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Changing Alcohol Norms (CAN): Florida’s Initiative to Lower Youth Drinking
Executive Summary Early in his first administration, Governor Bush set as a priority the reduction of substance abuse in Florida. Despite the ambitious nature of his goal – reduction by 50% – Florida has made great strides toward achieving it in virtually every area. The vast majority of use rates for individual substances of abuse by children are down by significant amounts since 1999: LSD by 47%, ecstasy by 46%, heroin by 50%, cocaine by 40%, and crack cocaine by 25%. Youth tobacco use, after several years of concerted effort, has dropped from 18.4% to 11.5%. Florida has led the nation in leading its children away from substance abuse. One area, however, where Florida remains locked with the rest of the nation is on youth alcohol abuse. For decades, alcohol has been the most widespread substance of abuse by youth. It far outstrips any other drug of abuse; marijuana and tobacco use is slightly more than one-third the rate of drinking among youth. While many other individual drugs and tobacco have fallen off in use by as much as 50% or more, alcohol use has moved down a mere 10% among children in 6th through 12th grade since 1999. Moreover, binge drinking is high among this group, as are all the unsafe and unhealthy practices that go along with adolescent drinking. Current use rates (defined as one or more drinks in the past 30 days,) remain around 30%. Clearly, where we have had success in virtually all other areas, alcohol-drinking norms remain resilient to change. We believe, however, that with the strategy presented herein, we can change youth alcohol norms. Furthermore, we believe we can do this without requiring an increase in dedicated resources. After five years of effort and much attendant success, we have built a prevention system of best practices that gives us a high probability of effectiveness wherever we focus our effort. In short, the resources and infrastructure, by and large, are already in place. They need to be brought to bear on youth alcohol use. Florida’s Drug Control Strategy has but one purpose – to protect our citizens from the dangers posed by illegal drugs. It presents a balanced plan that aims to bring down both the demand for and supply of illegal drugs in Florida by advancing policies and programs that support prevention and education, treatment and law enforcement. Over the long term, its intent is to cut substance abuse in Florida by half. The first goal in the Florida Drug Control Strategy states our commitment to “protect Florida’s youth from substance abuse.” That goal continues to be the first priority among Florida’s prevention leaders. As it relates to underage alcohol use, the target of the strategy is to reduce alcohol use by Florid 6th through 12th graders to 20% or less and to reduce illegal sales of alcohol to minors to 8% or less by 2005. Underage drinking is a serious threat to Florida’s youth. In order to achieve this goal, Florida’s prevention community, treatment and enforcement agencies have partnered to providemore holistictic approach to reducing underage drinking. Co-chairing the work-group, Changing Alcohol Norms (CAN): Florida’s Initiative to Lower Youth Drinking, is Columba Bush, Florida’s First Lady, and Jim McDonough, Director of the Florida Office of Drug Control. This work-group consists of expert members from a number of state agencies, associations, and organizations around the state. Since no single approach will prevent young people from drinking illegallwe mustust rigorously and deliberately integrate the best practices and proven-effective programs to eliminate underage drinking into an effective strategy. An integrated, long-term approach is essential to successfully reducing youth alcohol use in Florida to 20% or less. The Changing Alcohol Norms Workgroup (CAN) that was established in June 2003 has focused on public information efforts, education, law enforcement, collaboration, legislation, and treatment to developcomprehensive strategyegy to reduce underage drinking. This multi-agency collaboration represents unified leadership in promoting model programs and initiatives that are aggressively aimed at curtailing, and progressively eliminating alcohol use by underage youth. The workgroup has benefited from the recent National Academy of Sciences Institute of Medicine report “Reducing Underage Drinking, A Collective Responsibility”. Pertinent recommendations from the NAS report have been incorporated into this white paper, with specific application at the state and local level. This white paper, which wicontinually beybe reassessed, as the environment in which it is implemented is modified by its very application, is aimed at bringing youth drinking down to less than 20% by 2005. We support efforts to lower underage drinking by elementary, middle, high school, and college age youth. This is not a new approach or focus for our state. Coalitions and partnerships on the local level have been a major influence in all preventiefforts .Neighborhoodsods, communities, and campuses will be encouraged to develop programs that offer a consistent and non-conflicted message that underage drinking is unhealthy, risky and outside-accepted standard of behavior. Local efforts will be supported with a statewide public information campaign, seeking to create the society-wide ethic that we need not and shall not tolerate substances endangering the health and welfare our youthuth. In conclusion, the workgroup, Changing Alcohol Norms (CAN): Florida’s Initiatito Lowerwer Youth Drinking, is confident that through collaboration with national, state and local leaders, alcohol use by minors can and will decrease. With successfrefinement andand implementation, Florida can achieve the goal of reducing youth alcohol use by grades 6 through 12 to 20% or less, and illegal sales to 8% or less by 2005.
Mrs. Columba Bush, Florida’s First Lady, and Mr. Jim McDonough, Director of the Florida Office of Drug Control, co-chair the workgroup Changing Alcohol Norms (CAN): Florida’s Initiative to Lower Youth Drinking. In addition to Florida’s First Lady and the Office of Drug Control, at the time of the writing of the white papethe workgroupoup consisted of expert members from a number of state agencies, associations, and organizations1. Since its inception in June 2003, the workgroup divided itself into subcommittees focusing on public relations, legislation, training, integrated law enforcement, research and development, community coalitions and school systems in order to develop a comprehensive strategy to reduce underage drinking. The CAN workgroup’s multi-agency collaboration represents unified leadership in promoting model programs and initiatives that are aggressively aimed at curtailing, and progressively eliminating alcohol use by underage youth. The findings of this White Paper are further informed by the National Academy of Sciences Institute of Medicine’s report, “Reducing Underage Drinking,Collective Responsibilityity” to provide an integrated approach to reducing youth alcohol use. The NAS report was published September 30, 2003 and presented to the United States Senate Subcommittee on Substance Abuse and Mental Health to address underage drinking across the nation. This paper provides recommendations to federal and state government and organizations to reduce youth drinking. Through the leadership of Florida’s First Lady, the CAN workgroup used the NAS report as a starting point to address youth alcohol use on a state and local level. Florida is prepared to reduce underage drinking by serving as a pilot for the NAS study.
Findings from the 2003 Monitoring the Future study, a national drug use survey annually administered by the University of Michigan, highlight the pervasiveness of alcohol in middle and high schools today2. Alcohol is the drug used most often by youth. This is true not only on a national level, but also on a state level in Florida. Florida’s youth are using alcohol at a higher rate3. In order to collect baseline data and track annual progress, Florida instituted the Florida Youth Substance Abuse Survey (FYSAS). According to the 2003 FYSAS results, underage alcohol use by Florida’s 6th through 12th graders is as follows:
If underage usage rates are not sufficient evidence that alcohol is a problem for Florida’s youth, other startling statistics only reinforce the view. According to the Department of Business and Professional Regulation, Division of Alcoholic Beverages and Tobacco, the non-compliance rate for the sale of alcohol to youth is at 11%. This far outstrips the rate for non-compliance for the illegal sale of tobacco to minors, which is at 7%. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the rate of alcohol use more than doubles in young people who start drinking before age 15 compared to those who wait until age 21. The NIAAA also found that the rate of fatal crashes among alcohol-involved drivers between 16 and 20 years old is more than twice the rate for alcohol-involved drivers 21 and older. Such compelling evidence confirms the urgent need to focus sharper attention on youth alcohol use prevention strategies. While noteworthy strides have been made in this arena, much work remains to be done. Since no single approach will prevent young people from drinking illegally, we must rigorously and deliberately combine tbest waysays to eliminate underage drinking into an effective strategy.
The first goal in the Florida Drug Control Strategy asserts a commitment to “protect Florida’s youth from substance abuse.” That goal continues to be the first priority among Florida’s prevention leaders. As it relates to underage alcohol use, the target of the strategy is to reduce alcohol use by Florida6th throughugh 12th graders to 20% or less and to reduce illegal sales of alcohol to minors to 8% or less. As previously noted, Florida’s progress to reaching this goal is measured each year in the Florida Youth Substance Abuse Survey. Currently, youth alcohol use is at 30.9% and the illegal sale of alcohol to minors is at 11%. In order to achieve the Strategy’s goal, Florida’s prevention and enforcement agencies are partnering to provide a more holistic approach to reducing underage drinking.
Breaking Down the Last Barrier…Youth Alcohol Use Florida’s progress in reducing youth substance abuse is evident by looking at the results of the Florida Youth Substance Abuse Survey. Under Governor Bush’s leadership, the vast majority of use rates for individual substances of abuse by children are down by significant amounts since 1999: LSD by 47%, ecstasy by 46%, heroin by 50%, cocaine by 40%, and crack cocaine by 25%. Youth tobacco use, after several yearsconcerted effortfort, has dropped from 18.4% to 11.5%. Unfortunately, the reduction of youth alcohol use is slow. This challenge necessitates that Florida increase its efforts to reduce youth alcohol use. In order to make a change and meet the goal to reduce youth alcohol use to 20% and the illegal sale of alcohol to underage youth to 8% or less, Flormust implementment proven strategies using existing resources. Under the direction of the Governor, resources will focus on reducing underage drinking. Without neglecting continued emphasis on further reducing youth drug use, it is time to earmark a greater share of resources, organization, and activities towards reducing the youth alcohol usage rate. By emphasizing prevention and law enforcement efforts in the areas, we believe we can do both—keep suppressing all youth drug and tobacco use and breaking the youth proclivities to consume alcohol.
The Office of Drug Control, in collaboration with Clear Channel Communications, the Department of Children and Families and local anti-drug coalitions, is heading up a statewide media campaign to raise awareness about substance abuse. The goal of the campaign is to prevent an additional 50,000 youth in Florida from beginning illegal drug use or misuse of legal drugs. Consistently over the past four years, Florida’s youth have shown decreasing rates of substance abuse. We believe this media campaign can reduce the numbers yet again by up to 2%, or approximately 50,000 children in the target group of 12 to 18 year olds. During the 2003-2004 school year, at least 24,000 one-minute primetime radio ads and 160 billboards will reach almost one million teensfive millionllion adults in 10 media markets across the state of Florida. The messagesthe campaignpaign are developed in conjunction with and linked to local coalition prevention efforts. The correlated messages remind youth and adults to “Think About Ittheme indicatingating that there are severe negative consequences to youth substance abOne thirdthird of the ads target youth and underage drinking. Results of the media campaign are analyzed using random telephone surveys in four major markets. So far, the reshave exceededeeded the original goal for 21% of youth being aware of the dangers associated with substance abuse and 21% of parents being more aware of the importance of talking to their families about the risks associated with substance abuse. National: Recommendation 1-1: The federal government should fund and actively support the development of a national media effort, as a major component of an adult-oriented campaign to reduce underage drinking (NAS, Recommendation 6-1)4. Recommendation 1-2: Intensive research and development of a youth-focused media campaign relating to underage drinking should be initiated at the national level (NAS, recommendation 10-1). State: Recommendation 1-3: Expand the existing statewide media campaign highlighting the effects of underage drinking to include the following:
Local: Recommendation 1-4: Monitor activities and the impact of the media camin ordernorder to refine/adjust the campaign as needed and use materials from the state media campaign to distribute to local media outlets including:
Recommendation 1-5: Local coalitions should serve as the information source for members of the media to contact for information on local underage drinking efforts and to provide feedback to the state campaign.
Courtesy of the Department of Education Safe and Drug Free Schools funding and a result of centrally condensed, but locally expended programs, Florida school districts are leading the nation in using proven effective programs and strategies targeted at preventing substance abuse. Sixty-four of the 67 school districts in Florida are using evidence-based programs in their schools. Through the comprehensive school health program, school health nurses and social workers provided education on the dangers of alcohol use to 67,955 students during the 2001-2002 year. These programs are credited with playing a vital role in the overall reduction of substance abuse in the state of Florida over the past 4 years. High-risk and illegal alcohol consumption by underage college students is also a concern in Florida. In July of 2000, prevention professionals from colleges and universfrom aroundaround the state created the statewide coalition known as the Florida Higher Education: Alliance for Substance Abuse Prevention (FHE: ASAP). FHE: ASAP meinclude publicpublic and private, large and small, two and four year institutions. The coalition is committed to increasing the coordination of prevention efforts in higher education and throughout the state; encouraging the use of research-based prevention strategies; and developing campus community partnerships to begin to change environmental and cultural factors that contribute to underage drinking. Since college age students do not live in isolation from the community at large, it is important to include a broad range of community partners. Parents, employers, local media, health care provitreatment providersviders and faculty, staff and students all have a role in Florida’s preveefforts .Ongoingngoing collaboration from all of these partners can ensure the success of a comprehensive and effective statewide prevention strategy. Another alcohol-related problem facing Florida is the prenatal exposure to alcohol resulting in Fetal Alcohol Syndrome (FAS). FAS is one of the leading preventable causes of birth defects, mental retardation, and neurodevelopment disorders in the United States. Of the 200,000 babies born in Florida each year, approximately 2,000 have Fetal Alcohol Syndrome or Fetal Alcohol Exposure (FAE). There is no cure for FAS or FAE; however, its incidence can be totally prevented by abstinence from alcohol during pregnancy. Teens are especially at high risk for prenatal alcohol consumption. Education must be targeted toward teens to prevent the birth of children with FAS or FAE. The Fetal Alcohol Syndrome Interagency Action Group was established in 2001 to improve the system of care for individuals with Fetal Alcohol Syndrome and their families. In 2002 the action group developed a strategic plan. A strong emphasis of the plan involves preventing FAS among the children of adolescent mothers. Many of the education recommendations below are also outlined in the FAS Interagency WorStrategic PlangicPlan. National: Recommendation 2-1: The U.S. Department of Health and Human Services and the U.S. Department of Education should focus on funding evidence-based education interventions, with priority given both to those that incorporate elements knbe effectivefective and those that are part of comprehensive community programs (NAS, Recommendation 10-2). Recommendation 2-2: The National Institute on Alcohol Abuse and Alcoholism and the Substance Abuse and Mental Health Services Administration should continue to fund evaluations of college-based interventions, with a particular emphasis on targeting of interventions to specific college characteristics, and should maintain a list of evidence –based programsRecommendation 10ation10-4). State: Recommendation 2-3: Support development of a research-based, positive school climate framework; continue developing school cultures that promote alcohol prevention and intervention strategies. Recommendation 2-4: Increase state and local funding for evidence-based prevention education in schools and colleges. Recommendation 2-5: Facilitate regional focus groups with superintendents and higher education senior administrators to delineate the effects of underage drinking in their respective school districts and communities in order to build conswhat must whatmust be done to reduce the problem. Recommendation 2-6: Ensure colleges and universities adopt comprehensive prevention approaches including evidence-based screening, intervention strategies, consistent policy enforcement, and environmental changes that limit underage access to alcohol. Adopt universal education interventions, as well as selective and indicated approaches with relevant populations (NAS, Recommendation 10-3, edited). Recommendation 2-7: Strongly encourage servers be certified to serve alcoholic beverages. This license would require a background check and training for the server about identifying fake identification, the effects of alcohol on an underage youth and liability education. Recommendation 2-8: Promote education at both the high school and college level relating to Fetal Alcohol Spectrum disorders. Local: Due to the large nature of this section, recommendations are divided into the following groups: K-12 schools, higher education, parents, businesses, community and enforcement.A. K-12 Schools: Recommendation 2-9: Identify Florida prevention programs proven successful in reducing alcohol use and replicate the most commendable research-based alcohol prevention programs in Florida schools where appropriate. Programs should include peer-to-peer education, risk and protective factors, youth developed programs, and media literacy education. Recommendation 2-10: Provide training to teachers, school nurses, guidance counselors and school resource officers on how to identify problem drinkers and how to make referrals to the proper authorities. Education should also include the adverse impact of alcohol on a child’s developing brain. School personnel should also bthe risk of therisk and protective factors associated with healthy development. Recommendation 2-11: Promote rewarding alcohol-free activitiessober SpringsoberSpring Break opportunities, alcohol-free Homecoming, “Project Graduation”, weekend events and public service options. Recommendation 2-12: Address the void in Fetal Alcohol Spectrum Disorder (FASD) awareness among teens by presenting educational information to classes including parenting classes in Teen Parent Programs throughout the state. The presentation will provide age appropriate information regarding cognitive, behavioral,and physical disabilities caused by prenatal alcohol exposure with a focus on brain development, facial abnormalities, and other birth defects associated with FASD. In addition, presenters will facilitate a dialogue with the teens to identify reasons teens drink during pregnancy, and to strategize viable alternatives. Recommendation 2-13: Implement a systemic approach to educating middle school and high school students about the dangers of drinking alcohol. Recommendation 2-14: Insure that all health class curricula include information about FASD. Recommendation 2-15: Screen (and include as criteria for text book selection) all middle and high school health texts to insure that information regarding FASD is included. B. Higher Education: Recommendation 2-16: Support a concerted effort by colleges and universities to help mobilize campus/community coalitions to change the environment that supports high-risk underage use of alcohol. Recommendation 2-17: Identify evidence-based prevention programs and policies that reduce binge and underage use of alcohol; include prevention program evaluation and research support. Recommendation 2-18: Enlist involvement and support of college and university senior leadership for prevention of high-risk underage use of alcohol by college students on campus and in the community. Recommendation 2-19: Identify and/or develop comprehensive campus and community coalitions and prevention programs that:
Recommendation 2-20: Provide prevention education to first year students, student athletes and Greek organizations that discourage high-risk underage use of alcohol and promote college success strategies both in and outside the classroom. Recommendation 2-21: Provide education to members of the campus/community including parents and faculty and staff on signs and symptoms of alcohol abuse, on appropriate counseling and self-help referral information, underage drinking laws and policies and nonjudgmental ways to talk to college students about alcohol use and abuse. Recommendation 2-22: Conduct an annual statewide assessment of underage alcohol consumption by college students. The assessment will estimate the prevalence and frequency of high-risk drinking as well as student perceptions of social norms related to high risk drinking. An anonymous, self report, student survey will be used in the statewide assessment. The Florida Higher Education: Alliance for Substance Abuse Prevention can provide support in gathering data for the assessment. Recommendation 2-23: Secure federal research funding for a state university to conduct a periodic survey of environmental risk and protective factors at the county and state levels. Recommendation 2-24: Include information regardiappropriate undergraduatedergraduate level college course curricula. C. Parents: Recommendation 2-25: Develop parent peer groups that would offer the following resources:
D. Businesses: Recommendation 2-26: Implement evidence-based alcohol education (such as Team Awareness) for employees at alcohol serving businesses including specialized training programs for high-risk business locations. Recommendation 2-27: Improve server training on reading identification including tools and easy to use age calendars. Provide a similar training for cashiers where alcoholic beverages are sold. Recommendation 2-28: Provide training to retailers that include information on retailer liability for sales to underage persons and enfolicense suspensionesuspension/revocation laws. E. Community: Recommendation 2-29: Provide literature for landlords (especially landlords in college communities) about liability and ramifications of negligence to underage drinking on their property. Recommendation 2-30: Ensure local coalition representation engages all aspects of the community including health care providers, businesses, parents, schools, colleges and universities and law enforcement to achieve a holistic approach to reducing underage drinking. Recommendation 2-31: Provide give-away items to youth and their parents and mentors that have poignant messages on the dangers of underage drinking. Recommendation 2-32: Provide underage drinking education information to members of the religious community who in turn may provide education to Church/Synagogue/Mosque members both to recognize alcohol-involved youth and to provide alcohol warning signs and referral information to parents and youth members. Recommendation 2-33: Partner with private driving schools and driver education classes to add and/or strengthen the alcohol education portion of the curriculum. At initial renewal of a driver’s license (usually age 21) provide information on responsible drinking to youth who have recently turned the age of 21. Recommendation 2-34: Partner with local colleges and universities to develop strategies to change the drinking culture both on and off campus that contribute to underage and high- risk drinking. F. Law Enforcement: Recommendation 2-35: Provide ongoing training all Law Enforcement Agencies to include the following:
Recommendation 2-36: Provide training opportunities for judges and prosecutors who work with offenders and law enforcement agencies.
3. Enforcement of Underage Drinking Laws The Florida Department of Business and Professional Regulation, Division of Alcoholic Beverages and Tobacco (AB&T) has statewide responsibilities for reducing underage and binge drinking among Florida’s youth. Its partnership with local sheriff’s offices and police departments has reinforced the effort to prevent sales of alcohol to those underage. AB&T leadership teams around the state educate local authorities concerning beverage laws, conduct surveys to ensure compliance, and provide 1-866-540-7837(SUDS) for citizens to call in with violations of alcohol and tobacco laws. The ultimate goal of AB&T’s effort to ensure adherence to local laws is to achieve a 92% (and working to exceed to 95%) compliance rate by businesses statewide regarding alcohol and tobacco sales to minors. In addition to this effort, AB&T provides funding through the Florida Office of Drug Control to fund nine law enforcement agencies around the state to assist with preventing underage alcohol use. In conjunction with the Office of Juvenile Justice and Delinquency Prevention (OJJDP), Florida has been chosen to be one of five states to participate in the Enforcing the Underage Drinking Laws (EUDL) Discretionary Program. This community trials project implements research-based “best” and “most promising” practices to reduce the availability of alcoholic beverages to and the consumption of alcoholic beverages by underage persons. These funds will ultimately go to seven Florida communities and their law enforcement counterparts to develop a community program primarily focused on enforcing underage drinking laws. Seven other Florida communities will serve as control sites. National: Recommendation 3-1: The federal government should require states to achieve designated rates of retailer compliance with youth access prohibitions as a condition of receiving block grant funding, similar to the Synar Amendment’s requirements for youth tobacco sales (NAS, Recommendation 9-3). State: Recommendation 3-2: Strengthen Florida’s compliance check programs in retail outlets, using media campaigns and license revocation to increase deterrence.
Recommendation 3-3: Establish and implement a system requiring registration of beer kegs that records information on the identity of purchasers (NAS, Recommendation 9-8). Recommendation 3-4: Mete out consistent penalties for selling alcohol to a minor or possession of alcohol by an underage person. Alcohol education should be mandated for the offender; other deterrents such as community service, fines, and letters of notification to parents of offending minors should also be used. Local: Recommendation 3-5: Adopt and announce policies by local police (working with community leaders) for detecting and terminating underage drinking parties, including:
At the close of a site visit in September 2003, the United States Department of Education’s representative noted how well Florida’s various agencies and organizations collaborated on reducing substance abuse. Florida is modeling the ways collaboration can make a difference in reducing youth alcohol use. This White Paper is one of the products of that collaboration. Another evidence of Florida’s collaboration is the number of community anti-drug coalitions. Through the results of the Florida Youth Substance Abuse Survey, the Office of Drug Control discovered that substance abuse rates were lowest in areas where community anti-drug coalitions were present. In an attempt to increase the number of coalitions and consequently decrease the rate of youth substance abuse, the Governor’s Office of Drug Control, in collaboration with the Florida Alcohol and Drug Abuse Association, the Department of Children and Families and the Florida National Guard, began a statewide initiative to increase the number of anti-drug coalitions. In 2000, only 19 counties had anti-drug coalitions. Through the coalition expansion project (and including 9 counties that have just started coalitions), 65 of 67 counties currently have anti-drug coalitions. Using these community anti-drug coalitions and enhancing existing relationships with grassroots, prevention providers and state agencies, Florida can use existing resources to focus on underage drinking. An established and proven system is already in place. Florida youth substance abuse has decreased in large part because of key collaborations with community organizations throughout the state. A concentrated focus on reducing underage drinking is a logical next step to lowering youth alcohol use. National: Recommendation 4-1: A federal interagency coordinating committee on prevention of underage drinking should be established, chaired by the secretary of the U.S. Department of Health and Human Services, the Surgeon General, or the Undersecretary of Education for Safe and Drug Free Schools (NAS, Recommendation 12-1). Recommendation 4-2: We endorse the NAS Recommendation 7-1 that allsegments of the alcohol industry that profit from underage drinking, inadvertently or otherwise, should join with other private and public partners to establish and fund an independent nonprofit foundation with the sole mission of preventing and reducing underage drinking (NAS, Recommendation 7-1). Recommendation 4-3: Public and private funding sources should support community mobilization to reduce underage drinking. Federal funding for reducing and preventing underage drinking should be made available under a national program dedicated to community-level approaches to reducing underage drinking, similar to the Drug Free Communities Act, which supports communities in addressing substance abuse with targeted, evidence-based prevention strategies (NAS, Recommendation 11-2). State: Recommendation 4-4: Step up meaningful collaboration among state agencies andother stakeholders to engage shared responsibility in addressing widespread underagedrinking in the state of Florida. Recommendation 4-5: Ensure statewide data collection of college age use and abuse of alcohol and other drugs. Local: Recommendation 4-6: Assess the underage drinking problem in communities and consider effective approaches—such as community organizing, coalition building, and the strategic use of the mass media—to reduce drinking among underage youth (NAS, Recommendation 11-1). Recommendation 4-7: Ensure representation in local coalitions and engagement of all aspects of the community including health care providers, local businesses, parents, schools, colleges and universities and law enforcement to achieve a more holistic approach to reducing underage drinking.
Florida has worked to protect youth from alcohol and other drugs for many years. As early as 1939, lawmakers were concerned about underage drinking and other substance abuse as evidenced by one of the first laws that implied the hazards of drug use. The passage of several anti-alcohol laws over time is a strong testament of the State’s commitment to keeping young people free of alcohol and other drugs. In 1998, Governor Jeb Bush included as a major plank in his election campaign a vow to reinvigorate the state’s commitment to bringing down drug abuse. That vow was acted upon almost immediately when the Executive and Legislative leadership of Florida convened a Drug Summit in February of 1999 in Tallahassee. This two-day meeting brought together leading Floridians from all walks of life affected by, and in turn affecting, Florida’s drug abuse experience. The principles produced at that summit for countering illegal drugs in Florida were the beginning steps to making changes in substance abuse rates. These principles were later codified (by September 1999) in the Florida Drug Control Strategy. Since Governor Bush’s election, laws relating to substance abuse have been added to strengthen the penalties for illegal use. As it relates to alcohol, Section 2(c) was added to Florida Statute 562.11 in order to penalize underage persons attempting to purchase alcohol by facing the loss or delay of their driver’s license and privileges. National: Recommendation 5-1: Encourage and support Congressional hearings to address the issue of underage drinking as outlined in the NAS Report. Recommendation 5-2: Support federal legislation to fund and actively support the development of a national media effort, as a major component of an adult-oriented campaign to reduce underage drinking (NAS, Recommendation 6-1). Note: This is already in the Media Campaign section as a national recommendation. Recommendation 5-3: Support federal legislation that would provide the necessary funding for the U.S. Department of Health and Human Services to monitor underage exposure to alcohol advertising on a continuing basis. (NAS, Recommendation 7-4). State: Recommendation 5-4: Amend Florida Statute 562.111 to include consumption as illegal by an underage youth. Currently, the law only includes possession of alcohol. Recommendation 5-5: Enact and enforce graduated driver licensing laws (NAS, Recommendation 9-10). Recommendation 5-6: Strengthen and enforce the laws to revoke or suspend alcohol licenses from businesses engaged in repeated sales to underage persons. Recommendation 5-7: Support legislation to establish and implement a system requiring registration of beer kegs that records information on the identity of purchasers(NAS, Recommendation 9-8). Recommendation 5-8: Strengthen Florida’s current dram shop liability statute to enhance liability for commercial establishments that knowingly sell alcohol to minors who subsequently causes injury to others (NAS, Recommendation 9-5). Local: Recommendation 5-9: Review existing county and city ordinances related to underage drinking and strengthen the ordinances accordingly, including an environmental focus on zoning, outlet density, and related issues such as parking, bathrooms, street setback, minors present at establishments whose principal business is serving alcoholic drinks, and irresponsible drink specials.
Adolescents rarely seek help for problems related to alcohol and other drug use. Many parents are also often reluctant to seek such help, hoping that substance abuse is “just a phase,” or otherwise minimize their perceptions of the negative effects drinking has on their children. Referrals by juvenile courts are too often the first intervention. By this time, substance abuse is likely to have contributed to delinquent behavior, violence, and high-risk activities like unprotected sex and driving while intoxicated. The misuse of alcohol is deadly and youth dependent on alcohol must receive treatment. An alcohol dependent youth may also be dealing with the addiction of a family member. In this case, a more holistic approach must be taken to ensure full recovery. National: Recommendation 6-1: Continue to provide funding to state agencies to provide treatment to youth and their families. Investigate and implement effective science-based models that have been validated in research studies. State: Recommendation 6-2: Explore issues of access to quality comprehensive assessment and treatment services for youth and implement policy changes to improve access for youth and their families. Stakeholders should work in partnership with existing community treatment providers providing assessments and treatment recommendations at Florida’s Juvenile Assessment Centers to enhance and expand access to youth and their families. Recommendation 6-3: Continue examination of the effectiveness of substance abuse screening tools and assessment in identifying and referring youth with substance abuse problems to appropriate treatment. Substance abuse screening tools and assessment instruments should be scientifically valid and reliable in order to ensure consistent quality of the assessment and treatment recommendations. Recommendation 6-4: Encourage the use of evidence-based treatment for adolescent alcohol abuse. Recommendation 6-5: Provide increased training on alcohol-specific intervention for adolescent addiction counselors. Recommendation 6-6: Provide training to pediatricians, adolescent medical specialists, and other health service providers on screening for signs of alcohol abuse and on the adverse effects of alcohol on the developing adolescent brain. Recommendation 6-7: Improve accessibility to substance abuse treatment for parents who abuse alcohol or other drugs. Local: Recommendation 6-8: Expand treatment services to children with special needs (e.g., family involvement with substance abuse, co-occurring mental illness, disabilities, extreme poverty, etc.). Recommendation 6-9: Involve the entire family along with the individual in treatment. Lifestyle changes necessary to break the cycle of addiction must incorporate the family. Affected family members should be encouraged to utilize appropriate support groups. Recommendation 6-10: Work closely with school officials to provide school-based referral and assessment services. Provide opportunities in the school for counseling and coordination of treatment. Recommendation 6-11: Expand and fund drug courts. Recommendation 6-12: Work with doctors, pharmacists, medical examiners, and other public and medical officials to identify and curtail prescription drug abuse and provide treatment services and referrals when patients are in danger of becoming addicted. Recommendation 6-13: Funding should be expanded to include adequate resources to ensure rural based populations are reached, assessed and engaged into treatment based on the results of the assessment.
The Changing Alcohol Norms (CAN): Florida’s initiative to lower youth drinking workgroup is confident that through collaboration with national, state and local leaders, alcohol use by minors can and will decrease. With successful refinement and implementation of the above recommendations, Florida can achieve the goal of reducing youth alcohol use by grades 6 through 12 to 20% or less, and illegal sales to 8% or less by 2005.
Channing-Bete, Inc. (Dec 2003). Florida Youth Substance Abuse Survey (FYSAS). Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2004). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2003. (NIH Publication No. [yet to be assigned].) Bethesda MD: National Institute on Drug Abuse. This volume is not yet published, but may be found on the study’s Web site, www.monitoringthefuture.org. (NIAAA) National Institute on Alcohol Abuse and Alcoholism, Washington, D.C. Alcohol Alert No. 35, PH 371, January 1997. National Research Council and Institute of Medicine 2003. Reducing Underage Drinking: A Collective Responsibility. Committee on Developing a Strategy to Reduce and Prevent Underage Drinking, Richard T. Bonnie and Mary Ellen O'Connell, Editors. Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.
1Department of Business and Professional Regulation, Division of Alcoholic Beverages and Tobacco, Department of Highway Safetyand Motor Vehicles, Driver Education and DUI Programs, Department of Transportation, Law Enforcement Programs, Department of Health, Department of Children and Families, Department of Education, Safe and Drug Free Schools, Florida Highway Patrol, Department of Law Enforcement, Office of the Attorney General, Department of Juvenile Justice, Florida National Guard, Students Against Destructive Decisions, BACCHUS/GAMMA Peer Education, Mothers Against Drunk Driving, Center for Tobacco and Alcohol Access Prevention, Informed Families, Florida Prosecuting Attorneys Association, Florida Association of School Resource Officers, Florida Alcohol and Drug Abuse Association, Florida University system, Panhandle, Northeast and Heartland Education Consortiums, Florida Parent Teacher Association, Florida Association of District School Superintendents, Community Coalitions, Florida Medical Association Alliance, Florida Higher Education Alliance For Substance Abuse Prevention, and other key community leaders. 2In the United States:
3In Florida:
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