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STOP ACT Report to Congress on the Prevention and Reduction Of REPORT TO CONGRESS ON THE PREVENTION AND REDUCTION OF UNDERAGE DRINKING 2017 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration www.samhsa.gov Time period covered by this version of the Report to Congress: The 2017 version of the Report to Congress on the Prevention and Reduction of Underage Drinking primarily includes data from calendar year 2016. Epidemiological data in Chapters 1 and 2 draw from the most recently available federal survey data as of 2016. Chapter 3 includes data on ICCPUD member agency underage drinking activities in calendar year 2016. The state legal data reported in Chapter 4 reflects the state of the law as of January 1, 2016. The state survey data presented in Chapter 4 was collected in 2016, and is drawn from the most recent 12-month period in which the states maintained the data. Chapter 5 describes 2016 activities conducted by the Underage Drinking Prevention National Media Campaign. Recommended Citation U.S. Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA). (2017). Report to Congress on the Prevention and Reduction of Underage Drinking. REPORT TO CONGRESS ON THE PREVENTION AND REDUCTION OF UNDERAGE DRINKING, 2017 Table of Contents Foreword ........................................................................................................................................ iii Executive Summary .........................................................................................................................1 Chapter 1: Preventing and Reducing Underage Drinking: An Overview......................................11 Chapter 2: Nature and Extent of Underage Drinking in America .................................................29 Chapter 3: A Coordinated Federal Approach to Preventing and Reducing Underage Drinking.........61 Chapter 4: Report on State Programs and Policies Addressing Underage Drinking ...................119 Chapter 4.1: Introduction ....................................................................................................119 Chapter 4.2: Policy Summaries.......................................................................................... 131 Chapter 4.3: State Survey Summary and Results ...............................................................231 Chapter 5: Evaluation of the National Media Campaign: Talk. They Hear You. ...................... 255 _______________________________________________ Report to Congress on the Prevention and Reduction of Underage Drinking | i Foreword As U.S. Department of Health and Human Services Assistant Secretary for Mental Health and Substance Use and Chair of the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD), I am pleased to present the ICCPUD’s 2017 Report to Congress on the Prevention and Reduction of Underage Drinking. This Report is mandated by the Sober Truth on Preventing Underage Drinking Act, originally passed by Congress in 2006 and reauthorized in 2016. This is the ninth annual Report examining the issue of underage drinking, and it includes recent data from federal surveys, prevention activities by federal agencies, and state-specific data on prevention policies and enforcement efforts. Among Americans under age 21, alcohol is the most frequently used substance, used more often than tobacco, marijuana, or other illicit drugs. One in five 12- to 20-year-olds reports having used alcohol in the previous month. Underage alcohol consumption is a persistent and serious public health challenge, resulting in thousands of deaths each year through motor vehicle crashes, violence, suicide, alcohol poisoning, and other causes. Underage drinking is also implicated in sexual assault and other crimes, impaired brain function, decreased academic performance, and the increased risk of developing an alcohol use disorder later in life. Binge drinking (four drinks in a row for a female or five for a male) exacerbates underage drinking’s harmful consequences and is the most common underage consumption pattern, especially among college students. Importantly, there are evidence-based strategies for preventing or reducing underage alcohol use. Research indicates that these strategies are most effective when implemented as part of a multifaceted approach that includes parents and families, law enforcement, healthcare providers, community organizations, schools and universities, local and state governments, and the federal government. With community support, law enforcement can more effectively prevent youth from accessing alcohol. Parents, schools, and universities can provide clear, consistent education about the consequences of underage drinking. Healthcare providers can screen patients under 21 for alcohol use and provide brief intervention and referral to treatment as appropriate. Evidence suggests that current implementation of these strategies may be having a positive effect. Since 2004, past-month alcohol use by underage drinkers has declined by 29 percent. Past-month binge drinking decreased by 30 percent between 2004 and 2014, according to the most recent available data. The most effective way to sustain and continue these gains will be ongoing coordinated efforts at all levels of government and in our universities, schools, communities, and families to implement strategies that have proven to be effective. It is my hope that this Report will provide critical information to support such efforts. Elinore F. McCance-Katz, M.D., Ph.D. Assistant Secretary for Mental Health and Substance Use Department of Health and Human Services ______________________________________________ Report to Congress on the Prevention and Reduction of Underage Drinking | iii EXECUTIVE SUMMARY ______________________________________________ Report to Congress on the Prevention and Reduction of Underage Drinking | 1 Introduction ____________________________________________________________________________________________________ Introduction The use of alcohol by persons under age 21 is a complex and challenging social problem that has defied an easy solution. Underage drinking contributes to a wide range of costly health and social problems, including motor vehicle crashes (the greatest single mortality risk for underage drinkers), suicide, interpersonal violence (e.g., homicides, assaults, rapes), unintentional injuries (e.g., burns, falls, drowning), brain impairment, alcohol dependence, risky sexual activity, academic problems, and alcohol and drug poisoning. Annually, alcohol is a factor in the deaths of approximately 4,300 youths in the United States, shortening their lives by an average of 60 years (Stahre, Roeber, Kanny, Brewer, & Zhang, 2014).1 In 2006, Congress enacted the Sober Truth on Preventing Underage Drinking Act, popularly known as the “STOP Act.” The STOP Act, which was reauthorized in 2016, requires the Secretary of Health and Human Services, on behalf of the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD), to submit an annual Report to Congress. The Report to Congress includes the most current data on underage alcohol use in the United States, as well as information on federal and state prevention efforts. Characteristics of Underage Drinking in America Alcohol Is the Most Widely Misused Substance Among American Youth Why Is Underage Drinking a Problem? Alcohol continues to be the most widely used • Alcohol is used more widely than tobacco, substance among America’s youth, and a marijuana, and other drugs by our nation’s young higher proportion use alcohol than use people (Miech et al., 2016). tobacco, marijuana, or other drugs. For • Motor vehicle crashes are the greatest mortality risk for underage drinkers. In 2015, of the 1,886 drivers example, according to the 2015 Monitoring ages 15–20 who were killed in motor vehicle traffic the Future (MTF) study, 21.5 percent of 10th crashes, 494 (26%) had a BAC of 0.01 or higher graders reported alcohol use in the past 30 (NCSA, 2016). • Alcohol use contributes to brain impairment, sexual days, 14.8 percent reported marijuana use in assault, and academic problems (Brown & Tapert, the past 30 days, and 6.3 percent reported 2004; Abbey, 2011; White & Hingson, 2013). cigarette use in the same period (Miech, • Early initiation of drinking is associated with Johnston, O’Malley, Bachman, & development of an alcohol use disorder later in life (Hingson & Zha, 2009; Grant & Dawson, 1997). Schulenberg, 2016).2 Youth Start Drinking at an Early Age As discussed below, early initiation to alcohol use increases the risk for a variety of developmental problems during adolescence and for problems later in life. Early initiation is often an important indicator of future substance use (Buchmann et al., 2009; Grant & Dawson, 1998; Hawkins et al., 1997; Liang & Chikritzhs, 2015; Robins & Przybeck, 1985). Accordingly, delaying the onset of alcohol initiation may significantly improve later health. The peak years of 1 Complete references are provided in Appendix D. 2 For comparability with data from the 2015 National Survey on Drug Use and Health (NSDUH) and 2015 Youth Risk Behavior Survey (YRBS), the latest MTF data included in this report are also from 2015. The 2016 MTF data, available in December 2016, will be included in the next report. 2 | Report to Congress on the Prevention and Reduction of Underage Drinking ______________________________________________ _____________________________________________________________________________________________________
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