Youth in Detroit say alcohol, tobacco and other drugs are readily available at school and in their own neighborhoods. However, Detroit's high school students are less likely to use alcohol, tobacco and other drugs than are youth statewide. Binge drinking among high school students in the city is half the rate of teens statewide. Surveys report that Detroit youth often express disapproval of drug use and refer to crack cocaine users as "crackheads." Nationwide, as teens reach adulthood and confront employment and educational barriers, their rates of drug use often rise. Similar to national trends, rates of adult heroin use are rising in the city of Detroit. Although crack cocaine continues to be widely available, use has stabilized in Detroit.
Tobacco. In 1997, more than two-thirds of Detroit high school students had tried cigarettes, with one in five reporting smoking in the past month.This figure is significantly lower than past month rates for teens in Michigan (two in five) and the nation (one in three), but identical to the rate for African American teens nationally. Approximately 82 percent of Detroit's youth are African American. The Detroit Health Department's (DHD) Tri-Cities Tobacco Coalition and Project ASSIST prevent smoking through education and other community-based efforts.Youth have access to cigarettes through older students, adults, vending machines and stores. In 1995, DHD launched an initiative to stop the sale of tobacco to youth under age 18. Local youth groups assist DHD in conducting compliance checks, and the police impose penalties on vendors caught selling tobacco products to minors. According to Project ASSIST staff, these efforts have reduced tobacco sales to minors in the city of Detroit; evaluation data pertaining to the compliance checks will be available in 1999. Among Detroit adults, smoking is slightly more prevalent than in Michigan overall (29 percent vs. 26 percent). It is also higher than the national average (25 percent). Health experts in Detroit attribute the higher adult smoking rates to extensive tobacco billboard advertising in the city. In 1993, Michigan was among the top ten states in per capita tobacco revenues. Since the state adopted a $0.75 per pack excise cigarette tax in 1994, Michigan's cigarette sales have decreased by 22 percent, although smoking rates have remained steady. The current tax is far above the national average ($0.399). In 1997, Michigan collected $543 million in tobacco tax revenues. Six percent of these revenues support health programs, including tobacco control efforts in the city of Detroit and elsewhere.
Since September 1998, the state has required that each pack of cigarettes sold in Michigan have a tax stamp, indicating that excise taxes have been paid.The new policy is designed to deter interstate cigarette smuggling. Local experts report that without the tax stamp, buyers can purchase cigarettes on Native American reservations or in neighboring states with lower tobacco taxes and then sell them on the black market in Michigan. The Michigan Public Health Institute estimates that smoking-attributable direct health care costs in the Detroit area (including neighboring Hamtramck and Highland Park) are nearly $116 million annually; total smoking-attributable costs, including indirect costs, are estimated at $397 million annually.
Alcohol. Detroit teens' drinking rates are lower than those of youth statewide. In 1997, one in three Detroit high school students used alcohol in the past month compared to one in two students statewide. Like youth nationwide, Detroit students are more likely to drink as they get older; 30 percent of 9th graders drank in the month prior to the survey compared to 46 percent of 12th graders. Teenage drinking in the city of Detroit reflects generally lower rates among African American youth nationally. Binge drinking (consuming five or more drinks at one time) among high school students in Detroit (15 percent) is less than half the rate of students statewide (32 percent), and about half the rate for teens overall, but very close to the national rate among African American teens (16 percent). In 1995, 41 percent of Detroit adults reported drinking within 30 days of the survey. Binge drinking among adults in Detroit has not been measured.
Alcohol advertising concerns city officials and community leaders. The "Denounce the 40-Ounce" Initiative, created in 1995 under the direction of Councilwoman Alberta Tinsley-Williams, targets sales of 40-ounce malt liquor bottles. Currently, Tinsley-Williams and her group are working toward preventing sales of malt-liquor in 65-ounce bottles. Through collaborations among the Detroit Bureau of Substance Abuse (BSA), community leaders and local organizations, public awareness regarding alcohol abuse is growing; in addition, local efforts are helping reduce the number of alcohol billboard advertisements throughout the city. BSA is also collaborating with community organizations and residents to address youth drinking. Sponsored by the Michigan State Police Office of Highway Traffic Safety, BSA has launched a campaign to eliminate alcohol billboards, advertising and flyers targeting teens.
Like all states, Michigan collects excise taxes on the sale of alcoholic beverages. The excise tax on liquor (or a mixed drink) is $.021 per 1.5-ounce shot. Wine is taxed at $.02 per glass and beer at 1.9? per 12-ounce can or bottle. In 1997, Michigan collected approximately $118 million in alcoholic beverage excise taxes. In a national survey conducted by the Robert Wood Johnson Foundation in 1997, almost all Americans (96 percent) reported being concerned about underage drinking; most (82 percent) were willing to raise alcohol taxes to $.05 per drink if the additional revenue was used to fund alcohol treatment and prevention programs for minors.
Marijuana. Among Detroit high school students, marijuana is the second most widely used drug after alcohol. In 1997, one in two students reported having tried marijuana, which is consistent with national rates, including rates among African American teens. High school students in Detroit and throughout Michigan are equally likely to have tried marijuana at some point in their lives. However, past month use of marijuana is higher among students statewide than in Detroit (28 percent vs. 25 percent). Unlike drinking, for which there is little difference by gender, Detroit boys are more likely than girls to have used marijuana in the past month (29 percent vs. 21 percent). Marijuana use among Detroit youth (like youth nationwide) increases with age; 21 percent of 9th graders report marijuana use in the past month compared to 36 percent of 12th graders. Marijuana is the most commonly used illicit drug among adults in Detroit as it is in most cities. In 1995, 31 percent of adults surveyed in the city of Detroit had tried marijuana at some time and 6 percent had used it in the previous 30 days.
Other Illicit Drugs. Use of inhalants, cocaine, heroin or LSD among Detroit high school students is less than that of their peers statewide. For example, one percent of Detroit high school students have tried cocaine compared to 7 percent of students in Michigan. Use rates differ most dramatically for inhalants; 7 percent of Detroit's high school students have used inhalants compared to 22 percent of youth statewide. However, inhalant use is more common among younger teens in the city; in 1997, 5 percent of Detroit 12th graders had tried inhalants compared to 9 percent of 9th graders. The figures point to the need to educate youth and parents about the dangers of inhalants and to increase awareness among vendors about the purchase of these products by youth.
In 1995, 5 percent of Detroit adults reported having tried crack cocaine at least once while 1 percent used it in the preceding year. Although rates of use are low compared to marijuana, treatment needs, emergency room visits and toxicology reports indicate crack cocaine continues to be a problem. Heroin use is increasing in Detroit. Based on treatment admissions, medical examiner data and law enforcement data, the Michigan Department of Community Health Heroin Prevalence Study showed a 40 percent increase in the number of heroin users in Detroit between 1977 (24,200) and 1992 (33,800). Forty-two percent of Michigan's heroin users in 1992 were living in the city of Detroit. The 1992 heroin data are the most recent available. Experts caution that a significantly greater stigma is attached to heroin than to other drugs, which may lead to underreporting of use.
Availability. The 1992 Synar Amendment requires state agencies to enforce laws prohibiting tobacco sales to minors or risk losing federal prevention and treatment funds. The national goal is to have no more than 20 percent noncompliance by the year 2000. In 1999, data from a three year project by the Detroit Health Department will indicate whether or not youth access to tobacco products is compliant with Synar requirements. However, in 1997, just 15 percent of Detroit teens who smoke regularly said they were not asked to show proof of age during their last cigarette purchase.
In focus groups conducted in 1997 by the Wayne State University Addiction Research Institute, Detroit youth reported easy access to drugs. Most identified alcohol, tobacco and marijuana as the most available drugs in their neighborhoods, and almost half claimed that drugs were available "down the street" or "close to home." In 1997, 26 percent of Detroit high school students said they had been offered, sold or given illegal drugs on school property. During the same year, one in ten said they drank alcohol, smoked cigarettes or used marijuana on school property. According to the Detroit Public Schools, many Detroit youth believe adults facilitate teen drinking. In 1995, 58 percent of Detroit high school students and 44 percent of school staff knew of parents or other adults who condoned underage drinking in their homes.
Attitudes and Perceptions. Fifty-two percent of Detroit students think underage drinking is a serious problem. In focus groups, youth offered various explanations for alcohol and other drug use. Some said people experiment with drugs and then get "hooked," while others said people use drugs to be "cool."Youth also said alcohol and other drug use can be a coping mechanism, with parents often setting the example. Older students cited stress and pressure as contributing factors. Truancy increases the risk of delinquent activity, including alcohol and other drug use. In 1994, Michigan ranked 43rd among the states in public high school graduation rates. In the 1994-95 school year, 66,440 complaints of chronic absenteeism were investigated in Detroit.
Prevention Needs and Services. Michigan receives $16 million per year in federal Safe and Drug-Free Schools and Communities (SDFSC) funding; 91 percent goes to school districts while 9 percent goes to the Michigan Education Agency. Public schools in the city of Detroit receive about $1.5 million in SDFSC funds (an average expenditure of $8.33 per pupil), and all 263 Detroit public schools have drug and violence prevention programs. SDFSC dollars also support Student Assistance Programs (SAPs) which offer help to students with family, personal, substance abuse or mental health problems. The Detroit Public Schools Office of Guidance has a Peer Counseling Program in city schools to match youth with peer counselors who are trained to be attentive listeners and can provide support through difficult times.
The drug abuse prevention programs used in Detroit public schools include Growing Healthy and the Michigan Model for Comprehensive School Health Education. The full implementation of the Michigan Model in middle schools has been supported by the Skillman Foundation for five years, with funding exceeding the amount of SDFSC funds given annually to school districts. However, the Michigan Model has not been consistently or completely implemented in Detroit as a result of unresolved administrative, training and time management concerns within the public schools. Thus, while the school district has adopted the Michigan Model, not all schools teach it; those that do often teach only parts of it.
In addition to school prevention programs, prevention partnerships among agencies (including the Bureau of Substance Abuse, the Detroit Recreation Department, the Detroit Police Department and local community service groups) reach out to youth in the city's neighborhoods. Prevention efforts involve the promotion of healthy lifestyles among youth through teaching, tutoring and recreational activities.
Advertising. Alcohol and tobacco advertising billboards concern many Detroit residents. According to the Coalition Against Billboard Advertising of Alcohol and Tobacco (CABAAT), alcohol and cigarette billboards are found far more often in low-income zip codes in Detroit than in more affluent areas. In 1997, the Addiction Research Institute at Wayne State University reported little change in the number of tobacco billboards citywide since 1989; however, alcohol billboard advertising in Detroit dropped by 52 percent during the same eight year period, which may reflect the impact of CABAAT's efforts.
Drug Abuse and the Workplace. According to a 1998 survey by the Detroit Regional Chamber of Commerce, all large companies in the city have health plans that cover alcohol and other drug abuse treatment, compared to 91 percent of medium-sized companies and 71 percent of small companies. The majority of large (96 percent) and medium-sized (86 percent) companies also have published policies regarding drug use in the workplace, compared to half of small companies. The differences indicate that, like many employee benefits, alcohol and other drug abuse assistance is less affordable to small companies. The Federal Drug-Free Workplace Act of 1998 provides financial incentives and technical assistance to small businesses to develop employee assistance programs. In addition, Michigan Drugs Don't Work, a program housed in the Michigan Chamber Foundation, is a statewide effort to help employers in Detroit and across the state implement drug-free workplace programs.
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