Good News, Bad News

An inventory of youth risk behavior in America

Posted Sep 07, 2018

Pina Messina on Unsplash
Source: Pina Messina on Unsplash

When it comes to the topic of youth risk behavior, recent data (and events) present both good news and bad news. Let’s start with the good news.

A Youth Risk Behavior Survey report from the Centers for Disease Control and Prevention (CDC), meant to focus Americans on youth behaviors related to health and safety, was recently analyzed by The New York Times (Kann et al, 2017). What did they find? Compared to survey results from ten years ago, fewer kids report having had sex, drinking alcohol or using a host of other drugs (Hoffman, 2018).

Similarly, the Institute for Behavior and Health (IBH) collaborated with Sharon Levy, MD, Director of the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital, on a historic study recently published in Pediatrics (Levy et al, 2018). It documents the encouraging trend of an increased percentage of American youth who refrain from using any alcohol, cigarettes, marijuana or other drugs (DuPont, 2018).

IBH, a collaborator at the Center for Adolescent Research and Education (CARE), believes that youth substance use is a prevalent modifiable health behavior, thus understanding long-term trends is essential to inform prevention efforts and public health policy (CARE, 2018).

Indeed, prevention is the cornerstone of IBH’s One Choice initiative. IBH analyzed data from the National Survey on Drug Use and Health (NSDUH) from the Substance Abuse and Mental Health Services Administration (SAMHSA) showing that “the use by teens age 12 to 17 of any one of the three gateway drugs – alcohol, cigarettes or marijuana – dramatically increases the likelihood of use of the other two substances and other illicit drugs” (DuPont, 2017). Likewise, not using any one of these three drugs decreases the likelihood of using other drugs (DuPont et al, 2018).

Robert DuPont, MD, IBH founder and president, says, “One Choice is a consistent, clear social messaging concept designed to encourage young people under 21 not to use any alcohol, tobacco, marijuana or other drugs to protect their health, especially the health of their brains. At present, prevention efforts tend to focus on a single substance or circumstance, e.g., only marijuana, only alcohol or binge drinking, or not drinking and driving. One Choice cuts through these details and centers in on the single decision that teens face every day: whether or not to use any substance at all” (DuPont, 2017). It can be a hard choice.

So what’s the bad news?

According to the CDC study, one in seven high school students (14 percent) disclosed misuse of prescription opioids. While comparable data is not available because this was the first CDC survey measuring that behavior, this opioid misuse raises a red flag about the epidemic of youth prescription drug use (Hoffman, 2018).

Comparable or not, one thing is for sure: America is facing an opioid crisis of untold proportions.

The Opioid Center of Support, which was launched last week in conjunction with International Overdose Awareness Day and National Recovery Month, says opioids are responsible for the largest drug epidemic in our country’s history (Business Wire, 2018). In response, Center co-founders Vera Bullock and Curtis Hougland have created an online platform for the 14.2 million Americans coping with opioid misuse. They explain that the platform helps caregivers – families, friends, classmates, and colleagues – provide more informed assistance to loved ones misusing opioids, including heroin, fentanyl and prescription pain killers. The Center “organizes the most trusted resources on opioid misuse in one place online, for the first time.”

Among other reasons, the Center was “conceived as an antidote to the predatory treatment center ads, dense government sites, and scientific jargon dominating search results on opioids,” Hougland says. He adds, “While the Internet is the first-line of discovery for most people, there is an alarming lack of evidence-based resources that are helpful. More than 50% of opioid-related Google results are from organizations that don’t reveal that they are commercial. And, fewer than 8% of resources are intended for those impacted by the opioid misuse of a friend or family member despite the strong evidence of the role of community in recovery” (Business Wire, 2018).

Also of note is the work of the Opioid Policy Research Collaborative (OPRC) established at Brandeis University last November. The OPRC seeks to help government and public health officials align policies and laws with the realities of the epidemic, according to co-director Andrew Kolodny. “What are the right ways to try to prevent people from getting addicted? That’s what we want to study at the OPRC,” Kolodny added.

OPRC plays a prominent role in four key areas (Brandeis University, 2018):

  • Providing Cutting-Edge Research: OPRC generates research to objectively evaluate local, state and national interventions and policies that have been implemented in response to the opioid crisis.
  • Offering Innovative Policy Initiatives: OPRC develops evidence-based guidance and recommendations for a wide range of stakeholders, including federal, state and local government agencies, health care systems, and industry.
  • Serving as a Convener and Collaborator: OPRC brings together researchers, clinicians and policymakers from diverse disciplines to develop coordinated strategies for responding to the opioid addiction epidemic. The Collaborative creates opportunities for university faculty to collaborate with other top researchers in the fields of public health, health services research, epidemiology, addiction treatment, medical education and drug policy. 
  • Communicating Activities, Outcomes and Accomplishments: OPRC shares findings from innovative research and policy initiatives across academic, medical, nonprofit and government fields. OPRC works closely with media outlets to highlight key accomplishments for an even wider audience.

Additional work is being pursued by McCann Health in collaboration with CARE (PharmaLive, 2018). Their “Pay The Price” campaign around youth prescription drug use is anchored by an award-nominated short film developed as a way to demonstrate starkly the risks for young people associated with the elicit use of medications prescribed by medical professionals (Pay the Price, 2017).

Jeremy Perrott, McCann Health Global Chief Creative Officer, intended the film “to be a wake-up call that delivers a shocking moment of truth, like a stinging slap across the face. The visual style of filming the teenage boy’s first-person point of view delivers an immersive and immediate experience that shines a light on the danger of what can happen if parents do not take steps to create a prescription drug safe home” (PharmaLive, 2018).

Perrott continued, “We needed to address the incredible facts and be deliberately confrontational with a message that equaled the punch of the cold, hard statistics. Drunk driving deaths in the U.S. per day: 28. Suicide deaths in the U.S. per day: 120+ and Rx drug abuse deaths in the U.S. per day: 290 and counting.”

When good news is sobered by bad news, all of this innovative work is instrumental in updating our inventory of youth risk behaviors and taking action to protect America’s kids.

References

Brandeis University. (2018). Opioid Policy Research Collaborative. Schneider Institutes for Health Policy. Institute for Behavioral Health. The Heller School for Social Policy and Management. http://heller.brandeis.edu/opioid-policy/ (6 Sept. 2018).

Brandeis University. (2017). Brandeis launches Opioid Policy Research Collaborative. November 17, 2017. http://www.brandeis.edu/now/2017/november/slideshow-oprc.html (6 Sept. 2018).

Business Wire. (2018). The Opioid Center of Support announces free online support center for caregivers fighting the largest drug epidemic in U.S. history.  https://www.businesswire.com/news/home/20180827005357/en/Opioid-Center-Support-Announces-Free-Online-Support (6 Sept. 2018).

CARE. (2018). Center for Adolescent Research and Education. https://ecareforkids.org/ (6 Sept. 2018).

DuPont, R., Han, B., Shea, C. and B. Madras. (2018). Drug use among youth: National survey data support a common liability of all drug use. Preventive Medicine. Volume 113, August 2018. https://www.ncbi.nlm.nih.gov/pubmed/29758306 (6 Sept. 2018).

DuPont, R. (2018). Reducing rates of adult addiction must begin with youth prevention. One Choice. https://www.preventteendruguse.org/ (6 Sept. 2018).

DuPont, R. (2017). For a healthy brain, teens make “One Choice”.  Institute on Behavior and Health. https://static1.squarespace.com/static/58b590e5c534a5d38a84f013/t/5a7333ad71c10b8019558370/1517499310143/IBH_Commentary_One_Choice_10-23-17.pdf (6 Sept. 2018).

Hoffman, J. (2018). Sex and drugs decline among teens, but depression and suicidal thoughts grow. The New York Times. June 14, 2018. https://www.nytimes.com/2018/06/14/health/youth-risk-depression-suicide-opioids.html (6 Sept. 2018).

Kann, L. PhD, McManus, T. MS, Harris, W. MM. et al. (2017). Youth risk behavior surveillance – United States, 2017. Surveillance Summaries. Morbidity and Mortality Weekly Report. June15, 2018. Vol. 67, No. 8.  Centers for Disease Control and Prevention. https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf (6 Sept. 2018).

Levy, S., Campbell, M., Shea, C. and R. DuPont. Trends in abstaining from substance use in adolescents: 1975-2014. Pediatrics. August 2018. Volume 142, Issue 2. American Academy of Pediatrics. http://pediatrics.aappublications.org/content/142/2/e20173498?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token (6 Sept. 2018).

Opioid Center of Support. (2018). Welcome to the Opioid Center of Support. http://www.opioidcenterofsupport.org/ (6 Sept. 2018).

Pay the Price. (2017). Pay attention or pay the price. https://paytheprice.org/ (6 Sept. 2018).

PharmaLive. (2018). McCann Health & CARE confront the harsh reality of death by overdose from prescription drugs. PharmaLive. December 14, 2017. http://www.pharmalive.com/mccann-health-care-confront-the-harsh-reality-of-death-by-overdose-from-prescription-drugs/ (6 Sept. 2018).