Teen Alcohol Abuse Adolescent alcohol abuse has been an ongoing public health problem for many years. While alcohol abuse trends tend to increase and subside over time, recent research continues to show an alarming level of alcohol use. For example, surveys by the National Institute on Drug Abuse (NIDA) show that alcohol use has dropped slightly when compared with previous years, in 2011 almost two thirds (65%) of high school seniors and almost one third (29%) of eighth graders had used alcohol within the past month (Winters, Botzet & Fahnhorst, 2011).

Health Needs Assessment

As of 1988, the purchase of alcohol by youth under the age of 21 is prohibited. Therefore, the Centers for Disease Control (CDC) define underage drinking as consuming alcohol prior to the minimum legal drinking age of 21 years. Further, zero tolerance laws make it illegal in all states for youth under age 21 to drive with any measurable amount of alcohol in their system, that is, with a blood alcohol concentration (BAC) > 0.02 g/dL) (CDC, 2010).

The term substance abuse describes a pattern of substance (drug) use that leads to "significant problems or distress such as failure to attend work/school, substance use in dangerous situations (driving a car), substance-related legal problems, or continued substance use that interferes with friendships and/or family relationships" (Ohio State University, n.d.) Alcohol is the most common legal drug of abuse. Symptoms may include getting intoxicated on a regular basis and believing they need to drink in order to have fun (Ohio State University, n.d.)

There is a significant treatment gap between the number of adolescents who meet the criteria for alcohol abuse and those who receive treatment. According to Sterling, Weisner, Hinman, & Parthasarathy, only 6% to 8% of those who could benefit from alcohol treatment received treatment over the period between 2003 and 2006 (2010). The treatment gap occurs because of a number of factors, including poor health coverage, low motivation by the adolescent or parents, and a lack of specialized adolescent treatment programs (Winters, Botzet & Fahnhorst, 2011).

Demographics. According to the CDC, approximately 25% of young people begin drinking before the age of 13 (Ohio State University, n.d.). The National Survey on Drug Use and Health (NSDUH) reports that in 2010, about 10 million youth aged 12 to 20, 26.3% of this age group, reported that they drank alcohol within the past month. Of these numbers, approximately 6.5 million, or 17%, were binge drinkers, and another 2 million or 5.1% were heavy drinkers. More males than females aged 12 through 20 reported current alcohol use (28.3 versus 24.1%), binge drinking (19.8 versus 14.0%), and heavy drinking (6.7 versus 3.5%) in 2010 survey results (U.S. Department of Health and Human Services (HHS), 2011).

Effects of Alcohol Abuse. Because adult alcohol use is legal, many people do not consider it to be an addictive drug; however, alcohol is one of the most widely used drug substances in the world. Alcohol misuse has various negative impacts on the adolescent's quality of life. Binge drinking and alcohol use among youth is one of the nation's most serious public health problems:

In 2009, 24% of high school students reported episodes of heavy or binge drinking.

In 2009, an estimated 12% or 30.2 million people aged 12 or older reported driving under the influence of alcohol at least once in the past year (NIDA, 2011).

In 2009, 10% of high school students reported driving a vehicle during the previous 30 days when they had been drinking alcohol.

Every year approximately 5,000 people under the age of 21 die as a result of underage drinking. This figure includes about 1,900 deaths from motor vehicle crashes, about 1,600 from homicides, 300 from suicide, and hundreds more form other injuries such as falls, burns, and drowning (HHS, 2007).

Excessive alcohol use can harm the growing brain, and can affect the body in many ways ranging from hangovers to death from alcohol poisoning (HHS, 2007).

Long-term alcohol misuse is associated with liver disease, cancer, cardiovascular disease, and neurological damage, along with psychiatric problems such as depression, anxiety, and antisocial personality disorder (CDC, 2010).

Alcohol misuse is often accompanied by other conditions and risky behaviors, such as delinquency, exposure to human immunodeficiency virus (HIV), poor academic performance as well as suicide (Sterling, Weisner, Hinman, & Parthasarathy, 2010). Societal costs of alcohol misuse include time lost from school or work, increased criminal activity, and increased medical care use. Alcohol misuse has also been linked to unintentional injuries, physical fights, academic and occupational problems and illegal behavior (CDC).

Program goals, objectives, and intervention activities are described as follows.
Goals.

1. Reduce the incidence of underage drinking through the use of strategies that decrease personal and social risk factors and that strengthen personal and social protective factors.

2. Increase awareness of adolescents, their families, and the public that underage drinking is a serious, chronic problem.

3. Ensure the recognition of symptoms of adolescent alcohol misuse by patients, families, the community and the appropriate diagnosis by health care providers; underage drinking is believed to be the most commonly missed pediatric diagnosis.

Objectives.

1. By the end of one year of the program, the rates of current, binge, and heavy alcohol use among underage persons should decline by 0.5%, 0.2% and 0.1% respectively.

2. NDSUH survey data will be used to measure program effectiveness.

Interventions. Prevention approaches to reduce adolescent drinking include family-, school-, and community-based strategies. Researchers and clinicians have developed comprehensive approaches to preventing underage drinking based on modifying the social world of the adolescent and the environmental factors of the community and society. Activities for this intervention include the following:

1. Encouraging individual and family-based therapy which seeks to reduce an adolescent's use of alcohol and correct the problem behaviors that often accompany alcohol use. This approach addresses mediating family risk factors including poor family communication, cohesiveness, and problem solving. Family therapy is based on the therapeutic premise that the family provides the most significant and long-lasting influence on child and adolescent development. Family therapy usually includes the adolescent and at least one parent or guardian (Winters et al., 2011).

2. School-based prevention programs that provide alcohol education and interpersonal and behavior skills training. Effective school programs provide developmentally appropriate information about alcohol, including information on short-term and long-term effects.

3. Community-based prevention programs that involve the media and are aimed at parents and community groups to create changes in institutional policies (such as alcohol establishments, media outlets and schools) intended to reduce youth access to alcohol.

4. Develop coordinated planning and implementation of the different strategies and approaches.

Teen Alcohol Abuse Prevention Logic Model

Input

Activities

Outcomes

Impact

Family strategies

Individual and family-based therapy

Improved parent-child relations

Consistent discipline and rule-making

Monitoring adolescent's activities

Family skills training

Reduced

Alcohol use

Absenteeism

Levels of problem behaviors

Improved

Resistance to external pressures

Awareness that most adolescents do not use alcohol

Family bonding

School-based media

School-based prevention programs

Broad-based skills training

Development of personal, social, and resistance skills

Community participation

Community-based prevention programs

Reducing youth access to sources of alcohol

Increased awareness of underage alcohol misuse

Increased enforcement of drunk driving laws

Lower alcohol sales to underage buyers

Reductions in self-reported drinking-and-driving rates

Reductions in alcohol-impaired driving, traffic accidents and fatal crashes

Evaluation Plan

The purpose of the evaluation plan is to learn whether the education, prevention and public policy initiatives undertaken by the project plan are changing the attitudes and behavior of both youth and adults in the community about adolescent alcohol use.

Evaluation Plan Description. 2012 NDSUH survey responses will be analyzed to obtain information on the illegal use of alcohol in the civilian, non-institutionalized population of the U.S. aged 12 years or older. The survey collects data through face-to-face interviews of approximately 67,500 persons each year. The survey reports on alcohol use broken out by persons aged 12 to 20 by three categories: current (past month) use, binge use (five or more drinks on the same occasion on at least 1 day…