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Archive for June 2010

Surgeon General’s Call to Action

             This is three years old but, just as relevant today as it was then. I hope you take the time to read it. It is an important reminder that our kids need us . I recommend you click the embedded link and read the entire message, it really puts the focus on underage drinking and offers some real solutions.

Alcohol is the most widely used substance of abuse among America’s youth. A higher percentage of young people between the ages of 12 and 20 use alcohol than use tobacco or illicit drugs. The physical consequences of underage alcohol use range from medical problems to death by alcohol poisoning, and alcohol plays a significant role in risky sexual behavior, physical and sexual assaults, various types of injuries, and suicide. Underage drinking also creates secondhand effects for others, drinkers and nondrinkers alike, including car crashes from drunk driving, that put every child at risk. Underage alcohol consumption is a major societal problem with enormous health and safety consequences and will demand the Nation’s attention and committed efforts to solve.

For the most part, parents and other adults underestimate the number of adolescents who use alcohol. They underestimate how early drinking begins, the amount of alcohol adolescents consume, the many risks that alcohol consumption creates for adolescents, and the nature and extent of the consequences to both drinkers and nondrinkers. Too often, parents are inclined to believe, “Not my child.” Yet, by age 15, approximately onehalf of America’s boys and girls have had a whole drink of alcohol, not just a few sips, and the highest prevalence of alcohol dependence in any age group is among people ages 18 to 20.

I have issued this Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking to focus national attention on this enduring problem and on new, disturbing research which indicates that the developing adolescent brain may be particularly susceptible to longterm negative consequences from alcohol use. Recent studies show that alcohol consumption has the potential to trigger longterm biological changes that may have detrimental effects on the developing adolescent brain, including neurocognitive impairment.

Fortunately, the latest research also offers hopeful new possibilities for prevention and intervention by furthering our understanding of underage alcohol use as a developmental phenomenon—as a behavior directly related to maturational processes in adolescence. New research explains why adolescents use alcohol differently from adults, why they react uniquely to it, and why alcohol can pose such a powerful attraction to adolescents, with unpredictable and potentially devastating outcomes.

Emerging research also makes it clear that an adolescent’s decision to use alcohol is influenced by multiple factors. These factors include normal maturational changes that all adolescents experience; genetic, psychological, and social factors specific to each adolescent; and the various social and cultural environments that surround adolescents, including their families, schools, and communities. These factors—some of which protect adolescents from alcohol use and some of which put them at risk— change during the course of adolescence. Because environmental factors play such a significant role, responsibility for the prevention and reduction of underage drinking extends beyond the parents of adolescents, their schools, and communities. It is the collective responsibility of the Nation as a whole and of each of us individually.

The process of solving the public health problem of underage alcohol use begins with an examination of our own attitudes toward underage drinking and our recognition of the seriousness of its consequences for adolescents, their families, and society as a whole. Adolescent alcohol use is not an acceptable rite of passage but a serious threat to adolescent development and health, as the statistics related to adolescent impairment, injury, and death attest.

A significant point of the Call to Action is this: Underage alcohol use is not inevitable, and schools, parents, and other adults are not powerless to stop it. The latest research demonstrates a compelling need to address alcohol use early, continuously, and in the context of human development using a systematic approach that spans childhood through adolescence into adulthood. Such an approach is described in this Call to Action. Such an approach can be effective when, as a Nation and individually, we commit ourselves to solving the problem of underage drinking in America. We owe nothing less to our children and our country. Kenneth P. Moritsugu, M.D., M.P.H. vii

The Right Drug to Target!!!

The increased potency of today’s marijuana and the greater knowledge we have of the dangers of using marijuana justify the increased attention that law enforcement is giving to illegal possession of the drug. But the disappointing reality is that a nearly 30 percent increase in marijuana arrests does not translate into a comparable reduction in use of the drug. Something more is needed.Rudolph Giuliani’s success in slashing New York City’s crime rate by, among other things, going after low-level street crimes such as smoking and selling small amounts of marijuana inspired many other mayors to follow suit. When President Bush announced in 2002 a goal of reducing illegal drug use by 10 percent in two years and 25 percent in five years, he knew he had to focus on cutting marijuana use. Eliminating all other illegal drug use combined would not even get him close to his highly touted objective.

From the standpoint of protecting children, teens and the public health, reducing marijuana use makes eminent sense. For even though marijuana use has leveled off or waned slightly over the past several years, the number of children and teenagers in treatment for marijuana dependence and abuse has jumped 142 percent since 1992, and the number of teen emergency room admissions in which marijuana is implicated is up almost 50 percent since 1999. Though alcohol remains by far the teen substance of choice, teens are three times likelier to be in treatment for marijuana than for alcohol (and six times likelier to be in treatment for marijuana than for all other illegal drugs combined).

As has been true of tobacco since the 1960s, we’ve learned a lot about the dangers of marijuana since the 1970s. The drug adversely affects short-term memory, the ability to concentrate and motor skills. Recent studies indicate that it increases the likelihood of depression, schizophrenia and other serious mental health problems. Nora Volkow, director of the National Institute on Drug Abuse, has repeatedly expressed concern about the adverse impact of marijuana on the brain, a matter of particular moment for youngsters whose brains are still in the development stage. Volkow has stated: “There is no question marijuana can be addictive; that argument is over. The most important thing right now is to understand the vulnerability of young, developing brains to these increased concentrations of cannabis.”

The issue of marijuana use (and most illegal drug use) is all about kids. If we can get kids not to smoke marijuana before they reach age 21, they are virtually certain never to do so. So let’s do more than trumpet the arrest rate. Let’s focus on discouraging children and teens from getting involved with the drug in the first place.

This begins with understanding the importance of preventing kids from becoming cigarette smokers. Most kids who smoke cigarettes will not smoke marijuana, but a 2003 survey of 12- to 17-year-olds, conducted by the National Center on Addiction and Substance Abuse (CASA) at Columbia University, reveals that teens who smoke cigarettes are much likelier than non-smokers to try marijuana; they are also likelier to become regular marijuana users.

The next question is how to make public policies, including law enforcement approaches, more effective in discouraging marijuana use. Availability is the mother of use, so doing a far better job of reducing availability is high on the list. Beyond that — and recognizing that reducing demand is key to that goal — we should use the increased arrest rate as an opportunity to discourage use.

Years ago, while I was visiting Los Angeles, then-Mayor Dick Riordan told me that in his city kids were arrested an average of nine times for possession of marijuana before anything happened to them. I have since discovered that this situation is common in many American communities. Most kids do not even get a slap on the wrist the first few times they’re nabbed for smoking a joint. As a result, we let them sink deeper and deeper into drug use, with its dangers to their physical, mental and emotional development and its risk of addiction.

I am not suggesting that we put kids in jail for smoking pot. But why not treat a teen arrested for marijuana use much the same way we treat a teen arrested for drunk driving? Why not require kids arrested for marijuana possession to attend classes to learn about the dangers of marijuana use and to develop some skills (and the will) to decline the next time they are offered the drug? The incentive to attend such classes would be the threat of the alternative: for the first couple of arrests, loss of a driver’s license or a fine stiff enough to hurt; for continued use, a few nights in a local prison. Getting kids to attend sessions designed to discourage their marijuana use would give some practical meaning to increased law enforcement and would bring reductions in drug use more in line with increased arrest rates.

These steps will help, but the fact is that we cannot arrest our way out of the teen marijuana problem when (in a recent CASA survey) 40 percent of 12- to 17-year-olds report that they can buy the drug within a day, and 21 percent say they can buy it within an hour.

Parents are the first line of defense. Parents must understand that the drug available today is far more potent than what they might have smoked in the 1970s. For their children, smoking marijuana is not a harmless rite of passage but rather a dangerous game of Russian roulette.

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