is a highly interactive curriculum that teaches students skills that have been found to prevent substance use and violence. Rather than merely teaching information about the dangers of drug abuse, the LST program promotes healthy alternatives to risky behavior. Throughout the program, students develop strategies for making healthy decisions, reducing stress, and managing anger, as well as strengthening their communication skills and learning how to build healthy relationships. The program also helps students understand the consequences of substance use, risk-taking, and the influences of the media.

SOURCE National Health Promotion Associates. WHITE PLAINS, N.Y.June 25, 2015 /PRNewswire   World Journal of Preventive Medicine

Research Summary

Observational studies suggest that heavy, habitual marijuana use in adolescence may be associated with cognitive decline and adverse educational outcomes. However, conflicting data exists. The authors of this study used data from a large population-based prospective cohort of 1155 individuals from the United Kingdom to investigate the effects of cannabis use by age 15 on subsequent educational outcomes. They also explored the relationship between tobacco use and educational outcomes to assess for possible bias. The primary educational outcomes were performance in standardized English and mathematics assessments at age 16, completion of 5 or more assessments at a grade level C or higher, and leaving school having achieved no qualifications. Exposure was measured by self-report and serum cotinine levels.

* In fully adjusted models both cannabis and tobacco use were associated with adverse educational outcomes.

* A dose response effect was seen with higher frequency of cannabis use associated with worse outcomes.

* Adjustment for other substance use and conduct disorder attenuated these effects and tobacco had a stronger association than cannabis.

Comments:

This data sheds more light on a possible association between early exposure to cannabis and tobacco and subsequent poor educational outcomes. However, given the nature of the analysis, causality cannot be implied. Further research is needed at longer follow-up periods to gain more understanding of the relationship between cannabis use in adolescence and educational outcomes.  Jeanette M. Tetrault, MD

Source: Addiction. 2015;110(4):658–668.

…Than Students Not Subject to Testing in Same Schools

A study conducted by the Institute for Behavior and Health, Inc., funded by the U.S. Department of Education,a and published in the Journal of Child and Adolescent Substance Abuse shows students in schools with random student drug testing (RSDT) programs who knew they were subject to random testing and expected to be tested in the coming school year reported significantly less marijuana and other illegal drug use than students who knew they were not subject to testing.1

Anonymous self-report student surveys were conducted bi-annually over a three year period among eight high schools with well-established RSDT programs. In all schools, athletes and in five schools, students in extracurricular activities, were subject to RSDT; however, based on student surveys it was clear that many students did not know of their status in these programs. Based on student survey responses, researchers identified two subsets of students: those who knew they were in their schools drug testing pool and aware they could be randomly drug tested (Tested) and students who knew they were not in the testing pool and not subject to random testing (Not Tested).

Significantly fewer students in the Tested group reported past month use of marijuana and other illicit drugs (cocaine, opiates and amphetamine/methamphetamine)b than students in the Not Tested group: 26.3% of Not Tested students reported past month marijuana use and 12.6% of Tested students used marijuana in this time. Similarly, 14.0% of Not Tested students used any of the other three illicit drugs while 8.5% of Tested students reported use of these drugs. Similar differences were found among groups for past year use of drugs, with Tested students reporting significantly less drug use than Not Tested students.

Differences in self-reported rates of past month and past year drug use among Tested and Not Tested students were consistent within each grade, with significantly fewer Tested students in 9th, 10th, 11th and 12th grades reporting drug use than their Not Tested peers.

Groups did not differ in reported rates of past month alcohol use: 38.5% of all Not Tested students reported past month alcohol use compared to 37.1% of Tested students. No differences were found among groups for past year alcohol use. Only one school tested students for alcohol and thus, was excluded from these analyses. 2

Because many opponents of RSDT programs suggest that students subject to testing are typically less likely to use drugs because of school involvement (i.e. participation in athletics or extracurricular activities acts as a preventive measure), researchers examined differences between Tested and Not Tested students engaged in extracurricular activities. Tested/Extracurricular students reported significantly less past month marijuana use (11.9%) than Not Tested/Extracurricular students (19.1%). No differences were found for past month alcohol or other illegal drug use. No differences were found for past year alcohol or other illegal drug use.

This study provides evidence for the efficacy of RSDT in reducing rates of drug use when students are aware that they are subject to random testing and believe they are likely to be tested. It is worthy of note that the differences in past month and past year drug use among Tested and Not Tested students were not found for alcohol use, quite possibly because schools did not include alcohol on testing panels. The study also provides evidence that students subject to testing have more positive attitudes towards testing and their school’s drug and alcohol policies than students not subject to testing. More than half (54.5%) of Tested students reported that drug testing made them want to avoid drugs compared to 26.7% of Not Tested students. The significant difference between Tested/Extracurricular and Not Tested/Extracurricular students in past marijuana use suggests that random student drug testing may further reduce marijuana use among this population.

RSDT is not a stand-alone prevention program but rather one part of a school’s comprehensive prevention program.2 Because so few students actually are tested due to cost and administrative constraints, the study suggests that to ensure maximum effectiveness, existent and future RSDT programs should be aware that it is important for students to know that they are participants in school random drug testing pools.

* This study was part of a demonstration project funded from 2003-2007 by the U.S. Department of Education.

* Random drug test panels for all schools included marijuana, cocaine, opiates and amphetamine/methamphetamine.

For more information on the Institute for Behavior and Health, Inc. visit www.IBHinc.org.

For information about random student drug testing visit www.PreventionNotPunishment.org.

For information about the harmful effects of drug use by teens visit

www.PreventTeenDrugUse.org.   Robert L. DuPont, M.D.President, Institute for Behavior and Health, Inc.  First Director, National Institute on Drug Abuse (NIDA) 1973 to 1978

Source:  Institute for Behaviour and Health.    Revised April 22nd 2013

Filed under: Education :

These remarkable scans clearly reveal how smoking during pregnancy harms an unborn baby’s development.

New ultrasound images show how babies of mothers who smoke during pregnancy touch their mouths and faces much more than babies of non-smoking mothers.

Foetuses normally touch their mouths and faces much less the older and more developed they are. Experts said the scans show how smoking during pregnancy can mean the development of the baby’s central nervous system is delayed. Doctors have long urged pregnant women to give up cigarettes because they heighten the risk of premature birth, respiratory problems and even cot death.

Now researchers believe they can show the effects of smoking on babies in the womb – and use the images to encourage mothers who are struggling to give up.

Image shows the 4-D ultrasound scan of two foetuses at 32 weeks gestation, one whose mother was a smoker (top) and the other carried by a non-smoker (bottom). The foetus carried by the smoker touches its face and mouth much more, indicating its development is delayed

As part of the study, Dr Nadja Reissland, of Durham University, used 4-D ultrasound scan images to record thousands of tiny movements in the womb.

She monitored 20 mothers attending the James Cook University Hospital in Middlesbrough, four of whom smoked an average of 14 cigarettes a day.

After studying their scans at 24, 28, 32 and 36 weeks, she detected that foetuses whose mothers smoked continued to show significantly higher rates of mouth movement and self-touching than those carried by non-smokers. Foetuses usually move their mouths and touch themselves less as they gain more control the closer they get to birth, she explained.

The pilot study, which Dr Reissland hopes to expand with a bigger sample, found babies carried by smoking mothers may have delayed development of the central nervous system. Dr Reissland said: ‘A larger study is needed to confirm these results and to investigate specific effects, including the interaction of maternal stress and smoking.’

She believed that videos of the difference in pre-birth development could help mothers give up smoking.

But she was against demonising mothers and called for more support for them to give up. Currently, 12 per cent of pregnant women in the UK smoke but the rate is over 20 per cent in certain areas in the North East. All the babies in her study were born healthy, and were of normal size and weight.

Dr Reissland, who has an expertise in studying foetal development, thanked the mothers who took part in her study, especially those who smoked. ‘I’m really grateful, they did a good thing,’ she said. ‘These are special people and they overcame the stigma to help others.’

Co-author Professor Brian Francis, of Lancaster University, added: ‘Technology means we can now see what was previously hidden, revealing how smoking affects the development of the foetus in ways we did not realise.

‘This is yet further evidence of the negative effects of smoking in pregnancy.’ The research was published in the journal Acta Paediatrica. 


Read more: http://www.dailymail.co.uk  23 March 2015

Dutch study finds mathematics results suffer most from dope consumption – findings sure to fuel debate over steps towards legalisation If you want to do well in your exams, especially maths, don’t smoke dope.

This is the finding of a unique study that is likely to be fiercely debated by those in favour of and those against the liberalisation of cannabis laws.

Economists Olivier Marie of Maastricht University and Ulf Zölitz of IZA Bonn examined what happened in Maastricht in 2011 when the Dutch city allowed only Dutch, German and Belgian passport-holders access to the 13 coffee shops where cannabis was sold.

The temporary restrictions were introduced because of fears that nationals from other countries, chiefly France and Luxembourg, were visiting the city simply to smoke drugs, which would tarnish its genteel image.

After studying data on more than 54,000 course grades achieved by students from around the world who were enrolled at Maastricht University before and after the restrictions were introduced, the economists came to a striking conclusion.

In a paper recently presented at the Royal Economic Society conference in Manchester they revealed that those who could no longer legally buy cannabis did better in their studies.  The restrictions, the economists conclude, constrained consumption for some users, whose cognitive functioning improved as a result.

“The effects we find are large, consistent and statistically very significant,” Marie told the Observer.  “For example, we estimate that students who were no longer able to buy cannabis legally were 5% more likely to pass courses.

The grade improvement this represents is about the same as having a qualified teacher and, more relevantly, similar to decreases in grades observed from reaching legal drinking age in the US.”

For low performers, there was a larger effect on grades. They had a 7.6% better chance of passing their courses.  Interestingly, Marie and Zölitz found the effects were even more pronounced when it came to particular disciplines.

“The policy effect is five times larger for courses requiring numerical/mathematical skills,” the pair write.This, they argue, is not that surprising.  “In line with how THC consumption affects cognitive functioning, we find that performance gains are larger for courses that require more numerical/mathematical skills,” Marie said.  THC – tetrahydrocannabinol – is the active ingredient in skunk cannabis, which some studies have linked with psychosis.

The ground breaking research comes at a significant moment.  The clamour for liberalisation of cannabis laws is growing.

In Germany, Berlin is considering opening the country’s first legal cannabis shop. Uruguay plans to be the first nation in the world to fully legalise all aspects of the cannabis trade. In the US, more than 20 states now allow medical marijuana use, while recreational consumption has become legal in Alaska, Oregon, Washington and Colorado.

But, as Marie and Zölitz observe in their paper: “With scarce empirical evidence on its societal impact, these policies are mainly being implemented without governments knowing about their potential impact.

“We think this newfound effect on productivity from a change in legal access to cannabis is not negligible and should be, at least in the short run, politically relevant for any societal drug legalisation and prohibition  decision-making,” Marie said. “In the bigger picture, our findings also indicate that soft drug consumption behaviour is affected by their legal accessibility, which has not been causally demonstrated before.”

The research is likely to be seized upon by anti-legalisation campaigners.  But Marie was at pains to say the research should simply be used to raise awareness of an often overlooked aspect of drug use: its impact on the individual’s cognitive ability.  “If marijuana is legalised like it is in many states in the US, we should at least inform consumers about the negative consequences of their drug choices.”

It will also feed into the debate about THC levels in cannabis, which are becoming ever stronger. Levels of THC in marijuana sold in Maastricht’s coffee shops are around double those in the US. “Considering the massive impact on cognitive performance high levels of THC have, I think it is reasonable to at least inform young users much more on consequences of consuming such products as compared with that of having a beer or pure vodka,” Marie said.  History suggests that prohibition often results in the illicit drug or alcohol trade producing ever stronger products.

Campaigners for liberalisation argue that it could help bring THC levels down and allow users to know what they are buying. The authors concede that their findings could turn out to be different if they were to replicate their study in a country that did not have restrictions on cannabis use.  Marie said his work had helped inform his discussions with his teenage son.  “I have a 13-year old boy and I do extensively share this with him as a precautionary measure so that he can make the best informed choice if he is faced with the decision of whether to consume cannabis or not.”

http://www.theguardian.com/society/2015/apr/11/cannabis-smokers-risk-poorer-grades-dutch-study-legalisation

Several students and visitors from Wesleyan University were hospitalized on February 22 after taking the club drug MDMA. U.S. DEA/HANDOUT VIA REUTERS/REUTERS

At least 11 people from the Wesleyan University campus in Middletown, Connecticut, were hospitalized on Sunday with symptoms consistent with drug overdoses. School officials and emergency responders are blaming MDMA, also known as Molly, a form of the drug ecstasy that medical experts say has become increasingly popular on college campuses.

Though some reports said 11 people had received medical treatment, Wesleyan President Michael S. Roth put the number at 12 in an email to students on Monday. That includes 10 students and two visitors.

“I ask all students: Please, please stay away from illegal substances, the use of which can put you in extreme danger. One mistake can change your life forever,” Roth wrote. “And please keep those still hospitalized in your hearts and minds. Please join me in supporting their recovery with your prayers, thoughts and friendship.”

In a statement on Monday, a Middletown Police Department spokeswoman, Lieutenant Heather Desmond, wrote that her department would be involved in an investigation into “the origin of the drugs taken” and to “determine the extent of the criminal involvement in the case.”

A spokeswoman for Middlesex Hospital tells Newsweek it treated 11 people, three of whom are still there and four of whom were airlifted by helicopter to Hartford Hospital. She could not comment on the conditions of the three patients there. A spokeswoman for Hartford Hospital confirmed that four people were there. She too could not speak to their conditions. The police spokeswoman wrote that two individuals are in critical condition and two are in serious condition.

Middletown Fire Chief Robert Kronenberger tells Newsweek his department made seven runs to Wesleyan related to the incident on Sunday after receiving calls between 7:30 a.m. and 1:30 p.m. It rendered aid to eight individuals, including two people in a single dorm room. “We saw the trend and we worked with the university and the police department to notify them of the trend,” Kronenberger says. “We’ve never had anything to this extent,” he says, referring to health and safety issues at Wesleyan. “A couple of them were in some serious dire straits,” he says about the students, adding that they were cooperative. “As a parent of two college-age students, this definitely concerns me and hopefully something to this extent will open eyes,” he says.

Wesleyan’s student newspaper, The Wesleyan Argus, first reported about the incident on its website on Sunday after the school’s vice president for student affairs, Michael Whaley, sent a series of emails to students.

Medical experts say MDMA use on college campuses has grown in recent years, and while there have been reports of bad reactions to the drug, it appears the Wesleyan incident is the most widespread.

In 2013, a University of Virginia sophomore collapsed at a nightclub after taking MDMA and later died. Students at Syracuse University in Syracuse, New York; Plymouth State University in Plymouth, New Hampshire; and Texas State University in San Marcos, Texas have also died after taking the drug. In 2013, organizers of the Electric Zoo music festival in New York City cut the event short after two people died while taking MDMA, including a University of New Hampshire student.

“This age group is a risk-taking group that is willing to follow their friend wherever they go, and if the person next to them is popping a pill, then they’re going to do it too,” says Dr. Mark Neavyn, director of medical toxicology at Hartford Hospital, who treats patients there for MDMA overdoses.

“I think the popular culture engine kind of made it seem safer in some way,” Neavyn says, referring to references to the drug by the singers Miley Cyrus and Madonna that made headlines.

But when it comes to MDMA, people are rarely taking what they think they’re taking, the doctor says.

According to Neavyn, symptoms of an MDMA overdose include fast heart rate, high blood pressure, delirium, elevated body temperature and alterations in consciousness. Extreme cases could involve cardiac arrhythmia and seizures.

Wesleyan, which has about 2,900 full-time undergraduate students and 200 graduate students, also apparently dealt with MDMA-related issues last semester. As the Argus reported, the school’s Health Services Department emailed students on September 16 following a series of MDMA-related hospitalizations.

One former Wesleyan student from the class of 2011, who requested anonymity when discussing drug use, says the news is not surprising, given the prevalence of drugs on campus. “Anything you can imagine…would be readily available there,” the person says. “I don’t think at Wesleyan you need [a campus event] to take drugs. If it’s sunny, there’s probably a good percentage of people that are taking something.”

The campus activities calendar did not show any major events scheduled for Saturday or Sunday.

Another former Wesleyan student from the class of 2012, who also requested anonymity, says the drug culture at Wesleyan is comparable to that at similar schools. “It’s one of those things where, much like at those schools, you kind of have an understanding of where you can go to get it and who had it,” the person says. “If there’s a will there’s a way.”

www.newsweek.com weds Feb. 2015

This article shows how drug use in an area can impact more than the individual and their families and friends.  The local economy and small businesses are having to cope with lower productivity due to ‘functioning’ drug dependents in the workforce.    NDPA

New Hampshire drug czar: Addiction dragging state’s economy down

Providing more treatment and recovery options for drug addicts is as much about the addicts as it is about helping spur the state’s economy, said the state’s new drug czar.

“For me, it’s all about the money,” said John G. “Jack” Wozmak, senior director for substance misuse and behavioral health.  Wozmak was appointed in January by Gov. Maggie Hassan. The position is funded by a grant from the New Hampshire Charitable Foundation. Wozmak spent nearly a decade as the administrator of the Beech Hill substance abuse treatment facility in Dublin, and since 1998 had been the Cheshire County administrator.

“With a broad range of experience dealing with substance misuse through his roles in the public sector and in private substance abuse treatment, Jack will help strengthen our efforts to improve the health and safety of Granite Staters, and I thank him for his commitment to serving the people of New Hampshire, as well the New Hampshire Charitable Foundation for making his position possible,” Hassan said in a statement.

Wozmak’s task: Get a host of agencies and organizations to work together to reduce the state’s drug abuse, particularly heroin addiction.  Wozmak takes the post at a time when heroin overdoses and deaths are at an all-time high in New Hampshire. The Centers for Disease Control reports that New Hampshire is among 28 states that saw big increases in heroin deaths.

But Wozmak said drug addiction is more than the headline-generating heroin overdoses and drug-related burglaries and robberies that dominate the news.
“Yes, the number of heroin deaths is doubling (from the previous year). But that’s just the tip of the iceberg” of the state’s drug epidemic, he said.

Functioning addicts

The underlying problem – and what the drug czar said will help him get more money for treatment and prevention efforts from state legislators – is the thousands of drug abusers who do not necessarily overdose but drive up costs for employers, he said.
“You don’t hear about the day-to-day drug exposure that companies have because it’s all below the surface, like an iceberg,” he said.

Employers see everything from diminished production to having to overstaff or pay overtime to cover for employees addicted to drugs who miss work, he said. This hurts profit and, in turn, decreases the state’s revenue from business profits taxes. He said estimates from the state’s hospitality sector indicate that as many as 20 percent of that field’s employees may have drug addiction issues.

“I want to increase jobs and this is getting in the way,” he said. “It’s just interfering with productivity. It’s interfering with the economy.”  Wozmak said the drug problem as been exacerbated by a myriad of issues, including budget cuts for treatment programs, along with insurance companies cutting or capping policy coverage for substance abuse treatment.

In the 1980s, he said, the state had more than 600 beds at six private centers providing treatment for substance abuse. After all the cuts by insurance companies, the state now has 62 beds available, he said.

Further, the state ranks second-to-last – after Texas – in providing treatment for drug addiction and has the lowest rate in the country – 6 percent – of people who get treatment for their addictions.  “We have decimated the system of treatment and recovery, and we have to rebuild it,” he said. “Imagine the outrage if diabetes were treated this way.”

More money

Hassan has proposed more than tripling the state’s spending for the Commission on Alcohol and Drug Abuse Prevention, Treatment and Recovery in her proposed two-year budget, from a total of nearly $2.9 million in the 2014-15 budget, to nearly $9.6 million in 2016-17.

The way to convince legislators that the funding is necessary is by appealing to their desire for job growth in a state that has had anemic population growth, Wozmak said.  To get population and job growth, he said, the state has to make its work force healthier and the best way to do that is to reduce drug addiction.

“If you ran on a platform of job growth, you have to deal with this issue,” he said. “If (job growth is) not going to be from people moving here, then you have to improve the work force that’s here.  “If you’re not looking to take care of this problem, then you’re falling down on your promise,” he said. “If you want to create jobs, you have to make the work force more viable.”

Wozmak said the problem can be solved. He said his role includes getting the affected parties – including law enforcement, public resources, private or nonprofit organizations, charities and treatment facilities – working together. He said a provision of the Affordable Care Act that requires insurers to cover substance abuse again should help spur private investment in treatment and recovery facilities.

“There is no easy answer, but I believe there are many opportunities to make the change now on a variety of levels and a myriad of fronts,” he said. “I think we’re going to have a lot of success.”  He said getting help from the state’s medical professionals will also be key, as most heroin addicts, he said, start with addictions to prescription painkillers. He said medical professionals are “not the sole source” of the issue, but could be involved in changing the way pain is managed to help prevent addictions.

“None of them wanted to become addicts,” he said.

– See more at: http://www.unionleader.com/article/    8th March 2015

Not magic at all of course, but a consequence of the fact that substance use problems are closely related to other problems which often develop at early ages when substance use is just not on the agenda. The 2010 English national drug strategy and corresponding public health plans seemed to recognise this, breaking with previous versions to focus attention on early years parenting in general, and particularly among vulnerable families. 

Though studies are few compared to approaches such as drug education in schools, this renewed emphasis on the early years has a strong theoretical rationale and some research backing. Child development and parenting programmes which do not mention substances at all (or only peripherally) have recorded some of the most substantial prevention impacts. Though mainly targeted at the early years, some extend to early teenage pupils and their families. The rationale for intervention rests partly on strong evidence that schools which develop supportive, engaging and inclusive cultures, and which offer opportunities to participate in school decision-making and extracurricular activities, create better outcomes across many domains, including non-normative substance use. As well as facilitating bonding with the school, such schools are likely to make it easier for pupils to seek and receive the support they need.

Understandably, such findings do not derive from random allocation of pupils to ‘good’ versus ‘bad’ schools, so are vulnerable to other influences the study was unable to account for. More convincing if more limited in intervention scope are studies which deliberately intervene and test what happens among young people randomly allocated to the focal intervention versus a comparator. An early example was a seminal Dutch drug education study of the early ’70s which had a profound impact in Britain. For the practitioners of the time, it was a warning about the dangers of the dominant ‘scare them’ approach, but it might as well have been a lesson about the approach which outperformed the warnings – classroom discussions which simply gave teenage pupils a structured chance to discuss the problems of adolescence, leaving it up to them whether drugs cropped up.

Image

 

Among the most prominent and promising of current approaches is the Good Behavior Game classroom management technique for the first years of primary schooling  illustration. Well and consistently implemented, by age 19–21 it was estimated that this would cut rates of alcohol use disorders from 20% to 13% and halve drug use disorders among the boys. In the Effectiveness Bank you can read about the study and read a practitioner-friendly account of the research from the researchers themselves. The same programme has been combined with parenting classes, leading to reductions in the uptake and frequency of substance use over the next three years.

Another primary school example is the Positive Action programme which focuses on improving school climate and pupil character development. In Hawaii and then the more difficult schools of Chicago, it had substantial and, in Chicago, lasting preventive impacts.

In Britain perhaps best known is the Strengthening Families Programme, a family and parenting programme which in the early 2000s impressed British alcohol prevention reviewers. It features parent-child play sessions, during which parents are coached in how to enjoy being with their children and to reinforce good behaviour. At first the accent is on building up the positives before tackling the more thorny issues of limit-setting and discipline. Though the potential seems great, later research has not been wholly positive, and the earlier results derived from the minority of families prepared or able to participate in the interventions and complete the studies.

A final example comes from Norway, where a study raised the intriguing possibility that taking measures to effectively reduce bullying in schools helps prevent some of the most worrying forms of substance use.

Isolating these and other similar studies is not possible via our normal search facilities, so we have specially identified and coded them. They may prove to be the future for drug prevention, as traditional drug education struggles for credibility as a prevention tool. See how this future is shaping up today by running this hot topic search.

Source:  www.findings.org     3rd March 2015

Nearly five young people are being admitted to hospital every day in NSW because of alcohol, exclusive data from NSW Health shows.

The figures show the huge toll alcohol is taking on children and young people in NSW, with a child aged between zero and four admitted to hospital almost every week because of injuries linked to their parents’ drinking. 

In total, nearly 1800 children aged between zero and 19 were so injured by their own drinking or that of others they were admitted to hospital in the 2012-13 financial year.

Experts say the government needs to urgently crack down on alcohol sales to children by introducing undercover stings, while parents need to heed the message that providing alcohol to their kids is dangerous.

The director of the McCusker Centre for Action on Alcohol and Youth, Mike Daube, said the hospital admissions were just the tip of the iceberg.

“This is only injuries so severe they need hospitalisation, and even then it is five a day in NSW alone,” he said. “This comes in a week when research has shown more than half of kids say it’s easy to buy alcohol.

“How many more wake-up calls do we need … state governments need to crack down on this issue.”

In the 2012-13 financial year, the last for which information is available, 1565 teenagers aged 15 to 19 year were admitted to hospital because of problems linked to alcohol. The overwhelming majority were male.

The injuries could involve problems directly caused by alcohol consumption, or injuries linked to alcohol, NSW Health said. Last month a 19-year-old student, Carl Salomon, died after falling from a crane into water in Balmain after a night out drinking.

And the harm doesn’t stop with teenagers. More than 50 children aged between zero and four and 70 aged five to nine were treated in hospital because of injuries linked to alcohol. Even more would have suffered from problems linked to foetal alcohol syndrome, which occurs in a baby whose mother drinks heavily while pregnant, that are not included in the data.

The chief executive of the Foundation for Alcohol Research and Education, Michael Thorn, said cheap, two-for-one and similar alcohol deals encouraged young people to binge drink. “Kids are very price-sensitive,” he said. “And they don’t take it home if they haven’t drunk it all”.

This week the foundation released a report into alcohol’s impact on children and families that found up to a quarter of people could be experiencing harm from the drinking of family members.

“Being raised in a harmful environment is very deleterious to a child, it affects their education, their development, their wellbeing, and it certainly increases their likelihood of health problems later,” he said.

Jo Mitchell, the director of the centre for population health in NSW Health, said dangerous drinking did not just occur among young people. “This is a serious public health issue across all age groups,” she said. “Often people think there’s a specific problem for young people … whereas the data shows that across the board there are high levels of risky drinking among adults as well.”

A new NSW Health data snapshot shows the rate of alcohol hospitalisations in NSW increased by 35 per cent from 1998-99, with nearly 52,000 hospital cases linked to alcohol in 2012-13.

But she said there had been some good successes in recent years in decreasing drinking rates. The department was also focused on delaying the age at which young people drank, and raising awareness among parents about the dangers of alcohol supply.

One such program, called “Stop the Supply“, has been run by the Northern Beaches Community Drug Action Team.

Team chairwoman Susan Watson said many parents were not aware of the dangers of youth drinking.

“We know that alcohol causes damage to [a growing] brain, and we didn’t know that years ago … so it’s really about starting conversations with parents about that,” she said. “It can be really difficult for parents to make these decisions when there is all this pressure out there, not just from themselves but from other parents.”

Source: http://www.smh.com.au/nsw/children-admitted-to-hospital-because-of-alcohol 1st March 2015

STATEN ISLAND, N.Y. — As the prescription drug and heroin epidemic continues to worsen on Staten Island and elsewhere, Borough President James Oddo plans on combating that by impressing on kids the importance of staying away from drugs.

He outlined an initiative recently during an editorial board meeting with the Advance, beginning with fifth-graders and imparting on them why they are “Too Good For Drugs.”

The aptly named program will either pair classroom teachers with police officers during the school day or pair after-school leaders with officers to teach students “an evidence-based program that has proven to work,” Oddo said.

The program will be piloted in the spring in one public school in each Staten Island police precinct and later broadened to other public and private schools.

In the 120th Precinct, PS 16 will pilot the program; PS 44 in the 121st Precinct; PS 8 in the 122nd Precinct; and PS 3 in the 123rd Precinct.

STATEN ISLAND’S EPIDEMIC

Statistics show that alcohol and substance abuse among high school students is higher on Staten Island than the city average. That applies to all categories of use, including for alcohol, marijuana, heroin, cocaine, opioids and other prescription drugs.

Oddo’s director of education, Rose Kerr, said the NYPD, Department of Education and the Roman Catholic Archdiocese of New York reviewed the curriculum and found “that it will be one that can be adapted to the police officer in the classroom.”

There will be a mechanism, she said, to monitor behavioral changes or use feedback forms to determine effectiveness of the curriculum and then decide how to spread it to other schools.

Oddo said of the initiative, “to a certain degree, it’s the same approach” as the D.A.R.E program, which is no longer implemented in NYC schools.

Ms. Kerr said, “The curriculum is contact-based on specifically ways in which abuses can be combatted: Decision-making skills and other content and life skills.”

She added, “We are hoping that this will be an ounce of prevention as opposed to a cure. We need the prevention piece, we need young ones to think differently and make different choices.”

‘IT’S THE BEGINNING’

Oddo said it became clear that high school and even middle school is too late to begin talking to kids about substance abuse.

He hopes to “start at the fifth grade and then grow this curriculum so that at each grade, in multiple steps along the way, these kids have the right message to kind of counter the pressures.”

Oddo added, “Is this the panacea? No. But it’s the beginning of getting a much larger presence in our schools, to get much more aggressive with this captive audience to fight this. Because this is life and death and there’s been, frankly, too much death.”

Source: http://www.silive.com/news 27th Feb.2015

Abstract

Poor diet, physical inactivity, tobacco smoking and alcohol consumption are major risk factors for chronic disease and premature mortality. These behaviours are of concern among higher education students and may be linked to psychological distress which is problematic particularly for students on programmes with practicum components such as nursing and teaching. Understanding how risk behaviours aggregate and relate to psychological distress and coping among this population is important for health promotion. This research examined, via a comprehensive survey undergraduate nursing/midwifery and teacher education students’ (n = 1557) lifestyle behaviour (Lifestyle Behaviour Questionnaire), self-reported psychological distress (General Health Questionnaire) and coping processes (Ways of Coping Questionnaire).

The results showed that health- risk behaviours were common, including alcohol consumption (93.2%), unhealthy diet (26.3%), physical inactivity (26%), tobacco smoking (17%), cannabis use (11.6%) and high levels of stress (41.9%). Students tended to cluster into two groups: those with risk behaviours (n = 733) and those with positive health behaviours (n = 379). The group with risk behaviours had high psychological distress and used mostly passive coping strategies such as escape avoidance. The potential impact on student health and academic achievement is of concern and suggests the need for comprehensive health promotion programmes to tackle multiple behaviours.

As these students are the nurses and teachers of the future, their risk behaviours, elevated psychological distress and poor coping also raise concerns regarding their roles as future health educators/promoters  Attention to promotion of health and well-being among this population is essential.

© The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Source: Health Promot Int. 2014 Oct 14. pii: dau086. [Epub ahead of print]

Lighting it up before school might not be as cool as you think. A new study, published in the New England Journal of Medicine, links smoking marijuana in kids with lower intelligence and poorer focus, and may translate into long-term effects. A recent National Institute on Drug Abuse (NIDA) report says that in 2013, an estimated 22.7 percent of high school seniors were smoking weed, with 6.7 percent of them smoked it dail. Those numbers are rising, too. The idea that marijuana is a harmless substance to kids is very concerning for researchers, who found that regular use of the drug over time, especially among younger kids, can impair brain development during a critical time in their lives.

 

“Long term, heavy use of marijuana results in impairments in memory and attention that persist and worsen with increasing years of regular use,” the report said, according toTime. With two states, Washington and Colorado, legalizing recreational use of weed, the drug has the potential to be even more harmful to children. Some argue that easier access will reduce smoking risks, but with drug use among children rising, researchers are trying to understand the impact on the mind. The new research also reveals that kids who smoke pot might be more likely to dropout, to participate in criminal activity, and to have lower grades.

The scientists reported that adults who started smoking as adolescents had “impaired neural connectivity,” which affects memory, alertness, and processing of basic routines. In turn, the ability to learn is worsened. Researchers also found that impaired brain functioning occurred for a few days after smoking weed, affecting a child’s ability to perform at their greatest potential in the classroom. According to NIDA, other side effects of marijuana smoking include rapid heartbeat — which also causes the eyes to look red. This usually happens only a few minutes after  lighting up. The drug also slows reaction times, which can result issues with response to signals and sounds. Their research also correlates smoking weed over time with an increased risk of developing psychosis, a mental disorder that causes you to lose sight of reality. People with psychosis have delusions, hallucinate, and hear things that aren’t really there.  Smoking weed is also associated with emotional disorders, such as depression and anxiety.

 

Researchers still have a long way to go to fully understand all the negative effects of marijuana on a child’s brain, but what they have found may help explain why some kids have trouble learning and excelling to their highest capacity.

Source: Volkow N, Baler R, Compton W, Weiss S. Adverse Health Effects of Marjuana Use. The New England Journal of Medicine.    June 2014. 

Abstract

OBJECTIVE:

To provide a review of the evidence from 3 experimental trials of Project Towards No Drug Abuse (TND), a senior-high-school-based drug abuse prevention program.

METHODS:

Theoretical concepts, subjects, designs, hypotheses, findings, and conclusions of these trials are presented. A total of 2,468 high school youth from 42 schools in southern California were surveyed.

RESULTS:

The Project TND curriculum shows reductions in the use of cigarettes, alcohol, marijuana, hard drugs, weapon carrying, and victimization. Most of these results were replicated across the 3 trials.

CONCLUSION:

Project TND is an effective drug and violence prevention program for older teens, at least for one-year follow-up.

Source:  PMID: 12206445 Am J Health Behav. 2002 Sep-Oct;26(5):354-65.

Abstract

OBJECTIVE:

The aim of the study was to evaluate the contribution of cannabis to the prediction of delinquent behaviors.

METHOD:

Participants were 312 high-school students who completed self-report questionnaires measuring antisocial behaviors, the frequency of cannabis and alcohol use, psychopathic traits using the Youth Psychopathic traits Inventory, borderline traits, depressive symptoms, socio-economic status, life events, attachment to parents, and low academic achievement. Hierarchical multiple regression analyses were conducted to investigate the contribution of cannabis use and potential confounding variables to antisocial behaviors.

RESULTS:

Boys reported a greater number of delinquent behaviors than girls (10.2±9.2 vs. 5.4±5.3, t=9.2, P<0.001). Thirty-seven percent of boys and 24 % of girls reported having used cannabis at least once during the last six months (P<0.001). Among cannabis users, boys reported a greater frequency of use than girls: average use for boys was 2-3 times per month whereas average use for girls was once a month (3.4±2.3 vs. 2.6±2, t=2.9, P=0.004). Cannabis users reported a greater number of antisocial behaviors than non-users (13.2±9.9 vs. 6.1±6.3, t=13.6, P<0.001). Multiple regression analyses showed that cannabis use was a significant independent predictor of antisocial behaviors in both gender (β=.35, P<.001 in boys, β=.29, P<.001 in girls) after adjustment for alcohol use, psychopathological and sociofamilial variables.

DISCUSSION:

The unique and independent association between frequency of cannabis use and antisocial behaviors does not indicate the causal direction of the relationship. It may be that cannabis use induces antisocial behaviors by enhancing impulsivity or irritability or by the need for money to buy cannabis. Conversely, antisocial behaviors may lead to cannabis use either through becoming used to transgressions or through the influence of delinquent peers using cannabis. This link is probably bidirectional, cannabis use and antisocial behaviors influencing mutually in a negative interactive spiral. This association suggests that these two problems are to be jointly approached when treating adolescents using cannabis or having antisocial behaviors.

Source:PMID: 24815792  Encephale. 2014 May 7. pii: S0013-7006(14)00046-3. doi: 10.1016/j.encep.2013.11.003. [Epub ahead of print]

Universal Internet-based prevention for alcohol and cannabis use reduces truancy, psychological distress and moral disengagement: A cluster randomised controlled trial.

Abstract

AIMS:

A universal Internet-based preventive intervention has been shown to reduce alcohol and cannabis use. The aim of this study was to examine if this program could also reduce risk-factors associated with substance use in adolescents.

METHOD:

A cluster randomised controlled trial was conducted in Sydney, Australia in 2007-2008 to assess the effectiveness of the Internet-based Climate Schools: Alcohol and Cannabis course. The evidence-based course, aimed at reducing alcohol and cannabis use, consists of two sets of six lessons delivered approximately six months apart. A total of 764 students (mean 13.1years) from 10 secondary schools were randomly allocated to receive the preventive intervention (n=397, five schools), or their usual health classes (n=367, five schools) over the year. Participants were assessed at baseline, immediately post, and six and twelve months following the intervention on their levels of truancy, psychological distress and moral disengagement.

RESULTS:

Compared to the control group, students in the intervention group showed significant reductions in truancy, psychological distress and moral disengagement up to twelve months following completion of the intervention.

CONCLUSIONS:

These intervention effects indicate that Internet-based preventive interventions designed to prevent alcohol and cannabis use can concurrently reduce risk-factors associated with substance use in adolescents.

Source:  Prev Med. 2014 May 10;65C:109-115. doi: 10.1016/j.ypmed.2014.05.003. [Epub ahead of print]

Abstract

OBJECTIVES:

The online universal Climate Schools intervention has been found to be effective in reducing the use of alcohol and cannabis among Australian adolescents. The aim of the current study was to examine the feasibility of implementing this prevention programme in the UK.

DESIGN:

A pilot study examining the feasibility of the Climate Schools programme in the UK was conducted with teachers and students from Year 9 classes at two secondary schools in southeast London. Teachers were asked to implement the evidence-based Climate Schools programme over the school year with their students. The intervention consisted of two modules (each with six lessons) delivered approximately 6 months apart. Following completion of the intervention, students and teachers were asked to evaluate the programme.

RESULTS:

11 teachers and 222 students from two secondary schools evaluated the programme. Overall, the evaluations were extremely positive. Specifically, 85% of students said the information on alcohol and cannabis and how to stay safe was easy to understand, 84% said it was easy to learn and 80% said the online cartoon-based format was an enjoyable way to learn health theory topics. All teachers said the students were able to recall the information taught, 82% said the computer component was easy to implement and all teachers said the teacher’s manual was easy to use to prepare class activities. Importantly, 82% of teachers said it was likely that they would use the programme in the future and recommend it to others.

CONCLUSIONS:

The Internet-based universal Climate Schools prevention programme to be both feasible and acceptable to students and teachers in the UK. A full evaluation trial of the intervention is now required to examine its effectiveness in reducing alcohol and cannabis use among adolescents in the UK before implementation in the UK school system.

Source: PMID: 24840248 BMJ Open. 2014 May 19;4(5):e004750. doi: 10.1136/bmjopen-2013-004750.

Washington, DC (March 21, 2014) – Binge drinking for college students has proven to be a huge problem at many universities. The risk of DUI or even death makes it a public health concern that students and administrators need to face. A recent study by researchers at the University at Buffalo, State University of New York, found that college students exposed to the risk messages of alcohol-related cancer had lower intent to engage in binge drinking.

Cindy Yixin Chen and Z. Janet Yang of the University at Buffalo, State University of New York will present their study at the 64th Annual Conference of the International Communication Association in Seattle, WA. Chen and Yang conducted an online survey in which an experiment was embedded among a sample of college students. The survey examined if risk perception of alcohol-attributable cancer could decrease intention for binge drinking among college students.

Participants were exposed to a brief risk message presenting alcohol-attributable cancer incidence in textual, tabular, or graphic format. The experiment explored if risk messages regarding alcohol-attributable cancer in different formats (text, table, graph) have different influences on risk perception. The experiment also tested if such influences are contingent on different levels of numerical skills of college students.

Chen and Yang found that when risk of alcohol-related cancer was presented in visual tables and graphs, this increased participants’ risk perception and in turn, their reluctance to engage in binge-drinking behavior. Previous studies have examined college students’ perceptions of risk from experiencing alcohol-related problems such as having a hangover, feeling nauseated or vomiting, experiencing blackouts, drunk driving, and unplanned sex. Chen and Yang’s study is the first to examine what formats of messages regarding alcohol-attributable cancer are best to curtail this behavior.

“Binge-drinking among college students has been recognized as one of the most serious public health concerns for over a decade. The current alcohol-prevention campaigns generally focus on consequences of binge-drinking, such as DUI, unintended injuries, death, or a series of health and psychological problems. These negative consequences are well-known, and students hear these repeatedly, which may incur message fatigue,” said Chen. “The risk messages we designed focused on the cancer incidence rates attributable to drinking. This is an innovative approach in message design, as not many college students know the association between drinking and cancer.”

Source: www.sciencecodex.com  26th March 2014

Abstract

ISSUES:

The use of alcohol and drugs amongst young people is a serious concern and the need for effective prevention is clear. This paper identifies and describes current school-based alcohol and other drug prevention programs facilitated by computers or the Internet.

APPROACH:

The Cochrane Library, PsycINFO and PubMed databases were searched in March 2012. Additional materials were obtained from reference lists of papers. Studies were included if they described an Internet- or computer-based prevention program for alcohol or other drugs delivered in schools.

KEY FINDINGS:

Twelve trials of 10 programs were identified. Seven trials evaluated Internet-based programs and five delivered an intervention via CD-ROM. The interventions targeted alcohol, cannabis and tobacco. Data to calculate effect size and odds ratios were unavailable for three programs. Of the seven programs with available data, six achieved reductions in alcohol, cannabis or tobacco use at post intervention and/or follow up. Two interventions were associated with decreased intentions to use tobacco, and two significantly increased alcohol and drug-related knowledge.

CONCLUSION:

This is the first study to review the efficacy of school-based drug and alcohol prevention programs delivered online or via computers. Findings indicate that existing computer- and Internet-based prevention programs in schools have the potential to reduce alcohol and other drug use as well as intentions to use substances in the future. These findings, together with the implementation advantages and high fidelity associated with new technology, suggest that programs facilitated by computers and the Internet offer a promising delivery method for school-based prevention.

Source:  Drug Alcohol Rev. 2012 Oct 8th

 

Filed under: Education :

A new study by Canadian social scientists finds boys who display anti-social behavior in kindergarten will likely abuse drugs later in life — unless they receive intensive intervention in their “tween” years.

The study began in 1984, in Montreal. Some kindergarten teachers selected boys in their class who came from low-income households and showed anti-social behavior for a longitudinal study by the University of Montreal.

Of the 172 disruptive 5-year-olds chosen, 46 were channeled into an intensive intervention program over two years, starting when they were 7.

The boys were given social skills training to learn how to control emotions and build healthy friendships. They were also taught to use problem solving and communication instead of anti-social behaviors. Their families were involved in parts of the program, with parents learning skills to help their sons through difficulties.

Researchers studied two control groups: 42 boys got no intervention at all, and the remaining 84 received only a home visit. All the boys were followed until they were 17, with specific attention paid to their use of drugs or alcohol. Results published recently in the British Journal of Psychiatry indicate that the boys who received this intensive therapy were less likely than the rest to use drugs as teens.   Researcher Natalie Castellanos-Ryan, of the psychiatry department of the University of Montreal, said the boys who received the intensive interventions had much lower levels of anti-social behavior. They never caught up with the level of drug or alcohol use of the other boys in the study, who began substance use from early adolescence. Even the boys who received periodic in-home visits, but not intensive intervention, had a high rate of substance misuse during teenage years.

The study authors concluded that “adolescent substance use may be indirectly prevented by selectively targeting childhood risk factors that disrupt the developmental cascade of adolescent risk factors for substance use.”

Castellanos-Ryan said her team hopes to follow up with the same cohort of boys who are now 30 years old, to see if the intervention is still paying dividends.

Source:  www.scpr.org  16 Aug 2013

An intensive intervention programme for disruptive young children could help prevent drug and alcohol abuse in adolescence, according to a new study.

Canadian researchers writing in the British Journal of Psychiatry set out to examine whether a two-year prevention programme in childhood could stop substance misuse problems in later life.

Some 172 boys for poor socio-economic backgrounds and all with disruptive behaviour participated in the study. They selected 46 boys and their parents for the two-year intervention programme, when they were aged between 7 and 9 years old. The programme included social skills training for the boys at school, to help promote self-control and reduce their impulsivity and antisocial behaviour, as well as parent training to help parents recognise problematic behaviours in their boys, set clear objectives and reinforce appropriate behaviours. A further 42 boys received no intervention and acted as the control group.

The remaining 84 boys were assigned to an intensive observation group, which differed from the controls in that their families were visited in their homes by researchers, attended a half-day laboratory testing session, and were observed at school. All the boys were followed up until the age of 17, to assess their use of drugs and alcohol.

The researchers found that levels of drug and alcohol use across adolescence were lower in those boys who received the intervention. The reduction in substance use continued through the boys’ early adolescence right up to the end of their time at high school.

Researcher Natalie Castellanos-Ryan, of the Department of Psychiatry at Université de Montréal and Centre Hospitalier Universitaire Sainte Justine, Canada, said: “Our study shows that a two-year intervention aimed at key risk factors in disruptive kindergarten boys from low socioeconomic environments can effectively reduce substance use behaviours in adolescence – not only in early adolescence but up to the end of high school, eight years post-intervention. This finding is noteworthy because the effects are stronger and longer-lasting than for most substance use interventions that have been studied before.”

Dr Castellanos-Ryan added: “The intervention appeared to work because it reduced the boys’ impulsivity and antisocial behaviour during pre-adolescence – between the ages of 11 and 13. Our study suggests that by selectively targeting disruptive behaviours in early childhood, and without addressing substance use directly, we could have long-term effects on substance use behaviours in later life. More research is now needed to examine how these effects can generalise to girls and other populations, and to explore aspects related to the cost/benefit of this.

Source: www.onmedica.com  9th August 2023

Abstract

School factors are associated with many health outcomes in adolescence. However, previous studies report inconsistent findings regarding the degree of school-level variation for health outcomes, particularly for risk behaviours. This study uses data from three large longitudinal studies in England to investigate school-level variation in a range of health indicators. Participants were drawn from the Longitudinal Study of Young People in England, the Me and My School Study and the Research with East London Adolescent Community Health Survey. Outcome variables included risk behaviours (smoking, alcohol/cannabis use, sexual behaviour), behavioural difficulties and victimisation, obesity and physical activity, mental and emotional health, and educational attainment. Multi-level models were used to calculate the proportion of variance in outcomes explained at school level, expressed as intraclass correlations (ICCs) adjusted for gender, ethnicity and socio-economic status of the participants. ICCs for health outcomes ranged from nearly nil to .28 and were almost uniformly lower than for attainment (.17-.23). Most adjusted ICCs were smaller than unadjusted values, suggesting that school-level variation partly reflects differences in pupil demographics. School-level variation was highest for risk behaviours. ICCs were largely comparable across datasets, as well as across years within datasets, suggesting that school-level variation in health remains fairly constant across adolescence. School-level variation in health outcomes remains significant after adjustment for individual demographic differences between schools, confirming likely effects for school environment. Variance is highest for risk behaviours, supporting the utility of school environment interventions for these outcomes.

Source:    http://www.ncbi.nlm.nih.gov/pubmed/23793374

Filed under: Education,Health,Youth :

Prevention is often the best medicine, and that is not only true when it comes to physical health, but also public health. Case in point – young adults reduce their overall prescription drug misuse up to 65 percent if they are part of a community-based prevention effort while still in middle school, according to researchers at Iowa State University.

The reduced substance use is significant considering the dramatic increase in prescription drug abuse, said Richard Spoth, director of the Partnerships in Prevention Science Institute at Iowa State. The research published in the American Journal of Public Health focused on programs designed to reduce the risk for substance misuse. In a related study, featured in the March-April 2013 issue of Preventive Medicine, researchers found significant reduction rates for methamphetamine, marijuana, alcohol, cigarette and inhalant use.

Additionally, teens and young adults had better relationships with parents, improved life skills and few problem behaviors in general. The research is part of a partnership between Iowa State and Penn State known as PROSPER, which stands for Promoting School-Community-University Partnerships to Enhance Resilience. PROSPER administers scientifically proven prevention programs in a community-based setting with the help of the Extension system in land grant universities. The results are based on follow-up surveys Spoth and his colleagues conducted with families and teens for six years after completing PROSPER. Researchers developed the prevention programs in the 1980s and 1990s to target specific age groups.

Spoth said understanding when and why adolescents experiment with drugs is a key to PROSPER’s success. “We think the programs work well because they reduce behaviors that place youth at higher risk for substance misuse and conduct problems,” Spoth said. “We time the implementation of these interventions so they’re developmentally appropriate. That’s not too early, not too late; about the time when they’re beginning to try out these new risky behaviors that ultimately can get them in trouble.”

PROSPER administers a combination of family-focused and school-based programs. The study involved 28 communities, evenly split between Iowa and Pennsylvania. The programs start with students in the sixth grade. The goal is to teach parents and children the skills they need to build better relationships and limit exposure to substance use. “One of the skills students are taught through the school-based program is assertiveness, so that they feel comfortable refusing to do something that might lead to them getting in trouble,” Spoth said. “We try to help parents be more attuned to what their children are doing, who they’re with, where they’re going, effectively monitoring, supervising and communicating with their children.”

Parents say the program works. Michelle Woodruff will admit that being a parent is hard work. “Absolutely, underline and capital letters – it is hard,” said Woodruff, a mother of four sons who range in age from 13-21 years old. But the lessons learned through the PROSPER program, she believes, made her and her husband better parents and also brought out the best in their children. “It was a lot of little things that made us re-evaluate how we parented,” Woodruff said. “I think it makes children more responsible not only to themselves, but their parents and the community. They want to represent their families well, their schools well, their churches; I think it just makes them want to be a better person.” Woodruff is now a member of the PROSPER team in Fort Dodge, where she encourages and supports other parents who participate in the program. Facilitators of the family-focused program use games and role-playing to help parents and children improve communication and set expectations for behavior. Woodruff would like to see more families take advantage of the opportunity. “Do it, not only for the one-on-one time with your child, but also to meet other like-minded parents,” Woodruff said.

“We’re just trying to come together as a community to raise the best kids that we can possibly raise so that they’re successful members of society as adults.”

Community benefits . The ongoing community partnerships are evidence of the PROSPER program’s sustainability, Spoth said. The results extend beyond a reduction in prescription drug or marijuana use. Researchers know that substance abuse often leads to other problem behaviors, so prevention can have a ripple effect and cut down on problems in school and violent behaviors in general. The benefits are measured in economic terms as well as the overall health and outlook of the community. “There are things that can only happen over time if you have sustained programming, because more and more parents are exposed to programs that help them address all of the challenges in parenting,” Spoth said. “As a result, people feel like they’re making connections, their community is a better place to live, and they are positive about the leadership in their community.”

Read more at: http://medicalxpress.com/news/2013-04-prosper-substance-abuse-teens.html#jCp

Source: American Journal of Public Health Preventive Medicine April 25, 2013 in Addiction (Medical Xpress)

Smoking prevention in schools reduces the number of young people who will later become smokers, according to a new review published in The Cochrane Library. World-wide, smoking causes five million preventable deaths every year, a number predicted to rise to eight million by 2030. The researchers analyzed data from 134 studies, in 25 different countries, which involved a total of 428,293 young people aged 5-18. Of these, 49 studies reported smoking behavior in those who had never previously smoked. The researchers focused on this group because it offered the clearest indication of whether smoking interventions prevent smoking. Although there were no significant effects within the first year, in studies with longer follow up the number of smokers was significantly lower in the groups targeted by smoking interventions than in the control group. In 15 studies which reported on changes in smoking behavior in a mixed group of never smokers, previous experimenters and quitters, there was no overall long term effect, but within the first year the number smoking was slightly lower in the control group. The analysis revealed two key points: • School programs designed to discourage young people from smoking appear to be effective at least one year after their use. • Programs that included social skills training were more effective than those that just provided information or training on resisting peer pressure. “This review is important because there are no other comprehensive reviews of world literature on school-based smoking prevention programs,” Julie McLellan, one of the authors of the review based at the Department of Primary Care Health Sciences at the University of Oxford in the United Kingdom, wrote in the journal. “The main strength of the review is that it includes a large number of trials and participants. However, over half were from the United States, so we need to see studies across all areas of the world, as well as further studies analyzing the effects of interventions by gender.”

Source: ‘Smoking’ reported in www.cadca.org 2nd May 2013

Teen-age college students are significantly more likely to abstain from drinking or to drink only minimally when their parents talk to them before they start college, using suggestions in a parent handbook developed by Robert Turrisi, professor of biobehavioral health, Penn State.

“Over 90 percent of teens try alcohol outside the home before they graduate from high school,” said Turrisi. “It is well known that fewer problems develop for every year that heavy drinking is delayed. Our research over the past decade shows that parents can play a powerful role in minimizing their teens’ drinking during college when they talk to their teens about alcohol before they enter college.”

The researchers recruited 1,900 study participants by randomly selecting incoming freshmen to a large, public northeastern university. Each of the individuals was identified as belonging to one of four groups: nondrinkers, weekend light drinkers, weekend heavy drinkers and heavy drinkers.

The team mailed Turrisi’s handbook to the parents of the student participants. The 22-page handbook contained information that included an overview of college student drinking, strategies and techniques for communicating effectively, ways to help teens develop assertiveness and resist peer pressure and in-depth information on how alcohol affects the body. The parents were asked to read the handbook and then talk to their teens about the content of the handbook at one of three times to which they were randomly assigned: (1) during the summer before college, (2) during the summer before college and again during the fall semester of the first year of college and (3) during the fall semester of the first year of college.

“We were trying to determine the best timing and dosage for delivering the parent intervention,” Turrisi said. “For timing, we compared pre-college matriculation to after-college matriculation. For dosage, we compared one conversation about alcohol to two conversations about alcohol.” The results appeared in a recent issue of the Journal of Studies on Alcohol and Drugs.

“We know that without an intervention there is movement from each drinking level into higher drinking levels,” Turrisi said. “For example, non-drinkers tend to become light drinkers, light drinkers will become medium drinkers and medium drinkers will become heavy drinkers. Our results show that if parents follow the recommendations suggested in the handbook and talk to their teens before they enter college, their teens are more likely to remain in the non-drinking or light-drinking groups or to transition out of a heavy-drinking group if they were already heavy drinkers.”

According to Turrisi, talking to teens in the fall of the first year of college may not work as well; for many families it had no effect on students’ drinking behaviors. Likewise, adding extra parent materials in the fall seemed to have no additional benefit.


Source: eurekalert.org 19th March 2013

College students who use marijuana and other illegal substances, even occasionally, are more likely to leave school than students who don’t dabble in drugs, new research finds.

There’s a strong link between marijuana use and “discontinuous enrollment,” said study author Dr. Amelia Arria, director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health. The same goes for other illicit drugs, she added.

In a recent issue of the Journal of Studies on Alcohol and Drugs, Arria and her colleagues reported that students with high levels of marijuana use (more than 17 days a month) were twice as likely as those with minimal use (less than a day a month) to have an enrollment gap while in college. But even students who used pot less often, in the range of three to 12 days a month, were more likely to experience enrollment gaps.

Arria said, “We wanted to look at whether or not drug use interferes with goals students had set for themselves. Our results show that marijuana use is not a benign thing.”

For their research, the authors used data from the College Life Study, ongoing research on health-related behaviors among college students. They tracked 1,133 participants (47 percent male) over four years. All of the students began their freshman year between the ages of 17 and 19, and they all attended the same university located in the mid-Atlantic region of the United States.

During each school year, they participated in questionnaires and interviews, even if they had decided not to return to classes at the university (a financial incentive was offered). Their enrollment and graduation data were obtained from university records that the students consented to share.

“Continuous enrollment” was defined as being enrolled at the university for at least one credit during each fall and spring semester for the first four years of the study, Arria said. By the study’s end, 71 percent of the students had remained continuously enrolled over four years, and 29 percent had not.

Reasons that students left college varied. While some transferred to another university, others exited college life altogether, so the authors opted to use the term “discontinued enrollment” instead “dropout.”

Aria said it’s key to point out that their results were independent of other factors such as demographics, high school GPA, fraternity or sorority enrollment, personality type, risk-taking behaviors, and a student’s use of tobacco and alcohol.

“Marijuana use was still a predictor of discontinuous enrollment,” Arria said.

A second study, published in the journal Psychiatric Services and funded by the U.S. National Institute on Drug Abuse, looked at drug use and mental health problems and the risk of leaving college prematurely. Arria and her colleagues report that students who experience symptoms of depression and seek treatment for depression during college might be at risk for an enrollment gap, too, especially if they use pot or other illicit drugs.

However, students whose depression was identified and treated before heading to college were not at risk for enrollment problems once at the university level.

Dr. Marc Galanter, director of the division of alcoholism and drug abuse at NYU Langone Medical Center and a professor at the NYU School of Medicine, said the studies are interesting, especially when reviewed together.

“When they say there’s a need for early intervention for illicit drug users, there may be other issues that cast the die for drug use, namely depression,” Galanter said. “The question is, do drugs cause the problem or are they a consequence of some other problem? Could it be depression that leads people to use drugs secondarily? It’s not clear what’s causal.”

Study author Arria said that although marijuana tends to be viewed as a more benign drug, that is a fallacy. “The perceived risk of marijuana is declining because people think it’s more benign than it is, and its use is going up among college students. But we’ve known for a long time that marijuana affects cognition and memory.”

Nonmedical use of prescription drugs is also a concern among college students.

Galanter said, “The real serious drug problem is the painkillers — Percocet, Vicodin, OxyContin. There are a notable number of young people getting seriously addicted. It’s a noticeable statistic. Some of these drugs come from the family medicine cabinet but there are also people who get illicit prescriptions and then sell the drugs as dealers.”

Arria said that school administrators and parents can help by communicating with kids early in adolescence about the risks of drugs, and intervening when a child needs help and support. Armed with that support, students are more likely to stay in college once they get there.


Source: Health Day News 22nd March 2013


Research commissioned by Action on Addiction suggests mental health approach to teenage drinking is successful Targeted psychological interventions aimed at teenagers at risk of emotional and behavioural problems significantly reduce their drinking behaviour, and that of their schoolmates, according to the results from a large randomised controlled trial published today in JAMA Psychiatry. The authors argue that the intervention could be administered in schools throughout the UK to help prevent teenage alcohol abuse. The ‘Adventure Trial’ is led by Dr Patricia Conrod, King’s College London’s Institute of Psychiatry, in collaboration with the University of Montreal and Sainte-Justine University Hospital Center (Canada) and was commissioned by Action on Addiction. The trial involved 21 schools in London that were randomly allocated to either receive the intervention, or the UK statutory drug and alcohol education curriculum. A total of 2,548 year-10 students (average age 13.8 years) were classed as high or low-risk of developing future alcohol dependency. Those classed as high-risk fit one of four personality risk profiles: anxiety, hopelessness, impulsivity or sensation seeking. All students were monitored for their drinking behaviour over two years. Four members of staff in each intervention school were trained to deliver group workshops targeting the different personality profiles. 11 schools received the intervention where 709 high-risk teenagers were invited to attend two workshops that guided them in learning cognitive-behavioural strategies for coping with their particular personality profiles. Dr Patricia Conrod, from King’s Institute of Psychiatry and lead author of the paper, says: “Through the workshops, the teenagers learn to better manage their personality traits and individual tendencies, helping them to make good decisions for themselves. Depending on their personality profiles, they might learn cognitive-behavioural strategies to better manage high levels of anxiety, to manage their tendency to have pessimistic reactions to certain situations or to control their tendency to react impulsively or aggressively. Our study shows that this mental health approach to alcohol prevention is much more successful in reducing drinking behaviour than giving teenagers general information on the dangers of alcohol.” After two years, high-risk students in intervention schools were at a 29% reduced risk of drinking, 43% reduced risk of binge drinking and 29% reduced risk of problem drinking compared to high-risk students in control schools. The intervention also significantly delayed the natural progression to more risky drinking behaviour (such as frequent binge drinking, greater quantity of drinking, and severity of problem drinking) in the high-risk students over the two years. Additionally, over the two year period, low-risk teenagers in the intervention schools, who did not receive the intervention, were at a 29% reduced risk of taking up drinking and 35% reduced risk of binge drinking compared to the low-risk group in the non-intervention schools, indicating a possible ‘herd effect’ in this population. Dr Conrod adds: “Not only does the intervention have a significant effect on the teenagers most at risk of developing problematic drinking behaviour, there was also a significant positive effect on those who did not receive the intervention, but who

attended schools where interventions were delivered to high-risk students. This ‘herd effect’ is very important from a public health perspective as it suggests that the benefits of mental health interventions on drinking behaviour also extend to the general population, possibly by reducing the number of drinking occasions young people are exposed to in early adolescence.” Dr Conrod concludes: “This intervention could be widely administered to schools: it is successful from a public health perspective, appreciated by students and staff, and because we train school staff rather than professional psychologists, the intervention remains relatively inexpensive to roll out.” Approximately 6 out of 10 people aged 11-15 in England report drinking, and in the UK approximately 5,000 teenagers are admitted to hospital every year for alcohol related reasons. Across the developed world, alcohol accounts for approximately 9% of all deaths of people aged 15-29, and so far, universal community or school-based interventions have proven difficult to implement and shown limited success. Nick Barton, Chief Executive of Action on Addiction says: “Dr Conrod’s study, which helps young people reduce their chances of developing an addiction to alcohol and/or drugs in the future, is an exciting development for prevention work in the UK. This is generally recognised as inadequate, and as we see regularly in the media, currently fails to address binge drinking and drug taking among young people. “We know that problematic relationships with alcohol often start at a young age, so if it is possible to reduce the chances of harmful drinking and dependency in later life through school-based interventions we would welcome seeing this programme rolled out across UK schools. “We hope that the publication of this paper will create discussion and debate about the nature of addiction; to help shed light on the complex causes of addictive behaviour, unravel some of the stigma associated with it, help young people understand the triggers for dependency and, ultimately, bring us closer to our goal of disarming addiction.” Action on Addiction also works with children and young people suffering from the effects of addiction via its Families Plus programme, which offers support groups for families, partners and friends of substance misusers. Families Plus is rolling out M-PACT (Moving Parents and Children Together), a programme that takes a ‘whole family’ approach to tackling addiction, involving parents and children together in the treatment process.

Source: Conrod, P. et al. “A cluster randomized trial evaluating a selective, personality-targeted prevention program for adolescent alcohol misuse: Primary two-year outcomes and possible secondary herd effects” JAMA Psychiatry


If drug problems are greater in African American communities, providing more of the poison that serves as the root cause of the problem is not the answer. Marijuana causes the following:

Crime

According to ONDCP[1] 64 – 87% of people arrested test positive for drugs, depending on location. Marijuana is the most prevalent drug of abuse. Making marijuana more readily available will increase crime, as it has been the case in Sacramento, Stockton, Oakland and other cities which are witnessing record number of murders. According to African American Bishop Ron Allen, 90% of the black homicides are committed by blacks. Many of the crimes are directly related to drug deals or burglaries involving marijuana.

Permanent Brain Damage

A recent study in Australia[2]of 59 people who had been using marijuana for 15 years proved that marijuana interrupts the development of white matter in the brain, the complex wiring system. “Unlike grey matter, the brain’s thinking areas which peak at age 8, white matter continues developing over a lifetime.” (Dr. Marc Seal) There were disruptions and reductions in white matter of as much as 80%. The hippocampus, the area of the brain involved in memory, shrank in heavy users causing memory impairment and concentration. The average age of first use was 16, but as young as 10 or 11. The younger they started, the worse the damage.

Insanity
Marijuana’s impact on white matter has also been related to development of psychosis, including schizophrenia, paranoia and suicidal depression.. Age 14 – 16 is a critical period because the brain is going through a major development period, and cannabis can cause permanent damage.[3] A Dutch study showed teenagers who indulge in cannabis as few as 5 times in their life significantly increase their risk of psychotic symptoms.[4]

Still Births And Deformities[5]

Because today’s pot is 20 times stronger than decades ago, brain damage and physical deformities can occur to a fetus even two weeks after conception, before the mother even knows she is pregnant. The mother can quit but it’s too late for the unborn child. Studies from the 1973 done by Dr. Akira Miroshima showed that even low potency marijuana caused “more DNA damage than even heroin.” [6] While normal cells have 46 chromosomes, he discovered that one-third of “weekend smokers” who averaged two joints a week had only 20 to 30 chromosomes, about the same as a frog, which can cause mutations in sperm and ova and result in fetal damage. What’s worse, another study showed it is mutagenic, meaning it can skip one generation and affect the next.[7] Numerous studies confirm fetal damage by marijuana is a causal factor in physical deformities and behavioral problems of young people.

Addiction, Destruction and Death

According to the ONDCP, 17% of those under 18 and 9% of those over 18 years old who use marijuana will become addicted to it. Addicts either can’t work as well, or at all, so many turn to crime to feed their habit. More people are in treatment for marijuana that all other drugs combined. It doesn’t kill by overdose, but it is a major factor in suicides and a gateway to hard drugs that kill 3,400 Americans a month.

Adverse Impacts On Education

Impact on memory, motivation and ability to learn is a major factor in the 1.2 million high school drop outs nationally. America has declined to 26th in the world academically and going downhill. Preventing marijuana use by kids is of paramount importance.

Traffic Injuries and Death

33% of traffic deaths are related to drugged driving.[8] Marijuana, being fat soluble, stays in the brain for a month, compounding with each additional joint, adversely effecting memory, cognition, motor skills and reaction time. Nobody is in prison for simple possession, but rather for committing crimes while under the influence. Making marijuana more readily available will only exacerbate the problem. Black markets for those 21 and under will still exist, and drug dealers will relish the opportunity to advance marijuana users to the hard drugs. The focus should be on prevention, and keeping ALL kids in the system, safe and drug free.

——————————————————————————–

[1] Office of National Drug Control, The White House

[2] Seal, Dr. Marc 08/09/21012 Melbourne Murdoch Children’s Research Institute; Marijuana Causes Brain Damage.

[3] Dr. McGrath. University of Queensland.

[4] Patton, G.C. et al (2006) Cannabis use and mental health in young people. British Medical Journal.

[5] Science Daily (Aug 15, 2012) Study By Dr. Delphine Psychoyos, Texas A & M University

[6] Miroshima, Dr. Akira)

[7] Daliterio, Dr. Susan, U of Texas Medical School, San Antonio.

[8] DuPont, Dr. Robert – Institute of Behavior and Health www.stopdruggeddriving.com

Source: ROGER MORGAN rogermorgan.339@gmail.com 24th August 2012

Founder and Director of the Take-Back America Campaign, prior Chairman and Executive Director of the Coalition for A Drug-Free California. He is author of two books published on digital sites Amazon Kindle and Barnes & Noble’s Nook, called MARIJUANA: Brain Damage. Birth Defects. Addiction and SOROS. The Drug Lord. Pricking the Bubble of American Supremacy. CEO of Steelheart International LLC, engaged in international business development, and an entrepreneur and businessman in California for 30 years He was Founding Chairman of the Coronado SAFE Foundation (1997), a non-profit dealing with drug prevention; prior Board Member of the San Diego Prevention Coalition; member of the National Coalition for Student Drug Testing, and Special Advisor to the Golden Rule Society in Coronado. His passion for drug prevention stems from two step-children who became drug addicted at age 12 and 14 roughly 30 years ago, and two nephews who died from drug related causes. He is a Rotarian; a charter member of the Coronado Community Church; two adult children, three grandchildren; and currently lives in Lincoln, Ca.

Roger Morgan

Steelheart International LLC

(916) 434 5629

Surveys of American and European teenagers have found dramatic differences between the two groups’ substance use. While American teens smoke and drink less than their European peers, they are more likely to use illegal drugs.
The results come from coordinated school surveys about substance use that include more than 100,000 students around Europe. They are largely modeled on the University of Michigan’s Monitoring the Future survey in the United States, making comparisons possible between the American and European results.
The United States had the second lowest proportion of students who used alcohol and tobacco, compared with teens in 36 European countries, HealthCanal reports. Among American students, 27 percent drank alcohol in the month before the survey.

The average rate in Europe was 57 percent. Twelve percent of American students smoked cigarettes in the month before the survey, compared with an average of 28 percent in Europe.
Eighteen percent of American teens reported using marijuana or hashish in the previous month, compared with an average of 7 percent among European teens. American teens reported the highest level of marijuana availability. The U.S. had the lowest proportion of teens who associated use of marijuana with great risk, according to Lloyd Johnston, the principal investigator of the American surveys.
American teens were more likely than European students to have tried any illicit drugs other than marijuana, including hallucinogens, Ecstasy and amphetamines.
“Clearly the U.S. has attained relatively low rates of use for cigarettes and alcohol, though not as low as we would like,” Johnston said in a news release. “But the level of illicit drug use by adolescents is still exceptional here.”
Source: Join Together weekly news 8th June 2012

When it comes to prevention of substance use in our “tween” population, turning kids on to ‘thought control’ may just be the answer to getting them to say no, Medical News Today reports.

New research published in the Journal of Studies on Alcohol and Drugs, co-led by professors Roisin O’Connor of Concordia University and Craig Colder of State University of New York at Buffalo, has found that around the” tween-age” years, youth are decidedly ambivalent toward cigarettes and alcohol. It seems that the youngsters have both positive and negative associations with these harmful substances and have yet to decide one way or the other. Because they are especially susceptible to social influences, media portrayals of drug use and peer pressure become strong allies of substance use around these formative years.

“Initiation and escalation of alcohol and cigarette use occurring during late childhood and adolescence makes this an important developmental period to examine precursors of substance use,” O’Connor said. “We conducted this study to have a better understanding of what puts this group at risk for initiating substance use so we can be more proactive with prevention.”

The study showed that at the impulsive, automatic level, these kids thought these substances were bad but they were easily able to overcome these biases and think of them as good when asked to place them with positive words. O’Connor explains that “this suggests that this age group may be somewhat ambivalent about drinking and smoking. We need to be concerned when kids are ambivalent because this is when they may be more easily swayed by social influences.”

According to O’Connor, drinking and smoking among this age group is influenced by both impulsive (acting without thinking), and controlled (weighing the pros against the cons) decisional processes. With this study, both processes were therefore examined to best understand the risk for initiating substance use.

To do this, close to 400 children between the ages of 10 and 12 participated in a computer-based test that involved targeted tasks. The tweens were asked to place pictures of cigarettes and alcohol with negative or positive words. The correct categorization of some trials, for example, involved placing pictures of alcohol with a positive word in one category and placing pictures of alcohol with negative words in another category.

The next step in the study is to look at kids over a longer period of time. The hypothesis from the research is that as tweens begin to use these substances there will be an apparent weakening in their negative biases toward drinking and smoking. The desire will eventually outweigh the costs. It is also expected that they will continue to easily outweigh the pros relative to the cons related to substance use.

O’Connor said researchers would like to continue to track the youth, who, he said, know that drugs are inherently bad.

“The problem is the likelihood of external pressures that are pushing them past their ambivalence so that they use. In a school curriculum format I see helping kids deal with their ambivalence in the moment when faced with the choice to use or not use substances,” O’Connor concluded.

Source:www.cadca.org 15th March 2012

In this Dutch study, promoting parental rule setting and classroom alcohol education together nearly halved the proportion of adolescents who went on to drink heavily. Rarely have such strong and sustained drinking prevention impacts been recorded from these types of interventions.

Summary

This Dutch study tested the long-term impact of the Örebro intervention (first developed and tested in Sweden) targeting parental rule-setting in relation to the drinking of their adolescent children, allied with classroom alcohol education. The parenting element entailed a brief presentation from an alcohol expert at the first parents’ meeting at the start of each school year on the adverse effects of youth drinking and the negative effects of permissive parental attitudes towards children’s alcohol use. After this parents of children from the same class were meant to meet to agree a shared set of rules about alcohol use. In fact, only half the schools did this; the remainder used the later mailing to send a checklist of candidate rules to parents for them to select from and return to the school. Three weeks after this meeting, a summary of the presentation and the result of the classroom discussion was sent to parents’ home addresses. Classroom alcohol education consisted of four lessons from trained teachers at the schools plus a booster a year later, using mainly computerised modules to foster a healthy attitude to drinking and to train the pupils in how to refuse offers of alcohol.
The 19 schools which joined the study were randomly allocated to the parenting intervention alone, to classroom alcohol education alone, to the combination of both, or to act as control schools which carried on with alcohol education as usual.
An earlier paper from the same study reported that relative to education as usual, among the 2937 (of 3490) 12–13-year-olds not already drinking weekly and who met other criteria for the study, the combined parenting and education intervention curbed the initiation of weekly drinking and heavy weekly drinking over the next 22 months (and reduced the frequency of drinking). In contrast, on their own, neither the parenting elements nor the lessons made any significant difference when the whole sample of children not yet drinking weekly at the start were included in the analyses.

Main findings

The featured report tested whether these effects were still apparent a year later, 34 months after the start of the study and when the pupils averaged just over 15 years of age, a time when two thirds of Dutch youngsters are already drinking weekly and will soon (age 16) be able to legally buy alcohol. Of the 2937 in the initial sample of non-weekly drinkers, 2533 (86%) completed the follow-up assessment. The probable responses of the remainder were estimated on the basis of prior assessments and other data. As before, the parenting elements or alcohol education alone had made no statistically significant differences to drinking, but the impacts of both together in retarding uptake of weekly and heavy weekly drinking were greater than a year before chart. Compared to 59% and 27% in education-as-usual control schools, after the combined intervention 49% and 15% of pupils were drinking weekly or drinking heavily each week. After adjusting for other factors, the results meant that in combined intervention schools, the odds of these patterns of drinking versus less extreme drinking had been reduced to 0.69 relative to education as usual, highly statistically significant findings. Put another way, for every four pupils allocated to parenting plus alcohol education, one was prevented from drinking weekly and also one from drinking heavily each week at age 15.

The authors’ conclusions

In a liberal drinking culture where adolescent and underage drinking is common, targeting both parents and young adolescent pupils (but not either on their own) exercises a sustained and substantial restraining influence on the development of regular and regular heavy drinking as the youngsters approach the legal alcohol purchase age. The findings underline the need to target adolescents as well as their parents and of targeting adolescents at an early age, before they start to drink regularly and when family factors are a major influence on youth drinking. Doing so has the potential to create appreciable public health gains.

Source: Koning I.M., van den Eijnden R.J., Verdurmen J.E. et al.
American Journal of Preventive Medicine: 2011, 40(5), p. 541–547.

Reports that school prevention programs aimed at curbing alcohol misuse in children are somewhat helpful, enough so to deserve consideration for widespread use, according to a large, international systematic review.

The most significant program effects were reductions in episodes of drunkenness and binge drinking, reviewers found.

“School-based prevention programs that take a social skills-oriented approach or that focus on classroom behavior management can work to reduce alcohol problems in young people,” David Foxcroft, lead review author said. “However, there is good evidence that these sorts of approaches are not always effective.”

The reasons for inconsistent results with these programs are unclear, said Foxcroft, from Great Britain’s Oxford Brookes University.

Foxcroft and co-author Alexander Tsertsvadze, at the University of Ottawa Evidence-Based Practice Center, in Canada, analyzed 53 randomized controlled trials done in a wide range of countries with youth ages 5 to 18 when studies began.

Forty-one studies took place in North America, six in Europe and six in Australia. One was conducted in India and one in Swaziland. Two studies transpired in multiple locations.

Most studies assessed generic prevention programs that targeted several risky behaviors, such as drinking, smoking and drug abuse, while the rest focused on alcohol-specific programs.

The researchers compared drinking among the youngsters who took part in various school-based programs to the drinking done by students who were not. The youngsters in the comparison groups might have participated in other alcohol-prevention programs, such as family-based ones, or they might have just experienced the ordinary school curriculum.

The authors concluded that their evidence supported the use of certain generic prevention programs over alcohol-specific ones. They cited the Life Skills Training Program, the Unplugged Program and the Good Behavior Game as particularly effective interventions.

The review appears in the May 2011 issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

“These findings are important,” David Jernigan, Ph.D., director of the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health, said. “Efforts to reduce young people’s drinking through school-based programs are legion. A $300 million federal program supporting school-based prevention ended last year, partly based on research findings that these programs do not work. This review does not find that. Instead it indicates that there is something in certain school-based programs that in fact can work.”

Jernigan emphasizes that “school-based programs are so often expected to do the whole job of prevention, and this is an unfair expectation.” He describes school-based programs functioning as “lonely voices” in an environment saturated with marketing messages promoting youthful drinking. The amount of drinking in a youngster’s home and community and the price of alcohol are other major influences that need addressing, he said. Until then, “we can’t expect large effects from school-based programs alone.”

Health Behavior News Service is part of the Center for Advancing Health.

Source: www.cadca.org 12th May 2011

The NDPA have encouraged many individual users to get into treatment for their addiction. In some cases they have had to ‘fight’ for funding to get into residential rehab – with a further fight to stay for secondary treatment, i.e. 24 weeks instead of 12. The best chance for long term drug dependent users is a minimum of 6 months residential rehab. We can guarantee that no users in a residential rehab would ever be rewarded with drugs.

Heroin and cocaine addicts on the government’s treatment programme are being given drugs as a reward for clean urine samples, the BBC has learned. The National Treatment Agency (NTA), which runs the £500m-a-year scheme, admits the practice is “unethical”. Its own survey of almost 200 clinics in England found users were being offered extra methadone, a heroin substitute, or anti-depressants for good behaviour. Health Minister Dawn Primarolo has asked for a report into the survey. She said the survey had raised “very serious issues”. She said, “It is unacceptable, unethical, it should not happen that prescription drugs and doses are used, or suggested that they should be used, as either incentives or withheld as sanctions as part of a treatment programme.”

Best principles

A third of clinics in the survey said users who produced a drug-free urine sample may be offered increased doses of heroin substitute as a reward – known as “contingency management”. A quarter admits that clients can choose the type of substitute drugs they want. The survey also found clinicians offering anti-depressants, cash vouchers or access to detox as a reward. The NTA said offering drugs for anything other than clinical need was wrong and it wanted certain practices “squeezed out of the system”.

The agency’s chief executive Paul Hayes told the BBC, “One of the things that’s important before we start rewarding people through things like contingency management is to make sure that we’re doing it according to the best principles for drug treatment.”

“There are a range of practices associated with drug misuse in this country that are not what we would want them to be.”  He said the NTA was set up to not only expand the provision of drug treatment, but also to improve its quality.

Very different

He added, “It is entirely appropriate to prescribe other drugs alongside prescription drugs that are to deal with withdrawal. Not as a reward, which is why we wouldn’t advocate it.”

“What we would say is the dose people get ought to be determined by the individual’s needs, not by whether or not they’re co-operating with the regime. That’s why the contingency management programme that we’re thinking of introducing, based on American research, is going to be very different to the ad hoc rewards that operate in not very well managed services in this country at the moment.”

Martin Barnes, chief executive of drug information charity DrugScope, said it was “appalling” to offer drugs as a reward. “It is a complete distortion of the principles of ‘contingency management’,” he said. “The practice is unethical, contrary to official guidance and creates potentially serious risks for the drug user.”

Matthew Taylor, of the Royal Society of Arts, a think tank looking at how best to get addicts off drugs, said an overhaul of current policies was needed.

General problem

“I think the reality is that our drug strategy just isn’t working,” he told BBC One’s Breakfast.

“Only a very small proportion of those people who are put through drug detoxification successfully complete the programme, and even when people do successfully complete the programme they revert to drug use very quickly.”

“So we need a different approach, and the fact that some people feel that they need to incentivise drug users with other drugs in order to keep them off illegal drugs is, I think, part of that general problem.”

Dr Michael Ross, former clinical director of Bradford’s drug dependency service, said drug addicts needed to be self-motivated to achieve results. “The idea of bribing the patient to achieve a result which wasn’t actually something they felt important is quite abhorrent.” he said.

The drugs treatment project is the centrepiece of government strategy. Only about 6% of users on the programme leave free of drugs each year. However, there is evidence that giving addicts access to services can reduce crime and improve health even if they continue to take drugs.

Source: Daily Dose. Oct. 18th, 2007

Filed under: Education,Health :

Contact address: Fabrizio Faggiano, Department of Medical Sciences, University of Piemonte Orientale A. Avogadro, Via Santena 5 bis, Novara, 28100, Italy. fabrizio.faggiano@med.unipmn.it.
Editorial group: Cochrane Drugs and Alcohol Group.
Publication status and date: Edited (no change to conclusions), published in Issue 3, 2008.

Citation: Faggiano F, Vigna-Taglianti F, Versino E, Zambon A, Borraccino A, Lemma P. School-based prevention for illicit drugs’ use. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD003020. DOI: 10.1002/14651858.CD003020.pub2.

Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
________________________________________

Abstract

Background

Drug addiction is a chronic, relapsing disease. Primary interventions should be aimed to reduce first use, or prevent the transition from experimental use to addiction. School is the appropriate setting for preventive interventions.
Objectives
To evaluate the effectiveness of school-based interventions in improving knowledge, developing skills, promoting change, and preventing or reducing drug use versus usual curricular activities or a different school-based intervention .
Search strategy
We searched the Cochrane Drug and Alcohol Group trial register (February 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2004), MEDLINE (1966 to February 2004) , EMBASE (1988 to February 2004), and other databases. We also contacted researchers in the field and checked reference lists of articles.
Selection criteria
Randomised controlled trials (RCT), case controlled trials (CCT) or controlled prospective studies (CPS) evaluating school-based interventions designed to prevent substance use.
Data collection and analysis
Two authors independently extracted data and assessed trial quality.
Main results
32 studies (29 RCTs and three CPSs) were included with 46539 participants. Twenty eight were conducted in the USA; most were focused on 6th-7th grade students, and based on post-test assessment.

RCTs

(1) Knowledge versus usual curricula
Knowledge focused programs improve drug knowledge (standardised mean difference (SMD) 0.91; 95% confidence interval (CI) 0.42 to 1.39).
(2) Skills versus usual curricula
Skills based interventions increase drug knowledge (weighted mean difference (WMD) 2.60; 95% CI 1.17 to 4.03), decision making skills (SMD 0.78; CI 95%: 0.46 to 1.09), self-esteem (SMD 0.22; CI 95% 0.03 to 0.40), peer pressure resistance (relative risk (RR) 2.05; CI 95%: 1.24 to 3.42), drug use (RR 0.81; CI 95% 0.64 to 1.02), marijuana use (RR 0.82; CI 95% 0.73 to 0.92) and hard drug use (RR 0.45; CI 95% 0.24 to 0.85).
(3) Skills versus knowledge
No differences are evident.
(4) Skills versus affective
Skills-based interventions are only better than affective ones in self-efficacy (WMD 1.90; CI 95%: 0.25 to 3.55).

Results from CPSs

No statistically significant results emerge from CPSs.
Authors’ conclusions
Skills based programs appear to be effective in deterring early-stage drug use.
The replication of results with well designed, long term randomised trials, and the evaluation of single components of intervention (peer, parents, booster sessions) are the priorities for research. All new studies should control for cluster effect.
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Plain language summary

School-based prevention for illicit drugs’ use
Drug addiction is a long-term problem caused by an uncontrollable compulsion to seek drugs. People may use drugs to seek an effect, to feel accepted by their peers or as a way of dealing with life’s problems. Even after undertaking detoxification to reach a drug-free state, many return to opioid use. This makes it important to reduce the number of people first using drugs and to prevent transition from experimental use to addiction. For young people, peers, family and social context are strongly implicated in early drug use. Schools offer the most systematic and efficient way of reaching them. School programs can be designed to provide knowledge about the effects of drugs on the body and psychological effects, as a way of building negative attitudes toward drugs; to build individual self-esteem and self-awareness, working on psychological factors that may place people at risk of use; to teach refusal and social life skills; and to encourage alternative activities to drug use, which instil control abilities.
The review authors found 32 controlled studies, of which 29 were randomised, comparing school-based programs aimed at prevention of substance use with the usual curriculum. The 46,539 students involved were mainly in sixth or seventh grade. Programs that focused on knowledge improved drug knowledge to some degree, in six randomised trials. Social skills programs were more widely used (25 randomised trials) and effectively increased drug knowledge, decision-making skills, self-esteem, resistance to peer pressure, and drug use including of marijuana (RR 0.8) and hard drugs (heroin) (RR 0.5). The programs were mainly interactive and involved external educators in 20 randomised trials. Effects of the interventions on assertiveness, attitudes towards drugs, and intention to use drugs were not clearly different in any of the trials.
Most trials were conducted in the USA and, as a nation’s social context and drug policies have a significant influence on the effectiveness of the programs, these results may not be relevant to other countries. Measures of change were often made immediately after the intervention with very little long-term follow up or investigation of peer influence, social context, and involvement of parents.

Source: http://onlinelibrary.wiley.com and www.cochranlibrary.com 2008

Two of the most widely recommended US school and family prevention programmes retarded growth in some forms of substance use, especially among youngsters who had already used by their early teens, but there are some methodological concerns over the findings.
Summary 36 secondary schools in the rural US mid-west were randomly allocated to either carry on as normal (the control schools) or to one of two prevention programmes. Both were delivered primarily in the seventh grade (ages 12–13), and both featured the LifeSkills Training (LST) drug education curriculum consisting of fifteen classroom lessons with later ‘boosters’. In one set of schools, these lessons were supplemented by the Strengthening Families Program: for Parents and Youth 10-14. This entails seven two-hour evening sessions plus four booster sessions in the following year, during which groups of about six or seven families focus in turn on particular parenting issues and skills. In the first hour of each session, parents and children learn in parallel; in the second, they come together to practice these skills with each other. Only a quarter of the families allocated to these (and 38% of those actively recruited) attended any of the family sessions, but results are reported for all the families offered the intervention, regardless of attendance.
Questionnaire responses from 1677 pupils surveyed about six months before the grade seven lessons formed the baseline to assess changes in substance use among the same pupils over each of the five years following the lessons. Typically by then aged 17–18, about three quarters of the starting sample responded to the final assessments. For the featured report the sample was narrowed down slightly to pupils who had provided the relevant outcome measures at least three times: at baseline; about a month after the seventh grade interventions; and during at least one follow-up. For these pupils, the analysis tested whether over the five and a half years:
• trends in the growth of substance use differed between the three sets of schools; and
• whether by the end levels of substance use also differed.
First the study assessed how many pupils had started to use alcohol, cigarettes or cannabis. Most consistently positive results were found for cigarettes; growth in the proportion who had tried smoking, and the final proportion who had used by age 17–18, were significantly lower in intervention schools compared to control schools. For cannabis, only the final proportion was significantly lower, and for alcohol, only the growth trend, and then only when the family intervention had supplemented the lessons. When these measures were combined in an index representing experience of all three substances, both the growth trend and the final outcomes favoured the interventions. Experience of getting drunk was also measured and, like drinking itself, only the growth trend favoured the interventions.
Similar analyses for current use on at least a monthly basis and other more serious patterns of substance use found no results favouring the interventions. However, there were such results among the fifth of pupils considered at high risk of developing substance use problems. These were the pupils who at the first survey point at age 12–13 had already used two of the three substances. Compared to their lower risk peers, among these pupils both interventions had consistently greater effects on overall levels of use across the follow-up years. Further analysis showed that among lower risk pupils, the interventions made no significant difference. But among the higher risk fifth, growth in the average frequency of smoking cigarettes or using cannabis was less than in the control schools, and so too was final average frequency of use. This was not the case for the frequency of drinking or of getting drunk; for these measures only two of the eight outcomes significantly favoured the interventions. Among the same higher risk pupils, indices of serious use patterns combining measures of current or past use of all three substances consistently favoured the intervention schools.
Summarising their findings, the authors noted that for all substance initiation outcomes, one or both intervention groups showed significant, positive differences compared with the control group in the final follow-up year, and/or significant differences in growth trends over the five years since the interventions. In contrast, across all the pupils, more serious substance use outcomes reflecting mainly current and frequent use were not significantly affected. However, these forms of substance use were curbed when the analysis was restricted to higher risk pupils. Though the two interventions often bettered education-as-usual, in no case did one outperform the other. The authors speculated that less convincing initiation-prevention results than in earlier studies might have been due to the family intervention being delayed a year, when more pupils had already initiated substance use. In terms of affecting more serious forms of substance use, pupils already advanced in their substance use patterns responded relatively well, possibly because the messages were more ‘real’ for them and for their parents. Despite randomisation, there remained some significant baseline differences between control and intervention pupils which might also have obscured intervention impacts, though attempts were made to adjust for these in the analyses.
The two programmes tested in the study enjoy among the most widely respected research records in substance use prevention (LST SFP). The featured study’s strengths include large samples, reasonable follow-up rates, randomisation by school and an analysis controlling for the influence of the school itself, and outcome measures probing not just experience of the substances concerned, but how serious and lasting this was. Nevertheless the most which can be said is that the LifeSkills Training element probably retarded the initiation of smoking, possibly cannabis use, but not drinking, had no cross-sample benefits in respect of the forms of substance use of greatest concern, but may have had such benefits among the minority of pupils already relatively advanced in their substance use before the interventions started. Other LifeSkills Training studies have also most consistently found beneficial outcomes in respect of smoking, the programme’s original target.
Focusing on the featured study’s positive findings might give the impression of more all round success, but in respect of the full samples, these consisted of at most 13 out of 44 findings, and possibly (if arguably more appropriate methodological conventions had been followed) seven or fewer. Greater and more consistent success among the higher risk pupils is a tentative finding because of differences between intervention and control schools, because the study was not set up to test this subsample, and because of some methodological issues. Impacts on the forms of drug use of greatest concern emerged solely from this analysis, meaning that the interventions’ ability to reduce these cannot be considered to have been demonstrated, though the possibility that this might prove to be the case is encouraging. Importantly, though many tests did not show the interventions were superior to education-as-usual, none indicated that they were inferior; the only significant findings favoured the interventions. For more on all these issues see background notes.
Disappointingly, and despite earlier findings from the study, there was no real hint that adding the family programme improved on the school lessons in terms of the substance use measures reported in the study, though there may have been other benefits. Remaining support for the family programme comes mainly from a study whose findings (impressive as they were) derived from just over a third of the mainly white and rural families asked to participate in the study. A similar limitation applies to a later study of a substantially revised version among poor black families. Because of the way they were designed, these trials could establish benefits only among the minority of families prepared or able to participate in the interventions and complete the studies; they cannot be considered a secure indication of how the interventions would perform if applied across the board. So far in the UK a small pilot study has established the programme’s feasibility among a small set of families.
This leaves two of the most thoroughly researched universal prevention programmes for children of secondary school age with mixed findings of uncertain relevance to how they might perform if truly applied across the board. At least part of the problem lies in not in whether the benefits of these programmes are (or at least, can be) real, but in the difficulty of showing they are real. Verdicts in respect of drinking that public health strategies built on education and persuasion are relatively ineffective compared to measures such as restricting availability and raising price, would not be altered by the featured study. For smoking, the case for education in schools as a public health strategy is considerably stronger. Universal prevention programmes in general, and school-based programmes in particular, have greater impacts on tobacco use than on use of the other two substances featured in the study.
Some evidence supports the modest effectiveness of school programmes in preventing cannabis use. But of the four studies on which this verdict was based, one was a primary school programme not focused on substance use at all but on classroom management, education and parenting, another was conducted only among pupils for some reason excluded from mainstream education, and the programme studied in a third has since failed in a more real-world study conducted by researchers not associated with its development. The remaining study was conducted in secondary schools and concerned LifeSkills Training, but the impact on cannabis use was not statistically significant. This line up does not offer much support to drug education in mainstream secondary schools as a means of preventing cannabis use.
Mixed findings of a prevention impact from school programmes targeting substance use do not negate the possibility that general attempts to create schools conducive to healthy development will affect substance use along with other behaviours, nor do they relieve schools of the obligation to educate their pupils on this important aspect of our society. As much as the limited research, such considerations led the UK’s National Institute for Health and Clinical Excellence (NICE) to recommend that alcohol education should be an integral part of national science and health education curricula, in line with government guidance.
Thanks for their comments on this entry in draft to Richard Spoth of Iowa State University, Andrew Brown of the Drug Education Forum and David Foxcroft of Oxford Brookes University. Commentators bear no responsibility for the text including the interpretations and any remaining errors.
Last revised 02 July 2009

Source: Spoth R.L., Randall G.K., Trudeau L. et al.
Drug and Alcohol Dependence: 2008, 96(1–2), p, 57–68.

Background

The associations between age of onset of cannabis use and educational achievement were examined using data from three Australasian cohort studies involving over 6000 participants. The research aims were to compare findings across studies and obtain pooled estimates of association using meta-analytic methods.

Methods

Data on age of onset of cannabis use (<15, 15–17, never before age 18) and three educational outcomes (high school completion, university enrolment, degree attainment) were common to all studies. Each study also assessed a broad range of confounding factors. Results

There were significant (p < .001) associations between age of onset of cannabis use and all outcomes such that rates of attainment were highest for those who had not used cannabis by age 18 and lowest for those who first used cannabis before age 15. These findings were evident for each study and for the pooled data, and persisted after control for confounding. There was no consistent trend for cannabis use to have greater effect on the academic achievement of males but there was a significant gender by age of onset interaction for university enrolment. This interaction suggested that cannabis use by males had a greater detrimental effect on university participation than for females. Pooled estimates suggested that early use of cannabis may contribute up to 17% of the rate of failure to obtain the educational milestones of high school completion, university enrolment and degree attainment. Conclusions

Findings suggest the presence of a robust association between age of onset of cannabis use and subsequent educational achievement.

Source: www.sciencedirect.com April 2010

A new study released by the U.S. Department of Education Institute of Education Sciences conducted an experimental evaluation of mandatory random student drug testing (MRSDT) programs in 36 high schools within 7 school districts.i About half of the schools in each district were randomly assigned to the treatment group and half to the control group. Treatment schools began implementing MRSDT programs while control schools did not. MRSDT programs in public schools are limited to students who participate in athletics and extracurricular activities. In this study, some of the testing pools in schools with MRSDT were comprised of only athletes while others included athletes and extracurricular activity participants, leaving many students untested in those schools.

The frequency of drug testing and drug test panels in schools with MRSDT programs varied. All seven school districts tested for marijuana, amphetamines, and methamphetamines. Cocaine and opiates were included in six of the seven district panels. Districts also tested for an assortment of other substances. Students in all schools were surveyed and tracked over one year. Researchers compared students who participated in activities which made them subject to drug testing in schools with MRSDT to students who participated in the same activities in schools without MRSDT. Results are encouraging and provide extensive supportive of MRSDT programs.

Students subject to MRSDT reported a statistically significant lower rate of past 30-day use of substances included in their schools’ drug testing panels (16%) than comparable students in schools without MRSDT (22%). This included alcohol for three districts and nicotine for two districts. Similar differences were also found between the two groups on other substance use measures, though were not
statistically significant.

Contrary to what USA Today reports in “High school drug testing shows no long-term effect on use” (July 15, 2010),ii this study has demonstrated the value of MRSDT. Specifically USA Today highlights that MRSDT did not impact students’ plans to use drugs in the future. It is true that there was no difference between the percentage of students subject to MRSDT (34%) and the percentage not subject to MRSDT (33%) that reported they planned to use substances within the next 12 months. However,
MRSDT programs subject eligible students to random drug testing during the school year only; the summer months are a time when student substance use is no longer monitored. MRSDT programs are designed to deter substance use when students are in school. This study demonstrates that MRSDT is effective at achieving this goal.

Commentary August 12, 2010

It is sometimes claimed that drug testing programs deter student participation in extracurricular activities. In this study, MRSDT had no effect on the participation rates by students in activities that subjected them to drug testing. Nearly the same percentage of students in schools with MRSDT participated in activities covered by their schools’ testing programs (53%) as the percentage of students in schools without MRSDT who participated in such activities (54%). This indicates that students in
schools with MRSDT programs knew their participation in such activities subjected them to testing and it did not deter them from participation.
USA Today is critical of this study because there was no spillover effect on students who were not subject to MRSDT in schools with testing programs. This is not a surprise considering the MRSDT programs were studied for one year of implementation. As drug testing programs expand and include options for students to voluntarily enter the testing pool (as opposed to mandatory participation only
through extracurricular activities), a spillover effect in time is possible. Random student drug testing programs reinforce schools’ comprehensive substance use prevention programs as a deterrent against youth substance use. These programs offer students a good reason not to use drugs, including alcohol and tobacco which can be included in testing panels along with other illegal drugs.

Voluntary random drug testing programs also are used in public schools either as a single option or in combination with a mandatory program. This allows students, with a parent’s permission, to make an active choice to participate in random drug testing. The U.S. Department of Education is to be commended for supporting this ambitious study and shedding light on the many benefits of school-based random student drug testing programs. For more information on IBH and random student drug testing visit www.ibhinc.org and www.PreventionNotPunishmment.org.
Robert L. DuPont, M.D.

Source: Institute for Behavior and Health. USA 12th August 2010

Abstract

This study tests the impact of an in-school mediated communication campaign based on social marketing principles, in combination with a participatory, community-based media effort, on marijuana, alcohol and tobacco uptake among middle-school students. Eight media treatment and eight control communities throughout the US were randomly assigned to condition. Within both media treatment and media control communities, one school received a research-based prevention curriculum and one school did not, resulting in a crossed, split-plot design.
Four waves of longitudinal data were collected over 2 years in each school and were analyzed using generalized linear mixed models to account for clustering effects. Youth in intervention communities (N = 4216) showed fewer users at final post-test for marijuana [odds ratio (OR) = 0.50, P = 0.019], alcohol (OR = 0.40, P = 0.009) and cigarettes (OR = 0.49, P = 0.039), one-tailed. Growth trajectory results were significant for marijuana (P = 0.040), marginal for alcohol (P = 0.051) and non-significant for cigarettes (P = 0.114).
Results suggest that an appropriately designed in-school and community-based media effort can reduce youth substance uptake. Effectiveness does not depend on the presence of an in-school prevention curriculum.

Source: Health Education Research Vol. 21, Issue 1 2005

Research Summary

Fifth-grade students who took part in comprehensive, interactive school-based prevention programs starting as early as first grade were half as likely as their peers to use alcohol or other drugs, act out violently, or engage in sexual activity, according to a new study from the National Institute on Drug Abuse (NIDA).
“This study provides compelling evidence that intervening with young children is a promising approach to preventing drug use and other problem behaviors,” said NIDA Director Nora Volkow. “The fact that an intervention beginning in the first grade produced a significant effect on children’s behavior in the fifth grade strengthens the case for initiating prevention programs in elementary school, before most children have begun to engage in problem behaviors.”
Researchers led by Brian Flay of Oregon State University studied students at 20 public elementary schools in Hawaii who had participated daily in Positive Action (PA), a comprehensive K-12 program focusing on social and emotional development. Students who had received the PA lessons the longest had the least amount of problem behaviors, the study found.
The authors will next look at whether the PA program had lasting effects on older students.

Source: American Journal of Public Health June 18, 2009

Using teacher therapists to identify problem personality traits in teenagers, and help them understand their behaviour, could be the key to stopping them binge drinking and taking drugs.
Adolescent alcohol consumption has more than doubled in the past decade and 15% of pupils reported taking drugs last year.
Addiction experts believe prevention is the key – stopping young people abusing drink and drugs before they start, instead of simply treating the addiction once it has taken hold.
Researchers at the Institute of Psychiatry at King’s College, London, asked more than 1,000 13-year-olds at secondary schools in London to answer a range of questions about their personalities.
They were looking for pupils with four problem personality traits: negative thinking, anxiety, impulsiveness and sensation seeking.
Half of those teenagers were then given two tailored therapy sessions – one 90 minutes long, the second an hour. In small groups teenagers with particular personality traits were encouraged to explore their personalities – including strengths and difficulties.
They were encouraged to think about other ways to deal with the risks associated with that behaviour – techniques they hope the teenagers will then use when they come face to face with drink or drugs.
“It’s about coping with the trait rather than changing the personality – in no way do we ever suggest they stop being who they are or change who they are,” says Dr Patricia Conrod, Consultant Clinical Psychologist at King’s College.
“It’s changing how it is they’re coping with who they are and perhaps capitalising on some of the more positive sides of the trait and learning to manage some of its more difficult sides.”
The results, they say, speak for themselves – one study of 13 to 16-year-olds led to a 40% reduction in binge drinking and cut the chance of teenagers taking cocaine by 80%. It is the first school based programme outside the US to successfully prevent alcohol uptake and misuse in teenagers.
Students asked to give feedback about the sessions told the researchers they helped with controlling anger and dealing with negative thinking.
A second trial then looked at whether ordinary teachers, with no psychiatric training, could be taught to deliver the sessions.
Focusing on more than 20 secondary schools and another thousand pupils, it found that with little training: a three day workshop followed by three hours of supervised practice; teachers could do as good a job as the professionals.
Latest figures show that alcohol misuse currently costs the NHS around £2.7bn a year. Charities say as successful as treating an addiction can be, most do begin in adolescence, hence the need to attack the problem before it even exists.
“Prevention is important because we need to stop people progressing to much severer problems later in life,” says Nick Barton, the Chief Executive of Action on Addiction, who helped fund the study.
“We find for instance in our treatment centres that when we assess drinking or drug use history, that very often the onset was way back in adolescence, sometimes as young as 11 but certainly the period between 11 and 16 was when the first attraction to substance use took hold.”
The researchers believe this programme could be delivered with just two well trained counsellors per borough who would teach school staff how to lead the sessions.
It will cost money, they say, but in the long run a little bit of investment now to stop another generation of binge drinkers could save the NHS millions in the future.

Source: http://www.bbc.co.uk/news/health 25th August 2010

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.

Filed under: Education,Ketamine :


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

Filed under: Education,Youth :


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

Filed under: Alcohol,Education,Youth :

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

Filed under: Education,Youth :

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.

Source: Dr. Emma Porio, professor, Ateneo de Manila University study presented at the recent national conference on “Children in Drugs: Effective Community-Based Strategies for Prevention and Demand Reduction.’’ Reported on Manila On Line August 2004

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

Source:BMJ2002;324-632 16th March 2002


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

Filed under: Education,Youth :

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.

Source: Nancy G. La Vigne, Ph.D., is a Senior Research Associate at the Urban Institute.

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.

Filed under: Education,Youth :

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)

Filed under: Education,Nicotine,Youth :

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

Filed under: Education,Health,Nicotine :

“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”.

Sellers,C.S., Winfree,L.T., Griffiths, C.T.  – Journal of Drug Issues 23(3):493-513,1993. Available from Christine Sellers, Department of Criminology, University of South Florida, Tampa, FL 33620-8100

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

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