Six x Les essons sons Lea earned ned From m Can annabis nabis - PowerPoint PPT Presentation

Kevin n P. Hagger gerty ty, , MSW, PhD Univer Uni ersity ity of Washing hington on, , School ol of Social al Work rk Cannabis abis Legalization alization and Yout uth: : De Developing loping Clear ar Messages sages in an Evolv lving ing Polic licy y Clim imat ate Boulder lder, , CO Nov 15-16, 2018 18 Six x Les essons sons Lea earned ned From m Can annabis nabis Legalization in Washington State….one resear earch cher ers s perspec spectiv tive Dr. Haggerty is the director of the UW Center for CTC and does receive payments for training and consultation services

Six Lessons from Washington State 1. The sky hasn’t fallen…. 2. Parent’s make a difference 3. Public Health Messaging is critical 4. Defining Evidence Based Programs is difficult and essential 5. Communities bring it all together 6. There is a lot we still don’t know.

1. 1. The sky hasn’t fallen….

WSIPP WSIPP, 2017

For adults, use is increasing for those who have used in the past Kosterman et. al., 2017

We need to focus on increase in frequency of use rather than ever use or single use in the last 30 days. Monitoring the Future, 2018

AND…THC levels are going up…and we don’t know what that means….

2. Care aregiv giver ers ca can n in infl fluence uence ri risk sk fac actor ors for or ad adolesc olescent ent ca cannabis nnabis us use

Risk factors for youth cannabis misuse Community Family School Harrop & Catalano, 2016 Catalano et al., (2018) C ontemporary Health Individual/Peer Issues on Marijuana, Oxford University Press

Our work at SDRG has shown… ■ Peer or sibling use ■ Prior alcohol use Cannabis ■ Prior cigarette use Initiation

Parent Norms are an Important Risk Factor Children who perceive their parents as having favorable attitudes toward drug use were… 5 X more likely to have tried cannabis by 8 th grade 6 X more likely to be a frequent user by 10 th grade Source: Washington State Division of 12 Behavioral Health and Recovery, 2013

Our work at SDRG has shown… ■ Good family management ■ Norms against use & Cannabis perceived harm Initiation

Tip ips f s for Par Paren ents: ts: Developing messages for parents G = = Cl Clear and d Sp Speci cific ic Gui uide deli lines M = = Mon onit itor or C = = Co Conse seque uence nce & P & Prob oble lem-So Solv lvin ing

3. Pu Publi blic c Health ealth Me Messa ssagin ging g is is Critical ritical

What Parents Care About Hanson, K., Haggerty, K. P., Fleming, C. B., Skinner, M. L., Casey-Goldstein, M., Mason, W. A., ... & Redmond, C. (2018). Washington State Retail Marijuana Legalization: Parent and Adolescent Preferences for Marijuana Messages in a Sample of Low-Income Families. Journal of studies on alcohol and drugs , 79 (2), 309- 317.

Listen to Your Selfie You Can https://www.youcanwa.org/ Know This about Cannabis

4. Det Determining ermining EB EBPs Ps is is es essent sential ial

■ 19 Evidence Based Approaches – 16 Blueprints programs ■ 5 Promising – 3 Blueprints ■ 12 EBP recommendations for tribal communities – 4 have strongest research – 3 have some evidence (with concerns) – 5 have some evidence (pre-post only)

5. 5. Com ommunities munities Bri ring ng it it All ll Toge ogethe ther

Creating Opt ptim imal al Enablin ing g Contexts xts Effecti ective Effectiv Ef ective e Enabling ng Posit itiv ive e Implement mplementat ation ion Inter erventions entions for Tested, Contexts xts Child and Met ethods hods Family ily Effective Outcomes comes Blueprints registry Programs/Pratice Commun munit ity Coalit litions ions Communit munities ies that Care s/Policies Within Even when communities carefully select tested, effective Public Systems programs/practices/policies well-matched to their community-identified needs, we need the support of public systems to create enabling contexts for strong implementation. 22 National Implementation Resource Network

Different Different Norms & levels of risk The Challenge for Values and Community protection Prevention: Different Different Communities, Different youth Different Needs resources & problem capacity behaviors

■ Build a coalition of diverse stakeholders Communities that ■ Assess and prioritize risk, Care Builds protection, and behavior problems Prevention Capacity with student surveys and Infrastructure ■ Address locally prioritized risk and protection with tested, effective preventive interventions ■ Support/sustain high fidelity implementation of interventions delivered at scale

Promo omoti ting g Wel ell Bei eing u g usin ing g the e Socia ial l Devel elopm opmen ent t Strategy egy

What is the evidence that CTC has a collective impact?

Randomized Trial of Communities That Care 2003-2017 24 incorporat rporated d towns ns in 7 states s ~ Matched in pairs within state ~ Randomly assigned to CTC or control condition 4407 students ents followed d through ugh age 23 ~ All 5 th graders in public schools ~ Surveyed annually from grade 5 Supported by grants from the National Institute on Drug Abuse, National Cancer Institute, the Center for Substance Abuse Prevention, National Institute on Child Health and Human Development, National Institute of Mental Health, National Institute on Alcohol Abuse and Alcoholism

CTC Reduced Behavioral Health Problems After 3 Years (Grade 8) tobacco – 33% alcohol – 32% antisocial behavior – 25% binge drinking - 37% Significant community-wide reductions in drug use and delinquency compared to control communities by end of grade 8. Hawkins et al. (2009). Arch Pediatr Adolesc Med.163(9):789-798.

Age 11 Age 12 Age 13 Age 14 Age 16 Grade Age 18 Grade Age 19 Age 21 Age 23 Grade 5 Grade 6 Grade 7 Grade 8 10 12 2004 2005 2006 2007 2009 2011 2012 2014 2016 ✓ ✓ Risk ns ns Baseline ✓ Protection ns Delayed Initiation and Sustained Abstinence ✓ ✓ ✓ ✓ ✓ ✓ ✓ Antisocial Behavior ✓ ✓ ✓ ✓ Violence ns ✓ ✓ ✓ Gateway Drugs # Baseline ✓ ✓ ✓ ✓ males Alcohol ns ns ✓ ✓ ✓ ✓ males ✓ males ✓ males Cigarettes ✓ males Marijuana ns ns ns ns ns ✓ ✓ males ✓ Any Drugs + ns ns CTC EFFECTS ON YOUTH Reduced Prevalence of Recent Behavior (Past-month/Past-Year) ✓ ✓ Antisocial Behavior ns ns ns ns ✓ Violence ns ns ns ns OUTCOMES Baseline ✓ Alcohol ns ns ns ns ns ✓ Binge Drinking ns ns ns ns ns ✓ Cigarettes ns ns ns ns ✓ Smokeless Tobacco ns ns ns ns ns ✓ = significant CTC effect ns = not significant empty cells = CTC effect not tested # Gateway drugs = alcohol, cigarettes, or marijuana. + Any drugs include gateway drugs, nonmedical use of prescription drugs, inhalants, LSD, cocaine, stimulants, ecstasy,

Sustained Effects: % who have never Used Marijuana ARR= ARR= 1.21 1.07 Among baseline (grade 5) non-initiators ARR=Adjusted Risk Ratio Among baseline (grade 5) non-initiators (92% of sample) *p < .05 (91% of sample)

6. A few things we still don’t know…. ■ He Health lth and d beha ehavior vior conseq nsequences uences of incredibly redibly high gh doses ses of THC HC and d the e impa mpact ct on pare renti nting ng beha havi vior ors ■ The e costs sts of moderat derate e canna nnabis bis use, , impa pact ct on pare renting nting ■ Is alcohol cohol sneaking eaking through ough the e back ck door oor ■ Impact ct of evidence dence based sed pro rogra grams s in a lega galized lized cann nnabi bis s cont ntext xt ■ The e syne nergi rgistic stic effect ect of commu mmuni nity ty suppor pported d eviden idence ce based sed program, ogram, policies licies and d practices actices to prevent ent yout outh h cann nnabis abis use ■ What at indus dustr try will l do to reduc duce e regu gula lation tion and nd how w com ommunities munities can n advoca ocate e for r strong ong regul gulation tion

The book is coming… December 3 rd , 2018 For more information visit www.communitiesthatcare.net

Kevin n P. Hagger gerty ty, , MSW, PhD Univer Uni ersity ity of Washing hington on, , School ol of Social al Work rk Cannabis abis Legalization alization and Yout uth: : De Developing loping Clear ar Messages sages in an Evolv lving ing Polic licy y Clim imat ate Boulder lder, , CO Nov 15-16, 2018 18 Six x Les essons sons Lea earned ned From m Can annabis nabis Legalization in Washington State….one resear earch cher ers s perspec spectiv tive Dr. Haggerty is the director of the UW Center for CTC and does receive payments for training and consultation services