Youth and Drug Abuse

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1 Youth and Drug Abuse Eric F. Wagner, Ph.D. Florida International University United Nations Expert Group Meeting World Programme of Action for Youth May 2008

2 Frequency of Alcohol Use and Drinking to Intoxication During Past 12 Months in Youth Across Nations Source: The European School Survey Project on Alcohol and Other Drugs, 2003 ( )

3 Marijuana Use Youth Across Nations Source: The European School Survey Project on Alcohol and Other Drugs, 2003 ( ) lifetime 30-day

4 Addiction Is A Developmental Disease often starts in childhood and adolescence % in each age group who develop first time dependence 1.8% 1.6% 1.4% 1.2% 1.0% 0.8% 0.6% 0.4% 0.2% ALCOHOL THC TOBACCO 0.0% Age Age at alcohol, at tobacco, and at cannabis dependence as per DSM IV NIAAA National Epidemiologic Survey on Alcohol and Related Conditions, 2003.

5 Consequences of Teen Substance Use % 1+ Symptom of Alcohol Disorder 1 77 % 1+ Symptom of Cannabis Disorder % Clinical Behavior Problems % Physical Fight % Out of School % with 1+ ER in the past year No Past Year Alcohol or Marijuana Use Weekly Alcohol Use Weekly Marijuana Use (with Alcohol Use) 69 % Any Illegal Activity % 1+ Arrests Source: Dennis, Godley and Titus (1999) and 1997 NHSDA

6 Brain Maturation continues into the 20 s Maturation Sequence: -Structures that Underlie Coordination & Affect First -Planning and Inhibition More Slowly Fig. 3. Right lateral and top views of the dynamic sequence of GM maturation over the cortical surface Gogtay, Nitin et al. (2004) Proc. Natl. Acad. Sci. USA 101, Copyright 2004 by the National Academy of Sciences

7 Teen Drinking & Brain Activity: Compensation to Deactivation Hypothesis? Non-Drinkers Heavy Drinkers Age 16 Activation Age 20 De-activation

8 Compared to adult substance abusers, adolescent substance abusers briefer history, few medical consequences more episodic use more polysubstance use different developmental challenges more co-occurring problems greater likelihood of natural recovery pressing need for autonomy and individuation much less likely to seek treatment

9 Pediatrics, 2008, Special Issue on Underage Drinking sponsored by the U.S. National Institute on Alcohol Abuse & Alcoholism adolescent treatment approaches rely on adult treatment approaches developmental incongruence of adult-derived methods adolescent drug abusers are different from adult drug abusers normative developmental differences in order to be maximally effective, adolescent substance abuse treatment must take into account such developmental realities developmental realities include wide divergence in developmental status, anticipated effects and consequences of alcohol and drug use, social and emotional contexts of use, the risk factors contributing to the onset and trajectory of use

10 Screening with Brief Intervention Works Youth expect and are open to discussing alcohol and drug use (Steiner, Stern, 2006) Screening and brief interventions can reduce alcohol, tobacco and marijuana use (Knight, 2005, McCambridge, 2004, Oze et al., 2003) Brief Interventions in emergency rooms can reduce alcohol/drug use and related problems (Monti, et al., 2004) Brief Interventions in school settings can reduce alcohol/drug use and related problems (Wagner, 2007)

11 Science indicates that parents. play a vital role in prevention and treatment of adolescent drug abuse do not always understand they have influence do not know how to use the influence they have are ill-equipped to spot signs of experimentation and intervene effectively do not know how to locate treatment and support services ask the right questions when seeking help support their child through treatment and the recovery process

12 How Do Parents Influence Youth Drug Use? (adapted from Clayton, 1992; Jacob & Johnson, 1997; Willis & Yaeger, 2003) family history parent drug use parent attitudes parental monitoring parent connectedness parent-child conflict family stress events youth drug use

13 Summary: Youth and Drug Abuse 1. Adolescent alcohol and other drug use is widespread 2. Adolescent substance abuse is a significant public health concern 3. The peak onset age for substance dependence is late adolescence 4. Interventions can work, but too few teens get it 5. Few interventions are developmentally congruent 6. Brief interventions are effective, economical, and developmentally congruent 7. Parents have influence, but need guidance in how to use it

14 Goals & Targets: Youth and Drug Abuse Halve the number of youth who develop alcohol or drug use problems during adolescence Alcohol, marijuana, and tobacco use prevalence among population aged years Morbidity and mortality rates associated with adolescent alcohol and other drug use Substance abuse and dependence diagnoses prevalence among population aged years Achieve universal access to early intervention services for adolescents alcohol and other drug users Proportion of population of adolescent substance users with access to intervention or services Proportion of parents who are knowledgeable and skilled in preventing adolescent alcohol and other drug use

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