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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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How Do You Determine Bias and Information Quality?

Columns - On the Web

Saturday, 30 November 2002

As I write this column, there are headlines in the daily news focusing on conflicts of interest. The obvious ones concern the interests of corporate directors, as they cope with their own personal needs versus the needs of the company's shareholders. The conflict that caught my eye today deals with the represented perspective on broadcast television news. Apparently, several celebrities have been interviewed to discuss their experiences with certain prescription and over-the-counter medications. The interviews were presented as representative of what anyone taking the medication might experience. What viewers were not told, however, was that the celebrity was a paid representative of the medicine's manufacturer.

We don't know whether the income paid to the celebrity led to significant bias in their presentation. We don't know whether they would have said precisely the same thing had it not been for a check being cut. The extent to which we might presume bias in any situation is a difficult process to determine. If a famous individual is willing to talk about their arthritis medication at no charge to anyone, I'd certainly be more interested in what gets said than I would be if I knew the celebrity were collecting a few thousand dollars. But if the celebrity said only positive things, with no evidence of problems described, I'd wonder if there weren't an unspoken purpose behind the discourse.

Generally speaking, we all read our daily newspaper and watch network news on the assumption, however misguided, that the information presented is reasonably unbiased by advertising or underwriting. We recognize the system is not perfect, but it is a shame to discover, as we have repetitively in the past year, that the lack of apparent bias does not equal a lack of true bias. We've established some formats that have a lower risk for bias. The lack of commercial advertising in Consumer Reports is one such example. National Public Radio and PBS are others. How do we determine bias and information quality on the Web?

How do you look at a site on the Web? Do you think of it in your mind as the equivalent of Tom Brokaw telling you something on the evening news? Or is it more like public access cable where anyone with a video camera can create "content" to be broadcast? Do you judge the quality of the content in part by the appearance of the presentation? If a site is brought to you by a known entity such as Disney, do you assume a higher caliber of quality and a lower likelihood of bias than you would with a comparative unknown such as Salon.com? Do you base part of your conclusion about quality and bias upon the presence or absence of advertising as part of the site? Do you watch for change as time passes? Take a look at www.audiworld.com; this site started out as an enthusiast site dealing with the Audi A4 automobile. The site differed markedly from Audi's official corporate site in that it seemed to present a more-or-less unbiased viewpoint. Early A4's had brakes that squeaked. This was discussed openly at the time. As I look at the site today, I'm hard pressed to find any information that speaks badly of Audi's newer cars. Either the cars are now perfect, or the site is now underwritten by advertisers and receiving assistance from Audi to the extent that the authors of material at the site are less likely to give high visibility to negative commentary.

Let's turn, finally, to addiction issues on the Web. I recently received a press release about a new site, www.self-renewal.com. The home page of the site states that the pages will allow the viewer to find "many practical ways to improve the quality of your life." There are three basic divisions of the site: Breaking Addictions, Inner Peace, and Spiritual Vitality. As I reviewed each division, I found an interesting perspective and opinion that is likely helpful for some patients. As I read further, I realized that all the material on the site appeared to be written by a single individual, Jerry Dorsman. Dorsman is the author or co-author of three books in the field, each of which is promoted throughout the site. While the "About this site" area indicates that the site is designed to be of value to clinicians, the content serves as an infomercial for Dorsman's books. The site isn't clearly an advertisement; it doesn't present information telling me where to buy the books, nor does it permit a direct purchase. The web site name, "self-renewal," is not based upon the title of any of Dorsman's books. And yet while reading the presented material, I had not been exposed to alternative perspectives, nor had any reading material been suggested other than Dorsman's own books.

The site is cleanly laid out with no linking errors. The presented information seems to reflect the author's intent and his books with accuracy. My only concern is that of potential bias. If the site is intended as a promotional site for the author or for his books, it should clearly say so on the home page. If it isn't, then it should be inclusive of other perspectives. This would preserve for those who don't necessarily take into account potential bias as they surf the Net, the ability to quickly determine purpose and bias of a given site. What are your favorite addiction-related web sites? Are they biased, and if so, how and why? In one of our future columns, I'll turn my attention to www.alcoholMD.com. As part of the column, I'd like to include some of your comments about the site. Take a look and let me know what you think.

Stuart Gitlow, MD, is the author of Substance Use Disorders: A Practical Guide, from Lippincott Williams & Wilkins. He is Vice-Chair of the American Medical Association's eMedicine Advisory Committee. He writes and speaks frequently on both topics.