SADD recognized by Rear Admiral Kenneth Moritsugu Acting Surgeon General at National Prevention Network Research Conference

Remarks as prepared; not a transcript.

RADM Kenneth P. Moritsugu, M.D., M.P.H
Acting Surgeon General
U.S. Department of Health and Human Services

Address to National Prevention Network Research Conference
Monday, September 17 2007, Portland, OR

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Thank you, Bob (Robert Nikkel, Director of Oregon Addiction and Mental Health Division), for that gracious introduction.

Good morning, ladies and gentlemen.

I am honored to be here today and I am pleased to deliver this keynote address.
My boss, Michael Leavitt, Secretary of the U.S. Department of Health and Human Services, sends you his best wishes. 

We both know that events like this one are especially important. 

I believe this because I know the importance of moving emerging scientific findings into practice.

The transfer and adoption of technology is critical if we are to continually improve public health.

I say this because translating evidence-based science into practice is critical to the growth of the substance abuse field.

Applying best practices to prevent the abuse of alcohol and other drugs is essential in helping people and families at risk.  Many of you know this because you are on the front line. 

You observe -- and serve -- at-risk individuals and populations.
The programs and organizations you are associated with offer resources – such as information, referrals, substance abuse prevention and treatment services – where it is most needed.

I know you are here because these are issues that are important to you.
I appreciate your commitment to the health of the people of our great nation.

Health really is a combination of a healthy mind, a healthy body, and a healthy spirit.   
I know that many of you share this commitment.

I have been working with members of the “Leadership to Keep Children Alcohol Free,” an organization of current and former First Spouses that serves as a catalyst to create a momentum for change. 

The Leadership is collaborating with my office to roll out the Underage Drinking Call to Action at the state level. 

I salute former Oregon First Lady Sharon Kitzhaber (Kitz-ha-ber) for her ongoing involvement with the organization and her abiding interest in reducing underage drinking.

The First Lady, Mary Oberst, unfortunately could not be here today, but I can tell you that she is a supporter of the Leadership and is dedicated to ending underage drinking in Oregon.

I would like to also recognize former first lady of Hope Taft of Ohio, who now serves as Executive Director of the Leadership. 

Also with me today is Steve Wing from the Substance Abuse and Mental Health Services Administration. Steve is the Associate Administrator for Alcohol Prevention and Treatment Policy.

As I’ve traveled throughout the United States to bring attention to underage drinking, Steve and Hope have been very supportive in our efforts in the Office of the Surgeon General.
Their guidance has been invaluable.

Activities of individual professionals at the state and community organization levels are just as important.     

Your work has helped demonstrate that prevention, early intervention, treatment and recovery support services pay dividends.

They contribute to diminishing rates of HIV/AIDS, crime, violence, suicide, homelessness, injuries, and health care costs. 

At the same time, they promote productivity, employment, healthy families and healthy communities.

Data confirms that the human and economic toll of alcohol and drug misuse is reduced as we prevent or intervene early with the best science-based services available.

As professionals in the field, you know better than most that addiction is treatable.

Today, recovery is no longer the privilege of a few exceptional people, but a possibility for all.  It restores lives.

I commend the National Prevention Network (NPN), and your organizational “parent,” the National Association of State Alcohol and Drug Abuse Directors (NASADAD) for underscoring the promise of prevention and power of recovery.

Priorities

I would like to mention a few of the top priorities in the Office of the Surgeon General.

The first is Prevention - what each of us can do in our own lives and communities to make ourselves and our families healthier.

According to the CDC, more than 90 million Americans live with chronic disease.

Chronic disease causes seven out of 10 deaths every year.

And treating people with chronic disease accounts for about 75% of the $2 trillion America spends on health care each year. 

Our health system is focused on treatment instead of prevention.  We must place more emphasis on prevention.  Keeping people healthier longer reduces the cost of care and can contribute to a longer life.

Five key steps can prevent most chronic diseases:

• Tobacco control,
• Good nutrition,
• Physical activity,
• Maintenance of a healthy weight, and 
• Regular health screenings.

We need more Americans to embrace these steps to a healthier life. 

Another priority of my office is Public Health Preparedness.

This includes readiness and the capability of rapid response to all hazards, including hurricanes, earthquakes and pandemics. 

The third priority on which we are especially focused is Eliminating Health Disparities.

While, overall, our nation's health has improved, not all populations have benefited equally.  Many Americans who are members of racial and ethnic minority groups experience disparities in health outcomes and health care.

It is imperative that things change.  The Department of Health and Human Services is committed to eliminating health disparities.

Health literacy, the ability of an individual to access, understand, and use information and services to make appropriate health decisions, is another priority of my office.

• Nearly 9 out of 10 American adults lack the skills needed to take care of their own health, or know how to prevent disease.

We know that low health literacy impacts health.

People with low health literacy are less likely to know how to navigate the health care system, understand basic health information, or get preventive health care services.

As health care continues to become more complex, the importance of being health literate will increase.

Health literacy needs to be improved – today, tomorrow, and continually.

Health literacy is the ability of an individual to access, understand, and use health-related information and services to make appropriate health decisions.

More than 90 million people cannot adequately understand basic health information. And health illiteracy is impacting people of all ages, races and education levels.

People with low health literacy are less likely to know how to navigate the health care system, understand basic health information, or get preventive health care services.

When a patient does not understand that certain factors increase his or her risk for a disease...that is a problem.

When a student does not understand the reality of alcohol poisoning…that is a problem.

When a 10th grade student does not understand the effects that alcohol abuse can have on the development of his or her brain…that is a problem.

• Only 12 percent of adults have proficient health literacy.
• Put another way: nearly 9 out of 10 American adults lack the skills needed to take care of their own health, or know how to prevent disease.

In order to most effectively support substance abuse prevention - your messages must be truly understood by the individuals you are trying to reach.

We all have a responsibility to ensure that we translate the science and data into medical and health information that can be heard... understood... embraced... and ultimately put into action.

The fight to end health illiteracy should start with substance abuse programs that promote health literacy, education and promotion.

These programs should be developed with involvement from the people who will use them.

And these prevention and treatment efforts must also take culture and language skills and barriers into consideration.

Everyone in the audience today can help by becoming an ambassador for health literacy.

Purpose of visit
As you may know, the main reason I am in Oregon today is to discuss underage drinking. 

In March, I released a Call to Action To Prevent and Reduce Underage Drinking. 

From the beginning, it is important to understand that our efforts to reduce underage drinking are to ensure that our children have the greatest opportunity to succeed. 

Our goal, as parents, educators, providers, and caring adults, is to provide them with tools to make positive and healthy choices. 

Making healthy choices, such as delaying drinking, will assist them in obtaining success.

Most of you already know that alcohol is the most widely used and abused substance among our Nation’s youth. 

A higher percentage of young people between the ages of 12 and 20 use alcohol than tobacco or illicit drugs. 

Scope of the Problem
The 2005 National Survey on Drug Use and Health estimates that there are almost 11 million underage drinkers in the United States. 

Nearly 7.2 million are considered binge drinkers, meaning they drank more than five drinks on one occasion. 

In people under age 21, alcohol is a leading contributor to “death from injuries” – the main cause of death in that age group.

The Science
Alcohol use during adolescence is pervasive and it ramps up dramatically between the ages of 12 and 21.

Research shows that the brain continues to develop well beyond childhood – and through adolescence.  This research raises concerns that underage drinking may affect short-term and long-term cognitive functioning, and may even change the brain in ways that lead to future alcohol dependence. 

Research also shows that young people who start drinking before age 15 are five times more likely to have alcohol-related problems later in life. 

This research provides more reasons than ever for us to be concerned about the effects of underage drinking on our nation’s children. 

Secondhand Effects
5,000 deaths of people under the age of 21 are linked to alcohol. 

To put this into perspective, take the size of the Arlene Schnitzer Concert Hall here in Portland.  It holds a little more than 2,500 people.  Underage drinking kills double that amount each year.

Alcohol also plays a significant role in risky sexual behavior including unwanted, unintended and unprotected sexual activity.

It increases the risks of physical and sexual assault.

• Approximately 600,000 students are unintentionally injured while under the influence of alcohol (Hingson et al. 2005).
• An estimated 700,000 students are assaulted by other students who have been drinking (Hingson et al. 2005).
• About 100,000 students are victims of alcohol- related sexual assault or date rape (Hingson et al. 2005).

Findings like these are one reason the Office of the Surgeon General released the Call to Action.

The data are compelling.

They are evidence-based and science-driven.

Underage drinking is not a harmless “rite of passage.” 

The reality is our young people are being harmed by underage drinking.

The Call to Action articulates the Federal commitment to the underage drinking issue but also outlines the need for action on the state and community level. 

The goals include:

1. Fostering social changes that contribute to healthy adolescent development and that help prevent and reduce underage drinking.
2. Engaging parents, schools, communities, all levels of government, all social systems that interface with youth, and youth themselves in our coordinated national effort to prevent and reduce underage drinking and its consequences.
3. Promoting an understanding of underage alcohol consumption in the context of human development and maturation that takes into account individual adolescent characteristics as well as environmental, ethnic, cultural, and gender differences.
4. Conducting additional research on adolescent alcohol use and its relationship to development.
5. Working to improve public health surveillance on underage drinking and its risk factors.
6. Ensuring that policies at all levels are consistent with the national goal of preventing and reducing underage alcohol consumption.

I am confident that - when broadly discussed among parents, teachers, community leaders, and young people themselves - the goals of the Call to Action To Reduce and Prevent Underage Drinking, will be understood, appreciated, embraced and will literally save lives.

The Federal policy effort to address underage drinking is coordinated by the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD).

The committee’s member agencies support a wide range of programs in a comprehensive response to the challenge of preventing underage drinking.

Federal Initiatives
I would like to take a few moments to highlight some federal activities. 

Through the Enforcing Underage Drinking Laws (EUDL) initiative, the U.S. Department of Justice devotes dollars to enforcement, to holding young people, parents and communities accountable.

The National Highway Traffic Safety Administration, within the Department of Transportation, partners with Students Against Destructive Decisions (SADD) to develop numerous program materials to address underage drinking and driving. 

Concurrently, SAMHSA has reached out to parents, their children, educators and others.  
SAMHSA convened more than 1,200 Town Hall Meetings in all 50 states last year.

With the Ad Council, SAMHSA has developed an underage drinking prevention campaign directed at parents of 9- to 15-year-olds. Products include four television PSAs as well as PSAs for radio, print, and Internet.

“Reach Out Now,” a unique school-based underage drinking prevention initiative designed specifically for use by fifth- and sixth-grade students, their families, and their teachers, is another SAMHSA project.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA), a component of the National Institutes of Health, has been and remains an invaluable partnering in furthering the Call to Action goals. 

The agency is a co-founder of the Leadership to Keep Children Alcohol Free organization.  It is accurate to say the Federal effort to prevent youthful drinking would not be where it is without NIAAA’s guidance and leadership.

Underage drinking is multi-dimensional. To effect change we must approach underage drinking from many different levels.

To facilitate this change, the Office of the Surgeon General has created Guides to Action for Families, Communities, and Educators.

These plain-language guides help people understand what the Call to Action says and what it means to them.

They empower families, communities, and educators with the knowledge and tools useful in delivering the underage drinking message in a way that is easy to hear…understand…embrace…and put into action.

Rather than working separately, we need to “connect the dots” from all sectors of society: federal, state, and local levels.

We need to create linkages among public health, law enforcement, public safety, public education, parental involvement and, always, to young people.

And by tackling an issue—a public health issue, law enforcement issue, mental health issue—from a group perspective rather than an individual perspective, we can have a greater impact.

We must understand that underage drinking is not about spring break and it’s not just about parties. 

Consider this: 
Nearly one-third of youth begin drinking before the age 13.

This is unfortunate.

This is unacceptable.

This needs to stop.

Underage drinking is everybody’s problem, and its solution is everyone’s responsibility.
A perception exists that young people, adolescents will, as a matter of routine, drink alcohol – “no matter what.”

Not so.

When the American people rejected the use of tobacco and illicit drugs as a culturally acceptable behavior, the use of those substances declined, and the culture of acceptance shifted to disapproval.

The same change process is possible with underage drinking.

Parents’ opinion is actually one of the key reasons young people choose not to drink.

Parents must talk to their children.  Parents must talk with their children. 

Students perhaps should talk to your own younger brother or sister about alcohol. 

Parents need to become involved and remain involved with their kids’ decision-making.

Parents must send a clear, unequivocal and consistent message that underage drinking is unhealthy, unsafe, and unacceptable.  Period. 

When parents do so, they won’t be popular.  However, they will be responsible.

This is tough love.

It is never too early to talk to kids about alcohol, to give them accurate information about drinking, to answer the questions, even those they do not ask. 

We are following the evidence where it leads.  And it points the dangers of drinking for young people. 

Alcohol’s worst consequences are not inevitable, but they are real and can be indelible.

Think of the spike in violent crime, suicides, injuries, and traffic fatalities directly attributable to underage alcohol use;

Think of the increased numbers of young people taken into custody, incarcerated;
Think of the costs of addiction treatment;

The families and lives disrupted;

The futures of young people lost.

Think about it. 

As I close this morning, I want to leave you with a charge:

I strongly encourage each of you to reach out to your counterparts in state and local government to develop a comprehensive, interagency approach to preventing and reducing underage drinking. I encourage you to “connect the dots” because together we can accomplish more than we can alone.

I want to ask for your continued leadership in fostering changes in society that help prevent and reduce underage drinking.   

Alcohol’s worst consequences are antithetical to what we as a society, as a culture, as a nation want.

It is one reason you chose the field of substance abuse service provision as your profession.
 
The consequences of underage alcohol use are not consistent with what we want for our youth, what we all want for our families, friends, loved ones and neighbors.

They are inconsistent with a healthier America.

They diminish what is otherwise possible…for our kids, what we want for them, what they deserve: healthy bodies, healthy minds, and healthy spirits ... healthy and safe communities!

I look forward to collaborating with everyone here as we “connect the dots” to end underage drinking, discourage alcohol misuse, and promote responsible substance use. 

Thank you once again. We look forward to working with you today and in the future to prevent a reduce underage drinking across the U-S.

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Office of the Surgeon General - learn more about the Office of the Surgeon General

Office of Health and Human Services – learn more about the U.S. Department of Health and Human Services

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