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Continued Decline in Youth Substance Abuse

Current illicit drug use among teens is continuing to decline, according to a new report by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) released today. The study also shows positive signs that teens are seeing the dangers of abusing prescription drugs and methamphetamine and are pushing back. Among youth ages 12-17, the 2007 National Survey on Drug Use and Health (NSDUH), the Nation's largest substance use survey, shows that the significant decline in overall past month illicit drug use that began in 2002 continued through 2007, from 11.6 percent to 9.5 percent.

The survey, released at the start of the 19th Annual National Alcohol and Drug Addiction Recovery Month, shows that the reductions in youth drug use occurred for nearly every type of illicit drug including marijuana, cocaine, hallucinogens, LSD, and Ecstasy. The survey also shows dramatic declines in meth use, down by 67 percent (from 0.3% to 0.1%) and prescription drug abuse among teens, which declined overall by 18 percent, from 4 percent to 3.3 percent between 2002-2007.

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What in the WWW Will Work for Us?

Columns - On the Web

Monday, 31 May 2004

For years, critics have written of what they would like to see on television, hear on radio, or watch on Broadway. In contrast, much has been written regarding what exists on the Internet, but there has been quite little about what would be desirable within this comparatively new medium. As supervisors are so fond of telling the managers below them on the corporate ladder, don’t complain about problems unless you’re prepared to offer a solution.

After complaining about problems for the past 12 or so columns, I figure it’s time to present a solution or two. If you’re looking for comments about addiction online, this month’s column doesn’t address the topic. We are looking at the overall online issue broadly this time, and will bore down to the applicability of our suggestions to addiction online next time.

First, we have to look back. While the Internet has existed for several decades, the vast majority of its users learned of it only when the World Wide Web was launched in 1991 as the graphic interface between home and Internet. Prior to that, there were several graphic online interfaces, some of which were ultimately unsuccessful, such as Connect’s MacNET, which launched in 1988, and some of which were at least initially successful, such as QuantumLink, which eventually became America Online (AOL). In the early days, the only money around was that of the initial investors; there was no income from Madison Avenue, nor were federal grants likely to arrive. What that meant is: the people running the online areas were presenting their unique perspective.

In other media, a similar example is public access cable or a college radio station. Within those settings, you find perspectives that are unlikely to reflect the government ideal or the latest marketing strategies. Of course, with no significant funding to back up the presentations, there is little in the way of investigative research or presentation of timely information. “I can’t redo the cable show; I’ve got homework to do,” ends the discussion as to whether a new version of an outdated show will be presented. So we have a bind — the very funding that allows the development of timely, accurate, and compelling information often carries with it restrictions as to what the funding is to be used for.

So let’s go back to the early 1990s. At this time, AOL began taking off in terms of customer acceptance. The Web hadn’t yet become generally available, but users discovered that AOL presented ease of use that CompuServe and The Source hadn’t. Moreover, since advertisers weren’t supporting AOL’s online presentations, the information and support forums on AOL were operated by volunteers. AOL supervised these volunteers, providing them with free accounts in return for their efforts at presenting wholesome, informative, and entertaining forums. If, for example, in 1993, you visited the AOL Computing Forum to determine what printer would best suit your needs, you would have found a series of user-generated opinions alongside an editorial written by the forum leader. Overall recommendations were presented in a manner consistent with Consumer Reports.

AOL had managed, through the offer of free online access, to turn public access cable into network television. If one volunteer wouldn’t do the job the right way, he or she was replaced. Eventually, AOL had a marvelous support structure of community leaders bringing AOL members the best information available. And then — the Web arrived. The Web lacked the oversight AOL had been giving, and in fact, was the exact equivalent of public access cable. AOL, rather than proclaiming its many advantages, tried to combat the Web in other ways. Significant advertising arrived. The old, community-leader based system was gradually discontinued with internally based programming developed in response to what would and wouldn’t bring in supporting dollars from marketing. The accurate information of the past was replaced with marketing gambits. As time passed, AOL became little for many other than a window to the Web. With AOL’s time now past, we watch currently as their membership declines. We all are now left with Web sites that either have no clear oversight or are funded by those with clear bias. Even the governmental sites have political messages that may or may not reflect current scientific thought.

So what do we need? Given the omni-presence of the Web, it likely would be impossible to launch a competitor to a freestanding online service such as AOL that would ever generate the audience size necessary to support itself. That leaves us with the need to develop something within the Web that provides the following capabilities:

Information should be timely, accurate, complete, and unbiased.
Information should be presented in an attractive style — for if it is not, it will be ignored.
Information should be presented in a multimedia format, making use of audio and video where appropriate.
Presented material should have bylines, resource lists, and references.

To establish this, one would need the oversight of a “parent,” such as AOL used to provide, within the accepted medium of today — the Web. The development of networks within the Web environment could start to address these issues. Imagine if a brand were applied to a series of Web sites that all had a specific set of virtues of importance to you. You might follow that brand from site to site, particularly if the brand were associated with credibility and accuracy. This is no small undertaking, of course, but then the potential audience is enormous. The trick to this venture would be how to prevent what happened to AOL from happening to the new network.

So here’s your chance! What does the Web need in order to become relevant to us? And how can the network idea presented above work for us? Or do you have a better idea?

Stuart Gitlow, MD, MPH, is the author of Substance Use Disorders: A Practical Guide, from Lippincott Williams & Wilkins. He spoke at the Psychiatric Congress in Orlando in November 2003 on e-mail and the psychiatric patient.

This article is published in Counselor,The Magazine for Addiction Professionals, June 2004, v.5, n.3, pp. 73-74.