Simple Gifts

So what are we missing in drug-use prevention?

There is a vexing problem in prevention mental, emotional and behavioral disorders in the United States, which includes drug use in our youth and teens.  The vexation goes like this:

1.      Marijuana and psychotropic drug abuse has been going up among kids in America.  That’s not a good thing, unless you are part of the supply chain of drugs.

2.      Our current policy models of predicting marijuana or psychotropic drug abuse (e.g., standard risk and protective factors) don’t do a great job of predicting these problems—especially when you use percentage of students with the risks or protective factors as predictors in schools or communities.

3.      Analyses of risk and protective factors at a community or school level cannot detect regional or national forces predicting marijuana or other drug use.  By analogy, this like trying to predict the pulse rate of people in a school without taking into account there is a hurricane bearing down on the whole community.

So we huff and puff (pun intended) about the vexing problem. We blame the war on drugs. The legalizers and the non-legalizers square off.  We blame the parents. We blame the teachers.  Some blame it on the lack of prayer in schools.  The Left Wing and the Right Wing are both sure it’s all a conspiracy of the opposite Wing. Others claim it’s just adolescent experimentation.  As a thoughtful scientist and prevention advocate, I find none of this satisfying.

I like seeing nice, clean clear data that are consilient. That is, to be consilient means a clear unity of knowledge (literally a "jumping together" of knowledge).  This scientific idea has its roots in the ancient Greek concept of an intrinsic orderliness that governs our universe and world, inherently comprehensible by logical process.

Now here is the consilience issue: We need to be able to fit together the biological (e.g., reward centers, biochemistry and receptors), evolutionary (e.g., why do we have reward receptors, why the genes for substance abuse exist), sociological (e.g., culture, peers, family), and cognitive-behavioral (e.g., how we think, talk and act) data on what actually drives substance abuse.  If you are trying to wag the head of the substance abuse problem by pulling just one of these tails, you are not going to make much progress.

So I’ve been pondering the consilience issue on rising marijuana and prescription drug use for about 5-7 years.  I’ve made progress, but there are still missing pieces.

One puzzle piece that has fallen into my lap is sleep deprivation among young people.  It’s clear that it has been increasing.  Both as scientist and a licensed psychologist I know sleep deprivation plays havoc with human behavior, mental health and physical health. I’ve been involved in treating people in psych units for acute sleep deprivation, and it’s not pretty.  As a scientist, I know that chronic sleep deprivation changes biochemistry, gene expression, social interactions, cognitive ability, and risky behaviors.  But is sleep deprivation a cause in the rise of marijuana use?

Yes, based on a study published in PLOS on teen social networks, sleep deprivation and marijuana use. Oh, a lot of folks are NOT going to be happy.  You can read it here: http://bit.ly/bQxnk5Sleep. I am ecstatic and awed by the study; it is consilient. Here is the down and dirty summary (it’s more complicated in the actual document):

·        Sleep Deprivation. If your kid has one mutual friend who sleeps less than 7 hours per night, your kid has about a 30% chance of starting to sleep less than 7 hours. If your child’s friend has friend who sleeps less than 7 hours, your child has an additional 17% risk of sleeping less than 7 hours. If your child’s friend’s friend has a friend who sleeps less than 7 hours, your child has another additive 9% risk of starting to sleep less than 7 hours. This additive effect still happens after fourth-degree peer friendship separation.  The more first degree friends who don’t sleep properly, the effect gets added up. The bottom line: sleeplessness in your kid is contagious from your kid’s peer social network. 

·        Marijuana Use.  If your kid has one mutual friend who uses marijuana, then your kid’s chance of starting to use marijuana jumps up about 200%, and continues also for four-degrees of separation of friends of friend to have additive prediction.  For each friend your kid has who uses marijuana, your kid‘s future use goes up about 14%.  This finding is common sense, but it has been shown so elegantly in a large normative population.

·        Sleep and Marijuana Use Interaction. So what do your kid’s friends’ sleep habits of less than 7 hours per night do your kid’s marijuana use? Each of your kid’s friends who sleep less than 7 hours will increase your child’s use of marijuana by 19%. If your kid has more friends who sleep less, then each one of those friends adds another approximate 20% increase risk of marijuana use.

And for the total jaw punch: the authors show that the causal pathway is from sleep to drug use, not from drug use to sleep problems.  In short, your kid’s risk of using drugs increases as his or her friends sleep less.

Now didn’t your and my grandmother always tell us to get a good nights rest?  Well, she was right, very right.  And it looks like some smart grandmothers raised some smart scientists to prove it.  Those grandmothers should be proud.

Sleep deprivation is one of the hurricanes howling at doors of homes and schools throughout the country related to increasing substance abuse among our children—completely unmeasured by any existing policy or risk assessments.  And you can probably guess why sleep deprivation is increasing in America’s youth—all the electronic toys in the bedrooms for social networking and increased promotion of caffeinated beverages consumed by youth (advertised on said media).

So, this is why my colleagues and I have decided to put a major focus the Families United movement (See http://bit.ly/a3RR3B) on reducing sleep deprivation. 

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