Decreasing Illicit Drug Decreasing Illicit Drug Use in AdolescentsUse in Adolescents

Carolyn Rosa, BSN RNCarolyn Rosa, BSN RN

PNP/PHL Progam at UVAPNP/PHL Progam at UVA

GNUR 8610GNUR 8610

AbstractAbstract

Substance use & abuse begins frequently in teen Substance use & abuse begins frequently in teen yearsyears

Currently, the CDC (2011) reports 22 million Currently, the CDC (2011) reports 22 million adults struggle with substance abuseadults struggle with substance abuse

Healthy People 2020 encourages the use of Healthy People 2020 encourages the use of environmental and societal factors to influence environmental and societal factors to influence adolescents in making healthy choices for their adolescents in making healthy choices for their futuresfutures

Expansion is needed for current programs to Expansion is needed for current programs to include more strategies for illicit drug education include more strategies for illicit drug education and prevention, directed by social network and prevention, directed by social network approachapproach– Incorporate social networking sitesIncorporate social networking sites– Text messagesText messages– Peer supportPeer support

Illicit Substance Abuse in Illicit Substance Abuse in AdolescentsAdolescents

Adolescents: 10-19 years in ageAdolescents: 10-19 years in age Substance abuse has massive effect on societySubstance abuse has massive effect on society

– Associated with risk of teenage pregnancy, HIV/AIDS, Associated with risk of teenage pregnancy, HIV/AIDS, other sexually transmitted diseases, domestic abuse, child other sexually transmitted diseases, domestic abuse, child abuse, motor vehicle crashes and deaths, crime, homicide abuse, motor vehicle crashes and deaths, crime, homicide and suicide and suicide (Healthy People 2020)(Healthy People 2020)

2009 CDC Youth Risk Behavioral Surveillance 2009 CDC Youth Risk Behavioral Surveillance Survey shows that marijuana and prescription drug Survey shows that marijuana and prescription drug use commonuse common-36.8% of students have tried marijuana at least -36.8% of students have tried marijuana at least once in their lifeonce in their life-20.2% of students have used prescription drugs-20.2% of students have used prescription drugs

Elevation of IssueElevation of Issue

2005 reported 22,400 unintentional and 2005 reported 22,400 unintentional and intentional drug overdose deaths intentional drug overdose deaths (Paulozzi, 2008).(Paulozzi, 2008).    

Increase in ER visits for MDMA and GBH in Increase in ER visits for MDMA and GBH in teenagers teenagers (Banken, 2006)(Banken, 2006)

Dramatic increase in high risk drugsDramatic increase in high risk drugs– Between 1993 and 2005 there was a dramatic Between 1993 and 2005 there was a dramatic

increase between non-medical use of increase between non-medical use of prescription painkillers (343%), stimulants prescription painkillers (343%), stimulants (93%), tranquilizers (450%) and sedatives (93%), tranquilizers (450%) and sedatives (225%) (225%) (Benotsch, Koester, Luckman, Martin, & Cejka, 2011)(Benotsch, Koester, Luckman, Martin, & Cejka, 2011)

Reivew of LiteratureReivew of Literature

Lasting effects of Lasting effects of prevention programs are prevention programs are questionablequestionable– In 2008, Sloboda et al. In 2008, Sloboda et al.

performed a study that performed a study that examined the reports of examined the reports of substance abuse programs substance abuse programs in schools, and found that in schools, and found that many of the students did many of the students did not acknoweldge they had not acknoweldge they had received information on received information on illegal drugs within one illegal drugs within one yearyear

Team approachTeam approach– In 2010, Inman, Van In 2010, Inman, Van

Bakergem, Larosa and Bakergem, Larosa and Garr did a review of Garr did a review of evidence based evidence based programs for health programs for health promotion in schools and promotion in schools and implementation of these implementation of these programs and found programs and found using a team approach using a team approach enhanced the success of enhanced the success of any such programany such program

Project Alert found to be Project Alert found to be only program that increased only program that increased illegal drug refusalsillegal drug refusals

Review of LiteratureReview of Literature

Prevention found to be slightly more Prevention found to be slightly more effective in middle school effective in middle school (Goffredson & Wilson, 2003)(Goffredson & Wilson, 2003)

Delivery by teachers showed conflicting Delivery by teachers showed conflicting research research (O'Leary-Barrett, Mackie, Castellanos-Ryan, Al-Khudhairy, & , 2010) (O'Leary-Barrett, Mackie, Castellanos-Ryan, Al-Khudhairy, & , 2010)

High risk youth and social networkingHigh risk youth and social networking– 2011 study by Rice, Milburn and Monro showed 2011 study by Rice, Milburn and Monro showed

social networking is essential for adolescentssocial networking is essential for adolescents– Homeless youths using social networking to Homeless youths using social networking to

stay in contact with a positive role model had stay in contact with a positive role model had less substance abuseless substance abuse

Goal of ProjectALERT+Goal of ProjectALERT+ To expand upon the success of ProjectALERT To expand upon the success of ProjectALERT

using the social network approach and social using the social network approach and social ecology model to decrease illicit drug use in ecology model to decrease illicit drug use in adolescentsadolescents

ProjectALERT for 7ProjectALERT for 7thth and 8 and 8thth grade grade – Taught by teachersTaught by teachers– Address drug abuse specificallyAddress drug abuse specifically– Uses role playing, discussion, video Uses role playing, discussion, video (Project Alert, 2011)(Project Alert, 2011)

Additional components:Additional components:– Peer educators using Facebook Peer educators using Facebook – Weekly text messagesWeekly text messages– Role models from community high schoolRole models from community high school

ImplementationImplementation

Social network approach within social ecology modelSocial network approach within social ecology model– Addresses education of student based on school family life, media, Addresses education of student based on school family life, media,

social networkssocial networks and local culture and local culture (Gorin & Arnold, 2006).(Gorin & Arnold, 2006). – Utilizes the environment to encourage adolescents to make positive Utilizes the environment to encourage adolescents to make positive

choices about their futurechoices about their future

Responsibilities for Responsibilities for ImplementationImplementation

Project Director responsibilitiesProject Director responsibilities– Assess adolescent community in regards to Assess adolescent community in regards to

drug usedrug use– Implement ProjectALERTImplement ProjectALERT

Year one: Project ALERTYear one: Project ALERT Year two: Train peer support for Facebook communityYear two: Train peer support for Facebook community Recruit and train roles moelsRecruit and train roles moels Enroll students in text messagingEnroll students in text messaging Collect baseline data on effect of ProjectALERTCollect baseline data on effect of ProjectALERT

– Year three: Implement ProjectALERT+Year three: Implement ProjectALERT+ Collect data on effect of ProjectALERT+Collect data on effect of ProjectALERT+

InnovationInnovation

Specifically targets illicit drug useSpecifically targets illicit drug use Follow-up research will allow for data Follow-up research will allow for data

on illicit drug prevention onlyon illicit drug prevention only Utilizes social networks and Utilizes social networks and

technologytechnology Makes the program community Makes the program community

specificspecific New way to utilize social network New way to utilize social network

approach approach

EvaluationEvaluation

Qualitative evaluationQualitative evaluation– Interviews with peer support and role models Interviews with peer support and role models

for program feedbackfor program feedback Quantitative evaluation Quantitative evaluation

– Self-report online survey on community-Self-report online survey on community-specific abused drugs specific abused drugs

– Comparison to baseline ProjectALERT dataComparison to baseline ProjectALERT data– CDC Health Risk Behavior Survey county CDC Health Risk Behavior Survey county

specific (ie Lexington, MA)specific (ie Lexington, MA) (Youth Behavior Risk Surveillance Survey CDC, (Youth Behavior Risk Surveillance Survey CDC,

2007)2007)

Before and afterBefore and after

Budget EstimationBudget Estimation Expenses include:Expenses include:

– Project director salaryProject director salary– ProjectALERT ProjectALERT

program program ($150/educator)($150/educator)

– Classroom materials Classroom materials to implement to implement programprogram

– Group text serviceGroup text service– Website spaceWebsite space– Training fundsTraining funds– EvaluationEvaluation

For a drug free For a drug free tomorrow…tomorrow…

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