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					                   US Coast Guard
               Motorcycle Safety Summit




                            Mark Mattiko, M.Ed
                    Substance Abuse Program Manager
                        United States Coast Guard
Mattiko 8/08
                                8/25/2008
Mattiko 8/08
       So, what do we know?




Mattiko 8/08
                 So, what do we know?

                    We know that:


               Some things just
               don’t go together!
Mattiko 8/08
               Pathophysiology of Stupid




                             AMA established as a disease in 50’s

                             Over 720 scientific studies verifying
                             addiction is a disease

                             39% of people fatally injured in traffic
                             crashes were alcohol related
                                                          NHTSA, 2006

Mattiko 8/08
                         Motorcycles, fast cars, fast woman




               ALCOHOL




Mattiko 8/08
                    DoD Alcohol Use Trends
                                                     (1980-2005)
                  100
                                 Abstainer or Infrequent/Light
                                 Heavy Alcohol
                   80


                   60                                                                               Statistically
     Percentage




                                                                                                    significant
                                                                                                    increase from
                                                                                                    1980
                   40                                                                          *

                   20


                    0
                        19801982      1985    1988       1992    1995   1998       2002    2005


                        Heavy Alcohol Use = 5 or more drinks/occasion at least once a week in past 30 days.
  Mattiko 8/08              *Significant at .05 level
Substance Use
                     USCG Math
                (Alcohol Consumption Pattern Recommendation for men)
                                                                       NIAAA & WHO



       Monday                  Wednesday                      Thursday




                         Friday                    Saturday




Mattiko 8/08
               USCG Math
               (Alcohol Consumption Pattern)



         Underway Week 1
    Mon Tues Wed Thu Fri Sat Sun
       0 0 0 0 0 0 0
         Underway Week 2
    Mon Tues Wed Thu Fri Sat Sun
       0 0 0 0 0 0 0
Mattiko 8/08
                   USCG Math
                             Underway Week 1
                       Mon Tues Wed Thu Fri Sat Sun
               0   0        0       0        0        0   0
                             Underway Week 2
                       Mon Tues Wed Thu Fri Sat Sun
               0   0        0       0        0        0   0


                       Liberty Night 1




Mattiko 8/08
                               Binge Drinking
                        Rates by Service, 2002 - 2005
                                    Binge Drinking = 5 or more drinks on a single occasion
                                              at least once in in the past 30 days
      100

                                                              2002              2005
             80
Percentage




             60                                   54.2 53.2                                       56.4
                            52.8*                                                          53.8
                                    44.2                                            44.5                   42.0
                   41.4                    41.7                              41.8
             40                                                 34.0 33.9                                             34.0


             20


              0
                        Army           Navy         Marine       Air Force      Total         Total      Civilian   Civilian
                                                    Corps                       DoD         DoD 18-      College     Other
             *Significant difference between 2002 and 2005 at .05 level.
                                                                                             25 Yrs      (2004)     (2004)
              Civilian estimate for 1-4 years past High School reported from Monitoring the Future, past 2 weeks, 2004.
             Mattiko 8/08
 Substance Use
                               Binge Drinking
                        Rates by Service, 2002 - 2005
                                    Binge Drinking = 5 or more drinks on a single occasion
                                              at least once in in the past 30 days
      100

                                                              2002              2005
             80
Percentage




             60                                   54.2 53.2                                       56.4
                            52.8*                                                          53.8
                                    44.2                                            44.5                   42.0
                   41.4                    41.7                              41.8
             40                                                 34.0 33.9                                             34.0


             20


              0
                        Army           Navy         Marine       Air Force      Total         Total      Civilian   Civilian
                                                    Corps                       DoD         DoD 18-      College     Other
             *Significant difference between 2002 and 2005 at .05 level.
                                                                                             25 Yrs      (2004)     (2004)
              Civilian estimate for 1-4 years past High School reported from Monitoring the Future, past 2 weeks, 2004.
             Mattiko 8/08
 Substance Use
                               Binge Drinking
                        Rates by Service, 2002 - 2005
                                    Binge Drinking = 5 or more drinks on a single occasion
                                              at least once in in the past 30 days
      100

                                                              2002              2005
             80
Percentage




             60                                   54.2 53.2                                       56.4
                            52.8*                                                          53.8
                                    44.2                                            44.5                   42.0
                   41.4                    41.7                              41.8
             40                                                 34.0 33.9                                             34.0


             20


              0
                        Army           Navy         Marine       Air Force      Total         Total      Civilian   Civilian
                                                    Corps                       DoD         DoD 18-      College     Other
             *Significant difference between 2002 and 2005 at .05 level.
                                                                                             25 Yrs      (2004)     (2004)
              Civilian estimate for 1-4 years past High School reported from Monitoring the Future, past 2 weeks, 2004.
             Mattiko 8/08
 Substance Use
                               Binge Drinking
                        Rates by Service, 2002 - 2005
                                    Binge Drinking = 5 or more drinks on a single occasion
                                              at least once in in the past 30 days
      100

                                                              2002              2005
             80
Percentage




             60                                   54.2 53.2                                       56.4
                            52.8*                                                          53.8
                                    44.2                                            44.5                   42.0
                   41.4                    41.7                              41.8
             40                                                 34.0 33.9                                             34.0


             20


              0
                        Army           Navy         Marine       Air Force      Total         Total      Civilian   Civilian
                                                    Corps                       DoD         DoD 18-      College     Other
             *Significant difference between 2002 and 2005 at .05 level.
                                                                                             25 Yrs      (2004)     (2004)
              Civilian estimate for 1-4 years past High School reported from Monitoring the Future, past 2 weeks, 2004.
             Mattiko 8/08
 Substance Use
                      USCG Alcohol & Drug Arrests for
                        FY 2008 (10 months) N= 176

               80
               70      76         76
               60
               50
               40
               30
               20
               10                                    21         3
               0
                    18 to 24   25 to 31           32 to 39   40 and
                                                              over
                                   A ge R a nge




Mattiko 8/08
                  Drug & Alcohol Discharges: 2005 thru 2008*
                             (*2008 data is for 10 months only)
         250
                                                              2008 Projection
         225                                                      Alcohol (189-188)
                                                                   Drug (137-150)

         200
         175
                       Alcohol
         150           DRUGS
         125
         100
                    FY-05           FY-06            FY-07                    FY-08

        Alcohol      195             190               153                      157
        DRUGS        226             225               194                      114


Mattiko 8/08
                          USCG Discharges ( a ppr ov e d) for FY 2008*
                                         (for 10 m onths)


               50

               40

               30
                                                                         Alcohol
               20                                                        Drug

               10

               0
                    E-1     E-2    E-3   E-4    E-5     E-6   E-7




Mattiko 8/08
                         2008 Drug & Alcohol Discharges*

             25

             20
                                        Brain Matures
             15
    Amount




                                                              Alcohol
             10                                               Drug
               5

               0
                   19
                        20
                        21
                             22
                             23
                                  24
                                  25
                                       26
                                       27
                                            28
                                            29
                                                 30
                                                 31
                                                        32
                                                        33
                                                             36
                                                             37
                                                                  39
                                                                  41
                    E
             AG




                                       Age

Mattiko 8/08
               •   PublicServiceAn
                   nouncemt.mp3
Mattiko 8/08
Recommended Standards for USCG*
*Based   on World Health Organization, NIAAA & DSM IV criterion




           31-62%                                      22-28%                                 3-12%**
           **MSE very high; speculation not wise



          Responsible                     Harmful Use           Hazardous Use          Dependency &
          Alcohol Use                                                                    Tolerance
            Per session                    Causing damage to    Places self or
                                                health:         others at risk        Does not
    2 drinks for woman
                                                                                      demonstrate
                                          Physical –            Vehicle accidents     impairment at high
    3 for men                             Hang over Damage                            ETOH blood levels
                                          to liver              Does not drink        i.e.
    Not to exceed 15 per                                        then binges
    week for men; 10                      Mental –              heavily               Has .20 ETOH level
    for women.                            Anxiety                                     “and was fine”
                                          Depression onset      Has physical,
                                                                mental, social, and   DSM IV Criterion
                                          Social – Isolating    consequences



  Mattiko 8/08
    Serious Incidents for USCG*
         *Based on World Health Organization, HRB, NIAAA & DSM IV criterion & USCG Data




       Responsible          Harmful Use           Hazardous Use          Dependency &
       Alcohol Use                                                         Tolerance
          Per session       Causing damage to     Places self or
                                 health:          others at risk        Does not
  2 drinks for woman
                                                                        demonstrate
                           Physical –             Vehicle accidents     impairment at high
  3 for men                Hang over Damage                             ETOH blood levels
                          ~to85% of Coast
                              liver               Does Incidents
                                                Guard not drink         i.e.
  Not to exceed 15 per                     Live HERE!binges
                                                  then
  week                      Mental –              heavily               Has .20 ETOH level
                            Anxiety                                     “and was fine”
                            Depression onset      Has physical,
                                                  mental, social, and   DSM IV Criterion
                            Social – Isolating    consequences



Mattiko 8/08
                   Alcohol Use And Disease




               0          1 to 2     3 to 5     6 or more

                    Number of standard drinks per day
Mattiko 8/08
                   Alcohol Use And Disease




               0          1 to 2     3 to 5     6 or more

                    Number of standard drinks per day
Mattiko 8/08
                Risk Of Alcoholic Cirrhosis
   Alcohol                   Cirrhosis    Odds Ratio
(drinks/day)                  (%)        for Cirrhosis

      Teetotaler                 0.04        0
      <3                         0.15        0
        3-6                       1.0       10.9
      >6-9                        2.3       25.0
      >9                         4.9+       52.9+
  *Bellentani, Tiribelli. 2001
 Mattiko 8/08
    Epidemiology & Consequences
        of Drinking and Driving
                             NIAAA & NHTSA, 2003 & 2004




 82 million drunk driving trips with BAC’s
  above .08 each year
 1.5 million DUI arrests each year
 For every arrest 56 get away
 A BAC of .08 or > guarantees you:
        •      Reduced peripheral vision
        •      Poor recovery from glare
        •      Decrease performance in complex tracking
        •      Reduced attention span
        •      Impaired balance
Mattiko 8/08
Mattiko 8/08
Mattiko 8/08
Mattiko 8/08
              Do we have a
            responsibility to
           those who are not
             responsible for
              themselves?
Mattiko 8/08
                 Comments
               Easy Questions
                  (Job Offers)

Support Slides
Mattiko 8/08
               Other Slides




• Other Slides Other Slides Other Slides




Mattiko 8/08
Mattiko 8/08
                 2007 USCG Separations
               Enlisted Personnel Discharges 2007 (Count)
     70
     60
     50                                                     Drugs
     40                                                     ETOH
     30
     20
     10
        0
                  E1     E2      E3     E4      E5     E6           E7



Mattiko 8/08
                       USCG Enlisted Personnel 2007
                     Percent Lost to ETOH or Drug Abuse
10.00%
                                   (Discharges Only)
   8.00%

   6.00%

   4.00%
                                                   Mendacious Data?
   2.00%

   0.00%
               E1   E2   E3   E4     E5    E6    E7    E8    E9 E10


Mattiko 8/08
               Alcohol Discharges: 2005 thru
                           2008*
                  250
                  225                      Alcohol
                  200
                  175
                  150
                  125
                  100
                         FY-05   FY-06   FY-07       FY-08

               Alcohol    195     190     153         157




Mattiko 8/08
                    2008 Drug & Alcohol Discharges*
         25

         20

         15
Amount




                                                       Alcohol
         10                                            Drug

          5

          0
              19
                   20
                   21
                        22
                        23
                             24
                             25
                                  26
                                  27
                                       28
                                       29
                                            30
                                            31
                                                 32
                                                 33
                                                      36
                                                      37
                                                           39
                                                           41
               E
         AG




                                   Age

Mattiko 8/08
                         Standardized Comparisons of Substance Use,
                              Past 30 Days, by Age Group, 2005
                   100
                                                          DoD        Civilian
                    80
                           Ages          Ages          Ages           Ages           Ages            Ages
                           18-25         26-55         18-25          26-55          18-25           26-55
      Percentage




                    60

                                                      40.0*
                    40                                        35.4

                                                                     22.7 23.9     24.8*
                                  18.8                                                     17.4
                    20
                                                8.3                                                 9.7 9.5
                           6.8*
                                         2.9*
                     0
                              Illicit Drug Use            Cigarette Use             Heavy Alcohol Use

                   Heavy alcohol = 5 or more drinks per occasion at least once a week in past 30 days.
            *Statistically significant from Civilian at .05 level. Civilian data are from 2004 National Survey on Drug
            Use and Health and were standardized to the U.S. based 2005 military data by gender, age, education,
            race/ethnicity, and marital status.
     Mattiko 8/08
Substance Use
               Hurdles and Roadblocks
• Currency of USCG Data is poor

• Glamorization of Drinking

• Cultural Shift amongst Heavy Drinkers

• Alcohol Industry Spent 2 Billion (in 2003)

• Complex Societal Health Problem

Mattiko 8/08
                “The Way Ahead”
• Enter HRB DoD Study: Scientific Data

• Rethink our Strategic Plan (Seybold Model)

• Total SAFE Rewrite
        – More personal
        – Greater Chief involvement
        – Command Consistency

Mattiko 8/08
               Substance Abuse Prevention
                  Program Philosophy


                               EDUCATION




                                 Data




                  PREVENTION               TREATMENT




Mattiko 8/08
    Biophysiology of Alcohol Abuse &
                Addiction




Mattiko 8/08
Recommended Standards for USCG*
*Based   on World Health Organization, NIAAA & DSM IV criterion




          Responsible               Harmful Use               Hazardous Use          Dependency &
          Alcohol Use                                                                  Tolerance
            Per session             Causing damage to         Places self or
                                         health:              others at risk        Does not
    2 drinks for woman
                                                                                    demonstrate
                                    Physical –                Vehicle accidents     impairment at high
    3 for men                       Hang over Damage                                ETOH blood levels
                                    to liver                  Does not drink        i.e.
    Not to exceed 15 per                                      then binges
    week                            Mental –                  heavily               Has .20 ETOH level
                                    Anxiety                                         “and was fine”
                                    Depression onset          Has physical,
                                                              mental, social, and   DSM IV Criterion
                                    Social – Isolating        consequences



  Mattiko 8/08
 80.00%

 70.00%
                    If You Don't Drink: You Are Not Alone
 60.00%

 50.00%

 40.00%

 30.00%

 20.00%

 10.00%

   0.00%




                                                                                  l
               17
               18
                    19
                    20
                         21
                         22
                              23
                              24
                                    25
                                    26
                                          27
                                          28
                                               29
                                               30
                                                    31
                                                    32
                                                         33
                                                         34
                                                              35
                                                              36
                                                                   37
                                                                   38
                                                                               39
                                                                          n d 40
                                                                                ta
                                                                             To
                                                                        ra
                                                                         G
          N= 5000+ Personal Wellness Profile
Mattiko 8/08
               Frequency of Alcohol Use by PWP Responders
                                N=6000+
           7.00%            Respondents had at least 3 drinks per day.



                                      15 drinks or more
           6.00%
                                                                         Male
           5.00%
                                                                         Female
 Percent




           4.00%

           3.00%

           2.00%                                                                  At Risk
                                                                                  Population
           1.00%

           0.00%
                   0 1 2 3 4 5 6 7 8 9 10 11 12 13 14
Mattiko 8/08
Mattiko 8/08
So how much does substance abuse cost the USCG?
               USCG Personnel Discharged: 2007 (data through AUG)

                                     Enliste
                              ET     d Total    Drug %       ETOH %         Total % D/C due to
                 Drugs        OH     Count       D/C           D/C           Drugs or Alcohol     Cost to USCG
    E1                   9      10       210        4.29%           4.76%                 9.05%   $     924,578
    E2                   49     28      1086        4.51%           2.58%                 7.09%   $    4,468,156
    E3                   64     58      4999        1.28%           1.16%                 2.44%   $    7,350,622
    E4                   47     33      7610        0.62%           0.43%                 1.05%   $    5,546,240
    E5                   14     35      7455        0.19%           0.47%                 0.66%   $    3,998,792
    E6                   1      15      6645        0.02%           0.23%                 0.24%   $    1,489,680
    E7                   1       1      3285        0.03%           0.03%                 0.06%   $     225,878
    E8                   0       0       704        0.00%           0.00%                 0.00%
    E9                   0       0       319        0.00%           0.00%                 0.00%
    E10                  0       0          1       0.00%           0.00%                 0.00%
    Total              185    180      32314        0.57%           0.56%                 1.13%

                                                                                                  $
                                                                            Total Salary Only     24,003,946



                                                                            Total Human
                                                                            Capital Cost to
                                                                            USCG for Drugs        $
                                                                            and ETOH Alone        168,027,622
Mattiko 8/08
                    Drinking may not be so bad, say scientists

Posted Tue   Jul 10, 2007 12:10pm AEST

 Scientists say the research shows drinking alcohol does not kill off brain cells.
(Neuroscientists say a recent report indicates moderate drinking may have a positive
effect on the health of a person's brain.
Some of the world's top neuroscientists are meeting in Cairns, in far north Queensland,
to discuss ground-breaking research that shows brain cells continue to grow throughout
our lifetime.
Queensland Brain Institute director Professor Perry Bartlett says the report shows
drinking alcohol does not kill off brain cells - and that drinking up to four standard
glasses of wine a night might be beneficial.
"One of the myths was that once you were born you never had the capability of making
new brain cells," he said.
"In fact, we now know that even in old people, one's capable of making new brain cells
and most recent evidence suggests that the making of brain cells is very important in
maintaining good mental health."
Professor Bartlett says evidence suggests that moderate drinking is also beneficial to
the vascular system.
"[It] may well help to prevent things like stroke and heart disease so there may be a
positive effect of moderate drinking on brain health," he said.

     Mattiko 8/08
                 USCG Personnel Discharged: 2007 (data through AUG)

                                          Enliste
                                                d
                                               To
                                               tal
                                              Co                               Total % D/C due to
                                ETO            un    Drug %      ETOH %               Drugs or
                   Drugs              H         t       D/C         D/C                Alcohol            Cost to USCG
E1                          9     10          210      4.29%          4.76%                       9.05%   $      924,578
E2                         49     28         1086      4.51%          2.58%                       7.09%   $    4,468,156
E3                         64     58         4999      1.28%          1.16%                       2.44%   $    7,350,622
E4                         47     33         7610      0.62%          0.43%                       1.05%   $    5,546,240
E5                         14     35         7455      0.19%          0.47%                       0.66%   $    3,998,792
E6                          1     15         6645      0.02%          0.23%                       0.24%   $    1,489,680
E7                          1         1      3285      0.03%          0.03%                       0.06%   $      225,878
E8                          0         0       704      0.00%          0.00%                       0.00%
E9                          0         0       319      0.00%          0.00%                       0.00%
E10                         0         0          1     0.00%          0.00%                       0.00%
Total                     185    180        32314      0.57%          0.56%                       1.13%



                                                                              Total Salary Only           $   24,003,946




                                                                              Total Human Capital Cost
                                                                                    to USCG for Drugs
                                                                                    and ETOH Alone        $   168,027,622


  Mattiko 8/08
Mattiko 8/08
Mattiko 8/08
                     Millions of Australians at risk
                      from alcohol consumption

Posted Mon    Aug 6, 2007 9:48am AEST     (Reuters: David Gray)


The levels of alcohol that will place you at risk of brain damage is three
standard drinks per day for a woman and six per day for men for an eight-year
period.

A campaign has been launched to raise awareness of alcohol-related brain damage.
The chief executive of Alcohol Related Brain Injury Australian Services, Sonia Berton,
says 2 million Australians are at risk of brain damage because of the large amounts
of alcohol they are consuming. She says there are many misconceptions
 about the problem which is brought about by consuming between
three and six alcoholic drinks a day over about nine years.“
 The levels of alcohol that will place you at risk of
alcohol-related brain damage - now for a female it is around three
standard drinks per day or more and for men it's around six standard
 drinks per day, for an eight-year period. Now for
many Australians, this is considered to be no more than social drinking."
    Mattiko 8/08
Drinking may not be so bad,
say scientist

Jul 10, 2007
Scientists say the research shows drinking alcohol
does not kill off brain cells.(ABC News: Gary Rivett)

Neuroscientists say a recent report indicates
moderate drinking may have a positive effect on the health of a person's brain.
Some of the world's top neuroscientists are meeting in Cairns, in far north Queensland,
to discuss ground-breaking research that shows brain cells continue to grow throughout
our lifetime.
Queensland Brain Institute director Professor Perry Bartlett says the report shows
drinking alcohol does not kill off brain cells - and that drinking up to four standard
glasses of wine a night might be beneficial.
"One of the myths was that once you were born you never had the capability of making new brain cells," he said.
"In fact, we now know that even in old people, one's capable of making new brain cells and most recent evidence suggests that the making of brain cells is very
important in maintaining good mental health."
Professor Bartlett says evidence suggests that moderate drinking is also beneficial to
the vascular system.
"[It] may well help to prevent things like stroke and heart disease so there may be a positive effect
of moderate drinking on brain health," he said.

        Mattiko 8/08
               US Coast Guard Motorcycle
                    Safety Summit




Mattiko 8/08
                    “SAPT VISION”

• Above the Influence: (SAFE Rewrite)
        – Focus on WHO Model (use-harmful-hazardous-dependency)
        – Greater Chief Involvement (G.E.M.)
        – Command Consistency (3E’s)
• Command Drug and Alcohol Rewrite
• SAPT 2008 Vision Plan (Seybold Model)
• Enter HRB DoD Study: Scientific Data

Mattiko 8/08
                                  2008 Drug & Alcohol Discharges*
                        25

                        20


               Amount
                        15
                                                                               Alcohol
                        10                                                     Drug

                         5

                         0
                             19
                             20
                                  21
                                  22
                                       23
                                       24
                                            25
                                            26
                                                          27
                                                          28
                                                                29
                                                                30
                                                                     31
                                                                     32
                                                                          33
                                                                          36
                                                                               37
                                                                               39
                                                                                      41
                              E
                        AG




                                                          Age



                                                                 2008 Drug & Alcohol Discharges*
                                                     25

                                                     20

                                                     15
                                            Amount




                                                                                                          Alcohol
                                                     10                                                   Drug

                                                      5

                                                      0
                                                          19
                                                          20
                                                                21
                                                                22
                                                                      23
                                                                      24
                                                                           25
                                                                           26
                                                                                 27
                                                                                 28
                                                                                           29
                                                                                           30
                                                                                                31
                                                                                                32
                                                                                                     33
                                                                                                     36
                                                                                                          37
                                                                                                          39
                                                                                                                 41
                                                           E
                                                     AG




Mattiko 8/08
                                                                                Age
                    2008 Drug & Alcohol Discharges*
         25

         20

         15
Amount




                                                       Alcohol
         10                                            Drug

          5

          0
              19
                   20
                   21
                        22
                        23
                             24
                             25
                                  26
                                  27
                                       28
                                       29
                                            30
                                            31
                                                 32
                                                 33
                                                      36
                                                      37
                                                           39
                                                           41
               E
         AG




                                   Age


   Mattiko 8/08
Mattiko 8/08
Mattiko 8/08
Mattiko 8/08
    Epidemiology & Consequences
        of Drinking and Driving
                             NIAAA & NHTSA, 2003 & 2004

 82 million drunk driving trips with Back's
  above .08 each year
 1.5 million DUI arrests each year
 For every arrest 56 get away
 A BAC of .08 or > guarantees you:
        •      Reduced peripheral vision
        •      Poor recovery from glare
        •      Decrease performance in complex tracking
        •      Reduced attention span
        •      Impaired balance

Mattiko 8/08

				
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