Pubdate: Mon, 18 Mar 2002
Source: American Medical News (US)
Copyright: 2002, American Medical Association
Contact: http://www.ama-assn.org/public/journals/amnews/edlet.htm
Website: http://www.amednews.com/
Details: http://www.mapinc.org/media/1235
Author: Susan J. Landers
Bookmark: http://www.mapinc.org/youth.htm (Youth)

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/)
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MAP posted-by: Alex