Monday, 10 December 2012

Why don't the ASSAD Surveys' results always match our personal experience?

The 2011 Australian Secondary School Alcohol and Drug (ASSAD) survey was released today and for the next few years these figures will be used by a wide variety of people to describe what is going on amongst high school students in terms of alcohol and other drug use. I use the ASSAD data all the time - it is a great piece of research that provides some really useful information - but the response I get from many people I speak to, whether it be teachers, parents or those who work with young people in other sectors, is that the results simply don't match their experience.

For the purposes of this post I'll be looking at just the illicit drug use, we'll leave the alcohol, tobacco and over-the-counter information for another day ...

Once again, the data shows quite clearly that the majority of Australian secondary school students do not use illicit drugs. Here are just a few of the key findings:
  • in terms of lifetime drug use, rates were either stable or decreasing for all illicit drug use (apart for cannabis) when compared to the 2008 ASSAD survey among 12-17 year old students
  • lifetime cannabis use had risen from 13.6% in 2008 to 14.8% in 2011
  • 15.6% of 12-17 year old students reported using any illicit drug, including cannabis, in their lifetime. Excluding cannabis use, just 6.5% of students reported using any illicit drug in their lifetime
Even cannabis, the most popular illicit drug, had not been used by 85.2% of the 2011 sample - for some people (e.g., the parent who has a teenage son recently expelled from his school for supplying cannabis to classmates, or the drug worker running programs for at-risk young people) this just doesn't ring true. In their experience, cannabis is a major issue and a significant proportion of the young people that they work with use the drug or are exposed to it on a regular basis. So why don't the results match their personal experience?

Before we try to work out why there is this disparity, let's take a look at the survey a little more closely. This is the tenth survey in the series (and sixth to include questions on the use of over-the-counter and illicit substances) with just under 25,000 students aged between 12 and 17 years taking part in 2011. Students from government, Catholic and independent schools took part in this study with 893 schools invited to participate, with the aim to survey students from 414 schools across the country. That makes it a pretty good study - it has a more than decent sample size, it's collected across the three main education sectors and it has a random sampling methodology.

So, back to the reasons for the difference ...

Firstly, and most importantly, this is a survey of school-based young people, not Australian teenagers. Many youth workers, as well as others who work in health and law enforcement who come in contact with young people, usually see those who are no longer 'connected' to school. Those teens are not represented in this survey. These young people are much more likely to have used, or be currently using, illicit drugs and because they are often much more visible and their behaviour more extreme, they attract much more attention.

In the school setting the so-called 'druggie' group is usually labelled that way by teachers and students alike due to the behaviour they exhibit. They often talk loudly about their exploits, whether they be true or not, and they fit all the usual stereotypes. Even though the group may be small in number it often seems as if there are a lot of them simply because they are so loud and obvious. I can't tell you how many times I have been told by a well-meaning teacher that a particular year group has a 'drug problem' and when asked what evidence they have to support this the only response is 'we hear talk'! I'm certainly not saying to ignore gut feelings, but if you're concerned about possible drug use, get good evidence before you jump to conclusions ...

Finally, always remember that you can use statistics selectively to tell the story you want to get across. I believe in telling a positive story - saying that 85.2% of the sample had not used cannabis sends an affirming prevention message to those young people who choose not to use drugs, letting them know that they are not alone in their decision not to use. If I wanted to tell a different story and see the problems, I could say that one in five 15 year old Australian males have ever used cannabis, and over a quarter of 16 year old and one third of 17 year old males also reported using the drug at some time in their lives. Pretty depressing stuff if I wanted it to be ...

Overall, this survey tells a very positive story, i.e., illicit drug use is not the norm amongst Australian secondary school students. This doesn't make sense to some people who work with young people or have family members who experience great problems with their drug use. Look at the report a little more closely however and you will see that those young people who do use illicit drugs are indeed represented, but they are in the minority in this sample. Even though the figures may not match your personal experience, try to have an open mind and, at the same time, acknowledge that school-based young people are a diverse group, many of whom are simply not interested in illict drug use at this time of their lives.

Sunday, 2 December 2012

'Sheesha' smoking: Why should we be worried?

In the week that the world-first initiative of the plain packaging of cigarettes has finally been introduced in Australia, we should be incredibly proud of our achievements in the tobacco area. We have one of the lowest rates of daily smoking in the world and data that we have available from the latest 2011 ASSAD Survey indicates that we continue to see an upward trend in the number of Australian high school students who have never smoked cigarettes. That said, I am seeing a very worrying trend across the country that may be removing some of the existing barriers around smoking - the increasing popularity of 'sheesha' smoking.

About six months ago I was at a school in Sydney's eastern suburbs when a Year 10 student asked me about the harms associated with smoking a 'hubbly bubbly'. He had gone to a friend's 15th birthday and the parents of the birthday boy had given their son and his friends a sheesha to use at the party! I was absolutely floored - I couldn't believe a parent would do such a thing but since that time I've travelled the country and found that sheesha smoking is becoming increasingly popular, across all age groups, and most worryingly some see it as a 'healthy' way of smoking!

A sheesha (also known as a 'hookah' or 'hubbly bubbly') is a waterpipe, usually used to smoke flavoured tobacco. The smoke travels through a water basin before it is inhaled and, as such, many believe that this makes it a 'safer' way of smoking. Certainly this is what I'm hearing from young (and not so young) people across the country who truly think the water, plus the flavouring added to the tobacco, somehow reduces the risks associated with smoking. I even had one Year 12 girl who told me "it must be good for you, it's got fruit in it!" - truly scary ...

It has only been in recent years that some of the most significant harms have been identified. The sheesha has been used in many cultures for centuries and it is for this reason that harms are often downplayed. A World Health Organisation (WHO) report was released in 2005 and reported that sheesha smoking posed a serious potential health hazard and was certainly not a safe alternative to cigarette smoking. One of the most concerning findings was that during a 'sheesha session' of about 30mins, a smoker could be smoking the equivalent of between 30-100 cigarettes!

As much as we should be concerned about the fact that young people are smoking, more worrying is the belief that there is such a thing as 'healthy smoking'. It has taken such a long time for us to change community attitudes towards tobacco smoking that it would be really sad to see all our efforts undermined by sheesha use. Where we have managed to make cigarette smoking an 'antisocial' activity (who would have believed 25 years ago that if you wanted to have a puff of a cigarette you would have to stand in the middle of a freeway to do it?), you couldn't get further from the truth for sheesha smoking. Most adults are usually introduced to it at Middle Eastern restaurants, others when they were travelling internationally (particularly as backpackers), and now teens are first trying sheesha at gatherings on Saturday nights, usually while drinking alcohol. It is a social activity and that is a worry ... 

I am currently looking at the many Australian websites that sell sheesha products and trying to establish whether any of them are breaking advertising regulations. Claims that the products are "tar free" (they are until you smoke them!) and that they provide a "healthy smoking experience" (is there such a thing?) do push the boundaries of truth and it'll be interesting to see whether we can prove they are breaking the law ... Watch this space ....

Wednesday, 28 November 2012

The adolescent brain and alcohol

Since the 1990s we have learnt a great deal about the developing brain. It was once believed that this complex organ finished developing around the age of 15 years, we now know it takes much longer and that during the dynamic changes that occur during adolescence drinking alcohol can seriously damage long and short-term growth processes.

Before we look at alcohol's effects on the developing brain - let's first discuss what is different about a teenage mind.

We all know that adolescence can be a troubled time but now we are beginning to understand why this is the case - and it's not just all about raging hormones and puberty! Certain parts of the brain are underdeveloped, particularly the prefrontal cortex (the part that deals with judgement, decision-making, planning and impulse control) and when teens make decisions they tend to use an alternative section - the amygdala (the emotional part of their brain). This results in a decrease in reasoned thinking and an increase in impulsiveness. This often leads us to think that somehow adolescent brains are 'defective' in some way but that's just not true. As a professor of neurology was quoted as saying in the Harvard Magazine - "The teenage brain is not just an adult brain with fewer miles on it. It's a paradoxical time of development. These are people with very sharp brains, but they're not quite sure what to do with them."

What often defines adolescence is increased risk taking behaviour. In recent times we have come to understand what is actually happening here and why it occurs. Young people don't take part in risky behaviour because they want to hurt themselves and it's not that they don't understand the dangers - it's just that they weigh risk versus reward differently. As one academic is quoted as saying - "they don't downgrade the risk, they give more weight to the payoff."

This contradicts basic human behaviour of survival so why do teens behave in this way? Well, it's an evolutionary feature - young people are 'wired' to engage in risky behaviour during this period of their life so that they 'leave the village and find a mate'! This behaviour is not exclusive to humans, with rodents, primates and even some birds demonstrating behaviour such as seeking out same-age peers and fighting with parents during their 'adolescence'. Trying to fight the biology of risk taking may prove pretty difficult!

So what about alcohol - where does that fit into the mix?

Studies now show that drinking alcohol at intoxicating levels during adolescence produces permanent brain changes. 'Plasticity' is the term used to describe the brain's ability to physically change its internal structure when learning new things. During peaks of plasticity the brain must make key neural connections to wire us to become fully functioning adults. Drinking alcohol during peak periods of plasticity damages this 'brain wiring'.

There are two parts of the brain that are affected by alcohol during the teen years - the prefrontal cortex and the hippocampus (the learning and memory area). Research has found that adolescent drinking could cause severe changes in the formation of adult personality, as well causing up to a 10 per cent reduction in the size of the hippocampus, reducing memory and learning capacity. It is now believed that young people who drink regularly who are affected in this way may never be able to catch up in adulthood.

The message is clear - alcohol and the developing brain do not go together. If a young person is going to drink during this period they should not drink much and they should certainly not drink regularly. However, the evidence clearly indicates that they should not drink at all if at all possible.

Monday, 19 November 2012

What are 'bath salts'?

There are so many urban myths that exist to do with drugs and drug culture. It is difficult to work out how and where many of them originated, whereas others can be pinpointed exactly, as is the case with so-called 'bath salts'.

What is repeatedly mentioned in media stories to do with the new range of 'legal highs' or 'synthetics' is the story of a US man who reportedly stripped a homeless man naked and then attempted to chew his face off whilst under the influence of 'bath salts'. Witnesses described the man as a "zombie" and when the police finally arrived on the scene and intervened they shot and killed him. The attack was caught on video and, not surprisingly, the media had a field day. When the story broke there had been no toxicology conducted so no-one really knew what had caused this bizarre attack but that didn't stop the police or media from making wild claims. Nicknamed the 'Miami Zombie', Rudy Eugene became the poster boy for the new 'legal high' that was being sold as bath salts that few understood or knew very much about. There had been a number of bizarre crimes linked to the drug previously but this one was too good to miss ...

When toxicology results were finally released the only substance identified in Eugene's body was cannabis. No illicit drugs or alcohol and absolutely no bath salts! Even though the results were widely disseminated, the story of 'the man who tried to eat someone's face off' continues to be mentioned in media coverage dealing with the new range of 'synthetics' currently available - the latest offender being the Sunday Mail last weekend (an appalling piece that discusses another bizarre incident that may be related to these products, even though no toxicology has been conducted).

To the average Australian reading stories about people using bath salts as a way to get 'out of it' it all must seem pretty strange - don't you find these products sitting in your medicine cabinet? Do parents have to lock them away just in case their teenage child gets the urge to go clubbing on the weekend? A year or two ago UK parents faced a similar issue with the tabloid media reporting that 'plant food' or 'fertilizer' were being ordered online and then taken by clubbers for a drug effect. Why in heaven would anybody start using these products in this way?

Well of course they're not. 'Bath salts', 'plant food' and even 'swimming pool cleaner' (another product named by the UK media) are terms used by manufacturers to disguise a whole new range of synthetic substances and sell them online and thus hopefully avoid authorities. Prior to this, these substances were often sold as 'research chemicals'. These are a range of substances that are designed to have similar effects to illicit stimulants such as amphetamines, ecstasy and cocaine, most of which we know little, if anything, about. Plant food proved to be a drug called mephedrone and bath salts appears to be MDVP for the most part (although mephedrone has also been identified in some products, as well have some other similar compounds).

We need to be extremely careful about the warnings we issue about these drugs. We know next to nothing about them and having the media report on bizarre crimes and link them to these products without hard evidence is extremely dangerous. Young people, particularly young drug users, believe little of what authorities tell them about drugs - issuing warnings when we're not absolutely certain of the facts is problematic. You can only 'cry wolf' so many times - when we have something we really need them to listen to, there is a real danger that they will completely ignore us. I am certainly not saying that these products and the compounds they contain are not dangerous - without doubt there are surely a range of risks associated with their use - but linking them to bizarre incidents without proof is not the way to go.

Let's be honest and tell those considering using them that we know nothing about the risks involved with their use. These drugs are so new they haven't been tested on animals, let alone humans. If you decide to use them you really are being a guinea pig for the future. Isn't the truth scary enough?


Thursday, 8 November 2012

What hope do we really have?

It has been really interesting to see media coverage of the Melbourne Cup this year. Images of drunk racegoers falling to the ground with alcohol in their hands even managed to make front page news in the UK. It seems that no matter how you dress it up - getting drunk is not attractive - at last we're acknowledging that!

Then you find 'articles' like the one I was sent from Melinda Tankard-Reist yesterday that makes you realize just how far we have to go. Melinda does an amazing job highlighting a range of issues, particularly around the sexualisation of our young women. The piece she sent me came from Zoo Weekly magazine and was contained in an article called 'Truths that are Lies' challenging a number of so-called 'myths' including 'Alcohol kills brain cells'. Their response to this statement was as follows:

"Here's a good reason to go out, get slaughtered and urinate on a
policeman: even industrial quantities of booze won't destroy the grey matter. Numerous studies have shown that while getting leathered affects behaviour, positively and negatively, it's not linked with permanent cell damage, even for committed park-bench alcoholics. The cells' ability to communicate with each other is impaired during drinking (hence the falling over and the dad-dancing) but the moment you stop, those same cells begin functioning again."

Really?

Apparently, Zoo magazine is read by 28,000 young people aged 14-17 every month. The messages it sends around alcohol and getting drunk are consistently abhorrent - this piece, minimising the impact of binge drinking is no exception. Manipulating research in an attempt at schoolboy humour (get so drunk you can "urinate on a policeman") is shameful but unfortunately not unexpected from a publication like Zoo.

At a time when the community is becoming more concerned about underage drinking, and binge drinking more widely, it would be great to have the media on our side. Unfortunately we continue to have Top 40 radio show hosts asking teens to call up and tell their most embarrassing drinking story to the world and breakfast TV presenters laughing about how drunk they got at last year's Logies.

Alcohol is part of our world and I'm not suggesting that we pretend that isn't the case but why should we be constantly celebrating, and hence promoting, drinking to excess? Yes, it's a guaranteed laugh - but it's a cheap laugh ... Unfortunately it doesn't always end that way for some - I come in contact with young people who drink just a bit too much and end up sexually assaulted or a victim of senseless violence. Who laughs then?

Tuesday, 6 November 2012

The 'Schoolies' Week' phenomenon

It's that time of year that many parents dread - the lead-up to 'Schoolies' Week' (or 'Leavers' Week' as it is known in WA). Last week Foreign Affairs Minister Bob Carr issued a warning to Schoolies travelling overseas that if they break the law consular staff can't "rescue them if they are arrested". It was a great move by the Australian Government in my opinion but I doubt very much if it will have any great effect on those young people who choose to go overseas for Schoolies' celebrations.

You only need to take a look at a story that ran on Channel Ten's 'The Project' in response to the DFA's warning to realize what we are up against. If you go to the following link the story on Schoolies travelling overseas begins at 2min.20sec. The interview with the two young women who are planning to travel to Bali is quite disturbing. When asked why they chose to go overseas they make it clear that it is to avoid the laws around alcohol as they will be underage and that the purpose of the trip is to get drunk ... I know that it is extremely difficult to stop young people from attending Schoolies' Week events but any parent who believes that it is safer for their child to travel overseas to party rather than make the pilgrimage to the Gold Coast, Byron, Rottnest or Victor Harbour truly have their heads in the sand!

Of course you have to let your child experience life and they are going to make mistakes. Some parents have said to me that their child is planning to take a 'gap year' and that they see the overseas Schoolies' Week as a 'controlled' introduction to that experience. Are they nuts? The attraction for many young people to travel overseas for Schoolies is that they are not subject to laws around underage drinking - they want to drink, and drink a lot! Days of partying hard with a large number of other young people with a similar mindset. A 'gap year' of travelling is very different - I'm sure partying hard is part of the attraction for some but realistically you can't maintain that lifestyle for long (you'd also need a lot of money!) ...

I am certainly seeing a move away from Schoolies - a growing number of Year 12 students are choosing alternate activities and parents are getting smarter, offering their teens other potentially 'safer' options in an effort to tempt them away from the usual holiday destinations. Certainly young adults should be able to celebrate their school achievements but isn't it sad that some believe alcohol has to play such a major part?

Thursday, 11 October 2012

LSD - did it ever go away?

With the tragic 'tasering' death of the young Brazilian in Sydney earlier this year,  hallucinogen use is an issue that is now being discussed. Described by police at the coronial inquest into his death as being "in an LSD-induced ''psychotic state''', one article was quoted as saying that the drug had left the young man "paranoid, restless, and possessing "superhuman strength" as he tried to avoid arrest".

Whether or not any drug can give someone "superhuman strength" is highly debatable! Can someone affected by LSD be difficult to deal with, aggressive and violent? Without doubt, but "superhuman", most probably not ... so what is the story around LSD, what is it and what are the risks, particularly for the young?

Amazingly some commentators are surprised to find out that LSD even exists anymore, with many believing that it disappeared in the 60s, along with the 'flower power' generation. That couldn't be further from the truth! 

LSD, otherwise known as ‘trips’ or ‘acid’, certainly came to prominence in the 1960s and is closely associated with the 'hippy' movement, however, in recent years a range of hallucinogenic drugs, including LSD, has seen a resurgence in popularity, particularly amongst the younger set (in 2010 8.8% of the population reported that they had ever used hallucinogens at some time in their life - an increase from 2007).  It always amazes me when I give a talk to parent groups, how many of them actually believe that the drug no longer exists! 

LSD, like all hallucinogens, causes an altered sensory experience of senses, emotions, memories, time, and awareness. Unlike many other drugs, LSD's effects can last for a very long time - 6 to 14 hours (depending on your tolerance and how much you use) - for many, they are seen as 'value for money'. Users report seeing colours, hearing music differently and their sense of touch may be heightened. Of course, things can also go terribly wrong and the user may experience a 'bad trip' - an unpleasant, even terrifying experience where the effects are frightening and confusion and delusions result. 

LSD (d-lysergic acid diethylamide) is derived from the fungus ergot, which grows on rye and other grasses.  In its natural form ergot has been used for centuries as an aid to childbirth.  It was not produced synthetically until the 1920s, when researchers investigated the possibility of the drug treating migraines and assisting with obstetrics and geriatrics. In April 1943, Dr Albert Hoffman accidentally ingested a tiny amount of one of the substances he had derived from ergot. Shortly afterwards he pedalled home on his bike and becoming ‘transported into other worlds’.  Hoffman had become the first person to go ‘tripping’.

In the 1960s the potency of the drug was extremely high, each trip containing approximately 250 micrograms of LSD.  Nowadays available evidence suggests the average potency of a tab is much more 'manageable', being roughly 50 micrograms.  Its current popularity appears to stem from the fact that its potency is fairly stable, it is extremely cheap and readily available. Possibly most importantly for some, it is not detectable by sniffer dogs!

LSD is not a particularly toxic drug.  The deaths that have been linked to the drug are usually classed as ‘accidents’, suggesting the tripper was involved in a fall, a traffic accident, or something similar. It is rare to find people who use this drug daily as the tolerance of LSD’s effects build quickly so that a normal dose taken three or four days running will, by the fourth day, produce no trip. 

In vulnerable people, adverse psychological effects can persist after comedown. Users may suffer mental and emotional instability, depression, loss of confidence, paranoia and flashbacks.  Hallucinogen Persisting Percetive Disorder (HPPD) is now a medically recognised condition in which some people who have taken LSD constantly experience visual hallucinations, as opposed to brief flashbacks - why some people are more susceptible to this than others is not yet known.  What we do know is that if you have a pre-existing mental condition, LSD can ‘unlock’ that condition.

Most people have no idea whether or not they may have a mental condition. Experimenting with drugs is always a risk, particularly for the young.  One of the greatest risks is in the area of mental health.  No-one can give you a definite answer on whether using a particular mind-altering substance wil lunlock a pre-existing mental condition or not. You really are playing russian roulette.

Thursday, 27 September 2012

The minefield that is alcohol and other drugs ...

There is no easy way of dealing with the topic of alcohol and other drugs. Over the years I have been called a 'promoter of drugs' (once actually being accused of contributing to the 'killing of young people' with the messages I was promoting in schools!), as well as being an 'anti-drug crusader' (a term I particularly dislike - it sounds like I should be wearing a cape and flying through the sky ...) ...it really is extremely difficult to get the balance right - you simply can't please everyone!

A book has recently been published in the UK by Professor David Nutt who has found himself right in the middle of the debate a number of times in the past year or two. Once the leading advisor to the UK Government on issues around drugs, he was sacked for, amongst other things, comparing the harms of taking ecstasy to that of horse riding! The book, Drugs: Without the Hot Air, has been described as written in "straightforward language" and "explores the science of what a drug is and how it works, why people take drugs, and how it affects them."

 I haven't read the book but do plan to as soon as I can get my hands on one. I certainly don't agree with everything that Professor Nutt has been quoted in the media as saying, but an excerpt of his book that has been made available on the Internet is very powerful. See what you think ....

"A terrifying new “legal high” has hit our streets. Methyl-carbonol, known by the street name “wiz,” is a clear liquid that causes cancers, liver problems, and brain disease, and is more toxic than ecstasy and cocaine. Addiction can occur after just one drink, and addicts will go to any lengths to get their next fix – even letting their kids go hungry or beating up their partners to obtain money. Casual users can go into blind rages when they’re high, and police have reported a huge increase in crime where the drug is being used. Worst of all, drinks companies are adding “wiz” to fizzy drinks and advertising them to kids like they’re plain Coca-Cola. Two or three teenagers die from it every week overdosing on a binge, and another 10 from having accidents caused by reckless driving. “Wiz” is a public menace – when will the Home Secretary think of the children and make this dangerous substance Class A?"

Thursday, 20 September 2012

Parental supply of alcohol and adolescent drinking

A great paper has just been published by Australian researchers that attempts to sort out whether there is an association between between parental supply of alcohol and risky drinking.

The authors tested two hypotheses - firstly, that minors whose parents supply them with alcohol per se have increased odds of risky drinking, and secondly, where supply occurs for drinking without parental supervision, the odds of risky drinking are greater again.

They found that 'risky drinking' was common within their sample and increased sharply by school year. Their first hypothesis was not supported, however students whose parents supplied them with alcohol for consumption without parental supervision had four times the odds of risky drinking.

What does this mean for parents? Is there a simple message here? To be honest the study has a whole pile of limitations but it does seem to suggest that the practice of giving your child a couple of drinks to take to a party is most probably not appropriate. One statement made by the authors is particularly important - "it is critical to note that supply for drinking under supervision did not have the protective effect that may have motivated the behaviour."

Sunday, 2 September 2012

Ecstasy deaths and warnings

I was contacted by a Brisbane journalist on Friday regarding an ecstasy-related death that occured last weekend. He had already interviewed a young woman who had been at the house party where the young man had died and she she too had experienced severe effects and found herself hospitalised. There was also a great deal of conversation on social media sites and web-based chat rooms about a possible 'bad batch' of ecstasy.

The journalist was keen for me to provide some information on a substance known as PMA - a toxic form of amphetamine that has been found in ecstasy pills across the world than has led to a number of deaths. He also asked me to give my opinion on why no warnings had been issued by either health or law enforcement authorities even though someone had died after taking what was obviously a 'bad pill'.

In all my years of working with the media the one story that ended up causing me the most grief was when I made comment on an ecstasy-related death and it was written up that I was stating categorically that the tragedy was caused by a specific substance. I made no such claim but rather was asked questions about a particular drug and gave the journalist the information she requested - of course, that was not how it was written up!

As you can imagine after that experience I was very hesitant to comment on this tragedy. There have been no toxicology results and therefore we don't know anything about the substance that may have contributed to the young man's death. We are really assuming so much and that can get you into real trouble.

Authorities are really 'stuck between a rock and a hard place' here. To issue a specifc warning about a drug without knowing anything about it is fraught with problems. Many ecstasy users don't believe health authorities and law enforcement anyway, if a warning is issued and then found later to be inaccurate, it will only reduce the credibility of any warnings that may be released in the future. If they don't do something and there is another death, the media will be savage.

It will be interesting to see what happens next. There were a 'cluster' of ecstasy-related deaths in Canada earlier this year that were related to PMA. Authorities certainly do need to make sure this death is examined quickly and if specific warnings are needed, issue them in an appropriate way by credible authorities.

Sunday, 1 July 2012

Are our kids really that bad?

Here is an edited version of an Opinion Piece I wrote for ABC Online way back in January 2008.

If you believe the media you would quite honestly believe that we now have the ‘worst group of young people in the history of young people’. Current affairs programs and radio shock jocks love to tell tales of young people out of control, that we have higher rates of drug use than ever before and that drinking rates are through the roof.
 
I have been in an extremely privileged position over the past decade or so. Almost every week over that time I have been asked to speak to school communities right across the country about alcohol and other drug issues. I get to speak to a range of people about this subject and I continue to feel extremely positive about young Australians. So many of them are doing wonderful things, have made great choices and have amazing futures in front of them. When do we ever talk about them and celebrate the good things about our children?

Now that’s not to say that we don’t have a problem. There is drug use occurring and unfortunately those who do experiment tend to do it at a younger age, putting them at much greater risk. However, as far as illegal drugs are concerned we are talking about a small group and constantly highlighting the minority sends very confusing messages to that much larger group who have not used. They often feel like aliens and are often convinced that drug use is the norm, even though that is not their personal experience. Shouldn’t we concentrate on the majority who don’t ‘do the wrong thing’ and send a positive and empowering message?

This is particularly true when it comes to alcohol. This is the drug that we should be most concerned about when it comes to our children, but we have been so conditioned to worry about illicit drugs that alcohol use is often regarded as almost a rite of passage. It has become so normalised in our society that it really should come as no surprise that some of our young people are drinking at high levels and experiencing great problems.

Adolescent drinking should really come as no real surprise – simply examine the role models that our children have to follow. What do they see in their own home? How do their parents socialize? What is the one constant at almost every celebration in our society – whether it be a birth, a death, a victory or a loss? Their parents come home after a hard day at the office and what is the first thing they do? They have a drink to relax. They use a drug to get through the evening, to relax and wind down after a stressful day.

Even so, when you examine the statistics around alcohol use, you quickly realize that young people are not just one large homogenous group. They can be broken down to three key groups, two of which we rarely acknowledge. The first is the loudest and the most obvious, those young people who drink to excess. There is much debate whether this group is growing or not – I don’t believe it is, although it is quite clear that they are drinking at much riskier levels and getting younger.

The next group are the ones that drink responsibly. They don’t drink regularly and when they do drink they consume a small amount. This does not mean that there are still not risks involved for these young people but we do need to acknowledge that they are trying to do ‘the right thing’.

Finally we have the abstainers. An interesting fact that is rarely talked about is that between 20-25% of 16-17 school-based year olds have never drunk alcohol. We never speak about these young people and their decision; in fact we completely ignore them, making them feel even more alienated that they feel already within their peer group. I can’t begin to tell you how many students come up and speak to me after a presentation thanking me for acknowledging them during my talk. Constantly focusing on the at-risk drinkers is doing incredible damage to these young people who have made the decision not to drink.

What I find particularly illuminating are the types of questions that young people are generally interested in. They pretty well follow one theme – how can I keep myself and/or my friends safer? We do have a very caring group of young people in our society. The things they are interested include the following:
  •  How do I look after a drunk friend?
  • One of my friends drinks far too much. I’m worried about her, what can I do?
  • Are there any ways to prevent a hangover?
At a time when our younger generation is getting a ‘bad rap’ from the media it is important that we maintain some perspective. In actual fact we have a group of young people who are genuinely interested in collecting information on keeping themselves and their friends as safe as possible. Unfortunately we are so obsessed about providing them with information that we think they should have that we are neglecting to give them the information they really want and need.

Our kids are great, not problem free, but great nevertheless. It’s time we acknowledged all of the wonderful things they do and spoke about the majority of young people and the positive life decisions they make. Alcohol is the major drug problem with this group and all parents need to ensure that are well-informed about the risks associated with adolescents and drinking. It is also vital that all parents attempt to arm their children with information and skills to look after themselves and their friends during the difficult period known as adolescence.

Are Australians really the world's highest users of illicit drugs?

The annual release of the UN World Drug Report always creates a flurry of media interest in this country (I would imagine the rest of the world doesn't really take much interest in the contents!) mainly due to Australians and New Zealanders usually being awarded the dubious title of "the world's biggest drug users." This year was no exception!

According to the report, annual use of all drugs, except heroin, in our two countries "remain much higher than the global average". The latest available data suggests that New Zealand has the highest prevalence of the use of cannabis, with Australia not too far behind, and our use of ecstasy, although falling in recent years, continues to be the highest in the world.We are certainly seeing increasing availability of cocaine across the country and rates of use appear to be rising accordingly.

So what is the story? Are we actually the world's largest consumers of drugs and how is this report put together?

When you look at reports like this you need to remember that it incorporates information from countries all over the world. These countries all have very different legal and political frameworks, some with extremely limited capacity for collecting quality population data, particularly when dealing with information around the use of illegal drugs and some certainly have an agenda when presenting their data to an organisation like the UN. To look at these results without a very critical eye is extremely dangerous - certainly all the data we have suggests that Australians appear to have high rates of illicit drug use - but really, how can you compare our data with countries like Thailand and Indonesia, when admitting to drug use in those countries can result in life sentences in jail or even death?

There are two main factors that could contribute to the higher rates that need to be considered. Firstly, it is believed that Australians are generally more forthcoming about their drug use. We live in a society where researchers can put an advertisement in the paper to recruit for a study and drug users will come forward without fear of arrest or intimidation. There are not many countries in the world where that is the case. Even US researchers are often very surprised when that hear about how easy it can be for their Australian counterparts to collect illicit drug-related information.

Secondly, and most probably more importantly, we have great data collection instruments. The National Drug Strategy Household Survey (where most of the Australian information for the UN report was sourced) is one of the world's best. With a large sample and a questionnaire that is regularly updated, it provides accurate and up-to-date information on Australians' use of drugs that is extremely useful. It certainly isn't perfect and is often used inappropriately but it really does allow us to track trends over time. To compare this data to some of the information used in the UN report from other countries is highly problematic.

My concern about the media constantly pushing this UN line is the message it sends to the community, particularly young people. Certainly illicit drug use continues to be an issue but there are some promising signs that we rarely talk about. Use amongst secondary school students continues to fall across almost all drug types and we still need to remember that most young people choose not to use drugs! I continue to meet young people who actually think there is something wrong with them if they don't take drugs and media stories on reports like this just reinforce those beliefs.

Friday, 22 June 2012

Spirits and young people


One young Australian aged between 14-17 years old dies every weekend due to alcohol. That figure astounds me each time I say it to a group of students but it truly is beginning to surprise me that we don't see far more deaths than that due to the increasing use of spirits by the very young.
Recently I met a 16 year old girl at a school who wanted to thank me for the talk I had given her class the previous year. Only a couple of weeks after I had visited her school she had gone to a party and consumed almost a bottle of vodka with a couple of friends. She remembers little of the night apart from waking up in the hospital early the next morning with a drip in her arm and her parents sitting next to her, both of them in tears. Apparently she had lost consciousness and her friends had used some of the information I had given them in my talk to establish that she needed urgent medical assistance. 

She was an amazing young woman. She had been through an unbelievably terrifying experience but now totally 'owned' it and had made some decisions about how she now hoped to deal with alcohol and parties in the future.
It doesn't matter where I go, it is usually spirits, particularly vodka, that causes the major problems. Almost every death I have been involved with in schools has been vodka-related. So why are these drinks more risky?
First of all, spirits are much cheaper than they once were and this makes them much more accessible to young people. It is also important to remember that it takes much less vodka, rum or whisky to get drunk than for beer or wine. It would only take minutes to drink two shots of vodka (60mls), for most people it would take much longer to drink the equivalent amount of alcohol in beer (two 285ml glasses – 570mls).
If a group of young people share a bottle of spirits between them, they are drinking the equivalent of 22 glasses of full strength beer, 22 cans of mid-strength beer, more than 2 litres of a cask of red wine, or more than three bottles of champagne. For most young people, if they tried to do drink this amount of other forms of alcohol they would find it almost impossible to do so quickly before feeling the effects, thus preventing them from drinking more. 
Spirits, on the other hand, are much easier to consume quickly because you don’t need as much to achieve the desired effect. By the time you do feel the negative effects, you have drunk too much and are unable to modify your drinking accordingly. This is what is getting young people into trouble ... sharing a bottle of spirits is becoming a regular practice amongst some teenagers and something we urgently need to address.


Saturday, 2 June 2012

Parents, teenage parties and alcohol

Last weekend NSW Premier Barry O'Farrell made the front page of the Sun Herald on the issue of parents, parties and teenage binge drinking. The story begins by stating that "parents who supply alcohol to other people's children face up to 12 months jail" as part of the changes being pushed by the Premier.

When you actually read the story it really says no such thing - no new laws have been made, just the ordering of a parliamentary inquiry into changes to the law to potentially prevent minors from drinking in homes, parks and halls. Call me just a little bit cynical but I wonder what the O'Farrell government didn't want on the front page last Sunday that led them to this big announcement of 'not much at all'! I remember many years ago when the then Premier of NSW, Bob Carr announced a trial of medical cannabis was to be rolled out, knowing full well that his government couldn't do anything without the Federal Government's support, guaranteeing a front page story in every newspaper and top story on every news program. His announcement just happened to coincide with the release of a report on problems with the rail system - surprise, surprise - that report got very little, if any coverage!

Don't get me wrong, I do believe that governments do want to do something about teenage parties and underage drinking - it's just that they have no idea what to do. Does anyone honestly believe that we have the police numbers to support tight laws around the provision of alcohol at teenage parties? If we don't have the police to enforce the laws, what is the point? We already have 'secondary supply' laws that are rarely, if ever, enforced and it's very difficult to stand in front of a group of young people and tell them about the laws when they know they really don't mean anything. The Victorian Government changed their laws at the end of 2011 but realistically things have not changed. If anyone has been prosecuted under the new laws we certainly haven't been told about it and really what's the point of having a law if it isn't policed?

Certainly parents have been screaming out for assistance with this matter. Many of us thought the Victorian changes would provide some well-needed support for parents in that state.

The good thing about a law in this area is that parents can use it to their advantage, so when their teenager asks to hold a party and serve alcohol they can turn around and simply say  "I can't - it's against the law!" The problem is that now that parents have a law to do just that, some parents are actually supporting their children in getting around the law! The law states that it is now illegal for anyone to serve alcohol to anyone under 18 years old unless their parent or guardian has given permission - break this law and you could be fined more than $7000. What some parents holding parties are now doing is creating notes with a 'tear-off permission slip' at the bottom requesting permission to allow their child to drink from the parents of the invited young people ... hard to believe but true. Instead of using the law to help them parent and say 'no' when appropriate, they do just the opposite ...

It'll be interesting to see what comes of this NSW parliamentary inquiry but to be honest I'm not expecting much. Governments can't dictate how parents should parent, and nor should they, but if parents don't support existing laws what is the point of creating new ones?

Monday, 14 May 2012

New drugs and what to do with them

A couple of weeks ago the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) released a report that reported on the large number of new drugs that had been detected in the European Union in 2011. According to the report, a total of 49 new psychoactive substances were officially notified for the first time in 2011. This represents the largest number of substances ever reported in a single year, almost one every week, up from 41 substances reported in 2010 and 24 in 2009.

Many of these substances come under two main headings - 'synthetic cannabinoids' and 'synthetic cathinones'. Synthetic cannabinoids are the products often referred to in the Australia media as 'synthetic cannabis', with the best known of these being 'Kronic'. The cathinones are often described as being similar in effect to stimulant drugs like amphetamine, ecstasy and cocaine. The most popular of these is a substance called 'mephedrone'.

There was a time when substances identified in Europe or other parts of the world took quite a bit of time to make it to Australia. That is not the case today. The Internet has changed the way drugs are distributed and drug information is disseminated. Without a doubt some of these new substances are making it here and the problem is that we know nothing about them.

So why are so many of these substances popping up? Unfortunately, the way that authorities usually deal with a drug they know little or nothing about is to ban it. Making a substance illegal is supposed to stop people from using it - if you don't stop, there will be legal consequences. The theory behind banning something is simple but we know from experience that it doesn't always work that way.

Certainly some people change their behaviour when a substance is made illegal. You only have to look at the New Zealand experience around the 'party pills' phenomenon to see that when these products were made illegal many people stopped using them. That said, there are others who don't. In fact, for some people, the fact that it is illegal makes it even more interesting! This is particularly true for young people who are going through a time when they are constantly testing rules and boundaries, just to see how far they can go ...

Another unintended consequence of banning something is that people look for alternatives. This is when enterprising drug manufacturers start 'tweaking' molecules and change the existing 'illegal substance' into one that just manages to get around the new bans. Unfortunately, this is where it begins to get scary for those messing with these new substances because we have absolutely no idea of what it is that they are taking and what the potential risks could be for the user. They really are the 'guinea pigs' for the future!

Over the years I've seen Australian authorities ban many substances, usually not based on much evidence of significant harms, and usually useage rates have risen as a result. They certainly haven't disappeared because they were made illegal. With the large numbers of new substances coming onto the market we've got to find a better way of dealing with the problem.

Finding your child is using drugs

Welcome to the first of many (hopefully!) posts on my new blog - 'Doing Drugs with Paul Dillon'. The title comes from the radio show I did for many years on the national youth radio station - Triple J. Looking back on it, it was a pretty brave thing for them to do and I very much doubt whether we would get away with some of the things that we spoke about way back then .... That said, I hope that readers of the blog find its content useful, and that it provides me an outlet to let off steam occasionally!

It's going to take me a while to get going so if you happen to start reading this early in the piece and are disappointed that there isn't a lot here, I hope you will return later and take another look. Over time I'll try and post items like Opinion Pieces that I have written for newspapers and websites (I've put a couple up today), as well as make commentary on news stories of the day (particularly if they really get me angry) and highlight any new research that I find interesting. Of course, there is still my website but hopefully this will 'value-add' to that ...

Over the weekend I received an email from a mother had recently discovered that her teenage son was smoking cannabis. This was the second time he had been caught and he said he had smoked again as he didn't get an effect the first time and the approval of his peers was more important to him than how his parents felt. She was seeking advice on how to deal with the issue as she believed that simply yelling at him and confining him to his room was not going to work.

A parent discovering their child is experimenting with drugs is a pretty frightening experience and unfortunately hardly anybody is prepared for it. We know that the best way to respond is to take a breath, calm down, think through the issues and then respond accordingly - this rarely happens! We just fire off a punishment without really looking to the future!

The reasons that the young man gave for using cannabis are the 'normal' ones and much less worrying than others that could have been provided - "I use to feel better", "I use to forget", etc. This does not mean that there is not a problem - cannabis is illegal and should anyone get caught using or have it in their possession there could be life changing consequences! For example, f he got caught in a school situation there is every chance he could be suspended or even expelled!

My advice is as for any parenting situation - create rules and boundaries, make sure consequences are decided upon that will have an effect, and then follow through ... If your child has broken your rules and let you down, they have lost your trust - there must be consequences for that. Make these short, sharp and ensure they 'suit the crime' - grounding for long periods of time is just going to cause resentment and not solve anything ... Once you have dealt with the breaking of the rules, sit down and establish new rules around cannabis and then make sure that whatever you do, you follow through with the punsihments decided upon should he break the rules again ..

This sounds as though this is 'simple' experimentation but if it continues parents should seek professional help as early as possible. Remember there are no simple answers, every family is different and what will work for one may not work for another. If you are really concerned contact Family Drug Support (FDS) on 1300 368 186. This is a great organisation primarily made up of volunteers who have experienced first hand the trauma and chaos of having family members who use drugs. They have travelled the same road and will understand and refer you appropraitely.

Alcohol and young people

Here is an Opinion Piece I was asked to put together for the Newcastle Herald in February 2010 ....

Alcohol has always played a role in some young people’s lives. No matter what your age, if you cast your mind back to your final years of high school there were surely at least a small group of your classmates who were well known for their partying habits! Are we to believe today’s headlines that things are so dramatically different now?

Firstly, let me make something completely clear – we really have no evidence to indicate that we have more young people drinking than ever before. However, what we do appear to have is a hardcore group of risky drinkers who are drinking in a far more risky way than ever before. As already said, this group of risky drinkers have always been there – it’s just now they’re starting younger, drinking more, more often, and possibly most frighteningly their drink of choice is spirits, particularly vodka. So if they are such a small group why should we be so worried?

These young people, both male and female, are loud, they’re obvious and they attract a great deal of attention. These are the teenagers who get in trouble with the law, find themselves in accident and emergency rooms and find their stories on the front pages of newspapers across the country. As a result it appears that they’re a much larger group in number than they really are. Unfortunately, they’re also extremely influential and as a result their behaviour is perceived as the ‘norm’ by other young people. The belief that ‘everyone is doing this’ is extremely dangerous and needs to be challenged at every opportunity.

Adolescent drinking should really come as no real surprise. Drinking to the point of intoxication has become so normalised across our society that why wouldn’t our young people drink at high levels? Simply examine the role models that our children have to follow and it isn’t difficult to understand the pressures they face. What do they see in their own home? How do the celebrities and sport stars they look up to socialize? What is the one constant at almost every celebration in our society – whether it be a birth, a death, a victory or a loss? Alcohol is all pervasive and in recent years it appears to have gotten completely out of control.

One tragic consequence of this is young people dying. Over the years I have been involved with a number of teenagers who have died after drinking large amounts of alcohol. The last five schools I have been to where young people died all involved Year 10 girls who all died after each of them drank almost a bottle of vodka. None of these girls died alone. They all died in party settings and were being looked after by friends who were so drunk they really couldn’t look after themselves, let alone anyone else!

The Australian Government has made a commitment to dealing with the ‘teenage drinking issue’. A mass media campaign, a National Binge Drinking Strategy and funding of a range of community programs across the country have been rolled out but really what’s the point? What is the sense of pouring money into trying to deal with underage drinking if you don’t really deal with the problem for what it really is – a community issue?

Young people learn from watching those around them. Unless we address the wider community issues that we are facing with alcohol we will continue to see money poured into the ‘black hole’ that is underage drinking and nothing much will change. We know what will work when it comes to reducing alcohol problems in this country but none of the possible solutions are popular. Raising the price, reducing access and stopping alcohol advertising and sponsorship of sport are most likely to be the most effective ways to make real change, but it would be a very brave government who would really push any of these through. Try to reduce the average Australian’s access to alcohol and they will most probably find themselves out of power at the next election! That means we will continue to see lots of talk and most probably not a whole lot of real results and that is truly tragic for our kids.

Alcohol and parenting

Here is an Opinion Piece that I wrote in February 2011 for Melinda Tankard-Reist's website:

I often tell the story of my visit to a small country town waiting to give a presentation to a group of parents. I was waiting in a hotel room watching a news program and a story about young people and alcohol use was just about to begin. The piece started with a statistic, as they usually do, with the newsreader stating that “one out of every 10 young people binge drink”.  As you can imagine the story that followed was fairly alarming and I remember sitting on the bed with my head in my hands thinking what chance do our teenagers really have? That figure sounds pretty scary for parents and it is – drinking to excess is dangerous, particularly when you are dealing with the developing brain, but why must we always be pushing out a negative message when it comes to this issue? Wouldn’t it have been much more powerful and positive to have started the piece by saying that nine out of ten haven’t taken part in this activity?

Well the statistic was thrown around again today – only this time it was ‘one out of five regularly binge drink by the age of 16’. Once again, it’s a frightening statistic and one that all parents should be concerned about but truly why can’t we ever say anything good about our kids! Not all of them are doing this – in fact, the majority aren’t!
No-one should stick their head in the sand and pretend that there isn’t a problem. When it comes to alcohol – it would be true to say that most young people will experiment with it at some time during their adolescence, but constantly reinforcing the negative is not good for anyone! As a result, parents grow increasingly concerned and those young people who do not drink to excess (and most particularly those who do not drink at all) feel that there is something wrong with them.So what is the current situation when it comes to alcohol and young people in Australia?
Alcohol is such a huge part of Australian culture and it would be difficult to identify any social gathering that takes place in this country where it does not play a significant role. Whether it be a christening, a wedding, a funeral, a birthday party or simply getting together with a few friends for dinner – alcohol is there and often consumed to excess. As I always say, our young people learn from somewhere and we are very good teachers, even when we don’t want to be.
One of the most worrying things that I have noticed over the years is that parents now want to try and be their child’s best friend rather than their parent. It’s important to remember that your child has the opportunity to make lots of friends in their lives – they only get one set of parents and you are it! The fear that you may lose your relationship with your child if you act like a parent, particularly if you dare to say no to them, is irrational. Young people need parents to give them guidance and to set rules and boundaries around a whole range of activities, including alcohol use. Although teenagers may not always like the rules that are set, they are necessary and assist them to socialize with others in a responsible and healthy way.
Parents across the country are desperate for guidance on how to deal with the introduction of alcohol to their children. Unfortunately the jury is still out and there is no definitive answer that suits all families. One thing, however, is now extremely clear - the longer the human brain can avoid alcohol, the better chance it has to develop its full potential. All experts now agree that teenagers under 16 years of age should avoid alcohol.
This is a comparatively new message. For years when I was asked how and when to introduce alcohol to children, my response was “before someone else does and as early as you think appropriate, at a family meal.” That message has changed dramatically. You still want to try to ensure that your child’s first drink isn’t at a park on a Saturday night, but providing it too early, without clear rules and boundaries, is likely to be just as problematic.
Parents can make a real difference when it comes to alcohol consumption, particularly if they really put their mind to it. Here are some simple tips that may help:
Talk to your partner about the role alcohol plays in your lives and the message this is sending your children about its importance.
Set clear rules and boundaries early, ensuring your children understand why the rules exist, i.e. you love them and want to keep them safe.
Create consequences for breaking the rules and stick to them.
Educate by example – you are the most powerful role model in your child’s life – don’t make alcohol the focus of every social event.
Try not to drink every day and limit your consumption when you do drink.