# Louisiana State Epidemiological Workgroup Report for the Strategic Prevention Framework -- State Incentive Grant {#louisiana-state-epidemiological-workgroup-report-for-the-strategic-prevention-framework-state-incentive-grant .TitleString}

![](media/image1.png){width="1.86875in" height="1.9in"}

Prepared by

Louisiana State Epidemiological Workgroup

April 5, 2006

# Contributors {#contributors .Style-Heading-1-+-Left:--0\"-First-line:--0\" .unnumbered}

This report was compiled and written by the following members of the
State Epidemiological Workgroup as well as support staff listed below.

**Mr. Chris Andrieu** Louisiana Supreme Court

**Dr. Gary Asmus** University of Louisiana, Lafayette, Center for Child
Development

**Dr. Gary Balsamo** DHH, Office of Public Health, Infectious Disease
Epidemiologist

**Mr. Jody Bisco**e Northwestern State University, Louisiana Addiction
Technology Transfer Center

**Mr. Bill Blanchard** DHH, Office for Addictive Disorders Prevention
Services

**Mr. Frank Broussard** Department of Social Services, OCS

**Mr. George Cazenavette** Drug Enforcement Administration

**Ms. Cathy Childers** Attorney General's Office

**Dr. Yu-wen Chiu** Louisiana State University Health Sciences Center
School of Public Health

**Ms. Karen Faulk** Department of Social Services, OCS

**Dr. Murelle** **Harrison** Southern University Department of
Psychology

**Dr. James Heimda**l Louisiana Tech University Dept. of Health &
Exercise Sciences

**Dr. Barbara Hunter** Department of Social Services, ITT

**Dr. Tai Istre** Louisiana State University School of Social Work,
OSSRD

**Ms. Gloria Jones** Office of Motor Vehicles

**Mr. Jacques Kado** DHH, Office for Addictive Disorders - I/T Technical
Support Specialist

**Dr. M.Mahmud Khan** Tulane University School of Public Health &
Tropical Medicine

**Mr. Ronald Kinchen** Office of Alcohol and Tobacco Control

**Ms. Shirley Kirkconnell** DHH, Office of Public Health, Injury
Research & Prevention

**Dr. Randall Lemoine** DHH, Office of Mental Health

**Mr. Dan Magri** Department of Transportation and Development

**Dr. Nancy Mathews** Louisiana State University Campus Community
Coalition for Change

**Ms. Joan McGee** Division Of Administration, Office of Electronic
Services

**Lt. Jim McGuane** Louisiana State Police Technical Support

**Ms. Beth McLain** DHH, Office for Addictive Disorders Administration

**Ms. Kay Watson** DHH, Office for Addictive Disorders, Administration

**Mr. Robert Mehrtens** Louisiana Commission on Law Enforcement

**Dr. Steve Nelson** Louisiana State University Health Science Center
School of Medicine

**Ms. Karen Paterson** Division of Administration, Office of Electronic
Services

**Captain Jerry Patrick** Louisiana State Police Technical Support

**Ms. Monique Preau** Department of Education, Title IV

**Ms. Felecia Johnson** Department of Education, Title IV

**Mr. Henry Richardson** Drug Enforcement Administration

**Ms. Patrice Rose** DHH, Office of Public Health, Chronic Disease

**Dr. Helmut Schneider** Louisiana State University, ISDS Research Group
for Highway Safety

**Mr. Robert Starszak** DHH, Office of Public Health, Vital Statistics

**Dr. Katherine Theall** Louisiana State University School of Public
Health, Epidemiology

**Mr. Louis Thompson** Office of Alcohol and Tobacco Control

**Dr. Catrice Tolbert** Southern University Department of Psychology

**Mr. Neal Underwood** Division Of Administration, Office of Electronic
Services

**Ms. Nancy Wright** Department of Social Services, OFS, Program Policy

***[Support Staff]{.underline}***

**Ms. Dortha Cummins** SWCAPT

**Ms. Jan DeVillier** Governor's Office, Executive Director

**Ms. Dawn Diez** Governor's Office, Project Director SPF SIG

**Mr. Sanford Hawkins** DHH, Office for Addictive Disorders, Prevention
Services

**Ms. Linda McIntyre** DHH, Office for Addictive Disorders, Prevention
Systems Committee Liaison

SPF SIG

# Table of Contents {#table-of-contents .Style-Heading-1-+-Left:--0\"-First-line:--0\" .unnumbered}

[1. Introduction 2](#introduction)

[2. Impacts of Hurricanes Katrina and Rita
2](#impacts-of-hurricanes-katrina-and-rita)

[2.1. Population Redistribution 2](#population-redistribution)

[2.1.1. Parish Level Population Estimates
2](#parish-level-population-estimates)

[2.1.2. Demographics 2](#demographics)

[2.2. Substance Abuse Prevention Following a Disaster
2](#substance-abuse-prevention-following-a-disaster)

[3. Substance Abuse Related Mortality Impacts
2](#substance-abuse-related-mortality-impacts)

[3.1. All Causes of Death 2](#all-causes-of-death)

[3.2. Causes of Death from Substance Abuse
2](#causes-of-death-from-substance-abuse)

[4. Burden of Alcohol Use 2](#burden-of-alcohol-use)

[4.1. State and Parish Long-Term Health Consequences
2](#state-and-parish-long-term-health-consequences)

[4.2. State and Parish Alcohol Consumption Patterns
2](#state-and-parish-alcohol-consumption)

[4.3. State and Parish Immediate Health Consequences
2](#state-and-parish-immediate-health-consequences)

[4.3. College Alcohol Use 2](#college-alcohol-use)

[4.3.1. Louisiana State University Undergraduates' Alcohol Use
2](#louisiana-state-university-undergraduates-alcohol-use)

[5. Burden of Tobacco Use 2](#burden-of-tobacco-use)

[5.1. State and Parish Long-Term Health Consequences
2](#state-and-parish-long-term-health-consequences-1)

[5.2. State and Parish Consumption Patterns
2](#state-and-parish-consumption-patterns)

[5.3. State and Parish Immediate Health Consequences
2](#state-and-parish-immediate-health-consequences-1)

[5.4. College Tobacco Use 2](#college-tobacco-use)

[5.4.1. Louisiana State University Undergraduates' Cigarette Use
2](#louisiana-state-university-undergraduates-cigarette-use)

[6. Burden of Other Drug Use 2](#burden-of-other-drug-use)

[6.1. State and Parish Health & Social Consequences
2](#state-and-parish-health-social-consequences)

[6.2. State and Parish Consumption Patterns
2](#state-and-parish-consumption-patterns-1)

[6.3. State, Region, Parish Consumption Patterns by Demographics
2](#state-region-parish-consumption-patterns-by-demographics)

[6.4. College Other Drug Use 2](#college-other-drug-use)

[6.4.1. Louisiana State University Undergraduates' Drug Use
2](#louisiana-state-university-undergraduates-drug-use)

[7. Data Gaps and Implications 2](#data-gaps-and-implications)

[8. Problems of Greatest Impact and Hot Spots
2](#problems-of-greatest-impact-and-hot-spots)

[9. Definitions **Error! Bookmark not
defined.**](#__RefHeading___Toc132188010)

[10. SEW Policy Statement 2](#sew-policy-statement)

[11. References 2](#references)

# Introduction

The Strategic Prevention Framework State Incentive Grant (SPF-SIG) State
Epidemiological Workgroup (SEW) is a group of epidemiologists and other
professionals tasked with identifying and evaluating existing substance
abuse related data sources and identifying needs for additional
substance abuse related data sources. Membership is open to
representatives from departments, agencies, universities, and other
entities responsible for collecting, housing, analyzing, and reporting
data related to the consumption and consequences of substance abuse,
including underage drinking.

The primary purpose of the SEW is to support the efforts of the
Strategic Prevention Framework State Incentive Grant (SPF-SIG) known as
"The Governor's Initiative to Build a Healthy Louisiana". The SEW's role
is that of an advisory committee to the Prevention Systems Committee
(PSC) and Drug Policy Board (DPB). The Drug Policy Board was established
by legislation in 1990. The Drug Policy Board is "organizationally
positioned and structurally empowered to elicit, motivate, and
coordinate the best efforts and ideas of all organizations, agencies,
entities, and individuals who volunteer or can be conscripted to make a
contribution toward the goal of eradicating drug and alcohol abuse and
its poisonous fruit".  (Acts 1990, No. 1029, §2, effective July 26,
1990.)  In April 2005, the DPB approved the SEW and the PSC as formal
advisory groups. Louisiana is one of twenty states that was awarded this
grant. This process incorporates the SPF model that is endorsed and
utilized by the Substance Abuse and Mental Health Services
Administration's (SAMHSA) Center for Substance Abuse Prevention (CSAP).

The SEW provides advice on issues related to the use of data in planning
and evaluating substance abuse prevention activities. The grant is
intended to fund the development of a total systems approach at state
and community levels using data driven decisions and planning in
developing an outcomes based method of funding prevention activities.
The SEW report serves as a tool for substance abuse prevention planners
at state and community levels.

Data included are related to risk and protective factors for consumption
and consequences of substance abuse, including underage drinking, in the
state of Louisiana. The goal of the workgroup is to identify and/or
establish data that are capable of reflecting consumption and
consequences of substance abuse, and risk or protective factors at state
and community level. Data that are related to the entire life span
(birth to death) are targeted. The SEW will attempt to close the gaps
that exist in treatment and prevention data sources in Louisiana.

SEW members have introduced data sources from their respective
disciplines that might be applied to the chosen data set. Several ad hoc
committees and groups have been appointed to address specific needs:

-   Law Enforcement Compliance Group

-   Health Data Group

-   University and Survey Group

-   Data Systems Group

-   Geographic Information Systems Group

-   Prevention Program Data Resources Group

-   Attendance, Discipline, and Truancy School Data Group

-   Population Trends/Shifts

-   Impacts of Disasters

-   Substance Related Mortality

-   Substance Related Crime

-   Data Gaps Committee

-   Data Definitions and Terms Committee

-   SEW Policies Committee

> SEW accomplishments to date:

-   In April 2005, the SPF SIG SEW recommended and the Drug Policy Board
    adopted the following:

> Through agreements both informal and formal, policies and procedures
> among its members and substance abuse-related Louisiana agencies and
> entities represented by the board, established a substance abuse
> prevention planning infrastructure to:

-   harvest all archival census, crime, education, enforcement, health,
    and social service, etc. data related to substance abuse that is
    presently collected,

-   summarize available archival data from 1995 to the present using
    common attributes (e.g., gender, race, age range, parish, etc,),

-   house data within a system that allows agency staff and gives public
    access to data via the internet to use for planning,

-   provide analytical tools that cross tabulate the data sets for up to
    ten years and report it using graphic images (e.g., bar, GIS, pie,
    and trend line)

-   publish the link to the data system on an accessible website

```{=html}
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-   In August 2005, the SEW completed a review of consumption and
    consequences of substance abuse data. The data evaluated were from
    the following sources:

```{=html}
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```
-   State Epidemiological Data System set (SEDS)

-   NIDA six state study -- Bach Harrison 35

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```
-   Selected data from the Communities That Care/Caring Communities
    Youth Survey (CCYS)

-   In January 2006, the following data sources were evaluated for
    inclusion into the SEW report to the Policy and Planning Committee:

```{=html}
<!-- -->
```
-   SEDS

-   Bach Harrison 35

-   CCYS

-   College Alcohol Study, Louisiana State University results

-   Mortality data from the Office of Public Health

-   Motor Vehicle Crash and Fatality Data (FARS)

-   Department of Education Population Shift Data

On August 28 and 29, 2005, Hurricane Katrina catastrophically affected
the southeastern region of Louisiana. Katrina's impact, as well as the
impact of Hurricane Rita on September 24 in the southwest region of
Louisiana severely limited the continued activity of the SEW. Many SEW
members were associated with state agencies located in the affected
areas. The major universities in the affected areas were impacted,
limiting the assistance that could be provided to the workgroup. By
necessity, all agencies of State government were forced to address the
important issues brought about by the two storms and their after
effects. These two events have required the SEW members to re-examine
existing data collection and future data collection methods. At present,
there is no consumption and consequence data available on the displaced
population; however, we have been able to collect census data on the
school population. The full impact of these two storms is yet to be
determined.

# Impacts of Hurricanes Katrina and Rita

The State of Louisiana has suffered unprecedented consequences from two
hurricanes in 2005. On August 29, 2005, Hurricane Katrina made landfall
in southeastern Louisiana resulting in widespread damage and causing the
levee system to fail. Most of the New Orleans population evacuated prior
to landfall, but the failure of the levee system resulted in the
evacuation becoming a long-term displacement. On September 24, 2005,
Hurricane Rita made landfall in southwest Louisiana. The storm caused
severe damage in the southwest part of the state and caused the New
Orleans levees to fail once again. The two storms caused in excess of
\$75 billion in damage and more than 1,400 deaths. The parish of Orleans
was essentially depopulated following Katrina and the population has not
yet returned to pre-Katrina levels and perhaps, never will.

## Population Redistribution

This section of the report will provide data and analysis of current
estimates of the Louisiana population. It is critical to the SEW and the
SPF-SIG to have population estimates in order to complete the planning
process. Without the hurricanes, previous data could be used directly to
establish estimates and trends of consequence and burden. With the
hurricanes and the resultant Diasporas, data from across the state must
be carefully considered and re-evaluated for applicability.

Population estimates are typically based on decennial U.S. Census
information gathered and analyzed by the United States Census Bureau.
Annual estimates are created based on decennial census, births to US
women, deaths of US residents, net international migration and net
movement of US armed forces. None of this information can be used for
the unprecedented movement of people due to the hurricanes. After
careful consideration of various data sources, the Louisiana Department
of Education's (LDE) enrollment data was selected for use in determining
ongoing dynamics of population redistribution within the state of
Louisiana. LDE has been ranked number 1 three of the last four years in
accountability. This is due, in part, to their excellent system for
tracking enrollment in Louisiana's public schools. LDE is gathering
monthly enrollment from all school districts.

Previous years' enrollment and population estimates are used to
determine a standard ratio of public school students to total parish
population. This ratio is then applied to the new enrollment data
provided by LDE to generate new population estimates. The following maps
are illustrative of the population redistribution.

### Parish Level Population Estimates

The first map shows the initial Diaspora caused by hurricanes Rita and
Katrina (change in population from 2004 to October 2005). Initially, the
areas directly affected by the storms were almost completely
de-populated. New Orleans was evacuated twice -- once for each of the
storms. The schools have been closed and residents were not even allowed
into the city for weeks after the storms.

Figure 1 Pre to Post-Katrina Population Diaspora

![](media/image2.png){width="6.491666666666666in"
height="4.673611111111111in"}

*Data -- LA Department of Education, Department of Health and Hospitals
Bureau of Primary Care and Rural Health, US Census Bureau*

Following the evacuations caused by the storms and the flooding, there
has been some movement towards repopulating the affected areas. The
second map (Population shift from October to December 2005) shows that
most of the affected parishes have re-gained some population and the
areas to which people had evacuated lost population. Since these maps
are based on school enrollments, we can have a fair amount of confidence
that we are seeing real population movement. Parents do not readily
enroll or un-enroll their children in school unless they have truly
moved or plan on moving.

Figure 2 Population Shift October to December 2005

![](media/image3.png){width="6.492361111111111in"
height="4.836111111111111in"}

*Data -- LA Department of Education, Department of Health and Hospitals
Bureau of Primary Care and Rural Health, US Census Bureau*

While there was significant movement of people back to the affected
areas, this does not represent a complete re-population. As the final
map shows, all of the hurricane ravaged areas are still lacking
significant numbers from their pre-storm populations.

Figure 3 Population Redistribution as of December 2005

![](media/image4.png){width="6.492361111111111in"
height="4.776388888888889in"}

*Data -- LA Department of Education, Department of Health and Hospitals
Bureau of Primary Care and Rural Health, US Census Bureau*

Overall, population estimates indicate that there are nearly 500,000
fewer people residing in the state than there were prior to the
hurricanes.

Table 2‑1 Parish Level Population Estimates

  -------------------------------------------------------------------------------
  PARISH          January 06  December 05 November 05 October 05  U.S. Census
                                                                  Estimate July
                                                                  04
  --------------- ----------- ----------- ----------- ----------- ---------------
  Acadia Parish   60,146      60,738      60,738      61,804      59,168

  Allen Parish    26,072      26,108      26,126      26,209      25,407

  Ascension       97,463      97,775      97,839      100,432     87,164
  Parish                                                          

  Assumption      23,475      23,766      23,819      24,703      23,234
  Parish                                                          

  Avoyelles       42,655      43,554      43,815      45,419      41,981
  Parish                                                          

  Beauregard      34,137      34,405      34,394      34,951      34,094
  Parish                                                          

  Bienville       15,396      15,389      15,339      15,673      15,361
  Parish                                                          

  Bossier Parish  107,238     108,543     108,598     109,742     104,080

  Caddo Parish    254,125     253,593     254,662     258,179     251,506

  Calcasieu       182,352     183,679     183,047     184,961     184,961
  Parish                                                          

  Caldwell Parish 10,787      10,810      10,816      11,156      10,837

  Cameron Parish  7,851       7,798       7,568       1,936       9,681

  Catahoula       11,143      11,119      11,174      11,480      10,627
  Parish                                                          

  Claiborne       16,067      16,085      16,055      16,214      16,471
  Parish                                                          

  Concordia       21,322      21,491      21,701      22,213      19,724
  Parish                                                          

  DeSoto Parish   26,358      26,494      26,515      26,956      26,231

  East Baton      448,500     453,946     457,489     458,333     412,633
  Rouge Parish                                                    

  East Carroll    8,736       8,849       8,871       9,017       8,954
  Parish                                                          

  East Feliciana  22,279      22,416      22,571      23,329      20,950
  Parish                                                          

  Evangeline      35,758      36,294      36,323      36,766      35,451
  Parish                                                          

  Franklin Parish 19,553      19,637      19,727      20,176      20,812

  Grant Parish    18,921      18,983      19,004      19,702      19,139

  Iberia Parish   75,738      76,532      76,871      78,010      74,449

  Iberville       34,859      35,158      35,229      36,188      32,497
  Parish                                                          

  Jackson Parish  15,033      15,033      15,093      15,168      15,278

  Jefferson       363,309     354,337     328,223     258,128     453,590
  Parish                                                          

  Jefferson Davis 31,488      31,753      32,012      32,865      31,235
  Parish                                                          

  Lafayette       200,933     203,457     204,229     207,863     195,707
  Parish                                                          

  Lafourche       92,061      92,622      93,251      95,214      92,157
  Parish                                                          

  LaSalle Parish  14,316      14,410      14,316      14,718      14,161

  Lincoln Parish  43,600      43,993      44,253      44,844      42,382

  Livingston      112,520     112,924     113,188     115,691     105,653
  Parish                                                          

  Madison Parish  13,144      13,259      13,225      13,299      12,996

  Morehouse       30,466      30,496      30,484      30,443      30,551
  Parish                                                          

  Natchitoches    39,346      39,251      39,307      39,922      38,741
  Parish                                                          

  Orleans Parish  156,140     138,681     138,681     138,681     462,269

  Ouachita Parish 149,081     150,404     150,648     152,746     148,355

  Plaquemines     17,309      15,984      14,671      5,794       28,969
  Parish                                                          

  Pointe Coupee   22,852      23,189      23,511      24,852      22,537
  Parish                                                          

  Rapides Parish  136,217     137,179     137,499     140,435     128,013

  Red River       9,981       10,085      10,065      10,382      9,606
  Parish                                                          

  Richland Parish 20,696      20,816      20,906      21,223      20,485

  Sabine Parish   24,315      24,443      24,460      24,577      23,616

  St. Bernard     6,899       13,111      13,111      13,111      65,554
  Parish                                                          

  St. Charles     51,830      52,137      52,205      52,492      50,073
  Parish                                                          

  St. Helena      11,609      8,539       8,508       10,978      10,309
  Parish                                                          

  St. James       21,747      21,981      21,975      22,317      21,146
  Parish                                                          

  St. John the    49,286      49,983      51,065      54,668      45,581
  Baptist Parish                                                  

  St. Landry      92,921      94,186      94,186      95,644      89,635
  Parish                                                          

  St. Martin      51,647      51,706      51,747      53,055      50,453
  Parish                                                          

  St. Mary Parish 53,366      53,667      53,770      55,069      52,189

  St. Tammany     205,461     202,536     198,668     180,513     213,553
  Parish                                                          

  Tangipahoa      109,423     110,359     110,547     111,982     105,158
  Parish                                                          

  Tensas Parish   6,496       6,745       6,869       7,753       6,176

  Terrebonne      107,501     108,796     109,000     108,740     106,523
  Parish                                                          

  Union Parish    22,042      22,250      22,229      21,807      22,894

  Vermilion       54,325      54,720      54,816      40,153      54,751
  Parish                                                          

  Vernon Parish   49,119      49,550      49,719      50,632      49,545

  Washington      42,449      42,341      41,901      41,701      44,161
  Parish                                                          

  Webster Parish  40,510      40,869      41,432      42,001      41,254

  West Baton      24,004      24,397      24,574      25,746      21,880
  Rouge Parish                                                    

  West Carroll    11,921      12,048      12,089      12,568      11,963
  Parish                                                          

  West Feliciana  15,397      15,652      15,890      16,431      15,108
  Parish                                                          

  Winn Parish     16,219      16,277      16,306      16,765      16,151

  STATE TOTAL     4,137,915   4,137,331   4,116,925   4,054,522   4,515,770
  -------------------------------------------------------------------------------

*Data -- LA Department of Education, Department of Health and Hospitals
Bureau of Primary Care and Rural Health, US Census Bureau*

### Demographics

In addition to estimating the total population effects within Louisiana
parishes, it is also important to assess the demographics of the
displaced population. Based on studies performed by the Center for Child
Development of the University of Louisiana at Lafayette following the
storms, there are several observations that can be made. Detailed data
on evacuees was obtained from four school districts: Ascension, Caddo,
East Baton Rouge, and Lafayette Parish school systems.

The demographics of the students that were displaced by the hurricanes
are consistent with the demographics of the source parishes of
Jefferson, Orleans, St. Bernard, Plaquemines, and Cameron. The following
table shows the ethnic group demographics for the four Katrina-affected
parishes.

  ------------------- ------------------------- -------------------------
  Students in                                   
  Orleans, Jefferson,                           
  St. Bernard, and                              
  Plaquemines School                            
  Districts (2004-05                            
  SY)                                           

  **Race**            **Number of Students**    **Percentage**

  Black               91,106                    70%

  White               29,326                    22%

  Hispanic            5,879                     4%

  Asian               4,027                     3%

  Native American     583                       0%

  **Total**           **130,921**               
  ------------------- ------------------------- -------------------------

*October 1, 2004 Louisiana Department of Education Student Information
System*

The enrollment data for all four of the parishes more closely matches
the existing ethnic demographic than it does the source. For example, in
Lafayette Parish school system the evacuee students were about 45% black
and 41% white.

*October 1, 2004 Louisiana Department of Education Student Information
System*

This same pattern was observed in the other school systems that were
investigated, although there appears to be a distance effect. That is,
the further from the affected parishes, the more likely that the evacuee
demographics will be similar to the source parishes. While data is
limited, the information from the Caddo School system provides some
insight. The pre-Katrina demographics of the public school system
indicated that there were 35% white students and 63% black students. The
evacuee students in Caddo were 78% black and 18% white which is more
closely aligned with the evacuated parish demographics and, in
particular, is even closer to the Orleans parish demographics.

The data supports the observation that many of the highest poverty and
ethnic groups were evacuated to areas further from the affected areas.
It appears that those that could evacuate themselves headed toward
family and friends closer to New Orleans, while those that were
evacuated after the storms were sent out further.

This information seems to indicate that where data related to the SEW is
being considered the most important information regarding the
re-distribution of population will be two-fold. First, the closer to the
epicenter of the affected areas, the more similar the evacuee population
is to the pre-Katrina population demographically. This may imply that
where consequence and consumption data are related to ethnic, gender,
socio-economic or other demographic information, rates may simply be
scaled to account for the new population levels. This assumption is
independent of the effects of the disaster on substance abuse, which the
following section addresses.

The second factor is the continuing movement of the affected population.
While there was a large initial displacement of residents, there have
been significant numbers returning to the area. The current (ca. January
2006) population in the affected areas is still significantly less than
the pre-Katrina population. In order to insure that the proper resources
are available in the proper areas at the proper time, ongoing population
estimates will be required. The dynamics of the Louisiana population
will require that the State be flexible and agile in responding to the
changing needs and location of their citizens.

## Substance Abuse Prevention Following a Disaster

In the wake of a disaster, concerns about substance use and abuse may
seem minor in relation to the immediate devastation and the task of
rebuilding. However, it is during times of extreme stress such as those
following a disaster that substance use and abuse tends to increase.
Focused disaster management activities are critical in dealing with
disasters.

Disaster management activities can be viewed in three phases:
preparedness, response, and recovery. Phase 1 encompasses all
pre-disaster activities that lessen its effects and lay the groundwork
for response and recovery. Phase 2 includes the first 3 weeks
immediately following the disaster. Emergency assistance is provided
during this phase. Phase 3, the Recovery Phase, runs from 2 weeks to
several years after the disaster. This phase begins after basic needs
are met and focus shifts to returning things to normal.

As part of the Recovery Phase, substance abuse prevention professionals
must understand that survivors and disaster relief workers experience
several different emotional phases following a disaster. The Alert Phase
occurs when people actually realize that they can potentially be
affected by a disaster. During the disaster impact and immediately
following, people can experience the Heroic Phase and exert intense
effort toward survival. Next, the Honeymoon Phase may last 1 week to 6
months immediately after a disaster. This phase involves a strong sense
of companionship among the survivors and a renewed sense of community.
During the period of 2 months to 2 years following a disaster the
Disillusionment Phase can take over. Survivors can have feelings of
anger, loss, and resentment. Hopelessness and depression can also
surface. It is during this phase that the risk of substance abuse
increases. Finally, the survivor accepts their role in recovery and
takes on the responsibility to fulfill the role. This phase is called
the Reconstruction Phase and can last several years.

The statistics that are available and the reports from professionals
working in the field indicate that the extreme stress tied to disasters
can lead to: misuse of alcohol and other drugs; increase in problems
associated with substance abuse; breakdown of normal controls that
prevent substance abuse and its related problems; increased difficulties
for people in recovery; and increased initiation by children and youth
or abuse the elderly. Substance abuse prevention professionals must
remember "that all services that address mental health issues are
potentially substance abuse prevention services, since they address the
environmental factors that can give rise to increased alcohol and drug
use and other maladaptive behaviors." (Center for Substance Abuse
Prevention \[CSAP\], 1997).

# Substance Abuse Related Mortality Impacts

## All Causes of Death 

Several of the leading causes of death in Louisiana are at least
partially caused by the abuse of alcohol, tobacco, or other drugs.
Diseases of the heart (1^st^) are the leading cause of death in
Louisiana, followed by malignant neoplasms (cancer) (2^nd^) and
cerebrovascular disease (3^rd^), all of which are associated with
smoking. Chronic lower respiratory disease (6^th^) is also frequently
associated with smoking. Alcohol use is strongly associated with death
due to accidents (4^th^).

  ----------------------------------------- ------------------------------------ ---------------- -------------- ----------------
  **Age Adjusted Mortality Rates\* for the                                                                       
  Thirteen Leading Causes of Death in                                                                            
  Louisiana and the United States 2002**                                                                         

                                                                                                                 

                                                                                 **Louisiana**                   **United
                                                                                                                 States**

  **Rank\*\***                              **Cause of Death**                   **Age-Adjusted   **Rank\*\***   **Age-Adjusted
                                                                                 Death Rate**                    Death Rate**

  \-                                        All Causes                           996.5            \-             847.3

  1                                         Diseases of the Heart (I00-I09, I11, 268.3            1              241.7
                                            I13, I20-51)                                                         

  2                                         Malignant Neoplasms (C00-C97)        222              2              193.2

  3                                         Cerebrovascular Disease (I60-I69)    62.5             3              56.4

  4                                         Accidents (V01-X59, Y85-Y86)         47.6             5              37

  5                                         Diabetes Mellitus (E10-E14)          42.1             6              25.4

  6                                         Chronic Lower Respiratory Disease    40.9             4              43.3
                                            (J40-J47)                                                            

  7                                         Alzheimer\'s Disease (G30)           27.8             8              20.4

  8                                         Nephritis, Nephrotic Syndrome, and   23.6             9              14.2
                                            Nephrosis (N00-N07, N17-N19,                                         
                                            N25-N27)                                                             

  9                                         Influenza and Pneumonia (J10-J18)    23.4             7              22.8

  10                                        Septicemia (A40-A41)                 19.7             10             11.7

  11                                        Homicide (X85-Y09, Y87.1)            13.4             14             6.1

  12                                        Suicide (X60-X84, Y87.0)             11.3             11             10.9

  13                                        Chronic Liver Disease (K70, K73-K74) 8.4              12             9.4

  \*Age-Adjusted Rate per 100,000, 2000                                                                          
  U.S. standard population                                                                                       

  \*\*Causes of death are ranked based on                                                                        
  crude death rates                                                                                              

  International Statistical Classification                                                                       
  of Diseases (ICD) code definitions for                                                                         
  each indicator are provided in                                                                                 
  parentheses.                                                                                                   

  Sources: Louisiana State Center for                                                                            
  Health Statistics, National Center for                                                                         
  Health Statistics (National Vital                                                                              
  Statistics Reports - Deaths: Leading                                                                           
  Causes for 2002), United States Census                                                                         
  Bureau,                                                                                                        
  <http://wonder.cdc.gov/mortICD10J.html>                                                                        
  ----------------------------------------- ------------------------------------ ---------------- -------------- ----------------

## Causes of Death from Substance Abuse

The chart below displays the eleven leading causes of substance related
death in Louisiana. Ischemic cerebrovascular disease (1^st^), other
cardiovascular diseases (2^nd^), lung cancer (3^rd^), and lung disease
(4^th^) head the list and are associated with tobacco use. Alcohol
consumption is often associated with homicide (5^th^), suicide (6^th^),
traffic fatalities (alcohol related traffic fatalities (7^th^),
cirrhosis (8^th^), and deaths due to other accidents (alcohol related
accidents, 9^th^). The relationship of both cigarette related accidents
or fires (10^th^) and illicit drug deaths (11^th^) to substance use are
apparent.

From 1999 through 2003, cardiovascular disease death rates appear to
consistently lie between 3.25 and 3.5 per thousand population. No
significant increasing or decreasing trend is apparent.
![](media/image5.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

When leading causes of death by age group are observed, the importance
of substance related mortality is apparent. From ages 15 until 24, the
leading causes of death are unintentional injury (includes traffic
fatalities), homicide, and suicide. All three are associated with
substance use, particularly alcohol. From 25-34 years of age,
unintentional injury and homicide are 1st and 2^nd^ as the leading
causes of mortality. In older age groups, chronic causes of death
replace more proximal acute causes as the leading determinants of
mortality. At age 35 and over, at least two substance related causes of
mortality are ranked in the top three causes of death: heart disease
(tobacco related), malignant neoplasms (some cancers are associated with
tobacco use), and cerebrovascular disease (tobacco related) are common
chronic causes of mortality.

Top Ten Leading Causes of Death in Louisiana by Age 2001

<table>
<colgroup>
<col style="width: 5%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
</colgroup>
<tbody>
<tr class="odd">
<td></td>
<td colspan="13"><strong>Age Groups</strong></td>
</tr>
<tr class="even">
<td><strong>Rank</strong></td>
<td><strong>&lt;1</strong></td>
<td><strong>1-4</strong></td>
<td><strong>5-9</strong></td>
<td><strong>10-14</strong></td>
<td><strong>15-17</strong></td>
<td><strong>18-21</strong></td>
<td><strong>22-24</strong></td>
<td><strong>25-34</strong></td>
<td><strong>35-44</strong></td>
<td><strong>45-54</strong></td>
<td><strong>55-64</strong></td>
<td><strong>65+</strong></td>
<td><strong>All Ages</strong></td>
</tr>
<tr class="odd">
<td><strong>1</strong></td>
<td>Congenital<br />
Anomalies<br />
119</td>
<td><p>Unintentional Injury</p>
<p>63</p></td>
<td><p>Unintentional Injury</p>
<p>39</p></td>
<td><p>Unintentional Injury</p>
<p>42</p></td>
<td><p>Unintentional Injury</p>
<p>74</p></td>
<td><p>Unintentional Injury</p>
<p>150</p></td>
<td><p>Unintentional Injury</p>
<p>100</p></td>
<td><p>Unintentional Injury</p>
<p>262</p></td>
<td><p>Unintentional Injury</p>
<p>358</p></td>
<td>Malignant<br />
Neoplasms<br />
963</td>
<td>Malignant<br />
Neoplasms<br />
1,710</td>
<td>Heart<br />
Disease<br />
8,846</td>
<td>Heart<br />
Disease<br />
11,474</td>
</tr>
<tr class="even">
<td><strong>2</strong></td>
<td>Short<br />
Gestation<br />
117</td>
<td><p>Homicide</p>
<p>14</p></td>
<td>Malignant<br />
Neoplasms<br />
14</td>
<td>Malignant<br />
Neoplasms<br />
8</td>
<td><p>Homicide</p>
<p>24</p></td>
<td><p>Homicide</p>
<p>82</p></td>
<td><p>Homicide</p>
<p>53</p></td>
<td><p>Homicide</p>
<p>162</p></td>
<td>Malignant<br />
Neoplasms<br />
335</td>
<td>Heart<br />
Disease<br />
836</td>
<td>Heart<br />
Disease<br />
1,345</td>
<td>Malignant<br />
Neoplasms<br />
6,360</td>
<td>Malignant<br />
Neoplasms<br />
9,517</td>
</tr>
<tr class="odd">
<td><strong>3</strong></td>
<td>SIDS<br />
66</td>
<td>Congenital<br />
Anomalies<br />
13</td>
<td><p>Homicide</p>
<p>4</p></td>
<td><p>Homicide</p>
<p>5</p></td>
<td><p>Suicide</p>
<p>15</p></td>
<td><p>Suicide</p>
<p>40</p></td>
<td><p>Suicide</p>
<p>15</p></td>
<td>HIV<br />
84</td>
<td>Heart<br />
Disease<br />
323</td>
<td><p>Unintentional Injury</p>
<p>255</p></td>
<td>Diabetes<br />
Mellitus<br />
306</td>
<td>Cerebro-<br />
vascular<br />
2,145</td>
<td>Cerebro-<br />
vascular<br />
2,638</td>
</tr>
<tr class="even">
<td><strong>4</strong></td>
<td>Maternal<br />
Pregnancy<br />
Comp.<br />
42</td>
<td>Malignant<br />
Neoplasms<br />
7</td>
<td>Congenital<br />
Anomalies<br />
3</td>
<td>Congenital<br />
Anomalies<br />
4</td>
<td>Malignant<br />
Neoplasms<br />
13</td>
<td>Malignant<br />
Neoplasms<br />
22</td>
<td>Heart<br />
Disease<br />
12</td>
<td><p>Suicide</p>
<p>84</p></td>
<td>HIV<br />
151</td>
<td>Cerebro-<br />
vascular<br />
172</td>
<td>Cerebro-<br />
vascular<br />
230</td>
<td>Chronic Low.<br />
Respiratory<br />
Disease<br />
1,478</td>
<td><p>Unintentional Injury</p>
<p>2,029</p></td>
</tr>
<tr class="odd">
<td><strong>5</strong></td>
<td>Respiratory<br />
Distress<br />
30</td>
<td>Heart<br />
Disease<br />
4</td>
<td>HIV<br />
2</td>
<td>Heart<br />
Disease<br />
4</td>
<td>Heart<br />
Disease<br />
6</td>
<td>Heart<br />
Disease<br />
12</td>
<td>Malignant<br />
Neoplasms<br />
12</td>
<td>Heart<br />
Disease<br />
76</td>
<td><p>Suicide</p>
<p>105</p></td>
<td>Diabetes<br />
Mellitus<br />
130</td>
<td>Chronic Low.<br />
Respiratory<br />
Disease<br />
191</td>
<td>Diabetes<br />
Mellitus<br />
1,230</td>
<td>Chronic Low.<br />
Respiratory<br />
Disease<br />
1,763</td>
</tr>
<tr class="even">
<td><strong>6</strong></td>
<td><p>Unintentional Injury</p>
<p>22</p></td>
<td>Anemias<br />
2</td>
<td>Benign<br />
Neoplasms<br />
1</td>
<td>Influenza<br />
&amp; Pneumonia<br />
3</td>
<td>Congenital<br />
Anomalies<br />
4</td>
<td>Congenital<br />
Anomalies<br />
6</td>
<td>HIV<br />
7</td>
<td>Malignant<br />
Neoplasms<br />
73</td>
<td><p>Homicide</p>
<p>101</p></td>
<td>HIV<br />
109</td>
<td><p>Unintentional Injury</p>
<p>147</p></td>
<td>Alzheimer's<br />
Disease<br />
943</td>
<td>Diabetes<br />
Mellitus<br />
1,734</td>
</tr>
<tr class="odd">
<td><strong>7</strong></td>
<td>Placenta<br />
Cord<br />
Membranes<br />
18</td>
<td>Benign<br />
Neoplasms<br />
2</td>
<td>Heart<br />
Disease<br />
1</td>
<td><p>Suicide</p>
<p>3</p></td>
<td>Benign<br />
Neoplasms<br />
3</td>
<td>Anemias<br />
5</td>
<td>Chronic Low.<br />
Respiratory<br />
Disease<br />
5</td>
<td>Diabetes<br />
Mellitus<br />
15</td>
<td>Cerebro-<br />
vascular<br />
70</td>
<td><p>Suicide</p>
<p>89</p></td>
<td>Nephritis<br />
125</td>
<td>Influenza<br />
&amp; Pneumonia<br />
819</td>
<td>Nephritis<br />
993</td>
</tr>
<tr class="even">
<td><strong>8</strong></td>
<td>Atelectasis<br />
16</td>
<td>HIV<br />
2</td>
<td>Meningitis<br />
1</td>
<td>Meningo-<br />
coccal<br />
Infection<br />
2</td>
<td>Cerebro-<br />
vascular<br />
2</td>
<td>Benign<br />
Neoplasms<br />
3</td>
<td>Congenital<br />
Anomalies<br />
3</td>
<td>Septicemia<br />
13</td>
<td>Diabetes<br />
Mellitus<br />
49</td>
<td>Liver<br />
Disease<br />
75</td>
<td>Liver<br />
Disease<br />
77</td>
<td>Nephritis<br />
757</td>
<td>Alzheimer's<br />
Disease<br />
957</td>
</tr>
<tr class="odd">
<td><strong>9</strong></td>
<td>Intrauterine<br />
Hypoxia<br />
15</td>
<td><p>Four Tied</p>
<p>1</p></td>
<td></td>
<td><p>Three Tied</p>
<p>1</p></td>
<td><p>Seven Tied</p>
<p>1</p></td>
<td><p>Six Tied</p>
<p>2</p></td>
<td>Anemias<br />
2</td>
<td>Influenza<br />
&amp; Pneumonia<br />
12</td>
<td>Liver<br />
Disease<br />
39</td>
<td>Nephritis<br />
64</td>
<td>Septicemia<br />
73</td>
<td>Septicemia<br />
579</td>
<td>Influenza<br />
&amp; Pneumonia<br />
941</td>
</tr>
<tr class="even">
<td><strong>10</strong></td>
<td>Circulatory<br />
System<br />
Disease<br />
13</td>
<td><p>Four Tied</p>
<p>1</p></td>
<td></td>
<td>Three Tied 1</td>
<td><p>Seven Tied</p>
<p>1</p></td>
<td><p>Six Tied</p>
<p>2</p></td>
<td><p>Eight Tied</p>
<p>1</p></td>
<td><p>Two Tied</p>
<p>11</p></td>
<td>Viral<br />
Hepatitis<br />
31</td>
<td>Chronic Low.<br />
Respiratory<br />
Disease<br />
62</td>
<td>Influenza<br />
&amp; Pneumonia<br />
52</td>
<td><p>Unintentional Injury</p>
<p>517</p></td>
<td>Septicemia<br />
758</td>
</tr>
</tbody>
</table>

As stated above, more proximal causes of death, mortality consequences
following substance use or abuse more closely in time, are more evident
in younger age groups. Death rates from homicide are highest in 18-34
year olds. The highest number of homicides occurs in the 21-29 year old
group. Suicide rates and rates of death from illicit drugs remain fairly
constant from age 18 and up. The highest suicide and illicit drug death
rates are seen in the 65 and older group and the highest number of
suicides and illicit drug deaths is seen in the 35-54 year old group.
Nevertheless, the proportion of deaths from these two causes in older
age groups is reduced due to large numbers of deaths from chronic
causes.

![](media/image6.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

![](media/image7.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

The following two charts illustrate the importance of death from
ischemic cerebrovascular disease, other cardiovascular disease, lung
cancer, and lung disease (all associated with tobacco use) in Louisiana
residents.

![](media/image8.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**Years of Potential Life Lost**

The years of potential life lost (YPLL) calculation emphasizes premature
mortality by giving a larger computational weight to youthful deaths.
YPLL before age 65 computes the burden of mortality from a particular
cause responsible for life lost, assuming 65 years as a full life.~19~
The causes of mortality responsible for the greatest burden of potential
life lost are illustrated in the chart below. Unintentional injury,
malignant neoplasms, heart disease, homicide, suicide, and

cerebrovascular diseases can all be related to substance use.

![](media/image9.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

YPLL before age 85 computes the burden of mortality from a particular
cause responsible for life lost, assuming 85 years as a full life. The
causes of mortality responsible for the greatest burden of potential
life lost are illustrated in the chart below. Malignant neoplasms, heart
disease, unintentional injury, homicide, cerebrovascular diseases,
chronic lower respiratory disease, and suicide can all be related to
substance use.

![](media/image10.wmf){width="6.491666666666666in" height="4.43125in"}

Top Ten Causes of Non-Fatal Injuries in the United States by Age
2002-2004

  ---------- ---------------- ---------------- ---------------- ---------------- ---------------- ---------------- ---------------- ---------------- ---------------- ---------------- ----------------
             **Age Groups**                                                                                                                                                            

  **Rank**   **\<1**          **1-4**          **5-9**          **10-14**        **15-24**        **25-34**        **35-44**        **45-54**        **55-64**        **65+**          **All Ages**

  **1**      Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\
             Fall\            Fall\            Fall\            Fall\            Struck by/\      Fall\            Fall\            Fall\            Fall\            Fall\            Fall\
             375,016          2,624,494        2,023,255        2,007,409        Against\         2,220,340        2,394,065        2,215,221        1,661,751        5,311,690        23,364,042
                                                                                 2,904,703                                                                                             

  **2**      Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\
             Struck by/\      Struck by/\      Struck by/\      Struck by/\      MV-Occupant\     Overexertion\    Overexertion\    Overexertion\    Struck by/\      Struck by/\      Struck by/\
             Against\         Against\         Against\         Against\         2,732,539        2,069,322        1,958,897        1,253,726        Against\         Against\         Against\
             96,915           1,123,217        1,265,079        1,809,515                                                                            577,999          599,171          13,342,474

  **3**      Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\
             Fire/Burn\       Other Bite/\     Cut/Pierce\      Overexertion\    Fall\            Struck by/\      Struck by/\      Struck by/\      Overexertion\    MV-Occupant\     Overexertion\
             35,872           Sting\           376,334          839,054          2,529,728        Against\         Against\         Against\         568,821          567,125          9,890,879
                              406,675                                                             2,016,926        1,778,739        1,169,563                                          

  **4**      Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\
             Other Bite/\     Foreign Body\    Pedal Cyclist\   Cut/Pierce\      Overexertion\    MV-Occupant\     MV-Occupant\     MV-Occupant\     MV-Occupant\     Overexertion\    MV-Occupant\
             Sting\           327,452          333,450          483,113          2,244,439        1,851,821        1,539,953        1,047,402        562,925          492,622          9,015,525
             34,820                                                                                                                                                                    

  **5**      Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\
             Foreign Body\    Cut/Pierce\      Other Bite/\     Pedal Cyclist\   Cut/Pierce\      Cut/Pierce\      Cut/Pierce\      Cut/Pierce\      Cut/Pierce\      Cut/Pierce\      Cut/Pierce\
             26,007           259,763          Sting\           423,400          1,484,060        1,343,914        1,183,345        843,068          450,265          354,785          6,799,166
                                               281,309                                                                                                                                 

  **6**      Unintentional\   Unintentional\   Unintentional\   Other Assault\   Other Assault\   Other Assault\   Other Assault\   Unintentional\   Unintentional\   Unintentional\   Other Assault\
             MV-Occupant\     Overexertion\    Overexertion\    Struck by/\      Struck by/\      Struck by/\      Struck by/\      Other Specified\ Other Bite/\     Other Bite/\     Struck by/\
             24,041           218,633          226,837          Again\           Again\           Again\           Again\           384,295          Sting\           Sting\           Again\
                                                                348,435          1,349,060        821,156          670,997                           191,683          221,679          3,832,577

  **7**      Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Other Assault\   Unintentional\   Unintentional\   Unintentional\
             Poisoning\       Poisoning\       MV-Occupant\     Unknown/\        Other Bite/\     Other Bite/\     Other Specified\ Struck by/\      Other Specified\ Poisoning\       Other Bite/\
             20,722           188,891          225,583          Unspecified\     Sting\           Sting\           481,615          Again\           148,086          139,542          Sting\
                                                                342,162          485,493          436,417                           322,820                                            2,982,617

  **8**      Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\
             Cut/Pierce\      Fire/Burn\       Foreign Body\    MV-Occupant\     Unknown/\        Other Specified\ Other Bite/\     Other Bite/\     Other\           Other\           Other Specified\
             20,036           178,733          161,284          323,881          Unspecified\     391,140          Sting\           Sting\           Transport\       Transport\       2,141,911
                                                                                 480,987                           411,806          318,665          100,268          139,088          

  **9**      Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\
             Inhalation/\     Unknown/\        Dog Bite\        Other\           Other Specified\ Other\           Poisoning\       Poisoning\       Poisoning\       Unknown/\        Unknown/\
             Suffocation\     Unspecified\     153,735          Transport\       417,563          Transport\       322,534          253,775          100,230          Unspecified\     Unspecified\
             19,737           145,714                           200,625                           300,228                                                             134,572          2,020,666

  **10**     Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Unintentional\   Other Assault\   Unintentional\   Unintentional\
             Unknown/\        MV-Occupant\     Other\           Other Bite/\     Other\           Unknown/\        Foreign Body\    Other\           Struck by/\      Other Specified\ Other\
             Unspecified\     138,371          Transport\       Sting\           Transport\       Unspecified\     263,707          Transport\       Again\           98,642           Transport\
             18,385                            147,836          193,993          399,212          287,495                           189,180          89,118                            1,837,517
  ---------- ---------------- ---------------- ---------------- ---------------- ---------------- ---------------- ---------------- ---------------- ---------------- ---------------- ----------------

# Burden of Alcohol Use

In the United States, alcohol is consumed more frequently than all other
illicit drugs combined and is the drug most likely associated with
injury or death.~1~ Alcohol use in Louisiana cost the taxpayers
approximately \$2.989 billion in 1998. Many of these costs were
connected to alcohol related deaths, such as direct costs for
healthcare, medical consequences of alcohol consumption, ancillary
services at motor vehicle crashes, fire deaths, and loss of future
earnings from premature death due to alcohol use.~2~ As stated
previously, homicide, suicide, chronic disease (cirrhosis), and injuries
(motor vehicle crashes (MVCs) and other alcohol related accidents), are
substance use associated causes of death most frequently linked to
alcohol use.

## State and Parish Long-Term Health Consequences

**[Chronic Liver Disease Mortality]{.underline}**

Death from alcohol-related chronic disease does not appear in the
leading ten causes of death in Louisiana, but cirrhosis is eighth in the
list of substance use related deaths. Alcohol-related chronic liver
disease (AR-CLD), such as cirrhosis, is the single cause that accounts
for the most deaths due to alcohol-related chronic diseases. St. Bernard
Parish is characterized by the highest rate in the state. Orleans,
Jefferson, and Caddo Parishes have the highest number of deaths due to
AR-CLD. Cirrhosis is eighth in the list of Louisiana substance related
causes of death. During the years 1999 to 2001, the rate of cirrhosis
deaths in Louisiana was lower than the national rate. Levels have
remained constant in a range from 0.07 to 0.09 deaths per thousand
people in Louisiana from 1999 to 2004.

![](media/image11.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

From 1999 through 2001 in Louisiana, most cirrhosis deaths occurred in
the 35-54 year age group. The second highest number of deaths occurred
in the 65 and older group.

![](media/image12.wmf){width="6.499305555555556in"
height="4.445833333333334in"}

From 2002 through 2004, St. Bernard Parish exhibited the highest rate of
chronic liver disease mortality in the state. Orleans, Jefferson, and
Caddo Parishes had the next highest number of deaths due to chronic
liver disease during the same period.

![](media/image13.wmf){width="6.499305555555556in"
height="4.445833333333334in"}

![](media/image14.png){width="6.492361111111111in"
height="4.716666666666667in"}

*Data -- LA Office of Public Health (2002-2004)*

## State and Parish Alcohol Consumption

**[Adult Current Drinking]{.underline}**

The percentage of Louisiana residents 21 years of age and older that
reported any use of alcohol within the past 30 days prior to completing
CDC's Behavioral Risk Factor Surveillance System (BRFSS) survey was
higher than the national average (2001-2003). The highest percentages of
respondents reporting alcohol use were in the 21 to 29 year old group.
The lowest percentages were in the group 65 years of age and older.

![](media/image15.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**[Respondents Classified as Dependent/Abusing Alcohol by Age
22]{.underline}**

The National Survey on Drug Use and Health (NSDUH) provides annual data
on drug use in the United States. The NSDUH is sponsored by the
[Substance Abuse and Mental Health Services
Administration](https://nsduhweb.rti.org/frame/homepage1.cfm#%23%23%23)
(SAMHSA), an agency of the U.S. Public Health Service and a division of
the [Department of Health and Human
Services](https://nsduhweb.rti.org/frame/homepage1.cfm#%23%23%23)
(DHHS). The survey provides yearly national and state level estimates of
alcohol, tobacco, illicit drug, and non-medical prescription drug use.
Other health-related questions also appear from year to year, including
questions about mental health.^14^

In the 2002 NSDUH, the percentages of 12 to 17 year olds and respondents
26 and older were right at national levels. The percentage of
respondents 17-25 classified as dependent/abusing alcohol was above
national levels. Louisiana was slightly above the national average in
the composite of all age groups.

![](media/image16.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**[Adult Driving after Drinking]{.underline}**

The percentages of adults reporting driving after drinking in the year
prior to completion of the BRFSS (1999 and 2002) was above the national
average in all age groups in the 1999 survey. In the 2002 survey, the
percentages of adults reporting driving after drinking was well above
the national average only in 18 to 29 years of age. The percentages were
only slightly above national levels in the 30 to 54 year age group and
were below the national average in respondents 55 years of age and
older.

![](media/image17.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**[Adult Heavy Alcohol Use]{.underline}**

In the BRFSS, heavy alcohol use was defined as having an average of two
or more drinks per day for men or one or more drinks per day for women
during the month preceding the interview.^11,\ 12^ In 2001 and 2002, the
percentages of respondents indicating heavy usage was below the national
average, except in the 2001 30-34 year old group. In 2003, the
percentage of respondents indicating heavy alcohol use was above the
national average in 30-54 year olds, and very near national levels in
21-29 year olds and 55-64 year olds. In 2003, 18-20 and 65 and older
respondents indicated heavy alcohol use at percentages below the
national average.

![](media/image18.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**[Binge Drinking]{.underline}**

Binge drinking is defined by the BRFSS as having five or more drinks on
one occasion during the month preceding completion of the survey.~11~
The percentages of respondents indicating binge drinking behavior was
fairly close to the national average (2001-2003). Binge drinking in the
65 year and older age group was above the national average while the
three year mean of 2001 through 2003 percentages was slightly lower than
the national average in the 18 to 20 year group.

![](media/image19.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**[Youth 30-day Alcohol Use by Grade]{.underline}**

The Louisiana Caring Communities Youth Survey (CCYS) is a survey of
6^th^, 8^th^, 10^th^, and 12^th^ grade students designed to identify
adolescent substance use, antisocial behavior, and the risk and
protective factors that relate to these behaviors. The survey was
conducted in the spring of 2001, the fall of 2002, and the fall of 2004.
Thirty day use is a measure of the percentage of students who used the
substance at least once in the 30 days prior to taking the survey and is
considered a sensitive indication of the level of current use of the
substance.^13^

No national comparisons are available for 6^th^ graders. In 8^th^ and
10^th^ graders, the percentage of respondents indicating recent use was
above the national average for all three years. In 12^th^ graders, the
percentages were higher than the national average in 2001, but in 2002
and 2003 were nearly identical to national averages.

![](media/image20.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

In the 2002 NSDUH, the percentages of 12 to 17 year olds and respondents
26 and older dependent /abusing alcohol were equivalent to national
levels. The percentage of respondents 17-25 classified as
dependent/abusing alcohol was above national levels. Louisiana was
slightly above the national average in the composite of all age groups.

Table 4‑2: 30 Day Youth Alcohol Use (2004 CCYS)

  -------------------------------------------------------------------------
  District                  0 Occasions   1 or more     Youth Percent Use
                                          occasions     Within Last 30 days
  ------------------------- ------------- ------------- -------------------
  Zachary Community         173           152           46.77%

  St. Charles Parish        888           667           42.89%

  Cameron Parish            204           151           42.54%

  Avoyelles Parish          704           498           41.43%

  Terrebonne Parish         1222          780           38.96%

  Caldwell Parish           81            48            37.21%

  Allen Parish              519           287           35.61%

  Acadia Parish             1057          578           35.35%

  Plaquemines Parish        672           353           34.44%

  Jefferson Davis Parish    800           418           34.32%

  Beauregard Parish         746           383           33.92%

  Grant Parish              448           227           33.63%

  Ascension Parish          2370          1191          33.45%

  Iberville Parish          519           260           33.38%

  St. Martin Parish         1001          496           33.13%

  Evangeline Parish         741           363           32.88%

  Sabine Parish             651           307           32.05%

  West Carroll Parish       139           65            31.86%

  Assumption Parish         659           308           31.85%

  Iberia Parish             2015          934           31.67%

  St. Landry Parish         1837          838           31.33%

  Calcasieu Parish          4640          2097          31.13%

  Lafayette Parish          3361          1502          30.89%

  City of Bogalusa          235           105           30.88%

  Lafourche Parish          1629          690           29.75%

  Catahoula Parish          182           77            29.73%

  Livingston Parish         3561          1475          29.29%

  ***Louisiana Statewide*** ***70041***   ***28838***   ***29.16%***

  Webster Parish            941           379           28.71%

  East Baton Rouge Parish   6486          2607          28.67%

  Bienville Parish          374           148           28.35%

  Franklin Parish           456           180           28.30%

  Winn Parish               401           155           27.88%

  Union Parish              421           159           27.41%

  Claiborne Parish          369           137           27.08%

  Ouachita Parish           2660          978           26.88%

  Tangipahoa Parish         2777          1021          26.88%

  Natchitoches Parish       755           274           26.63%

  Caddo Parish              1121          403           26.44%

  St. James Parish          408           146           26.35%

  Washington Parish         637           227           26.27%

  Morehouse Parish          614           216           26.02%

  St. Mary Parish           1496          522           25.87%

  Bossier Parish            2176          757           25.81%

  West Baton Rouge Parish   487           166           25.42%

  Jefferson Parish          5339          1757          24.76%

  Red River Parish          146           48            24.74%

  West Feliciana Parish     433           140           24.43%

  Concordia Parish          515           165           24.26%

  East Carroll Parish       242           76            23.90%

  LaSalle Parish            440           136           23.61%

  Rapides Parish            1917          586           23.41%

  Vernon Parish             975           296           23.29%

  City of Baker             335           101           23.17%

  Richland Parish           578           170           22.73%

  Orleans Parish            647           190           22.70%

  Jackson Parish            359           97            21.27%

  Lincoln Parish            752           187           19.91%

  St. Bernard Parish        629           129           17.02%

  DeSoto Parish             499           100           16.69%

  City of Monroe            933           180           16.17%

  St. Helena Parish         223           36            13.90%

  Tensas Parish             140           18            11.39%

  Pointe Coupee Parish      137           11            7.43%

  Madison Parish            71            3             4.05%
  -------------------------------------------------------------------------

![](media/image21.wmf){width="6.5in" height="5.477083333333334in"}

## State and Parish Immediate Health Consequences 

Alcohol is involved in approximately half of all homicides, suicides,
and fatal traffic crashes in the United States.~3~ The three leading
causes of alcohol-related death in Louisiana are homicide, suicide, and
alcohol-related traffic fatalities. In Louisiana, the death rates from
homicide and motor vehicle traffic related accidents exceed the national
rates.~4~

From 1999 through 2001, Louisiana's homicide rate remained nearly double
the national rate. The Orleans Parish homicide rate is more than double
that of any other parish in Louisiana. Caddo, St. John the Baptist, and
East Baton Rouge Parishes all experience rates of homicide above the
state average (parish statistics, 2002--2004).

From 1999 through 2001, death rates for suicide in Louisiana rested
either right at, or slightly above the national rates. Evangeline and
Avoyelles Parishes exhibit high rates of suicide. The highest percentage
of suicides in Louisiana occurs in Jefferson, East Baton Rouge, and
Orleans Parishes, three of the states most densely populated parishes
(parish statistics, 2002--2004).

In the United States, the fourth and sixth leading causes of injury
deaths are accidental falls and drowning (CDC, 2002). In Louisiana from
1999 through 2004, Accidental Falls, Accidental drowning and death due
to fire/smoke/burns were among the leading causes of accidental deaths
other than MV accidents. According to the Centers for Disease Control
and Prevention (CDC), these three causes of accidental death are often
associated with alcohol consumption.^5^

**[Homicide]{.underline}**

![](media/image22.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

The highest number of homicides occurs in the 21-29 year old group and
the 35-54 year old group.

![](media/image23.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

Death rates from homicide are highest in 18-34 year olds.

![](media/image24.wmf){width="6.499305555555556in"
height="4.445833333333334in"}

The highest percentages (number) of homicides occur in Orleans,
Jefferson, East Baton Rouge, and Caddo Parishes. The number of homicides
in Orleans Parish is more than double that of any other parish.

![](media/image25.wmf){width="6.499305555555556in"
height="4.445833333333334in"}

Caddo, St. John the Baptist, and East Baton Rouge Parishes all
experience rates of homicide above the state average (parish statistics,
2002--2004).

![](media/image26.png){width="6.491666666666666in"
height="4.5993055555555555in"}

*Data -- LA Office of Public Health (2002-2004)*

**[Suicide]{.underline}**

![](media/image27.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

From 1999 through 2001, death rates for suicide in Louisiana were
equivalent to or slightly above the national rates. In looking at
suicides in Louisiana by age groups, the highest number of suicides is
seen in the 35-54 year old group (averaging over 180 suicides a year),
while the highest suicide rates are seen in the 65 and older group (16
for every 100,000 individuals in this age range).

![](media/image28.wmf){width="6.246527777777778in"
height="4.259722222222222in"}

![](media/image29.wmf){width="6.246527777777778in"
height="4.259722222222222in"}

![](media/image30.wmf){width="6.499305555555556in"
height="4.445833333333334in"}

The highest percentage of suicides in Louisiana occurred in Jefferson,
East Baton Rouge, and Orleans Parishes, three of the state's most
densely populated parishes (OPH statistics, 2002--2004).

![](media/image31.wmf){width="6.499305555555556in"
height="4.445833333333334in"}

Evangeline and Avoyelles Parishes exhibited high rates of suicide. (OPH
statistics, 2002-2004)

![](media/image32.png){width="6.492361111111111in"
height="4.727083333333334in"}

*Data -- LA Office of Public Health (2002-2004)*

**[Accidental Death]{.underline}**

In the United States, the fourth and sixth leading causes of injury
deaths are accidental falls and drowning (CDC, 2002). In Louisiana from
1999 through 2004, the three leading causes of accidental deaths other
than those caused by motor vehicle crashes were accidental falls,
accidental drowning, and death due to fire, smoke, or burns. According
to the Centers for Disease Control and Prevention (CDC), these three
causes of accidental death are often associated with alcohol
consumption.~5~

![](media/image33.wmf){width="6.748611111111111in"
height="4.615972222222222in"}

**[Alcohol-Related Traffic Fatalities]{.underline}**

Alcohol-related traffic fatalities are the 7^th^ leading cause of death
related to substance use in Louisiana and one of the three leading
causes of alcohol-related death. Almost half of all fatal motor vehicle
crashes in Louisiana somehow involve alcohol. The percentage of fatal
motor vehicle crashes in Louisiana during the years 1999 through 2003
was higher than the percentage nationwide. In Louisiana, the death rates
from alcohol-related motor vehicle crashes also exceed the national
rate.

![](media/image34.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

In 2003, the largest number of fatal alcohol-related motor vehicle
crashes were reported from Jefferson Parish (n=25). East Baton Rouge
(n=21), Orleans (n=20), Caddo (n=18), and Lafayette (n=16) Parishes also
reported large numbers of these types of fatal crashes.

**[Motor vehicle Crash Injuries Involving Alcohol]{.underline}**

In 2003, Orleans Parish experienced the largest number of injuries from
alcohol-related motor vehicle crashes, with 651. Caddo and East Baton
Rouge Parishes were next, each with over 300 alcohol-related crash
injuries. Calcasieu, Lafayette, Jefferson, and St. Tammany Parishes
reported between 200 and 300 such injuries in the same period.

![](media/image35.wmf){width="6.499305555555556in"
height="4.460416666666666in"}

Data - LA Highway Safety Commission

![](media/image36.wmf){width="6.499305555555556in"
height="4.460416666666666in"}

Data - LA Highway Safety Commission

The following map depicts the rates of alcohol related injuries by
parish throughout the state. As is apparent, several parishes experience
rates over 10% greater than the state rate.

![](media/image37.png){width="6.4944444444444445in"
height="4.759027777777778in"}

*Data -- LA Highway Safety Commission (2003)*

Data - LA Highway Safety Commission

The rate of alcohol-related traffic fatalities in 2003 was highest in
Tensas Parish (fatalities per one hundred thousand licensed drivers).

![](media/image38.wmf){width="6.497916666666667in"
height="8.377083333333333in"}

Data - LA Highway Safety Commission

![](media/image39.wmf){width="6.499305555555556in"
height="4.460416666666666in"}

Data - LA Highway Safety Commission

Data - LA Highway Safety Commission

The map shows that 34 Louisiana parishes report rates of fatal
alcohol-related auto crashes more than 10% higher than the state rate
(crashes per 100,000 licensed drivers).

![](media/image40.png){width="6.492361111111111in"
height="4.761805555555555in"}

*Data - LA Highway Safety Commission (2003)*

**[Violent Crime]{.underline}**

Both alcohol use and illicit drug use are related to violent crime.
Alcohol is the drug most frequently associated with violence and is also
associated with domestic violence, assault, and homicide. Alcohol is a
key factor in up to 68 percent of manslaughters, 62 percent of assaults,
54 percent of murders/attempted murders, and 48 percent of robberies.
Crack cocaine use is also a significant contributor to violence. Crack
use exerts a negative impact on many inner-city neighborhoods.~6~

![](media/image41.wmf){width="6.247916666666667in"
height="4.263194444444444in"}

![](media/image42.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

![](media/image43.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

From 2000 through 2002, reports of violent crime in Louisiana exceeded
the national average. Most violent crimes were reported in Orleans, East
Baton Rouge, Jefferson, and Caddo Parishes. The highest rates of
reported violent crimes were in St. James, Jefferson Davis, and Orleans
Parishes. Sixteen other Louisiana parishes report rates higher than the
state average.

![](media/image44.wmf){width="6.499305555555556in"
height="4.445833333333334in"}

![](media/image45.wmf){width="6.499305555555556in"
height="4.445833333333334in"}

![](media/image46.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

![](media/image47.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

![](media/image48.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

![](media/image49.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

## College Alcohol Use

**Defining the College Alcohol Problem**

The Harvard School of Public Health, based on its annual *College
Alcohol Study*, reported that the 2003 mean binge drinking rate was
44.4% (±14.2%; range 13.2% to 83.1%) for undergraduates enrolled at
institutions of higher education. Research from various studies has
identified a range of serious "first-hand" consequences of excessive
drinking by college students: deaths from vehicle crashes, accidents,
overdoses, suicides, and homicides; battery and sexual assaults;
physical injuries and psychological impairments; criminal offenses and
legal records; academic failures and career problems; credit card debt
and poor credit ratings, etc. The greater community is also subjected to
"second-hand" social and economic consequences resulting from
individuals' excessive drinking: physical harm, property damage,
devaluation of neighborhoods, community and university degradation,
excessive involvement of emergency and public safety personnel, and
increased legal costs -- all unduly draining available community
services and resources.

The Harvard School of Public Health also has reported: *"Binge drinking
rates vary among institutions and student subgroups. African American
and Asian, female, and older students have lower rates of binge drinking
than do White, male, and younger students. An increased presence of
students from groups in which alcohol is less heavily consumed tends to
moderate the level of binge drinking in high--binge drinking demographic
subgroups. The higher the percentage of minority, female, and older
(aged ≥ 22 years) students in a school, the lower the binge drinking
rates for total students and high-risk subgroups. In addition, students
who did not binge drink in high school are less likely to start binge
drinking at colleges with larger enrollments of minority and older
students, and students who were high school binge drinkers were less
likely to continue drinking this way".*

(Source: Wechsler and Kuo, "Watering Down Drinks: The Moderating Effect
of College Demographics on Alcohol Use of High-Risk Groups," American
Journal of Public Health, Nov 2003, 93.11.)

Based on those findings and others, epidemiologists should expect to
find varying statistics for alcohol use/consequences by undergraduate
students enrolled at different colleges within Louisiana and throughout
the nation. Not only do student populations vary, but so do the cultural
environments of the communities and regions in which they attend
college. Further, surveys base their findings on differing definitions
of "binge drinking" and other behaviors.

### Louisiana State University Undergraduates' Alcohol Use

Louisiana State University and Agricultural and Mechanical College is
the state's flagship institution of higher education with total student
enrollment at approximately 30,000 students. Since 1993, Louisiana State
University regularly has administered the College Alcohol Study
administered by the Harvard School of Public Health as part of a grant
requirement. As the only institution of higher education in the state
that consistently has been able to assess undergraduate student
substance use and consequences, the following charts provide data from a
representative and random sample of undergraduate students enrolled at
Louisiana State University in Baton Rouge. Response rates have ranged
between 45% to 56%. The data presented is typical of results that might
be found for undergraduate students enrolled in a primarily White,
metropolitan, four-year institution of higher education. The Harvard
School of Public Health has noted that the community's cultural
environment strongly influences students' alcohol consumption rates,
likely to vary both within the Louisiana and throughout the South. The
presentation by Louisiana State University in Baton Rouge serves as one
institutional example in Louisiana and should not be assumed to mirror
any other institution.

![](media/image50.wmf){width="5.991666666666666in"
height="3.2506944444444446in"}

Source: 1997-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

The College Alcohol Study administered by the Harvard School of Public
Health defines "binge drinking" for men as having five or more drinks in
a row at least once in the prior two weeks, and for women as having four
or more in a row. Though the combined binge drinking percentages for all
students varied between 43% to 51% from 1997 to 2003 at Louisiana State
University, none of the differences in the binge rate between survey
years were statistically significant at the .05 level. The lowest
overall rate occurred in 1999, the year after the campus experienced
negative national attention about a fraternity student's alcohol
overdose.

![](media/image51.wmf){width="6.004166666666666in"
height="3.185416666666667in"}

Source: 1997-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

The College Alcohol Study administered by the Harvard School of Public
Health defines "binge drinking" for men as having five or more drinks in
a row at least once in the prior two weeks, and for women as having four
or more in a row. Results indicate that the binge drinking rate for men
has ranged between 50% to 64% overall and for women between 36% to 55%
overall, a gender difference of 9% to 18% depending on the year. The
differences are explained in the next two graphs.

![](media/image52.wmf){width="5.996527777777778in"
height="4.060416666666667in"}

Source: 1997-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

The College Alcohol Study administered by the Harvard School of Public
Health defines "binge drinking" for men as having five or more drinks in
a row at least once in the prior two weeks, and for women as having four
or more in a row. Results indicate that the binge rate for male students
age 21+ has been fairly stable over time (hovering around 60% annually,
except for 43% in 1997). For females age 21+, there was 30% increase
from 1997 to 2000, when the variation between surveys stabilized
somewhat (5% to 8% difference).

![](media/image53.wmf){width="5.999305555555556in"
height="4.009027777777778in"}

Source: 1997-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

The College Alcohol Study administered by the Harvard School of Public
Health defines "binge drinking" for men as having five or more drinks in
a row at least once in the prior two weeks, and for women as having four
or more in a row. Results for students under age 21 indicate that there
was only a 6-7% difference between males and females for 1999, 2000, and
2001 (ranging between 41% to 49% for males, 34% to 43% for females). For
2002 and 2003, underage male binge drinking increased greatly to \~66%,
where it was in 1997 prior to the infamous fraternity student death.
There is more variation for the underage female population (ranging from
34% to 58%, depending on the year), though females consistently binge
drink less than males do, regardless of age.

![](media/image54.wmf){width="5.986805555555556in"
height="5.011111111111111in"}

Source: 1997-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

The College Alcohol Study administered by the Harvard School of Public
Health defines "frequent binge drinking" for men as having five or more
drinks in a row at least once in the prior two weeks, and for women as
having four or more in a row. "Frequent binge drinkers" drank in this
manner three or more times in two weeks. Results indicate that, between
1997 and 2003, frequent binge drinking has increased steadily and
significantly for undergraduate males. With the exception of 2002, there
has been little variation in frequent binge drinking rates (\~23%) for
female undergraduate students.

![](media/image55.wmf){width="5.995833333333334in"
height="3.3444444444444446in"}

Source: 1997-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

The College Alcohol Study administered by the Harvard School of Public
Health defines "frequent binge drinking" for men as having five or more
drinks in a row at least once in the prior two weeks, and for women as
having four or more in a row. This chart only demonstrates where binge
drinkers [reside]{.underline}, not where they consume alcohol. Results
indicate that more binge drinkers [reside]{.underline} in Greek houses
(64%-95%, depending on the year), followed by students residing in
off-campus houses or apartments (46% to 63%, depending on the year). The
fewest binge drinkers reside in on-campus residence halls (22% to 42%,
depending on the year) where many more freshmen choose to live and more
environmental controls are in place.

![](media/image56.wmf){width="5.997222222222222in"
height="3.1055555555555556in"}

Source: 1997-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

The College Alcohol Study administered by the Harvard School of Public
Health questions survey respondents about the negative consequences
resulting from their alcohol consumption. This chart reveals that
negative consequences over time have remained in the same relative
position, though some minimal declines (red lines below blue lines) have
been noted over the course of those years. The [highest-range negative
consequences]{.underline} experienced by 40% to 50% of respondents are:
drove after drinking, engaged in binge drinking, usually binged when
drinking, have had to "babysit" other drunken students, have had
studying or sleep disturbed. [Mid-range negative
consequences]{.underline} experienced by 20% to 40% of respondents are:
frequent binge drinking, 10+ drinking occasions in the last 30 days, was
drunk 3+ times in the past month, experienced 5 or more problems
(excluding hangover), missed a class, fell behind in school, did
something later regretted, forget where I was or what I did, engaged in
unplanned sex, have been insulted, and got into an argument.
[Lowest-range negative consequences]{.underline} experienced by 1%-20%
are: took up binge drinking in college, engaged in unprotected sex,
committed vandalism, got into trouble with police, got hurt or injured,
required medical treatment, was assaulted, had property vandalized,
experienced an unwanted sexual advance, and was a victim of date rape.

![](media/image57.wmf){width="5.9944444444444445in" height="3.24375in"}

Source: 1997-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

The College Alcohol Study administered by the Harvard School of Public
Health questions survey respondents about the negative consequences
resulting from their alcohol consumption. This chart illustrates what
percentage of respondents experienced five or more negative consequences
resulting from their drinking. Results for this category hover around
20% of undergraduate respondents, with the exception of 2002 which was
about 8% higher. \[Note: The 2002 study revealed higher rates for nearly
every negative consequence on the survey, compared with other years.\]

Outcomes

-   The following alcohol-related negative consequences to LSU
    undergraduate students declined 3-8% from 1997-2001 *(College
    Alcohol Study):*

    -   driving after drinking (49.9-41.9%)

    -   getting behind in school work (28.4-25.5%)

    -   forgetting what one did while drinking (29.4-25.7%)

    -   getting hurt or injured (11.7-8.4%)

    -   damaging others' property (12 -- 8.2%)

    -   getting in trouble with police ( 7.9-4.8%)

    -   having studying or sleep interrupted by others (46-43.6%)

-   Additional declines (3-8%) in alcohol-related consequences to LSU
    undergraduate students occurred between 1997-2003 (*College Alcohol
    Study*):

-   had studying/sleep interrupted (46-41.6%)

-   missing classes (33-27.8%)

-   getting behind in schoolwork (28.4-24%)

-   doing something later regretted (33.8-27.9%)

-   using marijuana (18.3-14.6%) and cigarettes (32.7-24.9%) in last 30
    days

-   experiencing five or more of above problems (22.1-18.0%)

-   What behaviors have not shown improvements?

    -   binge drinking

    -   frequent binge drinking among males

    -   insulting others

    -   arguments

    -   fights and assaults

    -   unplanned/unprotected sex under the influence

    -   babysitting other intoxicated students

# Burden of Tobacco Use

## State and Parish Long-Term Health Consequences

**[Cardiovascular Disease Mortality]{.underline}**

Death from cardiovascular disease is included in the category described
as the leading cause of mortality in Louisiana (diseases of the heart)
and is the leading cause of substance related mortality in the state.
The use of tobacco is the number one preventable cause of cardiovascular
disease.~9~ The highest rates of cardiovascular disease mortality were
found in Franklin, Jackson, Webster, Madison, and Catahoula Parishes
during the years 2001-2003. Nineteen (19) other parishes were
characterized by rates above the state average.

![](media/image58.wmf){width="6.499305555555556in"
height="4.445833333333334in"}

**[Ischemic Cerebrovascular Disease Mortality]{.underline}**

The National Vital Statistics System (NVSS) is a cooperative effort
between the National Center for Health Statistics (NCHS) and vital
registration systems operated in the various jurisdictions legally
responsible for the registration of vital
events\--[births](http://www.cdc.gov/nchs/births.htm),
[deaths](http://www.cdc.gov/nchs/deaths.htm),
[marriages](http://www.cdc.gov/nchs/mardiv.htm),
[divorces](http://www.cdc.gov/nchs/mardiv.htm), and [fetal
deaths](http://www.cdc.gov/nchs/about/major/fetaldth/abfetal.htm).^16^
In statistics provided by NVSS from the years 1999 through 2001,
Louisiana's rates of ischemic cerebrovascular disease were slightly
lower than composite rates for the U.S. The category, *ischemic
cerebrovascular disease,* includes heart attack and stroke.

Death from cerebrovascular disease alone is the third leading cause of
mortality in Louisiana and is included in the category *ischemic
cerebrovascular disease,* along with heart attacks. Smoking
significantly elevates the risk of ischemic cerebrovascular disease.^15^
Death from ischemic cerebrovascular disease is also primarily a problem
in Louisiana residents 65 and over, although a significant amount of
death from cardiovascular disease also occurs in those aged 55-64.

![](media/image59.wmf){width="6.627083333333333in"
height="4.521527777777778in"}

![](media/image60.wmf){width="6.379166666666666in"
height="4.356944444444444in"}

![](media/image61.wmf){width="6.379166666666666in"
height="4.356944444444444in"}

**[Lung Disease]{.underline}**

Besides cardiovascular disease and lung cancer, cigarette smoking is
also strongly associated with chronic lung disease.^18^ Death from lung
diseases other than cancer is the fourth leading cause of substance
related mortality in Louisiana. Chronic lower respiratory disease, a
type of lung disease other than cancer, is the sixth leading cause of
death in the state. According to statistics provided by NVSS from 1999
through 2001, rates of lung disease mortality in Louisiana were below
national rates. Winn, Bienville, Grant, Franklin, and Union Parishes
experienced the highest rates of lung disease mortality in the state.
(OPH statistics, 2002-2004) The highest percentages of lung disease
deaths in Louisiana occurred in Jefferson, Orleans, Caddo, East Baton
Rouge, St. Tammany, and Ouachita Parishes. (OPH Statistics, 2002-2004)

![](media/image62.wmf){width="6.370833333333334in"
height="4.347222222222222in"}

Winn, Bienville, Grant, Franklin, and Union Parishes experienced the
highest rates of lung disease mortality in the state. (OPH statistics,
2002-2004)

![](media/image63.wmf){width="6.622916666666667in"
height="4.529861111111111in"}

The highest percentages of lung disease deaths in Louisiana occurred in
Jefferson, Orleans, Caddo, East Baton Rouge, St. Tammany, and Ouachita
Parishes. (OPH Statistics, 2002-2004)

![](media/image64.wmf){width="6.746527777777778in"
height="4.620833333333334in"}

The following map displays the relative rate ratios of lung disease
death in Louisiana parishes. The parishes experiencing the highest rates
from 2002-2004 were in rural areas in north and central Louisiana.
Bienville, Franklin, Grant, Union, and Winn Parishes were the Louisiana
parishes with the highest rates of lung disease death.

![](media/image65.png){width="6.492361111111111in"
height="4.782638888888889in"}

*Data - LA Office of Public Health*

**[Lung Cancer Mortality]{.underline}**

Lung cancer deaths are the third most common cause of substance related
death in Louisiana. There is direct and incontrovertible evidence for a
dose related causal association between lung cancer and smoking.
Evidence exists that exposure to second-hand smoke also is a significant
risk factor for lung cancer. In statistics from 1999 through 2001
provided by NVSS, Louisiana's mortality rates for lung cancer deaths
have exceeded the national rates.

![](media/image66.wmf){width="6.379166666666666in"
height="4.356944444444444in"}

![](media/image67.wmf){width="6.379166666666666in"
height="4.356944444444444in"}

Mortality from lung cancer usually occurs in later years, the heaviest
burden in those persons aged 65 and above. Significant numbers of death
from lung cancer also occur in the 35-54 and 55-64 year age groups.

![](media/image68.wmf){width="6.246527777777778in"
height="4.272916666666666in"}

As would be expected, the highest mortality rate for lung cancer also
occurs in the upper ages, the highest in the 65 and over group. Rates
begin to rise significantly after age 35.

**Cardiovascular Disease Mortality (excluding heart attack and stroke)**

Cardiovascular diseases other than heart attack and stroke are the
second leading substance related causes of death in Louisiana. During
the years 1999-2001, Louisiana's rates of non-heart attack, non-stroke
related cardiovascular disease appeared to remain stable, no upward or
downward trend was noted, but the state rate remained well above the
national rate.

![](media/image69.wmf){width="6.4944444444444445in"
height="4.424305555555556in"}

Death from cardiovascular disease other than ischemic and
cerebrovascular disease (heart attack and stroke) is a problem primarily
in Louisiana residents age 65 and over, although a significant amount of
death from cardiovascular disease also occurs in those aged 55-64.

![](media/image70.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

![](media/image71.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**All Cardiovascular Disease**

![](media/image72.wmf){width="6.746527777777778in"
height="4.620833333333334in"}

![](media/image73.png){width="6.492361111111111in"
height="4.702083333333333in"}

*Data - LA Office of Public Health*

## State and Parish Consumption Patterns

**[Adult Current Cigarette Use]{.underline}**

Respondents were classified as current smokers if they had smoked \>100
cigarettes during their lifetimes and reported smoking every day or some
days during the 12 months preceding the survey. The percentage of
Orleans Parish respondents (30.1%) that indicated current use, was the
highest percentage of any U.S. county.~11,12~

The percentage of Louisiana respondents indicating current use was above
the national average in all age groups for 2001 through 2003, with the
exception of 2001 18-20 year olds and 2002 55-64 year olds. The mean
percentage for current use for the three years was above 15% in all age
groups except the 65 year and older group.

![](media/image74.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**[Adult Daily Cigarette Use]{.underline}**

The percentages of Louisiana residents 18 years of age and older that
indicated daily use of cigarettes were similar to the national average
(2001-2003). The highest percentages of respondents reporting cigarette
use were in the 21 to 29 year old group, although very high percentages
were reported in the 18-20, 30-34, and 35-54 year old groups. The lowest
percentages were in the group 65 years of age and older.

![](media/image75.wmf){width="6.503472222222222in" height="4.43125in"}

![](media/image76.wmf){width="6.377083333333333in"
height="4.370138888888889in"}

Table 5‑3: Youth Tobacco Use Within the last 30 days

  -----------------------------------------------------------------------------
  District            Not at all     1 or more        Percent Use Within Last
                                     occasions        30 days
  ------------------- -------------- ---------------- -------------------------
  Zachary Community   235            93               28.35%

  Cameron Parish      307            101              24.75%

  Union Parish        459            141              23.50%

  Caldwell Parish     92             27               22.69%

  Avoyelles Parish    944            267              22.05%

  Terrebonne Parish   1,590          445              21.87%

  Allen Parish        656            180              21.53%

  Catahoula Parish    194            53               21.46%

  Franklin Parish     507            135              21.03%

  Grant Parish        544            144              20.93%

  Beauregard Parish   920            239              20.62%

  Sabine Parish       771            190              19.77%

  Jefferson Davis     999            245              19.69%
  Parish                                              

  Webster Parish      1,095          260              19.19%

  West Carroll Parish 162            38               19.00%

  Iberia Parish       2,375          542              18.58%

  Bienville Parish    427            97               18.51%

  Iberville Parish    657            149              18.49%

  Lafourche Parish    1,925          431              18.29%

  St. Charles Parish  1,294          288              18.20%

  Natchitoches Parish 854            188              18.04%

  Calcasieu Parish    5,526          1,199            17.83%

  LaSalle Parish      473            102              17.74%

  Red River Parish    183            39               17.57%

  St. Martin Parish   1,240          255              17.06%

  Ouachita Parish     3,006          617              17.03%

  Plaquemines Parish  863            177              17.02%

  Richland Parish     616            126              16.98%

  Assumption Parish   827            168              16.88%

  Ascension Parish    3,019          590              16.35%

  St. Landry Parish   2,323          453              16.32%

  Livingston Parish   4,258          827              16.26%

  ***Louisiana        ***83,463***   ***16,042***     ***16.12%***
  Statewide***                                        

  Washington Parish   730            140              16.09%

  Lafayette Parish    4,114          778              15.90%

  Evangeline Parish   929            175              15.85%

  City of Bogalusa    284            53               15.73%

  Acadia Parish       1,378          255              15.62%

  St. Mary Parish     1,704          311              15.43%

  Vernon Parish       1,086          198              15.42%

  Tangipahoa Parish   3,312          590              15.12%

  West Feliciana      491            86               14.90%
  Parish                                              

  St. James Parish    486            85               14.89%

  Bossier Parish      2,495          433              14.79%

  Concordia Parish    583            101              14.77%

  Morehouse Parish    702            120              14.60%

  East Baton Rouge    7,748          1,322            14.58%
  Parish                                              

  West Baton Rouge    574            96               14.33%
  Parish                                              

  Jackson Parish      409            65               13.71%

  Claiborne Parish    441            70               13.70%

  City of Baker       362            57               13.60%

  Tensas Parish       132            20               13.16%

  Rapides Parish      2,140          320              13.01%

  Jefferson Parish    6,086          907              12.97%

  Caddo Parish        1,332          192              12.60%

  Winn Parish         503            72               12.52%

  Lincoln Parish      828            116              12.29%

  DeSoto Parish       510            67               11.61%

  St. Bernard Parish  709            91               11.38%

  East Carroll Parish 306            31               9.20%

  Orleans Parish      777            70               8.26%

  City of Monroe      1,047          81               7.18%

  St. Helena Parish   242            14               5.47%

  Pointe Coupee       154            5                3.14%
  Parish                                              

  Madison Parish      76             0                0.00%
  -----------------------------------------------------------------------------

![](media/image77.wmf){width="6.497916666666667in"
height="4.752083333333333in"}

**[Youth 30-day Cigarette Use by Grade]{.underline}**

Thirty day use is a measure of the percentage of students who used the
substance at least once in the 30 days prior to taking the survey and is
considered a sensitive indication of the level of current use of the
substance.^13^

No national comparisons are available for 6^th^ graders. A higher
percentage of Louisiana 8^th^ and 10^th^ graders reported cigarette use
than the national average in 2004. Percentages for Louisiana 12^th^
graders, however, were slightly less than the national average and
percentages of cigarette use consistently increased in all age groups
from 6^th^ to 12^th^ grade.

![](media/image78.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

![](media/image79.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

**[Adult Current Cigarette Use]{.underline}**

The percentages of Louisiana residents 18 years of age and older that
have smoked over 100 cigarettes in their lifetime and reported smoking
some days in the twelve months prior to the survey, CDC's Behavioral
Risk Factor Surveillance System (BRFSS) survey, were similar to the
national average (2001-2003). The highest percentages of respondents
reporting cigarette use were in the 21 to 29 year old group, although
very high percentages were reported in the 18-20, 30-34, and 35-54 year
old groups. The lowest percentages were in the group 65 years of age and
older.

![](media/image80.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Respondents were classified as daily smokers if they reported smoking
every day during the 12 months preceding the survey. The percentage of
Orleans Parish respondents (30.1%) that indicated current use was the
highest percentage of any U.S. county.~11,12~

The percentage of Louisiana respondents indicating daily use was above
the national average in all age groups for 2001 through 2003, with the
exception of 2001 18-20 year olds and 2002 55-64 year olds. The mean
percentages for current use for the three years were above 15% in all
age groups except the 65 year and older group.

![](media/image81.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

## State and Parish Immediate Health Consequences

In the United States, the fourth and sixth leading causes of injury
deaths are accidental falls and drowning (CDC, 2002). In Louisiana from
1999 through 2004, the three leading causes of accidental deaths other
than those caused by motor vehicle crashes were accidental falls,
accidental drownings, and death due to fire, smoke, or burns. According
to the Centers for Disease Control and Prevention (CDC), these three
causes of accidental death are often associated with alcohol
consumption.~5~

![](media/image82.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

![](media/image83.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

## College Tobacco Use

### Louisiana State University Undergraduates' Cigarette Use

(Note: This data is specific to Louisiana State University
[undergraduate]{.underline} students. Please do not refer to this as LSU
campus cigarette use as the term "campus" describes a circumscribed area
of land with university buildings, not the student population of which
80% live off-campus.)

Since 1993, Louisiana State University has regularly conducted the
College Alcohol Study administered by the Harvard School of Public
Health as part of a grant requirement. As the only institution of higher
education in the state that consistently has been able to assess
undergraduate student substance use and consequences, the following
charts provide data from a representative and random sample of
undergraduate students enrolled at Louisiana State University in Baton
Rouge. Response rates have ranged between 45% to 56%. The data presented
is typical of results that might be found for undergraduate students
enrolled in a primarily White, metropolitan, four-year institution of
higher education. The Harvard School of Public Health has noted that the
community's cultural environment strongly influences students' alcohol
consumption rates, likely to vary both within the state of Louisiana and
throughout the South. The presentation by Louisiana State University in
Baton Rouge serves as one institutional example in Louisiana and should
not be assumed to mirror any other institution.

![](media/image84.wmf){width="7.878472222222222in"
height="4.689583333333333in"}

Source: 1999-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

**Cigarette Use Over Time -- LSU**

The College Alcohol Study administered by the Harvard School of Public
Health questions survey respondents about how often, if ever, they have
used a variety of drugs, including cigarettes. This chart indicates
students' use of cigarettes in the past 30 days and in the past year
over time. Results indicate that the overall cigarette use rate in the
past 30 days has ranged between 25% to 34% and the overall cigarette use
rate in the past year has ranged between 36% to 42%. Rates of use in the
past year and in the past 30 days are at some of the highest levels in
2002, a year in which rates for nearly all other survey questions
pertaining to students' alcohol use and behavior were higher.

**Cigarette Use in Past Year Over Time, by Gender -- LSU**

![](media/image85.wmf){width="6.996527777777778in"
height="4.288888888888889in"}

Source: 1999-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

The College Alcohol Study administered by the Harvard School of Public
Health questions survey respondents about how often, if ever, they have
used a variety of drugs, including cigarettes. Even when divided by
gender, cigarette use in the past year for both males and females is
similar to total students' use in the past year. Results indicate that
the past year use of cigarettes rates for males range between 35% to
47%. For females, past year cigarette use rates range between 31% to
49%. The yearly cigarette use rate by gender was highest for females in
2002 (49%) while it was lowest for males in that same year (35%). In all
other years, males had higher use rates in the past year than females.

![](media/image86.wmf){width="7.002083333333333in"
height="4.159722222222222in"} Source: 1999-2003 LSU Results, College
Alcohol Study conducted by Harvard School of Public Health

**Cigarette Use in Past 30 Days Over Time, by Gender -- LSU**

The College Alcohol Study administered by the Harvard School of Public
Health questions survey respondents about how often, if ever, they have
used a variety of drugs, including cigarettes. Cigarette use rates in
the past 30 days for both males and females are lower than past year
rates. Results indicate that the past 30 days use of cigarettes rates
for males range between 27% to 37%. For females, past 30 days cigarette
use rates range between 20% to 41%. The rate of cigarette use in the
past 30 days by gender was highest for females in 2002 (41%) while it
was lowest for males in that same year (27%). In all other years, males
had higher use rates in the past 30 days than females.

# Burden of Other Drug Use

## State and Parish Health & Social Consequences

**[Drug related mortality (Illicit Drug Deaths)]{.underline}**

From 1999 through 2001, the rates of death in Louisiana from the use of
illicit drugs were higher than the national rates. The age group
experiencing the most deaths from illicit drugs was in the 35-54 year
old group. (NVSS) The Office of Public Health State Center for Health
Statistics reports that from 1999 through 2004, the highest percentage
of deaths related to drug use occurred in Orleans Parish. The rate in
Orleans Parish was four times the rate in Jefferson Parish, the parish
with the second highest percentage of drug deaths. The highest drug
related mortality rates in Louisiana were reported in Orleans and St.
Bernard Parishes.

![](media/image87.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

From 1999 through 2001 in Louisiana, the rates of death from the use of
illicit drugs were higher than national rates. (NVSS) The composite rate
from 1999-2004 (OPH statistics) is just over 0.02 deaths per 1000
population (2 deaths per 100,000).

![](media/image88.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

![](media/image89.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data - LA Office of Public Health

![](media/image90.wmf){width="6.499305555555556in"
height="4.445833333333334in"}

Data - LA Office of Public Health

The map below illustrates the relative rates of drug deaths in the
state. Again, Orleans and St. Bernard Parishes experienced the highest
rates.

![](media/image91.png){width="6.492361111111111in"
height="4.6194444444444445in"}

Data - LA Office of Public Health

![](media/image92.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**[Property Crime]{.underline}**

Property crimes are often committed to obtain money for the purchase of
illicit drugs. Drug-related property crimes include burglary, larceny,
and motor vehicle theft. Approximately 30% of burglaries can be
attributed to drug use.~7~ From 2000 through 2002, the rate of reported
property crimes in Louisiana exceeded the national rate with most
property crimes being reported in East Baton Rouge, Orleans, Jefferson,
and Caddo Parishes. The highest rates were seen in East Baton Rouge,
Caddo, Orleans, and Rapides Parishes. Nine other parishes also reported
rates higher than the state average.

![](media/image93.png){width="6.492361111111111in"
height="4.769444444444445in"}

![](media/image94.wmf){width="6.4944444444444445in"
height="4.424305555555556in"}

Most property crimes were reported in East Baton Rouge, Orleans,
Jefferson, and Caddo Parishes.
![](media/image95.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data -- LA Commission on Law Enforcement

The highest rates were seen in East Baton Rouge, Caddo, Orleans, and
Rapides Parishes. Nine other parishes reported rates higher than the
state average.![](media/image96.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data -- LA Commission on Law Enforcement

![](media/image97.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

*Data-Louisiana Commission on Law Enforcement*

![](media/image98.wmf){width="6.499305555555556in"
height="4.433333333333334in"}\
*Data-Louisiana Commission on Law Enforcement*

## State and Parish Consumption Patterns

**[Drug Dependence/Abuse]{.underline}**

The National Survey on Drug Use and Health (NSDUH) assesses the
dependence on or abuse of a substance within 12 months prior to
completion of the survey. Questions are used to classify persons as
dependent or abusing specific substances, such as alcohol, prescriptions
drugs, and/or illicit drugs based on criteria specified in the
*Diagnostic and Statistical Manual of Mental Disorders*, 4^th^ edition
(DSM-IV) (American Psychiatric Association \[APA\], 1994). The questions
on dependence inquire about health, emotional problems, attempts to
reduce use, tolerance, withdrawal, participating in activities related
to substance use, or using the substance in large quantities for long
periods of time. The questions on abuse include questions concerning
problems at work, home, and school; problems with family or friends;
physical danger; and legal problems associated with substance use.
Dependence is considered to be more severe than abuse.^14^

The greatest percentage of Louisiana respondents determined to be
dependent or abusing illicit drugs were within the 17-25 year old age
group. The second highest percentage of dependence or abuse was within
the 12-17 year old group. However, the percentages reported in both
these groups were lower than national percentages. Dependence or abuse
percentages in the age 26 and older group were the lowest in comparison,
but exceeded the national average. (2002 NSDUH)

![](media/image99.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**[Admissions]{.underline}**

Rates of admissions to public substance abuse treatment facilities and
programs from 2003 to 2005 are illustrated in the chart below. During
this period, approximately seven persons per one hundred thousand
population per year were admitted to programs across the state. The
number of admissions in East Baton Rouge Parish nearly doubled the
admissions from any other parish. Orleans Parish also exhibited a high
percentage of admissions. The highest rates of treatment admissions were
reported from St. Mary, Rapides, Terrebonne, and East Baton Rouge
Parishes.

Approximately 2/3 of treatment admissions were male. African Americans
make up 32.5% of Louisiana's population, but treatment admissions
comprised a slightly higher proportion of African Americans than that of
the general population.~8~ Most of the admissions, however, were white.
Most persons admitted were between 25 and 44 years of age, but a high
number of admissions were also reported from the 18 to 24 year age
group. An extremely high percentage of the admissions were unemployed.

The most common primary substances reported by treatment admissions were
alcohol (1^st^), cocaine (2^nd^), and marijuana (3^rd^). If secondary
substances were reported, the most common were alcohol (1^st^),
marijuana (2^nd^), and cocaine (3^rd^).

![](media/image100.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

![](media/image101.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data -- LA Office of Addictive Disorders

![](media/image102.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data -- LA Office of Addictive Disorders

![](media/image103.png){width="6.497916666666667in"
height="4.934027777777778in"}

Data -- LA Office of Addictive Disorders

![](media/image104.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data -- LA Office of Addictive Disorders

African Americans make up 32.5% of Louisiana's population, but treatment
admission comprised a slightly higher proportion of African Americans
than that of the general population.~8~ Most persons admitted, however,
were white.

. ![](media/image105.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data -- LA Office of Addictive Disorders

Most persons admitted for treatment were between 25 and 44 years of age,
but a high number of admissions were also reported from the 18 to 24
year age group.

![](media/image106.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data -- LA Office of Addictive Disorders

An extremely high percentage of persons admitted were unemployed.

![](media/image107.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data -- LA Office of Addictive Disorders

The most common primary substances reported by treatment admissions were
alcohol (1^st^), cocaine (2^nd^), and marijuana (3^rd^).

![](media/image108.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data -- LA Office of Addictive Disorders

If any secondary substances were reported, the most common were alcohol
(1^st^), marijuana (2^nd^), and cocaine (3^rd^).

![](media/image109.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

Data -- LA Office of Addictive Disorders

**Marijuana Use**

The greatest percent of Louisiana respondents reporting current use of
marijuana was within the 18-25 year old age group. The second highest
percentage of current use was within the 12-17 year old group. The
percentage reported in the 12-17 year group was below national
percentages. The percentage in the 18-25 year group was above the
national level. Current use percentage in the age 26 and older group was
the lowest in comparison and was lower than the national average.
Overall use of marijuana in all age groups was very near but slightly
above the national level. (2002 NSDUH)

![](media/image110.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

The same pattern of use by age was seen with other illicit drugs besides
marijuana. The highest percentage of use was in the 18-25 year group.
Louisiana's percentages were higher than the national average in all
categories.

![](media/image111.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

**[Youth 30-day Marijuana Use by Grade]{.underline}**

Thirty day use is a measure of the percentage of students who used the
substance at least once in the 30 days prior to taking the survey (CCYS)
and is considered a sensitive indication of the level of current use of
the substance.^12^

No national comparisons are available for 6^th^ graders. Of the
comparisons available, percentages of students that reported use of
marijuana were lower in Louisiana than the national averages for 8^th^,
10^th^ and 12^th^ graders. Thirty day marijuana use consistently
increased in Louisiana students from 6^th^ to 12^th^ grade.

![](media/image112.wmf){width="6.493055555555555in"
height="4.440972222222222in"}

No national comparisons are available for 6^th^ graders and no national
comparisons exist for 12^th^ graders in 2001. Of the comparisons
available, percentages of students that reported use of marijuana were
lower in Louisiana than the national average for 10^th^ and 12^th^
graders, and were lower for Louisiana students in 8^th^ graders in 2002
and 2004. In 2001, the Louisiana percentages were higher than national
levels for 8th graders. Thirty day marijuana use consistently increased
in Louisiana students from 6^th^ to 12^th^ grade.

![](media/image113.wmf){width="6.499305555555556in"
height="4.433333333333334in"}

##  State, Region, Parish Consumption Patterns by Demographics

Table 6‑4: Youth 30 day Marijuana Use (2004 CCYS)

  -------------------------------------------------------------------------
  District                   0 Occasions   1 or more       Percent Use
                                           occasions       Within Last 30
                                                           days
  -------------------------- ------------- --------------- ----------------
  Caldwell Parish            104           24              18.75%

  Zachary Community          266           51              16.09%

  St. Charles Parish         1302          246             15.89%

  Terrebonne Parish          1690          273             13.91%

  City of Bogalusa           296           45              13.20%

  Franklin Parish            534           81              13.17%

  East Baton Rouge Parish    7816          1166            12.98%

  Iberville Parish           664           98              12.86%

  Plaquemines Parish         888           131             12.86%

  Lafourche Parish           1994          285             12.51%

  East Carroll Parish        267           37              12.17%

  St. Martin Parish          1302          176             11.91%

  Lafayette Parish           4164          561             11.87%

  Union Parish               500           65              11.50%

  Beauregard Parish          984           127             11.43%

  Grant Parish               583           75              11.40%

  Bienville Parish           458           58              11.24%

  Avoyelles Parish           1050          128             10.87%

  Allen Parish               709           86              10.82%

  Calcasieu Parish           5935          718             10.79%

  Orleans Parish             737           88              10.67%

  Jackson Parish             397           47              10.59%

  Ascension Parish           3142          371             10.56%

  Iberia Parish              2597          301             10.39%

  ***Louisiana Statewide***  ***87271***   ***9917***      ***10.20%***

  Claiborne Parish           450           51              10.18%

  Morehouse Parish           736           83              10.13%

  Jefferson Parish           6283          704             10.08%

  Livingston Parish          4427          496             10.08%

  City of Baker              388           43              9.98%

  Natchitoches Parish        910           99              9.81%

  Jefferson Davis Parish     1071          115             9.70%

  Webster Parish             1168          124             9.60%

  St. Landry Parish          2348          249             9.59%

  Caddo Parish               1370          145             9.57%

  Concordia Parish           616           65              9.54%

  Tangipahoa Parish          3387          348             9.32%

  St. Mary Parish            1830          181             9.00%

  Catahoula Parish           234           23              8.95%

  Ouachita Parish            3259          320             8.94%

  Tensas Parish              144           14              8.86%

  St. James Parish           492           47              8.72%

  Sabine Parish              860           82              8.70%

  Washington Parish          774           73              8.62%

  West Baton Rouge Parish    583           54              8.48%

  Bossier Parish             2650          241             8.34%

  Red River Parish           177           16              8.29%

  Richland Parish            674           60              8.17%

  Cameron Parish             305           27              8.13%

  Vernon Parish              1161          102             8.08%

  Evangeline Parish          975           84              7.93%

  Acadia Parish              1455          121             7.68%

  Lincoln Parish             856           71              7.66%

  LaSalle Parish             534           43              7.45%

  Rapides Parish             2292          178             7.21%

  City of Monroe             1001          76              7.06%

  West Carroll Parish        189           14              6.90%

  St. Bernard Parish         694           50              6.72%

  Winn Parish                507           36              6.63%

  West Feliciana Parish      532           34              6.01%

  Assumption Parish          901           57              5.95%

  DeSoto Parish              546           34              5.86%

  St. Helena Parish          241           15              5.86%

  Pointe Coupee Parish       140           1               0.71%

  Madison Parish             72            0               0.00%
  -------------------------------------------------------------------------

![](media/image114.wmf){width="6.499305555555556in"
height="4.460416666666666in"}

## College Other Drug Use

-   Tobacco use among U.S. college students in 1999: past year
    prevalence

-   was 45.7%.

-   Tobacco use among U.S. college students in 1999: 30-day prevalence
    was

-   32.9%; males 37.9%; females 29.7%.

-   Marijuana use among U.S. college students in 2001: 30-day prevalence

-   was 17%.

-   Marijuana use among U.S. college students in 2001: past year
    prevalence

-   was 30%.

-   Ecstasy use among U.S. college students in 1999: past year
    prevalence

-   was 4.7%.

-   Opiod use among U.S. college students in 2001: past year prevalence
    was

-   7%.

### Louisiana State University Undergraduates' Drug Use

This data is specific to Louisiana State University
[undergraduate]{.underline} students. Please do not refer to this as LSU
campus drug use as the term "campus" describes a circumscribed area of
land with university buildings, not the student population of which 80%
live off-campus.

Since 1993, Louisiana State University has regularly conducted the
College Alcohol Study administered by the Harvard School of Public
Health as a grant requirement. The only institution of higher education
in the state that has consistently been able to assess undergraduate
student substance use and consequences, the following charts provide
data from a random and representative sample of undergraduate students
enrolled at Louisiana State University in Baton Rouge. Response rates
have ranged between 45% to 56%. The data presented is typical of results
that might be found for undergraduate students enrolled in a primarily
White, metropolitan, four-year institution of higher education. The
Harvard School of Public Health has noted that the community's cultural
environment strongly influences students' alcohol consumption rates,
likely to vary both within the state of Louisiana and throughout the
South. The presentation by Louisiana State University in Baton Rouge
serves as one institutional example in Louisiana and should not be
assumed to mirror any other institution.

Over the five-year period reported, the survey designers requested
information about usage of the following drugs in addition to marijuana
and cigarettes: (a) crack cocaine, (b) other forms of cocaine, (c)
barbiturates (prescription-type sleeping pills like Seconal, Nembutal,
downs or Yellow jackets), (d) amphetamines (methamphetamines, crystal
meth, speed, uppers, ups), (e) tranquilizers (prescription-type drugs
like Valium, Librium, Xanax, Ativan, Klonopin), (f) heroin, (g) other
opiate-type prescription drugs (codeine, morphine, Demerol, Percodan,
Percocet, Vicodin, Darvon, Darvocet), (h) LSD, (i) other psychedelics or
hallucinogens like mushrooms, mescaline, or PCP, and (j) Ecstasy.

![](media/image115.wmf){width="7.627083333333333in"
height="4.915277777777778in"}

Source: 1999-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

**Drug Use Over Time -- LSU**

The College Alcohol Study administered by the Harvard School of Public
Health questions survey respondents about how often, if ever, they have
used a variety of drugs, including marijuana (or hashish). This chart
indicates students' use of marijuana in the past 30 days and in the past
year over time. Results indicate that the overall marijuana use rate in
the past 30 days has ranged between 14% to 19% and the overall marijuana
use rate in the past year has ranged between 21% to 31%. Rates of use in
the past year and in the past 30 days are their highest levels in 2002,
a year in which rates for nearly all other survey questions pertaining
to students' alcohol use and behavior were higher.

**Psychedelic Drug Use Over Time - LSU**

![](media/image116.wmf){width="7.371527777777778in"
height="4.340277777777778in"}

Source: 1999-2003 LSU Results, College Alcohol Study conducted by
Harvard School of Public Health

The College Alcohol Study administered by the Harvard School of Public
Health questions survey respondents about how often, if ever, they have
used a variety of drugs, including Ecstasy, LSD, and other psychedelics.
Of the psychedelic drugs, Ecstasy is used most by LSU undergraduates
with ranges between 5% to 12%.

# Data Gaps and Implications

Over the past year the State Epidemiologic Workgroup (SEW) has
investigated several sources of consumption and consequence data from
different agencies and organizations throughout the state and nation.
This examination has resulted in discussions about the validity,
precision, and plausibility of each of the data sets. Several SEW
members have also scrutinized data sources from their own organizations
and/or agencies and identified problems with accuracy, timeliness,
sample number, etc. The end result of this scrutiny is that the SEW has
identified a multitude of data gaps, or complete absences of data that
in the opinion of the SEW, are worthy of working to develop in the
future.

This encouragement and advocacy of new and/or improved data source
development will be one of the primary roles of the SEW in the coming
years. The consensus of the group is that the membership will continue
to seek new sources individually and together as a group, and to work
within the members' respective agencies/organizations to accomplish the
goals initially stated in the SPF SIG.

Examples of data sources and related challenges that are planned to be
addressed are:

-   State/parish drug-related emergency room reporting

    -   No statewide system of emergency room reporting exists in
        Louisiana, although some hospitals report "complaint"
        information. No emergency room discharge or diagnostic reporting
        is required.

    -   Emergency departments are often reluctant to release data due to
        proprietary concerns.

    -   Reporting of emergency department diagnoses

        -   Reporting of multiple diagnoses or subgroup diagnoses is
            also desirable.

    -   Reporting of alcohol poisoning

-   State/parish drug/alcohol related arrests (including those involving
    drugs and/or alcohol but without obvious possession of such
    substances).

    -   Improvement of crime related data indicating possession or
        presence of alcohol and other non-controlled substances

    -   Reporting of drug and alcohol related homicide data

    -   Consistent collection of arrest data across all jurisdictions

    -   Timely collection of arrest data in all jurisdictions

-   State/parish drug related suicides (adults)

    -   Data on alcohol and drug related suicides

    -   Coroner reporting of substance related suicides

    -   Toxicological analysis of all suicide victims

-   Improvement of or creation of data sources dealing with alcohol or
    drug associated traffic accidents or other accidents

    -   Uniform consistent drug and alcohol testing of all victims

    -   More detailed reporting of non-traffic accidents (falls,
        industrial accidents, recreational accidents)

-   State/campus college populations consumption/consequence data
    collection

-   Age 18 and older consumption/consequence data

-   Data reported in consistent age cohorts or individuals years across
    most indicators

    -   Calculation of disability adjusted life years (DALYs) and/or
        years of potential life lost (YPLL) for mortality and morbidity
        data

-   Parish level tobacco sales

    -   Include data pertaining to citations given for sales to minors

-   Parish level alcohol and tobacco sales

    -   Include data pertaining to citations given for sales to minors

-   Improved substance related data collection on risk questionnaires
    (HIV/AIDS, STDs, hepatitis C)

-   Non-mortality accident data (injury data)

-   Child Welfare Populations:

    -   Limited and inconsistent methods of identifying and recording
        substance use/abuse in relation to validated complaints of child
        maltreatment.

    -   No data fields available in data system for capturing
        information learned about substance abuse in families following
        a validated complaint of maltreatment when there is continued
        agency involvement with the family.

    -   No data fields available for recording alcohol or other
        substance abuse by youth who are served in the foster care
        system.

The SEW will certainly not be restricted to consideration of the above
data sources and data improvements. The SEW feels that the role of
advocating adoption of new data sources and improvements to existing
sources will be ever-changing as community needs and assets change
through time.

It is intuitive that creation and improvement of these types of data
sources involve cooperation of many different entities and require
varying degrees of effort, some quite taxing to often scarce resources.
The SEW intends to illustrate the importance of these data to the
determination of the burden of substance abuse in Louisiana and to the
proper allocation of assets. Some improvements will require cooperation
of both government and private institutions and some will require
allocation of funds through legislation. The primary stumbling blocks
include lack of funding, manpower, and the will to carry out the task.

# Problems of Greatest Impact and Hot Spots

Most of the following tables show the levels by parish for some of the
most important indicators. Shaded rows in the tables indicate the parish
rate is higher than the state's.

Table 5 Alcohol Use - Binge

  ------------------------------------ ----------------------------------
  Age Range                            Percent Reported Binge Drinking

  College Age Binge                    32%

  Adult Binge 25-34                    22%

  Adult Binge 35-44                    20%

  Adult Binge 45-54                    12%

  Adult Binge 55-64                    8%

  Adult Binge 65+                      3%
  ------------------------------------ ----------------------------------

Table 6 Alcohol Use - Drinking and Driving

  ------------------------------------ ----------------------------------
  Drinking and Driving                 Percent Reporting Driving after
                                       Drinking

  18-20 yrs                            9%

  21-29 yrs                            10%

  30-34 yrs                            5%

  35-54 yrs                            4%

  55-64-yrs                            2%

  65+ yrs                              1%
  ------------------------------------ ----------------------------------

Table 7 Youth Alcohol Use

  ----------------------------------------------------------------------------
  ** **              **6th Grade**     ** **     ** **     ** **     ** **
  ------------------ ----------------- --------- --------- --------- ---------
  **Parish**         **Percent Use     **6th     **8th     **10th    **12th
                     within Last 30    Grade     Grade     Grade     Grade
                     days**            Binge**   Binge**   Binge**   Binge**

  Acadia Parish      16.70%            11.37%    17.00%    32.22%    43.06%

  Allen Parish       14.93%            13.97%    25.20%    28.33%    46.30%

  Ascension Parish   8.53%             5.88%     18.04%    33.79%    42.44%

  Assumption Parish  16.60%            13.68%    12.39%    25.53%    34.88%

  Avoyelles Parish   17.39%            11.00%    20.65%    33.90%    44.15%

  Beauregard Parish  14.63%            9.29%     26.83%    22.07%    28.57%

  Bienville Parish   14.63%            12.30%    17.68%    21.30%    28.18%

  Bossier Parish     8.25%             6.82%     12.72%    22.20%    32.42%

  Caddo Parish       6.76%             6.49%     11.36%    21.66%    28.21%

  Calcasieu Parish   7.88%             4.99%     15.98%    26.21%    33.15%

  Caldwell Parish    N/A               N/A       30.08%    N/A       N/A

  Cameron Parish     13.10%            8.08%     31.53%    31.43%    48.72%

  Catahoula Parish   12.90%            6.38%     13.56%    36.17%    39.58%

  Claiborne Parish   18.25%            10.77%    15.44%    20.33%    27.97%

  Concordia Parish   10.61%            8.71%     11.97%    25.88%    60.00%

  DeSoto Parish      12.81%            7.98%     15.26%    0.00%     0.00%

  East Baton Rouge   11.13%            8.57%     16.67%    19.03%    27.34%
  Parish                                                             

  East Carroll       14.89%            13.89%    15.15%    14.67%    21.74%
  Parish                                                             

  Evangeline Parish  14.07%            12.62%    18.21%    26.79%    41.07%

  Franklin Parish    12.81%            10.68%    15.90%    25.60%    39.64%

  Grant Parish       7.30%             5.32%     17.89%    28.57%    39.23%

  Iberia Parish      11.70%            8.03%     19.93%    27.00%    34.08%

  Iberville Parish   11.27%            7.31%     26.75%    30.57%    27.04%

  Jackson Parish     5.60%             3.76%     15.97%    13.95%    21.28%

  Jefferson Parish   10.64%            8.04%     14.13%    20.07%    26.37%

  Jefferson Davis    9.36%             5.90%     14.97%    33.33%    33.76%
  Parish                                                             

  Lafayette Parish   9.79%             8.76%     15.40%    32.36%    40.33%

  Lafourche Parish   9.01%             7.26%     22.42%    37.00%    43.23%

  LaSalle Parish     5.88%             4.65%     11.54%    33.63%    25.33%

  Lincoln Parish     4.37%             6.64%     11.19%    11.80%    31.13%

  Livingston Parish  8.30%             6.42%     14.97%    24.79%    34.94%

  Madison Parish     4.29%             4.00%     N/A       N/A       N/A

  Morehouse Parish   11.03%            8.37%     17.16%    18.13%    20.96%

  Natchitoches       8.68%             6.96%     19.72%    21.03%    32.16%
  Parish                                                             

  Orleans Parish     8.70%             7.77%     12.25%    15.57%    22.86%

  Ouachita Parish    8.12%             5.97%     15.21%    21.03%    28.31%

  Plaquemines Parish 11.93%            4.96%     22.13%    28.86%    38.86%

  Pointe Coupee      7.48%             8.44%     N/A       N/A       N/A
  Parish                                                             

  Rapides Parish     7.83%             4.94%     12.49%    26.33%    28.76%

  Red River Parish   8.57%             8.64%     16.44%    N/A       33.33%

  Richland Parish    11.83%            8.70%     10.82%    26.79%    32.29%

  Sabine Parish      7.76%             10.00%    21.18%    30.38%    33.02%

  St. Bernard Parish 9.21%             7.36%     15.16%    100.00%   N/A

  St. Charles Parish 100.00%           100.00%   14.87%    32.63%    37.67%

  St. Helena Parish  5.33%             5.26%     7.27%     14.58%    7.69%

  St. James Parish   12.35%            5.41%     12.64%    31.29%    30.91%

  St. Landry Parish  14.54%            10.37%    14.53%    24.25%    30.18%

  St. Martin Parish  11.19%            9.81%     17.55%    28.05%    49.01%

  St. Mary Parish    7.50%             9.03%     11.24%    20.19%    30.95%

  Tangipahoa Parish  9.11%             6.55%     10.80%    20.19%    32.58%

  Tensas Parish      8.33%             11.76%    9.52%     6.45%     7.89%

  Terrebonne Parish  66.67%            66.67%    20.49%    27.02%    34.39%

  Union Parish       12.43%            11.70%    15.22%    28.70%    32.43%

  Vernon Parish      7.99%             4.68%     18.23%    22.69%    25.49%

  Washington Parish  8.02%             7.45%     13.54%    17.70%    33.99%

  Webster Parish     9.95%             9.18%     15.40%    25.66%    28.11%

  West Baton Rouge   10.58%            7.58%     19.50%    16.67%    50.00%

  West Carroll       17.78%            13.33%    10.00%    34.43%    18.18%
  Parish                                                             

  West Feliciana     8.15%             7.65%     15.24%    17.89%    30.56%

  Winn Parish        9.04%             5.92%     13.82%    17.14%    29.23%

  City of Monroe     6.36%             5.68%     9.46%     13.83%    20.29%

  City of Bogalusa   5.26%             1.82%     14.73%    23.47%    30.77%

  City of Baker      11.48%            5.31%     14.05%    12.22%    19.23%

  Zachary Community  N/A               N/A       N/A       34.51%    34.34%

  State              0.100             0.077     0.250     0.247     0.330
  ----------------------------------------------------------------------------

Table 8 Alcohol Consequences

  --------------------------------------------------------------------------------------
  Rates are per  **-99 - Too                                              
  1000           Small to                                                 
  population     Count**                                                  
  except where                                                            
  noted                                                                   
  -------------- ----------- -------------- ------------- --------------- --------------
  ** **          **Rate      **Rate         **Rate        **Rate 2003     **Rate 2003
                 00-02**     2002-04**      2002-04**     (per 100K lic   (per 100K lic
                                                          drivers)**      drivers)**

  **Parish of    **Violent   **Homicide**   **Suicide**   **Alcohol       **Alcohol
  Residence**    Crime**                                  Related Crash   Related Crash
                                                          Fatalities**    Injuries**

  Acadia         3.495       -99.000        0.146         16.000          200.000

  Allen          3.345       -99.000        -99.000       15.000          116.000

  Ascension      4.173       0.055          0.114         17.000          164.000

  Assumption     3.421       -99.000        0.072         30.000          196.000

  Avoyelles      3.413       -99.000        0.183         8.000           119.000

  Beauregard     2.495       -99.000        0.059         0.000           77.000

  Bienville      1.329       -99.000        -99.000       0.000           202.000

  Bossier        6.084       0.094          0.120         9.000           103.000

  Caddo          8.313       0.182          0.102         12.000          217.000

  Calcasieu      6.341       0.078          0.114         10.000          234.000

  Caldwell       2.174       -99.000        0.031         0.000           124.000

  Cameron        3.042       -99.000        0.034         35.000          417.000

  Catahoula      2.797       -99.000        -99.000       28.000          197.000

  Claiborne      2.617       -99.000        -99.000       33.000          223.000

  Concordia      4.614       -99.000        -99.000       24.000          195.000

  DeSoto         6.896       -99.000        -99.000       12.000          117.000

  E.Baton Rouge  7.943       0.137          0.100         8.000           125.000

  E.Carroll      3.390       -99.000        -99.000       23.000          164.000

  E.Feliciana    5.490       -99.000        -99.000       22.000          30.000

  Evangeline     1.564       -99.000        0.236         10.000          268.000

  Franklin       3.447       -99.000        -99.000       31.000          31.000

  Grant          3.986       -99.000        -99.000       16.000          159.000

  Iberia         3.506       -99.000        0.090         9.000           160.000

  Iberville      8.246       0.112          0.071         32.000          169.000

  Jackson        2.780       -99.000        -99.000       27.000          100.000

  Jeff. Davis    10.965      -99.000        -99.000       39.000          234.000

  Jefferson      6.618       0.134          0.124         8.000           88.000

  Lafayette      6.543       0.045          0.101         12.000          210.000

  Lafourshe      2.798       -99.000        0.098         16.000          213.000

  LaSalle        1.475       -99.000        -99.000       21.000          105.000

  Lincoln        4.929       0.079          -99.000       12.000          198.000

  Livingston     4.117       -99.000        0.150         8.000           143.000

  Madison        7.334       -99.000        -99.000       34.000          170.000

  Morehouse      4.848       -99.000        0.120         26.000          142.000

  Natchitoches   7.508       0.060          -99.000       40.000          233.000

  Orleans        10.436      0.520          0.086         9.000           279.000

  Ouachita       6.786       0.079          0.083         14.000          165.000

  Plaquemines    2.376       -99.000        0.142         17.000          115.000

  Pt. Coupee     4.105       -99.000        0.089         28.000          223.000

  Rapides        8.078       0.089          0.107         10.000          183.000

  Red River      3.792       -99.000        -99.000       18.000          198.000

  Richland       1.294       -99.000        -99.000       32.000          205.000

  Sabine         4.138       -99.000        -99.000       13.000          145.000

  St. Tammany    3.061       0.037          0.140         8.000           158.000

  St.Bernard     1.965       -99.000        0.147         9.000           111.000

  St.Charles     7.199       -99.000        0.101         6.000           167.000

  St.Helena      3.920       -99.000        -99.000       0.000           152.000

  St.James       16.712      -99.000        -99.000       7.000           235.000

  St.John        2.243       0.148          -99.000       26.000          231.000

  St.Landry      7.535       0.071          0.154         23.000          201.000

  St.Martin      2.845       -99.000        0.113         38.000          217.000

  St.Mary        8.662       -99.000        -99.000       14.000          144.000

  Tangipahoa     9.149       0.106          0.093         14.000          141.000

  Tensas         4.411       -99.000        -99.000       57.000          86.000

  Terrebonne     7.427       0.072          0.097         14.000          189.000

  Union          3.051       -99.000        -99.000       33.000          178.000

  Vermilion      2.713       -99.000        0.110         14.000          171.000

  Vernon         3.814       0.040          0.093         14.000          97.000

  W.Baton Rouge  5.884       -99.000        -99.000       28.000          280.000

  W.Carroll      2.542       -99.000        -99.000       0.000           75.000

  W.Feliciana    2.332       0.022          -99.000       16.000          32.000

  Washington     6.957       -99.000        0.136         29.000          162.000

  Webster        3.118       0.081          0.153         30.000          178.000

  Winn           2.440       -99.000        -99.000       11.000          175.000

  STATE          6.349       0.133          0.110         13.000          166.000
  --------------------------------------------------------------------------------------

Table 9 Youth Drug Use

  ------------------------------------------------------------------------
  **District**     **Percent Marijuana Use      **Percent Inhalant Use in
                   Within Last 30 days**        previous 30 days**
  ---------------- ---------------------------- --------------------------
  Acadia Parish    7.68%                        6.05%

  Allen Parish     10.82%                       10.79%

  Ascension Parish 10.56%                       8.31%

  Assumption       5.95%                        5.59%
  Parish                                        

  Avoyelles Parish 10.87%                       9.65%

  Beauregard       11.43%                       8.65%
  Parish                                        

  Bienville Parish 11.24%                       7.95%

  Bossier Parish   8.34%                        7.67%

  Caddo Parish     9.57%                        6.18%

  Calcasieu Parish 10.79%                       8.10%

  Caldwell Parish  18.75%                       25.20%

  Cameron Parish   8.13%                        8.12%

  Catahoula Parish 8.95%                        9.38%

  City of Baker    9.98%                        8.96%

  City of Bogalusa 13.20%                       7.64%

  City of Monroe   7.06%                        8.79%

  Claiborne Parish 10.18%                       8.74%

  Concordia Parish 9.54%                        9.59%

  DeSoto Parish    5.86%                        5.64%

  East Baton Rouge 12.98%                       8.50%
  Parish                                        

  East Carroll     12.17%                       7.30%
  Parish                                        

  Evangeline       7.93%                        10.73%
  Parish                                        

  Franklin Parish  13.17%                       7.51%

  Grant Parish     11.40%                       7.58%

  Iberia Parish    10.39%                       5.98%

  Iberville Parish 12.86%                       8.05%

  Jackson Parish   10.59%                       9.66%

  Jefferson Davis  9.70%                        8.32%
  Parish                                        

  Jefferson Parish 10.08%                       7.38%

  Lafayette Parish 11.87%                       7.48%

  Lafourche Parish 12.51%                       0.00%

  LaSalle Parish   7.45%                        5.53%

  Lincoln Parish   7.66%                        8.17%

  Livingston       10.08%                       7.84%
  Parish                                        

  Madison Parish   0.00%                        6.88%

  Morehouse Parish 10.13%                       8.46%

  Natchitoches     9.81%                        4.90%
  Parish                                        

  Orleans Parish   10.67%                       7.00%

  Ouachita Parish  8.94%                        7.65%

  Plaquemines      12.86%                       6.84%
  Parish                                        

  Pointe Coupee    0.71%                        6.65%
  Parish                                        

  Rapides Parish   7.21%                        10.95%

  Red River Parish 8.29%                        7.40%

  Richland Parish  8.17%                        5.12%

  Sabine Parish    8.70%                        8.91%

  St. Bernard      6.72%                        6.98%
  Parish                                        

  St. Charles      15.89%                       8.20%
  Parish                                        

  St. Helena       5.86%                        6.95%
  Parish                                        

  St. James Parish 8.72%                        6.94%

  St. Landry       9.59%                        5.06%
  Parish                                        

  St. Martin       11.91%                       10.46%
  Parish                                        

  St. Mary Parish  9.00%                        8.45%

  Tangipahoa       9.32%                        8.25%
  Parish                                        

  Tensas Parish    8.86%                        7.31%

  Terrebonne       13.91%                       5.94%
  Parish                                        

  Union Parish     11.50%                       8.90%

  Vernon Parish    8.08%                        6.37%

  Washington       8.62%                        5.85%
  Parish                                        

  Webster Parish   9.60%                        5.94%

  West Baton Rouge 8.48%                        7.45%

  West Carroll     6.90%                        4.97%
  Parish                                        

  West Feliciana   6.01%                        7.57%

  Winn Parish      6.63%                        6.10%

  Zachary          16.09%                       7.60%
  Community                                     

  Louisiana        0.102                        0.078
  Statewide                                     
  ------------------------------------------------------------------------

Table 10 Drug Consequence

  -----------------------------------------------------------------------
  Rates are per 1000        **-99 - Too                    
  population except where   Small to                       
  noted                     Count**                        
  ------------------------- ------------- ---------------- --------------
  ** **                     **Rate        **Rate 00-02**   **Rate 00-02**
                            1999-04**                      

  **Parish of Residence**   **Drug        **Property       **Violent
                            Deaths**      Crime**          Crime**

  Acadia                    0.020         29.495           3.495

  Allen                     -99.000       15.910           3.345

  Ascension                 -99.000       34.237           4.173

  Assumption                -99.000       14.557           3.421

  Avoyelles                 -99.000       19.978           3.413

  Beauregard                -99.000       18.589           2.495

  Bienville                 -99.000       7.225            1.329

  Bossier                   0.010         45.404           6.084

  Caddo                     0.015         63.262           8.313

  Calcasieu                 0.005         53.343           6.341

  Caldwell                  0.000         10.838           2.174

  Cameron                   0.000         20.381           3.042

  Catahoula                 0.000         15.398           2.797

  Claiborne                 0.000         14.522           2.617

  Concordia                 0.000         22.473           4.614

  DeSoto                    -99.000       29.146           6.896

  E.Baton Rouge             0.005         75.779           7.943

  E.Carroll                 -99.000       15.401           3.390

  E.Feliciana               -99.000       11.106           5.490

  Evangeline                0.000         14.640           1.564

  Franklin                  0.000         16.304           3.447

  Grant                     0.000         19.434           3.986

  Iberia                    0.023         24.706           3.506

  Iberville                 -99.000       28.702           8.246

  Jackson                   -99.000       15.071           2.780

  Jeff. Davis               -99.000       36.843           10.965

  Jefferson                 0.018         51.945           6.618

  Lafayette                 0.009         27.207           6.543

  Lafourshe                 0.011         7.635            2.798

  LaSalle                   -99.000       48.319           1.475

  Lincoln                   0.020         40.851           4.929

  Livingston                0.017         25.055           4.117

  Madison                   0.000         27.997           7.334

  Morehouse                 -99.000       26.464           4.848

  Natchitoches              0.030         41.359           7.508

  Orleans                   0.086         61.060           10.436

  Ouachita                  0.009         48.039           6.786

  Plaquemines               -99.000       14.933           2.376

  Pt. Coupee                -99.000       16.200           4.105

  Rapides                   0.009         56.659           8.078

  Red River                 0.000         19.344           3.792

  Richland                  -99.000       15.022           1.294

  Sabine                    -99.000       14.304           4.138

  St. Tammany               0.019         31.009           3.061

  St.Bernard                0.083         13.606           1.965

  St.Charles                0.017         32.648           7.199

  St.Helena                 0.000         16.891           3.920

  St.James                  0.000         33.235           16.712

  St.John                   -99.000       28.012           2.243

  St.Landry                 0.017         37.767           7.535

  St.Martin                 -99.000       14.462           2.845

  St.Mary                   0.000         48.645           8.662

  Tangipahoa                0.034         48.203           9.149

  Tensas                    0.000         14.514           4.411

  Terrebonne                0.009         51.585           7.427

  Union                     -99.000       23.329           3.051

  Vermilion                 -99.000       16.509           2.713

  Vernon                    -99.000       20.256           3.814

  W.Baton Rouge             -99.000       53.621           5.884

  W.Carroll                 -99.000       17.714           2.542

  W.Feliciana               0.000         13.750           2.332

  Washington                0.030         39.981           6.957

  Webster                   -99.000       16.607           3.118

  Winn                      -99.000       12.380           2.440

  STATE                     0.021         44.179           6.349
  -----------------------------------------------------------------------

Table 11 Youth Tobacco use

  -----------------------------------------------------------------------
  ** **                            **CCYS**
  -------------------------------- --------------------------------------
  **District**                     **Percent Use Within Last 30 days**

  Acadia Parish                    15.62%

  Allen Parish                     21.53%

  Ascension Parish                 16.35%

  Assumption Parish                16.88%

  Avoyelles Parish                 22.05%

  Beauregard Parish                20.62%

  Bienville Parish                 18.51%

  Bossier Parish                   14.79%

  Caddo Parish                     12.60%

  Calcasieu Parish                 17.83%

  Caldwell Parish                  22.69%

  Cameron Parish                   24.75%

  Catahoula Parish                 21.46%

  City of Baker                    13.60%

  City of Bogalusa                 15.73%

  City of Monroe                   7.18%

  Claiborne Parish                 13.70%

  Concordia Parish                 14.77%

  DeSoto Parish                    11.61%

  East Baton Rouge Parish          14.58%

  East Carroll Parish              9.20%

  Evangeline Parish                15.85%

  Franklin Parish                  21.03%

  Grant Parish                     20.93%

  Iberia Parish                    18.58%

  Iberville Parish                 18.49%

  Jackson Parish                   13.71%

  Jefferson Davis Parish           19.69%

  Jefferson Parish                 12.97%

  Lafayette Parish                 15.90%

  Lafourche Parish                 18.29%

  LaSalle Parish                   17.74%

  Lincoln Parish                   12.29%

  Livingston Parish                16.26%

  Madison Parish                   0.00%

  Morehouse Parish                 14.60%

  Natchitoches Parish              18.04%

  Orleans Parish                   8.26%

  Ouachita Parish                  17.03%

  Plaquemines Parish               17.02%

  Pointe Coupee Parish             3.14%

  Rapides Parish                   13.01%

  Red River Parish                 17.57%

  Richland Parish                  16.98%

  Sabine Parish                    19.77%

  St. Bernard Parish               11.38%

  St. Charles Parish               18.20%

  St. Helena Parish                5.47%

  St. James Parish                 14.89%

  St. Landry Parish                16.32%

  St. Martin Parish                17.06%

  St. Mary Parish                  15.43%

  Tangipahoa Parish                15.12%

  Tensas Parish                    13.16%

  Terrebonne Parish                21.87%

  Union Parish                     23.50%

  Vernon Parish                    15.42%

  Washington Parish                16.09%

  Webster Parish                   19.19%

  West Baton Rouge                 14.33%

  West Carroll Parish              19.00%

  West Feliciana                   14.90%

  Winn Parish                      12.52%

  Zachary Community                28.35%

  Louisiana Statewide              0.161
  -----------------------------------------------------------------------

Table 12 Tobacco Consequences

  -----------------------------------------------------------------------
  Rates are per 1000                                   
  population except where                              
  noted                                                
  ---------------------------- ----------------------- ------------------
  ** **                        **Rate 2001-03**        **Rate 2002-04**

  **Parish of Residence**      **Cardiovascular        **Lung Cancer**
                               Disease**               

  Acadia                       3.674                   0.783

  Allen                        3.309                   0.540

  Ascension                    2.514                   0.454

  Assumption                   3.571                   0.660

  Avoyelles                    4.730                   0.773

  Beauregard                   3.722                   0.624

  Bienville                    4.994                   0.846

  Bossier                      2.579                   0.560

  Caddo                        3.708                   0.691

  Calcasieu                    3.491                   0.690

  Caldwell                     4.556                   0.934

  Cameron                      2.556                   0.755

  Catahoula                    5.327                   0.905

  Claiborne                    4.892                   0.865

  Concordia                    3.176                   0.622

  DeSoto                       4.399                   0.744

  E.Baton Rouge                2.876                   0.480

  E.Carroll                    3.986                   0.776

  E.Feliciana                  3.941                   0.713

  Evangeline                   3.746                   0.679

  Franklin                     6.585                   0.719

  Grant                        3.727                   0.758

  Iberia                       3.449                   0.752

  Iberville                    3.873                   0.539

  Jackson                      5.986                   0.916

  Jeff. Davis                  3.724                   0.824

  Jefferson                    3.169                   0.684

  Lafayette                    2.336                   0.532

  Lafourshe                    2.963                   0.543

  LaSalle                      4.723                   0.916

  Lincoln                      2.428                   0.451

  Livingston                   2.353                   0.535

  Madison                      5.482                   0.460

  Morehouse                    4.518                   0.785

  Natchitoches                 4.039                   0.481

  Orleans                      3.312                   0.631

  Ouachita                     3.109                   0.548

  Plaquemines                  2.789                   0.641

  Pt. Coupee                   4.002                   0.651

  Rapides                      4.032                   0.759

  Red River                    4.070                   0.695

  Richland                     4.903                   1.084

  Sabine                       4.138                   0.822

  St. Tammany                  2.467                   0.583

  St.Bernard                   3.576                   0.834

  St.Charles                   2.421                   0.552

  St.Helena                    3.303                   0.773

  St.James                     3.217                   0.472

  St.John                      2.446                   0.534

  St.Landry                    3.830                   0.760

  St.Martin                    3.163                   0.660

  St.Mary                      3.253                   0.592

  Tangipahoa                   3.517                   0.630

  Tensas                       4.790                   0.847

  Terrebonne                   2.766                   0.594

  Union                        4.122                   0.685

  Vermilion                    3.919                   0.631

  Vernon                       2.214                   0.456

  W.Baton Rouge                2.536                   0.551

  W.Carroll                    4.828                   1.019

  W.Feliciana                  2.481                   0.484

  Washington                   4.608                   0.924

  Webster                      5.534                   0.935

  Winn                         5.075                   0.836

  STATE                        3.304                   0.636
  -----------------------------------------------------------------------

![](media/image117.wmf){width="6.499305555555556in"
height="4.667361111111111in"}

# SEW Policy Statement

**Governing Policy of the Louisiana State Epidemiological Workgroup**

Strategic Prevention Framework State Incentive Grant

"The Governor's Initiative to Build A Healthy Louisiana"

Unanimously Adopted on February 24, 2005

Amended and Unanimously Adopted on December 15, 2005

The following is an outline of membership, roles and responsibilities
and procedures that are recommended to govern the Strategic Prevention
Framework State Incentive Grant

State Epidemiological Workgroup (SEW).

**Membership**

1.  The SEW membership is open to representatives from departments,
    agencies, universities and other entities with responsibility for
    collecting, housing, analyzing and reporting data related to drug
    abuse, including underage drinking, and its consequences.

2.  The number of active, voting members shall not exceed forty.

3.  Membership will be determined by the SPF SIG SEW grant requirements
    and recommendations of the SPF SIG staff.

**Members Roles and Responsibilities**

4.  The SEW role is an advisory committee of the SPF SIG Grant advising
    the Prevention Systems Committee and Drug Policy Board. It shall
    advise on issues related to the use of data planning and evaluating
    drug abuse prevention activities.

5.  Members are responsible to attend all scheduled monthly meeting of
    the SEW or provide a substitute (proxy). The substitute shall have
    voting privileges.

6.  After more than two absences per year the committee will either
    dismiss or replace the member who has been absent.

7.  Members, at times, may volunteer or be assigned to subgroups of the
    SEW to complete time-limited tasks. Participation in these subgroups
    is essential to the work of SEW. Members may be required to complete
    these tasks via phone and email correspondence.

8.  The Chairperson of the SEW shall be the Epidemiological Workgroup
    Director.

9.  The Chairperson is responsible for creating the agenda, facilitating
    the meetings and communicating with the SPF SIG staff.

10. Following the sixth meeting of the SEW a process will be recommended
    to appoint members of the SEW to rotate into the role of the SEW
    Chairperson.

**Procedures**

**Agenda**

11. All agenda items shall be generated from recommendations of the SEW
    membership and the SPF SIG staff.

12. The agenda shall be published at least seven workdays before the
    next scheduled SEW meeting.

**Minutes**

13. Minutes will be taken of all SEW meetings. The minutes will be
    published to all members of the SEW via email within two weeks of
    the meeting.

**Quorum**

14. A quorum will be established as 2/3 of the voting members being
    present.

**Voting**

15. One vote shall be counted representing the membership from each
    office within the same department, agency, university or entity.

16. All recommendations requiring a vote of the SEW will be submitted at
    least seven workdays prior to the next scheduled meeting of the SEW
    by the SPF SIG staff to the Chair of the SEW to be added to the
    agenda.

17. In the event that a recommendation requires a vote before the next
    SEW meeting, the vote on the recommendation will be completed
    electronically. It will be submitted by email to the membership at
    least five workdays before the vote is to be completed.

18. A proxy may make votes, by email or phone.

19. The determination of a recommendation passing will be based on the
    following guidelines:

    a.  [Governance of the Committee]{.underline} -- a simple majority
        of those present at the SEW meeting for which the recommendation
        is scheduled for a vote.

    b.  [Drug Policy Board and Prevention Systems Committee
        Recommendations]{.underline} -- 2/3 of the voting members of the
        SEW.

    c.  [Recommendations to Remove a Member]{.underline} -- a simple
        majority of all SEW voting members.

20. Within five workdays following passage of a recommendation to the
    Drug Policy Board, the Chairperson shall communication the
    disposition of the recommendation to the Drug Policy Board chair.

**Unanimously Adopted December 15, 2005**

SEW Chair recommended that formal voting requirements established in the
first three months of the SEW's existence be replaced by less formal
reliance on majority votes of members present for the immediate future
and that the SEW revisit the decision making process originally
considered at a meeting within the next three months. Including that
votes may be made by proxy and emergency votes required of the SEW
membership before scheduled meetings can be made by email or phone.

# References

*1. U.S. Department of Health and Human Services. National Institute on
Alcohol Abuse and Alcoholism. (2001, January 1). [Alcoholism: Getting
the Facts]{.underline}  (NIH Publication No. 96--4153)\[Brochure\].
Washington, DC: U.S. Government Printing Office.*

*2. The National Institute of Alcoholism and Alcohol Abuse (NIAAA) in
their\
10th Report to Congress on Alcohol and Health (June 2000)*

*3. CDC. (2006) Measures of Alcohol Consumption and Alcohol--Related
Health Effects from Excessive Consumption.
<http://www.cdc.gov/alcohol/factsheets/general_information.htm>*

*4.OPH (2004) 2004 Louisiana Health Report Card.
<http://www.oph.dhh.state.la.us/recordsstatistics/statistics/page359e.html?page=557>*

*5. CDC. (2006)Alcohol and Public Health. General Alcohol Information.
<http://www.cdc.gov/alcohol/factsheets/general_information.htm>*

*6. National Clearinghouse for Alcohol and Drug Information. (1995).
Making the Link: Violence, Alcohol & Other Drugs.
[www.health.org:80/govpubs/ml002/index.htm](http://www.health.org:80/govpubs/ml002/index.htm)*

*7. Substance Abuse and Mental Health Services Administration (SAMHSA)
(2006). SEDS. Indicator List. All Drug Indicators.
<http://www.epidcc.samhsa.gov/default.asp>*

*8. U.S. Census Bureau. (2000 census). State and County Quick Facts.
<http://quickfacts.census.gov/qfd/states/22000.html>*

*9. American Heart Association/American Stroke Association. (2006) Know
the facts, get the stats.
<http://www.americanheart.org/downloadable/heart/1136904664099KnowFctSht2006.pdf>*

*10. Naimi T, Brewer B, Mokdad A, Serdula M, Denny C, Marks J. (2003)
Binge drinking among U.S. adults. JAMA;289:70--5.*

*11. CDC. (2005) MMWR. Surveillance for Certain Health Behaviors Among
States and Selected Local Areas \-\-- Behavioral Risk Factor
Surveillance System, United States, 2003. 54(SS08);1-116*

*12. Substance Abuse and Mental Health Services Administration, Center
for Substance Abuse Prevention. The State and Territorial Guide to
Substance Abuse Prevention in Declared Disasters. DHHS Pub. No. (SMA)
97-3123; Rockville, MD: Center for Substance Abuse Prevention, 1997.*