# Presentation: 659306

## Slide 1

**Notes:**
Welcome. Introduce myself.

Activity:
Individually think about an 18-25 year-old you know or what it was like to be that age.

Briefly jot down some of the characteristics that come to mind when you are thinking of that age group.

Share your thoughts with the person next to you.

Shout out a word or phrase that you discussed as characteristics of 18-25 year-olds.

Today we are going to talk about substance abuse rates among young adults as a whole, college versus non-college students, young adults in the workplace in high risk occupations and military and why we should target prevention efforts among this age group. 

## BACKGROUND

## Why Focus on 18- to 25-Year-Olds?

- Highest prevalence of binge drinking (42%), heavy drinking (15%), and illicit drug use (20%)
- Alcohol prevalence rates steadily increase for the first three to five years after high school
- Two-thirds of today’s young adults have tried an illicit drug

- 	Substance Abuse and Mental Health Services Administration. (2007). *Results from the 2005 National Survey on Drug Use and Health: National Findings *(Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Rockville, MD.; Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007). *Monitoring the Future national survey results on drug use, 1975-2006. Volume II: College students and adults ages 19-45* (NIH Publication No. 07-6206). Bethesda, MD: National Institute on Drug Abuse, 307 pp.

**Notes:**
Now, specifically looking at 18-25 year-olds we know they have the highest prevalence of binge, heavy, and illicit drug use.

According to MTF – Drug use for all age groups decreased similarly since 1970s, however in 1990s young adult drug use began increasing while other age groups remained the same level or decreased

Highest prevalence of binge within the past 2 weeks
Alcohol - 45% of college males report binge drinking
By their late 20s, nearly two-thirds (63%) of today’s young adults have tried an illicit drug, and more than a third  (39%) have tried some illicit drug other than marijuana. (These figures do not include inhalants). Today one in six Americans (17% 2006) has tried cocaine by the age of 30, and 9% have tried it by their senior year in high school (age 17-18). (MTF page 33). 

Add’l Notes: 
Binge drinking- Five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) at least once in the past 30 days. 

Young adults reported: 16.6% using marijuana; 6.3% using prescription drugs (nonmedically); 2.6% using cocaine 1.5% reported using hallucinogens 

## Why Focus on 18- to 25-Year-Olds?

- Substance Abuse and Mental Health Services Administration. (2007). *Results from the 2005 National Survey on Drug Use and Health: National Findings *(Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Rockville, MD.

- Current, Binge, and Heavy Alcohol Use among Persons Aged 12 or Older, by Age: 2006**:**

**Notes:**
This slides demonstrates how different other age groups look relative to 18-25 year olds\

Current use – drinking in the past 30 days
Binge Use (not heavy) – 5 or more drinks 1-4 times in past 30 days
Heavy- 5 or more drinks 5 times or more in past 30 days

Points of interest in slide:
Binge and heavy peak 21-25
After 25 binge and heavy decline

Note about NSDUH – Not included in data set: homeless, active military, institutionalized (prison, mental institutions, nursing homes, long term hospitals)

## Why Focus on 18- to 25-Year-Olds?

- Highest rates of driving under the influence
- 20% of 18- to 20-year-olds and 27% of 21- to 25-year-olds report driving under the influence of alcohol
- 13% of 18- to 25-year-olds report driving under the influence of illicit drugs

- Substance Abuse and Mental Health Services Administration. (2007). *Results from the 2005 National Survey on Drug Use and Health: National Findings *(Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Rockville, MD.

**Notes:**
18-25 year-olds also report the highest rates of driving under the influence of alcohol and illicit drugs

## Why Focus on 18- to 25-Year-Olds?

**Figure 3.6 Driving Under the Influence of Alcohol in the Past Year among Persons Aged 16 or Older, by Age: 2005**

- Substance Abuse and Mental Health Services Administration. (2007). *Results from the 2005 National Survey on Drug Use and Health: National Findings *(Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Rockville, MD.

**Notes:**
Driving under the influence of alcohol was associated with age in 2005. An estimated 8.3 percent of 16 or 17 year olds, 19.8 percent of 18 to 20 year olds, and 27.9 percent of 21 to 25 year olds reported driving under the influence of alcohol in the past year (Figure 3.6). Beyond age 25, these rates showed a general decline with increasing age.
Among persons aged 12 or older, males were nearly twice as likely as females (17.1 vs. 9.2 percent) to drive under the influence of alcohol in the past year. 

## Why Focus on 18- to 25-Year-Olds?

- Mean Age at First Use for Specific Illicit Drugs among Past Year Initiates Aged 12 to 49: 2006

- Substance Abuse and Mental Health Services Administration. (2007). *Results from the 2005 National Survey on Drug Use and Health: National Findings *(Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Rockville, MD.

**Notes:**
With the exception of inhalants, PCP, and marijuana, the mean age of 1st use for illicits is over 18 years old

## Substance Use Among 18-25 Year-Olds

- Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007). *Monitoring the Future national survey results on drug use, 1975-2006. Volume II: College students and **adults** ages 19-45* (NIH Publication No. 07-6206). Bethesda, MD: National Institute on Drug Abuse, 307 pp.

**Notes:**
Note: briefly mention data source and limitations of Monitoring the Future
Long-term research program conducted at the University of Michigan’s Institute for Social Research. Annual nationally representative surveys of 8th-, 10th-, and 12th -grade students
It includes longitudinal data, following up on all graduated 12th graders for the past 30 years. Both college and non-college adults who graduated from high school (high school dropouts not included)

Data talking points
 Not much difference within the group
 No surprise we see a jump in alcohol use from 19-20 to 21 
 Peaks at 23-24, although that has not been the trend in previous years, where the peak has been at 25-26 so this maybe an anomaly in 2006 data.
 What we do see in trends is an increase in use of alcohol and slight increase in cigarette use from 18-25 years-old.

## SECTORS

**Notes:**
As the group very quickly too list the Characteristics of 18-25 year olds

Mosher, 1999
Risks taken in conjunction with heavy consumption of alcohol or use of drugs resulting in trauma (vehicle crashes or violence)
Institutions such as Government, the law, large corporations, the media, schools, health systems
Cynical that their participation will have an impact
Distrust and cynicism can lead to alienation 
Rebellion expressed in the form of drug and alcohol usage
Social ills such as protecting the environment, adequate health care and basic human necessities to those in need
Young adults are eager to have an opportunity to address social issues 
Research has shown that Latino, African American, and Native American cultural heritage provide a foundation for resisting alcohol and drugs though that protection is often undermined in the dominant culture when faced with poverty and racism

FROM NPN NOTES:
Explain Why this group is especially vulnerable to alcohol and drug use? Through our literature search we found several common themes as to why young adults are more likely to use alcohol or other drugs. 
Risk takers—leading to high rates of alcohol-related motor vehicle accidents and violence. (As we saw in the last slide with prevalence of DUI of alcohol and illicit drugs). Young adults are also most likely to drink in high risk situations—in public drinking settings that are frequently associated with driving and violence.

Substance use an act of rebellion. Skeptical of institutions and cynical about government participation—alcohol consumption can be a response to this sense of alienation. Young adults are also skeptical of most institutions—government, the law, leading corporations, the media, schools and health systems, etc. They are cynical about the political process and, for the most part, do not feel their participation will have any impact. Alcohol consumption can become a response to this sense of alienation—an act of rebellion.

Hold high ideals regarding social ills. On the other hand, young adults also hold high ideals regarding various social ills, including protecting the environment and providing adequate health care and other basic human necessities to those in need. When they are given meaningful opportunities to address social ills, they are eager to participate.
Vulnerable to the influences of the dominant culture, which often promotes alcohol and drug use as acceptable behavior.
Transitions: Such as going to college, workforce, military, etc.  Also transitions from living with parents to living in dorms, on their own, with peers, etc.  Other transitions include marriage and parenting.  Some of these transitions put them at higher risk for drug use, while other can serve as protective factors.
Changes in Perception of Harm:
According to trends over time, risk perception and disapproval of use remains the same across cohorts.  In other words, whatever perceptions young people have about drugs in high school remains with them into young adulthood. 
For most drugs perception of harm among young adults in 2006 was similar to that of high school students.  Exceptions are marijuana, crack and cocaine: perception of harm is smaller among young adults than high school students; perception of harm for crack and cocaine is higher for young adults than high school students; same is true for smoking tobacco. 
19 to 26 year-olds reported much lower perception of friends’ disapproval of binge drinking than either younger or older cohorts (friends disapproval for all other drugs are similar for 19 to 30 year-olds and high school students)
Fewer young adults report having friends who use illicit drugs compared to high school students, but more of them know friends who drink alcohol and get drunk.

## Where Are 18-25 Year-Olds?

- Source: US Dept. of Labor

- Percent of High School Graduates from the US Class of 2006 a year after graduation

**Notes:**
Note: 
Civilian non-institutional population.  Data refers to status of people as of October of 2006, and includes graduates and non-graduates from October 2005-October 2006 

## College vs. Non-College

- Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007). *Monitoring the Future national survey results on drug use, 1975-2006. Volume II: College students and adults ages 19-45* (NIH Publication No. 07-6206). Bethesda, MD: National Institute on Drug Abuse, 307 pp.

**Notes:**
Note: Again not looking at drop outs in this slide, would expect potential higher drug use rates...

Non-college population had higher use rates for EVERY illicit drug including inhalants, Ritalin, and Club Drugs.

In this slide only alcohol use is higher among college students. However, as we will see in the next slides the usage patterns differ based on 30 day use, daily use or binge drinking. 30 day and binge higher for college students. Daily is higher for non-college young adults.

Note to me:
Club drugs include ecstasy, ketamine, GHB, rohypnol, ice

”Ice” is a street name for crystal methamphetamine hydrochloride, which is a powerful, synthetic stimulant drug. Stimulant drugs speed up the messages going to and from the brain.
Ice is more potent than other forms of amphetamines. It is more pure than the powder form of methamphetamine ("speed").
Ice often appears as large, transparent and “sheet-like” crystals that may have a hint of pink, blue or green color.

## Although college students have a higher rate of binge drinking, young adults not in college are more likely to be using cigarettes, alcohol and illicit drugs on a daily basis.
Among adults aged 18 or older, college graduates had lower rates of dependence or abuse (7.3 percent) than those who graduated from high school (9.4 percent), and those who did not graduate from high school (10.3 percent)

- Although college students have a higher rate of binge drinking, young adults not in college are more likely to be using cigarettes, alcohol and illicit drugs on a daily basis.
- Among adults aged 18 or older, college graduates had lower rates of dependence or abuse (7.3 percent) than those who graduated from high school (9.4 percent), and those who did not graduate from high school (10.3 percent)

- College vs. Non-College

- Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007). *Monitoring the Future national survey results on drug use, 1975-2006. Volume II: College students and adults ages 19-45* (NIH Publication No. 07-6206). Bethesda, MD: National Institute on Drug Abuse, 307 pp.

**Notes:**
Note: Make sure to ask if there are any questions related to the data before transitioning to the next part of the presentation

Despite the substantial improvement in this country’s drug situation in the 1980s and the early 1990s, and then some further improvement beginning in the late 1990s, American secondary students and young adults show a level of involvement with illicit drugs that is among the highest in the world’s industrialized nations. (page 34 in MTF)

Also important to note from NSDUH that past the age of 26 binge and heavy drinking decrease among college graduates and they consistently remain lower then non-college drinking rates. Another argument to do prevention in the workplace among 18-25 year-olds because substance abuse patterns don’t change like they do after college.

Among adults aged 18 or older, the rate of past month alcohol use increased with increasing levels of education. Among adults with less than a high school education, 36.5 percent were current drinkers in 2006, significantly lower than the 67.3 percent of college graduates who were current drinkers. However, among adults aged 26 or older, binge and heavy alcohol use rates were lower among college graduates (19.1 and 5.4 percent, respectively) than among those who had not completed college (22.3 vs. 6.2 percent, respectively).
Since 1980, college students have generally had daily drinking rates that were slightly lower than their age peers, suggesting that they were more likely to confine their drinking to weekends, when they tend to drink a lot.

## College vs. Non-College

- Alcohol: Thirty-Day Prevalence

- Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007). *Monitoring the Future national survey results on drug use, 1975-2006. Volume II: College students and adults ages 19-45* (NIH Publication No. 07-6206). Bethesda, MD: National Institute on Drug Abuse, 307 pp.

**Notes:**
The top line on this slide represents full time college students. The 2nd line young adults 1-4 years past high school not in full-time college. The 3rd line is 12th graders.

College students are higher than non-college and high school students, however we can see that in the last few years, college and 12th graders are trending down while non-college young adults are trending up.

This pattern is also similar to Binge Drinking

## College vs. Non-College

- Alcohol: Thirty-Day Daily Use

- Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007). *Monitoring the Future national survey results on drug use, 1975-2006. Volume II: College students and adults ages 19-45* (NIH Publication No. 07-6206). Bethesda, MD: National Institute on Drug Abuse, 307 pp.

**Notes:**
For daily use young adults 1-4 years past high school have higher use rates than full-time college students. Both are also slightly trending upwards – but this is only true for the past few years.

## College vs. Non-College

- Marijuana: Thirty-Day Daily Use

- Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007). *Monitoring the Future national survey results on drug use, 1975-2006. Volume II: College students and adults ages 19-45* (NIH Publication No. 07-6206). Bethesda, MD: National Institute on Drug Abuse, 307 pp.

**Notes:**
Here the highest prevalence of daily marijuana use is among people 1-4 years past high school, 12th graders, and then full-time college students.

Success of public health campaigns is seen more among high school students and college students than in non-college adults

## College vs. Non-College

- Annual Prevalence: Illicit Drugs other than Marijuana

- Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2007). *Monitoring the Future national survey results on drug use, 1975-2006. Volume II: College students and adults ages 19-45* (NIH Publication No. 07-6206). Bethesda, MD: National Institute on Drug Abuse, 307 pp.

**Notes:**
Here the highest prevalence of daily marijuana use is among people 1-4 years past high school, 12th graders, and then full-time college students.

Trending upward since the mid-90s for both full-time college students and young adults not in full-time college.

Success of public health campaigns is seen more among high school students and college students than in non-college adults

## Two in five college students binge drink
45% of college freshman are heavy drinkers
1,700 college students ages 18–24 die annually from alcohol related unintentional injuries--80% are results of driving after drinking

- The US Department of Education's Higher Education Center for Alchol and Other Drug Abuse and Violence Prevention http://www.higheredcenter.org/

- Two in five college students binge drink
- 45% of college freshman are heavy drinkers
- 1,700 college students ages 18–24 die annually from alcohol related unintentional injuries--80% are results of driving after drinking

- Sectors: College Students

**Notes:**
Environmental factors

## High School Dropouts

- Illicit drug use higher among dropouts:
- 11% of high school dropouts, 9% of high school graduates, and 6% of college graduates
- More dropouts smoked cigarettes in the past month than non-dropouts
- Binge drinking rates slightly higher among dropouts, except ages 21-24

- Substance Abuse and Mental Health Services Administration. (2006). *Results from the 2005 National Survey on Drug Use and Health: National Findings *(Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Rockville, MD.

**Notes:**
Note: I wanted to include a slide on high school dropouts since MTF does not capture this group. This information comes from National Survey on Drug Use and Health and is probably an underestimate of dropout use rates, but it is the best national survey estimate that I could find for high school drop-outs.

In 2002, approximately 3.2 million 18 to 24 year-olds were considered to be school dropouts
Over half of school dropouts smoked cigarettes in the past month

Among young adults, more than half of school dropouts smoked cigarettes during the past month (54 percent versus 39 percent)

School dropouts were less likely to have used alcohol during the past month than non-dropouts, but rates of illicit drug use were similar among the 2 groups

Rates of binge alcohol use are slightly higher among dropouts (41 versus 39 percent) except during 21-24 years of age (dropouts 41 versus 46 percent).

## Sectors: Workforce

- 57% of 18- and 19-year-olds and 75% of 20 to 24-year-olds are employed
- Workers aged 18 to 25 are twice as likely to engage in illicit drug use and/or heavy drinking as older coworkers
- Most adults aged 18 or older with substance dependence or abuse were employed full-time in 2006.

- Substance Abuse and Mental Health Services Administration. (2006). *Results from the 2005 National Survey on Drug Use and Health: National Findings *(Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Rockville, MD.
- US Department of Labor, Bureau of Justice Statistics, Current Population Survey 2006. Available online: _[http://](http://www.bls.gov/cps/#charemp)__[www.bls.gov/cps/#charemp](http://www.bls.gov/cps/#charemp)_

**Notes:**
So how do we reach this group?
One option is to target the workplace. We know that most young adults not in college are in the workforce. 

Illicit drug use is highest among high school graduates with little to no college and high school dropouts. Yet these groups are not reached through college-based drug and alcohol prevention programs. Segue to next slide by making the point that traditionally, alcohol and drug education, prevention, and intervention programs have targeted young adults in high school and college settings. With the change in SAMHSA funding to target people across the life span comes the opportunity to refocus attention on this group.

Conclusions – a few conclusions we can draw are:
employment is associated with lower prevalence of problem use
Because many users are employed we should be addressing substance use through programs that target the workforce

## Employed vs. Unemployed

- 75% of illicit drug users >18 are employed
- 81% of binge and heavy drinkers >18 are employed
- Current alcohol use higher for employed while binge and heavy use for unemployed persons higher
- Of the 20.6 million adults classified with dependence or abuse, 12.7 million (61.5 percent) were employed full time

- Substance Abuse and Mental Health Services Administration. (2006). *Results from the 2005 National Survey on Drug Use and Health: National Findings *(Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Rockville, MD.
- US Department of Labor, Bureau of Justice Statistics, Current Population Survey 2006. Available online: _[http://](http://www.bls.gov/cps/#charemp)__[www.bls.gov/cps/#charemp](http://www.bls.gov/cps/#charemp)_

**Notes:**
Among adults aged 18 or older, the rate of drug use was higher for unemployed persons (18.5 percent) than for those who were employed full-time (8.8 percent) or part-time (9.4 percent). These rates were all similar to the corresponding rates in 2005.
Although the rate of past month illicit drug use was higher among unemployed persons compared with those from other employment groups, most drug users were employed. Of the 17.9 million current illicit drug users aged 18 or older in 2006, 13.4 million (74.9 percent) were employed either full- or part-time.
Rates of current alcohol use were 62.0 percent for full-time employed adults aged 18 or older in 2006, higher than the rate for unemployed adults (52.1 percent). However, the pattern was different for binge and heavy alcohol use. Rates of binge and heavy use for unemployed persons were 34.2 and 12.2 percent, respectively, while these rates were 29.7 and 8.9 percent for full-time employed persons.
Most binge and heavy alcohol users were employed in 2006. Among 54.0 million adult binge drinkers, 42.9 million (79.4 percent) were employed either full- or part-time. Among 16.3 million heavy drinkers, 12.9 million (79.2 percent) were employed.
Rates of substance dependence or abuse were associated with current employment status in 2006. A higher percentage of unemployed adults aged 18 or older were classified with dependence or abuse (19.5 percent) than were full-time employed adults (10.4 percent) or part-time employed adults (10.2 percent)

## Occupational Groups at Highest Risk for Alcohol and Drug Use

**Construction: **
- Highest past month heavy alcohol use
- Second highest past month illicit drug use
**Food service: **
- Highest past month illicit drug use
- Second highest past month alcohol use
**Trucking: **
- Third highest for past month alcohol use
- Seventh highest for past month illicit drug use

- Cook, R., & Schlenger, W. (2002). Prevention of substance abuse in the workplace: Review of research on the delivery of services. *The Journal of Primary Prevention, 23*(1), 115-142; Hersch, R. K., McPherson, T. L., & Cook, R. F. (2002). Substance use in the construction industry: A comparison of assessment methods. *Substance Use & Misuse, 37*(11), 1331-1358;Hoffman, J. P., Brittingham, A., & Larison, C. (1996). Drug use among us workers: Prevalence and trends by occupation and industry categories. Rockville, MD. *Substance Abuse and Mental Health Services Administration, May*, 96-3089; Nusbaumer, M., & Reiling, D. (2002). Environmental influences on alcohol consumption practices of alcoholic beverage servers. *American Journal of Drug & Alcohol Abuse, 28*(4), 733; Roman, P. M., & Blum, T. C. (2002). The workplace and alcohol problem prevention. *Alcohol Research and Health, 26*(1), 49-57

**Notes:**
Construction: Younger workers, apprentice workers, and single workers more likely to use illicit drugs than their colleagues 
Food service: Twice the national average rates for current illicit drug use and heavy alcohol use
Truck drivers: long-haul tractor-trailer drivers have among the highest rates of alcohol and drug use

Food service workers: Culture of drinking: environment where lots of drinking occurs; Reasons for drinking – sociability the same as patrons (Nusbaumer and Reiling 2002)

Construction Worker engage in heavy drinking (Janes and Ames 1989): Drinking serves to improve social relationships among co-workers; Reduce boredom and dissatisfaction; Express solidarity in defiance of management rules and working conditions. Sociocultural background where heavy male drinking was normative; Lack of extra-work social resources; Leisure activities restricted to coworkers and work-related contexts; No considerable community and social group involvements (i.e., family and peer networks other than co-workers) 

Truck drivers: Separation from normal, social, and sexual relationships, indexed by nights spent away from home, was significantly correlated with greater frequency of drinking. Studies have also found that long haul truck drivers, an occupation that demands long hours, mental alertness, and physical endurance are more prone to take methamphetamines to increase job performance (Doyle et al, 2006).

Traditional workplace strategies do not effectively reach these groups. Workforce is a setting for prevention strategies. Strategies generally focus more on white collar occupations (People, but not use need to look at more nontraditional approaches)

Risk Factors for Construction
where heavy male drinking is normative 
No community involvements (i.e., family and peer networks other than co-workers)
Drink to build social relationships
Many construction workers live in rural areas and/or are working away from home. 
Leisure activities restricted to coworkers and work-related contexts
Low community and social group involvements (i.e., family and peer networks other than co-workers) 
Many construction workers have less than high school or high school education (higher percentage of those with lower education drink)
Bonding in defiance of management rules and working conditions
Alcohol may be used as medication for injuries. 
Younger workers are frequently given the most “dangerous” jobs

What are the policy implications of these findings?

## Military-Civilian Comparisons

- Military-Civilian Comparisons

- Military personnel aged 18 to 25 showed significantly higher rates of heavy drinking (24.8%) than did civilians (17.4%)
- Military personnel in all age group were less likely than civilians to have used any illicit drug in the previous 30 days (4.6% vs. 12.8%)
- Cigarette smoking among military personnel was significantly higher than among their civilian counterparts (men, 42.4% vs. 37.6%; women, 29.2% vs. 25.8%).

- RTI Intertional (2005).  Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel.  Research Triangle Park, NC.  Available at: http://handle.dtic.mil/100.2/ADA465678

**Notes:**
Highlights from the Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel Report
(Civilian data based on 2004 NSDUH)
Military personnel aged 18 to 25 showed significantly higher rates of heavy drinking (24.8%) than did civilians (17.4%); rates for personnel aged 26 to 55 (9.7%) were not statistically different than those of their civilian counterparts (9.5%).
Military personnel in all age groups were significantly less likely than civilians to have used any illicit drug in the previous 30 days (4.6% vs. 12.8%)
Cigarette smoking among military men and women aged 18 to 25 was significantly higher than among their civilian counterparts (men, 42.4% vs. 37.6%; women, 29.2% vs. 25.8%).

## STRATEGIES

## Changing Workplace Norms

*Workplace norms – the beliefs that define the acceptable contexts for substance use and usage behaviors*
- Learned versus Selection Theory
- Underutilized technique in the workplace
- Privacy issues
- Discomfort  dictating off-the-job usage

- Ames, G., & Cunradi, C. (2004). Alcohol use and preventing alcohol-related problems among young adults in the military. *Alcohol Research and Health, 28*(4), 252–257.; Mangione, T., Howland, J., & Lee, M. (1999). Alcohol and work: Results from a corporate drinking study. In S. L. Isaacs & J. R. Knickman (Eds.), *To improve health and health care 1998-1999*. San Francisco, CA: Jossey-Bass.; Nusbaumer, M., & Reiling, D. (2002). Environmental influences on alcohol consumption practices of alcoholic beverage servers. *American Journal of Drug & Alcohol Abuse, 28*(4), 733.

## Employee Assistance Programs (EAP)

- Goal: Minimize employment loss caused by unaddressed substance abuse problems
- Focus on early identification of a “problem”
- Self-referral design
- Counseling and treatment services
- Relapse prevention
- Family involvement
- Success in rehabilitating workers

- Roman, P. M., & Blum, T. C. (2002). The workplace and alcohol problem prevention. *Alcohol Research and Health, 26*(1), 49-57
- Cook, R., & Schlenger, W. (2002). Prevention of substance abuse in the workplace: Review of research on the delivery of services. *The Journal of Primary Prevention, 23*(1), 115-142..

## Drug Testing

- Goal: To identify workers using illicit drugs
- Pre-employment testing
- “For-Cause” testing
- Random testing
- No conclusive evidence that testing deters substance use

- Roman, P. M., & Blum, T. C. (2002). The workplace and alcohol problem prevention. *Alcohol Research and Health, 26*(1), 49-57
- Cook, R., & Schlenger, W. (2002). Prevention of substance abuse in the workplace: Review of research on the delivery of services. *The Journal of Primary Prevention, 23*(1), 115-142..

## Workplace Education	

- Goal: To change attitudes, social responsibility, workplace culture
- Health Education
- Health Promotion
- Substance abuse prevention embedded in general health promotion
- Peer Assistance
- Encourage workers to intervene with colleagues (via professional groups and unions)
- Some evidence of effectiveness

- Roman, P. M., & Blum, T. C. (2002). The workplace and alcohol problem prevention. *Alcohol Research and Health, 26*(1), 49-57
- Cook, R., & Schlenger, W. (2002). Prevention of substance abuse in the workplace: Review of research on the delivery of services. *The Journal of Primary Prevention, 23*(1), 115-142..

## Workplace Policies	

- Goal: Set standard for whole company
- Drug-free workplaces
- Alcohol policies
- Expand no drinking policy to include at work, before work, at lunch, at functions, or before driving company vehicle
- Change definition of drinking to include “night before work” drinking
- Offer health education on hangovers
- Address risk factors such as stress, alienation, or influences of subcultures

- Mangione, T., Howland, J., & Lee, M. (1999). Alcohol and work: Results from a corporate drinking study. In S. L. Isaacs & J. R. Knickman (Eds.), *To improve health and health care 1998-1999*. San Francisco, CA: Jossey-Bass.
- Roman, P. M., & Blum, T. C. (2002). The workplace and alcohol problem prevention. *Alcohol Research and Health, 26*(1), 49-57.

## Questions to Consider

**Who** has need?
**Where** are they?
**Why** are they at risk?
**How** can they be reached?
**What** has been proven effective to create a change?
**When** will community be ready to change?
**Who **should be at the table?

**Notes:**
In a SPF (data-driven) era, it is important to ask these questions regarding 18-25 year-olds:
We have begun this discussion which will continue later today

Who has need?
Where are they? (i.e., college, workforce, high-risk industry, military, etc.)
Why are they at risk?  What are their risk factors?
How can they be reached?  - How can these groups be engaged?
What has been proven effective to create a change? – What are evidence-based interventions?
When will community be ready to change? – Readiness 

## Contact Information

- CSAP’s Northeast CAPT
- 96 Morton Street
- New York, NY 10014
- Deborah McLean Leow _[dmclean@edc.org](mailto:dmclean@edc.org)_