substance abuse trends and consequences martin arocena

Substance Abuse Trends and ConsequencesMartin Arocena

Outline

Introduction Substance Consumption Patterns Consequences Need Assessment and Identification of

Critical Needs

Strategic Prevention Framework

DSHS applied for and received a grant to participate in SAMHSA’s Strategic Prevention Framework initiative.

Part of the requirements of the grant is that each funded state organize a state epidemiological workgroup (SEW).

State Epi Workgroup

The purpose of the SEW is to:

Assess the status of the state with respect to substance abuse prevalence

Select consumption-related consequences and measure the state’s status on them

State Epi Workgroup

Identify the state’s critical needs in terms of problem, population, and geographical location where problems are more severe.

Work with the Advisory Council to inform them and provide data as needed to help them make informed decisions.

State Epi Workgroup

Texas’ epi workgroup consists of representatives from several state agencies, community organizations and academia that have information and access to consumption and consequences databases;

We received technical assistance from researchers from the Pacific Institute for Research and Evaluation and work closely with CSAP. They provide advice, leadership, and participate in the decision-making process.

State Epi Workgroup

Drs. Cervantes and Rey from Behavioral Assessment Inc. as the contracted program evaluators are members of the group.

Liang Liu, the principal investigator of the Texas School Survey and I are the co-coordinators of the group.

The collaborators provided the data to us and we did the statistical analyses and reporting.

Databases Consulted

Consumption: 2002-2003 National Survey on Drug Use and

Health (NSDUH)2004 Texas School Survey2000 Texas Survey of Substance Abuse among

Adults (TCADA- Lynn Wallisch)2004 Behavioral Risk Factor Surveillance2003 Youth Risk Behavior Surveillance System

Substances Selected: Alcohol Tobacco Marijuana Inhalants Cocaine/crack Any other illicit drug

used

Measures: Current use (past 30

days) Past year use Age of initiation Binge drinking (5 or +) Heavy drinking (2 +)

Consequences

Alcohol and Drug Dependency Alcohol-related fatalities Crime statistics Mortality rates

Databases Consulted

Consequences:

2003 Fatalities Analyses Reporting System

2003 Uniform Crime Reports

2003 Mortality Data from CHS/DSHS

Census of the Population data

CONSUMPTION

Age of InitiationPercent of Secondary Students Who Reported Initiating Use before Age 13

(Source: Tx. S. S.)

56

30

50

0

10

20

30

40

50

60

Alcohol Marijuana Tobacco

Age of Initiation

Prevalence Rates

12 to 17 Years Old

18 to 25 Years Old

26 and Older

Alcohol Use Past Month

676,983

33%

1,570,504

58%

8,679,640

50%

Tobacco Use Past Month

348,749

17%

1,164,339

43%

5,207,784

30%

Marijuana Use past month

266,690

13%

352,010

13%

520,778

3%

Cocaine Use past 30 days

92,316

4.5%

189,544

7%

347,186

2%

Total Pop. 2,051,464 2,707,766 17,359,279

Comparison of Past Month Consumption of Alcohol, Tobacco, and marijuana by Age groups (Sources: TxSS & NSDUH)

33

58

50

13 13

3

17

42

30

0

10

20

30

40

50

60

70

12 to 17 18 to 25 26 and older

Alcohol Use

Marijuana use

Any tobacco use

Consumption of Alcohol By Age Groups (Sources: School S & NSDUH)

33

58

50

23

32

23

7

14

5

0

10

20

30

40

50

60

70

12 to 17 Group 18 to 25 Group 26 and older

Current Use Binge Drinking Heavy Drinkers

Binge Drinking

Binge Drinking

The 2004 Texas School Survey reports that approximately 23% of the students in grades 7 – 12 had 5 or more drinks on one occasion during the past year. The rate of binge drinking is decreasing from 27% in 2000 to 26% in 2002.

Based on YRBSS, 25.7% of high school students in Texas reported episodic heavy drinking (5 drinks or more in a row during the past 30 days).

Driving While Intoxicated

37%

29%

27%

26%

26%

25%

26%

23%

24%

14%

11%

8%

12%

17%

18%

18%

18%

18%

0% 5% 10% 15% 20% 25% 30% 35% 40%

SY-1988

SY-1990

SY-1992

SY-1994

SY-1996

SY-1998

SY-2000

SY-2002

SY-2004

Percent of Texas Seniors

Driving While High from Drugs

Driving While Drunk

Binge Drinking

Binge DrinkingAmong the 18 to 25 years old group, about

58% were current drinkers and 40% were binge drinkers.

The current drinkers among the older group drops to about 50%. Binge drinkers drops to about 23%, and 5% heavy drinkers

Drinking and Driving

About 14% of students in grades 9 through 12 admitted they had driven a car after having had a good bit to drink at least once in the past year, and 24% of the seniors said so.

11% of students in grades 9 through 12 reported having driving when they were high from drugs and 18% of the

seniors said so.

Alcohol Consumption Patterns

5962

57

52 51

26

32

22

18

12

8

14

5 5.3 4 5 4

38

33

37

0

10

20

30

40

50

60

70

12 to 17 18 to 24 25 to 34 35 to 44 45 - 54 55 to 64 65 and older

Current

Binge

Heavy

Trends for Youth (Source: School Survey)

42.843.6

32.6

20.9

24.2

26.2 26.3

22.4

18.217

12.6

37

39.4

37.3 38

36.134.5

22.9

11.5

7.8 6.812

15.9 15.2

13.7 14.4

0

5

10

15

20

25

30

35

40

45

50

SY-1988 SY-1990 SY-1992 SY-1994 SY-1996 SY-1998 SY-2000 SY-2002 SY-2004

Per

cen

t

Alcohol Tobacco Marijuana Inhalants Cocaine/Crack

Adults Trends

Past Month Measure 1999-2000 2000-2001 1999-2000 2000-2001

Alcohol 54.70% 54.90% 44.80% 46.20%

Binge Drinking 35.70% 36.70% 19.90% 20.20%

Any Illicits other than mj. 5.60% 7.00% 1.60% 1.60%

Marijuana 10.30% 10.30% 1.60% 1.90%

Cocaine 6% 5.60% 1.10% 1.20%

Tobacco 40% 38.90% 27.70% 27.90%

18 - 25 Years Old Group 26 ad Older Group

Adults Trends

The source for the Adult Trend information is: SAMHSA, Office of Applied Studies , National Household Survey on Drug Abuse 1999, 2000, and 2001

The information is for Texas.

Demographics:

Gender

Ethnicity

Gender Differences

Youth Males

Youth Females

Adult Males

Adult Females

Alcohol 32.5% 32.7% 59.3% 41.9%

Tobacco 18.9% 15.3% 28.1% 21.2%Marijuana 14.3% 11.0% 6.1% 2.5%

Inhalants 6.9% 6.4% 0.2% 0.1%Cocaine/C 3.7% 2.7% 1.4% 0.5%

Any Illicit 16.% 12.7% 7.9% 3.5%S: sch. survey

S: 2000 Adults

Adults Consump by Ethnic (Source: Risk Survey)

58.8

43.5

48.549.6

16.1

12.1

19.4

10.7 10.9

6.44.6 5.7 5.4 5.2

23.7

20.218.7

27.426.3

0

10

20

30

40

50

60

70

White African-American Hispanic Other Multiracial

per

cen

t

Current Users

Binge Drinkers

Heavy Drinkers

Smokers

Youth Consumption of Drugs by Ethnic/Race Groups

5.8

5

8.4

13.9

12

16.8

12.2

11

14.3

2.5

0.9

6.2

0

2

4

6

8

10

12

14

16

18

Anglo African-American Hispanic

Per

cen

t

Inhalants Any Illict Drug Marijuana Cocaine/crack

Inhalants

About 7% of the youth had used inhalants in the past month. Due to its harmful effects on the brain and the relative easiness of getting the product the use of inhalants is considered a serious problem in the state

Cocaine

The use of crack/cocaine in Texas has higher prevalence rates than in the other 50 states.

Approximately 7% of the 18 to 25 years old population reported using cocaine.

Methamphetamines

The proportion of clients admitted to treatment that mentioned methamphetamines as their primary drug has increased from 5% to 10% in 2004.

Unlike the other drugs, more than one half (53%) of these clients were women.

At Risk Populations

Use of alcohol, but not cigarettes, marijuana and cocaine, is higher among college students than among non-college youth of the same age.

There is a significant difference in the use of cocaine between border and non-border Hispanics.

Regional Differences

Wallisch in the TCADA 2000 Adult Survey found that compared to the mean level for the state:

Region 6 had higher-than-average rates of alcohol use.

Region 7 had the highest rate of marijuana use in the state

Region 8 had the highest rate of cocaine use.

CONSEQUENCES

Substance Abuse Dependence

The 2002-2003 NSDUH included questions designed to measure dependence and abuse of alcohol and drugs based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV).


According to the national survey in Texas:

12 to 17 group: 6 % = 123,088 18 to 25 group: 17 % = 460,320 26 and older: 6 % = 1,123,054

Texans were alcohol dependent or abusers.


Alcohol is the most frequently mentioned primary drug reported by the Adult population admitted to publicly-funded treatment centers in Texas.

About 30 % of the clients reported this substance as their primary substance at admission.


The national survey estimated the following percentages of residents in Texas who are dependent or abusers of any illicit drug:

12 to 17 group: 5 % = 102,573

18 to 25 group: 7 % = 189,543

26 and older: 1.5 % = 280,764

Motor Vehicle Fatalities

Texas was the state with the largest number of alcohol-related fatalities in the nation. Of the 42,643 MVF in the nation, 3,675 (1.58%) occurred in Texas.

Of the total 3,765 crashes in the state, 1,709 (47%) were alcohol-related. It is higher than the national average, 41%.


In 2003, of the 5,011 drivers involved in a MVF, 1,469 (29.3%) were identified as having had some alcohol.

The age-group with the highest percentage of drunk drivers was the 21 – 29 years old group (38%)


The counties with the greatest concentration of population in Texas have the larger number of MVF and had the higher number of intoxicated drivers involved in fatalities.


The next slide will show 19 counties with 21 or more drivers during the past 3 years who were involved in a MVF.

Together these 19 counties had :60% of the 3,081 drivers involved in a MVF

from the age-group.59% of the 2,052 intoxicated drivers involved

in a MVF from the same age group.


The columns for the next slides present:

Name of the County

Total number of drivers involved in crashes in which at least one person died.

The number of alcohol-involved drivers in crashes in which at least one person died. (Expressed as a fraction because the probability of alcohol involvement is imputed using a probabilistic model.)

The percent of alcohol-involved drivers.

Sampled Population:From the Individual FARS;

Years: 2001, 2002, 2003 Ages 12 to 17, 18 to 20, 21 to 29


County Total # of Perc. Intox. D Of DDGalveston 49 21.0 45%Hays 46 21.0 48%Jefferson 74 22.7 32%Smith 91 23.9 29%Nueces 58 24.0 43%Bell 79 24.6 32%Williamson 79 24.9 31%Lubbock 70 30.9 44%Collin 78 32.8 44%Denton 97 33.4 38%


County Total # of Perc Intox. Of DDCameron (Valley) 81 38.1 47%Montgomery (N. of H) 126 40.4 33%El Paso 140 51.9 38%Hidalgo (Harlingen) 173 65.4 38% Travis (Austin ) 181 75.7 43%Tarrant (Ft. Worth) 223 78.6 35%Bexar (San Antonio) 270 99.9 38%Dallas 444 167.5 38%Harris (Houston) 772 325.8 42%


Groups Number of Total Drivers

Number of Intoxicated

Drivers

All Counties 5,151 (100%) 2,052 (100%)

The 19 Counties

3,081 (60%) 2052 ( 59%)

The Top 7

(> 21 DDs)

2,189 (42%) 238.6 ( 42%)

Violence

As reported in the 10th Report to the U.S. Congress on Health and Alcohol:

The relationship between the offender’s drinking and the perpetration of violence has continued to show that the offender’s drinking is related to violence

Violence

The amount of alcohol consumed tends to be larger in more serious offenses;

The connection between drinking and violence is stronger where the relationship between the perpetrator and victim is closer, and

Persons consuming large amounts of alcohol were at greater risk for violence than those consuming smaller amounts.

Crime-Related Statistics

Violence rate includes aggravated assault, rape, and robbery. It is associated with alcohol abuse.

The UCR reports show that the Texas’ violence rate per population is higher than the national rate

Violent Crime 5-Year Trends, U.S. vs. Texas Source : 2003 Uniform Crime Report

Violent Crime 5-Year Trends, US. vs. Texas, 2003 UCR

523.0

506.5 504.5

494.4

475.0

560.3

545.1

572.8578.6

552.5

400.0

420.0

440.0

460.0

480.0

500.0

520.0

540.0

560.0

580.0

600.0

1999 2000 2001 2002 2003

Vio

len

t C

rim

e R

ate

per

100

,000

US. VC. TX. VC


The counties in Texas with the higher violence rates per population were:

Victoria (-), Kleberg, Lamar, Potter, Nueces, Dallas, Wichita, Harris, Lubbock, and Jim Wells (+).


The counties with the higher number of reported violent offenses were:

Jefferson (-), Lubbock, Nueces, Hidalgo, Travis, El Paso, Tarrant, Bexar, Dallas, and Harris (+)


Property crimes such as burglary, larceny, and motor vehicle theft have been associated statistically with drug consumption.

The property crime rate in Texas is higher than the rate for the United States.


The counties with the highest numbers of property crime reports were: Harris, Dallas, Bexar, Tarrant, Travis, Hidalgo, and El Paso.

Property Crimes, U.S. vs. Texas, Five Years Trends,Source: Uniform Crime Reports, 2003

Property Crimes, US vs. TX, Five Year Trends , 2003 UCR

3,588.40

4,595.30

3,743.60

3,630.603,658.103,618.30

4,611.00

4,410.404,471.50

4,579.90

2,500.00

3,000.00

3,500.00

4,000.00

4,500.00

5,000.00

1999 2000 2001 2002 2003

US. PC.

TX. PC


Taking into consideration property crime rates per 1,000 population, it was found that among the top 20 counties, 6 were in the Rio Grande Valley (Cameron, Hidalgo, Kleberg, Webb, and Nueces Counties)

Mortality

For this project, the selection of causes of death was based on the strength of the relationship between the illness and consumption of alcohol, drugs and tobacco.

Alcohol use is an intervening variable in homicides, suicides, and chronic liver disease.

Homicides

Texas’ homicide rate, 6.9 per 100 K population is higher than the United States (5.9). The 18 to 29 age group had the highest homicide rate.

Although African-Americans have lower rates of

substance abuse prevalence, they have higher rates of homicides.

1,516 deaths were attributed to homicide.

Suicide

Alcohol and other drugs are a contributing factor in suicides. State’s rate was 10.8 vs. 10.5 for the nation.

There were 2,354 suicides in Texas in 2,003. This is the leading cause of violent deaths each year.

Chronic Liver Disease

The state’s chronic liver disease prevalence rate (10.5 per 100 K pop) is higher than the national rate (9.5).

Over 90% of the deaths due to this disease happened to individuals in the older age groups.

Hispanics have a greater rate of deaths due to chronic liver disease (25.5) than other groups, 18.6 for Whites and 12.7 for African-American.

Tobacco-related mortality

According to the CDC, tobacco is the leading cause of preventable deaths in the United States. Lung cancer, heart disease, and illnesses such as emphysema, bronchitis, and chronic airways obstruction are responsible for the largest number of smoking related deaths.

Tobacco-related mortality

The majority of the individuals whose cause of death was lung cancer were in the 65 years old or older group.

This age disparity shows the long-term effect of cigarette smoking.

Summary

Alcohol is the substance that is used by the greater percent of the population who use substances. Its use begins early, and the percent of users peaks in early adulthood. Its use continues to be high during adulthood, but the percent of users declines with age.

Summary

Alcohol is strongly associated with the leading causes of death among the population under 20 years old: motor vehicle crashes, homicides and suicides.

Although it can be classified as the main problem of the state, the use of other substances such as inhalants at early age, cocaine, and other drugs cannot be ignored.

GOALS

To reduce the percentage of adolescents who begin experimenting with alcohol, tobacco and other drugs by age 13.

To reduce the percentage of binge drinkers among underage and young adults (18 to 25)

To reduce the rates of intoxicated drivers involved in MVF especially among the 16 to 25 age group.

substance abuse trends and consequences martin arocena

Documents

state slide

consumption slide

population data slide

age of initiation slide

gender ethnicity slide

drug use

past month

use of inhalants