Opinion

DRUG ABUSE NEEDS TO BE ADDRESSED ALONG GENDER

Despite some encouraging statistics about recent declines in substance
abuse, the use of drugs, alcohol and tobacco by teenagers and young adults
remains one of the nation's most serious and destructive health problems.

A lot of time, money and words have been expended on prevention programs.
So, why haven't we made more progress in reaching young people about the
dangers of drug abuse and addiction?

The National Center on Addiction and Substance Abuse at Columbia University
has come up with an intriguing answer to at least part of the puzzle - it's
a Gender Gap.

The prevention efforts have largely been designed with males in mind,
ignoring the unique needs of females and, thereby, failing to influence
millions of young girls and women, according to a three-year study and a
231-page report - The Formative Years: Pathways to Substance Abuse Among
Girls and Young Women, Ages 8-22 - issued by the Center earlier this month.

"The findings from this study cry out for a fundamental overhaul of public
health prevention programs," says Joe Califano, president of the Center and
former Secretary of the U. S. Health, Education and Welfare Department.
"The women of America have paid a fearful price in premature death and
destroyed lives for our failure to craft programs aimed at their unique needs."

The numbers bear out Califano's alarms. More than 4.4 million women are
alcoholics or abuse alcohol. More than 2 million use illegal drugs.
Thirty-one million women smoke.

At the high school level, 45 percent of girls drink alcohol and 26.4
percent binge drink. One in five smoke marijuana. More than quarter of
female high school students smoke cigarettes and nearly four percent are
users of cocaine while another 4.2 percent use inhalants.

The study cites a long list of risks and consequences of smoking, drinking
and drug use that are unique to women. Among these:

Girls typically experience puberty at an earlier age than boys. Girls who
experience early puberty are at greater risk than boys of smoking, drinking
and using drugs.

Girls are likelier than boys to have been physically or sexually abused,
Such girls are at increased risk for substance abuse.

Substance use can sink into substance abuse more quickly for girls and
young women than for boys and young men.

Girls are likelier than boys to diet and to have eating disorders. Such
girls are at increased risk for substance abuse.

Key transitions such as frequent moves from one home or neighborhood to
another pose greater risks of substance abuse for girls than boys.
Similarly, the transition from high school to college creates greater risks
of substance use for young women.

Girls using alcohol or drugs are more likely to be depressed or suicidal
increasing the risk for substance abuse.

Girls and women are more likely than boys and men to experience adverse
health consequences from smoking, drinking or using drugs. Females have
greater smoking-related lung damage than males and are more susceptible to
alcohol-induced brain damage, cardiac problems and liver disease.

Tobacco and alcohol manufacturers come in for heavy criticism for their
practice of spending billions of dollars each year on advertising and
promotions, sponsorships of events and product placements in movies and
television shows in an effort to promote use of their products by women.

"The tobacco industry has a long history of targeting its marketing efforts
to young women, exploiting women's desire for independence and
sophistication, and appealing to perennial female concerns about weight and
appearance," the report says. "Alcohol industry advertising makes drinking,
and by association women who drink, appear fun and sexy."

What can be done to reduce the risks for women, particularly young women in
their formative years?

Not unexpectedly, the report cites parents as the "first line of
prevention." In a survey of 1,220 girls, nearly 62 percent who had
conversations with their parents about substance use said the conversation
made them less likely to smoke, drink or use drugs.

The report urged that health care professionals be alert to signs of
substance abuse in routine screening of young female patients and encourage
those in need of help to seek treatment.

The report also recommended that prevention programs target girls at times
of highest risk and be sensitive to the reasons they use drugs, how they
get them and the very neglected conditions such as depression that increase
their risk.

The report calls for more government investment in research, prevention and
treatment that focuses on the special needs of girls and women.

Despite the deplorable findings of the study, the Califano is optimistic
that a properly crafted prevention program that recognizes the unique needs
of women can bring about major change in the outlook for a reduction of
substance abuse.

Califano projects that a reduction of only 25 percent in the number of
women abusing and addicted to substances could mean saving 8 million women
from smoking, 1 million from alcoholism and abuse, and a half million from
drug abuse and addiction.

Under Califano's leadership, the National Center on Addiction and Substance
Abuse, has produced an extremely valuable document that should alert the
nation to the need for a major change in the way we approach women's
health, particularly in the critical arena of substance abuse.