The Consumption and Consequences of Alcohol and Drugs in Allen County a County Epidemiological Profile 2009

The Consumption and Consequences of Alcohol and Drugs in Allen County

A County Epidemiological Profile 2009

Drug & Alcohol Consortium of Allen County 532 West Jefferson Blvd Fort Wayne, IN 46802 (260) 422-8412 Fax: (260) 423-1733 [email protected] www.dacac.org

The Consumption and Consequences of Alcohol and Drugs in Allen County: A County Epidemiological Profile 2009

Developed by the Research/Local Epidemiology and Outcomes Workgroup, 2009

Our Vision ∗ A community culture of invested organizations replicating their own SPF activities at the front lines ∗ All primary, secondary, and higher education to install evidence- based prevention into their curricula ∗ Serving, educating, enjoining, and facilitating targeted corporations to install evidence-based prevention and intervention programs ∗ A community intolerance of under-aged and binge drinking by youth ∗ A 50% reduction in under-aged and binge drinking by 2020

Our Mission To reduce substance use and abuse among youth and young adults in Allen County.

Published by the Drug & Alcohol Consortium of Allen County

Allen County Strategic Prevention Framework Advisory Council

Paula Hughes, Chair Deborah McMahan, M.D. Council Member, District 2 Health Commissioner Allen County Council Allen County – Fort Wayne Department of Health Dick Conklin Sharon Mejeur Executive Director Vice-President of Student Life Tobacco Free Allen County University of St. Francis Andrew Downs, PhD Wyatt Mullinax Director Commissioner, Drug-Free Indiana Mike Downs Center for Indiana Politics Indiana Criminal Justice Institute Indiana-Purdue University at Fort Wayne

Honorable Thomas Felts Marty Pastura Judge President/CEO Allen County Circuit Court YMCA of Greater Fort Wayne Loren Fifer Jerry Peterson District 4 Representative, Vice-President President/CEO Indiana Beverage Commission United Way of Allen County Kenneth Fries Denise Porter-Ross Sheriff Mayor’s Northeast Area Advocate Allen County Sheriff’s Department City of Fort Wayne

Honorable Frances Gull Kirk Ray Judge Chief Executive Officer Allen Superior Court St. Joseph Hospital

Sister Elise Kriss Jonathan Ray President Executive Director University of St. Francis Fort Wayne Urban League Melissa Long Paul Wilson Commissioner, Drug-Free Indiana President/CEO Indiana Criminal Justice Institute Park Center George McClellan, PhD Rusty York Vice-Chancellor for Student Affairs Chief Indiana-Purdue University at Fort Wayne Fort Wayne Police Department

Allen County Epidemiology and Outcomes Workgroup (LEOW)

Andrew Downs, PhD, Chair Timothy Miller Director Court Administrator Mike Downs Center for Indiana Politics Allen County Circuit Court Indiana Purdue University at Fort Wayne

Greg Barnes Kelly Sickafoose Executive Director Northeast Region Community Consultant Youth Services Bureau Indiana Criminal Justice Institute Governor’s Commission Drug-Free Indiana

Kim Churchward Paul Spoelhof Director, Criminal Division Services Manager of GIS/Special Projects Allen Superior Court City of Fort Wayne

Kevin Corey Captain Kellie Turner Fort Wayne Police Department SPF-SIG Program Director Projects Drug & Alcohol Consortium of Allen County

Amy DiNovo Hathaway Jeff Yoder SPF-SIG Administrative Assistant Assistant Director, Criminal Division Services Drug & Alcohol Consortium of Allen County Allen Superior Court

Nancy Flennery Angie Zelt Community Planning Manager SPF-SIG Administrative Assistant United Way of Allen County Drug & Alcohol Consortium of Allen County

TABLE OF CONTENTS

Introduction 6

1. Methods & Data Source List 11

2. Description of Allen County 20

3. Community Risk & Protective Factors 24

4. Alcohol Use in Allen County: 36 Consumption Patterns and Consequences

5. Alcohol and Drug Treatment Episodes and 82 Admissions Data

6. Other Substance Use in Allen County: 85 Consumption Patterns and Consequences Marijuana, Cocaine, Methamphetamines, Amphetamines, Heroin, Prescription Drugs, LSD, Injected Drugs, Inhalants, MDMA, and GHB

7. Conclusion 131

Appendix I 132 Acronyms

Appendix II 133 Local Household Telephone Survey

Appendix III 144 Alcohol and Your Body Alcohol Impairment Charts

Appendix IV 148 Maps Tables Figures 5

Introduction

In July 2005, Indiana’s Office of the Governor received a grant from the U.S. Department of health and Human Services’ Center for Substance Abuse Prevention (CSAP) as part of CSAP’s Strategic Prevention Framework State Incentive Grant (SPF-SIG) Program. The SPF-SIG grant program represents the continuation of ongoing CSAP initiatives to encourage states to engage in data-based decision-making in the area of substance abuse prevention planning and grant- making.

The SPF-SIG grant was made on the heels of an earlier CSAP State Incentive Grant (SIG) which helped to lay much of the groundwork for this new initiative. A great deal of work was completed under the first SIG to assess substance abuse prevention services and develop a strategic framework to guide policymaking in this area for the 21st century. The final report summarizing the outcomes of this work, entitled Imagine Indiana Together: The Framework to Advance the Indiana Substance Abuse Prevention System, was prepared by the Governor’s Advisory Panel within the Division of Mental health and Addiction (DMHA), Indiana Family and Social Services Administration. It is available from the DMHA and the Indiana Prevention Resource Center at Indiana University Bloomington (www.prevention.indiana.edu/imagine).

For the first SIG, CSAP required that the Governor form a state advisory council to oversee all of the activities related to the grant. In 2007, Governor Mitch Daniels appointed Sheriff Matt Strittmatter of Wayne County to serve as chair for the Governor’s Advisory Council (GAC) for the SPF-SIG. An additional federal requirement of the SPF-SIG initiative was that Indiana also establish a State Epidemiology and Outcomes Workgroup (SEOW) to collate and analyze available epidemiological data and report findings to the GAC in order to facilitate data-based decision-making regarding substance abuse prevention programming across the state. Twelve community agencies in eleven counties were each awarded $660,000 for the four-year period of time for alcohol, cocaine, and methamphetamine abuse, reduction, and prevention. One of the goals of this grant is to mobilize community efforts across multiple sectors for culture change and population-based impact.

The Drug and Alcohol Consortium of Allen County (DAC) received a county SPF-SIG effective July 1st, 2007 to 2011. In the State Epidemiological indicators, Allen County ranked fourth in the state among the 92 counties for alcohol abuse. Our grant focuses on the reduction of alcohol abuse in Allen County with particular focus on reducing binge drinking amoung18-25 year olds. This epidemiologic report includes data from a wide variety of community sources including 6 student perception of risk surveys, law enforcement, healthcare, census, justice and general population telephone surveys.

Executive Review of the Findings

We know that the majority of young adults who binge drink between the ages of 18 and 25 years old have a history of drinking during their earlier teen years. The majority of the data and information that we have available is based upon secondary education. From national studies and personal observations, we know that young adults and youth do not tend to drink casually. They drink for the express purpose of getting drunk. They binge drink. According to our local research and despite it being illegal, 28.7% of high school seniors report that they binge drink, 29% of the 8th graders drank alcohol in the past year, and 18.3% of 6th graders drank alcohol at some time in their life. Approximately one in every five high school seniors (18.4%) have consumed alcohol more than forty times in their lifetime One out of every ten high school seniors (11.2%) have consumed alcohol forty or more times in the past year. While 67.7% of high school seniors say that their parents would disapprove or strongly disapprove of one or two drinks occasionally, according to our telephone survey of the community, 87% of the respondents said that parents allowing drinking or providing alcohol for minors for social gatherings in their home is a problem in our community.

According to the 2007 PRC Community Health Assessment sponsored by Parkview Health, in Allen County, 14.2% of the adults are binge drinkers, which represent a significant decrease from the binge drinking rate of 24.2% reported in 2003. Four percent of the total area adults report an average of two or more drinks of alcohol per day in the past month. This is similar to Indiana’s state rate of 4.2% of the population who consume two or more drinks per day. In the 2008 DAC telephone survey, more than 10% of those surveyed drank twenty or more drinks in the past thirty days and also drank five or more drinks at a sitting.

The consequences from alcohol abuse are devastating to young brains that have not yet finished the developmental process which continues until age 25. Alcohol can seriously damage long- and short-term growth processes. In addition, short-term or moderate drinking impairs learning and memory far more in youth than in adults. Adolescents need only drink half as much to suffer the same negative effects.

Drug- and alcohol-related arrests account for nearly half (45%) of the total arrests in Allen County. While the number of total crashes declined significantly from 2007 to 2008, the number of alcohol-related crashes slightly increased, the number of fatalities doubled, and the number of alcohol-related fatalities tripled. While this is not good news, the number of alcohol-related crashes is significantly lower in 2007 and 2008 than in previous years. A 2007 review of one 8 hundred hospital-based blood tests conducted on drivers who, according to police-administered breath tests were intoxicated, found that sixty-eight percent were positive for two or more additional drugs as we well as to the alcohol that was present in the drivers’ systems.

In 2008 compared to 2007, the number of minor consuming investigations/arrests rose significantly; arrest tickets issued for possession/consumption/transporting of alcohol by a minor increased by 54%; and arrest tickets to adults for inducing a minor to possess alcoholic beverages increased 63%.

In 2007, the Excise Police conducted a “Survey for Alcohol Compliance” in establishments where it is lawful for youth to patronize, such as grocery stores, convenience stores and restaurants. The rate of non-compliance statewide was 32%. Allen County’s non-compliance rate was 51%. In 2008, the cadets and officers of the Allen County Sheriff’s Department conducted 45 compliance checks of liquor stores in the county. Thirty-one percent of those retailers sold to minors. In the first quarter of 2009, those cadets and officers conducted checks of 37 liquor stores in the county. 13.5% of these retailers sold to minors.

Let us review a key statistic from our studies. Eighty-seven percent of the respondents said that parents allowing or providing alcohol for minors for social gatherings at their home is a problem in our community. It is one that is highly worthy of our best intervention.

Questions or comments about this report should be directed to:

Jerri Lerch Executive Director Project Director, SPF-SIG Drug & Alcohol Consortium of Allen County Phone: (260) 422-8412 FAX: (260) 423-1733 E-mail: [email protected]

Andrew Downs, PhD Indiana University Purdue University at Fort Wayne Chair, Research/LEOW Committee Drug & Alcohol Consortium of Allen County

Stephen Jarrell President, Board of Directors Drug & Alcohol Consortium of Allen County

DDAACC OOrrggaanniizzaattiioonnaall CChhaarrtt

President of the Drug and Alcohol Consortium of Allen County Executive Board of Directors Board of Officers: President, Vice President, Past President, Vice President of Committee Directors Finance/Treasurer and Secretary -H.R. Additional Directors: Chairpersons of each additional standing committee -Membership (Finance, Intervention, Justice, Membership, Prevention, and Public Policy & Research) At –Large Directors: Community leaders representing city government, county Executive Director: government, judicial branch, public education and corporate leadership SPF SIG Advisory Jerri Lerch Committee

ACTIVE MEMBERS AND AFFILIATE MEMBERS

Positive Prevention Justice Finance Intervention Research / Communication/ Pathways Committee Committee Committee Committee LEOW Legislative (ATR) Committee Committee

NAND Committee

Faith Based Committee

Higher Education Committee 1. METHODS & DATA SOURCE LIST

Methods The purpose of the Allen County LEOW is to review local data and identify patterns of consumption and consequences associated with binge drinking in 18-25-year-old individuals in our county. Our LEOW is comprised of local “experts”, individuals who have firsthand understanding of the issue binge drinking and its impact on our community. Ultimately, the members of the LEOW seek to create a data-driven process to better understand and monitor the use of alcohol in Allen County. The LEOW shares its findings with the Local Advisory Council and the community at large. We expect that eventually the work of the LEOW will be used as a model for studying other substance abuse issues facing our area. The members of the LEOW are drawn from local agencies involved in substance abuse prevention that have data that can be useful in understanding what is happening locally. Members represent agencies involved in prevention and intervention projects, law enforcement, the Department of Health, higher education, justice, and healthcare. The LEOW’s work is ongoing and involves monitoring the impact of the final comprehensive strategic plan and emerging challenges.

Activities of the LEOW include: - Identifying potential data sources. - Determining the groups and situations where the use and/or negative consequences associated with binge drinking are most severe. - Identifying the prevailing factors that are driving the patterns the LEOW has identified.

Data gathered by the LEOW is reviewed for relevance to the issue of underage drinking and binge drinking. When appropriate, gross data is “cleaned” of superfluous information not applicable to this project. The remaining information is included in the epidemiologic report, utilized for strategic planning purposes, and made available to the community.

III. LEOW WORK PLAN Each LEOW should begin by developing a work plan that identifies the sources of data to be analyzed and outlines a general framework to guide the analysis and interpretation of those data. Because the primary purpose of the LEOW is to develop a thorough, data-based understanding of what is happening within the local community with regard to the substance priority that they were funded to address, there can be no single set of recommendations that applies to all LEOWs. It is up to each community to develop a plan that works for them. The process the LEOWs will go through, however, will likely be similar to what the SEOW went through in identifying the high need communities. The primary difference is that the LEOWs will need to examine in greater depth the risk and protective factors that are driving the high rates of use and negative consequences associated with the priority for which they were funded. Below, I outline a general framework that LEOWs may wish to consider as they develop their work plan.

Version: October 4, 2007 The steps draw on those the SEOW went through and include some specific strategies that the LEOWs might wish to build into their individual work plan. Step 1: Identify potential data sources. Because many groups are involved in addressing substance abuse, there are many potential sources of data that LEOWs might use, including existing sources as well as ideas for collecting new data. Consequently, the first challenge that LEOWs will need to confront is trying to select most appropriate sources of data. The SEOW began by making a list of all the possible data sources available from the federal government and state agencies, and I would recommend that LEOW’s begin their investigation by constructing such a list (copies of the SEOW’s list of data sources are available in the State Epidemiological Profile, upon request, and online at www.healthpolicy.iupui.edu/SEOW). Once you have your list, the LEOW should discuss the strengths and weaknesses of each data source. Remember, not all data are equal, and there is no such thing as the “perfect” data source. In most cases, you will want to identify a set of data sources so you can examine patterns across different sources. Some things to consider in evaluating each data source are: • What is the nature and extent of the data available from the source? What data elements are included? Are the data simply descriptive (e.g., lists of individuals arrested) or do they include additional information that might permit the identification of subgroups (e.g., age, race, gender, social class, residential location) or the “reasons” behind individuals substance abuse behavior (e.g., attitudes, beliefs, knowledge)? • How recent are the data and are data available for several time periods (e.g., months, years)?

• How reliably are the data collected? That is, are the data collected the same way every time and likely to yield “consistent” results because the data were collected in the same manner every time? • How valid are the data? Do the data accurately reflect what is going on? Are the data collected in such a way that might create systematic “biases”? Are particular stakeholders more likely to be concerned about one type of data over another?

Because all data sources have strengths and weaknesses, scientists and public policy makers generally have greater confidence in the accuracy of conclusions when they are drawn from multiple data sources (e.g., use of alcohol is consistently highest among 18-21 year olds in data on treatment admissions, arrests for public intoxication, and alcohol-related fatal automobile accidents). Indeed, social scientists often try to “triangulate” or compare the patterns observed across several different data sources in order to evaluate the strength or “robustness” of a particular patterns. Thus, LEOWs are strongly encouraged to examine as many different types of data available as possible. Step 2: Determine the groups, locations, and/or situations where the use and/or negative consequences associated with the targeted substance are most severe. Once you have access to your data, you should begin to examine the patterns of use and/or negative consequences associated with the substance your community was funded to address. As noted above, your community was identified as having significantly greater problem than other Indiana counties, but this observation may not be true of all individuals in the target population identified by the SEOW. Therefore, it is probably best to try and identify key sub-populations that are at particularly high risk. You may also wish to examine data regarding other substances, particularly substances that are often used together (e.g., alcohol and marijuana, cocaine, or meth). Indeed, the SEOW noted that co-morbid use of substances is actually somewhat more likely to occur in Indiana than in the nation as a whole.

Version: October 4, 2007 A critical question you will need to answer is “high, compared to what?” Most social science is comparative. Indeed, the SEOW opted to use the national rates of various use and negative consequences measures as a “comparison point.” Local LEOWs could, for example, identify sub-groups that have especially high risk relative to the county rates or numbers overall. Alternatively, you might compare different subpopulations within your community to identify those that have the highest rates (e.g., white men versus African American men). Finally, you may also want to examine trends over various time periods within a single population or set of populations to highlight groups where a problem seems to be expanding dramatically. The list of sub-populations is extensive. You will find, however, that different data sources often contain different kinds of information which limit your ability to look at some sub-populations. To thoroughly understanding what is going on in your community, you may need to compile several data sources to explore the patterns of consumption and negative consequences across different groups.

Key Analysis Question Some Characteristics to Examine

Who are exhibiting the most • Demographic characteristics (e.g., age, significant negative race/ethnicity, gender, socio-economic consequences? status, income, education, sexual orientation) • Known high risk sub-population groups (e.g., commercial sex workers, foster youth, individuals within the criminal justice system)

Step 3: Identify the “intervening,” “causal,” or “risk and protective” factors that are driving the patterns you identify. Once you have a sense of what group(s) you think you should target, you will need to dig deeper and try to understand the factors driving these behaviors. To the extent possible with the data you have, you may be able to explore some of the potential intervening or causal factors driving these behaviors. Fortunately, there is a research literature that can help focus your analysis. Indeed, there are numerous studies that have outlined characteristics that are often associated with risk behavior (i.e., risk factors) as well as characteristics that tend to discourage risk behavior (i.e., protective factors). Your challenge will be to determine which risk and protective factors are operating in your target population. Keep in mind, there are probably multiple risk and protective factors influencing a particular group’s behavior, so your goal should be to identify as many forces as possible, as these will represent the most important “targets” for your strategic planning process. In the table below, we provide some questions to think about as you plan your analysis.

Key Analysis Question Some Characteristics to Examine When, where, and under what conditions are • When and where do these groups use/abuse these groups using/abusing the substance? the substance? Are their particular times of day (e.g., after school) or locations (e.g., a particular street or neighborhood) where they engage in these behaviors? • Are there particular situations when they engage in the behaviors (e.g., at parties, when parents away)? • What individual (e.g., attitudes, knowledge), familial (e.g., family involvement, regulation), social (e.g., peer or community norms), and environmental variables (e.g., exposure to alcohol or tobacco advertising, availability of alcohol) are encouraging or discouraging these groups to engage in problem behavior?

Version: October 4, 2007 Unfortunately, many of the readily available data do not provide a wealth of information about risk and protective factors that you can use to understand what is really happening in your community. In these situations, you may wish to conduct your own study or studies of your community to fill in these gaps. Given the short timeline and limited resources, your LEOW will need to think about what studies would provide the biggest return on investment with regard to your strategic planning process. There are a number of possibilities, however. You might, for example, conduct of brief survey of individuals you identified in Step 2 above to better understand the risk and protective factors influencing their behavior. You might also opt to do some simple observational studies where you count the number of alcohol related advertisements. You might consider conducting face-to-face interviews or focus groups with members of the high risk groups you identified and ask them about when and where they engage in the behavior as well as what individual, familial, social, and environmental factors are shaping the patterns of use/abuse. Collecting original data will require time and resources, and we encourage your LEOW to work closely with the youth and young adults in your community to get involved. Research has shown that youth can be valuable partners in substance abuse prevention research. Not only do they bring a valuable perspective to the project, involvement in the project also serves to reinforce prevention messages in the youth who participate. Of course, there are important challenges in conducting “youth action research” which you should investigate before you launch such a study. Regardless, if your LEOW decides they would like to collect original data to support their decision-making, we strongly encourage you to work closely with your technical assistance provider and the SEOW support staff. There are many existing resources, and we can help you not “reinvent the wheel.” Even more important, where possible, we want to encourage communities to work together with the State so that the data that the individual communities collect can be shared with others to improve all of our understanding of the substance use and abuse challenges we face in the state of Indiana.

IV. USING THE FINDINGS FROM THE LEOW Data-driven decision making requires an accurate and thorough understanding of what is happening. Ultimately, the findings from your LEOW will identify a set of priorities that your LAC will use to develop the required comprehensive strategic plan. Initiatives and programs outlined in your plan should logically follow from the needs identified in your LEOW report. In this regard, your plan is most likely to have a community-level impact when it reflects an in-depth and very detailed understanding of the local situation. Clearly, this is no easy task. The behaviors are complex, and local situations are very dynamic. For this reason, the LEOW’s work will be ongoing, in part, to monitor the impact of the final comprehensive strategic plan but also to monitor emerging challenges and guide community decision-makers to address them. Ultimately, the SPF SIG framework is founded on the idea that data- based decision making and evaluation will improve prevention programming and reduce the burden of substance use and abuse on our communities.

Data Source List This report describes alcohol and drug consumption and consequence patterns for Allen County residents. Following is a list of the data sources used in this report.

Alcohol, Drug Expulsion and Suspension Data Description: Number of expulsions and suspensions involving drugs, weapons or alcohol for most schools in Allen County. Sponsoring Organization/Source: Indiana Department of Education Geographic Level: Allen County Availability: http://www.sis.indiana.edu/ Years: 2006-07, 2007-08

Alcohol Induced Deaths Description: Alcohol Induced Deaths by Age and Sex, Alcohol Induced Deaths by Age and Race, Alcohol Induced Deaths by Age and Ethnicity, proportion of all births, count of all births Sponsoring Organization/Source: Indiana State Department of Health Geographic Level: Allen County Availability: http://www.in.gov/isdh Years: 2001-2005

Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents (ATOD) Survey Description: The Indiana Prevention Resource Center (IPRC) administers this survey regarding alcohol, tobacco, and other drug use among children and adolescents (6th through 12th graders) in a number of schools throughout Indiana. Sponsoring Organization/Source: Indiana Prevention Resource Center (IPRC) and the Indiana Division of Mental Health and Addiction (DMHA) Geographic Level: State, regional, local Availability: Reports with data tables are accessible from the IPRC website: http://www.drugs.indiana.edu/data-survey_monograph.html Year: 2007

Behavioral Risk Factor Surveillance System (BRFSS) Survey Description: BRFSS is a state health survey that monitors risk behaviors related to chronic diseases, injuries, and death. Sponsoring Organization/Source: Centers for Disease Control and Prevention (CDC) and Indiana State Department of Health (ISDH) Geographic Level: National and state Availability: National and state data are available from the CDC at http://apps.nccd.cdc.gov/brfss/. Year: 2006

CDC WONDER Online Query System Description: WONDER online databases utilize an ad-hoc query system for the analysis of public health data. Reports and other query systems are also available. Sponsoring Organization/Source: Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics Geographic Level: National Availability: http://wonder.cdc.gov Years: 1979 – 2004

The Clery Act Report Description: The Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act, codified at 20 USC 1092 (f) as a part of the Higher Education Act of 1965, is a federal law that requires colleges and universities to disclose certain timely and annual information about campus crime and security policies. Sponsoring Organization/Source: Universities in Allen County Geographic level: Local university Availability: http://www.ipfw.edu/police/reports/clery.shtml Year: 2007

Community Telephone Survey Description: 600 phone interviews conducted with 400 interviews being a random selection of and an additional 200 interviews with a random selection of Allen County residents age 18-25. Sponsoring Organization/Source: Drug and Alcohol Consortium of Allen County Geographic level: Allen County Availability: Available through the Drug and Alcohol Consortium of Allen County, 532 W. Jefferson, Fort Wayne, IN Year: 2008

Drug & Alcohol Services Information System (DASIS) Description: The Drug and Alcohol Services Information System (DASIS) is the primary source of national data on substance abuse treatment and has three components: National Survey of Substance Abuse Treatment Services (N-SSATS), Treatment Episode Data (TEDS); Inventory of Substance Abuse Treatment Services. Sponsoring Organization/Source: Offices of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA) Geographic Level: National Availability: Online at http://oas.samhsa.gov. Year:

Healthy People 2010, 2nd Edition Description: Available information includes socio-demographic data for population-based objectives (i.e., race and ethnicity, gender, and socioeconomic status) and operational definitions for objectives that have baseline data. Sponsoring Organization/Source: U.S. Department of Health and Human Services Geographic Level: National Availability: http://wonder.cdc.gov. Years: November 2000

Indiana Traffic Safety Facts Description: The Indiana Traffic Safety Facts are a series of Fact Sheets on various aspects of traffic accidents, including alcohol-related crashes, light trucks, large trucks, speeding, children, motorcycles, occupant protection, and young drivers. Additional briefs provide information on county and municipality data. Sponsoring Organization/Source: Indiana Criminal Justice Institute Geographic Level: Allen County Availability: http://www.in.gov/cji/SAC/traffic/2007/County%20Fact%20Sheet.pdf Year: 2006

Monitoring the Future (MTF) Survey Description: MTF is an ongoing study of youth behaviors, attitudes, and values. Annually, approximately 50,000 students in 8th, 10th, and 12th grades are surveyed. Follow-up surveys are distributed to a sample of each graduating class for a number of years after initial participation. Sponsoring Organization/Source: National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH) Geographic Level: National Availability: Data tables are available at http://www.monitoringthefuture.org/data/data.html Year: 2006

National Institute on Alcohol Abuse and Alcoholism Description Supports and conducts biomedical and behavioral research on the causes, consequences, treatment, ... Sponsoring Organization/Source: National Institute on Alcohol Abuse and Alcoholism Geographic Level: National Availability: http://wwww.niaaa.nih.gov/ Years: 2007

PRC Community Health Surveys Description: Self-reported health status, death and disability, infectious and chronic disease, births, modifiable health risks, access to healthcare, health education and outreach. Sponsoring Organization/Source: Professional Research Consultants and Parkview Health Geographic Level: Northeast Indiana Availability: http://www.prconline.com Years: 2007

PRC National Health Survey Description: A systematic, data-driven approach to identifying the health status, behaviors and needs of Americans. Sponsoring Organization/Source: Professional Research Consultants Geographic Level: National Availability: http://www.prconline.com Years: 2005

Prev-Stat: County Profiles Data Description: PREV-STAT uses GIS software and data from a variety of sources to create county profiles and customized project reports, including maps and tables. PREV-STAT enables you to understand the characteristics of a place, to locate a group of people with particular attributes, or to study a subset of the population of a given locale. Sponsoring Organization/Source: Indiana Prevention Resource Center Geographic Level: Allen County Availability: http://www.drugs.indiana.edu/data-prevstat_pubs.html Years: 2006, 2007

Pride Survey Description: Includes data for alcohol, marijuana, hallucinogens, and cocaine for 6th-12th grade students Sponsoring Organization/Source: PRIDE Geographic Level: Allen County Availability: Hard copy available through the Drug and Alcohol Consortium of Allen County, 532 W. Jefferson, Fort Wayne, IN Year: 1994

Spillman Software System Description: Database for all law enforcement records in Allen County Sponsoring Organization/Source: County of Allen Geographic Level: Allen County Availability: Data only available to a limited number people who have the appropriate passwords Year: 2007 Treatment Episode Data Set (TEDS) Description: TEDS provides information on the demographic and substance abuse characteristics of annual admissions to treatment for abuse of alcohol and drugs in facilities that report to individual state administrative data systems. A treatment episode is defined as the period between the beginning of a treatment service for a drug or alcohol problem (admission) and termination of services. Sponsoring Organization/Source: Substance Abuse and Mental Health Services Administration (SAMHSA) and the Indiana Division of Mental Health and Addiction (DMHA). Geographic Level: State Availability: 2007 TEDS data were acquired from the Inter-university Consortium for Political and Social Research (ICPSR) at http://webapp.icpsr.umich.edu/.

Uniform Crime Reporting (UCR) Program: County-Level Detailed Arrest and Offense Data Description: The UCR program provides a nationwide view of crime based on the submission of statistics by local law enforcement agencies throughout the country. Sponsoring Organization/Source: United States Department of Justice, Federal Bureau of Investigation (FBI) Geographic Level: Allen County Availability: http://www.icpsr.umich.edu/NACJD/ucr.html. Years: 2001-2002 19

2. Description of Allen County

Allen County has a population 347,316 residents, as reported by Allen County IN Depth Profile for 2005. The county population increased almost 44,000 over the last fifteen years. Geographically, Allen County is the largest county east of the Mississippi River. It is the third most populous county in Indiana as of 2005, representing 5.5% of Indiana’s total population, and is racially composed of (as of 2005) 84.4% Caucasian residents, 11.7% African American residents, 1.8% Asian residents, 0.4% Native American, and 5.3% Hispanic residents (with 1.7% in two or more race categories). The Hispanic population has increased 322% in the last 15 years, from 5663 in 1990 to 18,262 in 2005. The 2000 Census data reported the following: 18.8% of the county’s families are headed by single mothers, (up 28% from 1990), 11.3% of the county’s families are headed by single fathers (up 72.2% from 1990).

As one of only fifty federal refugee communities in the country for the last forty years, Allen County hosts diverse international cultures, all with significant needs. Fort Wayne is a moderately-sized urban center where many languages are spoken and there are a variety of levels of literacy. The largest population of Burmese outside of Burma can be found here.

Economic disadvantage is a factor in Allen County. A leading indicator of poverty is single parent households headed by a female, particularly with children under age 5. Forty-five percent of these families had incomes below the poverty level (39th in the state). Twenty-five percent (24.5%) of Allen County’s population is below 200% of the poverty level. In January 2007, the Allen County Criminal Division Services reported the following information regarding their Alcohol Countermeasures Program clients: 632 (32%) of their clients were at or below 125% of the poverty level, an additional 261 (13%) were at or below 150% of the poverty level and 1,102 (55%) were at 200%+ poverty level.

Map 2.1 Indiana Counties

Map 2.2 Allen County Townships

Allen County

Source:http://www.acimap.us/website/allenco

Other cities and towns include:

• New Haven, east of Fort Wayne, with a 2003 population of 13,592. • Leo-Cedarville, in northern Allen County in the growing Cedar Creek Township, with a population of 2,874. • Huntertown, north of Fort Wayne in the growing Perry Township, with 2,335 residents. • Woodburn, in eastern Allen County with 1,629 residents. • Monroeville, in southeastern Allen County, with a population of 1,275. • Grabill, in northeastern Allen County, with a population of 1,147. • Zanesville, a town bordering both Allen County and Wells County, with a population estimate of 602 total in both counties.

REFERENCES, CHAPTER 2

Indiana Prevention Resource Center: Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents (ATOD) Survey http://www.drugs.indiana.edu/data-survey_monograph.htm

Indiana Prevention Resource Center: Community Profiles Data for Allen County. Retrieved January 2009 from http://www.drugs.indiana.edu/search/prevstat

Indiana State Epidemiology and Outcomes Workgroup, 2008 (SEOW ), http://www.policyinstitute.iu.edu/health/publicationDetail.aspx?publicationID=533

Indiana Criminal Justice Institute, Indiana Traffic Safety Facts(2008). County profiles 2007. Retrieved December 2008 from http://www.policyinstitute.iu.edu/PubsPDFs/TrafficBook3_2008%20FINAL.pdf

3. Risk Factors and Protective Factors

Research over the past two decades has tried to determine how drug abuse begins and how it progresses. Many factors can add to a person’s risk for drug abuse. Risk factors can increase a person’s chances for drug abuse, while protective factors can reduce the risk. However, individuals who are at-risk do not necessarily abuse drugs or become addicted. Risk and protective factors can affect children at different stages of their lives. At each stage, risks occur that can be changed through prevention/intervention. Early childhood risks, such as aggressive behavior, can be changed or prevented with family, school, and community interventions that focus on helping children develop appropriate, positive behaviors. If not addressed, negative behaviors can lead to more risks, such as academic failure and social difficulties, which put children at further risk for later drug abuse. Research-based prevention programs focus on intervening early in a child’s development to strengthen protective factors before problem behaviors develop.

Table 3.1 Describes how risk and protective factors affect people in five domains, or settings, where interventions can take place.

Source: http://www.nida.nih.gov/Prevention/risk.html

Risk Factors

Risk factors can influence drug abuse in several ways. The more risks a child is exposed to, the more likely the child will abuse drugs. Some risk factors may be more powerful than others at certain stages in development, such as peer pressure during the teenage years; just as some protective factors, such as a strong parent-child bond, can have a greater impact on reducing risks during the early years. An important goal of prevention is to change the balance between risk and protective factors so that protective factors outweigh risk factors.

Community Risk factors include availability of alcohol and drugs, laws, norms, and extreme economic and social depravation.

Community Risk Factors: Availability of Alcohol

Table 3.2 shows the number of alcohol outlets in Allen County compared to the state in 2007. Outlets also include grocery stores and supermarkets where alcohol is sold.

Table 3.2 Alcohol Sales Outlets Per Capita, (IN AGS, 2007, ATC, 2007)

Allen Co. Indiana

Total Population (2006 est.) 346,350 6,310,320 Number of Outlets (March 2006) 534 11,011 Outlets Per Capita 0.0015 0.0017

Outlets Per 1,000 Persons 1.54 1.74

Community Risk Factors: Laws and Norms

According to Allen County, Indiana Business Data in 2002, there are 44 beer, wine & liquor stores, 81 drinking establishments that serve alcoholic beverages, and 238 full-service restaurants in Allen County. Allen County residents rank 33rd in Indiana for spending on alcohol.

Table 3.3 Per Household Spending on Alcohol,. (AGS, 2007)

Allen County Indiana U.S. Spending on Alcohol for Consumption

Outside the Home 598.9 664.9 621.7 Beer and Ale not at Home 83.7 93 87 Wine away from Home 40.9 45.4 42.5 Whiskey away from Home 68.1 75.6 70.7 Alcohol On Out-Of-Town Trips

73.6 81.7 76.4 Spending on Alcohol for Consumption in the Home 331.1 367.2 343.4 Beer and Ale at Home 177.7 197.1 184.3 Wine at Home

95.8 106.2 99.3 Whiskey at Home 23.3 25.9 24.2 Whiskey and other liquor at home 57.6 63.9 59.7

Median Household Income 49,170.70 54,272.10 48,276.60 Total Spending Per HH as % of Median HH income 1.89137 1.225 1.288 Rank for Spending as % of Median HH Income

Community Risk Factors: Extreme Economic and Social Deprivation

Unemployment is a risk factor. The unemployment rates in Allen County have remained consistent with the rates in state and nation, but in 2005 and 2006 Allen County percentages were greater than the nation percentages.

Table 3.4 Unemployment Rates - Annual (Percents) Allen County Indiana U.S. 2000 2.6 2.9 4 2001 4.3 4.2 4.7 2002 5.1 5.2 5.8 2003 5.7 5.3 6 2004 5.5 5.3 5.5 2005 5.3 5.4 5.1 2006 4.9 5 4.6

Source: Bureau of Labor Statistics, for county and Indiana reported by www.stats.indiana.edu/laus/laus_view3.html

The educational attainment for Allen County residents for those with less a 9th grade education and those who attended high school but did not receive a diploma is less than state and national averages, but still affects 14.3 percent of the population.

Table 3.5 Educational Attainment. (AGS, 2007)

Allen County Indiana U.S.

Less than 9th grade 4.2 5.3 7.5 9th to 12th grade, no

diploma 10.1 12.6 12.1 Total, Less Than 9th or less than HS Diploma

14.3 17.9 19.6 Source: PREV-STAT County Profiles #5 (2008)

A family risk factor is being part of a single parent household. The number of males who are single parents in Allen County is above state and national averages.

Table 3.6 Types of Households w/ Children where one parent is absent

(AGS, 2008) Allen County, IN Indiana U.S.

Lone Parent Male (percent) 11.3 8.3 8.0 Lone Parent Female (Percent) 18.8 24.2 25.8 Single Parent Families (M+F) % 30.1 32.4 33.8 Source: PREV-STAT County Profiles #5 (2008)

Poverty is a community risk factor. The percent of families in poverty in Allen County is close to state percentages, but lower than national percentages. However, more than one-fourth of children living in single parent households in Allen County are living in poverty.

Table 3.7 Families in Poverty as Percent, 2006 est. (Claritas, 2008)

Allen Indiana U.S.

Families with own child under 18 in Poverty as % of all Families with own children under 18 10.2 10.4 13.6 Married Couple Families with Child in Poverty as % of Married Couple 3.0 3.8 6.4

Married Couple Family w Ch in Poverty, % of 16.8 19.2 20.7

Single Dads in Poverty, % of Single Dads 14.2 14.1 17.7

Single Moms in Poverty ,% of Single Moms 31.2 30.4 34.3

Single Parents in Poverty, % of all Single Parents 27.6 26.4 30.5

Source: PREV-STAT County Profiles #5 (2008)

Family Risk Factors include family management problems, family conflict and family attitudes and involvement. The following tables show county children’s earliest interactions occur in the family; sometimes family situations heighten a child’s risk for later drug abuse, for example, when there is:

• a lack of attachment and nurturing by parents or caregivers;

• ineffective parenting; and

• a caregiver who abuses drugs.

But families can provide protection from later drug abuse when there is:

• a strong bond between children and parents;

• parental involvement in the child’s life; and

• clear limits and consistent enforcement of discipline.

Interactions outside the family can involve risks for both children and adolescents, such as:

• poor classroom behavior or social skills;

• academic failure; and

• association with drug-abusing peers.

Source: http://www.nida.nih.gov/Prevention/risk.html

TABLE 3.8 CHILDREN IN HOMES WITH NO PARENT PRESENT (CENSUS 2000, SF3)

Allen Indiana U.S.

Households with children (2003) 47,377 833,017 39,042,996

Non-family Male Head (%) 3.0 1.4 1.1

Non-family Female Head (%) 3.6 0.3 0.3 Total Households w/ Children and No Parent (%) 6.6 1.7 1.4

Source: PREV-STAT County Profiles #5 (2008)

One way to measure family involvement is to look at households where every available Source: PREV-STAT County Profiles #5 (2008) parent is working. In Allen County, according to the 2000 Census, the following percents of children were living in households where both parents work.

TABLE 3.9 HOUSEHOLDS WHERE ALL PARENTS WORK (US CENSUS BUREAU, 2000

Allen County Indiana U.S.

Living with 2 parents 72% 74% 72% Both parents in labor force 46% 48% 43% Father only in labor force 22% 22% 22% Mother only in labor force 2% 2% 3% Living with 1 parent 28% 26% 28% Living with father 5% 6% 6%

In Labor Force

4% 5% 5%

Living with mother 22% 20% 22% In Labor Force 18% 16% 16%

Source: PREV-STAT County Profiles #5 (2008)

Suspensions and Expulsions

In comparing reports from 2006-2007 and 2007-2008, Reports for 2007-2008 shows an increase in suspensions and expulsions for middle school students and a decrease for high school students.

Figure 3.1 Allen County Public School Suspensions and Expulsions Involving Alcohol and/or other drugs: School year 2006-2007

Middle Schools High Schools 208

Figure 3.2 Allen County Public School Suspensions and Expulsions Involving Alcohol and/or other drugs: School year 2007-2008

60 Middle Schools 6 High Schools 88

Protective Factors

Researchers know less about protective factors than they do about risk factors because fewer studies have been done in this area. However, they believe protective factors operate in three ways. First, they may serve to buffer risk factors, providing a cushion against negative effects. Second, they may interrupt the processes through which risk factors operate. Third, recent scientific studies have shown that community resources also can influence individual teenagers’ positive traits. For example, young people are more likely to be a part of youth organizations and sports teams if their parents perceive that the community is safe and that it has good neighborhood and city services (such as police and fire protection or trash pickup). Similarly, youth are more apt to be exposed to good adult role models other than their parents when communities have informal sources of adult supervision, when there is a strong sense of community, when neighborhoods are perceived to be safe, and when neighborhood and city services are functioning.

TABLE 3.10 COMMUNITY PROTECTIVE FACTORS (INFO USA, 2008; INFO USA, 2007; INDIANA STATE LIBRARY, 2008; DEPARTMENT OF EDUCATION, 2008; HEALTHY FAMILIES, 2006; PSUPP, 2006)

Allen Indiana Places of Worship 393 8,886 Youth Serving Agencies 66 1,025 Libraries 14 461 Schools 93 1,950 Healthy Families 1 PSUPP 1 Year 2008 2008

Source: CSAP. Science-Based Prevention Programs and Principles 2002. Rockville: U.S. DHHS, SAMHSA, 2003.

Table 3.11 A Community Assessment of Prevention Programs

Allen County Prevention Programs # of Youth Age of Youth Model Program Agency/Site Served Served Afternoon ROCKS Jennings Recreation Center 200 per year 10-14 years old Afternoon ROCKS Southwick Elementary School 56 in fall of 2008 10-14 years old Afternoon ROCKS Prince Chapman Middle School 53 in fall of 2008 10-14 years old Afternoon ROCKS/Project New Haven Middle School 66 in fall of 2008 Alert 10-14 years old Afternoon ROCKS/Project Miami Middle School-Urban Min. 37 in fall of 2008 Alert 10-14 years old Afternoon ROCKS/Project Miami Middle School-Urban Min. Alert Afternoon ROCKS/Project Lakeside Middle School Alert Afternoon ROCKS/Project Lane Middle School Alert Afternoon ROCKS/Project Portage Middle School 43 in fall 2008 Alert 10-14 years old Afternoon ROCKS Harrison Hill Elementary 51 in fall of 2008 10-14 years old Afternoon ROCKS Metro Youth Sports 62 in fall of 2008 10-14 years old Afternoon ROCKS Boys & Girls Club 22 in fall of 2008 10-14 years old Afternoon ROCKS/Project Union Baptist Church Alert Al's Pals Lifeline Youth & Family Services 45 3-5 years old CRAWL IPFW 50 per year 19 years and up Project Alert Eagle's Nest Youth Center 15-20 12-17 years old Positive Action Urban Ministries Center, Inc. 40 10-14 years old Too Good For Drugs Mental Health Association

Afternoon ROCKS/TGFD Living World of God Ministries 18 in fall of 2008 10-14 years old Afternoon ROCKS/TGFD Old Fort YMCA Afternoon ROCKS/TGFD Maplewood Elem.-Urban Min. 26 in fall of 2008 10-14 years old Afternoon ROCKS/TGFD Jefferson Middle School Scott Academy Elementary Afternoon ROCKS/TGFD School Afternoon ROCKS/TGFD Franke Park Elementary School # of Youth Age of Youth Other Programs Agency Served Served Basketball Program Jennings Recreation Center 600 6-18 years old 3 years - 12th 4H Purdue Extension Services 1,100 grade City Girls Girl Scouts 694 7th-12th grade Decisions: It's Up to You McMillen Center for Health Ed. 3,212 11-13 years old Age of Youth Served Other Programs Agency # of Youth Age of Youth 33

Diga No United Hispanic Americans Up to 20 12-18 years old McMillen Center for Health Drug Free: Way to Be Education 3,128 9-11 years old Gap Powerhouse Youth Center Between 8-12 6th-12th grade Glo Powerhouse Youth Center 60-90 6th-12th grade Head Start CANI 703 3-5 years old HIV/STD Awareness AIDS Task Force 3,000 13-19 years old Mentoring Powerhouse Youth Center 48 6th-12th grade Power Plant Powerhouse Youth Center Up to 25 6th-12th grade Take Care of your Body Student Focus on Health 3,000 13-18 years old What's Up group Powerhouse Youth Center Between 8-12 6th-12th grade Youth as Resources Leadership Fort Wayne 0-300 3-18 years Youth Empowerment AIDS Task Force 700 13-19 years old Youth Leadership Leadership Fort Wayne 320 15-16 years old

Table 3.12 Intervention Programs in Allen County

t apse l e

t /R ercare cute Inpatient cute Inpatient Prevention Prevention Residential Abuse Substance Education Hospitalization Hospitalization Outpatien Intensive Intervention Detoxification Medical Detoxification Detoxification Social Partial/Day A Aft Substance Abuse Group Group Abuse Substance Therapy Individual Family Therapy Family Therapy Outpatien AIDS Task Force A A,T,C,F Allen County Detention Center T T T T T Center for Behavioral Health A A A A A A Community Corrections A A A A Family and Children Services A A,TA A,T,C,FA,T,C,F A A A Freedom House A A Genesis Outreach A A A,F F A.F A A Hope House/Martha's Place A A A Indiana Development House A A Peace Counseling Inc A A A A A A A A Recovery Center - AADP A A A Shepherd's House A A,T,F St. Joe Hospital A A A A A A A A Thirteen Stephouse A A A Transitions A A A,F A A A Vessel House A A A Wise Choices A A,T A A,T,F A=Adult, T=Teen, F=Family, C=Children

REFERENCES, CHAPTER 3

Allen County Indiana Business Data (2002). Retail Availability of Alcohol in Allen County. Retrieved January 2009, from http://www.city-data.com/business2/econ-Allen_County-IN.html

Indiana Prevention Resource Center. (2008) PREV-STAT County Profiles #5 Highlights (2008). Retrieved March 2009 from http://www.drugs.indiana.edu/data-prevstat-factsheet05.html

National Institute on Drug Abuse (NIDA) The Science of Drug Abuse and Addiction, Preventing Drug Abuse Among Children and Adolescents, Risk and Protective Factors, Retrieved January 2009, from http://www.nida.nih.gov/Pevention/risk.html

STATS Indiana (2002-2006), Unemployment rates in Allen County and Indiana, as reported by Indiana Department of Workforce Development (IDWD): Indiana counties & MSAs, Bureau of Labor Statistics: U.S. and 50 states. Retrieved March 2009 from http:// www.stats.indiana.edu/laus/laus_view3.html

4. Alcohol Use in Allen County

According to the 2007 Alcohol, Tobacco, and Drug Use Survey, past month, annual, and lifetime alcohol use are all lower than the state and national rates. The perception of parents in Allen County who would disapprove/strongly disapprove of 1-2 drinks occasionally, students who see a moderate-great risk in having 1-2 drinks occasionally, peers who would approve/strongly approve of 1-2 drinks occasionally, and peers who would approve/strongly approve of binge drinking weekly are very close to the state rates. The perception of parents who would disapprove/strongly disapprove of binge drinking weekly in Allen County are higher than the state rates for 9th-12th grades. The number of Allen County students reporting that there is moderate-great risk in binge drinking weekly is higher than the state rate. The number of students in Allen County who have engaged in binge drinking in the past two weeks are at or lower than the state number. Youth who obtained alcohol in Allen County received it primarily from someone older than 21 or by having someone else buy it. The reasons most often given in Allen County for why youth chose to drink were to experiment, because it tastes good, and to fit in with friends. Note that higher numbers are expected in the 2009 ATOD Survey, due to the participation of out largest school district.

Problems and Costs Associated with Underage Drinking in Indiana

Underage drinking cost the citizens of Indiana $1.3 billion in 2005. Costs include work loss, medical care, and pain and suffering associated with the multiple problems resulting from the use of alcohol by youth.1 In 2005, underage drinkers consumed 17.2% of all alcohol sold in Indiana, totaling $384 million in sales. These sales provided profits of $186 million to the alcohol industry.

Violence involving youth and motor vehicle crashes attributable to underage drinking are very costly to the state of Indiana, yet an array of other problems contribute to the overall cost. Among the children of teen mothers, fetal alcohol syndrome (FAS) alone costs Indiana $22.7 million.

Table 4.1 Cost of Underage Drinking by Problem, Indiana 2005

Total Costs Problem (in millions)

Youth Violence $677.9

Youth Traffic Crashes $338.6

High-Risk Sex, Ages 14-20 $118.5

Youth Property Crime $60.6

Youth Injury $36.1

Poisonings and Psychoses $9.5

Fetal Alcohol Syndrome Among Mothers Age 15-20 $22.7

Youth Alcohol Treatment $57.7

Total $1,321.6

Figure 4.1 Cost of Underage Drinking, Indiana 2005

Costs of Underage Drinking, Indiana 2005

Work Lost Costs, $306m Pain & Suffering Medical Costs, Costs, $867m $148m

1 Miller, TR, Levy, DT, Spicer, RS, & Taylor, DM. (2006) Societal costs of underage drinking Journal of Studies on Alcohol, 67(4) 519-528 2 Grant, B.F., & Dawson, D.A. (1997). Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: Results from the Nation Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse 9: 103-110. 3 Office of Applied Studies, Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set (TEDS). (2004). Substance Abuse Treatment by Primary Substance of Abuse, According to Sex, Age, Race, and Ethnicity. 4 Center for Disease Control (CDC). (2005). Youth Risk Behavior Surveillance System (YRBSS).

Adverse Effects of Alcohol

Alcohol can produce a variety of adverse effects at different stages of use. Stages of use

include acute ingestion of moderate amounts, severe intoxication, chronic ingestion, withdrawal, and effects as a result of malnutrition. Mental and psychiatric adverse events

include anxiety, panic, sedation, euphoria, irritability, restlessness, aggressiveness, violence,

depression, sleep disturbances, memory and cognitive deficits, confabulation, hallucinations,

and delusions. Figure 4.2 Affect of Alcohol use Across a Lifespan

FAS Cumulative Binge Organ Drinking Damage Consequences

Alcoholic Family Alcohol Medications Environment Dependence Interactions

O - O - 1 - 3

Zero Zero ≤One ≤ Three underage drinking drink per Drinks per drinking and driving hour occasion Source:pubs.niaaa.nih.gov

Fetal Alcohol Syndrome

Alcohol (wine, beer, or liquor) is the leading known preventable cause of mental and physical birth defects in the United States. When a woman drinks alcohol during pregnancy, she risks giving birth to a child who will pay the price — in mental and physical deficiencies — for his or her entire life. Yet many pregnant women do drink alcohol. About 1 in 12 pregnant women in the United States reports alcohol use, and about 1 in 30 pregnant women in the United States reports binge drinking (having five or more drinks at one time). (www.cdc.gov/ncbddd Department of Health and Human Services)

It's estimated that each year in the United States, 1 in every 750 infants is born with a pattern of physical, developmental, and functional problems referred to as fetal alcohol syndrome (FAS), while another 40,000 are born with fetal alcohol effects (FAE). FASD is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. It refers to conditions such as fetal alcohol syndrome (FAS), fetal alcohol effects (FAE), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD). (http://fascenter.samhsa.gov/)

Signs and Symptoms of Fetal Alcohol Syndrome

Characteristics of FAS include:

• low birth weight • small head circumference • failure to thrive • developmental delay • organ dysfunction • facial abnormalities, including smaller eye openings, flattened cheekbones, and indistinct philtrum (an underdeveloped groove between the nose and the upper lip) • epilepsy • poor coordination/fine motor skills • poor socialization skills, such as difficulty building and maintaining friendships and relating to groups • lack of imagination or curiosity • learning difficulties, including poor memory, inability to understand concepts such as time and money, poor language comprehension, poor problem-solving skills • behavioral problems, including hyperactivity, inability to concentrate, social withdrawal, stubbornness, impulsiveness, and anxiety

Children with FAE display the same symptoms, but to a lesser degree.

Diagnosis and Long-Term Effects

Problems associated with FAS tend to intensify as children move into adulthood. These can include mental health problems, troubles with the law, and the inability to live independently.

Kids with FAE are frequently undiagnosed. This also applies to those with alcohol-related neurodevelopmental disorder (ARND), a recently recognized category of prenatal damage that refers to children who exhibit only the behavioral and emotional problems of FAS/FAE without any signs of developmental delay or physical growth deficiencies.

Often, in kids with FAE or ARND, the behavior can appear as mere belligerence or stubbornness. They may score well on intelligence tests, but their behavioral deficits often interfere with their ability to succeed. Extensive education and training for the parents, health care professionals, and teachers who care for these kids are essential. (http://kidshealth.org/parent/medical/brain/fas.html#)

Epidemiology

Birth defects related to these disorders can be prevented by avoiding alcohol ingestion during pregnancy. Although FASD is more strongly associated with higher levels of alcohol consumption compared with lower levels, animal studies have suggested that even a single episode of consuming the equivalent of two alcoholic drinks during pregnancy may lead to loss of fetal brain cells (one drink = 12 oz of beer, 5 oz of wine, or 1.5 oz of "hard" liquor). Despite widespread knowledge of alcohol's deleterious effects, a study of women between 18 and 44 years of age showed that 10 percent used alcohol during pregnancy and that 2 percent engaged in "binge drinking" (i.e., five or more drinks on one occasion). Maternal factors that increase the risk of FASD include being older than 30 years, a history of binge drinking, and low socioeconomic status.

Figure 4.3 Serving sizes of alcoholic beverages

When Alcohol Affects a Fetus

The dark portions of the bars represent the periods of greatest vulnerability, the lighter portions represent periods of time in which alcohol could cause minor structural abnormalities. Because central nervous system development is occurring throughout the gestation period, consumption of alcohol is a concern at every stage. Figure 4.4 Fetal Development Chart

Source: Centers for Disease Control and Prevention

Damage to the Brain

Areas of the brain that can be damaged in utero by maternal alcohol consumption:

• Cerebrum: Largest portion of the brain, including the cerebral hemispheres (cerebral cortex and basal ganglia); involved in controlling consciousness and voluntary processes. • Corpus callosum: A bundle of fibers connecting the brain's hemispheres. • Hippocampus: Part of the limbic system, which is involved in emotional aspects of survival behavior; also plays a role in memory. • Basal ganglia: A group of structures lying deep in the brain; involved in movement and cognition. • Cerebellum: Involved in maintenance of posture, balance and coordination. 42

Figure 4.5 Areas of the brain that can be damaged in utero by maternal alcohol consumption:

• Cortex: Outer layer of gray matter covering the surface of the cerebrum and the cerebellum. • Neocortex: Outermost portion of the cerebral cortex; contains the most structurally complex brain tissue. • Septal area: Related to the limbic system, which is involved in emotional aspects of survival behavior. • Thalamus: Communication center that relays information to the cerebral cortex. • Hypothalamus: Important in maintaining the body's internal environment, or homeostatis, through the receipt of sensory and chemical input.

Figure 4.6 Brain of a normal baby and a brain of a baby with FAS

The brain of a normal baby (left) and the brain of a baby with fetal alcohol syndrome (right). Source: www.fasarizona.com

Characteristic Features of a Child with Fetal Alcohol Syndrome Several physical characteristics are common among children with FAS. They are shown in the figures 4.7, 4.8, and 4.9.

Figure 4.8. Characteristic facial features in a child with fetal alcohol spectrum disorders. Findings may include a smooth philtrum, thin upper lip, upturned nose, flat nasal bridge and midface, epicanthal folds, small palpebral fissures, and small head circumference.

Lip-Philtrum Guide. (A) The smoothness of the philtrum and the thinness of the upper lip are assessed individually on a scale of 1 to 5 (1 = unaffected, 5 = most severe). The patient must have a relaxed facial expression, because a smile can alter lip thinness and philtrum smoothness. Scores of 4 and 5, in addition to short palpebral fissures, correspond to fetal alcohol syndrome. (B) Guide for white patients. (C) Guide for black patients.

Figures 4.9 & 4.10 Characteristic features of an ear and a hand of a child with FAS

Characteristic features of an ear of a Characteristic features of a hand of a child child with fetal alcohol spectrum with fetal alcohol spectrum disorders. Note disorders. Note the underdeveloped the curved fifth finger (clinodactyly) and the upper part of the ear parallel to the upper palmar crease that widens and ends ear crease below ("railroad track" between the second and third fingers appearance). ("hockey stick" crease). Source: http://www.aafp.org/afp/20050715/279.html 45

Table 4.2 The Number of Children in Indiana and Allen County Affected by FAS According to the Indiana Birth Defects and Problems Registry (IBDPR):*

2003 2004 2005 2006 Number of Children reported to IBDPR by Birth Year 26 29 17 14 Number of Children with Only One Reportable Condition 10 11 3 5 Number of Children with More Than One Reportable Condition 16 18 14 9

*Only those conditions which have been confirmed or which have been determined to be highly probable on the Chart Audit Process are included in the data.

In Allen County, the confirmed and probable counts and rates of a newborn affected by maternal alcohol use for 2003-2004 births is 10 of the 10,097 live births, which is .99%. For comparison’s sake, in Marion County, 5 of their 27,982 live births were affected by maternal alcohol use, a rate of .18%.

Surgeon General's Advisory on Alcohol Use in Pregnancy

Thirty-two years ago, United States researchers first recognized fetal alcohol syndrome (FAS). The discovery of FAS led to considerable public education and awareness initiatives informing women to limit the amount of alcohol they consume while pregnant. But since that time, more has been learned about the effects of alcohol on a fetus. It is now clear that no amount of alcohol can be considered safe.

Based on the current, best science available we now know the following:

• Alcohol consumed during pregnancy may cause alcohol related birth defects, including growth deficiencies, facial abnormalities, central nervous system impairment, behavioral disorders, and impaired intellectual development. • No amount of alcohol consumption can be considered safe during pregnancy. • Alcohol can damage a fetus at any stage of pregnancy. Damage can occur in the earliest weeks of pregnancy, even before a woman knows that she is pregnant. • The cognitive deficits and behavioral problems resulting from prenatal alcohol exposure are lifelong. • Alcohol-related birth defects are completely preventable.

For these reasons:

1. A pregnant woman should not drink alcohol during pregnancy.

2. A pregnant woman who has already consumed alcohol during her pregnancy should stop in order to minimize further risk.

3. A woman who is considering becoming pregnant should abstain from alcohol. 4. Recognizing that nearly half of all births in the United States are unplanned, women of childbearing age should consult their physician and take steps to reduce the possibility of prenatal alcohol exposure. 5. Health professionals should inquire routinely about alcohol consumption by women of childbearing age, inform them of the risks of alcohol consumption during pregnancy, and advise them not to drink alcoholic beverages during pregnancy. www.surgeongeneral.gov

Alcohol and the Adolescent Brain

The average age of a child's first drink is now 12, and nearly 20 percent of 12 to 20 year-olds are considered binge drinkers. While many believe that underage drinking is an inevitable "rite of passage" that adolescents can easily recover from because their bodies are more resilient, the opposite is true. Alcohol can seriously damage long- and short-term growth processes. In addition, short-term or moderate drinking impairs learning and memory far more in youth than in adults. Adolescents need only drink half as much to suffer the same negative effects.

The Adolescent Brain From early adolescence through their mid-20s, a the brain goes through dynamic change and develops from back to front. The parts of the adolescent brain which develop first are those which control physical coordination, emotion and motivation. The part of the brain which controls reasoning and impulses, known as the Prefrontal Cortex (see the figure below), is near the front of the brain and, therefore, develops last. Because this part of the brain does not fully mature until the age of 25, it can have noticeable effects on adolescent behavior. These effects include:

• difficulty holding back or controlling emotions,

• a preference for physical activity,

• a preference for high excitement and low effort activities (video games, sex, drugs, rock 'n' roll),

• poor planning and judgment (rarely thinking of negative consequences),

• more risky, impulsive behaviors, including experimenting with drugs and alcohol. The use of drugs and alcohol may disrupt the development of the adolescent brain in unhealthy ways, making it harder for teens to cope with social situations and the normal pressures of life.

Figure 4.11 The areas of the brain

Another part of the brain region that is highly involved in memory formation and learning and suffers from the worst alcohol-related brain damage in teens is the hippocampus. Those who had been drinking more and for longer had significantly smaller hippocampi (10 percent). The hippocampus is an old cortical structure located deep within a region of the brain known as the temporal lobes (see the figure 4.3). The temporal lobes run along the sides of your brain at about the level of the temples.

Figure 4.12 The hippocampus

Moreover, the brain's reward circuits (the dopamine system) get thrown out of whack when under the influence. This causes a teen to feel in a funk when not using drugs or drinking alcohol - and going back for more only makes things worse. All drugs of abuse overload the body with dopamine — in other words, they cause the reward system to send too many "feel-good" signals. In response, the body's brain systems try to right the balance by letting fewer of the "feel-good" signals through. As time goes on, the body needs more of the drug to feel the same high as before. This effect is known as "tolerance."

The effects of drugs on the brain don’t just end when the high wears off. When a person stops taking a drug, his dopamine levels are low for some time. He may feel down, or flat, and unable to feel the normal pleasures in life, even when meeting a basic life need. His brain will eventually restore the dopamine balance by itself, but it takes time — anywhere from hours to days, or even months, depending on the length and amount of abuse and the person.

Drinkers vs. non-drinkers: research findings

• Adolescent drinkers scored worse than non-users on vocabulary, general information, memory,

memory retrieval, and at least three other tests

• Verbal and nonverbal information recall was most heavily affected, with a 10 percent performance

decrease in alcohol users

• Significant neuropsychological deficits exist in early to middle adolescents (ages 15 and 16) with

histories of extensive alcohol use

• Adolescent drinkers perform worse in school, are more likely to fall behind, and have an increased

risk of social problems, depression, suicidal thoughts, and violence

• Alcohol affects the sleep cycle, resulting in impaired learning and memory as well as disrupted

release of hormones necessary for growth and maturation

• Alcohol use increases risk of stroke among young drinkers

Figure 4.13 How alcohol may harm mental function

Lasting implications

Compared to students who drink moderately or not at all, frequent drinkers may never be able to catch up in adulthood, since alcohol inhibits systems crucial for storing new information as long-term memories and makes it difficult to immediately remember what was just learned.

Additionally, those who binge once a week or increase their drinking from age 18 to 24 may have problems attaining the goals of young adulthood—marriage, educational attainment, employment, and

51 financial independence. Rather than "outgrowing" alcohol use, young abusers are significantly more likely to have drinking problems as adults.

Alcohol Use among School-Aged Youth

Table 4.3 Grade of First Alcohol Use in Indiana

6th 7th 8th 9th 10th11th 12th

Has not engaged in 76.7 66.8 54.5 47.9 38.4 34.9 29.8 drinking Has engaged in drinking 20.2 29.8 41.7 48.3 57.5 61.3 70.2

No Answer 3.1 3.4 3.8 3.8 4.1 3.8 0

Figure 4.14 Age of First Alcohol Use in Indiana

18.0

16.0

14.0

12.0

10.0 6th grade 7th grade 8.0 8th grade 9th grade 6.0 10th grade 4.0 11th grade 12th grade 2.0

0.0

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 4.15 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Alcohol Use

40 Allen County 30 Indiana 20 National

0 6th Grade7th Grade8th Grade9th Grade 10th 11th 12th Grade Grade Grade

Figure 4.16 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Alcohol Use

50 45 40 35 30 25 Allen County 20 Indiana 15 National 10 5 0 6th Grade 7th Grade 8th Grade 9th Grade 10th 11th 12th Grade Grade Grade

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 4.17 Percentage of Allen County Students Reporting Lifetime Alcohol Use

90.0 80.0 70.0 60.0 No Answer 50.0 Never 40.0 1‐5 times 30.0 6‐19 times 20.0 20‐40 times 10.0 40+ times 0.0 6th 7th 8th 9th 10th 11th 12th grade grade grade grade grade grade grade

Figure 4.18 Percentage of Indiana Students Reporting Lifetime Alcohol Use

90.0

80.0

70.0

60.0 No Answer 50.0 Never

40.0 1‐5 times 6‐19 times 30.0 20‐40 times 20.0 40+ times 10.0

0.0 6th 7th 8th 9th 10th 11th 12th grade grade grade grade grade grade grade

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 4.19 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Alcohol Use

40 Allen County

30 Indiana National 20

0 6th 7th 8th 9th 10th 11th 12th Grade Grade Grade Grade Grade Grade Grade

Figure 4.20 Percentage of Allen County and Indiana Middle and High School Students Reporting that their Peers would Approve/Strongly Approve of 1-2 Drinks Occasionally

50 45 40 35 30 25 Allen County 20 Indiana 15 10 5 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 4.21 Percentage of Allen County and Indiana Middle and High School Students Reporting that their Peers would Approve/Strongly Approve of Binge Drinking

15 Allen County Indiana 10

0 6th 7th 8th 9th 10th 11th 12th

Figure 4.22 Percentage of Allen County and Indiana Middle and High School Students Reporting their Perception of Parents Who Would Disapprove/Strongly Disapprove of 1-2 Drinks Occasionally

90 80 70 60 50 Allen County 40 Indiana 30 20 10 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 4.23 Percentage of Allen County and Indiana Middle and High School Students Reporting their Perception of Parents Who Would Disapprove/Strongly Disapprove of Binge Drinking Weekly

82 Allen County 80 Indiana 78

74 6th 7th 8th 9th 10th 11th 12th

Figure 4.24 Percentage of Allen County and Indiana Middle and High School Students Reporting that there is Moderate-Great Risk in Having 1-2 Drinks Occasionally

45 40 35 30 25 Allen County 20 Indiana 15 10 5 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 4.25 Percentage of Allen County and Indiana Middle and High School Students Reporting that there is Moderate-Great Risk in Binge Drinking Weekly

80 78 76 74 72 70 Allen County 68 Indiana 66 64 62 60 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Table 4.4 Binge Drinking in the Past Two Weeks in Indiana (Percentage)

6th 7th 8th 9th 10th 11th 12th

Has not engaged in binge drinking 89.2 86.6 82.4 78.1 73.2 71.9 66.8

Has engaged in binge drinking 4.9 8.3 13.2 16.9 21.7 23.2 28.6

No Answer 5.9 5.1 4.4 5 5.1 4.9 4.6

Figure 4.26 Binge Drinking in the Past Two Weeks in Indiana

8 Once Twice 6 3‐5 Times

4 6‐9 Times 10+ Times 2

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Table 4.5 Binge Drinking in the Past Two Weeks in Allen County (Percentage)

6th 7th 8th 9th 10th 11th 12th

Has not engaged in binge drinking 91.3 83.4 83.5 78.7 73.4 71.4 66.4

Has engaged in binge drinking 4.3 8 8.1 13 17.5 21.3 28.6

No Answer 4.4 8.6 8.4 8.3 9.1 7.3 5

Figure 4.27 Binge Drinking in the Past Two Weeks in Allen County

Once 8 Twice

6 3‐5 Times 6‐9 Times 4 10+ Times

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Table 4.6 Main Source of Alcoholic Beverages in the Past Month in Indiana (Percentage)

6th 7th 8th 9th 10th 11th 12th

Has not engaged in drinking 81.9 77.9 71.3 66.1 60.2 57.7 51.9

Has engaged in drinking 7 12 19 22.6 28.2 30 35.4

No Answer 11.1 10.1 9.7 11.3 11.6 12.3 12.7

Figure 4.28 Main Sources of Alcoholic Beverages in the Past Month in Indiana

14 12 10 8 6th 6 7th 4 2 8th 0 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Table 4.7 Main Source of Alcoholic Beverages in the Past Month (Percentage)

6th 7th 8th 9th 10th 11th 12th

Has not engaged in drinking 83.9 76.4 73.8 67.8 62 57.2 51.4

Has engaged in drinking 6 9.2 12.8 19 23.4 28.8 35.6

No Answer 10.1 14.4 13.4 13.2 14.6 14 13

Figure 4.29 Main Sources of Alcoholic Beverages in the Past Month in Allen County

4 6th 7th 2 8th 9th 0 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Table 4.8 Most Important Reasons for Drinking in Indiana (Percentage)

6th 7th 8th 9th 10th 11th 12th

Has not engaged in drinking 83.9 76.4 73.8 67.8 62 57.2 51.4

Figure 4.30 Most Important Reasons for Drinking in Indiana

10 6th

7th 5 8th 0 9th

10th 11th

12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Table 4.9 Most Important Reasons for Drinking in Allen County (Percentage)

6th 7th 8th 9th 10th 11th 12th

Has not engaged in drinking 83 76.4 67.3 59 48.2 43.6 38.8

Figure 4.31 Most Important Reasons for Drinking in Allen County

20 18 16 14 12 10 8 6th 6 4 7th 2 8th 0 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Relationship Between Higher Education and Alcohol Abuse – Studies show that students who enroll in high school or college but fail to achieve the desired diploma are at an increased risk for development of alcohol abuse or dependence during adulthood compared to persons with college degrees or postgraduate education. Specifically, individuals who dropped out of high school were more than six times more likely to develop alcohol abuse or dependence, and those who entered college but failed to get a degree were three times more likely to develop alcohol abuse or dependence, than were those with a college degree. Furthermore, adults who left school before completing the ninth grade were also at increased risk relative to those with a college degree.

Other characteristics found to be associated with risk of alcohol abuse or dependence were male gender; being separated or divorced, being widowed, or never having married; and becoming intoxicated for the first time before the age of 18 years. Currently working for pay was associated with a lower risk of alcoholism. (Crum RM, Bucholz KK, Helzer JE, Anthony JC. Am J EpidemioL 1992;135:989-999.)

Table 4.10 Allen County Graduates to Higher Education, 2003-2006

2003 2004 2005 2006

Total Graduates 3,484 3,014 3,700 4,216

3,363 3,830 Total to Higher Education 3,151 2,165

Four-Year 2,673 1,639 2,711 3,042

Two-Year 287 269 398 462

Vocational/Tech 191 257 254 326

Source: Indiana Department of Education

Table 4.11 Percent of Allen County High School Education Intent, 2007

High School Graduates Higher Education Intent, 2007

Pct. Dist. Indiana Pct. Dist.

Graduates 100.00% 100.00%

Total Going on to Higher 91.20% 83.20% Education

Four-Year Institution 74.00% 60.90%

Two-Year Institution 11.20% 15.40%

Vocational and Tech. 6.00% 6.90%

Military 2.20% 2.60%

Gender Trends on Campus

Allen County is mirroring the national trend of women outnumbering men on the college campus. In Indiana, females outnumber men three to two. Here is the analysis of gender in colleges in Allen County.

Figure 4.32 College Enrollment by Gender by Percentage

Indiana Allen

41% Female 44% Female 59% 56% Male Male

Table 4.12 Allen County University Attendance by Gender

Male Female

Concordia Theological Seminary 354 36

Taylor University 173 290

Indiana Institute of Technology 1,019 865

Ivy Tech Community College (Fall ’06) 2,732 4,278

University of Saint Francis 627 1,508

Indiana University-Purdue University 5,143 6,800

Clery Data on Allen County colleges with five of the six campuses having on campus housing.

Table 4.13 Number of Arrests or Persons Referred for Campus Disciplinary Action

Arrests - On campus Total arrests on campus Law Violation 2005 2006 2007 A. Drug law violation 3 0 5 B. Liquor law violation 0 1 16

Number of people referred for Disciplinary Disciplinary Actions- On campus Action on campus Law Violation 2005 2006 2007 A. Drug law violation 22 15 10 B. Liquor law violation 109 139 313

Arrests -On campus Resident Halls Total arrests on campus Law Violation 2005 2006 2007 A. Drug law violation 3 0 4 B. Liquor law violation 0 1 7

Clery Safety: Annual Security Report

Indiana Counties: Alcohol-related Crashes, Alcohol Testing, and BAC Results Indiana counties exhibit considerable variation in total and alcohol-related fatalities, rates of alcohol testing, and reported BAC results. In 2007, alcohol-related fatalities averaged 27.5 percent of total fatalities across counties.

Crash Statistics for Allen County, Indiana

While the number of total crashes declined significantly from 2007 to 2008, the number of alcohol-related crashes slightly increased, the number of fatalities doubled, and the number of alcohol-related fatalities tripled. While this is not good news, the number of alcohol-related crashes is significantly lower in 2007 and 2008 than in previous years.

Figure 4.33 Total Crashes - Allen County, Indiana

12000 11004 10486 9886 10000 9241 8800 8595 8217 8000

ACSD 6000 FWPD NHPD

4000

2809 2632 2346 2310 2178 2000 1762 1831

397 278 355 368 352 346 270 0 2002 2003 2004 2005 2006 2007 2008 Year

Figure 4.34 Total ATOD-Related Crashes - Allen County, Indiana

450 419

400

358 343 350 328

300

261 251 250 ACSD FWPD 200 NHPD

150

107 107 99 100 91 77 68 50 50 22 14 13 8 10 9 10 0 0 2002 2003 2004 2005 2006 2007 2008 Year

Figure 4.35 Total Crash Fatalities - Allen County, Indiana

30 28

20 19 18 17

15 ACSD 15 14 14 13 FWPD 12 NHPD

10 9 8 8

5 5 4 3 2 1 1 1 0 0 0 2002 2003 2004 2005 2006 2007 2008

Year

Figure 4.36 ATOD-Related Fatalities - Allen County, Indiana

14 14

10 9

8 ACSD 8 FWPD NHPD

6 5 5

444 44 4 3

2 11 1

0000000 0 2002 2003 2004 2005 2006 2007 2008 Year

Figure 4.37 Crashes and Fatalities in Allen County 2005

19 Total Crashes 473 31 Alcohol Related Crashes 11800 Alcohol Related Fatalities

12 Other Fatalities

Figure 4.38 Crashes and Fatalities in Allen County 2006

5 Total Crashes

338 Alcohol Related Crashes 10 13181 Alcohol Related Fatalities

Other Fatalities 5

Figure 4.39 Crashes and Fatalities in Allen County 2007

5 Total Crashes 352 Alcohol Related Crashes 20 11821 Alcohol Related Fatalities Other Fatalities 15

Figure 4.40 Crashes and Fatalities in Allen County 2008

20 Total Crashes 480 25 Alcohol Related Crashes 12000 Alcohol Related Fatalities 5 Other Fatalities

Figure 4.41 Allen County Arrests for 2007

OWI arrests 3,697

narcotic s‐related arrests 6,629 Total Arrests 21,391

Figure 4.42 Allen County Arrests for 2008

OWI Arrests 3,674

Narcotics‐ related arrests 6,847

Total Arrests 23,084

Source: Spillman

Blood Test results

In a sample of 100 blood tests from September 2006 to May 2007 collected from individuals arrested for operating a motor vehicle while intoxicated, the following results were collected:

• 100% of blood tests were positive for alcohol. • 32% were positive for alcohol alone. • 42% were positive for alcohol and two other drugs. • 16% were positive for alcohol and three other drugs. • 10% were positive for alcohol and four other drugs.

Other than alcohol, the other drugs detected in the blood tests included:

• 42% were positive for marijuana. • 22% were positive for cocaine. • 19% were positive for benzodiazepines. • 7% were positive for opiates. • 6% were positive for amphetamines • 5% were positive for barbiturates. • 3% were positive for methadone.

Juvenile Investigations/Arrests for Alcohol or Alcohol-Related Offenses

The number of Minor Consuming Investigations/Arrests rose significantly in 2008 compared to 2007 as noted in Table 4.14 below:

Table 4.14 Minor Consuming Investigations/Arrests 2007 2008

Allen County Sheriff’s Dept. 109 102

Fort Wayne PD 142 309 estimated

New Haven PD 109 85

Total 360 496 73

The number of citations issued to juveniles and the number of juveniles arrested by the Indiana State

Excise Police increased when comparing 2007 to 2008 as seen in the chart below:

Table 4.15 Citations issued to juveniles/juvenile arrests 2007 2008

Citations to permit location for Minor in Tavern 5 5

Citations to permit location for Sales of Alcohol to a Minor 8 14

Arrest tickets issued for Possession of False Identification 10 62

Minors arrested for Minor in Tavern/Liquor Store 42 96

Arrest Tickets issued for Possession/Consumption/Transporting of Alcohol by a Minor 95 177

Juvenile arrested for OWI 0 1

The number of arrest tickets issued to adults by the Indiana State Excise Police for their actions related to minors consuming are as follows:

Table 4.16 The number of arrest tickets issued to adults 2007 2008

Arrest tickets to adults furnishing alcoholic beverages for minors 4 4

Arrest tickets to adults for inducing a minor to possess alcoholic beverages 12 19

Alcohol Compliance Checks

In 2007, the Excise Police conducted a “Survey for Alcohol Compliance” in establishments where it is lawful for youth to patronize, such as grocery stores, convenience stores, and restaurants. The rate of non-compliance statewide was 32%. Allen County’s non-compliance rate was 51%. The breakdown is as follows:

Table 4.17 Compliance Checks for 2007

Non- Compliance Permit Type Pass Fail Total Checks Rate for Type Restaurant 56 79 135 59% Grocery/Pharmacy 38 19 57 33% Total 94 98 192 51%

In 2008, the Cadets and officers of the Allen County Sheriff’s Department conducted compliance checks of liquor stores in the county. The results of those checks were as follows:

Table 4.18 Compliance Checks for 2008 Number Who Sold Total Stores Number Cited During Stores Checked in: to Minors Checked June & July Checks June 2007 8 29 N/A

July 2007 6 16 2

Total 14 45 2

In the first quarter of 2009, the cadets and officers of the Allen County Sheriff’s Department conducted compliance checks of 37 liquor stores in the county. The results of those checks were as follows:

Table 4.19 Compliance checks for first & second quarter 2009 Number Who Sold Total Stores Number Cited During Stores Checked in: to Minors Checked 1st Quarterly Checks First Quarter January-March 5 37 5 Second Quarter April - June 6 35 6

Total 11 72 11

Drug Testing of Juvenile Offenders

As juveniles enter probation or the Juvenile Justice Center, they are tested for drugs. The findings for the last eight years are shown in the chart below. Please note that the Justice Center has switched the brand/type of test they use, and that a more significant amount of the toxin is required to produce a positive test result. This equates to a reduction in number of positive test results. However, it is still apparent that many teens use marijuana, methamphetamine, or cocaine. Table 4.20 Drug testing results of juvenile offenders

2001 2002 2003 2004 2005 2006 2007 2008

Juvenile Probation Clients 843 997 1002 1278 1832 2038 1913

Number of Samples Produced 5941 7220 6029 5238 9152 7447 8622 8655

Tested Positive - Marijuana 723 909 941 551 1327 731 991 278

% Positive - Marijuana 12.17 12.59 12.45 10.5 14.5 9.88 11.5 3.2

Tested Positive - Amphetamine 78 129 80 107 129 171 n/a n/a

% Positive - Amphetamine 1.31 1.78 1.33 2 1.4 2.31 n/a n/a

Tested Positive - Cocaine N/A 17 22 17 124 46 22 18

% Positive - Cocaine N/A 0.23 0.36 0.32 1.3 0.62 2.22 0.21

Juveniles at Juvenile Justice Center 2833 2833 2611 3874 3107 7873 2332 2290

Number of Samples Produced 3775 3707

Tested Positive - Marijuana, Meth or Cocaine 1060 1077 953 1225 1046 1118 1208 495

% Positive - Marijuana, Meth or Cocaine 37 37.9 33.7 31.9 33.7 14.2 32 13.4

Chronic Drinking - According to the 2001-2007 PRC Community Health Assessment sponsored by Parkview Health, the percentage of total area adults who reported an average of two or more drinks of alcohol per day in the past month has increased from 0.6% in 2001 to 4.0% in 2007.

Figure 4.43

Chronic Drinkers (Allen County, 2001- 2007) 6.0%

5.0% 4.0% 4.0% 3.4% 3.0%

2.0%

1.0% 0.6%

0.0% 2001 2003 2007

Binge Drinking - According to the 2001-2007 PRC Community Health Assessment sponsored by Parkview Health, the percentage of total area adults who reported that there is generally one or more times during a typical month during which they drink five or more drinks on a single occasion has increased from 4.8% in 2001 to 14.2% in 2007. Figure 4.44

Drinking & Driving - According to the 2001-2007 PRC Community Health Assessment sponsored by

Binge Drinkers (Allen County, 2001-2007) 30.0% 24.2% 25.0%

20.0% 14.2% 15.0%

10.0% 4.8% 5.0%

0.0% 2001 2003 2007 77

Parkview Health, the percentage of total area adults who reported having driven a vehicle in the past month after they had perhaps too much to drink has increased from 4.8% in 2001 to 5.1% in 2007.

Figure 4.45

Have Driven in the Past Month After Perhaps Having Too Much to Drink (Allen County, 2001-2007)

5.25% 5.15% 5.10% 5.10% 5.05% 4.95% 4.85% 4.80% 4.75% 4.65% 4.55% 2001 2003 2007

Source: • 2001-2007 Community Health Assessment sponsored by Parkview Health • PRC Community Health Surveys, Professional Research Consultants. © PRC 2001-2007 • Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2005 Indiana data. • 2005 PRC National Health Survey, Professional Research Consultants. © PRC 2005 • Healthy People 2010, 2nd Edition. U.S. Department of Health and Human Services. Washington, DC: U.S. Government Printing Office, November 2000. [Objective 26-11c] • CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted April 2007.

Alcohol and Mortality

Mortality is the most commonly used indicator of the severity of health problems. The causes of death presented in the following data are either directly or indirectly associated with alcohol. The death rate was determined by applying a fraction that represents the association that each cause of death has with alcohol. An example of a death directly linked with alcohol abuse is alcohol cirrhosis of the liver. This type of death is counted as one death in computing the mortality rate. In contrast, a chronic pancreatitis death is linked indirectly with alcohol abuse, and therefore is counted as a fraction of a single death. Chronic pancreatitis was assigned a fraction (.60 of a death) to represent the proportion of pancreatitis deaths that are associated with prior alcohol abuse. Deaths indirectly linked with substance abuse contribute significantly to the overall proportion of deaths. If the death rate calculation had been limited to causes that were directly related to substance abuse, then many deaths indirectly related to alcohol and drugs would have remained unrecognized. The alcohol and drug associated fractions used for the mortality data came from The Substance Abuse and Mental Health Services Administration.

The registration of deaths is a state function. Physicians, hospitals, laboratories and other health care entities are required to submit death reports to the Indiana State Department of Health. All deaths were classified according to codes in the World Health Organization's International Statistical Classification of Diseases (ICD).

Alcohol-Induced Deaths

Table 4.21: Alcohol-Induced Deaths by Age and Gender for Allen County Residents, Indiana, 2002- 2006 Age Group Male Female Total 18-24 0 1 1 25-34 3 0 3 35-44 16 5 21 45-64 39 12 51 65+ 9 4 13 Total 67 22 89

Table 4.22: Alcohol-Induced Deaths by Age and Race for Allen County Residents, Indiana, 2002- 2006 Age Group White Black Other Total 18-24 0 1 0 1 25-34 2 1 0 3 35-44 18 3 0 21 45-64 39 11 1 51 65+ 8 5 0 13 Total 67 21 1 89

Table 4.23: Alcohol-Induced Deaths by Age and Ethnicity for Allen County Residents, Indiana, 2002-2006 Age Group Hispanic Non-Hispanic Total 18-24 0 1 1 25-34 1 2 3 35-44 1 20 21 45-64 1 50 51 65+ 0 13 13 Total 3 86 89 National Center for Health Statistics (NCHS) ICD-10 Codes for alcohol-induced deaths. ICD-10 Code Classification E24.4 Alcohol-induced pseudo-Cushing's syndrome F10 Mental and behavioral disorders due to alcohol use G31.2 Degeneration of nervous system due to alcohol G62.1 Alcoholic polyneuropathy G72.1 Alcoholic myopathy I42.6 Alcoholic cardiomyopathy K29.2 Alcoholic gastritis K70 Alcoholic liver disease K86.0 Alcohol-induced chronic pancreatitis R78.0 Finding of alcohol in blood X45 Accidental poisoning by and exposure to alcohol X65 Intentional self-poisoning by and exposure to alcohol Y15 Poisoning by and exposure to alcohol, undetermined intent

Alcohol-induced causes exclude accidents, homicides, and other causes indirectly related to alcohol use. This category also excludes newborn deaths associated with maternal alcohol use. Source: Indiana State Department of Health, PHSDD, Data Analysis Team

REFERENCES, CHAPTER 4 Allen County Police Department (2008). Local data on ATOD related arrests, traffic violations and compliance check data.

Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2005 Indiana data.

Center for Disease Control (CDC). (2005). Youth Risk Behavior Surveillance System (YRBSS). Centers for Disease Control and Prevention.(2008).Fetal Alcohol Syndrome. Retrieved February 2009, from http://cdc.gov/ncbddd/fas/

CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted April 2007.

Community Health Assessment sponsored by Parkview Health 2001-2007 Fort Wayne Police Department (2008). Spilman data on ATOD related arrests and traffic violations. Grant, B.F., & Dawson, D.A. (1997). Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: Results from the Nation Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse 9: 103-110.

Healthy People 2010, 2nd Edition. U.S. Department of Health and Human Services. Washington, DC: U.S. Government Printing Office, November 2000. [Objective 26-11c]

Indiana Prevention Resource Center. (2008). Alcohol, tobacco, and other drugs use by Indiana Children and adolescents. Retrieved February 2009 from http://www.drugs.indiana.edu/data-survey- monograph.html Indiana State Department of Health, PHSDD, Data Analysis Team.(2001-2005). Retrieved March 2009 from http://www.in.gov/isdh/reports/natality/2005/index.htm

KidsHealth Comes From Nemours Foundation. Fetal Alcohol Syndrome. Retrieved January 2009 from http://kidshealth.org/parent/medical/brain/fas.html Miller, TR, Levy, DT, Spicer, RS, & Taylor, DM. (2006) Societal costs of underage drinking Journal of Studies on Alcohol, 67(4) 519-528 National Archive of Criminal Justice Data, Inter-university Consortium for Political and Social Research, University of Michigan. (n.d.). Uniform Crime Reporting Program. Retrieved June 3, 2008, from http://www.icpsr.umich.edu/NACJD/.

National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2008). Affect of Alcohol use Across a lifespan. Retrieved February 2008 from http://pubs.niaaa.nih.gov/publications/AA74/AA74.htm

Office of Applied Studies, Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set (TEDS). (2004). Substance Abuse Treatment by Primary Substance of Abuse, According to Sex, Age, Race, and Ethnicity.

PRC Community Health Surveys, Professional Research Consultants. © PRC 2001-2007

PRC National Health Survey, Professional Research Consultants. © PRC 2005

Substance Abuse and Mental Health Services Administration, Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence (2008). Retrieved January 2009 from http://fascenter.samhsa.gov/

5. Alcohol and Drug Treatment Episodes and Admissions Data

The Treatment Episodes Data Set (TEDS) provides counts of patients that received services from state funded substance abuse treatment programs. States, in this case the Indiana Division of Mental Health and Addiction (DMHA), report the TEDS annually to the Substance Abuse and Mental Health Services Administration’s Office of Applied Studies. Presently, Indiana DMHA does not collect discharge data, therefore they apply a formula to estimate the number of treatment episodes in a given year. A treatment episode is defined as the period between the beginning of a treatment service for a drug or alcohol problem (admission) and the termination of services. In Tables 5.1 and 5.2 the dependence of the substance listed is defined as “individuals reporting the listed substance to be their primary substance at the time of their substance abuse treatment admission.”

Table 5.1 Number of Allen County Residents in Substance Abuse Treatment Who Reported using Alcohol or Drugs. Drugs listed were reported as the Primary Substance at Admission, 2007.

e Use Heroin Alcohol Cocaine Marijuana Heroin use Cocain use Alcohol Use Alcohol Use Dependence Dependence Dependence Dependence Marijuana Use e Dependence Methamphetamin Methamphetamin

894 688 582 318 264 147 12 4 21 9

Table 5.2 Number of Allen County Residents in Substance Abuse Treatment Who Reported using prescription Drugs as their Primary Substance at Admission, 2007.

Prescription Drug Abuse Drug Prescription Dependence Pain Reliever Abuse Pain Reliever Dependence Sedative & Tranquilizer Abuse Sedative & Tranquilizer Dependence Stimulant Abuse Stimulant Dependence 29 4 4 3 2 0 2 1

Table 5.3 Combination of Drugs used by Poly-substance Abusers in Substance Abuse Treatment, 2007 Combinations # % Alcohol, Marijuana 269 41 Alcohol, Cocaine 140 21.3 Alcohol, Cocaine, Marijuana 120 18.3 Cocaine, Marijuana 59 9 Alcohol, Marijuana, unknown drug 44 6.7 Alcohol, opiates/synthetics 24 3.7 656 Source: Indiana Family and Social Services Administration, Revenue Enhancement and Data, 2008

Figure 5.1 Combined treatment modality categories are Detoxification, Rehabilitation/Residential, and Ambulatory. The combined drug of abuse categories are alcohol, marijuana/hashish, cocaine/crack and others.

500 450 400 350 300 2005 250 2006 200 150 100 50 0 17 24 34 44 64 ‐ ‐ ‐ ‐ ‐ 0 over

18 25 35 45

and

Ages 65

Source: http://www.sis.indiana.edu/EpisodeDrugQuery.aspx?county=Allen

REFERENCES, CHAPTER 5

Indiana Family and Social Services Administration, Revenue Enhancement and Data. (2008). Substance abuse population by county, 2006-2007. Indianapolis, IN: Indiana Family and Social Services Administration.

Indiana Prevention Resource Center. (2007) County-level Epidemiological Indicators query episode data by year and social demographics and treatment modality. Retrieved February 2009 from http://www.sis.indiana.edu/EpisodeDrugQuery.aspx

Substance Abuse and Mental Health Data Archive. (2008). Treatment Episode Data Set (TEDS) Series. Retrieved June 3, 2008, from Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services: http://webapp.icpsr.umich.edu/cocoon/SAMHDA- SERIES/00056.xml

6. Other Substance Use In Allen County

MARIJUANA

Source: www.marijuana-picture.com

Marijuana is the most commonly abused illicit drug in the United States. 36 million Americans age 12 and older have used marijuana daily or almost daily, according to the 2007 National Survey on Drug Use and Health (NSDUH)( Substance Abuse and Mental Health Services Administration. Results from the 2007 National Survey on Drug Use and Health: National Findings.)

Figure 6.1 Long-Term Trends in Life Marijuana Use by 12-th Graders

Marijuana is a green, brown, or gray mixture of dried, shredded leaves, stems, seeds, and flowers of the hemp plant (Cannabis sativa). It usually is smoked as a cigarette (joint, nail), or in a pipe (bong). It also is smoked in blunts, which are cigars that have been emptied of tobacco and refilled with marijuana, often in combination with another drug. It might also be mixed in food or brewed as a tea. As a more concentrated, resinous form it is called hashish and, as a sticky black liquid, hash oil the strongest form that has very high levels of THC, the psychoactive ingredient in cannabis.

Marijuana frequently is combined with other drugs, such as crack cocaine, PCP, formaldehyde, and codeine cough syrup, sometimes without the user being aware of it. Thus, the risks associated with marijuana use may be compounded by the risks of added drugs, as well (Community Epidemiology Work Group. Epidemiologic Trends in Drug Abuse, Vol. II, Proceedings of the Community Epidemiology Work Group. December 2003).

Figure 6.2 Synonyms for Marijuana

Weed, Pot Ganga, Chronic, Skunk Boom

Gangster Reefer, Herb

Love boat Mary Jane or Tical PCP

Wicky or Marijuana PCP Crack Cocaine Happy Primo sticks

Crack Cocaine

Aunt Mary Woolies

Bubble Hash Gum Northern Lights Afghani #1

Source: Community Epidemiology Work Group. Epidemiologic Trends in Drug Abuse, Vol. II, Proceedings of the Community Epidemiology Work Group. December 2003

The main active chemical in marijuana is THC (delta-9-tetrahydrocannabinol). The membranes of certain nerve cells in the brain contain protein receptors that bind to THC. Once securely in place, THC kicks off a series of cellular reactions that ultimately lead to the high that users experience when they smoke marijuana.

Figure 6.3 Marijuana’s Affect on the Brain

Marijuana's Effects on the Brain

Brain Region Functions Associated With Region

Brain regions in which cannabinoid receptors are abundant

Cerebellum Body movement coordination

Hippocampus Learning and memory

Cerebral cortex, especially Higher cognitive cingulate, frontal, and parietal functions When marijuana is smoked, its active ingredient, THC, regions travels throughout the body, including the brain, to produce its many effects. THC attaches to sites called Nucleus accumbens Reward cannabinoid receptors on nerve cells in the brain, affecting the way those cells work. Cannabinoid receptors are abundant in parts of the brain that Basal ganglia Movement regulate movement, coordination, learning and • Substantia nigra pars reticulata control memory, higher cognitive functions such as judgment, and pleasure. • Entopeduncular nucleus • Globus pallidus • Putamen

Brain regions in which cannabinoid receptors are moderately concentrated

Hypothalamus Body housekeeping functions (body temperature regulation, salt and water balance, reproductive function)

Amygdala Emotional response, fear

Spinal cord Peripheral sensation, including pain

Brain stem Sleep and arousal, temperature regulation, motor control

Central gray Analgesia

Nucleus of the solitary tract Visceral sensation, nausea and vomiting Source: http://www.nida.nih.gov/Infofacts/marijuana.htm

Addictive Potential

Long-term marijuana abuse can lead to addiction for some people; that is, they abuse the drug compulsively even though it interferes with family, school, work, and recreational activities. Drug craving and withdrawal symptoms can make it hard for long-term marijuana smokers to stop abusing the drug. (Haney M, Ward AS, Comer SD, et al. Abstinence symptoms following smoked marijuana in humans. Psychopharmacology 141(4):395–404, 1999.) figure 6.4 Effects of Marijuana

Marijuana Short Term Effects Long Term Effects Impaired memory and Respiratory Problems ability to learn • Persistent coughing, symptoms of bronchitis and more frequent chest colds are possible symptoms Difficulty thinking and • Benzyprene, a known human carcinogen, is present in problem solving marijuana smoke.

Anxiety attacks or feelings • Regardless of the THC content, the amount of tar of paranoia inhaled by marijuana smokers and the level of carbon monoxide are 3 to 5 times higher than in cigarette smoke. Impaired muscle Memory and learning • coordination and judgment Recent research shows that regular marijuana use compromises the ability to learn and to remember information by impairing the ability to focus, sustain, and shift attention.

Increased susceptibility to Marijuana impairs short-term memory and decreases

infections motivation to accomplish tasks, even after the high is over.

Dangerous impairment of Fertility driving skills. Long-term marijuana use suppresses the production of Cardiac problems for hormones that help regulate the reproductive system. people with heart disease For men, this can cause decreased sperm counts and or high blood pressure, very heavy users can experience erectile dysfunction. because marijuana increases the heart rate

Source: www.brown.edu/Student_Services/Health_Services/Health_Education/atod/resources.htm#3

Marijuana Use Among School-Aged Youth

According to the 2007 ATOD Survey and 2006 MTF Survey, marijuana usage rates in Allen County are lower than state and national averages in all categories except for daily usage among 10th graders.

Figure 6.5 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Marijuana Use

25 Allen County

20 Indiana National 15

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 6.6 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Marijuana Use

20 Allen County

15 Indiana National 10

0 6th 7th 8th 9th 10th 11th 12th

Figure 6.7 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Marijuana Use

20 18 16 14 12 Allen County 10 Indiana 8 National 6 4 2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 6.8 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting

Daily Marijuana Use

Allen County 3 Indiana

2 National

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

METHAMPHETAMINE

Methamphetamine (meth) is a very addictive stimulant drug that activates certain systems in the brain. It is chemically related to amphetamine but, at comparable doses, the effects of methamphetamine are much more potent, longer lasting, and more harmful to the central nervous system (CNS).

Meth initially sends a message to the pleasure center in the brain. When a person first uses meth, he/she might feel alert, full of energy and self-confident. The brain is releasing dopamine - a brain chemical that carries messages between brain cells. Dopamine is associated with feelings of pleasure, usually after food or sex. Hours after taking meth, brain cells release an enzyme that stops the dopamine flow. If a person keeps taking meth, he/she will potentially lose the ability to experience pleasure.

Figure 6.9 Eroding the Mind

Methamphetamine is taken orally, intranasal (snorting the powder), by needle injection, or by smoking. Abusers may become addicted quickly, needing higher doses and more often. At this time, the most effective treatments for methamphetamine addiction are behavioral therapies such as cognitive behavioral and contingency management interventions. “Poor Man's Cocaine" is one slang term for Meth - for good reason. Meth generally costs the same or less than crack cocaine (ranging from $25 to $100 per gram) but because the user's body metabolizes it more slowly, the high lasts much longer. Users tend to believe they get "more bang for their buck" with meth. An intense rush is felt almost immediately when a user smokes or injects meth. Snorting the drug affects the user about five minutes later; it takes about twenty minutes for the rush to kick in if a user ingests meth.

Figure 6.10 Synonyms for Methamphetamine

Poor chalk Man's Cocaine glass

tweak crystal

METH

zip speed

crank ice

tina

Source: http://www.mappsd.org/HowMethAffects.htm

Methamphetamine is a Schedule II stimulant, which means it has a high potential for abuse and is available only through a prescription that cannot be refilled. It can be made in small, illegal laboratories, where its production endangers the people in the labs, neighbors, and the environment. Street methamphetamine is referred to by many names, such as "speed," "meth," and "chalk." Methamphetamine hydrochloride, clear chunky crystals resembling ice, which can be inhaled by smoking, is referred to as "ice," "crystal," "glass," and "tina." (http://www.mappsd.org/How0MethAffects.htm).

Figure 6.11 Symptoms of Methamphetamine

People who are on Meth will show one or more of the following signs:

High body temperature with excessive sweating from cooking their internal organs

Acne type sores from scratching Pale face

Signs and Symptoms of Meth Use

Body odor of Thin from glue or weight loss mayonnaise

Dental decay with blackened or yellow teeth

Addiction Meth users suffer the same addiction cycle and withdrawal symptoms as do crack cocaine users. Both drugs lead to binging - consuming the drug continuously for three or more days without sleep. While cocaine binges rarely last longer than 72 hours, meth binges can last up to two weeks. The user is then driven into a severe depression followed by paranoia and aggression (known as tweaking). When heavy cocaine users experience paranoia, it almost always disappears once the binge ends. With meth, severe mood disturbances, bizarre thoughts and behavior may last for days - sometimes weeks - and the user loses a grip on reality.

Meth use causes both short- and long-term affects - physical as well as mental. Some people mistakenly believe meth is less harmful than crack, cocaine or heroin, but because of the ingredients used in its manufacturing, there is a greater chance of suffering a heart attack, stroke or serious brain damage with meth than with other drugs. It is far more dangerous than the meth which was popular back in the 1950s and '60s. Today's ephedrine-based meth can kill you. (http://www.mappsd.org/How%20Meth%20Affects.htm).

Figure 6.12 Effects of Methamphetamine Methamphetamines Short Term Effects Long Term Effects

increased wakefulness problems with muscle rigidity and tremors

increased physical reduced motor speed and impaired verbal learning activity

decreased appetite emotional and cognitive problems

confusion aggressiveness

increased respiration extreme anorexia

rapid heart rate memory loss

irregular heartbeat severe dental problems

increased blood increased risk of stroke pressure

For intravenous (IV) methamphetamine users, there is increased risk of hepatitis or HIV infection, and endocarditis (inflammation of the inner layer of the heart).

Source: www.brown.edu/Student_Services/Health_Services/Health_Education/atod/resources.htm#3

Meth Labs

The number of meth labs found by police in Indiana increased by a third last year. The number, 1,059, is the second-highest annual total in the history of the Indiana State Police. The Fort Wayne district found the most labs in the state, more than double the previous year’s total. Noble County – historically one of the most active counties for meth production – led the state with 80 labs discovered. Of the 228 labs discovered in northeast Indiana, nearly four out of five were in the counties that make up the northeast corner of the state: DeKalb, LaGrange, Noble and Steuben. DeKalb County borders Allen County. The majority of the meth lab busts beginning in the spring of 2008 were “one-pot” methods. This method, often done in 2-liter soda bottles, produces less of the drug and doesn’t create as many noxious fumes as a typical meth lab. The new production method is different, but still dangerous. Vapors must be let out of the bottles or they can explode, and the chemicals can cause burns. Two northeast Indiana counties were among the top 10 most active in the state last year:

Table 6.1 Top Ten Indiana Counties with Highest Number of Meth Lab Seizures

County Number of Meth Labs Busts Noble 80 Elkhart 65 Decatur 54 Miami 51 Venderburgh 47 LaGrange 45 Perry 44 Knox and Posey 42 Marshall 41

Table 6.2 The Annual Clandestine Laboratory Responses for Allen County since 1992

Year Total 1992-2001 0 2002 1 2003 1 2004 4 2005 6 2006 2 2007 2 2008 13

Map 6.1 Meth Lab Siiesures in Indiana 2008

Meth Use Among School-Aged Youth

According to the 2007 ATOD Survey and 2006 MTF Survey, methamphetamine usage in Allen County in each of the categories of use is lower than state or national rates with the exception of 7th grade annual usage and 6th, 7th, 8th and 11th grade past month usage.

Figure 6.13 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Methamphetamines Use

5 4.5 4 3.5 3 Allen County 2.5 Indiana 2 National 1.5 1 0.5 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 6.14 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Methamphetamines Use

2.5

2 Allen County 1.5 Indiana National 1

0.5

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 6.15 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Methamphetamines Use

1.6 1.4 1.2

1 Allen County 0.8 Indiana 0.6 National 0.4 0.2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Amphetamines

Amphetamine is a prescription Central Nervous System stimulant commonly used to treat attention- deficit disorder (ADD) and attention-deficit hyperactivity disorder (ADHD) in adults and children. It is also used to treat symptoms of traumatic brain injury, the daytime drowsiness symptoms of narcolepsy, and chronic fatigue syndrome. Initially, it was more popularly used to diminish the appetite and to control weight. Brand names of the drugs that contain amphetamine include Adderall and Dexedrine. The drug is also used illegally as a recreational club drug and as a performance enhancer. Psychological effects of amphetamine could include euphoria, a sense of well being, increased alertness, increased concentration, increased talkativeness, increased energy, excitability, feeling of power or superiority, repetitive behaviors, increased aggression, and in rare cases, paranoia. Effects are similar to cocaine, especially when insufflated or injected. According to the 2007 ATOD Survey and 2006 MTF Survey, amphetamine usage in Allen County in each of the categories of use is lower (or equal to in 6th grade) than state or national rates.

Figure 6.16: Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Amphetamines Use

8 Allen County 6 Indiana 4 National

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

100

Figure 6.17 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Amphetamines Use

9 8 7 6 5 Allen County 4 Indiana 3 National 2 1 0 6th 7th 8th 9th 10th 11th 12th

Figure 6.18 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Amphetamines Use

4 3.5 3 2.5 Allen County 2 Indiana 1.5 National 1 0.5 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

101

COCAINE

Source: www.usdoj.gov/dea/images_cocaine.html

Cocaine is a powerfully addictive stimulant drug that is snorted, sniffed, injected, or smoked. The powdered, hydrochloride salt form of cocaine can be snorted or dissolved in water and injected. Crack is cocaine that has been processed from cocaine hydrochloride to a free base for smoking. This form of cocaine comes in a rock crystal that can be heated and its vapors smoked. The term "crack" refers to the crackling sound heard when it is heated.

Figure 6.19 Synonyms for Cocaine

Nose candy Star- spangled Yao powder

Sugar Snow boogers

COCAINE

White Flake dragon

Fast white Blow lady Devil's dandruff

102

Cocaine and Alcohol an Added Danger: Cocaethylene When people mix cocaine and alcohol consumption, they are compounding the danger each drug poses and unknowingly forming a complex chemical experiment within their bodies. NIDA-funded researchers have found that the human liver combines cocaine and alcohol and manufactures a third substance, cocaethylene, that intensifies cocaine's euphoric effects, while potentially increasing the risk of sudden death.

Figure 6.20 Effects of Cocaine

Cocaine

Short Term Effects Long Term Effects

erratic • Cardiovascular problems, including irregular heartbeat, heart attack, and heart failure

delusional Sleeplessness or sexual dysfunction

paranoid Diminished sense of smell or perforated nasal septum

violent Nausea, and headaches

psychotic Pulmonary effects

Psychiatric complications Source:• www.brown.edu/Student_Services/Health_S raises blood pressure ervices/Health_Education/atod/resources.htm#3

• Increases heart rate Increased risk of traumatic injury from accidents and aggressive

Source: www.brown.edu/Student_Services/Health_Services/Health_Education/atod/resources.htm#3

103

Crack Cocaine Use Among School-Aged Youth

According to the 2007 ATOD Survey and 2006 MTF Survey, crack usage in Allen County is at or near the state and national rates, with the exception of past month use among 12th graders.

Figure 6.21 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Crack Use

3.5

2.5

Allen County 2 Indiana

1.5 National

0.5

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

104

Figure 6.22 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Crack Use

2.5

2 Allen County 1.5 Indiana 1 National

0.5

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

Figure 6.23 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Crack Use

5 Allen County 4 Indiana 3 National

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

105

Other Drug Use Among School-Aged Youth Heroin According to the 2007 ATOD Survey and 2006 MTF Survey, lifetime and annual heroin usage is higher among Allen County students in the 7th, 11th, and 12th grades. For past month use, Allen County rates are equal to or higher than national rates, and higher than the state rate in 11th grade.

Figure 6.24 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Heroin Use

2.5

2 Allen County 1.5 Indiana 1 National 0.5

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

106

Figure 6.25 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Heroin Use

2.5

1.5 Allen County

1 Indiana National 0.5

0 6th 7th 8th 9th 10th 11th 12th

Figure 6.26 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Heroin

1.2

0.8 Allen County 0.6 Indiana 0.4 National 0.2

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

107

Tranquilizers

According to the 2007 ATOD Survey and 2006 MTF Survey, lifetime, annual, and past month tranquilizer use in Allen County is equal to or below all state averages. However, it is higher than the national average for 8th and 10th grades.

Figure 6.27 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Tranquilizer Use

16 14 12 10 Allen County 8 Indiana 6 National 4 2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

108

Figure 6.28 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Tranquilizer Use

10 9 8 7 6 Allen County 5 4 Indiana 3 National 2 1 0 6th 7th 8th 9th 10th 11th 12th

Figure 6.29 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Tranquilizer Use

4 Allen County 3 Indiana 2 National 1

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

109

Rohypnol

According to the 2007 ATOD Survey, Allen County is equal or below state averages for lifetime use; above state averages for annual use among 11th and 12th grades; and above the state average for past month usage for 11th grade.

Figure 6.30 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Rohypnol Use

1.8 1.6 1.4 1.2 1 Allen County 0.8 0.6 Indiana 0.4 0.2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

110

Figure 6.31 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Rohypnol Use

1.4

1.2 1 0.8 Allen County 0.6 Indiana 0.4

0.2 0 6th 7th 8th 9th 10th 11th 12th

Figure 6.32 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Rohypnol Use

0.9 0.8 0.7 0.6 0.5 Allen County 0.4 0.3 Indiana 0.2 0.1 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

111

Ritalin According to the 2007 ATOD Survey, lifetime Ritalin usage rates are equal to below state rates. Annual and past month Ritalin use is above state rates in 11th and 12th grades.

Figure 6.33 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Ritalin Use

6 Allen County

4 Indiana

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

112

Figure 6.34 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Ritalin Use

9 8 7 6 5 Allen County 4 3 Indiana 2 1 0 6th 7th 8th 9th 10th 11th 12th

Figure 6.35 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Ritalin Use

4 3.5 3 2.5 2 Allen County 1.5 Indiana 1 0.5 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

113

Steroids

According to the 2007 ATOD Survey and 2006 MTF Survey, all three categories of use are equal to or below state and national rates with the exception of the 11th grade.

Figure 6.36 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Steroids Use

2.5

2 Allen County 1.5 Indiana 1 National 0.5

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

114

Figure 6.37 Percentage of Allen County, Indiana, and U.S. Middle and High School Students

Reporting Annual Steroids Use

2 1.8 1.6 1.4 1.2 Allen County 1 0.8 Indiana 0.6 National 0.4 0.2 0 6th 7th 8th 9th 10th 11th 12th

Figure 6.38 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Steroids Use

1.4 1.2 1

0.8 Allen County 0.6 Indiana 0.4 National 0.2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey, and 2006 Monitoring the Future Survey

115

Narcotics

According to the 2007 ATOD Survey, Allen County usage rates are lower than the state rates with the exception of the 6th grade in annual and past month usage.

Figure 6.39 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Narcotics Use

14 12 10 8 Allen County 6 Indiana 4 2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey, and 2006 Monitoring the Future Survey

116

Figure 6.40 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Narcotics Use

9 8 7 6 5 Allen County 4 3 Indiana 2 1 0 6th 7th 8th 9th 10th 11th 12th

Figure 6.41 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Narcotics Use

4.5 4 3.5 3 2.5 Allen County 2 1.5 Indiana 1 0.5 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

117

Over the Counter Drugs

According to the 2007 ATOD Survey, Allen County usage rates for over the counter drugs are lower than the state rates in each of the categories of use.

Figure 6.42 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Over the Counter Drug Use

16 14 12 10 8 Allen County 6 Indiana 4 2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

118

Figure 6.43 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Over the Counter Drug Use

6 Allen County

4 Indiana

0 6th 7th 8th 9th 10th 11th 12th

Figure 6.44 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Over the Counter Drug Use

7 6 5 4 Allen County 3 Indiana 2 1 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

119

LSD

According to the 2007 ATOD Survey and 2006 MTF Survey, lifetime usage of LSD in Allen County is below or equal to state and national rates in 6th, 7th, 8th, and 9th grades. They are higher than the national rate for 10th grade and 12th grade, and higher than the state rate for 11th grade. For annual usage, Allen County rates are higher than state and national rates in 6th, 11th, and 12th grades. For past month LSD usage, Allen County rates are higher than the state rates in 6th grade, 11th grade, and 12th grade, and higher than all national rates.

Figure 6.45 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime LSD Use

4 Allen County 3 Indiana 2 National 1

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

120

Figure 6.46 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual LSD Use

4.5 4 3.5 3 2.5 Allen County 2 Indiana 1.5 National 1 0.5 0 6th 7th 8th 9th 10th 11th 12th

Figure 6.47 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month LSD Use

2.5

1.5 Allen County

1 Indiana National 0.5

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

121

Injected Drugs

According to the 2007 ATOD Survey, Allen County rates are above state rates in 11th and 12th grades for lifetime usage. For annual usage, rates in 7th and 11th grade are higher in Allen County than Indiana. Rates for 6th and 11th grade in Allen County are higher for past month usage than they are for Indiana.

Figure 6.48 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Injected Drug Use

2.5

1.5 Allen County

1 Indiana

0.5

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

122

Figure 6.49 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Injected Drug Use

2.5

1.5 Allen County 1 Indiana

0.5

0 6th 7th 8th 9th 10th 11th 12th

Figure 6.50 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Injected Drug Use

2 1.8 1.6 1.4 1.2 1 Allen County 0.8 Indiana 0.6 0.4 0.2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

123

Inhalants

According to the 2007 ATOD Survey and 2006 MTF Survey, all inhalant use is lower across the board in Allen County as compared to the state and national rates, with the exception of a slight increase in past month usage among 12th graders.

Figure 6.51 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime Inhalants Use

18 16 14 12 10 Allen County 8 Indiana 6 National 4 2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

124

Figure 6.52 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual Inhalants Use

10 9 8 7 6 Allen County 5 4 Indiana 3 National 2 1 0 6th 7th 8th 9th 10th 11th 12th

Figure 6.53 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month Inhalant Use

4.5 4 3.5 3 2.5 Allen County 2 Indiana 1.5 National 1 0.5 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

125

MDMA

According to the 2007 ATOD Survey and 2006 MTF Survey, lifetime MDMA usage in Allen County is lower than in the state or nation. Annual usage is lower in Allen County with the exception of a slight increase in 12th grade. Past month usage is lower in Allen County with the exception of 6th and 11th grades.

Figure 6.54 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime MDMA Use

6 5

4 Allen County 3 Indiana 2 National

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

126

Figure 6.55 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual MDMA Use

4.5 4 3.5 3 2.5 Allen County 2 Indiana 1.5 National 1 0.5 0 6th 7th 8th 9th 10th 11th 12th

Figure 6.56: Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month MDMA Use

1.6 1.4 1.2 1 Allen County 0.8 Indiana 0.6 National 0.4 0.2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

127

GHB

According to the 2007 ATOD Survey, lifetime GHB usage is higher among Allen County 11th and 12th graders. Annual GHB usage is higher than state rates in 7th, 11th, and 12th grades. Past month GHB usage is higher among Allen County 11th graders than in the State.

Figure 6.57 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Lifetime GHB Use

1.6 1.4 1.2 1 0.8 Allen County 0.6 Indiana 0.4 0.2 0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

128

Figure 6.58 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Annual GHB Use

1.4 1.2 1 0.8 Allen County 0.6 Indiana 0.4 0.2 0 6th 7th 8th 9th 10th 11th 12th

Figure 6.59 Percentage of Allen County, Indiana, and U.S. Middle and High School Students Reporting Past Month GHB Use

0.8

0.7

0.6

0.5

0.4 Allen County

0.3 Indiana

0.2

0.1

0 6th 7th 8th 9th 10th 11th 12th

Source: 2007 Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents Survey

129

REFERENCES, CHAPTER 6

Brown University Department of Health Education/ Student health Services. Effects of Cocaine. Retrieved February 2007 from http://www.brown.edu/Student_Services/Health_Services/Health_Education/atod/resources.htm#3

Community Epidemiology Work Group. Epidemiologic Trends in Drug Abuse, Vol. II, Proceedings of the Community Epidemiology Work Group. December 2003

Haney M, Ward AS, Comer SD, et al. Abstinence symptoms following smoked marijuana in humans. Psychopharmacology 141(4):395–404, 1999

Indiana Law Enforcement (2008). Clandestine Meth Lab Incidents in Allen County and top 10 Indiana Counties.

Indiana Prevention Resource Center: Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents (ATOD) Survey http://www.drugs.indiana.edu/data-survey_monograph.htm

METH Awareness and Prevention Project. General Information on methamphetamine use and the consequences Retrieved January 2009 from . http://www.mappsd.org/HowMethAffects.htm

National Institute on Drug Abuse (NIDA) The Science of Drug Abuse and Addiction, NIDA InfoFacts: Marijuana http://www.nida.nih.gov/Infofacts/marijuana.html

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7. Conclusion

The majority of young adults who binge drink between the ages of 18 and 25 years old have a history of drinking during their earlier teen years. Young adults and youth do not tend to drink casually; they drink for the express purpose of getting drunk. They binge drink. The consequences from alcohol abuse are devastating to young brains that have not yet finished the developmental process which continues until age 25. Drug- and alcohol-related arrests account for nearly half (45%) of the total arrests in Allen County. In recent alcohol compliance checks, Allen County’s non-compliance rate has been as high as 51%. Eighty-seven percent of the respondents in a household survey said that parents allowing or providing alcohol for minors for social gatherings at their home is a problem in our community. These key pieces of information demonstrate the need to continue our efforts to expand the availability of proven- effective prevention programs after school and within the schools, reduce retail availability through a pledge campaign and compliance checks, and embark upon other programs, strategies, and awareness campaigns to reduce substance use and abuse among youth and young adults in Allen County.

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Appendix I: Acronyms

ADD Attention Deficit Disorder IYTS Indiana Youth Tobacco Survey Methylenedioxymethamphetamine - ADHD Attention Deficit Hyperactivity Disorder MDMA Ecstasy ARDI Alcohol-Related Disease Impact Database MTF Monitoring the Future Survey Alcohol, Tobacco, and Other Drug Use by ATOD NCHS National Center for Health Statistics Indiana Children and Adolescents Survey BRFSS Behavioral Risk Factor Surveillance System NCI National Cancer Institute National Clandestine Laboratory Seizure CDC Centers for Disease Control and Prevention NCLSS System CHD Coronary Heart Disease NDIC National Drug Intelligence Center National Highway Traffic Safety COPD Chronic Obstructive Pulmonary Disease NHTSA Administration CSAP Center for Substance Abuse and Prevention NIDA National Institute on Drug Abuse

DAC Drug & Alcohol Consortium of Allen County NIH National Institutes of Health

DEA U.S. Drug Enforcement Agency NSDUH National Survey on Drug Use and Health

DOE U.S. Department of Education NVSS National Vital Statistics System

DMHA Division of Mental Health and Addiction NYTS National Youth Tobacco Survey

EPIC El Paso Intelligence Center OAS Office of Applied Studies

ETS Environmental Tobacco Smoke ONDCP U.S. Office of National Drug Control Policy Smoking-Attributable Mortality, Morbidity, FARS Fatality Analysis Reporting System SAMMEC and Economic Costs U.S. Substance Abuse and Mental Health FSSA U.S. Family and Social Services Administration SAMHSA Services Administration GAC Governor’s Advisory Council SEDS State Epidemiological Data System State Epidemiology and Outcomes GHB gamma-Hydroxybutyric acid -Liquid Ecstasy SEOW Workgroup HBV Hepatitis B Virus Infection SIDS Sudden Infant Death Syndrome Strategic Prevention Framework State HCV Hepatitis C Virus Infection SPF-SIG Incentive Grant International Classification of Diseases, 10th ICD-10 SPSS Statistical Package for the Social Sciences Revision Inter-University Consortium for Political and ICPSR STD Sexually Transmitted Disease Social Research IDU Injection Drug User TEDS Treatment Episode Data Set

IPRC Indiana Prevention Resource Center UCR Uniform Crime Reports U.S. Department of Health and Human ISDH Indiana State Department of Heath USDHHS Services ISP Indiana State Police WHO World Health Organization Indiana Tobacco Prevention and Cessation ITPC YRBSS Youth Risk Behavior Surveillance System Agency

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Appendix II: Local Household Telephone Survey

General Population Telephone Survey – General Population Responses

1. Do you think it is very difficult, somewhat difficult, or not difficult at all to obtain alcohol from: Very Somewhat Not Difficult Don’t Difficult Difficult At All Know Older siblings 1.5% 20.5% 74.8% 3.3%

Parents 19.0% 43.5% 31.5% 6.0%

Other adult relatives 20.3% 48.8% 22.3% 8.8%

Other adults 16.8% 42.8% 34.3% 6.3%

Friends who are the same age 10.3% 16.0% 72.5% 1.3%

Bars 60.8% 27.8% 7.3% 4.3%

Restaurants 66.3% 26.5% 4.5% 2.8%

Liquor stores 63.0% 28.5% 6.8% 1.8%

Grocery stores 56.3% 34.8% 6.5% 2.5%

Convenience stores 45.3% 41.0% 9.3% 4.5%

2. Do you think it is very difficult, somewhat difficult, or not difficult at all for young people to get alcohol from home without their parents knowing about it? • Very difficult 2.5% • Somewhat difficult 22.8% • Not difficult at all 71.5% • Don’t know 3.3%

3. Would you say that parents allowing or providing alcohol for minors for social gathering in their home is a significant problem, minor problem, or not a problem at all in our community?

• Significant problem 39.3% • Minor problem 47.8% • Not a problem 6.8% • Don’t know 6.3%

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4. Would you say that parents allowing or providing alcohol for their own children is a significant problem, minor problem, or not a problem at all in our community?

• Significant problem 32.5% • Minor problem 52.8% • Not a problem 9.5% • Don’t know 5.3%

5. Do you strongly agree, agree, disagree, or strongly disagree with each statement.

Strong Strongly Don’t No Agree Disagree Agree Disagree Know Answer Most adults I know think that binge drinking by other adults is 3.3% 20.8% 57.8% 17.5% 0.8% NA acceptable Most adults I know think that binge drinking by people age 18- 2.8% 9.8% 71.0% 15.8% 0.8% NA 20 is acceptable

Most adults I know think that it is OK for people under age 21 to 1.8% 17.0% 62.5% 18.0% 0.8% NA drink alcohol

6. If one drink is equal to a 12-ounce beer, a 5-ounce glass of wine, or a drink with one shot of liquor, during the past 30 days have you had at least one drink of any alcoholic beverage such as beer, wine, a malt beverage, or liquor?

• YES 53.5% • NO 46.5% • DON’T KNOW 0.0%

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7. During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage?

Days Per Week (165 respondents) • 1 Day 2.7% • 2 Days 30.9% • 3 Days 12.7% • 4 Days 9.1% • 5 Days 9.1% • 6 Days 1.8% • 7 Days 3.6%

Days In The Past 30 Days (49 respondents) • 7 Days 8.2% • 8 Days 18.4% • 10 Days 22.4% • 15 Days 10.2% • 20 Days 12.2% • 30 Days 28.6%

8. During the past 30 days, on the days when you drank alcohol, approximately how many drinks did you drink on average?

• 1 Drink 42.5% • 2 Drinks 30.4% • 3 Drinks 13.6% • 4 Drinks 5.1% • 5 Drinks 5.1% • 8 Drinks 1.9% • 12 Drinks 1.4%

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9. How many times in the last 30 days have you had five or more alcoholic drinks such as beer, wine, or liquor at a sitting?

• None 87.4% • Once 2.8% • Twice 4.2% • 3-5 Times 2.8% • 6-9 Times 1.4% • 10 or more times 1.4%

10. During the past 30 days how did you usually get your alcohol?

68.7% I bought it at a store such as a liquor store, convenience store, supermarket, discount store, or gas station 27.1% I bought it at a restaurant, bar, or club. 4.2% I got it at a party.

11. During the past 30 days, how many times have you been driving when you’ve had perhaps too much to drink?

• 0 times 96.7% • 1 times 3.3%

12. Do you strongly agree, agree, disagree, or strongly disagree with each of these as a reason to drink alcohol. Strongly Agree Disagree Strongly Don’t No Agree Disagree Know Answer To experiment or to see what it is 7.8% 46.5% 35.5% 7.8% 2.0% 0.5% like To relax or relieve tension 7.8% 60.8% 23.8% 5.8% 1.5% 0.5%

To feel good or get high 6.0% 36.3% 45.3% 10.0% 2.0% 0.5% To have a good time with my 17.3% 51.0% 26.0% 4.3% 1.0% 0.5% friends To fit in with a group I like 15.0% 29.5% 41.5% 11.5% 2.0% 0.5% To get away from my problems 4.0% 31.5% 49.5% 13.8% 0.8% 0.5% and troubles Because of boredom or having 2.0% 22.0% 59.5% 14.8% 1.3% 0.5% nothing else to do Because of anger or frustration 2.8% 28.0% 54.3% 12.0% 2.5% 0.5%

To get through the day 1.5% 19.8% 58.0% 17.0% 3.0% 0.8% To increase or decrease the 0.0% 13.5% 60.0% 17.5% 8.5% 0.5% effects of some other drug To get to sleep 0.8% 21.8% 59.8% 13.0% 4.3% 0.5%

Because it tasted good 2.0% 50.8% 35.0% 7.0% 4.8% 0.5% Because I am hooked and feel I 1.5% 15.3% 55.3% 23.0% 4.5% 0.5% have to drink

13. How many times in the past 30 days have you used…?

1-5 6-19 20-40 40+ Don’t No Never times times times times Know Answer Alcohol (beer, wine, wine 1.9% 69.4% 16.2% 9.7% 1.4% 1.4% 0.0% coolers, liquor) Marijuana (pot, weed, hash) 99.5% 0.5% 0.3% 0.0% 0.0% 0.0% 0.0%

Powder cocaine 99.5% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0%

Crack 99.5% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0%

Inhalants (glue, fumes, amyls) 99.5% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0%

Amphetamines (uppers) 99.5% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0% Methamphetamines (meth, 99.5% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0% crank, crystal) Prescription drugs (non- 99.5% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0% prescribed use only) Heroin 99.5% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0%

Ecstasy or X 99.5% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0%

LSD (acid) 99.5% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0% Over-the-counter drugs (non- 99.5% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0% medical use)

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14. Is this something that has happened frequently, sometimes, rarely or never to you in the past 30 days as a result of drinking alcohol or using drugs. IF FREQUENTLY OR SOMETIMES Has this

been caused by alcohol, drugs, or both Don’t Don’t Consequence Frequently Sometimes Rarely Never Alcohol Drugs Both No Answer Know Know Been arrested 0.0% 0.0% 0.0 % 100% 0.0% NA NA NA NA NA

Damaged property 0.0% 0.0% 0.0% 100% 0.0% NA NA NA NA NA Driven a car while under 0.0% 0.0% 4.2% 95.8% 0.0% NA NA NA NA NA the influence Got into an argument or 0.0% 0.0% 1.9% 98.1% 0.0% NA NA NA NA NA fight Been hurt or injured 0.0% 0.0% 0.0% 100% 0.0% NA NA NA NA NA

Been taken advantage of 0.0% 0.0% 0.0% 100% 0.0% NA NA NA NA NA sexually Taken advantage of 0.0% 0.0% 0.0% 100% 0.0% NA NA NA NA NA another sexually

Thought I might have a 0.0% 0.0% 0.5% 99.5% 0.0% NA NA NA NA NA drinking or drug problem

Missed work/school 0.0% 0.0% 1.9% 98.1% 0.0% NA NA NA NA NA Performed poorly at 0.0% 0.0% 0.5% 99.5% 0.0% NA NA NA NA NA work/school Done something I later 0.0% 0.0% 0.9% 99.1% 0.0% NA NA NA NA NA regretted Got nauseated or vomited 0.0% 0.0% 0.5% 99.5% 0.0% NA NA NA NA NA

Had a hangover 0.0% 0.9% 5.1% 94.0% 0.0% 100% 0.0% 0.0% 0.0% 0.0%

Could not remember 0.0% 0.0% 0.0% 100% 0.0% NA NA NA NA NA things 15. In the past 30 days, have members of your family or friends told you that you should cut down on using alcohol or drugs?

• Yes 0.0% • No 100.0%

16. Do you have any kind of health care coverage?

• Yes 93.0% • No 6.5% • Don’t Know 0.5%

If yes, does it cover drug and alcohol treatment?

• Yes 42.7% • No 5.6% • Don’t Know 51.6%

Demographic Information

1. Are you male or female? • Male 38.3% • Female 61.8%

2. Are you of Spanish or Hispanic origin? • Hispanic 1.5% • Non-Hispanic 98.5%

3. What is your race? • White 92.8% • African American 6.3% • Asian Pacific Islander 0.0% • Some other race 1.0% • Don’t know 0.0% 4. Are you currently married, divorced, widowed, separated, a member of an unmarried couple, or have you never been married? • Married 80.0% • Divorced 3.0% • Widowed 0.5% • Separated 0.0% • Member Of An Unmarried Couple 2.0% • Never Been Married 14.0% • Don’t Know 0.0%

5. Are there any children under the age of 18 living in your household? • 1 Yes 28.0% • 2 No 72.0%

If yes, are any of them: Yes No Don't Know Under 5 years old 30.4% 69.6% 0.0%

5 through 13 years old 64.3% 35.7% 0.0%

14 through 17 years old 44.6% 55.4% 0.0%

6. What is the highest level of education you have achieved? • Less Than A High School Diploma 3.0% • High School Diploma Or Equivalent 30.8% • Some College 22.0% • Associate’s Degree 11.5% • Bachelor’s Degree 20.0% • Some Graduate School 1.8% • Graduate Degree 10.8% • Don’t Know 0.0% • No Answer 0.3%

Drug and Alcohol Consortium of Allen County 141 7. Which of the following best describes your current situation?

• Employed for wages 45.0%

• Self-employed 11.3%

• Out of work for more than one year 1.5%

• Out of work for less than one year 1.5%

• Homemaker 12.0%

• Student 0.8%

• Retired 25.5%

• Unable to work 2.0%

• No answer 0.5%

If employed, which category best describes where you are employed?

• Agriculture 3.6%

• Construction 8.9%

• Manufacturing 10.2%

• Wholesale or retail trade 12.0%

• Transportation and warehousing 6.7%

• Government or utilities 5.8%

• Finance and insurance 3.1%

• Real estate and rental and leasing 3.1%

• Education 14.2%

• Health care 11.1%

• Social services 0.9%

• Hotel, restaurant, or other hospitality 3.1%

• Professional scientific, or technical services 8.9%

• Other 8.4%

Drug and Alcohol Consortium of Allen County 142 8. Total household income

• Less than $15,000 2.3%

• $15,000 to $24,999 6.0%

• $25,000 to $39,999 12.3%

• $40,000 to $49,999 13.5%

• $50,000 to $74,999 26.5%

• More than $75,000 31.8%

• No answer 7.8%

Drug and Alcohol Consortium of Allen County 143 Appendix III: Alcohol and Your Body

What kind of substance is alcohol?

Alcohol is classified as a depressant because it slows down the central nervous system, causing a decrease in motor coordination, reaction time and intellectual performance. At high doses, the respiratory system slows down drastically and can cause a coma or death.

Alcohol Impairment Charts

Despite the tireless efforts of thousands of advocates, impaired drivers continue to kill someone every 30 minutes, nearly 50 people a day, and almost 18,000 citizens a year. Remember — impairment begins with the first drink.

Alcohol affects individuals differently. Your blood alcohol level is affected by your age, weight, gender, time of day, physical condition, prior amount of food consumed, other drugs or medication taken, and a multitude of other factors. In addition, different drinks may contain different amounts of alcohol, so it’s important to know how much and the concentration of alcohol you consume.

The body metabolizes alcohol at the rate of about one drink per hour. Does drinking strong coffee or taking a cold shower have an effect on the person who is drunk? The answer is yes — the result being an alert, cold, and wet drunk. Time and only time can sober a person up.

A woman of equivalent weight drinking an equal amount of alcohol in the same time period of time as a man may have a higher blood alcohol concentration than that man. Therefore, women should refer to the

BAC chart for women.

Drug and Alcohol Consortium of Allen County 144

Blood Alcohol Concentration Estimate – for Men

Influence DrinksA Body Weight In Pounds B 100 120 140 160 180 200 220 240 1 .04 .03 .02 .02 .02 .02 .02 .02 Possibly 2 .08 .06 .05 .05 .04 .04 .03 .03 3 .11 .09 .08 .07 .06 .06 .05 .05 Impaired 4 .15 .12 .11 .09 .08 .08 .07 .06 5 .19 .16 .13 .12 .11 .09 .09 .09 DUI 6 .23 .19 .16 .14 .13 .11 .10 .09 7 .26 .22 .19 .16 .15 .13 .12 .11 8 .30 .25 .21 .19 .17 .15 .14 .13 9 .34 .28 .24 .21 .19 .17 .15 .14 10 .38 .31 .27 .23 .21 .19 .17 .16 A One drink is 1.25 oz. of 80 proof liquor, 12 oz. beer, or 5 oz. of wine B Subtract .01 for each hour of drinking

Source: Greater Dallas Council on Alcohol & Drug Abuse

Blood Alcohol Contentration – for Women DrinksA Body Weight In Pounds InfluenceB 90 100 120 140 160 180 200 220 1 .05 .05 .04 .03 .03 .03 .02 .02 Possibly 2 .10 .09 .08 .07 .06 .05 .05 .04 3 .15 .14 .11 .10 .09 .08 .07 .06 Impaired 4 .20 .18 .15 .13 .11 .10 .09 .08 5 .25 .23 .19 .16 .14 .13 .11 .10 DUI 6 .30 .27 .23 .19 .17 .15 .14 .12 7 .35 .32 .27 .23 .20 .18 .16 .14 8 .40 .36 .30 .26 .23 .20 .18 .17 9 .45 .41 .34 .29 .26 .23 .20 .19 10 .51 .45 .38 .32 .28 .25 .23 .21

A One drink is 1.25 oz. of 80 proof liquor, 12 oz. beer, or 5 oz. of wine B Subtract .01 for each hour of drinking Source: Greater Dallas Council on Alcohol & Drug Abuse Drug and Alcohol Consortium of Allen County 145 Effects of blood alcohol content on thinking, feeling and behavior: Now that you know how to calculate BAC, see how alcohol affects your body at different levels.

0.02 - 0.03 Legal definition of intoxication in R.I. for people under 21 years of age. Few obvious effects; slight intensification of mood.

0.05 - 0.06 Feeling of warmth, relaxation, mild sedation; exaggeration of emotion and behavior; slight decrease in reaction time and in fine-muscle coordination; impaired judgment about continued drinking.

0.07 - 0.09 More noticeable speech impairment and disturbance of balance; impaired motor coordination, hearing and vision; feeling of elation or depression; increased confidence; may not recognize impairment.

0.08 Legal definition of intoxication in R.I. for people 21 years and older.

0.11 - 0.12 Coordination and balance becoming difficult; distinct impairment of mental faculties and judgment.

0.14 - 0.15 Major impairment of mental and physical control; slurred speech, blurred vision and lack of motor skills; needs medical evaluation.

0.20 Loss of motor control; must have assistance moving about; mental confusion; needs medical assistance.

0.30 Severe intoxication; minimum conscious control of mind and body; needs hospitalization.

0.30 - 0.60 This level of alcohol has been measured in people who have died of alcohol intoxication.

0.40 Unconsciousness; coma; needs hospitalization.

http://www.brown.edu/Student_Services/Health_Services/Health_Education/atod/alc_aayb.htm

Alcohol Statistics

• More than 100,000 U.S. deaths are caused by excessive alcohol consumption each year. Direct and indirect causes of death include drunk driving, cirrhosis of the liver, falls, cancer, and stroke.1

• At least once a year, the guidelines for low risk drinking are exceeded by an estimated 74% of male drinkers and 72% of female drinkers aged 21 and older.2 • 65% of youth surveyed said that they got the alcohol they drink from family and

friends.7

• Nearly 14 million Americans meet diagnostic criteria for alcohol use disorders.5

• Youth who drink alcohol are 50 times more likely to use cocaine than those who never drink alcohol.3

Drug and Alcohol Consortium of Allen County 146 • Among current adult drinkers, more than half say they have a blood relative who is or was an alcoholic or problem drinker.1

• Across people of all ages, males are four times as likely as females to be heavy drinkers.1

• More than 18% of Americans experience alcohol abuse or alcohol dependence at some time in their lives.6

• Traffic crashes are the greatest single cause of death for persons aged 6–33. About 45% of these fatalities are in alcohol-related crashes.4

• Underage drinking costs the United States more than $58 billion every year — enough to buy every public school student a state-of-the-art computer.2

• Alcohol is the most commonly used drug among young people.1

• Problem drinkers average four times as many days in the hospital as nondrinkers — mostly because of drinking-related injuries.1

• Alcohol kills 6½ times more youth than all other illicit drugs combined.2

• Concerning the past 30 days, 50% of high school seniors report drinking, with 32% report being drunk at least once.2

Sources 1 Substance Abuse: The Nation’s Number One Health Problem, Feb. 2001 2 Mothers Against Drunk Driving 3 National Center on Addiction and Substance Abuse 4 National Highway Traffic Safety Administration 5 Alcohol Health & Research World 6 National Institute on Alcohol Abuse and Alcoholism Analysis 7 The Century Council

Drug and Alcohol Consortium of Allen County 147 Appendix IV: Figures, Maps and Tables

Maps 2.1 Indiana Counties 21 2.2 Allen County Townships 22 6.1 Indiana Meth Lab Seizures, 2008 97

Tables 3.1 Five Categories of Risk and Protective Factors 24 3.2 Alcohol Sales Outlets Per Capita 25 3.3 Per Household Spending on Alcohol 26 3.4 Unemployment Rates – Annual 27 3.5 Educational Attainment 27 3.6 Types of Households with Children and Median Family Income 28 3.7 Families in Poverty 28 3.8 CHILDREN IN HOMES WITH NO PARENT PRESENT 29 3.9 HOUSEHOLDS WHERE ALL PARENTS WORK 30 3.10 COMMUNITY PROTECTIVE FACTORS 32 3.11 PREVENTION PROGRAMS IN ALLEN COUNTY 33 3.12 INTERVENTION PROGRAMS IN ALLEN COUNTY 34 4.1 Cost of Underage Drinking by Problem, Indiana 2005 37 4.2 The number of children Effected by FAS 45 4.3 Grade of First Use of Alcohol in Indiana 52 Binge Drinking in the Past Two Weeks – Indiana Main Source of Alcohol 4.4 59 in Past Month – Indiana Binge Drinking in the Past Two Weeks – Allen County Main Source of 4.5 60 Alcohol in Past Month – Allen County 4.6 Main Source of Alcoholic Beverages in the past month -Indiana 61 4.7 Main Source of Alcoholic Beverages in the past month –Allen County 62 4.8 Most Important Reasons for Drinking – 63 4.9 Most Important Reasons for Drinking – Allen County 64 Allen County Graduates to Higher Education 2003-2006 Allen County 4.10 65 University Attendance by Gender 4.11 Percent of Allen County high School Education Intent, 2007 66 4.12 Allen County University Attendance by Gender Arrests 2001-2006 67 4.13 Number of Arrests or Persons Referred for Campus Disciplinary Action 67 4.14 Juvenile Investigations/Arrests for Alcohol or Alcohol-Related Offenses 73 4.15 Citations Issued to Juveniles/Juvenile Arrests 74 4.16 Number of Arrests Tickets issued to Adults 74

Drug and Alcohol Consortium of Allen County 148 4.17 Compliance Checks for 2007 75 4.18 Compliance Checks for 2008 75 4.19 Compliance Checks for First Quarter 2009 75 4.20 Drug Testing Results of Juvenile Offenders 76 4.21 Alcohol Induced Deaths by Age & Gender 2001-2005 80 4.22 Alcohol Induced Deaths by Age & Race 2001-2005 80 4.23 Alcohol Induced Deaths by Age & Ethnicity 2001-2005 80 Number of Allen County Residents in Substance Abuse Treatment Who 5.1 82 Reported using Alcohol or Drugs Number of Allen County Residents in Substance Abuse Treatment Who 5.2 82 Reported using prescription Drugs Combination of Drugs used by Poly-substance Abusers in Substance 5.3 83 Abuse Treatment, 2007 6.1 Top Ten Indiana Counties with Highest Number of Meth Lab Seizures 96 The Annual Clandestine Laboratory Responses for Allen County since 6.2 96 1992 Figures 3.1 Allen Public School Suspensions & Expulsions 2006-2007 31 3.2 Allen Public School Suspensions & Expulsions 2007-2008 31 4.1 Cost of Underage Drinking, Indiana 2005 38 4.2 Affect of Alcohol use Across a Lifespan 39 4.3 Serving sizes of alcoholic beverages 41 4.4 Fetal Development Chart 42 Areas of the Brain that Can Be Damaged in Utero by Maternal Alcohol 4.5 43 Consumption 4.6 Brain of a Normal Baby and Brain of Baby With FAS 44 4.7 Characteristics of Child with FAS 44 4.8 Characteristic Facial Features of FAS 45 4.9 Characteristic Features of an Ear of a Child with FAS 45 4.10 Characteristic Features of an Hand of a Child with FAS 45 4.11 Areas of the Brain 48 4.12 The Hippocampus of the Brain 49 4.13 Brain Images of How Alcohol May Harm Mental Function 51 4.14 Age of First Alcohol Use in 52 4.15 High School Students and Annual Alcohol Use 53 4.16 High School Students and Past Month Alcohol Use 53 4.17 Allen County Students and Lifetime Alcohol Use 54 4.18 Indiana Students and Lifetime Alcohol 54 4.19 High School Students and Lifetime Alcohol 55 4.20 Peer Approval of Occasional Alcohol Use 55 4.21 Peer Approval of Weekly Binge Drinking 56

Drug and Alcohol Consortium of Allen County 149 4.22 Parental Approval of Occasional Alcohol Use 56 4.23 Parental Approval of Weekly Binge Drinking 57 4.24 Perception of Risk of Occasional Alcohol Use 57 4.25 Perception of Risk of Weekly Binge Drinking 58 4.26 Indiana Binge Drinking in the Past Two Weeks - Indiana 59 4.27 Binge Drinking in the Past Two Weeks – Allen County 60 4.28 Main Source of Alcohol in Past Month – Indiana 61 4.29 Main Source of Alcohol in Past Month – Allen County 62 4.30 Use Most Important Reasons for Drinking – Indiana 63 4.31 Most Important Reasons Use for Drinking – Allen County 64 4.32 College Enrollment by Gender by Percentage 66 4.33 Total Crashes- Allen County 68 4.34 Total ATOD-Related Crashes- Allen County 69 4.35 Total Crash Fatalities – Allen County 69 4.36 ATOD- Related Fatalities – Allen County 70 4.37 Crashes and Fatalities in Allen County - 2005 70 4.38 Crashes and Fatalities in Allen County - 2006 71 4.39 Crashes and Fatalities in Allen County - 2007 71 4.40 Crashes and Fatalities in Allen County - 2008 71 4.41 Allen County Arrests for 2007 72 4.42 Allen County Arrests for 2008 72 4.43 Chronic Drinkers –Allen County 2001-2007 77 4.44 Binge Drinkers – Allen County 2001-2007 77 4.45 Drinking And Driving in the Past Month – 2001-2007 78 5.1 Combined Treatment Episodes by Age Group 2005 & 2006 83 6.1 Long-Term Trends in Lifetime Marijuana Use by 12-th Graders 85 6.2 Synonyms for Marijuana 86 6.3 Marijuana’ Effects on the Brain 87 6.4 Effects of Marijuana 88 6.5 Students Reporting Lifetime Marijuana Use 89 6.6 Students Reporting Annual Marijuana Use 90 6.7 Students Reporting Past Month Marijuana Use 90 6.8 Students Reporting Daily Marijuana Use 91 6.9 Methamphetamine – Eroding the Mind 92 6.10 Synonyms for Methamphetamine 93 6.11 Symptoms of Methamphetamine Use 94 6.12 Effects of Methamphetamine 95 6.13 Students Reporting Lifetime Methamphetamine Use 98

Drug and Alcohol Consortium of Allen County 150 Figures (Continued 6.14 Students Reporting Annual Methamphetamine Use 99 6.15 Students Reporting Past Month Methamphetamine Use 99 6.16 Students Reporting Lifetime Amphetamine Use 100 6.17 Students Reporting Annual Amphetamine Use 101 6.18 Students Reporting Past Month Amphetamine Use 101 6.19 Synonyms for Cocaine 102 6.20 Effects of Cocaine 103 6.21 Students Reporting Lifetime Crack Use 104 6.22 Students Reporting Annual Crack Use 105 6.23 Students Reporting Past Month Crack Use 105 6.24 Students Reporting Lifetime Heroin Use 106 6.25 Students Reporting Annual Heroin Use 107 6.26 Students Reporting Past Month Heroin Use 107 6.27 Students Reporting Lifetime Tranquilizer Use 108 6.28 Students Reporting Annual Tranquilizer Use 10 6.29 Students Reporting Past Month Tranquilizer Use 109 6.30 Students Reporting Lifetime Rohypnol Use 110 6.31 Students Reporting Annual Rohypnol Use 111 6.32 Students Reporting Past Month Rohypnol Use 111 6.33 Students Reporting Lifetime Ritalin Use 112 6.34 Students Reporting Annual Ritalin Use 113 6.35 Students Reporting Past Month Ritalin Use 113 6.36 Students Reporting Lifetime Steroid Use 114 6.37 Students Reporting Annual Steroid Use 115 6.38 Students Reporting Past Month Steroid Use 115 6.39 Students Reporting Lifetime Narcotics Use 116 6.40 Students Reporting Annual Narcotic Use 117 6.41 Students Reporting Past Month Narcotic Use 117 6.42 Students Reporting Lifetime Over-the-Counter Drug Use 118 6.43 Students Reporting Annual Over-the-Counter Drug Use 119 6.44 Students Reporting Past Month Over-the-Counter Drug Use 119 6.45 Students Reporting Lifetime LSD Use 120 6.46 Students Reporting Annual LSD Use 121 6.47 Students Reporting Past Month LSD Use 121 6.48 Students Reporting Lifetime Injected Drug Use 122 6.49 Students Reporting Annual Injected Drug Use 123 6.50 Students Reporting Past Month Injected Drug Use 123 Drug and Alcohol Consortium of Allen County 151 6.51 Students Reporting Lifetime Inhalants Use 124 6.52 Students Reporting Annual Inhalants Use 125 6.53 Students Reporting Past Month Inhalant Use 125 6.54 Students Reporting Lifetime MDMA Use 126 6.55 Students Reporting Annual MDMA Use 127 6.56 Students Reporting Past Month MDMA Use 127 6.57 Students Reporting Lifetime GHB Use 128 6.58 Students Reporting Annual GHB Use 129 6.59 Students Reporting Past Month GHB Use 129

Drug and Alcohol Consortium of Allen County 152