Comparative Analysis of Drug use Among Secondary School Students in 13 Caribbean Countries Antigua and Barbuda, The Bahamas, Barbados, Belize, Dominica, Grenada, Guyana, Haiti, Jamaica, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, Trinidad and Tobago Research Roundtable Discussion Pernell Clarke, Specialist, Inter-American Observatory on Drugs Secretariat for Multidimensional Security July 12, 2016 1
Summary Introduction. Main Results and comparison with 2010 report. Analysis of Results. Conclusions Policy Implications Strategic Prevention 2
Introduction Drug use, as well as the social context in which that use occurs, are etiological factors in a wide range of other social phenomena Drug use is known to be causally related to a variety of physical and mental health problems, crime, poor school performance, family disruption, among others Previous research has also consistently found strong connections between drugs and violence. 3
Methodology The SIDUC survey of secondary school students applies a uniform methodology The main objective of the uniformity of the approach is to allow the direct comparison of data between surveys that have been undertaken in different countries As a result, the sampling procedures, data collection, and data entry methods are all the same, or comparably similar 4
Questionnaire The questionnaire consists of a standard set of questions: Basic socio-demographic information Beliefs about future academic performance Discipline and academic problems Perceptions of harm associated with the consumption of drugs Prevalence of substance use and patterns of consumption Incidence of substance use Frequency of use 5
Objectives General Objectives To estimate the magnitude of illicit and licit drug use among secondary school students in the Caribbean and its distribution according to select demographic variables To determine the perceived risk of drug use, access to drugs, availability of drugs, and frequency of use To examine risk and protective factors for drug use by school students. 6
MAIN RESULTS 7/15/2016 7
Alcohol Alcohol is the most prevalent legal drug used by Caribbean Students. Prevalence in the past month: Average = 31.1% Max = 56.4% (Dom) Min = 16.5% (Guy) Average Age of first Use: 11.9 (M), 12.4 (F) Range: 10.9 (Dom) to 13.7 (Haiti) 4 out of 13 countries had higher past month prevalence rates for females. Overall binge drinking rates have increased from 31.5% to 36.8%. 8
90 Lifetime, Past Year and Past Month Prevalence of Alcohol Use Lifetime Past Year Past Month 80 70 60 50 40 30 20 10 0
Past Year Prevalence by Gender males females 70 60 50 40 30 20 10 0
Age of First Use of Alcohol overall males females 14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0
80.0 Comparison of Alcohol Use - Overall Prevalence 2013 survey 2010 report 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 lifetime past year past month 12
Binge Drinking
Marijuana Marijuana is the most prevalent illegal drug used by Caribbean Students. Prevalence in the past year: Average = 13.7% Max = 19.6% (Dom) Min = 2.4% (Hai) Average Age of first Use: 12.9 (M), 13.6 (F) Range: 12.5 (SKN) to 13.9 (Bel) Past year prevalence rates for males was higher than that for females. The overall perception of harm caused by marijuana smoking has declined since the last round of surveys while the overall prevalence of marijuana has increased (from 9.8% to 13.7% (past year)). 14
Marijuana Prevalence Lifetime Past Year Past Month 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0
Past Year Marijuana Use by Gender males females 30.0 25.0 20.0 15.0 10.0 5.0 0.0
14.0 Past Year Marijuana Prevalence for Students 14 Years or Younger 12.0 12.3 10.6 10.6 10.5 10.4 10.0 8.0 7.9 7.9 7.1 6.0 6.0 5.4 4.5 4.0 2.9 2.0 1.7 0.0 St. Vincent and the Grenadines Dominica St. Lucia Antigua and Barbuda Belize Barbados St. Kitts and Nevis Grenada Trinidad and Tobago Jamaica Bahamas Guyana Haiti
Average Age of First Use of Marijuana by Gender Overall Average Males Females 18 16 14 12 10 8 6 4 2 0 Antigua and Barbuda Bahamas Barbados Belize Dominica Grenada Guyana Haiti Jamaica St. Kitts and Nevis St. Lucia St. Vincent and the Grenadines Trinidad and Tobago
Lifetime Prevalence of Marijuana Use and Behavioral Problems 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 Never Once Few Times Often
Ease of Obtaining Marijuana easy hard unable to don t know 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Antigua and Barbuda Bahamas Barbados Belize Dominica Grenada Guyana Haiti Jamaica St. Kitts and Nevis St. Lucia St. Vincent and the Grenadines Trinidad and Tobago
45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Past Year Marijuana Use by Ease of Obtaining It easy hard unable to don t know 21
18 Past Year and Past Month Incidence of Marijuana Use past year past month 16 14 12 10 8 6 4 2 0 Antigua and Barbuda Bahamas Barbados Belize Dominica Grenada Guyana Haiti Jamaica St. Kitts and Nevis St. Lucia St. Vincent Trinidad and the and Tobago Grenadines 22
Cannabis Abuse Screening Test (CAST) Not a problem Low risk High risk 60.0 50.0 40.0 30.0 20.0 10.0 0.0 23
18 16 Past Month Prevalence Cigarettes Compared to Marijuana Cigarette Marijuana 14 12 10 8 6 4 2 0 24
30.0 Comparison of Marijuana Use by Gender - Overall Average Prevalence 2010 2013 25.0 20.0 15.0 10.0 5.0 0.0 male lf female lf male yr female yr male mth female mth 25
Prevalence of Inhalant Use lifetime past year past month 25 20 15 10 5 0
14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0 Comparison of Inhalant Use - Past Year Prevalence 2013 2010 27
Prevalence of Tranquilizer Use Lifetime year month 12 10 8 6 4 2 0 28
Prevalence of stimulants Lifetime year month 8 7 6 5 4 3 2 1 0
3.5 Lifetime and Past Year Prevalence of Cocaine Use Lifetime Past Year 3.0 2.5 2.0 1.5 1.0 0.5 0.0
4.0 Lifetime and Past Year Prevalence of Crack Cocaine Use 3.5 Lifetime Past Year 3.0 2.5 2.0 1.5 1.0 0.5 0.0 Antigua and Barbuda Bahamas Barbados Belize Dominica Grenada Guyana Haiti Jamaica St. Kitts and Nevis St. Lucia St. Vincent and the Grenadines Trinidad and Tobago
4.0 Lifetime Prevalence of Ecstasy 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 Antigua and Barbuda Dominica Barbados Belize Grenada St. Lucia Guyana Jamaica Trinidad and St. Kitts and Tobago Nevis Bahamas Haiti St. Vincent and the Grenadines
Analysis of Results By far the most widely consumed substance is alcohol and this is followed by marijuana. Prevalence is relatively high but there is plenty of variability from country to country. Marijuana is the most widely used illegal substance and in most cases, its use is even more prevalent than tobacco.
Analysis of Results A very important finding relates to students perception of how easy it is to access drugs. Perception of availability of marijuana was very high-- four to five of every ten students indicated that they could access marijuana easily in most of the countries. Additionally, the perception of harm associated with marijuana appears to be declining among secondary school students
Analysis of Results Many students do not know the dangers of: frequent misuse of prescription drugs occasional or frequent use of inhalants occasional or frequent use of ecstasy The most important finding about marijuana was that in most countries there was an increase in prevalence when compared to the 2010 report and at the same time there was a decline in the harm associated with marijuana use.
Population-Based Surveys Population surveys are important tools used to generate epidemiological information on drug use The Caribbean has benefitted from the standardized school surveys developed by CICAD they allow cross country comparisons to be made 36
Researchers and Policy Makers There is often an uneasy relationship between researchers and policy practitioners. Each looks at the world through different colored lenses. (Edwards 2004)?????????? 37
What is the perspective of researchers? There is a lack of Government interest in research Quite often there are impediments to researchers accessing data held within bureaucracies There is an anti-intellectual approach adopted within government There is a risk averse attitude to findings that practitioners could see as embarrassing to the Minister of the government Short time frames under which governments operate lead to preferences for immediate instrumentalist policy advice in other words all we need are good ideas 38
What about policy makers? Research often deals with issues other than those that are central to and directly relevant to the political and policy debate It fails to take the reality of many people s lives into account when identifying research questions It is often driven by ideology paraded as intellectual inquiry rather than genuinely seeking to evaluate or interpret impact 39
How can we influence policy? Identify stakeholders who should be influenced by the results. Engage them early in the planning process for the research project. Having a relevant Government agency (or NGO) involved in the project helps. Determine how the results will feed into the policy making process in your country. Research results must be followed by ACTION. 40
Policy Implications There are serious prevention education implications for the findings related to perception of harm related to substance use. e.g. Marijuana perceptions appear to be changing. In relation to other regions, the prevalence of use of some of these substances particularly marijuana and inhalants, is relatively high. How do we address this? The age of first use estimates are fairly consistent across countries so the specific point in time where prevention programs intervene can also be fairly uniform. We think that the primary school to secondary school transition is a critical time for intervention.
SAMHSA Strategic Prevention Framework SAMHSA has designed a planning process for preventing substance misuse: Assess Needs: What is the problem, and how can I learn more? Research Build Capacity: What do I have to work with? Plan: What should I do and how should I do it? How can I put my plan into action? Is my plan succeeding? Research 42
Guiding Principles Cultural competence: The ability to interact effectively with members of your population Sustainability: The process of achieving and maintaining longterm results. 43
Distinctive Features Data driven Dynamic Focused on population-level change Considers prevention across the lifespan Reliant on a team approach 44
In Conclusion, we need to complete the cycle Evaluation Research Practice Policy 45
Acknowledgements Country-Specific Contributions Antigua & Barbuda: Dr. John Swift, Consultant, and Ms. Norma Jeffrey Dorsett, Substance Abuse Prevention Officer. The Bahamas: Terrence Fountain, National Anti-Drug Secretariat Barbados: Jonathan Yearwood and Laura Lee Seale, Research Department, National Council on Substance Abuse (NCSA). Belize: Amelio Matura, National Drug Abuse Control Council, and Ion Cacho, Consultant Dominica: Martha Jarvis, National Drug Prevention Unit. Grenada: Dr. Cecilia Younger, Consultant, and Elizabeth Japal, Drug Control Secretariat Guyana: Clement Henry, Ministry of Home Affairs, and Tiffany Barry, Consultant. Haiti: Jean Alain Bernadel and Joseph Gabeaud, Haitian Drug Observatory. Jamaica: Michael Tucker and Uki Atkinson, National Council on Drug Abuse, and Patrice Whitehorne-Smith, Consultant. St. Kitts and Nevis: Karimu Byron, National Council on Drug Abuse Prevention, and Gaile Gray Phillip, Consultant. St. Lucia: Cyprian Yarde, Substance Abuse Advisory Council Secretariat. St. Vincent and the Grenadines: Patsy Wyllie, Ministry of Health, and Selwyn Allen, Consultant. Trinidad & Tobago: Arlene Emmanuel, National Alcohol and Drug Abuse Prevention Programme Secretariat, and Dr. Brader Brathwaite, Consultant. 46
Thank you for your attention