Portland Profile. Trends. Alcohol + Other Drug Abuse in the Tri-County Area. Oregon Partnership Preventing Substance Abuse and Suicide

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1 Portland Profile 211 Trends Alcohol + Other Drug Abuse in the Tri-County Area Multnomah Washington Clackamas Oregon Partnership Preventing Substance Abuse and Suicide

2 Oregon Partnership exists to end substance abuse and suicide. Portland Profile 211 Trends Alcohol + Other Drug Abuse in the Tri-County Area Multnomah Washington Clackamas Oregon Partnership Preventing substance abuse and suicide 5 SW Macadam Ave, Ste 4 Portland, Oregon P F

3 Introduction Visit our website for updated information: Oregon Partnership and Community Action to Reduce Substance Abuse (CARSA) are proud to offer this abbreviated version of the Portland Profile: Trends in Alcohol and Other Drug Abuse in the Tri-County Area. Oregon Partnership, a statewide nonprofit that exists to prevent substance abuse and suicide, and the Portlandarea coalition CARSA have produced this edition of Portland Profile. A work in progress, it offers statistics on several alcohol and other drug issues facing Oregon and Clackamas, Multnomah and Washington counties. It will be updated regularly as new data is released. As you ll see, we ve registered successes. We also face enormous challenges that threaten the health and safety of individuals, families and communities. Although underage drinking has declined in the last couple of years, alcohol continues to be the largest drug problem among youth. Far too many adolescents and teens smoke marijuana, which today is more potent than ever. And admissions to publicly funded treatment facilities for prescription opiates have skyrocketed. This latter trend is fueled by a dramatic increase in prescription drug abuse. While such medications play a crucial role in saving lives, treating illnesses and relieving pain, abuse of these drugs represents a growing crisis. In 21, one in every 2 people in the United States age 12 and older 12 million people reported using prescription painkillers non-medically, according to the National Survey on Drug Use and Health. The federal Centers for Disease Control and Prevention (CDC) reported that the death toll nationally from overdoses of prescription painkillers has more than tripled in the past decade. The CDC said the problem has risen to epidemic levels, killing more people than heroin and cocaine combined. In Oregon alone, more than 4 people died of prescription drug overdoses in both 28 and 29. The good news is that, working together, parents and schools, professionals in the health care, prevention and treatment fields, elected officials, law enforcement and other key stakeholders can reduce the enormous toll of prescription drug and other substance abuse. No single statistic provides an adequate measure of substance abuse impacts. Taken together, however, multiple indicators offer valuable insight into key aspects of the problem. Our goal is to provide a reference into the drugs used the most, who is using them and why, and other emerging trends. This publication is just the start of what will be a broader, more in-depth Profile in 212 one that serves as an effective tool to shape public policies that reduce the tremendous human, social and economic costs of alcohol and other drug abuse Portland Profile 3

4 Prescription Drugs Oregon sees striking increase in treatment admissions for prescription opiates Did you know? Among those 12 or older in who used prescription pain relievers non-medically in the past year, 55 percent got the pain relievers from a friend or relative for free. Another 11.4 percent bought them from a friend or relative, and 4.8 percent took them from a friend or relative without asking. (Source: 21 National Survey on Drug Use and Health) The number of treatment admissions among Oregonians for abuse of opiates other than heroin has increased dramatically in the last several years, due largely to prescription drugs. Prescription opiates, which include the painkillers Hydrocodone (Vicodin, Lortab, Lorcet-HD, etc.) and Oxycodone (OxyContin, Tylox, Percodan, etc.), account for the greatest dependency rates for prescription medication. Major increases in the number of prescriptions written, aggressive marketing by the industry and illicit doctor shopping have contributed to the escalation in prescription drug abuse. Many people also perceive that prescription medications are safer and less addictive than illicit drugs, leading to abuse. Oregon Substance Abuse Treatment Admissions for Other Opiates, Including Prescription Opiates % An increase of since Source: Treatment Episode Data Set (TEDS), maintained by the Office of Applied Studies, the federal Substance Abuse and Mental Health Services Administration. While TEDS does not represent the total national demand for substance abuse treatment, it does comprise a significant proportion of all admissions to substance abuse treatment, and includes those admissions that constitute a burden on public funds. The other opiates category excludes heroin but includes methadone, codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, pro poxyphene, tramadol, and any other drug with morphine-like effects

5 youth ACCESS TO PRESCRIPTION DRUGS Did you know? In 29, non-medical users of prescription opiates outnumbered new users in any other class of drugs by 85 percent. (Source: ONDCP Press Release September 21: Obama Administration Officials Urge immediate Action to Reduce Prescription Drug Diversion, Abuse) The National Center on Addiction and Substance Abuse (CASA) asked teens about the availability of prescription drugs. Teens still say it's easiest to buy cigarettes and marijuana. But for the first time in survey history, they say prescription drugs not prescribed to them are easier to get than beer. (19 vs. 15 percent that s a 46 percent increase since 27). The prescription drug teens say is most commonly abused are painkillers. Their main source of drugs such as OxyContin, Percocet, Vicodin and Ritalin: the medicine cabinet, said Elizabeth Planet, director of special projects for CASA. Another big source of these drugs are their friends. The majority of teens said that they get prescription drugs from their homes, parents or the medicine cabinet, while 31 percent said from friends or classmates. CASA s survey also identified schools as a place where teens can get drugs and alcohol, with nearly twothirds of high schoolers and 21 percent of middle schoolers saying that drugs are used, kept or sold on their school grounds. The survey also found that 44 percent of high school students and 16 percent of middle school students know a place near their school, but off school grounds, where kids go to get high. The National Survey of American Attitudes on Substance Abuse XIII: Teens and Parents Opioid Deaths in Oregon from Source: Oregon Public Health Division - Injury Prevention Program; Drug Abuse Warning Network; Oregon State Medical Examiner Karen Gunson, M.D.

6 in the community Did you know? Non-medical use of prescription drugs is the fastest growing drug problem in the U.S. (Source: ONDCP Press Release September 21: Obama Administration Officials Urge immediate Action to Reduce Prescription Drug Diversion, Abuse) Prescription pain medication No. 2 reason people call Crisis Lines Prescription pain medication is now the number two reason, after alcohol, that people call Oregon Partnership s Crisis Lines, surpassing methamphetamine. Prescription drug-related calls increased sharply from 28 to 21. Nationwide, deaths from prescription pain medication overdoses are now twice those of automobile accidents. In Oregon those overdose deaths total over four times the number of homicides. Many individuals in crisis call the lines in withdrawal, having had their prescriptions abruptly discontinued by their medical provider. Yet, the individuals continue to suffer acute pain as well as symptoms of withdrawal. In some cases, people feel in such dire straits they express thoughts of suicide. Experts in the field say that even the first instance of prescription pain medication abuse is very risky. Prescription drug abuse is a silent epidemic that is stealing thousands of lives and tearing apart communities and families across America. From day one, we have been laser focused on this crisis by taking a comprehensive public health and public safety approach. All of us have a role to play. Health care providers and patients should be educated on the risks of prescription painkillers. And parents and grandparents can take time today to properly dispose of any unneeded or expired medications from the home and to talk to their kids about the misuse and abuse of prescription drugs Prescription drug related calls to the Oregon Partnership Crisis Lines An increase of 51% Gil Kerlikowske, Director of Office of National Drug Control Policy

7 6 YOUTH ALCOHOL USE: OREGON S HIDDEN CRISIS Alcohol most abused drug by far among youth Alcohol is the most commonly abused drug among youth in the U.S., according to the Centers for Disease Control and Prevention. Nearly three-quarters of students (72%) consumed alcohol by the end of high school, according to the 28 Monitoring the Future study, which is funded by the National Institute on Drug Abuse. Each year, the study surveys a total of about 5, students in eighth, 1th, and 12th grades. In 28, 55% of 12th graders and 18% of eighth-graders reported having been drunk at least once. Over one in every five eighth-graders, and over a third of 11th-graders, in the tri-county area and statewide have consumed alcohol in the past 3 days, making it the most used drug by youth an alarming fact that carries potentially devastating health and safety consequences. 6 Youth Alcohol Use: Past 3 Days During the past 3 days, on how many days did you have at least one drink of alcohol? 4 2 Percentage of students who drank alcohol on one or two days or more in the past month * * 4 Eighth Grade Eleventh Grade 2 Tri-County 2 Oregon Tri-County Percentages are weighted Source: Oregon Healthy Teens Survey and * Oregon Student Wellness Survey

8 Did you know? Oregon 8th and 11th graders who drank in the past 3 days said they consumed hard liquor more than any other form of alcohol. (Source: the 21 Oregon Student Wellness Survey) An American Medical Association report shows that adolescent drinkers perform worse in school, are more likely to fall behind and have an increased risk of social problems, depression, suicidal thoughts and violence. Even occasional heavy drinking injures young brains. In April 21, The American Academy of Pediatrics indicated that the brain s frontal lobes, essential for functions such as emotional regulation, planning and organization, continue to develop through adolescence and young adulthood. At this stage, the brain is more vulnerable to the toxic and addictive actions of alcohol and other drugs. Adolescents who drink before age 15 are four times more likely to develop alcohol dependence than those who begin drinking at age 21, research has found. Children who drink before age 13 have over a 4 percent chance of lifetime alcohol problems. Long-term studies now show a direct link between alcohol advertising and youth drinking. Young people who see and hear more alcohol ads are more likely to drink - and in many cases drink more heavily - than their peers. 6 4 Youth Alcohol Use: Accessibility 2 Percent of students who say it is Sort of easy or Very easy to get some beer, wine or hard liquor. if you wanted to get some beer, wine or hard liquor (for example, vodka, whisky or gin), how easy would it be for you to get some? * * Eighth Grade Eleventh Grade 2 Tri-County 2 Oregon Tri-County Percentages are weighted Source: Oregon Healthy Teens Survey and * Oregon Student Wellness Survey

9 BINGE DRINKING Over 21% of 11th graders binge drink Did you know? One in every ten Oregon 11th graders rode in a vehicle at least once in the last 3 days that was driven by a teenager who had been drinking alcohol. (Source: the 21 Oregon Student Wellness Survey) According to the Oregon Student Wellness Survey, in 21 nearly nine percent of Oregon 8th graders and over 21 percent of 11th grade students reported binge drinking on at least one day in the past month. In eighth grade, girls have slightly higher binge drinking rates; by eleventh grade, boys have higher rates than girls. Excessive alcohol consumption, also called binge drinking, is a pattern of drinking alcohol that brings the blood alcohol level concentration (BAC) to.8 or above. For the typical adult, this pattern corresponds to 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours. (NIAAA). A drink refers to half an ounce of alcohol (example: one 12-ounce beer, one 5 ounce glass of wine, or one 1.5 ounce shot of distilled spirits). This amount is enough alcohol to impair judgment, impede coordination, remove inhibitions, cause slurring of words and potentially put someone at risk of serious health or social consequences, lasting brain damage and even death. The binge drinking rate among youth is troubling because of the many serious consequences. Recent studies have found heavy exposure to alcohol may interfere with brain development, 6 which continues well beyond childhood. 4 Binge Drinking: Past 3 Days 2 Percent of students who report binge drinking in the past 3 days during the past 3 days, on how many days did you have 5 or more drinks of alcohol in a row, that is, within a couple of hours? * * 4 Eighth Grade Eleventh Grade 2 Tri-County 2 Oregon Tri-County Percentages are weighted Source: Oregon Healthy Teens Survey and * Oregon Student Wellness Survey

10 YOUTH MARIJUANA USE Marijuana use has begun to rise Did you know? 4 percent of 11th graders and 26 percent of 8th graders said people who smoke marijuana once or twice a week are at no risk or slight risk of harming themselves. (Source: the 21 Oregon Student Wellness Survey) In Oregon, over 12 percent of 8th graders and over 23 percent of 11th grade students polled by the Student Wellness Survey said that they had used marijuana in the past 3 days. After a decade of gradual decline, marijuana use has begun to rise. According to the National Institute on Drug Abuse (NIDA) Monitoring the Future report, lifetime, annual, and 3-day prevalence of marijuana use leveled in 28 and began to increase in 29. This appears to be tied to the emergence of medical marijuana in states such as Oregon, and the perception by youth that, if it s medically indicated, use must be benign. Estimated U.S. 3-day Current Substance Use Prevalence by 8th, 1th, and 12th Graders percentage who used in last 3 days Current Use Marijuana The increase in 3-day use for the three grades combined (from 12% to 14%) was, in fact, significant. So, it would appear that the turnaround, though not yet dramatic, is real. As is often the case, this increase was preceded and accompanied by a decline in adolescents beliefs about how much risk marijuana use poses. The proportion seeing great risk in regular marijuana use fell from 76% in 24 to 7% in 29 among 8th graders, from 66% in 25 to 6% in 29 among 1th graders, and from 58% in 25 to 52% in 29 among 12th graders. Did you know? 3 percent of 11th graders said they smoked marijuana for the first time by age 15 or younger. (Source: the 21 Oregon Student Wellness Survey)

11 Marijuana use by teens with prior serious antisocial problems can quickly lead to dependence on the drug Marijuana is the most widely used illicit drug among youth, and today s marijuana is much stronger than in the past. The younger children are when they begin to use marijuana, the more likely they are to become dependent on it or other illicit drugs later in life. In addition, studies show that regular marijuana use can have serious health consequences and affect a child s success in school. According to one study, marijuana use by teens with prior serious antisocial problems can quickly lead to dependence on the drug. That study also found that, for troubled teenagers using tobacco, alcohol and marijuana, progression from their first use of marijuana to regular use was about as rapid as their progression to regular tobacco use, and more rapid than their progression to regular alcohol use. National Institute on Drug Abuse 6 Youth Marijuana Use: Past 3 Days During the past 3 days, how many times did you use marijuana? 4 2 Percentage of students who smoked marijuana one or more times during the past 3 days * * 4 Eighth Grade Eleventh Grade Tri-County 2 Oregon Tri-County Percentages are weighted Source: Oregon Healthy Teens Survey and * Oregon Student Wellness Survey 6

12 MARIJUANA Access Many teens saying marijuana and prescription drugs are easier to obtain than beer According to the 28 National Survey of American Attitudes on Substance Abuse XIII, teens can easily obtain marijuana and prescription drugs with many saying these drugs are easier to obtain than beer. The survey found that 42 percent of 12- to 17-year olds can buy marijuana in a day or less; 23 percent in an hour or less. In addition, half of 16- and 17-year olds say that among their age group smoking marijuana is more common than smoking cigarettes and 23 percent of teens find it easier to buy than beer. Marijuana is readily available, with 23 percent of teens able to get the drug in an hour or less, and 42 percent of teens able to get it in a day or less. The survey reveals a 35 percent increase over prior year in teens who can get marijuana in an hour or less, and a 14 percent increase over last year in teens who can get the drug in a day or less. The National Survey of American Attitudes on Substance Abuse XIII: Teens and Parents 6 4 Youth Marijuana Use: Accessibility if you wanted to get marijuana, how easy would it be for you to get some? 2 Percent of students who say it is Sort of easy or Very easy to get some marijuana Tri-County 2 Tri-County Percentages are weighted * * Eighth Grade Oregon Eleventh Grade Source: Oregon Healthy Teens Survey and Oregon Student Wellness Survey

13 WHAT YOU CAN DO Substance abuse takes a tremendous toll on families, community livability, and the working environment and business bottom line. But there are numerous ways to address the issue at home, in your neighborhood and on the job. Parents and caregivers Educate yourself and others Learn what your child s school is doing to prevent alcohol and other drug use. Good parents can become even better parents. Team up to form a network with other parents of children who attend school, play sports or spend time together. These networks help parents educate themselves about substance use and other problem behavior among adolescents; support one another through the challenges of modern parenting; and set common guidelines for their children s behavior. Parents alone are the single-greatest influence in their children s lives. However, the entire community needs to be engaged in raising safe and healthy kids. Talk with your kids about alcohol and other drugs. Talk early, and often, with your child about the dangers of alcohol, tobacco and other drugs. Listen to your child and try to understand his or her concerns. Paraphrase what he or she says to you and ask for input about family decisions. Praise your child and reward good behavior consistently and immediately. Catch them being good! Establish clear rules and consequences for inappropriate or problem behavior. Set a good example. What we do influences our children. Promote healthy, creative activities such as arts and sports, and encourage your child to tell you about their hopes and dreams. Get involved with school activities as much as you can. Establish together time, a regular weekly routine for doing something special with your child Portland Profile 13

14 Community and business leaders Build a community coalition * Define the substance abuse problem and its impact on your community. Identify key participants, including representatives of each community sector, diverse cultural and ethnic groups, people with influence, those most impacted by the problem, businesses, and service organizations. Promote and convene an evening meeting in a reputable neighborhood facility and offer child care. Share perspectives. A facilitator can help everyone be heard and keep the meeting moving forward. Discuss the reality of substance abuse in your community and develop a specific statement, with clear goals, about how you would like the issue to look. Create a vision for your community. Craft a positive, inspirational vision statement that describes the goal and illustrates the big picture. Determine next steps. Ensure those involved know what needs to be done and establish a timetable for accomplishing the next steps. Businesses Establish education and employee wellness programs as well as drug-free workplace policies and procedures. Invite representatives from your local anti-drug coalition to your workplace to help educate employees. Include in internal s and newsletters information and resources about alcohol and other drug abuse prevention, treatment and recovery programs. Display anti-drug posters in your break room or lunchroom that feature a good balance between positive, inspirational images and negative consequences of drug use. To find out more about youth and parenting education and resources, or making your neighborhood, community or workplace drug free, please contact Oregon Partnership at , or info@orpartnership.org * Source: Community Anti-Drug Coalitions of America Portland Profile 14

15 References American Medical Association Oregon Healthy Teens Survey Oregon Student Wellness Survey White House Office of National Drug Control Policy "Policy Statement: Alcohol Use by Youth and Adolescents: A Pediatric Concern," Pediatrics, published online April 12 Underage Drinking in the United States: A Status Report, 25 The Center on Alcohol Marketing and Youth at Georgetown University American Academy of Pediatrics Policy Statement -Alcohol Use by Youth and Adolescents: A Pediatric Concern Committee on Substance Abuse Johnston, L. D., O Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (21). Monitoring the Future national results on adolescent drug use: Overview of key findings, 29 (NIH Publication No ). Bethesda, MD: National Institute on Drug Abuse, p. 5. ( Monitoring the Future - prevalence of current substance use among 8th, 1th & 12th graders combined) Early alcohol initiation and subsequent sexual and alcohol risk behaviors among urban youths. Am J Public Health. 25;95(5): Portland Profile 15

16 Resources Youth Alcohol Youth Alcohol Use: Past 3 days (29) Youth Binge Drinking: Youth Marijuana Youth Marijuana Use: Past 3 days (29) Oregon Healthy Teens Survey public.health.oregon.gov/birthdeathcertificates/surveys/oregonhealthyteens/results/29/pages/index.aspx Youth Cigarette Youth Cigarette Use: Past 3 Days American Cancer Society (29) (looks like they update this in November) Adult Binge Drinking & Marijuana Use Binge Drinking: Past 3 Days Statewide & National CDC Marijuana Use: Past 3 Days Statewide & National Adult Illicit Drug Use Other Illicit Drug Use: Past 3 Days Monitoring the Future (21) Crisis Line Calls at Oregon Partnership - Crisis Lines Call Data Substance Abuse Treatment Substance Abuse Treatment Clients Served Tri County Area and Statewide Percentage of Substance Abuse Treatment Clients Served Statewide Alcohol and Intoxicant-Related Traffic Fatalities Number of Auto Crash Fatalities Involving Alcohol and/or Other Intoxicants Auto Crash Fatalities per, Involving Alcohol and/or other Intoxicants Statewide and Tri-County Other Prevalence & Trends CDC Database: Results from the 29 National Survey on Drug Use and Health: Volume I. Summary of National Findings Portland Profile 16

17 Carsa leadership Council Mayor Sam Adams city of portland Kovi Ashley OREGON PARTNERSHIP YOUTH ADVISORY COUNCIL Ed Blackburn Central City Concern Claire Brennan Drug Enforcement Administration Bill Cameron, Ph.D. Oregon Health & Science University Barbara Caplan Oregon Partnership Judy Cushing Oregon Partnership David Downey Drug Enforcement Administration Jim Ferraris Portland Police Bureau Joanne Fuller Multnomah Co. Department of County Human Service Mary Ellen Glynn Alcohol and Drug Policy Commission Louise Grant volunteer, neighborhood safety Diana Hall Multnomah Co. Department of County Human Services Jan Halsey parent representative Dwight Holton former United States Attorney, District of Oregon Erin Hubert media representative Ray Hudson Multnomah Co. Department of County Human Services Judge Dale Koch Multnomah County Circuit Court Michael Kuykendall Portland Business Alliance Carolyn Leonard Portland Public Schools Donna Libemday CARSA/oregon partnership Judge Jean Maurer Multnomah County Circuit Court Steve McCoid Oregon Restaurant Association Mark McDonnell Multnomah County District Attorney s Office Shane Abma Portland Business Alliance Chief Deputy Tim Moore Portland Police Bureau Tom Parker Oregon Partnership Roberta Phillip Office of Chair Jeff Cogan Chief Mike Reese Portland Police Bureau Stephanie Reynolds Office of Neighborhood Involvement Bill Russell Union Gospel Mission Mike Schrunk Multnomah County District Attorney s Office Carole Smith Portland Public Schools Sheriff Daniel Staton multnomah county Joshua Todd Multnomah County Youth Commission Kathleen Treb Multnomah County Dept of Community Justice Judge Suzanne M. Upton Washington County Circuit Court David Tyree Drug Enforcement Administration Judge Nan Waller Multnomah County Circuit Court Pat Walsh Portland Police Bureau Lisa Weatheroy Portland Public Schools Karen Williams Lane Powell, PC Portland Profile 17

18 Oregon Partnership Board of Directors Erin Hubert, Co-President Vice President/General Manager Entercom Radio Julie Elkins, Co-President Attorney at Law Zipse Elkins & Mitchell Dan McMillan Vice President Vice President, Insurance Services Group The Standard Lon Getlin Treasurer Chief Executive Officer Cashco Distributors, Inc. Marci Lematta Walsh Secretary Executive Marketing Assistant Columbia Helicopters Stephanie Dreyfuss Member at Large Regional Director Network Development Providence Health Plans Anne Naito-Campbell Consultant Business and Community Development Bill Eaquinto Vice President Transmission & Distribution Operations PacifiCorp Jim Ferraris Deputy Chief of Police Salem Police Department Chris Gibson Director Oregon HIDTA Program Steve Glenn Director Enterprise Program Management Office, Regence Dan Heine The Bank of Oswego Roy Jay African American Chamber of Commerce Dr. Loren Jenkins KPNW Spine Services Kaiser Permanente NW Doug Lyons Member at Large Principal Clere Consulting Patrick McCreery Member at Large Vice President /General Manager kptv / KPDX / Meredith Corporation Nathan Sasaki Apex Real Estate Partners Judge Nan Waller Multnomah County Circuit Court Judy Cushing President / CEO Oregon Partnership Dr. Marvin Seppala (Advisor) Hazelden - Minnesota Dr. Chris Farentinos (Advisor) DePaul Treatment Centers Brigadier General Bruce Prunk (Senior Advisor) Oregon Air National Guard Portland Profile 18

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