CASA's new report calls for nationwide overhaul in prevention and treatment programs
WASHINGTON, D.C., Feb. 5, 2003 – Girls and young women use cigarettes, alcohol and other drugs for reasons different from boys, their signals and situations of higher risk differ and they are more vulnerable to substance abuse and addiction and its consequences, according to a report released today by The National Center on Addiction and Substance Abuse (CASA) at Columbia University, The Formative Years: Pathways to Substance Abuse among Girls and Young Women Ages 8-22.
This 231 page report, the culmination of more than three years of research and analysis underwritten by the Bristol-Myers Squibb Foundation, is an unprecedented analysis of the characteristics of girls and young women who abuse substances, when they are at highest risk of doing so and the impact of such abuse.
Despite promising statistics on recent declines in youth substance use, more than one quarter (27.7 percent) of high school girls currently smoke cigarettes, 45 percent drink alcohol, more than a quarter (26.4 percent) binge drink and 20 percent use marijuana. Younger girls are smoking and drinking like boys. High school girls are almost as likely as boys to use cocaine and inhalants. More girls are using substances at earlier ages, nearly as early as boys. Unfortunately, girls suffer consequences beyond those of boys.
“The findings from this study cry out for a fundamental overhaul of public health prevention programs,” says Joseph A. Califano, Jr., CASA president and former U.S. Secretary of Health, Education and Welfare. “Unisex prevention programs – largely developed without regard to gender, often with males in mind – fail to influence millions of girls and young women. 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.”
Califano noted that launching prevention programs designed for girls and young women will reduce the number of women abusing and addicted to substances: “A reduction of only 25 percent would mean saving 8 million women from smoking addiction, one million from alcoholism and alcohol abuse and half a million from drug abuse and addiction.”
Among risks and consequences of smoking, drinking and drug use that the CASA report identifies as unique to girls and young women are these:
- Girls experiencing early puberty are at higher risk of using substances sooner, more often and in greater quantities than later maturing peers; puberty is a time of higher risk for girls than boys.
- Girls are more likely than boys to be depressed, have eating disorders or be sexually or physically abused--all of which increase the risk for substance abuse.
- Substance use can sink into abuse and addiction more quickly for girls and young women than for boys and young men, even when using the same amount or less of a particular substance.
- Girls using alcohol and drugs are likelier to attempt suicide.
- Girls and young women are likelier than boys and young men to experience more adverse health consequences, such as greater smoking-related lung damage. Women are more susceptible to alcohol-induced brain damage, cardiac problems and liver disease, which occur more quickly and with lower levels of alcohol consumption than with males.
- Girls are likelier than boys to abuse prescription painkillers, stimulants and tranquillizers.
- Girls who move frequently from one home or neighborhood to another are at greater risk of using substances than boys who move frequently.
- Transitions from elementary to middle school, from middle to high school, and from high school to college are times of increasing risk for girls. Girls making the transition from high school to college show the largest increases in smoking, drinking and marijuana use.
- Girls are more likely to be offered substances by a female acquaintance, a young female relative or a boyfriend and to receive offers in private settings, while boys are more likely to be offered drugs by a male acquaintance, a young male relative, a parent or a stranger and to receive these offers in public settings.
- Religion is more protective for girls than for boys.
“My heart goes out to all those saddened parents across America whose daughters have sunk into substance abuse and addiction,” says Florida First Lady Columba Bush, a CASA board member who, along with Califano, released the report. “By showing the many and varied paths that girls may go down to substance abuse and how these paths frequently differ from those of boys, CASA's report empowers families, schools, communities and clergy to take steps needed to make a difference.”
The report reveals that caffeine is a little known risk factor. Girls and young women who drink coffee are significantly likelier than girls and young women who do not to be smokers (23.2 percent vs. 5.1 percent) and drink alcohol (69.8 percent vs. 29.5 percent). Young women who drink coffee began smoking and drinking at earlier ages. Parents are the first line of prevention. CASA's Formative Years survey showed that most girls (61.6 percent) who had conversations with their parents about substance use said that the conversation made them less likely to smoke, drink or use drugs.
Prevention programs should target girls at times of highest risk and be sensitive to the reasons why girls use drugs, how they get them and conditions such as depression that increase their risk.
Health professionals should screen young female patients for substance use, depression, sexual and physical abuse, poor school performance, eating disorders, and stress and provide appropriate referrals.
Government should invest resources in research, prevention and treatment that focus on the special needs of girls and women.
The media should refrain from presenting glamorous images of women smoking and drinking or making positive associations between smoking or drinking and thinness or sex appeal; refuse to accept alcohol advertisements for television and for magazines with high proportions of young female readers; and include more programming and articles that convey prevention messages against smoking, drinking, drugging and excessive dieting.
For a decade, CASA, with financial support from the Bristol-Myers Squibb Foundation, has been on the forefront of studying women and substance abuse--in its reports Substance Abuse and the American Woman (1996) and Under the Rug: Substance Abuse and the Mature Woman (1998). The Formative Years: Pathways to Substance Abuse Among Girls and Young Women Ages 8-22 completes the trilogy.
As part of this study, CASA conducted a unique national survey of 1220 girls and young women passing from elementary to middle school, from middle to high school, from high school to college, and from college into the world beyond. CASA also conducted focus groups with preadolescent girls and with their parents to understand their attitudes, beliefs and behaviors about smoking, drinking and using drugs.
The National Center on Addiction and Substance Abuse (CASA) at Columbia University is the only national organization that brings together under one roof all the professional disciplines needed to study and combat all types of substance abuse as they affect all aspects of society. CASA's missions are to: inform Americans of the economic and social costs of substance abuse and its impact on their lives; assess what works in prevention, treatment and law enforcement; encourage every individual and institution to take responsibility to combat substance abuse and addiction; provide those on the front lines with tools they need to succeed; and remove the stigma of substance abuse and replace shame and despair with hope.
With a staff of more than 70 professionals, CASA has conducted demonstration projects in 60 sites in 32 cities and 21 states focused on children, families and schools, and has been testing the effectiveness of drug and alcohol treatment, monitoring individuals in numerous programs and drug courts in several states.