Decreasing Illicit Drug Use in Adolescents

1. Decreasing Illicit Drug Use in Adolescents Carolyn Rosa, BSN RN PNP/PHL Progam at UVA GNUR 8610

2. Abstract • Substance use & abuse begins frequently in teen years • Currently, the CDC (2011) reports 22 million adults struggle with substance abuse • Healthy People 2020 encourages the use of environmental and societal factors to influence adolescents in making healthy choices for their futures • Expansion is needed for current programs to include more strategies for illicit drug education and prevention, directed by social network approach • Incorporate social networking sites • Text messages • Peer support

3. Illicit Substance Abuse in Adolescents • Adolescents: 10-19 years in age • Substance abuse has massive effect on society • Associated with risk of teenage pregnancy, HIV/AIDS, other sexually transmitted diseases, domestic abuse, child abuse, motor vehicle crashes and deaths, crime, homicide and suicide (Healthy People 2020) • 2009 CDC Youth Risk Behavioral Surveillance Survey shows that marijuana and prescription drug use common -36.8% of students have tried marijuana at least once in their life -20.2% of students have used prescription drugs

4. Elevation of Issue • 2005 reported 22,400 unintentional and intentional drug overdose deaths (Paulozzi, 2008). • Increase in ER visits for MDMA and GBH in teenagers (Banken, 2006) • Dramatic increase in high risk drugs • Between 1993 and 2005 there was a dramatic increase between non-medical use of prescription painkillers (343%), stimulants (93%), tranquilizers (450%) and sedatives (225%) (Benotsch, Koester, Luckman, Martin, & Cejka, 2011)

5. Lasting effects of prevention programs are questionable In 2008, Sloboda et al. performed a study that examined the reports of substance abuse programs in schools, and found that many of the students did not acknoweldge they had received information on illegal drugs within one year Team approach In 2010, Inman, Van Bakergem, Larosa and Garr did a review of evidence based programs for health promotion in schools and implementation of these programs and found using a team approach enhanced the success of any such program Project Alert found to be only program that increased illegal drug refusals Reivew of Literature

6. Review of Literature • Prevention found to be slightly more effective in middle school (Goffredson & Wilson, 2003) • Delivery by teachers showed conflicting research (O'Leary-Barrett, Mackie, Castellanos-Ryan, Al-Khudhairy, & , 2010) • High risk youth and social networking • 2011 study by Rice, Milburn and Monro showed social networking is essential for adolescents • Homeless youths using social networking to stay in contact with a positive role model had less substance abuse

7. Goal of ProjectALERT+ • To expand upon the success of ProjectALERT using the social network approach and social ecology model to decrease illicit drug use in adolescents • ProjectALERT for 7th and 8th grade • Taught by teachers • Address drug abuse specifically • Uses role playing, discussion, video (Project Alert, 2011) • Additional components: • Peer educators using Facebook • Weekly text messages • Role models from community high school

8. Implementation • Social network approach within social ecology model • Addresses education of student based on school family life, media, social networks and local culture (Gorin & Arnold, 2006). • Utilizes the environment to encourage adolescents to make positive choices about their future

9. Responsibilities for Implementation • Project Director responsibilities • Assess adolescent community in regards to drug use • Implement ProjectALERT • Year one: Project ALERT • Year two: Train peer support for Facebook community • Recruit and train roles moels • Enroll students in text messaging • Collect baseline data on effect of ProjectALERT • Year three: Implement ProjectALERT+ • Collect data on effect of ProjectALERT+

10. Innovation • Specifically targets illicit drug use • Follow-up research will allow for data on illicit drug prevention only • Utilizes social networks and technology • Makes the program community specific • New way to utilize social network approach

11. Evaluation • Qualitative evaluation • Interviews with peer support and role models for program feedback • Quantitative evaluation • Self-report online survey on community-specific abused drugs • Comparison to baseline ProjectALERT data • CDC Health Risk Behavior Survey county specific (ie Lexington, MA) (Youth Behavior Risk Surveillance Survey CDC, 2007) • Before and after

12. Budget Estimation • Expenses include: • Project director salary • ProjectALERT program ($150/educator) • Classroom materials to implement program • Group text service • Website space • Training funds • Evaluation

13. For a drug free tomorrow…

14. References • Banken, J.A. (2006). Drug abuse trends among youths in the United States. Annals of the • New York Academy of Sciences, (1025) 465-471. • Benotsch, E.G., Koester, S., Luckman, D., Martin, A.M. & Cejka, A.(2011). Non- • medical use of prescription drugs and sexual risk behavior in young adults. • Addictive behaviors (36)12, 152-155. • Centers for Disease Control and Prevention (2011). Adolescent and School Health. • Retrieved from http://www.cdc.gov/HealthyYouth/yrbs/index.htm on June 6, • 2011. • Edberg, M. (2007). Essentials of Health Behavioral Social and Behavioral Theory in • Public Health. Sudbury, MA: Jones and Bartlett Publishers. • Goffredson, D.C., & Wilson, D.B. (2003). Characteristics of school based substance • abuse prevention programs. Prevention Science: the official Journal for the Society of Prevention Research (4)1. • Gorin, S. S. & Arnold, J. (2006). Health Promotion in Practice. San Francisco, CA: • Jossey-Bass.

15. References • Healthy People 2020 (2011). Adolescent Health & Educational and Community Based • Programs & Substance Abuse . Retrieved from: http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=2 on June 11, 2011. • Humenskey, J. (2010). Are adolescents with high socioeconomic status more likely to • engage in alcohol and illicit drug use in early adulthood? Substance abuse • treatment, prevention and policy (5) 5, 19. • Inman, D.D., Van Bakergem, K.M., Larosa, A.C. & Garr, D.R. (2010). Evidence-Based • Health Promotion Programs for Schools and Communities. American Journal of • Preventive Medicine (40)2. • Litt, DM & Stock, ML (2011). Adolescent alcohol-related risk cognitions: The roles of • social norms and social networking sites. Psychology of Addictive Behaviors: • Journal of the Psychologists of Addictive Behavior, 6. • O'Leary-Barrett, M., Mackie, C.J, Castellanos-Ryan, N., Al-Khudhairy, N. & Conrod, P.J. (2010). Personality-targeted interventions delay uptake of drinking and • decrease risk of alcohol-related problems when delivered by teachers. Journal of • the American Academy of Child and Adolescent Psychology (49)9. • Patrick, M.E., Schulenberg, J.E., O'Malley, P.M., Johnston, L.D. & Bachman, J.G. • (2011). Adolescents' Reported Reasons for Alcohol and Marijuana Use as Predictors of Substance Use and Problems in Adulthood. Journal of studies on alcohol and drugs (72)1. • Paulozzi (2008). Testimony. Retrieved from: http://www.hhs.gov/asl/testify/2008/03/t20080312b.html

16. References • Project Alert (2011). Retrieved from http://www.projectalert.com/about/highlights on June 10, 2011. • Ramchand R., Griffin B.A., Suttorp M., Harris K.M. & Morral A (2011).Using a Cross- • Study Design to Assess the Efficacy of Motivational Enhancement Therapy- • Cognitive Behavioral Therapy 5 (MET/CBT5) in Treating Adolescents with Cannabis-Related Disorders. Journal of studies on alcohol and drugs (72)3. • Rice, E., Milburn, N.G. & Monro (2011). Social Networking Technology, Social • Network Composition, and Reductions in Substance Use Among Homeless Adolescents. Prevention Science (12)1, 80-88. • Rhew, I.C., Hawkins, D.J. & Oesterle, D (2011). Drug use and risk among youth in • different rural contexts. Health & Place (17)3, 775-785. • Sloboda, Z., Pyakuryal, A., Stephens, P.C., Teasdale, B., Forrest, D., Stephens, D.C. & • Grey, S.F. (2008). Reports of substance abuse prevention programming available in schools. Prevention Science: the official Journal for the Society of Prevention Research (9)1, 27-38. • Terry-McElrath Y.M., O'Malley P.M., & Johnston L.D (2010). Exercise and substance • use among American youth, 1991-2009. American Journal of Preventative • Medicine (40)5, 530-540.