PREVENTION PRIORITIES, OPPORTUNITIES, CHALLENGES

& THE NUMBERS THAT DRIVE THEM

Pamela S. Hyde, J.D.SAMHSA Administrator

SAMHSA CSAP Prevention DayNational Harbor, MD • February 4, 2013

PREVENTING . . .

To avoid doing; to stay away from dangerous or risky things

Measures taken to prevent diseases or injuries rather than curing them or treating their symptoms

PROMOTING . . .

To present information to consumers as well as others

To increase demand

To differentiate a product

PROMOTING . . .

Attitudes

Beliefs and Values

Skills

Policies

Environmental Factors

Actions/Behaviors

SAMHSA PREVENTION PRIORITIES

Substance Abuse and Mental Illness; Build Emotional & Behavioral Health

Suicide Prevention

Prevent Underage Drinking

Prescription Drug Abuse/Misuse

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PROGRESS MADE AMONG YOUTH/YOUNG PEOPLE

Tobacco use is

Cocaine use is

Methamphetamine use is

Abuse/Misuse of prescription drugs is (depending on age group)

Underage Drinking is (except 18-20 yr olds)

Use of hallucinogens is

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YET, FOR 12 AND OLDER . . . STAGNANT OR SLIGHTLY ↑

Current illicit drug users• 8.7 percent of pop. (22.5 million) in 2011 from

8.1 percent in 2008

Marijuana• 7.0 percent of pop. (18.1 million) in 2011 from

5.8 percent in 2007

Heroin• 620,000 people in 2011 from 373,000 in 2007

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FIRST TIME USE/INITIATES 2011 12 & OLDER – INITIATED USE BEFORE AGE 18

~2.9 M used alcohol for the first time; ~7,900 new users/day

~1.5 M used marijuana for the first time; ~4,100 new users/day

~1.3 M smoked cigarettes for first time; ~3,700 new users/day

~800,000 used prescription pain relievers non-medically for the first time; ~2,100 new users/day

~500,000 used inhalants for the first time; ~1,300 new users/day

~500,000 used hallucinogens for first time; ~1,400 new users/day

~200,000 used cocaine for the first time; ~500 new users/day

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WHEN PREVENTION FALLS SHORT…

Untreated Substance Abuse/Misuse/Addiction • 21.6 M adults needing specialized treatment for an illicit

drug or alcohol use problem in 2011 – only 10.8 percent received needed treatment (2.3 M)

Long Time Elapses Before Treatment• Among 669,000 adults admitted for SA treatment for the

first time, an average of 15.6 years had elapsed since the first time they started using the substance (2010 TEDS)

• Longer for males than females (16.5 years versus 13.8 years) and longest for alcohol (20.2 years) while shortest for prescription painkillers (7.8 years)

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Suicide: 2,286 ages 12 to 20

Homicide: 2,930 ages 12 to 20 years

PREVENTABLE DEATHS

CDC WISQARS, 2011

Motor Vehicle Crashes: 2,739 ages 15 to 20

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ALCOHOL ABUSE/UNDERAGE DRINKING: DEADLY REACH

All ages combined: ~ One-third (31.5 percent) of homicides and ~ one-quarter (22.7 percent) of suicides were alcohol attributable, occurring when decedent had a BAC ≥ 0.10 g/dL

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MISSED OPPORTUNITIES TO SAVE LIVES

Of 2,739 young drivers ages 15-20 killed in MVCs, 694 (25 percent) had a BAC ≥ .08 g/dL

Among 16 to 20 years old at 0.08 percent BAC, male drivers were 52 times more likely than sober male drivers the same age to die in a single-vehicle fatal crash

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UNDERAGE DRINKING – DESPITE PROGRESS . . .

Remains unacceptably high

Alcohol remains most widely used substance of abuse among our Nation’s young people

When youth drink, they tend to drink in extreme ways/binge

Two-thirds (> 67 percent) of young people who start drinking before age 15 will try an illicit drug

> 4 in 10 who begin drinking before age 15 eventually become dependent on alcohol

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SUICIDE – DEATHS AND ATTEMPTS

Annually, 11 M+ Americans seriously consider taking their own lives• 8 M make a plan• 2.5 M > 14 years attempt• 38,000+ died from suicide in 2010

America loses ~ 100 people every 24 hours• Not to battles of war, acts of terrorism, or natural

disasters, but to suicide

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PRESCRIPTION DRUGS

Nation's most prevalent illicit drug problem after marijuana• ~22 M persons initiated nonmedical pain reliever use since 2002• ~1 in 22 (4.6 percent) reported misuse/abuse of prescription pain

relievers (2010 & 2011)• US represents 4.5% of world’s population, yet consumes 99% of

world’s hydrocodone (Internat’l Narcotics Control Bd)Emergency room visits

• Non-medical use of ADHD stimulant medications nearly tripled from 5,212 to 15,585 visits; about one-fifth involved illicit drugs (21 percent) or alcohol (19 percent) 2005 – 2010

SU treatment admissions • Benzodiazepine and narcotic pain reliever abuse ↑ 569.7 percent

(from 5,032 admissions in 2000 to 33,701 admissions in 2010)

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SOME FAMILY AND FRIENDS AREN’T HELPING

Marijuana – ~ 70 percent of 523,000 teens aged 12-14 received the drug for free the last time they used– Over half (55.6-percent) received from friends– Over 10 percent received from someone in their family

Prescription Pain Relievers – 54 percent of persons 12 and ↑ who used non-medically received them from a friend or relative for free

Alcohol – ~20 percent of the time, parents, guardians, or other adult family members provided alcohol for underage drinkers

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PREVENTION’S POWER: PERCEPTION OF RISK

• Percentage of adolescents (12 to 17) who perceived great risk from having five or more alcoholic drinks once or twice a week ↑ (38.2 percent in 2002 to 40.7 percent in 2011)– During same period, the rate of binge alcohol use among

adolescents (10.7 to 7.4 percent)

COMPARED TO• Percentage of adolescents who perceived great risk from smoking

marijuana once or twice a week from 54.6 to 44.8 percent – During same period (2007-2011), rate of past month marijuana

use among adolescents ↑ from 6.7 to 7.9 percent

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ON PREVENTION’S HORIZON – OPPORTUNITIES

ACA Implementation• New opportunities for selective (screening) and indicated

prevention (brief intervention)• Parity

National Prevention Strategy & National Prevention Council Action Plan (part of ACA)• Tobacco• Alcohol • Substance Abuse• Depression/MI screening

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ON PREVENTION’S HORIZON – OPPORTUNITIES

National Suicide Prevention Strategy & Pres’ Exec Order re MH for Military & Vets• SA & MH – Prevention, treatment, research, workforce • Suicide screening in MU2 (ACA)

Anti-Bullying Efforts – WH/ED/HHS

National Dialogue on Mental Health• Secretaries of Dept of Ed and HHS will soon launch, to help

change the conversation and galvanize action• Violence – MI is the focus; SA a bigger problem

ON PREVENTION’S HORIZON – CHALLENGES

Marijuana – attitudes and laws

Synthetic Drugs of Abuse

Prescription Drugs

Weight Control Medications

Deficits/Sequester/State & Local Funding

Immigration and Gun Safety

PREVENTION NOT A PRIORITY• SA /MH still seen as a social or moral issue rather than

a public health issue!

COMMUNITIES AND GRANTEES

Make your voices heard in health reform

Stay current with National Strategies

Join or Lead Local Dialogues

Partner

Send the message every chance you get . . . PREVENTION WORKS!

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