Preventing teen marijuana use: What works

What programs are most effective for preventing teen marijuana use?  That question is being studied by the Washington State Institute for Public Policy (WSIPP) which recently released an updated review of scientific evidence about prevention programs.  They reviewed 23 youth marijuana prevention and treatment programs  and categorized them as "evidence-based", "research-based", or "promising."  

The top ten prevention programs identified by WSIPP are:

1. Life Skills Training
2. Communities That Care
3. Project STAR
4. Lions Quest Skills for Adolescence
5. SPORT
6. Keepin’ it REAL
7. Strengthening Families for Parents and Youth 10-14
8. Multidimensional Treatment Foster Care
9. Case management in schools
10. Project Northland

Detailed information about these programs may be found on the National Registry for Evidence-based Programs and Practices website.  

While WASAVP advocates for the funding of these programs, the WSIPP list does not include policies proven to reduce youth access to drugs which is the focus of most of WASAVP's work.  The Guide to Community Preventive Services is the place to start to gain an understanding of public policies that prevent youth alcohol and tobacco use.  Among effective policies are those that limit the density of retailers that sell alcohol and tobacco, the enforcement of minor in possession laws, and taxes.  

As I-502 is implemented, an understanding of prevention is needed

The need to scientifically-define prevention is once again obvious when reading the latest Brookings Institute report on our state’s implementation and evaluation of I-502.  In the report, the author notes that some marijuana revenue is dedicated to funding prevention and treatment programs.  He claims, “Given the paucity of good scientific information about marijuana, this is a tall order . . .”  In fact, research has already shown what works to prevent adolescent marijuana use.  A few examples of evidence-based programs are:

• Keepin' it REAL
• Guiding Good Choices
• Life Skills Training
• Lions Quest
• SPORT
• Project Northland

Revenue from I-502 earmarked for prevention will fund community coalitions.  These coalitions will then identify drug-related risk factors particular to their communities and implement programs, policies, and practices that are proven to reduce those risk factors.  The programs listed above are examples of prevention activities to be implemented, but community-based policies and practices (also called “environmental” strategies) will also be implemented. 

What we don’t know is if policies and practices that work for preventing alcohol and tobacco use among adolescents will work for marijuana since it has never been marketed and sold like alcohol and tobacco.  Right now, prevention providers advocate for the following policies that are best practices for alcohol and tobacco prevention:

• Limit the number of retailers that sell the drugs in a community. 
• Limit days and hours of sale.
• Levy high taxes on the drugs.
• Enforce age limits for purchasing and using.
• Limit where products may be consumed.

Most of these policies are included in the new marijuana system.  The policies limiting the number of marijuana stores in a community, limiting hours of sale, limiting where marijuana products may be consumed, and high taxes on marijuana should be maintained and studied.  As the Brookings paper suggests, this is an experiment and we should strive to learn as much as possible from it. These policies work for alcohol and marijuana, we should find out if they work for marijuana, too.  

Liquor Control Board to limit marijuana-infused products appealing to children

Today, the Washington State Liquor Control Board adopted emergency rules adding a requirement that all marijuana-infused products, packaging, and labeling be approved by them.  The rules are to clarify the types of marijuana-infused products the board will allow to be produced and sold.  The board's issue paper on the emergency rules states:

"Many marijuana-infused products on the medical marijuana market today are appealing to children.  Products such as lollipops, gummy bears, and cotton candy are very appealing to children too young to read a label."

To gain approval from the board, marijuana processors must submit a picture of the product, its label, and packaging to them.  The board will not approve products that appeal to children. 

Marijuana-infused products that look like foods and beverages that children commonly eat and drink have been a concern for WASAVP and adolescent substance use prevention advocates even prior to the I-502 vote.  Concerns were expressed to the Liquor Control Board during their rule-making process and as they developed recommendations for reconciling the recreational and medical marijuana systems. 

The emergency rules also include guidelines regarding serving sizes.  The new rules read:

"Marijuana-infused products in solid form that contain more than one serving must be scored to indicate individual serving sizes, and labeled so that the serving size is prominently displayed on the packaging."

"Marijuana-infused products must be homogenized to ensure uniform disbursement of cannabinoids throughout the product."  

Seattle Times calls for marijuana prevention programs

Last week, a Seattle Times editorial stated that teen marijuana use prevention efforts should start now.  "Washington instead is waiting for the spring of marijuana tax revenue to gurgle up and fund prevention efforts. That’s a mistake," the editorial says.

In fact, many substance abuse prevention strategies can be implemented without funding.  As yesterday's post explains, policies supporting public health should be adopted before the new marijuana industry is fully up and running.  Several public health prevention strategies can be put in place by key institutions in our state without prevention-specific funding.

• Local jurisdictions can strictly enforce the ban on public consumption of marijuana.  
• Products attractive to children and teens can be prohibited.
• Statements supporting limits on the number of marijuana stores can be made by public officials.  
• Tighter restrictions on advertising can be adopted.  

The idea that substance abuse prevention is all about implementing school-based programs or mass media campaigns is outdated.  (Though, there is nothing stopping the Seattle Times from forming a private-public partnership and running marijuana prevention ads pro bono right now.)  Yes, those elements of teen drug use prevention are important, but to be most effective they need be part of a comprehensive strategy that addresses the many individual and community factors that contribute to marijuana use among minors.

Preventing youth marijuana use: What works?

Last week, WASAVP hosted "What Works!", a symposium for Washington prevention advocates and providers about what can be done to prevent youth marijuana use.  Presentations from the symposium are now available on the Athena Forum website.

Risk and Protective Factors for Youth Marijuana Use: Preliminary Findings

Predicting the Uncertain Future of Legal Marijuana

Environmental Prevention Strategies Discussion: Lessons Learned from the Field

Initiative 502 Implementation: Creating Washington's system of legalized marijuana 

Making comments about proposed rules

Tobacco Lessons for Marijuana Policies and Environmental Systems Interventions

High School Traffic Safety Programs

What Works? Program Review