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DRUGS |
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Testimony before the U.S. House of Representatives
Statement
of Steve Pasierb President and CEO, The Partnership for a Drug-Free
America
Committee on House Government Reform Subcommittee on Criminal Justice,
Drug Policy, and Human Resources
July 26, 2006
Mr. Chairman, Ranking Member Cummings, members of the subcommittee,
thank you for inviting me to testify today about the problem of prescription
drug abuse. I am Steve Pasierb, president and CEO of the Partnership
for a Drug-Free America.
Before I offer my testimony today, I want to take this opportunity
to thank the subcommittee - and especially you, Mr. Chairman and you,
Mr. Cummings - for your leadership on the drug issue. Year after year,
you remain steadfast in your dedication to help the country contend
with the issue of substance abuse. I have no doubt that your leadership
and perseverance have contributed to the progress we have made in
the last seven years in reducing the number of teenagers who use illicit
drugs. All of us who work in prevention, law enforcement, and treatment
are exceptionally grateful for the work of this subcommittee, and
especially to both of you, for your unwavering commitment to this
critical issue.
Overview
While overall substance abuse among teens has decreased 19 percent
since 2001, when you examine individual drugs of abuse, there are
some troubling trends, including the abuse of methamphetamine, inhalants,
prescription drugs and over-the- counter drugs to get high. The Partnership
is especially concerned about the advent of what we have dubbed "Generation
Rx" - a cohort of young people for whom "pharming," or abusing a host
of medicines and chemical products to get high has become normative.
The Partnership's 18th annual Partnership Attitude Tracking Study
(PATS), which examines teen drug use and attitudes, showed that the
intentional abuse of prescription and over-the-counter drugs to get
high is now an entrenched behavior among teens. Our study confirmed
that an alarming number of today's teenagers are more likely to have
abused prescription and over-the-counter drugs than a variety of illegal
drugs like Ecstasy, cocaine, crack and methamphetamine. According
to PATS:
--Nearly one in five (19 percent or 4.5 million) teens has tried a
prescription medication to get high;
--One in 10 (10 percent or 2.4 million) teens report abusing cough
medicine to get high; and
--Abuse of prescription and over-the-counter medications is on par
with or higher than the abuse of illegal drugs such as Ecstasy (8
percent), powder/crack cocaine (10 percent), methamphetamine (8 percent)
and heroin (5 percent).
The abuse of prescription medications has become "normalized" in teen
culture. Two out of five teens report having a close friend who abuses
prescription pain relievers to get high and nearly three out of 10
report having a close friend who abuses cough medicine to get high.
So, even if teens are not abusing these medications themselves, one
of their close friends may be. With this perception that "everyone
is doing it" there is great risk that the "pharming" phenomenon will
only grow larger.
The fact that prescription drugs are now the second most popular illegal
drugs among teens, falling just behind marijuana, is certainly alarming.
Equally disturbing is the number of people of all ages initiating
use of this class of drugs. According to the National Survey on Drug
Use & Health, in 2004 more people were initiating use of prescription
pain relievers (2.4 million) than marijuana (2.1 million). Non-medical
use of tranquilizers ranked third among initiates (1.2 million).
From talking to consumers, we know that this problem is not even on
parents' radar screen. The Partnership has recently launched a nationwide
media campaign to increase awareness and spur a dialogue about "pharming"
between parents and teens. More information on this campaign follows.
Access and Perception of Risk
The Partnership's study found that two key factors are driving the
"pharming" phenomenon: many teens have a misperception that intentionally
abusing prescription and over-the-counter medicines is not harmful,
and teens say there is easy access to these drugs through a medicine
cabinet at home or at a friend's house or via the Internet.
When asked why they thought prescription drug abuse was becoming more
of a problem among their peers, the most common response was the ease
of access. In fact, 72 percent of teens say that it is easy to get
these medications from their parents' medicine cabinets; 65 percent
say that it is easy to get these medications using other people's
prescriptions; 55 percent say that these drugs are available everywhere,
and 36 percent say that it is easy to buy the drugs over the internet.
In addition to the ease with which these substances can be acquired,
there is also a false sense of security about them because they are
FDA-approved, legitimate medications from the medicine cabinet rather
than street drugs imported into the United States and possibly cut
with an unknown, dangerous substance. Because we know that the riskier
a teen believes a drug is, the less likely they are to use it, The
PATS study's findings on perception of risk is especially troubling:
--Two in five teens (40 percent or 9.4 million) agree that prescription
medicines, even if they are not prescribed by a doctor are "much safer"
to use than illegal drugs;
--Nearly one-third of teens (31 percent or 7.3 million) believe that
there is "nothing wrong" with using prescription drugs without a prescription
"once in a while;"
--Nearly three out of ten teens (29 percent or 6.8 million) believe
prescription pain relievers, even if not prescribed by a doctor, are
not addictive; and
--More than half of teens (55 percent or 13 million) don't strongly
agree that using cough medicines to get high is risky.
The challenge is to get the message across to teens that there is
a difference between good medicine and bad behavior. When these medications
are abused, or used for anything other than their intended purpose
under a doctor's supervision, they can be every bit as dangerous as
illegal street drugs.
Motivation for Use
The Partnership's research shows that that teens see distinct benefits
from different drugs and choose substances based on whether their
motivation is simply to get high, to deal with problems such as stress
or depression, to change their body or to help with school work.
Marijuana is the classic party drug; 81 percent of teens tell us that
they use it to get high, and only 16 percent use it to deal with problems.
Those numbers look quite different when you ask a teen about prescription
drugs. A sizeable number of teens are self-medicating with these substances
in order to get ahead in school or to deal with stress or depression.
Forty three percent of teens report that they use prescription stimulants
like Adderall or Ritalin without a doctor's prescription to help with
school work, 31 percent say they use them to deal with problems, and
22 percent say they use them to get high. When it comes to prescription
pain relievers, nearly half of kids say they use them to get high
but 40 percent use them to help them to deal with a problem.
Parents Unaware of Teens' Intentional Misuse of Medications
Parents are crucial in helping prevent the abuse of prescription and
over-the-counter medications but right now there is a huge disconnect
between parents and teens about "pharming." Only one percent of parents
say that it is "extremely or very likely" that their own teen has
tried a prescription pain killer but 21 percent of teens admit to
trying this type of drug to get high. The same holds true for prescription
stimulants: two percent of parents say it is "extremely or very likely"
that their own teen has used them to get high whereas 10 percent of
teens actually have.
Today's cohort of parents is the most drug-experienced in history,
but they do not understand this new drug abuse behavior among teens.
As a result, they are looking for the classic signs of illegal drug
use and are missing this trend. Parents need to be aware that the
drugs their teens abuse today, including medicines, are not the drugs
from decades past. Only through education and parental involvement
can we reverse this trend. Once parents are educated about this problem,
they can get through to their kids about the dangers of these substances.
We know that kids who learn a lot about the risk of drugs from their
parents are up to 50% less likely to use drugs than teens who don't
learn from their parents. Most parents say that they have talked to
their kids about the dangers of drugs but our research shows that
the message may not be getting through. Nine out of ten parents of
teens say they have talked to their child about the dangers of drugs,
yet fewer than one-third of teens (31 percent or 7.4 million) say
they "learn a lot about the risks of drugs" from their parents.
Partnership research shows that parents are also the first place that
teens turn for information about the risk of drugs. Fifty- six percent
of teens report that they talk would turn to their mother and 45 percent
would turn to their father when they have a question about drugs.
Parents need to be educated so that they can seize that opportunity.
The Partnership's efforts are helping parents understand the power
that they have when it comes to their kids' decision about drugs and
empower them to exercise it.
The Partnership is working to increase awareness about the dangers
of "pharming" so that parents can talk to their kids about the dangers
of abusing prescription and over-the-counter drugs. Our research shows
that we need to target parents specifically on this issue: while three
out of five parents report discussing drugs like marijuana "a lot"
with their children, only a third of parents report discussing the
risks of using prescription medicines or non-prescription cold or
cough medicine to get high.
The Partnership's National Rx and OTC Medicine Abuse Campaign
The Partnership's annual tracking study - the largest, ongoing analysis
of drug-related attitudes in the country - began measuring teen abuse
of select medications in 2003. With three years of data in hand and
last year's data heralding the emergence of this new category of substance
abuse, the Partnership recognized this shift in teen drug abuse behavior
as one of the most significant in recent history and immediately began
developing a necessary prevention and education campaign directed
at parents.
In May, the Partnership launched a comprehensive, multi-year prevention
communications effort targeting the abuse of prescription and over-the-counter
medications. It is the first national campaign of its kind. The Partnership
created this effort with support from the Consumer Healthcare Products
Association and its member companies. The campaign speaks directly
to parents by alerting them that their own homes are easily accessible
sources for teens to obtain and abuse these medications. The campaign
is comprised of hard-hitting television, newspaper, magazine and radio
messages, a multifaceted interactive online component, and is supplemented
by informational brochures to help parents get the conversation started
with their teen. A multi-faceted public relations effort will provide
media support for the campaign, in addition to the great coverage
it has already received. When the Partnership released the research
findings and launched the campaign in May, there was significant coverage
around the country in the broadcast, print, and internet media, including
on CNN, CBS Evening News, the Associated Press and the Washington
Post.
The prescription and over-the-counter drug education effort is a priority
campaign for the Partnership, which will work directly with national
and local media to gain significant placements for the public service
campaign messages. Television messages from the campaign will run
nationally across all Comcast systems throughout the summer. Comcast
will donate more than $2 million in advertising media exposure to
support the campaign. In addition, Univision will also be lending
extensive radio support to Spanish-language radio messages targeting
the Hispanic community via Univision's national radio network. Univision
will also be highlighting this issue in a special television program
this Saturday, July 29.
The campaign also features an innovative online component consisting
of unique and engaging Web sites focused on the dangers of abusing
cough medicine/dextromethorphan (dextromethorphan, or DXM, is the
active ingredient in cough medicine). And, in a first for the Partnership,
we are driving visitors to the websites with a comprehensive search
engine marketing campaign.
The Partnership's Web site www.drugfree.org
features comprehensive online content on the abuse of prescription
drugs. Original online content created specifically for parents and
teens on the abuse of cough medicine can be found at: www.drugfree.org/Parent/.
--For teens - www.dxmstories.com/
The message of this campaign can be summed up in three words: educate,
communicate and safeguard. Educate yourself about the medications
kids are abusing. Communicate with your kids and dispel the notion
- for yourself as well as for your kids - that these medicines can
be safely abused. And safeguard your medications by learning which
ones can be abused, limit access to them and keep track of the quantities
you have in your home - and make sure your friends do the same.
As I mentioned, the Partnership has worked closely on this campaign
with the Consumer Healthcare Products Association and its member companies,
who are taking seriously the abuse of over- the-counter cough medications
and helping find proactive solutions that reduce a negative behavior.
They have been wonderful in this regard. We have seen similar positive
actions by individual companies in the prescription drug industry.
The prescription industry overall, however, thus far has focused its
attention on the appropriate use of their products as well as on product
safety and efficacy. This is an important step, but needs to be linked
to complementary efforts to address the separate and very different
consumer behavior of intentional abuse to get high. Again, this is
an issue of good medicine meeting bad behavior, something both teens
and parents do not fully understand. We are optimistic that the industry
will do more to acknowledge the unfortunate fact that teens are abusing
these products and take part in comprehensive, appropriate education
and prevention efforts.
Effectiveness of Media Campaigns
The reason that the Partnership for Drug-Free America is focusing
on a media campaign to educate parents about the problem of prescription
and over-the-counter drug abuse is simple: anti-drug advertising works.
This is documented in independent research, as well as in our own
national tracking study, now in its 18th year.
A study published in the August 2002 American Journal of Public Health
found anti-drug advertising is associated with a reduced probability
of marijuana and cocaine/crack use among adolescents. A team including
researchers from Yale University, New York University, the London
Business School and Baruch College evaluated the effectiveness of
drug-education messages from the Partnership for a Drug-Free America
from 1987 through 1990. The researchers said that by 1990, "after
three years of Partnership ads, approximately 9.25 percent fewer adolescents
were using marijuana." The team also noted the decrease came at a
time when anti-drug ads had increasing levels of media financial support
- and thus were seen more often. "Given the results," the researchers
said, "this increase appears to have been a worthwhile investment."
Previously, the February 2001 issue of the American Journal of Public
Health reported television advertising contributed to a significant
decline in marijuana use among teenagers. Research funded by the National
Institute on Drug Abuse (NIDA) chronicled the impact of anti-drug
TV ads on teens described as "sensation seekers" - adolescents attracted
to risky activity and behavior. Conducted by Dr. Philip Palmgreen
and a team of researchers at the University of Kentucky, the study
tracked the impact of ad campaigns in select counties in Kentucky.
The study showed a 26.7 decline in marijuana use among sensation-seeking
teens exposed to anti-drug ads over a two-year period. Most ads used
in the study were created by the Partnership for the Media Campaign.
National tracking data also support the effectiveness of anti- drug
ads. Dr. Lloyd Johnston, lead researcher for the University of Michigan's
Monitoring the Future study, said MTF research showed that:
"Over the past two years, there has been an increase in the proportion
of students seeing marijuana use as dangerous; this change in beliefs
may well explain some of the recent gradual decline in use. Quite
possibly, the Media Campaign aimed at marijuana use, that has been
undertaken by the White House Office of Drug Control Policy in collaboration
with the Partnership for a Drug-Free America, has been having its
intended effect. I am not aware of any other social influence process
that could explain these changes in how young people view marijuana."
Johnston also remarked of the Partnership's early efforts to combat
inhalant abuse: "The use of inhalants began to turn downward in 1996,
following the launching of an ad campaign by the Partnership for a
Drug-Free America, and has been gradually and steadily declining since
then."
Dr. Johnston has also said the survey consistently finds a very high
degree of recalled exposure to Partnership ads, that the ads have
high credibility with the audience and that they have high- judged
impact on the behavior of that audience.
The effectiveness of anti-drug advertising is also underscored in
findings from the Partnership Attitude Tracking Study: Year after
year, tracking data show that teenagers who are exposed to anti- drug
advertising frequently have stronger anti-drug attitudes and are considerably
less likely to use drugs than teens who see and hear these messages
infrequently.
There is also evidence of effectiveness from the National Youth Anti-Drug
Media Campaign. The data cited below are drawn from the 2005 PATS
Study. Last year, we sampled over 7,200 teenagers, in grades 7 through
12, across the country; we also over-sampled for African- and Hispanic-Americans
to enable specific analysis of these two groups. Our findings in PATS
track consistently with those of the Monitoring the Future study,
conducted by the University of Michigan's Institute for Social Research
under grants from the National Institute on Drug Abuse.
--Significantly fewer teenagers are using marijuana today when compared
to 1998, the year the Media Campaign launched. Reductions are evident
in all measured categories of prevalence - lifetime, past year and
past month use. As you surely know, the Media Campaign focuses heavily
on preventing adolescent use of marijuana - the most widely abused
of all illicit substances.
--Marijuana-related attitudes among teenagers have improved significantly
over the same time. In the past year, teen perception that marijuana
use carries 'great risk' of getting in trouble with the law and dropping
out of school increased significantly. Looking at risks by category,
or type of risk, relational risks such as upsetting their parents,
losing their friends or not being able to get a girlfriend or boyfriend
are all significantly greater than in 1998.
--Teens are less likely to report that their close friends use marijuana.
This is important because teens whose friends use drugs are more likely
to use drugs themselves.
The Partnership for a Drug-Free America
The Partnership is a non-profit coalition of volunteers from the communications
industry. Using a national drug-education advertising campaign and
other forms of media communication, the Partnership exists to reduce
illicit drug use in America. The organization began in 1986 with seed
money provided by the American Association of Advertising Agencies.
The Partnership, which receives major funding from the Robert Wood
Johnson Foundation and support from more than 200 corporations and
companies, is strictly non-partisan and accepts no funding from manufacturers
of alcohol and/or tobacco products. All actors in the Partnership's
ads appear pro bono through the generosity of the Screen Actors Guild
and the American Federation of Television and Radio Artists.
National research suggests that the Partnership's national advertising
campaign - the largest public service campaign in the history of advertising
- has played a contributing role in reducing overall drug use in America.
Independent studies and expert interpretation of drug trends support
its contributions. The New York Times has described the Partnership
as "one of the most effective drug-education groups in the United
States."
In addition to its work on the national level, the Partnership's State/City
Alliance Program supports the organization's mission at the local
level. Working with state and city governments and locally-based drug
prevention organizations, the Partnership provides the guidance, on-site
technical assistance and creative materials necessary to shape anti-substance
abuse media campaigns tailored to the needs and activities of any
given state or city.
The Partnership also participates in the National Youth Anti-Drug
Media Campaign, coordinated by ONDCP. At the core of this multi- faceted
initiative is a paid advertising program, featuring messages created
by the Partnership.
Today, the Partnership is run by a professional staff of 50. Partnership
campaigns have received every major award in the advertising and marketing
industries for creative excellence and effectiveness, including the
American Marketing Association's highest honor for marketing effectiveness.
Conclusion
The intentional abuse of medications among teens is a real issue threatening
the health and well being of American families. We have a situation
where a widespread and dangerous teen behavior has become normalized
and has found our way into our homes. These findings should serve
as a wake-up call to parents that their teens are facing a drug landscape
that did not exist when they were teens. The abuse of prescription
and over-the-counter drugs has taken root among America's teens and
the behavior is not registering with parents. Unless we all take action,
it is a problem that is only going to get worse.
Thank you for calling this important hearing today to shed light on
this problem. The Partnership for Drug-Free America looks forward
to working with this Committee and the Congress to educate the public
about this problem and change teen attitudes and behavior regarding
"pharming." |
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