DRUG AND ALCOHOL USE

AMONG JUVENILE PROBATIONERS

IN UTAH

OCTOBER, 1997

R. Steven Harrison, Ph.D.

Associate Research Professor

Social Research Institute

University of Utah

Salt Lake City, Utah 84112

Assistance provided by:

Utah State Administrative Office of the Courts

Utah Commission on Criminal and Juvenile Justice

Utah State Division of Substance Abuse

Utah State Office of Education

ACKNOWLEDGMENTS

This study was a cooperative project of the Social Research Institute at the Graduate School of Social Work, University of Utah, the Utah State Administrative Office of the Courts, the Utah State Office of Education, and the Utah State Division of Substance Abuse.

There have been many individuals who have helped with this project. I would like to thank Mike Pepper and Carolyn Andersen who had the interest in conducting a follow- up survey of substance use by the youth on probation and then worked to make it a reality. They were very helpful in designing the questionnaire, organizing meetings, and coordinating the overall survey effort. Also, I would like to thank Lynne MacLeod for her assistance with developing the questionnaire and data entry, Russ Van Vleet and Mark Winiger for conducting the focus group interviews, Chris Wehl, Ph.D. for assistance with data analysis and reviewing the results, and Terri Cravens and Jill Tabish for entering the responses from the questionnaires into the computer for analysis.

Finally, I would like to thank the staff of the Social Research Institute: Bruce Parsons, Ph.D., Russ Van Vleet, M.S.W., Suzanne Plumb, Sara McPhee, Robin Davis, and Hailey Wolfenbarger for their assistance in entering data and reading various drafts of this report and providing valuable feedback.

TABLE OF CONTENTS

Page

Executive Summary	iv

Introduction	1

Methodology	2

Questionnaire Development and Administration	2

Data Analysis	3

Focus Groups	3

Results	4

Survey Participants	4

School and Employment	5

Family Characteristics	6

Alcohol and Other Drug use Among Probationers	8

Delinquency and Gangs	15

Other Findings	16

Risk and Protective Factors For Substance Abuse and Other Youth Problems	17

Community Risk Factors	17

Family Risk Factors	19

School Risk Factors	20

Individual and Peer Risk Factors	21

Protective Factors	22

Risk and Protective Factor Scales	24

Need For Substance Abuse Treatment	28

Diagnostic Criteria for Substance Abuse and Dependence	28

Male and Female Differences in Need for Treatment	30

Focus Groups	30

Probation Contact	31

School	31

Alcohol, Tobacco, and Other Drugs	31

Guns	32

Gangs	32

Religiosity	32

Neighborhoods	32

Other Discussion Issues	33

Summary	34

Appendix	37

EXECUTIVE SUMMARY

In 1992, Jeffrey M. Jenson, Ph.D. conducted a survey of alcohol, tobacco, and other drug (ATOD) use among juvenile probationers in Utah. That study was supported by four agencies that were interested in the substance use and other problems of youth on probation. The agencies were the Utah State Administrative Office of the Courts, the Utah Commission on Criminal and Juvenile Justice, Utah State Division of Substance Abuse, and Utah State Office of Education. The results of the study showed that juvenile probationers used more ATODs than youth in the general population, and were more at risk for mental health problem, delinquency, gang involvement, and other problem behaviors. The present survey, again supported by the same four agencies was conducted as a follow-up to the 1992 survey to determine the current level of ATOD use and problem behaviors among probationers.

Results of the present survey will be compared to those from the 1992 survey as well as the results from the recent (1997) youth household survey conducted by Dan Jones and Associates for the Utah State Division of Substance Abuse. Having the results of these other surveys will allow a longitudinal comparison of problem behaviors and ATOD use by probationers from 1992 to 1997 as well as a comparison between probationers and youth from the general population in Utah.

The value of this survey is also enhanced by two other projects conducted by the Social Research Institute and the Division of Substance Abuse. The projects are: 1) an investigation of the risk and protective factors for substance abuse and 2) estimating the need for substance abuse treatment in Utah. The goal of the risk factor project was to find the factors that place youth at risk for substance abuse and the factors that protect youth from substance abuse. Utah worked with five other states and the Social Development Research Group at the University of Washington on this project. The risk-focused model of prevention that formed the basis for this Six-State Project was developed by J. David Hawkins, Ph.D., Richard R. Catalano, Ph.D., and their associates at the University of Washington. Descriptions of the risk-focused model have been published in Communities That Care by Hawkins and Catalano in 1992, and can be consulted for additional information on the risk-focused model of substance abuse prevention.

The risk-focused model makes several generalizations about risk in youth: 1) risks exist in many areas of a young person's life, 2) the more risk factors that are present in the youth's life the greater the overall risk of abusing ATODs, 3) common risk factors predict several behavior problems such as substance abuse, delinquency, violence, teen pregnancy, and school dropout, and 4) protective factors help reduce the effects of exposure to risk. The risk and protective factors have been divided into four domains: 1) community, 2) family, 3) school, and 4) the individual and his peers. A more detailed description of the risk and protective factors for substance abuse and how the probationers in this survey scored on the 20 risk and 12 protective factor scales is presented in the Risk and Protective Factor Section of the final report.

The project to determine substance abuse treatment needs in Utah provided the methodology for determining the need for treatment among probationers. That methodology was based upon asking youth questions that would allow a determination of whether they met the diagnostic criteria for Psychoactive Substance Abuse or Dependence according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) published by the American Psychiatric Association. Those who meet the diagnostic criteria for Psychoactive Substance Abuse or Dependence are definitely in need of treatment.

There were several topics of investigation that could not easily be put into questionnaire form. Probationers' thoughts and feelings about these issues was explored through focus groups. Topics for the focus groups included: 1) Youth knowledge of laws and penalties associated with substance use, 2) Types of court programs that have helped youth stay out of trouble, 3) Penalties that have helped deter criminal behavior, 4) The court's response to crime and drug use, 5) Youth perception of the criminal justice system, with recommendations for program development, and 6) Substance use issues such as perceived harmfulness of drugs, availability, and youth expectations of future drug use.

RESULTS

Survey Participants

This survey was designed to include all youth on probation in the eight judicial districts across the state, and questionnaires were completed by probationers during their regular visit to the probation office. The final number of survey participants was 1,032. They had a mean age of 15.5 years, and 15% were female and 85% male. They were on probation for an average of 7.7 months. Their ethnicity was 68% Caucasian, 15.5% Hispanic, 8.2% Native American, 5.2 Asian/Pacific Islander, and 1.7% African American.

Alcohol and Other Drug Use

As can be seen in Table 1, probationers used drugs in all categories at rates much higher than youth in the community. In fact, probationers' lifetime use ranged from three times the community rate for alcohol and 3.5 times the rate for cigarettes to 13 times the 1997 community rate for hallucinogens and 27 times the rate for opiates. The most frequently used drugs among probationers and youth in the community were cigarettes, alcohol, and marijuana.

There has been a modest decrease in the proportion of the probationers reporting alcohol, cigarette, and stimulant use since the 1992 youth probation survey.

TABLE 1

PERCENTAGE OF RESPONDENTS USING ATODs DURING THEIR LIFETIME

DRUG USED	1997 COMMUNITY	1997 PROBATION	1992 PROBATION
Smokeless Tobacco	8%	48%	N/A
Cigarettes	25%	88%	92%
Alcohol	27%	85%	90%
Marijuana	12%	77%	70%
Hallucinogens	3%	41%	43%
Stimulants	4%	37%	49%
Inhalants	6%	35%	34%
Cocaine/crack	2%	32%	26%
Sedatives	3%	28%	N/A
Opiates	.4%	11%	N/A

The percentage of respondents using substances in the past 30 days is shown in Table 2. As with lifetime use, the probationers had lower rates of alcohol and tobacco use than they did in 1992, but a much higher rate of use of ATODs than the youth in the community.

TABLE 2

PERCENTAGE OF RESPONDENTS USING ATODs DURING THE PAST 30 DAYS

DRUG USED	1997 COMMUNITY	1997 PROB	1992 PROB
Cigarettes	10%	59%	78%
Alcoholic beverages	12%	34%	40%
Marijuana	5%	26%	29%
Hallucinogens	1%	9%	9%
Stimulants	2%	11%	11%
Inhalants	2%	4%	3%
Cocaine/crack	1%	6%	3%
Sedative/hypnotics	1%	9%	N/A
Opiates	.1%	3%	N/A
Table 3 shows the reported age of first use of alcohol and marijuana for the 1997 community and probation surveys and the 1992 probation survey. The probationers in 1992 had higher rates of alcohol use at ages 12, 15, and 18. By the age of 18, 81% of current probationers had used marijuana compared to 70% of the 1992 probationers and 13% of the youth in the general population.

TABLE 3

AGE OF FIRST USE OF ALCOHOL AND MARIJUANA
AGE OF FIRST USE	1997 COMM	1997 PROB	1992 PROB
Used alcohol by age 12	9%	37%	48%
Used alcohol by age 15	21%	75%	85%
Used alcohol by age 18	26%	86%	90%
Used marijuana by age 12	2%	22%	29%
Used marijuana by age 15	10%	69%	65%
Used marijuana by age 18	13%	81%	70%

Probationers were asked to assess the risk involved with the use of various drugs. Table 4 shows the percentages from the 1992 survey and the 1997 survey that endorsed "great risk" from using the various drugs. Probationers have changed markedly since the 1992 survey in their assessment of the risk of regular use of marijuana with a decrease from 45% in 1992 to 28% in 1997. The perceived harmfulness of "taking cocaine regularly" also decreased from 95% stating that there was "great risk" in 1992 to 66% in 1997. This trend should be monitored closely since a decrease in the perceived harmfulness of a substance usually occurs prior to an increase in the use rate of the substance.

TABLE 4

RISK ASSOCIATED WITH ATOD USE
Would be at "great risk" using the following drugs	1997 PROB	1992 PROB
Smoking marijuana regularly	28%	45%
Taking cocaine regularly	66%	95%
Taking stimulants regularly	60%	68%
Having 4 or 5 drinks nearly every day	45%	67%
Having five or more drinks once or twice each weekend	36%	33%
Taking hallucinogens regularly	54%	N/A
Probationers were asked to rank the ease of obtaining various drugs, from "very easy" to "very hard." Table 5 shows the rates of endorsement of "very easy" and "sort of easy" responses of youth in the community and those completing the 1997 probation survey. The probationers report that ATODs are easier to get.

TABLE 5

EASE OF OBTAINING DRUGS
"Very easy" or "Sort of easy" to get:	1997 COMM	1997 PROB
Alcohol	41%	71%
Cigarettes	49%	82%
Marijuana	39%	70%
Cocaine, LSD, or amphetamine	25%	49%

Need for Substance Abuse Treatment

As shown in Table 6, a total of 32.3% of individuals on probation need substance abuse treatment. While no direct comparison of Utah youth from the general population is available at this time, a recent estimate of the need for treatment among youth by the Division of Substance Abuse placed the need for treatment at 7.2%.

For an individual to receive a diagnosis of Psychoactive Substance Dependence according to the DSM-III-R, they must meet at least three of nine criteria for substance dependence and the symptoms must have persisted for at least one month or occurred repeatedly over a longer period of time. The nine criteria for Psychoactive Substance Dependence include: 1) substance often taken in larger amounts or over a longer period than the person intended, 2) persistent desire to cut down or control substance use, 3) a great deal of time spent in activities necessary to get the substance, taking the substance, or recovering from its effects, 4) frequent intoxication or withdrawal symptoms when expected to fulfill major role obligations at work, school, or home, or when substance use is physically hazardous, 5) important social occupational or recreational activities given up or reduced because of substance use, 6) continued substance use despite knowledge of having a persistent or recurrent social, psychological, or physical problem that is caused or exacerbated by the use of the substance, 7) marked tolerance, or markedly diminished effect with continued use of the same amount, 8) characteristic withdrawal symptoms, and 9) the substance is often taken to relieve or avoid withdrawal symptoms.

Individuals also need treatment if they meet the criteria for Psychoactive Substance Abuse. The diagnostic criteria for Psychoactive Substance Abuse includes two criteria from the Dependence criteria listed above (numbers 4 or 6) and the individual does not meet the diagnostic criteria for Psychoactive Substance Dependence.

TABLE 6

NEED FOR SUBSTANCE ABUSE TREATMENT BY YOUTH ON PROBATION

Percent Needing Treatment
For Dependence	For Abuse	Dependence or Abuse
Substance	Male	Fem	Total	Male	Fem	Total	Male	Fem	Tota l
Alcohol	18.4	16.7	18.1	1.9	.7	1.8	20.3	17.4	19.9
Marijuana	23.7	21.5	23.2	2.1	.7	1.9	25.8	22.2	25.1
Cocaine	7.0	8.3	7.3	1.4	.7	1.3	8.4	9.0	8.6
Hallucinogens	7.5	4.2	7.1	1.3	1.4	1.3	8.8	5.6	8.1
Heroin/other opiates	3.9	2.1	3.7	1.6	.7	1.4	5.5	2.8	5.1
Stimulants	8.3	10.5	8.7	1.3	.7	1.2	9.6	11.2	9.9
Inhalants	4.3	2.8	4.2	1.4	.7	1.3	5.7	3.5	5.5
All Drugs (not alcohol)	27.0	27.1	26.9	4.0	2.8	3.8	29.1	27.8	28.9
Total (alcohol or drugs)	30.2	33.3	30.5	4.4	2.8	4.2	32.1	34.0	32.3

SUMMARY

As with the 1992 survey of probationers, the results of the current survey show that juvenile probationers used more alcohol, tobacco, and other drugs than youth in the general population, and were more at risk for mental health problems, delinquency, and antisocial activities. Additionally, the current survey clearly shows that when compared to youth in the general population, probationers have more risk and less protection for substance abuse and other problems in the four important areas of their daily lives: the community, the family, the school, and within individuals themselves and their peer interactions.

In the community, probationers report drugs and alcohol to be more available, they perceive that the laws and norms of the community are more favorable to drug use, and there is considerable transition and mobility in their communities. In their families, they report that they are not as attached to their families or see as many opportunities for positive involvement with their families as youth from the general population. They report that their parents are not monitoring them as closely as parents from the general population. At school, they are more prone to academic failure, and have less commitment to school. With their peers and for the individuals themselves, probationers are more likely to engage in anti-social behavior, have early initiation of anti-social behavior, interact with anti-social peers, have favorable attitudes toward drug use, have friends who use drugs, are less religious, and lack social skills. They are also more likely to need treatment for substance abuse with 32% meeting the DSM-III-R diagnosis of substance abuse or dependence. The estimate for youth in the general population that need substance abuse treatment is 7%.

Positive Trends. The juvenile probationers in 1997 are less likely to use cigarettes, alcohol, hallucinogens and stimulants than they were in 1992. They have been exposed to skill training opportunities more than the probationers in 1992, and they report less of an intention toward use of alcohol and marijuana in the coming year. Also, gang membership among probationers has decreased from 20% belonging to a gang in 1992 to 17% reporting gang membership in 1997. Probationers in the focus groups indicated that gangs were not really impacting their lives.

Negative Trends. For juvenile probationers, school enrollment is down from 1992 levels. Since school attachment and the opportunities for success that can be found in the educational system provide important protective factors for these youth, any decrease in the availability of educational opportunities compromises their bonding, positive behavior, and chances of personal success.

The use of marijuana, inhalants and cocaine are up from 1992 survey levels. The use of these "harder drugs" have serious societal implications. The biological insult to adolescents using these drugs compromises their efforts to achieve personal success; bond with their community, schools, and family; and develop a realistic sense of well being and personal health.

Two alarming trends are: 1) the apparent ease with which drugs and alcohol can be obtained, and 2) the rise in the percentage of youth who do not perceive a risk associated with drug and alcohol use. Easy access and the belief that drugs and alcohol are harmless is a recipe for increased ATOD use rates in the future. Again these indicators are higher than reported in 1992.

Females in particular are in more need of treatment than reported in 1992. The percentage of females that need treatment in 1997 is higher that the percentage of males that need treatment. The female probationers also are more at risk for substance abuse and other problems than males. When compared to males in this survey, they report that alcohol and other drugs are more available to them, they have more favorable attitudes toward drug use, and they view the laws and norms of the community to be more favorable to drug use. They have more family conflict, come from families with a history of anti-social behavior, are not as attached to their families, and do not see as many opportunities for positive involvement with their families. At school they have a greater risk for academic failure, tend to have more friends that use drugs, and they are less resilient than male probationers.

These differences between male and female probationers are even more serious when the male-female differences of the general population are reviewed. For the general population, females are generally less at risk and have more protection than males, just the opposite of the females on probation. Thus, every effort should be made to provide treatment opportunities that are specifically designed for the females on probation.

There has been a reduction in the proportion of probationers definitely intending to use alcohol and marijuana. In 1992, 32% were sure to drink alcohol and 18% were sure to smoke marijuana in the coming year, while in 1997, only 18% were sure to use alcohol and 14% smoke marijuana. The intention to use other drugs remains unchanged from 1992. While this could be seen as a positive indicator, it may not be. Although it would seem that a desire to quit using alcohol and marijuana is a good thing, it is possible that the real issue is that because these youth have serious substance abuse problems, they are more likely to endorse the idea of quitting than someone who does not have as great a need for treatment. With the prevalence of harder drug use increasing, it seems that this group of youth has a serious substance abuse problem.

The arrests rate for juvenile drug violations also points to a greater substance abuse problem for youth currently on probation. Data from the Utah Bureau of Criminal Identification, Department of Public Safety shows that the arrest rate for drug law violations (possession, sale, use, growing, manufacturing of illegal drugs) per 100,000 juveniles (age 10-17) increased from 188 in 1991 to 685 in 1995. This indicates that a trend of increasing criminal activity for juveniles is occurring.

Conclusion. Since there is a significant drop in the use of cigarettes and alcohol from 1992 to 1997, it would seem wise to determine why this has occurred and to replicate this methodology with marijuana and cocaine. Perhaps the "media blitz" surrounding the tobacco industry and the harmful effects of cigarette smoking has managed to impact youth prevalence rates of tobacco products. The interviews with youth in the focus groups suggest that probationers have learned that tobacco is very harmful, however, they do not perceive alcohol and other drugs as that harmful. The techniques for providing information about the harmfulness of tobacco should be explored for use in combating the perceived benign nature of alcohol and other drugs. Using the types of messages that have been used with tobacco would be a strategy worth investigating for use with marijuana and cocaine which also have serious and profound health consequences.

It would also be appropriate to address why fewer probationers are seeking substance abuse treatment. Is this a function of managed health care, insufficient funding for children at risk, systemic access problems, poor assessment and triage, or something less obvious. This seems to be an important question which needs further investigation.

Finally, the information in this report shows that compared to youth in the general population, probationers in Utah are more at risk for substance abuse and other problems; have higher rates of use of alcohol, tobacco, and other drugs; and have a higher need for substance abuse treatment. The challenge for the juvenile probation system is to provide an array of successful treatment programs that address probationers' problem behaviors. In order to be successful, treatment programs need to be run according to established protocols that have been shown to be effective with youth on probation. A key component of a successful treatment system is a strong evaluation component that will ensure that programs are being implemented as they were designed and are having positive outcomes on the lives of the youth who participate.

Those working with juvenile probationers should investigate and implement programs that are well researched and have been shown to reduce youth problem behaviors. Without successful programs to address the problems of these youth, they will become prime candidates to move into the adult criminal justice system.