Substance Use Trends in the Military, Veteran and Family Population

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1 Substance Use Trends in the Military, Veteran and Family Population Prepared by: Shana Malone Arizona Criminal Justice Commission Statistical Analysis Center

2 National Illicit Drug Use 1 in 10 individuals ages 12+ years in the general population have used illicit drugs in the past 30 days 1 in 8 active duty military personnel are current users of illicit drugs Sources: NSDUH; ONDCP

3 20 Arizona Adult Marijuana Use in the Past 30 Days by Veteran Status (2010) Percent (%) Reporting % Higher Iraq/Afghanistan Veteran Other Veteran Non-Veteran Note: Scale reduced for visual purposes; accurate depiction is out of 100% Source: 2010 Arizona Health Survey

4 National Alcohol Misuse Occurs in 11.5%-36% of our active duty forces returning from Afghanistan and Iraq Veterans who screen positive for post traumatic stress disorder (PTSD) or depression are two times more likely to have an associated alcohol problem Binge drinking: Occurs monthly in 43% of active duty (particularly in those years of age) Rates increase dramatically after a deployment Sources: NEJM; Addictive Behaviors; AJPM

5 100 Arizona Adult Alcohol Use in the Past 12 Months by Veteran Status: 5+ drinks in a single day (2010) Percent (%) Reporting % Higher Iraq/Afghanistan Veteran Other Veteran Non-Veteran Source: 2010 Arizona Health Survey

6 100 Arizona Adult Alcohol Use in the Past 12 Months by Veteran Status: Number of Days Engaging in 5+ drinks in a single day (2010) Percent (%) Reporting % Higher Iraq/Afghanistan Veteran Other Veteran Non-Veteran 0 days 1-12 days 13 or more days Source: 2010 Arizona Health Survey

7 National Rx Drug Misuse The Opioid Influx A 4 fold increase in the quantity of Rx Pain Relievers sold in the U.S. in the last decade The United States makes up 4.6% of the world s population, but consumes 80% of its Rx opioids 46 people a day are dying! Source: CDC

8 Arizona The Rx Drug Problem? Availability Percentage of Pills by Drug Type in Arizona (2014) ~ 579 million Class II-IV pills were prescribed in Arizona in 2014 Pain Relievers accounted for 60.0% of all pills prescribed Hydrocodone and Oxycodone accounted for 81.4% of all pain relievers prescribed in Arizona Why it matters = probability and access! Benzodiazepine 21.8% All Other Rx Drugs 14.9% Other Rx Pain Relievers 11.1% Oxycodone 27.9% Hydrocodone 20.9%

9 Volume:Access Ratio Enough Rx pain relievers are dispensed every year to medicate every adult in Arizona around-the-clock for 2 weeks straight!!!

10 Opioids and SMVF Populations Over 50% of VA patients seen in primary care settings report chronic pain Prescription drug abuse among service members and veterans has more than doubled since 2002 In veterans aged the risk for prescription drug abuse is at an all time high Opioid use in the military is twice that of use in the general population Sources: VA; DOD

11 20.0 Arizona Adult Rx Drug Misuse in the Past 30 Days by Veteran Status Percent (%) Reporting % Higher Iraq/Afghanistan Veteran Other Veteran Non-Veteran Note: Scale reduced for visual purposes; accurate depiction is out of 100% Source: 2010 Arizona Health Survey

12 Number of Drug Overdose Deaths Involving Selected Drugs in Arizona Number of drug poisoning deaths Opioid pain relievers* (T40.2-T40.4) Cocaine (T40.5) Heroin (T40.1) Source: ADHS Year *Includes methadone

13 Number of Heroin Overdose Deaths in Arizona Number of drug poisoning deaths % Increase 20 Source: ADHS Year

14 Heroin and Other Substances

15 50 45 Arizona Mental Health and Substance Abuse Problems by Veteran Status (2010) 70-92% Higher Percent (%) Reporting Iraq/Afghanistan Veteran Other Veteran Non-Veteran Mental Health Condition Substance Abuse Risk Note: Scale reduced for visual purposes; accurate depiction is out of 100% Source: 2010 Arizona Health Survey

16 PTSD percent who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) 1. Has levels of severity Often a delayed presentation from 6 months to 1 year 17 percent with PTSD had an increased probability of an alcohol use disorder 2. Females who serve in combat are more at risk 1.

17 Addiction and Suicide Approximately veterans are dying each day by suicide 1. Alcohol and drug abuse are contributing factors 2. Nearly 6,000 military veterans take their own lives each year Highest age group years of age Higher prevalence in men than women Higher rate of women veterans than women in general population

18 Barriers to Access Veterans struggling with addiction are being discharged to local communities and VA Centers where a capacity for treatment exists for only 20 percent of the existing total population Nearly 2.7 million veterans have enrolled in the VA health care since ,000 of these will likely need substance use screening and treatment Source: ONDCP

19 Homelessness Disability as a Reason for Homelessness by Veteran Population (2013) 25.0% 20.0% 15.0% 10.0% 5.0% 23.0% 15.0% 0.0% Veteran Not a Veteran Alcohol Use as a Reason for Homelessness by Veteran Population (2013) 18.0% 16.0% 14.0% 12.0% 10.0% 8.0% 16.0% 6.0% 4.0% 8.0% Source: ASU, Morrison Institute 2.0% 0.0% Veteran Not a Veteran

20 Arizona Youth Living in Military and Veteran Families Source: Arizona Youth Survey, Arizona Criminal Justice Commission

21 CONSUMPTION Identifying the severity of the problem and who is most affected

22 Percentage of Arizona Youth Reporting Past 30 Day Substance Use (2014) Alcohol Marijuana Cigarettes Chewing Tobacco Prescription Drugs OTC Inhalants Hallucinogens Ecstasy Synthetics Steroids Heroin Meth Percent (%) Reporting Use

23 Percentage of Arizona Youth Reporting Past 30 Day Use of the Most Common Substance Types Percent (%) Reporting Use % Decrease 3.1% Increase % Decrease 41.1% Decrease Alcohol Cigarettes Marijuana Rx Drugs Note: scale reduced for visibility; accurate depiction is out of 100%

24 30 Percentage of Youth Reporting the Most Common Substances Used in Past 30 Days (2014) 25 Percentage (%) of Use Alcohol Marijuana Cigarettes Rx Drugs Youth with Military Parent/Guardian Youth with Non-Military Parent/Guardian Note: Scale reduced for visual purposes; accurate depiction is out of 100%

25 50 Percentage of Youth with Military Parent/Guardian Reporting Current Substance Use (2014) % Higher Percentage (%) of Use % Higher 60-92% Higher 55-83% Higher Alcohol Marijuana Cigarettes Rx Drugs Deceased Military Parent/Guardian Active Duty Parent/Guardian Veteran Parent/Guardian Reservist Parent/ Guardian Note: Scale reduced for visual purposes; accurate depiction is out of 100%

26 CONSEQUENCES Identifying the Costs of Substance Use and Markers of Return on Investment for Prevention

27 35 Percentage of Youth Reporting Public Safety Consequences by Military Status (2014) 30 Percent (%) Reporting Consequences Got into fights Arrested Sold Drugs Drinking & Driving Driving while misusing Rx drugs Passenger to imparied driver Youth with Military Parent/Guardian Youth with Non-Military Parent/Guardian Note: Scale reduced for visual purposes; accurate depiction is out of 100%

28 45 Percentage of Youth Reporting School-Related Consequences by Military Status (2014) Percent (%) Reporting Consequences Drunk/high at school In fights at school Suspended from school Bullied at school Bullied another student Threatened at school Youth with Military Parent/Guardian Youth with Non-Military Parent/Guardian Note: Scale reduced for visual purposes; accurate depiction is out of 100%

29 CONTEXTUAL FACTORS Identifying What Can Be Changed

30 100 Notable Risk Factors among Youth with a Military Parent/Guardian (2014) Percentage (%) at High Risk Perceived Availability of Drugs Early Initiation of Drug Use Poor Family Management Parental Attitudes Favor Drug Use Attitudes Favor Drug Use Peer Drug Use No Substance Use Any Substance Use

31 Alcohol

32 Most Common Source of Alcohol for Youth with a Military Parent/Guardian 43%

33 Parents 1 out of 5 got alcohol from their parents 23% higher rate than youth with non-military parent/guardian

34 Marijuana & Rx Drugs

35

36 Easy Access 78.9% of Arizona youth who have misused prescription drugs in the past 30 days report getting them from friends, family or right out of the home

37 Where Arizona Youth Obtained Marijuana* Percent (%) Youth Reporting Each Source Friends Parties Family/Relative Someone with a medical mj card 11.3 School 6.1 Home *Students could pick more than one source; will not sum to 100%

38

39 Why Does Age of Initiation Matter?

40 National Data; Source: SAMHSA

41 National Data; Source: NIDA

42 Average Age of 1 st Use for Alcohol, Tobacco, Marijuana and Rx Drugs in Arizona?

43 Youth Living in Military Families: Age of First Alcohol Use High School 27.4% Elementary 29.4% Middle School 43.1% Youth Living in Non-Military Families: Age of First Alcohol Use High School 31.4% Elementary 25.1% Middle School 43.5%

44 Youth Living in Military Families: Age of First Marijuana Use High School 34.8% Elementary 15.7% Middle School 49.5% Youth Living in Non-Military Families: Age of First Marijuana Use High School 36.9% Middle School 50.2%

45 Youth Living in Military Families: Age of First Rx Drug Misuse High School 34.3% Elementary 23.5% Youth Living in Non-Military Families: Age of First Rx Drug Misuse Middle School 42.4% High School 37.2% Elementary 19.8% Middle School 43.0%

46

47 50 Reasons Past 30 Day Youth Substance Users Gave for Using (2014) Percent (%) Reporting Reason Have fun Deal with Stress Get high Keep from feeling sad Other Stop boredom Try something new Help Focus Fit In Feel normal Because I needed it Lose weight Get back at my parents Be more grown up Be like famous person Youth with Military Parent/Guardian Youth with Non-Military Parent/Guardian Note: Scale reduced for visual purposes; accurate depiction is out of 100%

48 100 Source of Stressors for Youth Indicating Stress as a Reason for Past 30 Day Substance Use (2014) 90 Percent (%) Youth Reporting Stress Source Family Peer/Friend School Community Youth with Military Parent/Guardian Youth with Non-Military Parent/Guardian

49

50 100 Reasons Youth Gave for Not Using Substances in the Past 30 Days (2014) Percent (%) Who Provided Reason Not interested Can hurt me Parent disapproval Could be arrested Other adult disapproval Morally wrong Lose privileges Might get expelled Get bad reputation Friends disapprove Against beliefs Couldn't find any Don't like Youth with Military Parent/Guardian Youth with Non-Military Parent/Guardian

51 100 Percentage of Arizona Youth Reporting No/Slight Perceived Risk of Substance Use (2014) 90 Percent (%) Youth Reporting Stress Source Drinks Daily Cigarettes Rx Drug Misuse Trying Marijuana Regular Marijuana Use Youth with Military Parent/Guardian Youth with Non-Military Parent/Guardian

52 Percentage of Arizona Youth Reporting No/Slight Risk of Marijuana Use Percent (%) Reporting Use %% Increase 116.6% Increase Try Marijuana Regular use of marijuana

53 Over HALF of Arizona youth have never talked to their parents about alcohol or drugs!

54 Percentage of Arizona Youth Who Have Never Talked to Their Parents about Drugs and Alcohol (2014) Percent (%) Youth Reporting Stress Source Active Duty Parent/Guardian Reservist Parent/ Guardian Veteran Parent/Guardian Deceased Military Parent/Guardian Non-Military

55 Take Away Message

56 What Should We Do?

57 How Do We Get There?

58 Think BIG! 1. Things to do at a state level? 2. Things the AZCMF could do? 3. Things you could do individually?

59 For More Information Shana Malone SAC website: Community Data Project website:

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