Campus-Community Strategies in Substance Use/Misuse and HIV Prevention Frances M. Harding Director SAMHSA s Center for Substance Abuse Prevention

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1 Campus-Community Strategies in Substance Use/Misuse and HIV Prevention Frances M. Harding Director SAMHSA s Center for Substance Abuse Prevention MSI CBO & HIV CBI New Grantee Meeting December 9, 2015 Bethesda, Maryland

2 Leading Change 2.0 Strategic Initiatives Prevention of Substance Abuse and Mental Illness 2. Health Care and Health Systems Integration 3. Trauma and Justice 4. Recovery Support 5. Health Information Technology 6. Workforce Development

3 2014 National Survey on Drug Use and Health (NSDUH) Highlights Progress in reducing some forms of substance use, especially among adolescents. Substance use levels in many areas have remained constant. Mental illness levels also have remained constant, but adolescents are experiencing higher levels of depression than in past years.

4 Youth and Young Adults Youth Aged 12 thru 17 Illicit drug use g (10.1 to 8.8 percent), up to 9.4 percent in 2014 Marijuana, psychotherapeutics, inhalant, hallucinogen use over last several years Aged 18 to 25 News is not so good Illicit drug use flat since 2009 (21.4 to 22.0 percent) Marijuana use from 2008 Therapeutic and cocaine use Hallucinogen use fairly stable since 2002 Heavy and binge drinking high or g

5 Why Focus on Youth and Young Adults (16-25 age group) Brain Development & First Use/Onset Until age 21 or so for girls; 25 for boys ½ of adult mental illnesses/addictions begin < age 14; ¾ < age 25 First episode of many serious mental illnesses (e.g., psychosis) occurs in year range; time to treatment is years If we can prevent a young person from taking a drink before age 25, likelihood of adult alcohol addiction is significantly reduced Suicide and Drinking Suicide is 2nd leading cause of death among year olds Strong relationship between suicidal behavior and substance use Highest binge/heavy drinking & non-med prescription drug use Often have lowest level of help-seeking

6 Diagnoses of HIV Infection Among Adolescents and Young Adults Aged Years, by Race/Ethnicity, United States and 6 Dependent Areas Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting. a Hispanics/Latinos can be of any race.

7 Diagnoses of HIV Infection Among Adolescents and Young Adults Aged Years, by Transmission Category, United States and 6 Dependent Areas Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays and missing transmission category, but not for incomplete reporting. a Heterosexual contact with a person known to have, or to be at high risk for, HIV infection. b Includes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified.

8 College Students - Health Habits, Behaviors, and Perceptions 2/3 of respondents reported having at least one sexual partner within last 12 months. HIV testing rates need to be improved. Less than 25 percent of respondents reported EVER being tested for HIV. Perceived risk of alcohol and marijuana use was significantly higher than actual use 62.6 percent reported using alcohol in last 30 days - perceived use was 93.1 percent 18.5 percent reported using marijuana in last 30 days - perceived use was 84 percent Following alcohol use, students reported memory loss and regretting behaviors, including unprotected sex. American College Health Association, National College Health Assessment, Spring 2015

9 Behavioral Health and HIV/AIDS Behaviors associated with substance use/misuse fuel HIV transmission: Alter judgment unprotected sex, inability to consent Lower adherence to treatment Injection drug use: 9 percent of all new HIV infections; 3 percent among MSM/IDU Mental illness can predispose to HIV.

10 Behavioral Health and Hepatitis C Injection drug use is currently the most common means of HCV transmission in the U.S. The most recent surveys of active injection drug users indicate that approximately one third of young (aged years) IDUs are HCV-infected. There are very limited epidemiologic data to suggest an additional risk from non-injection (snorted or smoked) cocaine use, but this risk is difficult to differentiate from associated injection drug use and sex with HCV-infected partners.

11 Student-Led Campus Prevention Students are motivated stakeholders. Students trust other students. Peers help ensure prevention is culturally appropriate. Planning creates a cooperative climate. Training is important.

12 Collaborative Opportunities Substance Use Behavioral Health College Campus Mental Health Primary Care Community

13 The Path to Success

14 Making Community Responses Work

15 Takeaways Tackling HIV and behavioral health issues effectively takes teamwork on and off campus. Involving students is vital. Collaborative and integrated practices must include prevention. One size does not fit all. Be proactive. Take a long-term view.

16 Sustainability

17 Collaboration: Foundation for Success Center for Substance Abuse Prevention Center for Mental Health Services Center for Substance Abuse Treatment Center for Behavioral Health Statistics and Quality

18 Questions and Discussion

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