PTTC Post Article - April 2024

Guiding your Community in Alcohol Awareness and Alcohol Misuse Prevention

April is Alcohol Awareness Month. Prevention professionals and prevention organizations have been in the forefront of preventing the initiation of substance use and addressing alcohol misuse for decades. Prevention professionals rely on the latest data and research to guide programming and interventions. Some data shows a 29% increase in alcohol-related deaths post-COVID (Esser et al., 2024); that binge-drinking and marijuana/vaping use has increased in certain adult populations (University of Michigan, 2022); but also, that confidence in child/family relationship can positively influence prevention interventions (Kao et al., 1993).

This issue highlights recent research and resources your organizations can use to continue providing effective programming and interventions for multiple populations.

Deaths from Excessive Alcohol Use on the Rise

A new Centers for Disease Control and Prevention (CDC) study assessed deaths from excessive alcohol use and changes in these deaths from 2016 to 2021. The study shows that the average of annual deaths from excessive alcohol use in the US increased by 29% from approximately 138,000 deaths per year during 2016–2017 to approximately178,000 deaths per year during 2020–2021. These 178,000 deaths per year are preventable (Esser et al., 2024).

Focusing on 58 causes of alcohol-related death, the study examined conditions that are fully caused by alcohol use (such as alcoholic liver disease and alcohol use disorder), and those conditions that are partially caused by alcohol use (such as injuries and certain cancers). The study found that the average annual number of deaths from excessive alcohol use increased 26.8%, among males (94,362 per year to 119,606), and 34.7% among females (43,565 per year to 58,701). The overall increase in deaths associated with excessive alcohol use increased 29.3% from 137,927 during 2016–2017 to 178,307 during 2020–2021. Age-standardized alcohol-related death rates increased from 38.1 to 47.6 per 100,000 population (Esser et al., 2024).

 Adolescent Substance Use Behaviors and Overdose

Recent findings from the Monitoring the Future survey show that the percentage of adolescents reporting they used any illicit substances in 2023 continued to hold steady below the pre-pandemic levels reported in 2020. According to the 2023 survey, 10.9% of eighth graders, 19.8% of 10th graders, and 31.2% of 12th graders reported any illicit drug use in the past year (NIDA, 2023).

Monitoring the Future 2022-2023 Comparison

Alcohol Use

Alcohol use remained stable for eighth and 10th graders, with 15.1% and 30.6% reporting use in the past year respectively, and declined for 12th graders, with 45.7% reporting use in the past year (compared to 51.9% in the previous year).

Nicotine Use

Nicotine vaping remained stable for eighth graders, with 11.4% reporting vaping nicotine in the past year. It declined in the older grades, from 20.5% to 17.6% in 10th grade and from 27.3% to 23.2% in 12th grade.

Cannabis Use

Cannabis use remained stable for all three grades surveyed, with 8.3% of eighth graders, 17.8% of 10th graders, and 29.0% of 12th graders reporting cannabis use in the past year.

Of note, 6.5% of eighth graders, 13.1% of 10th graders, and 19.6% of 12th graders reported vaping cannabis within the past year, reflecting a stable trend among all three grades.

However, there is a disturbing trend of increased overdose deaths among teens. It is critical to recognize that the use of certain substances may decline, but the deadly nature of substance use cannot be ignored.  Overdose deaths remained elevated well into 2022 according to a NIDA analysis of CDC and Census data and illustrated in the image below (NIDA, 2023).

Substance Use Behaviors in Adults 19-to-60 years old

The impact of adolescent substance use continues well into adulthood. An annual survey of substance use behaviors and attitudes of adults 19-to-60 years old is compiled in the Monitoring The Future Panel Study Annual Report 2022 (Patrick et al., 2023). The 2022 report shows that binge drinking has remained stable or declined for the past 10 years among younger adults, whereas adults aged 35 to 50 in 2022 reported the highest prevalence of binge drinking ever for this age group. In addition, adults aged 35 to 50 past-year use of marijuana and hallucinogens reached all-time highs in 2022, while in younger adults 19 to 30 marijuana use and vaping were at their highest historic levels (MTF, 2023).

The Importance of Prevention

In a December 2023 National Institute on Drug Abuse (NIDA) news release, NIDA director, Nora Volkow, emphasized the importance of prevention.

“Research has shown that delaying the start of substance use among young people, even by one year, can decrease substance use for the rest of their lives,” Volkow said. “It remains crucial to continue to educate young people about the risks and harms of substance use in an open and honest way, emphasizing that illicit pills and other substances may contain deadly fentany” (NIDA, 2023).

Further evidence for the need for substance use prevention, particularly alcohol misuse prevention, comes from a 2020 study of U.S. National Survey data analyzing responses of 740 parent-child dyads about past 30-day alcohol use (Bohm & Esser, 2023).

The study found that adolescents whose parents binge drank or drank more than weekly, on average, were more likely to drink. The results provide further evidence that underage drinking is correlated with parents and other adults that drink. The findings of this national study suggest that if parents drink less often and avoid binge drinking, they could reduce the likelihood of underage drinking and associated alcohol-related harms (Bohm & Esser, 2023). Bohm and Esser suggest that parent-based interventions and evidence-based population-level interventions can prevent both excessive drinking among adults and underage drinking population. Suggested strategies include

  • Parent-based interventions that promote monitoring, strong communication, and emotional support.
  • Population-level strategies to reduce excessive drinking among both adults and adolescents, including increasing alcohol taxes, enforcing laws prohibiting sales to minors, and maintaining limits on when and where alcohol is sold (Bohm & Esser, 2023).

Effective Action Communities and prevention organizations are instrumental in addressing the related harms due to alcohol misuse. The research shows that different populations, different age groups, and different identifying factors are associated with alcohol use and misuse. Prevention messaging and programs that are designed for specific populations and needs are the most effective. There are several resources and related-research findings to assist communities in implementing community specific, effective prevention policies and programs.

Prevention Technology Transfer Center Network

The Prevention Technology Transfer Center (PTTC) Network develops and disseminates tools and strategies needed to improve the quality of substance abuse prevention efforts. Comprised of 10 Regional Centers and Network Coordinating Office (NCO). The PTTC Network leverages expertise and resources to engage the next generation of prevention professionals.

The purpose PTTC is to improve implementation and delivery of effective substance use/misuse prevention interventions, and provide training and technical assistance services to the substance use/misuse prevention field.  It does this by developing and disseminating tools and strategies needed to improve the quality of prevention efforts; providing intensive technical assistance and learning resources.

Check out two example resources below. Alcohol Awareness Toolkit created by the Northwest PTTC. The Alcohol Awareness Toolkit seeks to raise awareness about alcohol-related harms and the importance of strong alcohol policies using memes, and encourage engagement from prevention and public health stakeholders to strategically educate and inform decision makers about effective alcohol policies by providing easy-to-personalize, templated opinion editorials, letters to legislators and proclamations.

On-line, free course the Introduction to Prevention Core Competencies the course covers a wide variety of topics including prevention science, community organization, need & resource assessment, evidence-based interventions, and more. The Prevention Core Competencies and accompanying knowledge, skills, and abilities offer professional direction to the prevention field, affecting staff development and career ladders and pipelines, and providing guidance for training programs and service delivery qualification.

Alcohol Disparities Research

The Alcohol Research Group (ARG) conducts disparities research that focuses on identifying, understanding, and preventing inequitable alcohol-related health outcomes and conditions experienced by specific population groups.  Such inequities are often identified along racial or ethnic lines but can also be experienced by people who have limited access to health services, live in poorer neighborhoods, or face discrimination because of their gender or sex. The researchers identify knowledge gaps and share expertise and findings to advance health equity. One recent study reveals Disparities in At-Risk Drinking Among People with Diabetes, Cancer, or a Heart Condition and another finds that Black, Hispanic/Latinx, and Younger Adults are Less Likely to Attend AA. In addition to the research findings, ARG provides suggestions for further study and improved practice.

Community Guide to Preventing Alcohol Misuse

In 2022, the Substance Abuse and Mental Health Services Administration (SAMHSA) published a guide Implementing Community-Level Policies to Prevent Alcohol Misuse  to provide an overview of effective prevention policies that can be implemented at the local, state, tribal, and/or territorial levels. It lays out key considerations and strategies for these policies, including the most equitable ways to implement and enforce them.

Healthcare Professionals Resource

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) developed a Healthcare Professional’s Core Resource on Alcohol. The Core Resource provides busy clinicians with easy-to-read articles, insights, and tools to improve alcohol-related healthcare and clinical outcomes. The articles provide free CME/CE credit and focus on basic foundational knowledge of risk factors, vulnerability, stigma, and neuroscience along with in-depth clinical consideration and medical implications.

Online Alcohol Research Report Harvard

Medical School provides a series of online reports in the categories of alcohol, substance use, tobacco use, and gambling use disorders. The report related to alcohol use, The DRAM: Drinking Report for Addiction Medicine provides research highlights on alcohol use disorders. A recent report on culturally-responsive-alcohol-drug-program-native-american-youth found that Native American culturally specific alcohol interventions had longer lasting effects than a program offered for the general population. The study also highlights the need for more financial resources, awareness of, and support for culturally relevant programs targeting alcohol and drug use among Native American youth.

Center for Advancing Alcohol Science to Practice

The Center for Advancing Alcohol Science to Practice (Center) is committed to preventing excessive alcohol use and underage drinking by creating more knowledgeable and connected communities across the nation. The Center provides community and state partners free technical assistance and is developing an Alcohol Epidemiology & Prevention Training Series that is a self-paced course designed to provide information about the Center’s role, a broad overview of the CDC’s Alcohol Outlet Density Toolkit, and key considerations for alcohol epidemiology teams working on excessive alcohol use prevention with state and local partners.

References

Bohm, M.K., & Esser, M. (2023, September 14).  Associations between Parental Drinking and Alcohol Use Among Their Adolescent Children: Findings from a National Survey of United States Parent-Child. Retrieved April 1, 2024, from https://www.jahonline.org/article/S1054-139X(23)00303-8/fulltext

Esser MB, Sherk A, Liu Y, Naimi TS. (2024, February 29). Deaths from Excessive Alcohol Use — United States, 2016–2021. MMWR Morb Mortal Wkly Rep 2024;73:154–161. Retrieved April 1, 2024, from DOI: http://dx.doi.org/10.15585/mmwr.mm7308a1

Kao, T. A., Ling, J., Dalaly, M., Robbins, L. B., & Cui, Y. (2020). Parent-Child Dyad's Collective Family Efficacy and Risky Adolescent Health Behaviors. Nursing research, 69(6), 455–465. https://doi.org/10.1097/NNR.0000000000000465 Retrieved April 1, 2024, from https://pubmed.ncbi.nlm.nih.gov/33136800/

NIDA. (2023, December 13). Reported drug use among adolescents continued to hold below pre-pandemic levels in 2023. Retrieved February 29, 2024 from https://nida.nih.gov/news-events/news-releases/2023/12/reported-drug-use-among-adolescents-continued-to-hold-below-pre-pandemic-levels-in-2023

Patrick, M. E., Miech, R. A., Johnston, L. D., & O’Malley, P. M. (2023). Monitoring the Future Panel Study annual report: National data on substance use among adults ages 19 to 60, 1976-2022. Monitoring the Future Monograph Series. Ann Arbor, MI: Institute for Social Research, University of Michigan. Retrieved April 1, 2024, from https://monitoringthefuture.org/wp-content/uploads/2023/07/mtfpanel2023.pdf

Substance Abuse and Mental Health Services Administration (SAMHSA). (2022). Implementing Community Level Policies to Prevent Alcohol Misuse. SAMHSA Publication No. PEP22-06-01-006. Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration. Retrieved April 1, 2024, from https://store.samhsa.gov/product/implementing-community-level-policies-prevent-alcohol-misuse/pep22-06-01-006

University of Michigan. (2023, August 17). Marijuana and hallucinogen use, binge drinking, reach historic highs among adults 35-50. Retrieved April 1, 2024 from https://news.umich.edu/marijuana-and-hallucinogen-use-binge-drinking-reach-historic-highs-among-adults-35-50/

University of Michigan. (2023, December 13). Teen Drug use remains below pre-pandemic levels. University of Michigan News, Retrieved April 1, 2024, from https://news.umich.edu/teen-drug-use-remains-below-pre-pandemic-levels/

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