Scott Caldwell

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Dane Co. Youth and Drinking What the Data Shows
and What We Should Do About It

• Scott Caldwell Connie Bettin
• Presentation to the recently formed Coalition
• Madison, WI
• January 5, 2009

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Three considerations

• Adolescence is a unique and powerful
  developmental period
• Alcohol use impacts teens differently than adults
• There are multiple pathways to effective
  prevention and intervention

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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

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

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Adolescent Neuroscience

• New science
• Insights into teen behaviors
• Implications for parents, counselors, educators,
  policy makers

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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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Research These areas are still developing during
adolescence
CEO judgment, decision making, planning ahead
Directs motivation
amygdala
Regulates emotion
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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

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Why should we be concerned about teen drinking?

• Alcohol use amplifies the vulnerabilities.

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Analysis of Dane Co. youth Brian Koenig,
Principal Investigator

• 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

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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
77
77
Source DCYA (2005)
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Teen drinking is associated with

• Reduced sensitivity to intoxication
• Involvement with other drugs

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

• Reduced sensitivity to intoxication
• Involvement with other drug use
• Risk taking

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

• Reduced sensitivity to intoxication
• Involvement with other drug use
• Risk taking
• Risk for cognitive deficits

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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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Teen drinking is associated with

• Reduced sensitivity to intoxication
• Involvement with other drug use
• Risk taking
• Risk for cognitive deficits
• School difficulties

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Current drinking corresponds with decreased
school connection, attendance, and grades
Source DCYA (2005)
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Teen drinking is associated with

• Reduced sensitivity to intoxication
• Involvement with other drug use
• Risk taking
• Risk for cognitive deficits
• School difficulties
• Co-occurring problems

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Drinking among HS students is linked to
co-occurring problems
Source DCYA (2005)
Any past year delinquency
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Teen drinking is associated with

• 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

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Percentages of Past Year Alcohol Problems among
Adults Aged 21 or Older, by Age of First Use
Source SAMHSA (2005)
Early age drinking increases future risk by 6
times
Age Started Drinking
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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

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Five areas to consider

1. Involve parents and families

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My parents think its wrong to drink alcohol
( strongly agree)
AVE 42
Source DCYA (2005)
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My parents know what Im doing after school
( very often)
AVE 54
Source DCYA (2005)
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Five areas to consider

• Involve parents and families
• Increase youth perception of risk for alcohol
  effects (demand)
• Address alcohol accessibility (supply)
• Address alcohol marketing to youth
• 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