The Herald Bulletin

April 18, 2010

Addiction happens early

Teens, Alcohol & Drugs, Part I

By Justin Schneider
The Herald Bulletin

ANDERSON, Ind. — Addiction happens early.

Researchers have long known that people who use alcohol and tobacco at a young age are more likely to carry those habits into adulthood. But a recent study suggests that the barriers to underage use in Madison County are relatively weak.

The study, “The Consumption and Consequences of Alcohol and Drugs in Madison County,” is based on data collected by Healthy, Tobacco-Free Madison County, with help from legal, educational and medical organizations. It found that the number of tobacco and alcohol retail outlets in Madison County exceeds the statewide average and that those retailers break the law almost as often as they obey it.

“We’re just finishing up 100 interviews with people in Madison County, from higher elected officials to ordinary, everyday people,” said Karesa Knight-Wilkerson, executive director of Healthy, Tobacco-Free Madison County and project director for the study. “What’s surprising to me is, looking over their interviews, they’re not seeing a correlation between underage alcohol use and the number of places that sell it.”

Those findings could sound a warning signal to parents of children and teens with summer approaching and more time on their hands.

According to the study, Madison County is home to 7.1 tobacco outlets per 1,000 youth (those ages 10-17), while the statewide average is 6.5. Retail outlets that offer alcohol number 20.6 per 1,000 youth, compared to a statewide average of 17.2.

Those numbers would present little cause for alarm if retailers obeyed laws that prohibit the sale of tobacco products to those under 18 and sales of alcohol to those under 21. This, however, is not the case. The Indiana State Excise Police reported a 49 percent failure rate on alcohol compliance checks performed between April 2007 to March 2009; the state average (excluding Madison County) is 34.5 percent. In other words, Madison County retailers illegally sold alcohol to minors nearly half the time.

“The compliance checks are only around 50 percent,” Knight-Wilkerson said. “That’s a huge deal.”

Nearly one-fourth (24 percent) of respondents reported their first use of alcohol between the ages of 7 and 16, while 52 percent reported first use between 17 and 26. That means high school seniors and college freshman who could feel peer pressure to drink in party situations.

“The Consumption and Consequences of Alcohol and Drugs in Madison County” was written by Dr. Michael Bruce, of Anderson University’s Falls School of Business, with primary data collected through Healthy, Tobacco-Free Madison County under the direction of project director Knight-Wilkerson and program director Andrew Sprock. Secondary data was provided by law enforcement, judicial, educational, medical and governmental organizations, while a telephone survey conducted by State Epidemiological Outcomes Workgroup in November 2008 provided a third source of data.

House of Hope

Elizabeth Ploog, director of House of Hope in Anderson, helped collect data from the organization’s clients. House of Hope provides a 90-day residential transition program for adult men suffering from drug and alcohol addiction, providing counseling while teaching clients self-sufficiency.

She said having such a study available helps recovery agencies procure funding by demonstrating a direct need in the community.

“One of the big advantages to having this (study) is that it’s going to play a key role in assisting us when we are writing grants,” Ploog said. “You always want to have current data on your community.”

House of Hope has six part-time staff members, including two licensed counselors. Several employees went through House of Hope’s transitional program before being hired.

“It does seem that chemical use seems to start earlier and earlier,” said Ploog, one of 15 people chosen to serve on a Local Epidemiological Outcomes Workgroup,  or LEOW, assembled with the mission to meet monthly to reduce incidence and impact of alcohol, tobacco and drugs.

The workgroup also includes Anderson attorney David Gotshall, who is chairman of the board for House of Hope and also serves on the board for Sowers of Seeds and Fifth Chapter House. He assisted with data collection by distributing questionnaires during 12-step meetings hosted by Fifth Chapter House.

“My hope, out of all of this, is that it will help us underscore the need for services and will help with funding agencies that will all be seeking both,” Gotshall said. “Sowers of Seeds, especially, operates on a shoestring budget. They’re making efforts to obtain grants and make an effort in that area.”

Drug use takes root

As attorney for Anderson Community School Corp. for 27 years, Gotshall oversaw expulsion hearings and saw first-hand how drug and alcohol use by students contribute to behavioral problems. That use can take root during the idle hours of spring and summer break.

Work on the county epidemiological study began on Oct. 1, 2008. Earlier in the year, the Governor’s Advisory Council identified Madison County as one of eight Indiana communities facing significant substance abuse challenges, and approved funding through Indiana’s Strategic Prevention Framework, which began in July 2005. Nearly 73 percent of respondents were between the ages of 18 and 25. Just 7 percent of respondents were 51 and older.

“This was intentional in light of the higher proportion of alcohol and drug abuse among the younger individuals in the population,” study author Dr. Michael Bruce writes. “This larger proportion will enable the study to examine more closely the consumption and behavior of a group who commonly abuse alcohol, drugs and tobacco.”

This philosophy seems to be confirmed by the results of the survey. Daily alcohol use among eighth-, ninth- and 11th-graders in Madison County exceeded state and national averages. Monthly use by sixth-, seventh-, eighth- and ninth-graders also exceeded state and national averages, as did binge drinking by sixth-, eighth- and ninth-graders.

“Alcohol affects the brain differently up to the age of 21. It’s not just an arbitrary number; the brain is still developing.”

Ploog said addiction to drugs and alcohol has yet to find public acceptance as a disease, despite being identified as such by the American Medical Association.

“It’s a medical fact that people who have alcoholism process alcohol differently,” Ploog said. “The pathways of the brain change. The disease process does take some time, so the younger you start, you’re getting that disease in motion earlier, while the brain is still developing.”

Smoking rates high

Tobacco use also represents an area of concern. An estimated 14,117 adults smoke in Madison County, or roughly 15 percent. Cigarette use among students in ninth, 11th and 12th grades exceeds statewide averages. More than 20 percent of ninth-graders use cigarettes, while use among 11th- and 12-graders approaches 30 percent.

“Smoking and obesity are some of the most significant health care strains on our nation,” said Sprock, program director for the study. “Smoking is often associated with poverty and, if smokers are on some sort of social assistance for health care, that means everyone is paying for smoking.”

Economic factors — and their connection to crime and education — loom over the entire study from the first sentences of the Executive Summary:

“Demographically, Madison County has experienced a significant decline in population due to the economic impact of the loss of manufacturing jobs,” it reads. “This change has led to a lower level of household income as well as an increase in crime in the county. Educationally, the county has a lower percentage of individuals who have completed post-secondary schooling when compared to the rest of the state and nation.”

Sprock said economic hardships trigger stress, which contributes to substance abuse and leads to further familial problems.

“With poverty, not only is it lower income, but they’re typically dealing with more stresses,” Sprock said. “More people living in smaller amounts of space. More transition that creates stress, divorce and a lot of intense emotion that goes along with that. It leads to violence and other things.”

All of which speaks to the importance of decreasing substance abuse in young people.

Knight-Wilkerson said clean data is essential to the process. An epidemic of prescription drugs — epitomized, perhaps, by the Indiana Medical Licensing Board revoking the license of Middletown Dr. Phillip Foley — underscores the importance of consistent data collection and reporting among law enforcement.

“Prescription drug abuse is skyrocketing in Madison County,” Knight-Wilkerson said. “None of the police stations have the same data reporting, so it’s hard to figure out is it Xanax? Is it sleeping pills? Is it Adderall? What is it that the kids are using? They usually just say stimulant or depressant.”