12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Current Substance Use Among California Secondary Students Results of the 2007/08 12 th Biennial California

12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08

Current Substance Use AmongCalifornia Secondary Students

Results of the 2007/08

12th Biennial California Student Survey

Drug, Alcohol and Tobacco Use

Greg Austin, PhD, and Rod Skager, PhD

WestEdJanuary 23, 2009, Governor’s Prevention Advisory Council


What is the CSS?

• Biennial survey of substance use and other risk behaviors among California secondary students, since 1985

• Office of Attorney General legislatively mandated to conduct (1991)

• Co-sponsored by Dept. of Alcohol and Drug Programs and California Dept. of Education

• Controlled administration (by contractor)

• Representative state sample; random schools/classrooms

• School/student participation voluntary, with parent consent

• Approved by state Committee for Protection Human Subjects


What is the CSS?

• Source of items on the California Healthy Kids Survey

• Fully integrated with other CHKS content in 1999 (aka “The biennial statewide CHKS”), to provide state norms for local comparison

— Enabled joint administration by 43% of schools, nearly same as 2005 (40%)

— Has improved recruitment efforts.


Sample

• 13,930 students, grades 7, 9, & 11

• 48 middle and 68 high schools (including 10 continuation)

• Race/ethnicity consistent with prior surveys

• % males increased, gender controlled by weighting


Consent

• Passive parental consent allowed since 2005 if required policies adopted by school board*

— 78% of school adopted, vs. 56% in vs. 58 and 62% previously

• Evident Effects

— Increased student response rate: 78%, same as 2005-06 vs. 58 and 62% previously

— Increased participation by males

— No meaningful differences in 2005, written vs. passive schools

*Ed Code 519381b — applies only to grade 7 and above


Content – 2007 Modifications

• Modified to comply with SAMHSA requirements for collecting National Outcome Measures (NOMs)

— Entailed significant content changes, including:(1) deleting questions to make room; and(2) replacing/modifying similar questions

• Expanded frequency options to better identify experimenters vs. heavy users

• Expanded gambling questions for ADP Office

• Reduced 7th grade instrument, based on feedback


NOM’s• Changes

— Perceived HARM (frequent, occasional) deleted and replaced by NOM’s question on perceived risk

— Friends’ disapproval of respondent AOD use replaced w/ respondent disapproval of friends’ use

— Same change made for disapproval of possession of weapons

• Additions

— Likelihood would work for employer that conducts drug tests

— Talked w/ parents about dangers of ATOD use

— Exposure to messages about ATOD use

— Age of onset of alcohol, cigarettes, smokeless tobacco, marijuana, other drug (Added 2006)


Changes - Lifetime ATOD Use

• Expanded substances and made separate question on recreational use of pharmaceuticals (high school only)

— Based on 2004 data showing almost 15% of 11th graders had used prescription painkillers

— Added cold/cough medicines, diet pills, and Ritalin/Adderal

• Use frequency options increased from 4+ to 7+ times

— To better identify regular users

• Deleted use of cocaine, LSD, and ecstasy in 7th grade because so low


Issues in Interpreting Results

• Ability to assess 2005-07 trends severely restricted by changes to instrument:

— NOMs

— 6-month alcohol use vs. specific beverage

— Expansion of frequency options appears to have increased prevalence rates. Did not occur in unchanged items.

• Report focuses on implications of current data rather than between-survey differences.

— Changed items treated with extreme caution. Differences do not necessarily reflect change in actual behavior.


Summary of 2005 Results

• General leveling-off of previous declining trends across grades and substances

• Most changes small and often inconsistent by grade.

— 7th: Slight-to-marginal increases in several indicators

— 9th/11th: Changes few and small; most in negative direction, continuing previous declining trend.

• Rise in drinking/driving one exception

*Binge drinking, drunk/sick from drinking, drinking and driving, high on drugs & drunk/high at school, weekly use of alcohol or marijuana


Summary of 2007 Results

• Prescription pain killers 2nd to marijuana in 11th & 3rd in 9th, just after inhalants

• All non-mj drugs exceeded by recreational use of cold/cough medicine (“to get high”), and equal to mj in 9th.

• Previous levels of substance use underestimated by under-assessing “medicinal” drugs

• Prevalence rates for unchanged questions stable.

• No meaningful declines on any measure with exception of methamphetamines in 11th.

• Some increases in indicators of heavy/risky use in 11th


Lifetime PrevalenceGrade 9 Grade 11

(%) (%)

Street Drugs Marijuana 25 42 Inhalants 14 15 Methamphetamines 5 7 LSD/psychedelics 5 8 Ecstasy 6 10Prescription/Medicinal Drugs* Painkillers 12 18 Barbiturates 2 3 Sedatives/tranquilizers 4 6 Diet pills 9 8 Ritalin/Adderal 4 6OTC Cold/Cough Medicines 26 25*to get high – not for medicinal reasons


Aggregated Lifetime Categories

9th 11th 9th 11th 9th 11th

(%) (%) (%) (%) (%) (%)

Alcohol 47 66

Marijuana 25 42

Prescription Drugs 18 23

OTC Cold/Cough Medicines 26 25

Prescription/OTC 31 35

Any Drug Except Marijuana 21 28 29 36 39 45

Total Drugs 31 46 37 50 45 57Total AOD Use 52 69 54 70 60 74

W/ Prescription W/ OTC


Heavy Use

• Two point percentage increases for experiencing 2 or more AOD dependency-related indicators

— 7% for 9th and 16% for 11th

• Three point increases for experiencing 2 or more problems caused by AOD use


• Lifetime drinking and driving involvement increased in both 9th and 11th to the highest levels in past 6 years



2 Plus Problem and Dependency Indicators*

*Of 11 Social, Personal, and Educational Problems and 7 Indicators based on DSM-IV Dependency Criteria


Drink & Drive, Grade 11

0

10

20

30

40

50

1997-98 1999-00 2001-02 2003-04 2005-06 2007-08

Any

3 or more times


Analysis Using DSM CriteriaCSS 9th 11th

2003 2005 2007 2003 2005 2007

DSM dependency 4.3 4.1 4.5 8.4 8.6 10.9

DSM abuse 6.0 6.7 7.6 10.0 10.2 10.5

DSM dependency or abuse (Total) 10.3 10.8 12.1 18.4 18.9 21.4

DSM DEPENDENCY CRITERIA (Meets 3):

Evidence of Tolerance to Use [1 question]Lack of Use Control [1 of 2 questions]Time-consuming Substance Use Lifestyle [1 question]Important Activities Given Up/Reduced [1 question]Persistent or Recurrent Physical or Psychological Problems [1 of 2 questions]Use Cessation or Reduction Efforts [1 of 4 questions]


Two Positive Findings

• Increases for students (1) attempting to stop drinking and (2) believing school would provide help to stop use


Conclusions

• Despite problems with trend assessment, confirms 2005 conclusion that previous declining trend is over.

— Prevention efforts may be bottoming-out

• Heavy use persistent problem. Early identification and intervention with high-risk students essential.

— In an average 11th-grade classroom of 35 students:• 5-6 students may be in need of some intervention• 3 need counseling or even treatment


Conclusions (cont.)

• New data on prescription and OTC drug use red-flag for targeted prevention efforts and warning that may be underestimating drug use among adolescents.

• Reversal of previous declines in drinking and driving another warning against complacency.

Documents

12th Biennial CALIFORNIA STUDENT SURVEY, 2007-08 Current Substance Use Among California Secondary Students Results of the 2007/08 12 th Biennial California