scott caldwell & connie bettin presentation to the recently formed coalition madison, wi january...

Scott Caldwell & Connie Bettin

Presentation to the recently formed Coalition Madison, WI

January 5, 2009

Dane Co. Youth and Drinking: What the Data Shows and What

We Should Do About It

1. Adolescence is a unique and powerful developmental period

2. Alcohol use impacts teens differently than adults

3. There are multiple pathways to effective prevention and intervention

Three considerations:

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The “Health Paradox” of AdolescenceSource: Dahl (2005)

On one hand…

Measures of most abilities show that adolescence is the healthiest and most resilient period of the lifespan

But on the other hand…

Clinical problems and mortality rates increase 200 to 300 percent 3

Primary causes of clinical problems and mortality during adolescence are related to difficulties with control of behavior and emotion

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• New science

• Insights into teen behaviors

• Implications for parents, counselors, educators, policy makers

Adolescent Neuroscience

General findings:

• Adolescence is a period of unique and profound brain maturation

• Remodeling of structure

• The brain maturation process is not complete until about age 24!!

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amygdala

Research: These areas are still developing during adolescence

CEO: judgment, decision making, planning ahead

Directs motivation

Regulates emotion7

Teen Brain Teen Behavior

• Limits to motivation:

• Limits to emotional regulation:

• Limits to judgments:

preferences for low effort, high excitement activities

moodiness, quick to anger

increased risk taking, decreased planning ahead 8

Why should we be concerned about teen drinking?

Alcohol use amplifies the vulnerabilities.

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• On-going survey of students 7th – 12th grade• 189 items• 23,542 students participated (66% HS)• Voluntary and anonymous• HS alcohol groups examined:

Abstainers (≈ 49%) = No past year drinking vs.

Current drinkers (≈ 27%) = At least one drink during the past 30 days

Analysis of Dane Co. youthBrian Koenig, Principal Investigator

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Teen drinking is associated with:

• Reduced sensitivity to intoxication

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Of current high school drinkers, percentage who reported binge drinking:

Source: DCYA (2005)

77%

• Reduced sensitivity to intoxication

• Involvement with other drugs

Teen drinking is associated with:

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Current drinking is strongly associated with past year drug use Source: DCYA (2005)

• Reduced sensitivity to intoxication

• Involvement with other drug use

• Risk taking

Teen drinking is associated with:

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Current drinking is strongly associated with current risk behaviors Source: DCYA (2005)

• Reduced sensitivity to intoxication

• Involvement with other drug use

• Risk taking

• Risk for cognitive deficits

Teen drinking is associated with:

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Binge drinking and the teen brain

15 year old male non-drinker

15 year old male heavy drinker

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• Reduced sensitivity to intoxication

• Involvement with other drug use

• Risk taking

• Risk for cognitive deficits

• School difficulties

Teen drinking is associated with:

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Current drinking corresponds with decreased school connection, attendance, and grades

Source: DCYA (2005)

• Reduced sensitivity to intoxication

• Involvement with other drug use

• Risk taking

• Risk for cognitive deficits

• School difficulties

• Co-occurring problems

Teen drinking is associated with:

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Drinking among HS students is linked to co-occurring problems

Any past year delinquency

Source: DCYA (2005)

• Reduced sensitivity to intoxication

• Involvement with other drug use

• Risk taking

• Risk for cognitive deficits

• School difficulties

• Co-occurring problems

• Risk for long-term alcohol problems

Teen drinking is associated with:

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Percentages of Past Year Alcohol Problems among Adults Aged 21 or Older, by Age of First

Use Source: SAMHSA (2005)

Age Started Drinking

Early age drinking increases future risk by 6 times

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The very same brain areas developing during adolescence

are implicated in addiction

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Summary of the Data

• Adolescents are not “mini adults”

• Teens are particularly vulnerable to the harmful effects of alcohol

• Potential risks can be immediate as well as long-term

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What to do?

Directions for this Coalition to consider….

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Selected Principles of Effective PreventionSource: NIDA (2003)

• Start early (preschool, K-6)

• Target key risk and protective factors

• Target developmental transitions

• Utilize multiple strategies, across multiple levels and settings

• Deliver consistent, community-wide messages

Five areas to consider:

1. Involve parents and families

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My parents think it’s wrong to drink alcohol (% strongly agree)

Source: DCYA (2005)

AVE = 42%

My parents know what I’m doing after school (% very often)

Source: DCYA (2005)

AVE = 54%

Five areas to consider:

1. Involve parents and families

2. Increase youth perception of risk for alcohol effects (demand)

3. Address alcohol accessibility (supply)

4. Address alcohol marketing to youth

5. Screening, brief intervention, and referral for treatment (SBIRT) in “opportunistic” settings

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What does not work:

• Education

• Scare tactics

• Messages to “drink responsibly”

• Confrontational interventions

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Questions and Discussion