Healthnetwork.org

It’s a complex world out there and prevention needs to keep up, particularly school-based programs and teaching.

So many curricula emphasize teaching facts and information, easy to test and grade. BUT knowledge does not translate into healthy/safe behaviors. We need to focus on attitudes and skills.

One way of influencing attitudes is to explore stereotypes. Ask the group what an addict looks like. Most think an addict is under 30, wears black clothing, poor grooming, and skulks around the outskirts of society. Why is this the stereotype? Explain how stereotypes are “short hand” memory devices based on quick, repetitive impressions from many sources. In this case, most of their sources are mass media, which portray addicts this way for plot purposes or for quick character recognition–information they should be aware of to be savvy media consumers. This is a good opportunity to discuss the process of addiction and intervention. Review and expand on this topic several times to insure better understanding and recall.

In order to be relevant and engaging, state-of-the-art prevention must be multi-modal. Use short video clips, internet, etc. In fact, some of the best projects can be computer-based if they also include critical thinking and connection to a teen’s life and goals. Dialogue, debate and discussion create critical thought paths from facts to real life, and from facts to personal relevance.

Teens must be active participants in their education, particularly drug prevention education. Didactic methods of one-way information dispersal is not the most effective for the 21st century teen. Today’s teen wants to connect with ideas, wants seek out information and content, and synthesize it into new learning. This is what they’re doing already, following links, building memories and knowledge related to their interests (music, politics, celebrities, etc.)

We need to design a framework for students to take charge of their leaning, then step back and let them dig in for a while. It is fascinating to find out where their research takes them, and they will need adult assistance to separate fact from fiction. In fact, one way to allow them to share what they’ve learned is to ask students to pose 6 or 7 “fact or fiction” questions to the class. The class can guess and explore ideas, then listen to the student researcher tell more about what he/she has learned. Being an expert and explaining ideas helps reinforce self-efficacy, and also sets the student up as a resource for others.

This generation of youth is particularly devoted to improving the planet and social causes. Use those interests to help them harness their energy for positive prevention, health and safety. Individual, small group and class projects can range from writing letters to local politicians to advocacy at local forums and meetings to connecting with national or international groups.

Prevention must move into the 21st century now!

“Our Drug Policy Is a Success”

by John Walters, ONDCP Director, Wall Street Journal, December, 1008

http://online.wsj.com/article/SB122843725720181453.html?mod=googlenews_wsj

This article touts successes of drug courts, school drug testing, interdiction, drug treatment. It never mentions drug prevention or community drug coalitions. And it only mentions “illegal drugs” so it’s a little incomplete, since alcohol is the most prevalent drug of abuse.

John Walters says: “The good news in drug policy is that we know what works, and that is moral seriousness …..”

Moral seriousness is not a drug policy, to my knowledge. In my professional opinion, drug policy is serious business, and after three decades of research, we really do know what works:

1) proven prevention strategies and programs
2) sustained, consistent positive messages about health and safety
3) early intervention
4) healthy community norms
5) tax policies that make tobacco and alcohol more difficult for youth to acquire
6) sustained sufficient funding for prevention, intervention, treatment
7) appropriate treatment

As 2008 comes to a close, best wishes for a healthy and safe new year!
Isabel

Over 100 college presidents have asked the country to consider lowering the drinking age. Their public document is known as the Amethyst Initiative, and has generated conversation and controversy. Look it over at: www.amethystinitiative.org

On Thursday September 18, The Journal News, a suburban NY newspaper covering 3 counties, convened a panel of experts to discuss this issue. This was webcast and is available for viewing at:
http://www.lohud.com/apps/pbcs.dll/section?Category=MOGULUS03

Panelists:

–Isabel Burk, Credential Prevention Professional, substance abuse expert
–Norma Canals, Suffern High School counselor
–Lisa Denig, co-chair of Putnam County’s drug & alcohol task force
–Dr. Valencia Douglas, superintendent of Nyack schools
–Ellen Morehouse, Executive Director of Student Assistance Services Corp.
–Barrett Seaman, author of “Binge: Campus Life in an Age of Disconnection and Excess” and director of Choose Responsibility
–Dr. Walter Schneider, vice president/dean of students at St. Thomas Aquinas College
–Dr. Thomas Schwarz, president of Purchase College, SUNY, signer of Amethyst Initiative

I’m sure this issue will be a very hot topic this fall and in 2009.

The US Substance Abuse and Mental Health Services Administration released a report in August 2008 that reveals important information about youth who have used inhalants in the past year: they are twice as likely to have experienced a major depressive episode within the past year as well. And among female teens, the rate is triple that of non-inhalant users.

The report concludes that clinicians and parents monitoring teens for depression should be alert to the potential for inhalant abuse and other substance abuse. In addition, teens involved with inhalants should be screened for depression or other mental health issues.

To see the full report: http://download.ncadi.samhsa.gov/prevline/pdfs/NSDUH08-0821.pdf

A report by University of Massachusetts Medical School toxicologist Richard Church (June, 2008) tracked 4,600 caffeine-related calls to poison control nationwide in 2005, the most recent statistics available. Half involved people under age 19. 2345 calls involved treatment in a healthcare facility.
Articles and interviews with Dr. Church elaborate on the problem of youth and adults consuming many different caffeine products and experiencing serious symptoms such as heart palpitations, dizziness, pounding in the chest, nausea, vomiting. Dr. Church said that people who have predisposed seizure conditions can be at risk for having seizures. People with predisposed heart conditions can have potentially life-threatening abnormal rhythms in their heart.”

Energy Drinks: The New Eye-Opener for Adolescents, Babu, Church, Lewander,
Clinical Pediatric Emergency Medicine, 9:35-42, 2008

The NY Times reports on the front page, August 17, about MDs prescribing methadone for pain management and some fatal results. Some experts believe doctors who prescribe the medication for pain management don”t have sufficient bio-medical knowledge of how methadone is metabolized, or how patients can experience different effects. Physicians might prescribe too much of the drug too fast, and patients are not aware of the risks of using alcohol or other medications with the methadone.

It’s been clear from the abuse angle that OxyContin and related compounds are being abused by circumventing the drugs’ normal dosage and administration. Methadone deaths now being reported, about 4600+ in 2006, are mostly related to medical purposes, not deliberate abuse. The article points out that methadone is relatively inexpensive, so insurance companies encourage doctors to select it rather than more expensive options such as OxyContin.

Interesting history for methadone, isn’t it?

More than half of all consumers go online to look for prescription drug information, vs. 41% in 2007, says a newly released survey conducted by Prevention, Men’s Health and Women’s Health magazines, with technical assistance from the U.S. Food and Drug Administration (FDA). This annual survey on Direct-to-Consumer (DTC) advertising looks at many different aspects of the issue since the FDA first allowed DTC marketing in America in 1997.

The 11th annual survey on Consumer Reaction to DTC Advertising of Prescription Medicine also reported that:
—58% of consumers are currently taking a prescription drug, compared to 47% ten years ago.
—Over a 5-year average, among every person who saw a DTC ad, 73% of the consumers talked to their doctor about a medicine while 25% asked the doctor to prescribe it.
—Of those who just talked about the drug, 25% received the prescription for the advertised medicine.
—Of those who specifically asked for the advertised drug, 77% received the prescription.

BusinessWeek (8/31/07) reports that pharmaceutical companies spent $5.3 billion on advertisements in 2006, up 14% from the year before. The DTC survey reinforced the impact of these marketing efforts, finding that three-fourths of consumers believe that TV and magazine advertising are useful in conveying a drug’s benefits and risks.

DTC marketing of pharmaceutical products probably made a big difference in the introduction and success of Viagra starting in 1998. It’s not easy to discuss personal issues with a healthcare provider, but the marketing campaigns depicted people who were pleased that they had been able to try the product, serving as role models for others who might be spurred to open up about similar concerns. Other medications for erectile dysfunction soon gained approval, and it is not uncommon to see these ads in all media, TV as well as magazines.

Time will tell how DTC marketing will affect today’s youth and what kind of healthcare consumers they become. While seeking information on the Internet, will they be able to weed out inappropriate content? Will they be able to differentiate products that are useful from products that could be harmful? Will they seek–and act on–advice from professionals?

Time will tell.