TEEN COCKTAIL OF CHOICE: DRUGS, ALCOHOL AND UNPROTECTED SEX

Physicians are urged to help steer their teen and young adult patients away
from destructive behavior by using incisive questions and straight answers.

Washington -- Almost a quarter of sexually active teens and young adults --
about 5.6 million nationally -- have had unprotected sex because they were
drinking or using drugs at the time, according to a Kaiser Family
Foundation survey.

"For teens, drinking and sex is at least as dangerous as drinking and
driving," said Joseph A. Califano Jr., president of the National Center on
Addiction and Substance Abuse at Columbia University in New York and a
former U.S. secretary of health, education and welfare. The survey was
released last month at a conference held at Columbia.

Data from other studies show that approximately 15 million new cases of
sexually transmitted diseases occur annually in the United States. By age
24, one in three sexually active people will have contracted an STD -- and
many may not realize it when they become infected. In addition, substance
use may make a person biologically more susceptible to infection, according
to Kaiser data.

"The message of this study is loud and clear," said Califano. "To be
effective, sex education -- in all its forms -- must discuss the connection
between sexual activity and alcohol and drug abuse, and those who promote
abstinence must help teens see that connection."

The Bush administration favors abstinence programs and to that end
recommended a $33 million increase in funding over fiscal year 2002 levels
for abstinence-only education.

The Kaiser survey also found that of the 1,200 respondents, who ranged in
age from 15 to 24 years old:

Twenty-nine percent said they were more sexually active than they had
planned because of alcohol and drug use.

Fifty percent said "people their age" mix alcohol or drugs and sex "a lot."

Seventy-three percent believe that their peers often don't use condoms when
alcohol and drugs are included in the picture.

Thirty-seven percent want more information about "how alcohol and drugs
might affect decisions about having sex."

"Many teens, as well as young adults, are mixing sex with alcohol and
drugs, and putting themselves at risk," said Drew E. Altman, PhD, president
of the Kaiser Family Foundation. "These are sensitive issues that many
young people don't like to talk about, so these data likely underestimate
the full extent of the problem."

While parents and schools play a large role in educating teenagers about
issues surrounding sexual activity, physicians also have a key role to
play, said Angela Diaz, MD, professor of pediatrics at Mount Sinai School
of Medicine and director of the Mount Sinai Adolescent Health Center in New
York.

"When you work with teenagers, their bodies are fine. What they need is for
a doctor, or any health professional, to connect to them, to listen to
them," she said during a panel discussion at Columbia on the Kaiser survey.

Working exclusively with teenagers has taught Dr. Diaz and her colleagues
to speak in very direct language. "When you do that, teenagers are like an
open book," she said. "They're honest. They want to be helped. They want to
do the right thing."

When recording a teen's medical history, Dr. Diaz covers all facets of
their lives, including how they are doing in school; their future career
goals; how well they communicate with their parents; whether they are in a
relationship and, if so, what kind of relationship; and whether they have
been the victim of sexual violence.

"At the beginning it was hard for me because I was not used to asking those
questions, but with time, you get more and more comfortable and those kids
know that. Teenagers read through you," she said.

While the abstinence message is a good one, it might not be enough, said
Dr. Diaz. Teens who are abstaining should be provided all the skills they
need to stay that course. But teens who are already having sexual
intercourse need the skills to protect themselves, she added.

ADDITIONAL INFORMATION:

Risky behavior Percent of sexually active young people who say:

Alcohol or drugs have influenced their decision to do something sexual.
Teens 15 to 17: 29% Young adults 18 to 24: 37%

They have done more sexually than planned because they had been drinking or
using drugs. Teens 15 to 17: 24% Young adults 18 to 24: 31%

They have worried about STDs or pregnancy because of something they did
sexually while drinking or using drugs. Teens 15 to 17: 26% Young adults 18
to 24: 28%

They have used alcohol or drugs to help them feel more comfortable with a
sexual partner. Teen 15 to 17: 13% Young adults 18 to 24: 16%

They have had unprotected sex because they were drinking or using drugs.
Teens 15 to 17: 12% Young adults 18 to 24: 25%

Source: Kaiser Family Foundation

National Center on Addiction and Substance Abuse at Columbia University
(http://www.casacolumbia.org/)

Kaiser Family Foundation survey on sexual activity and substance abuse
among youth (http://www.kff.org/content/2002/20020207a/)