Substance Abuse Trends and Consequences

1
Substance Abuse Trends and Consequences

• Martin Arocena

2
Outline

• Introduction
• Substance Consumption Patterns
• Consequences
• Need Assessment and Identification of Critical
  Needs

3
Strategic Prevention Framework

• DSHS applied for and received a grant to
  participate in SAMHSAs Strategic Prevention
  Framework initiative.
• Part of the requirements of the grant is that
  each funded state organize a state
  epidemiological workgroup (SEW).

4
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 states status on them

5
State Epi Workgroup

• Identify the states 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.

6
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 receive 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.

7
State Epi Workgroup

• Drs. Cervantes and Rey from Behavioral Assessment
  Inc. as the 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 databases to us
  and we performed the statistical analyses and
  reporting.

8
Databases Consulted

• Consumption
• 2002-2003 National Survey on Drug Use and Health
• 2004 Texas School Survey
• 2000 Texas Survey of Substance Abuse among Adults
• Behavioral Risk Factor Surveillance, and
• Youth Risk Behavior Surveillance System

9

• 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
• Heavy drinking

10
Consequences

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

11
Databases Consulted

• Consequences
• 2003 Fatalities Analyses Reporting System
• 2003 Uniform Crime Reports
• Vital Statistics
• Census of the Population data

12
Age of Initiation
13
(No Transcript)
14
(No Transcript)
15
(No Transcript)
16
(No Transcript)
17
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).

18
(No Transcript)
19
Binge Drinking

• Binge Drinking
• Among 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

20
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.

21
(No Transcript)
22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
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

27
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.

28
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.

29
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.

30
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.

31
CONSEQUENCES

• CONSEQUENCES

32
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).

33
Substance Abuse Dependence

• 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.

34
Substance Abuse Dependence

• 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.

35
Substance Abuse Dependence

• 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

36
Motor Vehicle Fatalities

• Texas was the state with the largest number of
  alcohol-related fatalities in the nation. Of the
  total 3,765 in the state, 1,709 (47) were
  alcohol-related. It is higher than the national
  average, 41.

37
Motor Vehicle Fatalities

• In 2003, of the 4,917 drivers involved in a car
  crash that resulted in a fatality, 1,447 (29.3)
  were intoxicated with alcohol.
• The age-group with the highest percentage of
  drunk drivers was the 21 29 years old group
  (38).

38
Motor Vehicle Fatalities

• The counties with the larger metropolitan areas
  of the state have the larger number of MVF and
  had the higher number of intoxicated drivers
  involved in fatalities.

39
Motor Vehicle Fatalities

• 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.

40
Motor Vehicle Fatalities

• The next slide will show 18 counties with a high
  concentration of MVF in 2003 and where about 67
  of the population live. Together these 18
  counties had
• 52 of the 1,828 drivers involved in a MVF from
  the age-group.
• 56 of the 644 intoxicated drivers involved in a
  MVF from the same age group.

41
Motor Vehicle Fatalities

• Fort Bend (s. of H) 26 7.0
• Grayson (border with Ok) 12 7.6
• Smith (Tyler) 27 7.9
• Jefferson (border with La) 24 8.1
• Cameron (Brownsville) 21 9.0
• Nueces (Corpus) 15 9.1
• Bell (Ft. Hood) 32 9.4
• Denton 33 10.1
• Lubbock

42
Motor Vehicle Fatalities

• Collin (N. of Dallas) 23 11.8
• Montgomery (N. of H) 49 12.9
• El Paso 35 18.1
• Travis (Austin) 57 21.2
• Hidalgo (Harlingen) 58 21.4
• Tarrant (Ft. Worth) 63 21.4
• Bexar (San Antonio) 79 35.9
• Dallas 152 51.7
• Harris (Houston) 220 87.0

43
Motor Vehicle Fatalities
44
(No Transcript)
45
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.

46
Homicides

• Texas homicide rate, 6.9 per 100 K population is
  higher than the United States. The 18 to 29 age
  group had the highest homicide rate.
• In Texas, the homicide rate statistics reveal a
  disparity by ethnic/racial group. Although
  African-Americans have lower rates of substance
  abuse prevalence, they have higher rates of
  homicides.

47
Suicide

• Alcohol and other drugs are a contributing factor
  in suicides.
• There were 2,354 suicides in Texas in 2,003. It
  is very prevalent among the older group,
  especially whites.
• Suicide rates are high among native-Americans.

48
Chronic Liver Disease

• The states 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.

49
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.

50
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.

51
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.

52
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 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.

53
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.