Join this online discussion that will look at the substance abuse and high risk behavioral issues facing schools and students across the country. The Web chat will highlight successful interventions that are working to turn lives around and help students make the most of their classroom experiences and their lives.

Our chat host, Ellen Morehouse, is the Executive Director of Student Assistance Services a non-profit, tax exempt corporation in Tarrytown, New York. She is the creator of the Westchester County Student Assistance Program, an alcohol and drug abuse prevention and early intervention program currently being implemented in 37 High Schools and 21 Middle Schools and two Residential Facilities in the Westchester County area. This program is being replicated in schools in 19 other States, Canada, and in 14 other counties in New York State.

Morehouse received her Bachelors Degree from Cornell University and her Masters Degree in Social Work from New York University. She has spent the past 25 years working with adolescents with alcohol and drug related problems and with children of alcoholic parents. She has served as a consultant to treatment programs, school districts, parent and professional organizations, community groups, and State agencies in planning and implementing alcohol and drug abuse prevention, early intervention, and treatment programs. Morehouse has been the recipient of grants from the National Institute on Alcohol Abuse and Alcoholism, the Centers for Disease Control and Prevention, the Center for Substance Abuse Prevention, and the U.S. Department of Education. She has presented at conferences in 40 States and taught at Fordham University Graduate School of Social Service.

MODERATOR: Welcome to the Recovery Month 2002 Web chat. Our chat host, Ellen Morehouse, is the Executive Director of Student Assistance Services, a non-profit, tax exempt corporation in Tarrytown, New York. She is the creator of the Westchester County Student Assistance Program, an alcohol and drug abuse prevention and early intervention program currently being implemented in 37 high schools and 21 middle schools and two residential facilities in the Westchester County area. This program is also being replicated in schools in 19 other states, Canada, and in 14 other counties in New York State.

Our topic today is "Helping Students in Trouble." This online discussion looks at the substance abuse and high risk behavioral issues facing schools and students across the country.

Please note that the views and opinions expressed by non-CSAT staff members in the Web chats and webcasts should not be interpreted as official CSAT policy, but, as the views and opinions of the individuals participating in these events.

The chat transcript will be available shortly after the chat at the following URL: http://ncadi.samhsa.gov/2002/multimedia/webchat2.htm

MODERATOR: What resources are available for middle school at-risk students?

SPEAKER_Ellen Morehouse: The number one reason that young people do not return to substance use is that they remember the negative consequences of their use. Specifically remembering the arguments with their friends and families, not having money, and remembering the disciplinary problems at school.

MODERATOR: In your work with young people what is the number one reason in their minds that has helped them remain in recovery?

SPEAKER_Ellen Morehouse: Remembering feeling sick, and all of these negative consequences keep young people from returning to use. I think it is helpful for young people to talk about missing the times they were high instead to recall the times after they were high, in other words, the fallout.

scratchy: What signs do you look for to classify a student as being "at risk"?

SPEAKER_Ellen Morehouse: There are a number of researchers who have identified factors that put kids at risk for substance abuse. For example, teenagers who are experiencing high levels of transition, that is, moving from one community into another school. Also, kids who are not bonded to the school, and that have favorable attitudes towards substance use, those who lack peer refusal skills, those that have a family that has attitudes favorable to drug use, and those living in a community that has attitudes favorable to drug use. These are just some of the risk factors. For a more complete list, contact CSAP and visit their Web site and they can provide you with publications that list the risk and protective factors for young people and communities.

nyc dc: Why do you think alcohol use at the college level is so prevalent?

SPEAKER_Ellen Morehouse: I think there is a high prevalence of alcohol use at college for a number of reasons. First, many young people at college overestimate the number of their peers and classmates that are drinking. So they feel that they are the odd person and the minority. It is natural for college students to want to fit in. That is why programs that clarify college drinking norms help students understand that most of their peers are not drinking excessively. A second reason is that some students who are heavy drinkers of alcohol in high school get to college and they build up tolerance to alcohol. So they need to drink even more to accomplish the same feelings and behavior. If you combine that with the fact that as students get older more is expected of them socially and emotionally, yet they have not developed the skills in high school and, therefore, they feel more at a deficit and drink more. The third reason is that some colleges have ambiguous or uneven enforcement of policies around student alcohol use. Add all of these reasons to being away from home and the academic stress of college and that is why kids drink more at college.

MODERATOR: For more information, visit NIAAA's College Drinking Web site at http://www.collegedrinkingprevention.gov

MODERATOR: I found little bags in my son's dresser. He told me that all he is doing is pot and he is going to be 18 years old in 3 weeks. He tells me that the pot comes in the small bags; it looks more like bags that crack comes in. However I also found a lot of burnt foil in with it. I need to get him some kind of help before he turns 18. Is there any help I could get from his school in this case? We live in Florida.

SPEAKER_Ellen Morehouse: I am not sure what resources there are in your school, so let me give you two possibilities. You can ask the school psychologist or social worker, substance abuse prevention specialist, or nurse if they could recommend a place where you can go to get help for your son. If you don't feel comfortable doing that, contact the Florida State alcohol and drug abuse association or the state of Florida alcohol and drug agency and ask them to recommend a place where you can get help for your son. The fact that you found the foil indicates that your son is already using drugs and even if it is "just" marijuana, you should still get him treatment. The foil could also indicate that he is using cocaine, heroin, or possibly other drugs as well.

HSutusky: What tools are needed to assist teachers and SST in our middle and high schools? How can the community be of assistance?

SPEAKER_Ellen Morehouse: All teachers should receive training on understanding risk and protective factors for substance use, signs and symptoms of use, procedures to follow if they are aware of a student who might be using either in school or out of school, and they should be aware of community resources where they can refer students and families that need additional help. The community can be helpful to the school by either providing the training for the school staff or providing the resources for someone else to do the training and then being supportive of the school's policy.

OSAIS: Is there a similar prevalence of alcoholism in American kids as opposed to European kids and why?

SPEAKER_Ellen Morehouse: I don't know the answer to the question, but if you contact the National Institute on Alcoholism and Alcohol Abuse they can direct you to a source to get that information.

MODERATOR: For more information, please visit http://www.niaaa.nih.gov

Itchy: What role can resident assistants play in either enabling or preventing alcohol abuse on campus? To what extent do campuses train RA's on this issue?

SPEAKER_Ellen Morehouse: Resident assistants play a critical role in preventing and reducing alcohol use by students. There are several actions they can take. First, they can identify students who appear under the influence, speak to them the next morning or at a time when they are not under the influence, and refer them to on-campus or off-campus resources for help. Second, they can reach out to students whose roommate or friend may appear intoxicated and make suggestions to that student for how he or she can help his or her friend. And third, they cannot close their eyes when they see a student who is violating the college policy but should report the violation to the proper campus authority. Resident assistants should be trained on how to do this and have an opportunity for follow-up to discuss barriers they encounter.

Marilyn from Iowa: Iowa is a new SIG (State Incentive Grant) State. What Model Programs would you recommend for this population?

SPEAKER_Ellen Morehouse: There is no one model program that is right for every case and every person. What I recommend is that you go to the model program Web site at http://www.modelprograms.samhsa.gov and use the Decision Support System to determine which model program is most appropriate for the goals that you want to achieve.

trompy: Do students in recovery for substance abuse face additional challenges around mental health? How do the two relate, if at all?

SPEAKER_Ellen Morehouse: I believe students in recovery do face additional challenges in regards to mental health. Because they are encountering all of the normal adolescent stresses without the aid of what I call the chemical blanket that has been wrapped around them. So many times they don't have the skills to face these stresses.

MODERATOR: For more information, visit the Web site for the Center for Mental Health Services, Knowledge Exchange Network at http://mentalhealth.samhsa.gov.

dfudge: I work with high risk teens in an alternative high school, and the vast majority are very much into using a wide range of substances. I am also finding that their parents are also substance abusers. What are some pointers for breaking the wall of "my parents do it, so it is OK for me to do it?"

SPEAKER_Ellen Morehouse: In our program, we nickname these types of students "double trouble," because they have two significant issues. That is, having an alcohol and drug problem themselves and being the child of an abusing parent. I have an article on this topic that was published in Alcohol Health and Research World, Vol. 8, No. 4, summer of 1984. The basic strategy is to first talk with them about the impact of their parents' alcohol and drug use. And they outline five steps for doing them, which you can read about in the article. Then you reframe the adolescents' own alcohol and drug use and a possible coping strategy for the stress of having a substance abusing parent.

Marilyn from Iowa: Could you define the "chemical blanket"?

SPEAKER_Ellen Morehouse: The chemical blanket is a metaphor for if a person is out in the cold and is all bundled up with heavy blankets, they would not feel the cold, so they would be able to stand there and not feel uncomfortable. Chemicals do the same thing. They can create a numbness so teens don't feel the stresses of family, social, or legal situations. When they stop using chemicals, it is like having that person go back out into the cold without all of the blankets and warm clothes. Obviously it is a very uncomfortable experience.

Ronna Corliss: If a kid is referred to the SAP for using, at what point do you determine this student requires services above and beyond what can be provided in the school setting?

SPEAKER_Ellen Morehouse: It depends on the student's motivation, the student's willingness to accept services outside of the school, the student's willingness to attend 12-step meetings in the community, and the student's willingness to involve the parent.

kwolf: Are there any model programs designed for Native American youth populations?

SPEAKER_Ellen Morehouse: Yes, there are model programs that have demonstrated effectiveness in preventing and reducing substance use with Native American teens. For a complete listing, contact CSAP. The Model program Web site is at http://www.modelprograms.samhsa.gov, or there is a toll-free line to call at 877-773-8546.

Elaine: What different methods do schools in urban versus rural areas need to look at in preventing or reducing substance use?

SPEAKER_Ellen Morehouse: There are model programs that have demonstrated effectiveness and both urban and rural communities, and then there are other model programs that have only demonstrated effectiveness in one of those settings. For more information, again, contact the CSAP model program Web site, or call the toll-free number listed above.

trompy: Do you think support groups are a good way to keep youth sober?

SPEAKER_Ellen Morehouse: In-school, support groups for recovering students can help in preventing relapse and supporting sobriety. But they should not be the only service for recovering students.

Doc Joe: What do you think of random drug testing programs in schools to help kids say "No"?

SPEAKER_Ellen Morehouse: I support random drug testing programs in schools as long as there are also resources for students to get help.

KrisV: Where do you think the greatest challenge lies in moving prevention to a greater level of effectiveness?

SPEAKER_Ellen Morehouse: The greatest challenge is in getting financial resources to conduct outcome evaluations using comparison or control groups to measure a program's effectiveness. Very few prevention programs have the financial resources to conduct these kinds of evaluations.

cspiker: I represent an outside agency that delivers alcohol and other drug education to schools. We also provide facilitators for small group work with children from substance abusing families. My question is, "How do you successfully overcome the barrier that youth have with the perception of the limited dangers of marijuana use?" Our experience has been that marijuana is the one drug that youth have difficulty staying away from. The consequences do not seem to be as immediate with marijuana use.

SPEAKER_Ellen Morehouse: Young people need to be given accurate information about the effects of marijuana on teens. Specifically they need to know that marijuana impairs memory, and having a good memory is critical for both academic and social learning. Second, they need to know that marijuana often reduces anxiety and it is important for teens to be aware of anxious feelings so they can figure out appropriate coping strategies or ways to avoid anxiety-provoking situations. For example, I tell Junior High School-aged students that you would not want to smoke marijuana if you are in a wilderness survival school because you may not remember what you need to do to stay alive in a dangerous situation. Or you would not want to be smoking marijuana as you walk through a snake-infested jungle and not have the appropriate anxiety when you encounter a poisonous snake.

MODERATOR: For more information for teens regarding marijuana, please visit http://www.freevibe.com.

MODERATOR: Please note that the views and opinions expressed by non-CSAT staff members in the Web chats and webcasts should not be interpreted as official CSAT policy, but, as the views and opinions of the individuals participating in these events.

Doc Joe: I counsel with a lot of early users and get very frustrated with the lack of referral to get help by the law enforcers. How can we get the local courts more concerned to get first-time offenders into an evaluation and treatment process?

SPEAKER_Ellen Morehouse: There are two important steps. First is to provide education for law enforcement and judicial personnel so they understand the dangers of use, and provide resources that are available to help young users. The second step is to create community support for enforcing existing laws and referring teens for services when they violate those laws.

trompy: Do you think that meeting and hearing stories from youth and young adults in recovery is a good way to prevent other youth from going down that path?

SPEAKER_Ellen Morehouse: Research indicates that stories from drug-using teens heighten curiosity and may stimulate use among young people who have not used alcohol or other drugs. However, for teens who are already substance abusers, hearing stories of recovery can provide hope and motivation for treatment.

MODERATOR: How do you feel about using "responsible drinking" messages in programs? I find that students will only respond if we first acknowledge there is a problem.

SPEAKER_Ellen Morehouse: I don't think that any use of alcohol by people under the age of 21 can be called responsible, because it is unhealthy. We have to help young people understand that new research indicates that the brain is still developing up until the age of 20 or 21. Therefore, using alcohol, even occasionally, can impact learning, memory, and other brain function. The analogy I use with teens is that there is no such thing as responsible sun bathing without sunscreen, because even small amounts of sun exposure without sunscreen can cause skin damage that can lead to melanoma.

Marilyn from Iowa: How do you recommend reaching parents? So much emphasis is placed on youth use, but young people's first role models are their parents.

SPEAKER_Ellen Morehouse: I tell parents that the best thing they can do is be a good role model. If they choose to drink, look at whether they are using alcohol as a beverage that may accompany a meal, or are they using it as a drug to deal with the pressures of their life to help them socialize. Second, I help parents understand that when their child says how can you tell me not to drink when you drink? The child needs to understand that alcohol has a very different impact on the body of someone over 21 whose brain has developed who has received an education, and has developed appropriate social and coping skills than on a child or teen. A good way of demonstrating this concept to a child or younger teen is to take a small glass of water and say, "This is the child," and take a large clear pitcher of water and say, "This is the adult." Now put one drop of red food coloring in each container of water. The child will see that the same amount of food coloring had as much greater impact on the small glass of water than on the large pitcher of water. This is how the discussion begins.

SPEAKER_Ellen Morehouse: In conclusion, there is a lot of good information on SAMHSA Web sites, the NIDA Web site, the NIAAA Web site, the Office of Juvenile Justice and Delinquency Prevention Web site, the CADCA Web site, the NACoA Web site, as well as many others. NACoA is good for children of substance abusing parent questions. Also, the National Clearinghouse for Alcohol and Drug Information is a good resource for information at 1-800-729-6686. You can order publications and research studies, or be referred to knowledgeable professionals who can give you additional resources.

MODERATOR: Our hour has concluded. We would like to thank our host, Ellen Morehouse from Student Assistance Services, for her participation in this online event, and thank our participants for their questions. This transcript will be available shortly so that others may benefit from the dialogue.

MODERATOR: Join us for our next live Web chat on Wednesday, June 19 from 3:00-4:00p.m., featuring Janice Ford Griffin, Deputy Director of Join Together. Our topic will be "Calling Community-Based Voices to Action."

MODERATOR: The chat has now officially ended.