Update on Methamphetamine Addiction

The chemical methamphetamine hydrochloride is generally simply known as methamphetamine. Common street names for methamphetamine include crank, speed, meth, crystal meth, ice and crystal tea. It has been a popular drug of abuse for many years in its conventional, powdered form, which is usually snorted or injected.

Methamphetamine differs from amphetamine in that, at comparable doses, much greater amounts of methamphetamine get into the brain, making it a more potent stimulant than amphetamines. It also has longer-lasting and more harmful effects on the central nervous system. These characteristics make it a dangerous drug with high potential for widespread abuse.

Methamphetamines are produced to be potent and easily smoked, in addition to being smoked or injected. In one of its forms, known as “ice,” the substance resembles rock candy or a chip of ice. It is smoked in a similar fashion to crack, a form of cocaine, and provides the user with an immediate, intense high and false sense of increased alertness.

Crystal methamphetamine is highly and virtually immediately addictive. It is a psychostimulant that increases the levels of at least 3 important neurotransmitters: dopamine, serotonin, and norepinephrine. The high from meth occurs almost instantaneously, rapidly producing feelings of mood elevation, euphoria, and elimination of fatigue, excessive talking, social and sexual disinhibition, and a sense of increased personal power. Methamphetamine abuse also contributes to increased transmission of infectious diseases, such as hepatitis and HIV/AIDS.

According to data from the 2012 National Survey on Drug Use and Health (NSDUH), “over 12 million people (4.7 percent of the population) have tried methamphetamine at least once. NSDUH also reports that approximately 1.2 million people used methamphetamine in the year leading up to the survey.”

The Drug Abuse Warning Network (DAWN), which collects information on drug-related episodes from hospital emergency departments (EDs) throughout the USA, claims methamphetamine accounted for about 103,000 ED visits in 2011. Other drugs may interact with methamphetamine, including prescription and over-the-counter medicines, vitamins, and herbal products.

Our current knowledge base clearly demonstrates that illicit psychostimulants produce lasting neural and behavioral changes that contribute to the progression and maintenance of addiction. Psychotherapy is the most effective treatment for methamphetamine addiction. Comprehensive behavioral treatment approaches that combine cognitive-behavioral therapy, family education, individual counseling, 12-Step support, drug testing and encouragement of non-drug-related activities can be effective in reducing methamphetamine abuse.

There are no medications available to counteract the specific effects of methamphetamines, help prolong abstinence from or reduce the abuse of methamphetamine. Talk to an addiction treatment center or personal care provider for resources to provide addiction help through support and therapy.

On Being a “Teacher”: Thoughts as I Prepare to Depart from South Africa

I first answered Africa’s siren song in 1992, when I spent half of my junior year in college in Kenya and Tanzania. In 2008, I returned to Namibia, Botswana, and Zambia, where I started writing my doctoral dissertation in a tent on quiet afternoons. This year, I was invited to South Africa, to Cape Town and Durban, to share my expertise in addiction research with physicians and psychotherapists. I came as a teacher and like all good teachers, I find that I am also a student.

There is no doubt that South Africa is a magical country. Twenty years after the end of apartheid and only a short time since Mandela’s passing, I find myself in a country that has made incredible advances with regard to racial equality and a land that remains troubled by its past. One of the ways in which these troubles are manifest is this nation’s almost-out-of-control turn toward substance abuse. According to the South African Central Drug Authority, substance abuse in South Africa is double that of the global average and South Africa is ranked among the top 10 countries with regard to the amount of alcohol consumed annually. The use of drugs like cocaine and “tik” is twice as much in South Africa as compared with other nations around the world. The economic cost of alcohol abuse in South Africa is estimated at 130 billion rand each year. It is also estimated that 7,000 people in South Africa die annually from drunk driving. All this in a nation of 52 to 53 million people. These are staggering figures.

Given this climate, I have a great deal to offer in terms of fluency with the current research on addiction and addiction recovery. My work as Director of Addiction Research for Cliffside Malibu is to advance the field by drawing attention to the latest scientific findings in a variety of subjects and to use those findings to improve the quality and efficacy of addiction treatment. I am humbled by the scope of the addiction problem in the USA, South Africa, and so many other nations around the world, because each statistic signifies a human life, a human life devastated by suffering. This suffering is not unique to the addict, but experienced to some degree by the addict’s family, friends, and community. At the same time, I am also honored that Cliffside has made a solid commitment to both research and education. I know of no other treatment center that keeps a full time researcher on staff and supports annual attendance at multiple international conferences. This commitment allows me to move the discussion around addiction treatment forward with clinicians who in some cases have limited or no resources, other than their dedication and training. They work with people in desperate need in areas which have seen devastation of a type most Americans cannot imagine. Cliffside sends me to these places, to work with these professionals knowing that we’ll never see a client from our efforts. In my opinion (and admittedly, I am biased!), Cliffside’s commitment to helping addicts recover is truly exemplary in the field.

And yet, as I teach, I also learn. At the Lentegeur Hospital near Cape Town, South Africa, I met with an incredible crew of dedicated physicians, psychiatrists, nurses, social workers, and students. Their smiles belie the overwhelming nature of their work, the almost incomprehensible need in the communities they serve. As professionals, we collaborated, having animated discussions about how we might “think outside the box” and use the limited resources available to improve treatment outcomes as much as possible. For example, if one-on-one psychotherapy is precluded because of lack of psychotherapists to meet the need, how can we re-group individuals or re-imagine group therapy to help the greatest number of clients? We discussed positive psychology, looking at the strengths and assets individuals bring to treatment. We imagined ways to connect community programs that are currently administered in a disjointed way. There is so much work to be done! Yet there was a sense in the group of progress and of hope.

After my wonderful experience in Cape Town, I flew to Durban to attend the World Congress for Psychotherapy. In my presentation, I was scheduled to cover new neuroscientific understandings of addiction, both how addiction develops and how it might be treated in imaginative ways to improve treatment outcomes. This group was most interested in the relationship between addiction and co-occurring psychological disorders, such as depression. According to other conference participants, the World Health Organization projects that depression will be the world’s leading illness by 2020. Having suffered from depression myself, I wanted to shout, “Why are we so hopeless?” when I heard this, for in addition to its biochemical components, depression is in large part a manifestation of hopelessness, social isolation and/or grief. So I re-focused my presentation not only on the neuroscience of addiction, but also the relationship between addiction and depression. After my presentation and for the remainder of the day, I was flooded with requests to pass along the research studies I had cited. How does the brain change in response to addiction and how are addiction and depression treated concurrently? What role does aftercare play in treating co-occurring disorders and again, where psychotherapists are not to be found, what other programs or therapies might we use to help improve the quality of individual’s lives? These are the topics we discussed that led to exhilarating ideas for all involved.

How do we care for those who suffer, not only from addiction or mental illness, but from all sorts of issues? How do we provide care when resources are scant? These are the questions we have asked here in South Africa over the past two weeks. My only hope is that I have taught at least half as much as I have learned.

Marijuana: The Gateway Drug Myth

Marijuana continues to be the most commonly used illicit drug according to the 2012 National Survey on Drug Use and Health (NSDUH) report. It is also the third most popular recreational drug in the United States, behind alcohol and tobacco. Upward of 24 million people have used marijuana, based on the latest estimates, with 14 million using it regularly, yet misinformation about marijuana abounds.

Marijuana is not a gateway drug. People who have tried marijuana may eventually go on to try harder drugs in search of a stronger high, and experimentation may lead them down a dangerous path toward addiction. However, the science shows overwhelmingly that for most people marijuana is not a gateway drug.

Many people mistakenly believe that marijuana use precedes rather than follows initiation of other illicit drug use. In fact, most drug use begins with alcohol and nicotine before marijuana, making nicotine and alcohol the two most common drugs of abuse. Evidence indicates marijuana is usually not the first substance abused before more dangerous illicit drug experimentation.

A study published in the peer-reviewed Journal of School Health has concluded that the theory of a gateway drug is not associated with marijuana, but rather one of the most damaging and socially accepted drugs in the world, alcohol. The findings from this investigation support that alcohol should receive primary attention in abuse prevention programming, since the use of other substances could be impacted by delaying or preventing alcohol use.

An alternative gateway may just be the trials and tribulations some kids face while growing up. According to Dr. Karen Van Gundy, an associate professor of sociology at the University of New Hampshire,

“Whether marijuana smokers go on to use other illicit drugs depends more on social factors like being exposed to stress and being unemployed, not so much whether they smoked a joint in the eighth grade. Because underage smoking and alcohol use typically precede marijuana use, marijuana is not the most common, and is rarely the first illicit drug used.”

This isn’t to say that marijuana is safe or its use among teens and young adults should be ignored; quite the contrary. Marijuana use should be a focus of substance abuse prevention programs, but we need to tell kids the truth, not attempt to scare them with myths. The problem with marijuana use at an early age is that the human brain is still developing. Using marijuana before the age of twenty-five can lead to irreversible issues, such as low impulse control and memory problems. Of course, young people can’t quite grasp the severity of these types of consequences, so it is up to adults to do their best to be a protective buffer and help young people make better choices.

It is important to note that, while drugs like alcohol could and do indeed lead to other harmful substance abuse, the main issue with drug problems is the mental state of the user. Some people use drugs to escape reality and run away from problems they do not have the skills to cope with in more healthful ways.

Improve Addiction Recovery with Mindfulness

Addiction has generally been characterized as a chronic relapsing condition, causing physical or psychological need for a habit-forming substance, such as alcohol, or compulsive involvement in an activity, such as gambling. Current research data suggests that the lack of mindfulness may reinforce addictive behavior and furthermore, teaching mindfulness skills or practices may be one reason for improved treatment outcomes among addicts.

Addiction experts increasingly suggest mindfulness-based interventions (MBIs) as a therapeutic approach for substance use and misuse. Current evidence suggests that MBIs can significantly reduce an individual’s consumption of several substances including alcohol, cocaine, amphetamines, marijuana, cigarettes, and opiates. Although extremely limited, preliminary evidence also suggests that MBIs are associated with a reduction in craving, as well as increased mindfulness, which is in and of itself a positive outcome.

A very similar approach, mindfulness-based relapse prevention (MBRP) targets cravings and their negative role in the relapse process, by using skills in cognitive-behavioral relapse prevention combined with mindfulness meditation.  Therapists teach individuals to increase discriminative awareness by focusing on acceptance of uncomfortable states or challenging situations without reacting “automatically.”

A recent study found that those people randomized to MBRP, as compared with those in a control group, demonstrated lower rates of substance use and greater decreases in craving following treatment. Scientists noted that individuals in MBRP did not report increased craving or substance use in response to negative affect. It is not surprising that the areas of the brain that have been associated with craving, negative affect, and relapse are the same areas affected by mindfulness training.

Another study evaluated the feasibility and initial efficacy of an 8-week outpatient Mindfulness-Based Relapse Prevention (MBRP) program as compared to treatment as usual (TAU). Participants who completed intensive inpatient or outpatient treatment had significantly lower rates of substance use in those who received MBRP as compared to those in TAU over a 16-week post-intervention period. They also demonstrated greater decreases in cravings and increases in acceptance and acting with awareness as compared to TAU.

Results from this initial trial support the feasibility and initial efficacy of MBRP as an aftercare approach for individuals who have recently completed an intensive treatment for substance use disorders. Rigorous and larger randomized controlled studies are needed to verify such promising possibilities using mindfulness in addiction recovery. Seek available treatment options and further information from your health care provider or an addiction treatment center.

College Binge Drinking for Social Satisfaction

Binge drinking is defined as consuming at least four drinks for women and five drinks for men in a single drinking session, at least once every 14 days on average. New research suggests that binge drinking at college is associated with high status and these drinkers are happier with their college social experience than their non-binge drinking peers.

According to the study, students from higher status groups (i.e., wealthy, male, heterosexual and white) were consistently happier with their college social experience than their peers from lower status groups (i.e., less wealthy, female, Lesbian/Gay/Bisexual/Transgender/Questioning (LGBTQ) and non-white). In addition, students from higher status groups were more likely than their peers from lower status groups to binge drink.

Carolyn L. Hsu, co-author of the study and an associate professor of sociology at Colgate University said,

“Students, who are considered more socially powerful, drink more. Binge drinking then becomes associated with high status and the ‘cool’ students on campus. It is a symbolic proxy for high status in college and it is what the most powerful, wealthy, and happy students on campus do. Among all groups, we found that binge drinking and social satisfaction were strongly connected.”

The study relied on a survey of nearly 1,600 undergraduates attending a selective Northeastern residential liberal arts college in 2009.

Researchers found that across race, socioeconomic status, gender and sexuality, the connection between binge drinking and satisfaction with the college social experience, remained consistent. The students in all groups consistently liked college more when they joined other students in the binge drinking culture, feeling that it was the most socially acceptable thing to do. The desire to be part of the “in” crowd often contributed to binge drinking even when many personally preferred not to. Many students saw binge drinking as a logical means to adapt, survive, and seek out the most favorable life while in college.

Very interestingly, the survey data did not indicate that unhappy students were binge drinking to self-medicate. Instead, the students with the most stress, anxiety, and experiences with discrimination or sexual abuse, were the least likely to drink.

“It’s the kids who say everything is great who drink the most. Low status students in particular seem to be using binge drinking as a vehicle for social mobility and as a way to contend with an otherwise hostile social environment,” Hsu said.

According to the Centers for Disease Control and Prevention, about 90% of the alcohol consumed by youth under the age of 21 in the United States is in the form of binge drinking.

What can colleges do? Clearly, there is an issue with campus culture if the best means to popularity and sociability is by binge drinking. Engaging students in the discussion about cultural change is probably a great place to start.

The Tragic Reality of Substance Abuse in South Africa

South Africa, a giant in the global drug trade, is at breaking point with the number of child addicts reaching an all-time high. Research has found that substance abuse in South Africa is double that of the global average and ranked in the top 10 countries concerning the amount of alcohol being consumed each year. The Central Drug Authority (CDA) of South Africa gathered statistics from June 2010 – March 2011 indicating the alarming rise and consequences of alcohol and drug use.

Marijuana, crystal meth, heroin, crack cocaine and methamphetamines are taking over the streets and injecting a new generation of deprived children with a life of addiction; alcohol remains the most common drug of abuse. More than 6,000 people, many of them children, die because of alcohol every year; then add the sad fact that South Africa has the highest reported incidence of Fetal Alcohol Syndrome in the world. Alcohol affects 17.5 million South Africans. The use of drugs among teenagers increased by 1100% from 1997-2007, and is still increasing. This is alarming by any standard.

The continent of Africa is increasingly becoming vulnerable to the drug trade and organized crime. The international community needs to make necessary resources available to monitor the rising drug situation. Illicit drugs continue to jeopardize the health and welfare of people throughout the world and they represent a clear threat to the stability and security of entire regions.

The latest drug trafficking trends show that Africa is a vulnerable transit continent for both cocaine and heroin. The spillover effect of the increased trafficking of drugs through Africa on drug use in African countries is a matter of concern, although to study and document the trend remains a challenge. Gaps in availability of reliable data on all aspects of the drug phenomenon from many regions continues to limit the understanding of the drug market dynamics on the African continent, posing further challenges for the development of appropriate prevention and treatment interventions.

This destructive cycle must be halted in order to protect the right of people to healthy communities. The problem is growing worse while nations are without the resources to provide rehabilitation. There are whole regions where evidence-based drug dependence treatment and care are still not available or accessible. The National Drug Master Plan (2013-2017), is being implemented as South Africa’s blueprint for preventing and reducing alcohol and substance abuse and its associated social and economic consequences on South African society. Perhaps South Africa will be a model for other nations.

I will be in South Africa later this month to speak at the World Congress for Psychotherapy in Durban and at hospitals in Cape Town. I will share many of the latest evidence-based treatment techniques and hope to be part of the solution to South Africa’s growing substance abuse problem.

The Success of Prescription Drug Monitoring Programs

Prescription drug monitoring programs (PDMPs) are valuable tools in mitigating the abuse and diversion of prescription controlled substances from legitimate medical use to illicit use. Drug monitoring programs, the procedures and powers of which can vary significantly from state to state, all share a similar strategy: to require doctors, pharmacists or both to enter all prescriptions into a database that can — or, in some states, must — be consulted later to make sure patients do not get excess medication.

Forty-nine states use some form of PDMPs and many are working on improvements or changes to prevent abuse, with Missouri the only holdout. The goal is to require doctors to check databases before prescribing opioid drugs to prevent and recognize patients that may be abusing or doctor shopping, along with requiring pharmacists to monitor patients and the doctors who may be overprescribing addictive medications.

The prescribing of opioid painkillers parallels the dramatic increase in numbers of deaths, emergency room visits, and treatment episodes attributable to non-medical use of controlled substances. Health care systems and facilities are responsible for and committed to quality improvement and the safety of their patients, although prescription drug abuse has continued to rise in the United States over the last 15 years.

Consider the evidence:

  1. Deaths from unintentional drug overdoses continue to rise, surpassing motor vehicle fatalities asthe leading cause of accidental death. 
  2. Emergency department visits due to misuse of controlled substances now substantially outnumber those for illicit drugs such as heroin and cocaine.
  3. Treatment admissions for prescription opioids have more than doubled in the last decade.
  4. The costs stemming from the non-medical use of prescription opioids in lost productivity, law enforcement, drug abuse treatment, and medical complications; estimated at over $50 billion annually.

The Prescription Drug Monitoring Program (PDMP) Center of Excellence was founded to combat the prescription drug abuse epidemic. The expertise, experience and commitment of the Center make it a unique resource in the fight against prescription drug abuse. The Center draws from the recommendations of 77 nationally recognized experts in addiction treatment, pain medication management, public health and epidemiology. The Center of Excellence has issued a groundbreaking report recommending that medical insurers use prescription-monitoring data to reduce overdoses, deaths and health care costs associated with abuse of opioids and other prescription drugs.

The medical objective of provider interventions is to refer patients to substance abuse treatment rather than law enforcement. There is a continuing need for studies to determine the best practices on prescriber education, use of PDMPs, clinical response if addiction or abuse is determined, privacy legislation, and data sharing contracts between states with differing PDMP programs. More can be done to make PDMPs more successful in the future to combat increasing drug abuse and help the individual find solutions to their suffering.

The Use of Positive Psychology in Addiction Treatment

This past week, I presented a paper at the 2nd Canadian Conference on Positive Psychology. The paper was titled, “From Despondency to Hope: Ending Addiction for Good Using a Positive Psychological Approach.”

 

Positive Psychology is a relatively new field of psychological research and intervention. The University of Pennsylvania describes positive psychology in this way:

 

Positive Psychology is the scientific study of the strengths and virtues that enable individuals and communities to thrive. The field is founded on the belief that people want to lead meaningful and fulfilling lives, to cultivate what is best within themselves, and to enhance their experiences of love, work, and play.”

 

In effective addiction treatment, positive psychological approaches play an important role in achieving long-term addiction recovery goals. Traditionally, addicts are told that they have a disease; that they will have to manage it for the rest of their lives; to expect relapse and that from a statistical perspective, most will die from their illness. This is a tremendously demoralizing prognosis to provide to someone. A positive psychologist would reframe the situation, suggesting that addiction is a behavioral disorder and even the most entrenched behaviors can be changed. While not denying the negative statistics surrounding addiction recovery, a reframing of the opportunity to recover into something attainable is empowering and motivating to many who suffer from substance abuse.

 

After encouraging the addict by suggesting that recovery is possible not just for a select few, the positive psychologist then begins to work with the addict to re-envision life and begin a process of self-discovery in which the addict comes to know what activities and relationships are most important to him/her. There are no limits. For example, at the conference one researcher who works with suicidal geriatric individuals shared this story; she had a wheelchair bound, elderly woman say that what was most important in life to her was saving seals. Instead of telling the woman that she could not save seals because she was too old and in a wheelchair or provide any other excuse, the woman was encouraged to look into what it would take for her to save seals. She decided that while she could not physically work with seals, she could be involved via the internet in those types of activities and fundraise to support the work. This is precisely the type of visioning process that is successfully used with addicts, to help them imagine a world beyond using and to give them tangible goals to work toward that will help them maintain their recovery.

 

Meaningful recovery is achieved when the pain of the past is worked through and goals for the future are set and worked toward. Part of the problem of addiction is an inability to envision a different future, a future in which happiness, good work, and strong relationships are the fabric of daily life. Using positive psychology, therapists are able to help addicts plan for and believe they can attain the kind of future of which they previously could not even dream.

Can Psilocybin Mushrooms Help Cure Mental Illness?

Advocates of hallucinogens claim that substances that alter the conscious may be a key to treating mental illness and can be more effective than some prescription drugs. There has been a resurgence of interest in psychedelic research in the last few years with promising results. However, treatments using restricted Schedule 1 drugs like psilocybin are legal only for limited research at this time.

Dr. David E. Nichols, psychedelic research expert and co-founder of The Heffter Research Institute, explains:

“We have been able to accomplish so much in such a relatively short time. Psilocybin, the psychoactive compound in magic mushrooms, is proving a prodigious treatment for anxiety, depression, addiction, and one study even found it might lead to neurogenesis, or the regrowth of brain cells.”

This is great news for the hopeful development of successful new treatment options for common mental health issues. What is the evidence supporting such claims? Here is a list of recent studies.

  1. In a study by Dr. Michael Bogenschutz, at the University of New Mexico, researchers gave psilocybin-assisted therapy to 10 volunteers with alcohol dependence. Drinking decreased significantly beginning in the second month of treatment, after psilocybin was administered, and improvement remained significant for an additional six months of follow-up.
  2. A study by Dr. Matthew Johnson at Johns Hopkins, administered psilocybin within a 15-week smoking cessation treatment. Participants were 15 healthy smokers with a mean of six previous lifetime quit attempts who were smoking an average of 19 cigarettes per day for 31 years. Measures of smoking behavior showed that 12 of the 15 participants (80%) were no longer smoking at six-month follow-up.
  3. In a study at the Imperial College London, scientists found psilocybin reduced blood flow to the cingulate cortex, the region of the brain responsible for extreme thoughts or behavior.

These few, small studies indicate that psilocybin could produce great results. Much more research involving larger groups will be needed to conclusively prove the positive benefits of the therapeutic use of hallucinogens, particularly psilocybin. Three phase drug studies with FDA approval will also have to be completed before these types of drugs can be removed from the list of substances with no medical purpose. Safety and quality control are always important and will also need much more research.

The problem is that pharmaceutical companies are not interested in researching an inexpensive substance that has been around for a long time. There is no money to be made with a non-patentable drug that is given only once or twice in a lifetime.There is the sad dilemma. Research of hallucinogens at this time is primarily done by non-profit organizations. Fortunately holistic approaches are becoming acceptable in main-stream science today, and hopefully enlightened medical scientists will prevail over profit-seeking.

Consequences of Teenage Drinking

An alarming number of young people are consuming alcohol nowadays, often binging on the weekends and combining drinking with drug experimentation. These risky behaviors are causing health problems with consequences that will have to be dealt with throughout their adult lives. I should know. I was once that teenage drinker turned alcoholic. As such, these statistics hit home for me.

More than 4 million American children aged 12 to 17 consume alcohol each month, according to the 2012 National Survey on Drug Use.

Research shows psychological disorders such as anxiety and depression frequently co-occur with alcohol abusers; childhood and adolescent emotional trauma are factors related to future alcohol abuse and addiction.

A 23-year study known as “Lives Across Time: A Prospective Study of Adolescent and Adult Development,” originally began as a possible three or four year project. Started in 1988 with 1200 participating 15 years-olds, the project has changed into a lifetime study of the effects of alcohol for Michael Windle, professor at the University at Buffalo Research Institute on Addictions.

“A lot of adolescents experiment with alcohol and drugs,” says Windle. “Some of them will use these substances long term, and others will stop. The larger question is how do we change those patterns over time, knowing that not everyone changes in the same way or at the same time?”

Some key points emerged over time that have helped change perceptions of alcoholism. Alcoholics are no longer portrayed as drunk older men sleeping it off in some doorway. Use, abuse, and addiction are the highest among men and women between 23 and 27 years of age. This makes a big difference in treatments and prevention plans.

Teens tend to start drinking or experimenting for a variety of reason. After attaining legal drinking age, many young people unwisely enjoy being able to drink when and where they want without the stress of parental control. By the time individuals approach their thirties, they are entering the career and family stages of life when alcohol and partying are no longer such an important part of their focus. This is the age where many people get their drinking under control or they may become self-destructive alcoholics, if they are not already out of control.

To identify those at risk, Windle and a group of experts created a guide that clinicians and educators can use to screen children for alcohol use. Developed by the NIAAA Task Force for Underage Drinking, the practitioner’s guide—”Alcohol Screening and Brief Intervention for Youth”—is available free at niaaa.nih.gov/youthguide. The task force is evaluating the guide, now in use throughout the United States, to measure its effectiveness. The guide is one way of increasing opportunities for the safe passage of children from adolescence to young adulthood and beyond.

Education and information is needed to teach young people about the lifetime of problems that alcohol abuse can lead to. Children are precious and full of potential for the future, and therefore need to be protected against developing preventable problems and a lifetime of regrets.