1

Running head: ADOLESENT AND YOUNG ADULT ALCOHOLISM

Community Health Promotion for Adolescents and Young Adults Suffering with Alcoholism Kaitlyn Baldwin Ferris State University

2 ADOLESCENT AND YOUNG ADULT ALCOHOLISM Abstract The research presented in this paper summarizes the need to address alcoholism in the adolescent and young adult age group early to help prevent problems with alcoholism in adult life. Community based strategies are summarized that help to accomplish the goals of reducing the ability to drink underage. Keywords: Alcoholism, Community based models, Underage drinking, College drinking, binge drinking.

3 ADOLESCENT AND YOUNG ADULT ALCOHOLISM Community Health Promotion for Adolescents and Young Adults Suffering with Alcoholism Community health promotion in nursing presents many areas of needed improvement. The community based models of health promotion is becoming a growing concept. Community interventions target either the majority of the population in a community or the community as a whole, as the goal is to change the entire setting (Pender, Murdaugh, & Parsons, p. 69). One particular stubborn area that has been addressed in community health is alcoholism. More specifically alcoholism in the adolescent and young adult age group has been an area of focus to modify the morbidity and mortality rates. Using evidence based interventions there has been several community based programs that aim to decrease alcohol use. Alcohol Dependency Alcohol use is generally known to have short term and long term consequences of intoxication and eventual dependence, if used over time. Alcohol use has been studied for many years. The addiction to alcohol has also been studied. Research has shown that almost one in four U.S. high school students began drinking alcohol before they entered high school (Centers for Disease Control and Prevention, 2008). The age that alcohol use began impacts future life outcomes. At the University of Washington a longitudinal study was done on the consumption of alcohol by minors and found that the onset of use before age 11, when compared with initiation during early adolescence, was related to an increased chronicity of adult alcohol dependence (Guttmannova et al., 2011). The reality of this statistic of chronic dependence on alcohol is described by Cara T Mackie in her autoethnographic essay Leaving an Alcoholic Life.

4 ADOLESCENT AND YOUNG ADULT ALCOHOLISM

I never felt pressured to drink, at least not at the beginning of my drinking life. I was simply a curious child. When I was 13, I took my first drink. It wasnt an innocent drink or let me just try a sip drink. It was a black out, throw up, learn a lesson drink. I thought I had learned a lesson, but I hadnt. Later on, I would see that I drank differently than most people. I drank to become another self. I drank passionately. I craved and desired alcohol, always yearning for more. (Mackie, 2008)

Binge drinking in the young adult has increased. The percentage of 18- to 24-year- old college students who drank five or more drinks on an occasion in the previous 30 days increased from 41.7 percent to 45.2 percent (Hingson, 2010). This is contributing to mortality rates in this age group. Among 18- to 24- year-old college students, deaths from all alcohol related unintentional injuries, including traffic and other unintentional injuries, increased from 1,442 in 1998 to 1,825 in 2005 (Hingson, 2010). The risks to the community are of great magnitude on several levels. The physiological effects that alcohol has on the individual as well as the general safety of the community are in jeopardy. As many as 46 percent of the 4,553 people killed in 2005 crashes involving 18- to 24year-old drinking drivers were people other than the drinking driver (Hingson, 2010). Based on the prevalence of bad outcomes related to adolescent and young adult alcoholism there is a need that must be met. Treatment Research In addressing the prevalence of adolescent alcoholism the environmental factors need to be evaluated to determine the modifiable areas. The way that is done is with the use of screening tools. Currently, the diagnostic criteria for an alcohol use disorder are based on the American Psychiatric Associations (APAs) Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR; APA 2000) (Willenbring, 2010). The Survey of College Alcohol

5 ADOLESCENT AND YOUNG ADULT ALCOHOLISM Norms and Behavior (SNMRP) was initiated in 2000, and sent out annually each spring to students from 32 different colleges (DeJong, Towvim, & Schneider, 2007). The National Institute on Alcohol Abuse and Alcoholism (NIAAA) conduct national surveys and report trends in a periodical. Screening identifies potential or current alcohol use disorders. Screening for alcohol use in the adolescent and young adult can help to identify goals that improve overall health of the individual. In cooperating a variety of tools in different settings will also help with determining the prevalence of alcohol use. The tools should screen adolescents and young adults in primary physician offices, voluntary surveys, and at schools (Windle & Zucker, 2010). Incorporating a wide base of information helps address and treat the people who suffer from alcohol use disorders. Treatment research is also done to gage the effectiveness of interventions. Several community-based initiatives have successfully reduced drinking- and/or alcohol related problems among young people (Hingson, 2010).
Six comprehensive community programs have achieved reductions in alcohol problems among college aged youth: Communities Mobilizing for Change Program (Wagenaar et al. 2000) - This program attempted to reduce the flow of alcohol to youth from illegal sales by retail establishments and from the provision of alcohol to youth by adults in the community. Community Trials Program (Holder et al. 2000)- Communities formed coalitions aimed at reducing illegal sales of alcohol to youth, implementing responsible beverage service and decreasing drunk driving offences by increasing awareness of consequences. Saving Lives Program (Hingson et al 1996) - This program tried to reduce drunk driving related consequences through media campaigns, police training, high-school peer-led education, college prevention programs, increased alcohol outlet surveillance and other measures.

6 ADOLESCENT AND YOUNG ADULT ALCOHOLISM

Fighting Back Program (Hingson et al. 2005) - this program tried to reduce availability of alcohol through environmental policies and expanded substance abuse screening, counseling, and treatment. Sacramento Neighborhood Alcohol Prevention Project (Treno et al. 2007)- This program included community mobilization, a public awareness campaign, responsible beverage service training, legal drinking age enforcement, and intoxicated patron law enforcement. Reduce Underage Drinking Through State Coalitions (Wagenaar et al. 2006)- This Initiative used a community coalition model at the State level in 10 states to mobilize citizens, increase media coverage, and implement policy changes such as alcohol price and tax changes and greater restrictions on commercial and social access to alcohol (Hingson, 2010).

Community Acceptance These different community based programs are only efficient in making change if the community is up to making the effort to implement the changes. The changes have to come from within the targeted group in the community. In this research the targeted group is the adolescent and young adults in the community. On the campus of The University of Boston, the Survey of College Alcohol Norms and Behavior (SCANB) revealed that the student body supported policy that reduced alcohol consumption. The study revealed Students nationwide supported efforts at their college to crack down on underage drinking (DeJong, Towvim, & Schneider, 2007). Community based interventions are not the only effective way to inhibit the growing problem of alcoholism in young adults. Individual based programs are effective as well. Individually oriented approaches such as screening and brief motivational interventions can reduce drinking not only among students who voluntarily seek out these programs but also among those mandated to receive counseling because of alcohol related disciplinary actions (Hingson, 2010)

7 ADOLESCENT AND YOUNG ADULT ALCOHOLISM Conclusion Many young adults develop problematic drinking habits before they enter college. It is important to screen the students in high school and college to identify if there are symptoms of alcohol use disorders as defined in the DSM-IV-TR. Community base interventions that restrict sale of alcohol, media influence, and more strict punishments for violating policies are supported by the population. It is important to also treat each high risk individual with support and motivational influence to help them overcome alcoholism. Overcoming alcoholism improves the health of the individual as well as improves public safety issues associated with alcoholism.

8 ADOLESCENT AND YOUNG ADULT ALCOHOLISM References

DeJong, W., Towvim, L., & Schneider, S. (2007, November/December). Support for alcoholcontrol policies and enforcement strategies among US sollege students at 4-year institutions. Journal of American College Health, 56, 231-236. Guttmannova, K., Bailey, J., Hill, K., Lee, J., Hawkins, J., Woods, M., & Catalano, R. (2011, March). Sensitive periods for adolescent alcohol use iniation: predicting the lifetime occurrence and chronicity of alcohol problems in adulthood. Journal of Studies on Alcohol and Drugs, 221-231. Hingson, R. W. (2010). Focus on: college drinking and related problems. Alcohol Research & Health, 33, 45-54. Mackie, C. (2008). Leaving an alcoholic life. Journal of Loss and Trauma, 13, 547-556. doi:10.1080/15325020802173512 Pender, N. J., Murdaugh, C. L., Parsons, M. A., (2006). Health promotion in nursing practice (6th ed.). Upper Saddle River, NJ: Pearson Prentice Hall. Willenbring, M. (2010). The past and future of research on treatment of alcohol dependence. Alcohol Research & Health, 33, 55-63. Windle, M., & Zucker, R. (2010). Reducing Underage and Young Adult Drinking. Alcohol Research and Health, 33, 29-44.