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Dr. Jason Kilmer, who is the Associate Professor of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, joins us for this month's episode. During this, his third appearance on the podcast, he discusses the impact of local marijuana legalization on his campus, explains why talking about prevention "fails" is important, gives words of encouragement to other prevention professionals, and much more.
Rich Lucey: Hi, everyone, and welcome to this episode of Prevention Profiles: Take five. I'm Rich Lucey in the Drug Enforcement Administration's Community Outreach and Prevention Support Section. Today, thrilled to have a return guest who actually has been on the show for about three years or so. Jason Kilmer, who is the Associate Professor of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine.
So let me tell you a little bit about Dr. Kilmer. So Dr. Jason is an Associate Professor in Psychiatry and Behavioral Sciences at the University of Washington and he serves as an investigator on studies evaluating prevention and intervention efforts for alcohol, cannabis and other drug use by college students. In addition to research and teaching, he has worked extensively with college students and student groups around alcohol and other drug misuse prevention programming and presentations throughout his career, both at UW and on over one hundred campuses across the United States. Jason also serves as the chairperson of Washington State's College Coalition for Substance Abuse Prevention. Jason was the 2014 recipient of the National Prevention Network's Award of Excellence for Outstanding Contributions to the Field of Prevention and was also the 2017 recipient of the Washington State Prevention Professional Award of Excellence. With that, Jason, welcome to the podcast.
Jason Kilmer: Thank you. What a treat to get to work with you again. I appreciate the invitation.
Rich: Absolutely. And so I got to ask you, before we get into the questions, how, what goes through your mind when you hear somebody reading your bio? I just had this experience last week for the Higher Ed Center's National meeting. They were reading my bio and my reaction live to everybody was, but I do so much more than that.
Jason: That's a good question. We do, do a lot more than that and there's also that element where I'm like, oh, I just make it stop.
Rich: Yeah, yeah.
Jason: I feel like I should try and get like a one sentence; this is Jason who does some stuff. Here's Jason [inaudible].
Rich: Yes. Well, a mentor of mine, early in my career and Fran Harding would also say it was her mentor. She had this great line that the most powerful person in the world, you know, the head of our country, is introduced by five words; Ladies and gentlemen, the president. So, you know, if you can just get it down to those number of words, I guess, then that's half the battle.
Jason: I'm going to work on the five words. We'll, have something by the end of this.
Rich: Yeah, okay, that sounds good. So let's get into it. As I said at the opening that you haven't been a solo guest on the podcast for about three years now. You were part of our retrospective episode this past January to kick off our fourth season of the podcast series. Thrilled to have you back, you know, on your own and delve into some of these issues.
So first question, I'm going to preface this by stating that under federal law, medical and personal or what some will call recreational use of marijuana is illegal. And yet during the past nine years, a number of states and the District of Columbia have legalized cannabis use for adults over the age of 21. In fact, Washington state was one of the first two states to move in that direction. So, Jason, from your perspective, what has been the biggest impact of this movement on the nation's colleges and universities?
Jason: I bet you have a different answer depending on what school you asked and what school you talk to. I'm confident it depends on, you know, potentially what state someone's in. I'm sure it depends on if they're, you know, in more of a city or farther away from large population centers, you name it. But I can say that when I look at the evolution of even in my own state, kind of the impacts. There was this initial sense of, well, you know, we have policies in place that should be, in quotes, good enough. And I think people learned that that wasn't necessarily true, that there needed to be more of a clear effort, in some ways, to do exactly what you did at the beginning, Rich, which is reminding folks that independent of what the state's done, it remains federally illegal and that, you know, for schools to stay compliant with drug free schools and campus regulations, which involve making sure that we're working to stop the use and possession of illegal drugs. And since it is federally illegal, nothing that happened with our state initiative changed any of that.
But even when, you know, our vice president of student affairs at the time, I thought did a great job of communicating that, but there was, there was almost not even so much confusion as there was the potential for mixed messages. You saw on campus clear statements being made about what was and wasn't allowed. But all you got to do is walk across the street and get off campus property and maybe you saw some different messaging in terms of what was being enforced, what wasn't. So that, I do think that made it very tough.
I think that there are some folks that are honestly potentially operating off of an old script. When people say, well, in quotes, it's just weed or, you know, in quotes, what's the big deal? If someone says, I used when I was younger and I turned out fine. They used different stuff. So, you know, the number of times I saw, almost jokingly, displays in a campus bookstore with, you know, cannabis games you can play with your friends or cannabis cookbooks set out during orientation week. It's like, wait, what? What are we doing? And they're like, but it's funny. It's like; it's not funny from an addiction standpoint, from an academic outcomes standpoint and so on.
Finally, you know, I mentioned the old script part. We have become a high potency market. If you look at what scientists call in quotes, the strong stuff, it's anything over 10 percent THC; 97 percent of the Washington market is over 10 percent THC. So what people were not aware of is products even 10 years ago have changed so dramatically. And what the science is suggesting is that high potency cannabis is associated with more cannabis use disorder, addiction, more mental health concerns. Certainly there's research that shows that cannabis is associated with poor academic outcomes.
So we really need to make sure that folks are realizing this is something we take seriously and anyone that says I want to be a champion for student success, I want to be a champion for mental health, also has to be a champion for prevention.
Rich: I love the way that you said that and tease out something that you mentioned about, you know, the legal age. So that's always been my...So, again, working for the federal government, our message is going to be what the federal position is. Right? And the way I also nuance that messaging is, look, I get it. Some of the states and the district, they've passed these legislative initiatives and such, but no matter what state you're in, it's still illegal if you're under the age of 21. So, you know, in an ideal world, you're prevention messaging, you're prevention strategy doesn't change, shouldn't change, I should say, because for that very reason.
Jason: That's right, and I think that, you know, on college campuses, we have a, as we do with alcohol, we have a blend. We have people under 21 when we have people over 21. But you're very, very right that that prevention messaging doesn't change. We just have, I feel like we're playing catch up though. I mean, we have over eight years of legalization in the state of Washington, yet, you know, people solidly get don't drink and drive. I don't know that everyone solidly understands, you know, don't drive with someone who's been using cannabis. Don't drive yourself if you've used cannabis recently. When you hear people say things like, I drive better when I'm high, not according to a single published study ever. And so we wouldn't be a passenger in a car with someone who's been drinking. Why are people getting in the car with someone who just used weed, things like that? We can certainly up our game in terms of the prevention message we do about dangers like that.
Rich: Yeah. I wonder if, as you say, that I don't feel like we missed the boat, if you will, on messaging, because we've always been pretty clear on that, that it does affect your, it does impair your driving skills, but maybe there's more amplifying of the message we need to do or something. I just don't understand the rationale of the individuals who have, they're holding on to this belief that it makes me a better driver. I just, you know...So what do we do to counter that? You know, that's, I guess that's for us to figure out.
Jason: Well, and the scientist in me says we get the science out there.
Rich: Yes.
Jason: People are big fans of cannabis, you know, are very passionate about both potentially, you know, defending their own use or talking about why it's in their eyes, maybe not so bad, but, you know. If you, when one article comes out, you go, huh? Well, there's one article. But when we get a number of studies and they start telling a fairly consistent message, it's important to start listening to those. And I think that, you know, the perfect single study doesn't exist. And that's why we look at a body of literature and if a body of literature starts to tell a consistent message, I mean, at some point, it's getting that out there and making sure people understand what the science is.
Rich: Right. This, I think, is a good segue to my second question for you, because it's also dealing with the cannabis issue. So you have a long history of studying the impact of alcohol misuse among college students, as well as looking at the impact of marijuana use among youth and young adults. I know for me, over the past few years, I've attended or presented at conferences and there's one that sticks out to me in particular, and it was a working lunch. And the campus staff who were engaged in conversation at that working lunch, they seem to want to treat marijuana as so much more different than alcohol when it comes to prevention. And it was kind of, you know, really just frustrating me that I ultimately finally had to say something. Basically, I said, stop it, stop doing that. So, you know, from your experience, what are some of the lessons learned around preventing alcohol misuse among college students that also apply to preventing marijuana use?
Jason: That a mix of strategies is best. I mean, the National Institute on Alcohol Abuse and Alcoholism, NIAAA, is College Alcohol Intervention Matrix, CollegeAIM, reviews over 60 individually and environmentally focused prevention strategies, based on their relative cost and relative effectiveness. And in the narrative leading up to it, it makes very, very clear a mix of strategies is best. If all you do is environmental approaches, you're missing some of the more individually focused things, particularly to folks that might be more high risk. If you only do individually focus things, you're missing the environmental part.
I think a blend of correcting misperceived norms of working with people who have made the choice to use and who may be experiencing some harms or unwanted effects. I think that consistent enforcement of policy. I think that, you know, looking at it from that type of mix of strategies approach is absolutely essential.
Where it is, where there are some differences is around strategies that people might use. I started working in Alan Marlatt's lab when I was a junior in college as an undergraduate research assistant. Dr. Marlatt was my advisor in grad school. He was the first alcohol researcher to start testing harm reduction approaches with college students. The first article on college student drinking was 1945. The first article showing, look, we can reduce drinking and-or consequences 45 years later, wasn't until 1990.
We don't have 45 years to wait for effective prevention policy.
Rich: Right.
Jason: But I didn't appreciate until Allen passed away in 2011, how controversial it was for him to do harm reduction at the time. At the time he was testing it, the number of published studies showing, again, significant reductions in drinking consequences or both, was none. But according to the Reagan National Library, at the end of the 1980's, the number of Just Say No clubs across the country was 12,000. So to do anything other than just say no was viewed as controversial, and not in line with where we were as a country.
So people say, well, can we do harm reduction with cannabis? The short answer is yes, but the longer answer is if you look at the research, Fisher and Colleagues wrote an incredible article that said lower risk guidelines, cannabis guidelines didn't say low risk. And the reason why is they reviewed 10 guidelines for lower risk use and the number one guideline was don't use. They said if you truly are saying, I want to avoid risks and harms, then abstinence is the only way to do that. Does the federal government have low risk guidelines for alcohol use for people over 21? Yes. Are there guidelines for low risk cannabis use? Not according to the science, because the Fisher and Colleagues article says people that make the choice to use just need to understand that they're engaging in a behavior that necessarily incurs risks and harms. So, once you get past that, I mean, obviously, any steps towards less frequent use, less potent use can be steps in the right direction. But that's where you're right, prevention approach, we wouldn't necessarily approach different. Prevention messaging, there needs to be something a little different because if someone, say, makes the choice to drink. Are there ways to do that in less dangerous or less risky way? Yes. If people make the choice to use cannabis, are there ways to do that in less dangerous, less risky way? There is going to encourage risk. We've got to make that clear.
Rich: Absolutely. There are two things I'm thinking of, as you were giving this excellent information. And one, I think what frustrated me so much, hearing these professionals working in prevention. And again, I don't know what length of time they've had in the field. I don’t know if they were entry level, I have no idea if they have the foundational training that they need in prevention science. I think that's a big issue for our field, quite honestly. But it all came back to the SPF for me, the Strategic Prevention Framework, which we have said all along, I don't care if you're talking about alcohol, marijuana, cocaine, heroin, you know, hallucinogens; the sciences, the science. You follow a strategic planning process that will help guide you to where you want to get to be.
So I felt like they were kind of pushing the SPF aside to, you know, to treat marijuana differently. But what you just mentioned about harm reduction. So that's been a slippery slope my entire career, which has been in government. I mean, state government, federal government, right, nine years in New York and then 21 years plus for the feds. And it's always been the slippery slope. And I tried to navigate it as well as I can by, and by doing that, what I hope to impart on the leaders I've had and every agency I've worked on, have to grasp the concept and say, yeah, nonuse, first and foremost, that's our number one message if you are under the age of 21. But for those students who ignore the law and we know there are those students who ignore the law when it comes to alcohol, when it comes to marijuana, prevention professionals on campus have to be able to turn to strategies to help those students.
Jason: That’s true.
Rich: You can't ignore them. You can't ignore that it's going to happen.
Jason: The messaging, though, you know, it's fresh in my mind because I just talked about CollegeAIM earlier today. We would never stand up in front of a group of students and say, look, I know you're going to drinks if you do, dot, dot, dot.
Rich: Right.
Jason: I know you're going to drink is a normative misperception. And if they're under 21, it kind of sounds like permission giving.
Rich: Yep.
Jason: So we always make clear; under 21, it's illegal to drink. Driving after drinking, not recommended. And if someone says I want to avoid all of alcohols unwanted effects completely, abstinence is the best way to do that. Yet if you make the choice to drink, there are ways to do it in less dangerous or less risky ways. We never say in a safe way. The boost; when these reviews of the published literature started looking at, here are evidence based strategies, showing that some of these harm reduction strategies are associated with reductions in use, on a federal website, certainly means yes, they work, but they work with that asterisk of how we describe them is really, really important. You know what you have on your own website with Campus Drug Prevention on a tool to help people with their planning for substances in general. As you bring up the SPF, this becomes important for people to utilize as a tool as well.
Rich: Right. Well, you and I have worked together, we've co-presented together. We've done this podcast together with friends and colleagues for a long time. So one would think that we've rehearsed this type of segue in transition, but it just naturally happens because what you're talking about leads perfectly into my third question. So I want to talk a little bit about evidence based strategies. We have more than three decades of prevention science, thanks in large part to the National Institute on Alcohol Abuse and Alcoholism. As you mentioned, researchers such as yourself. As a field, how do you think we're doing in implementing evidence based practices to prevent drug misuse among college students?
Jason: I want to, I mean, I'm an optimist, I want to say look at all that is being done and the challenge is, the challenges of the last 17 months, I don't want to do something that anchors where we are in time too much.
Rich: Right.
Jason: But you and I are talking about this on August 9th, 2021. The last 17 months have certainly been challenging. And I will quote our common friend and colleague, David Arnold, who says, prevention has to be a narrative, it has to be ongoing. The second we take our foot off the gas, we regress. And so, you know, if people said, well, we really didn’t have students at our campus for the last year or so, the hope is that doesn't mean that prevention stopped. It doesn't mean that prevention halted. Prevention maybe took on a different look or maybe more was done virtually or through Web-based formats than when we're all in person and things are, in quotes, normal. But it had to keep happening. So any one school, as they complete their biennial review, it's a chance to kind of say, how are we doing? What are we doing well? Where might there be gaps? What do we need to do differently? What story do our data tell us?
And so I do think that as long as people are willing to take that look at this...I heard Alicia Baker recently say from University of Florida say, it shouldn't just be a box to check. And I believe she may have even been quoting Eric Davidson in saying that. But it's going beyond the box to check is, are we doing the right thing? It's not just, are we doing stuff that looks good and is visible? Are we doing things that are going to benefit our student body? Are we doing things are going to help our students succeed?
And if a school can say, yeah, we're putting our best foot forward, this is worth investing in, we're doing all we can, then awesome. If the sense is, well, you know, maybe prevention hasn't gotten the attention it deserves, then I think they can be doing more. But it's, that's another question that's going to vary from school to school. I've got to believe, because it does depend on not only their general approach pre March 2020, but even, you know, what have they been thinking about and doing over these last 17 months becomes important too.
Rich: I know as someone whose particular area of focus in my entire career has been preventing alcohol and drug misuse among college students, I was so excited in 2002 when the NIAAA came out with the four tiers of effectiveness. I thought, great, we've got guideposts now. Schools are going to be following these. And what was it? About six years later when Dr. Tobin Nelson came out with his journal article that said, you know what? Not doing so great of a job. It was very disappointing to see that that was the case.
Jason: Tobin's article was interesting because it was challenging to be able to say how is, how this, I say in quotes a lot because I'm making air quotes and you can see that. But if you're just listening, you can't. So I apologize for my overuse of in quotes but I'm an air quote kind of person.
So, you know, they asked administrators, since the Call to Action Task Force report came out, how are things? What have you been doing at your campus? And, what was it, 21 percent of college administrators said, I don't know what report you're referring to?
Rich: Right.
Jason: But 79 percent of schools said, of course, I know about it. So that is, that is a good thing. Most were headed in the right direction. Is it concerning, that 21 percent didn't know what the report was? Yes. But is it optimistic and hopeful that 79 percent did? Absolutely. It's challenging. It is hard to make sense of that. I think the key is, again, it's not just do we do, do we put in a bunch of stuff in motion? How are we doing getting students connected to it? I'm going to read a quote. So I'm going to use quotes that captures this so beautifully. And it's never felt more poignant than during the summer of 2021. Fickson# and Colleagues from 2010, in a tool called Implementation of Evidence Based Treatment for Children and Adolescents, Research findings and Implications for the Future, said the use of effective interventions on a scale sufficient to benefit society requires careful attention to implementation strategies as well. One without the other is like serum without the syringe, the cure is available, but the delivery system is not. I don't think I've ever been more moved by a statement about syringes and cures than I am during the summer of 2021.
But if you have, for example, a gold standard evidence based approach for mandated students; in other words, once people violate a campus policy, they are referred and they get connected with an evidence based strategy. You've got the serum, do you have the syringe? If you don't have consistent enforcement of policy, if once students get to conduct, there's not a consistent pathway to get people there, then you may not have that delivery system. On almost every campus I have the honor of talking with, I ask them to critically think about their delivery system. So if you have a program that is required of incoming first year students, I've heard schools say, yeah, we require and we do pretty well. We get about 90 percent of students. My first reaction is yeah, well what's happening to the ten percent that didn't do it? If you are in fact following up with them and saying, you got to do this to register for the next quarter semester, great. But if it's like well, you know, we did our best shot, sadly, those 10 percent, what was their takeaway? Nothing is enforced around here. And that's a very bad unintended impact. So I really think that, you know, how are schools doing? If they go, well look, we have these nine things we're offering. Cool. What's your delivery system? Are you getting the people that need to get to them, to those programs?
Rich: So, you, yeah, you brought up the biennial review and I started my federal career at the US Department of Education and the Office of Safe and Drug Free Schools. The biennial review came up frequently and, you know, for many it was a box check, as Alicia might have said, as we talked about that. And I said, yeah, but aside from it being a compliance issue, it is just good prevention practice.
Jason: Absolutely.
Rich: Every two years to take a look at what you're doing to see if it's working. I mean, we didn't even talk about the SPF's at that point. I mean, some of us did, but, you know, it wasn't like it was written into the law that way or anything like that or in the regulations. It just said every two years, take a look and make sure your program's effective and you are consistently enforcing your disciplinary, you know, sanctions and such. But I really tried to get, impress upon people; get away from the box mentality. This is a, this is good prevention practice, right?
Jason: Yeah, perfectly said. And unfortunately, too often, the burden of going through that falls on one or two people shoulders and it's like multiple eyes should be on that biennial view so that everyone can take accountability for how we doing? What are we looking at? And it's a good chance to take the pulse of what needs to stay the same, what needs to change and so on.
Rich: Right. Well, this is not a, this is no doubt a shameless plug at all. So for any of you who are listening who are involved in dealing with your biennial reviews, since it's come up in our interview here with Jason, go to campusdrugprevention.gov and in the practitioner's toolbox, we have posted sample campus policies and biennial review reports for you to take a look at. As well as Jason, you mentioned, Eric Davidson was very kind enough to share the checklist they follow at Eastern Illinois University with preparing their biennial review report, which is just a really excellent, you know, guidepost to follow so.
Jason: Your website is an excellent guidepost to follow, and I'm not, that's a shameless plug it all about what you said, I think it's, people need tools in their toolbox. That's a, that's a tool that should be in peoples, in people's hands.
Rich: Thank you. All right. So we've talked about evidence based strategies. So now for the fourth question, I'm going to totally flip this on its ear and talk about nonsuccesses, you know, to not say the word failure sometimes. So let's call them what they are. So a few years ago, I had the pleasure of moderating a panel that you were on at the National Strategies Conference. And that session was called Epic Fails in Prevention, Learning from Efforts that Don't Work as Planned. From your perspective, why is it so important to not shy away from talking about epic fails in prevention?
Jason: All day to tell a story. And if your data say, well, when we did this, this and this, it worked, awesome. If you're data's say well, when we did this, this and this, it didn't work, I mean, we don't totally celebrate, but we also try and get that published and disseminate because what lessons can be learned from it? If there's something that you meant to, you target a large group of students and overall, it didn't work, well there's some students for whom it did work. What do we need to do differently next time? And that, that, those types of lessons learned are as important as the successes. And so I really do think any time there's an unintended impact, if there's no change over time, is that because literally nothing changes over time in behavior? Or is it that all the work we do in prevention kind of kept things steady? But without a control group, you would know that. Like with a control group, did things you increase in the wrong direction, for example?
We've talked for years about do your data do you justice? The data you're collecting, do they tell the right story? And if they do, well, there you go. But if they don't, what other data could you be collecting to get a greater understanding of what's happening?
But I do think that, you know, in research, when we have a hypothesis that's supported, we all say yeah, and we write it up and try and get it published. When we have one that's unsupported, we lose the yeah, but we still write it up and try and get it published because you can learn as much from an unsupported hypothesis as you can from one that is supported.
Rich: I know for me, well, one of the great things about that panel is so, I remember we had on the panel you and our good friends and colleagues from around the country, Dolores Cimini, Sally Linowski, Diane Padorchak, and it just, it's refreshing to me to look at people that I admire and consider leaders in this field, to sit there and shine a light on things that didn't work out as they had planned. We are so quick to want to celebrate our successes. Right. And yet sometimes we shy away from the nonsuccesses but they can be is just as important learning moments for people, as I think that's what I'm hearing you say.
Jason: Absolutely, absolutely, and not just for them, but we're all in this together and I say that not in a rah-rah way. Anyone that knows me knows I'm so proud to be a part of the prevention community. And we are all in this together. And so the chance to learn from what worked well and less well, across the board for all of us, is really important.
Rich: Absolutely. And one example you gave, you know, about, you know, behavior maybe didn't change over a period of time; one might look at that as a success, actually.
Jason: That’s right.
Rich: You know, if the rates are going up, you know, then maybe you are doing something right, if you will. So that could be, you know, celebrated. Don't always think of it as a, you know, that graph chart's going up or down, you know, a flat line sometimes is not a bad thing.
Jason: That's exactly right.
Rich: So as we wind down, I ask you the question I ask of all of the guests on the podcast series because it's more or less your opportunity to, you know, get out the message that you've been wanted to get out to the field. And that's, you know, what do you want to say to encourage your peers who are listening to the podcast?
Jason: Never question for a second, the value of the work that you do. Prevention is so important. And there's the old Benjamin Franklin quote, that an ounce of prevention is worth a pound of cure. I don't think prevention, the value has ever weighed more, truthfully, when you look at the challenges of the last year. Plus, when you look at, you know, all we face on college campuses and increasing studies that show how, if you do something about substance use, it pays dividends elsewhere.
Our friend and colleague, Laurie Davidson, when she did work with the Suicide Prevention Resource Center, said, want to be a school that does good suicide prevention, do good alcohol prevention, because alcohol prevention is suicide prevention.
Rich: Right.
Jason: You heard me say before what we do about substance use will pay dividends in the classroom. There is very clear science that shows that the more students report alcohol use, the lower their grades tend to be. The more they report being tired all the time, less faculty engagement you see. The more students report cannabis use, the lower their grade point average tends to be, the less likely they are to graduate on time if they even make it to graduation.
So never questioned for a second the value of the work you do and realize, you've got a lot of time partners out there. It's easy to feel outnumbered in prevention sometimes. And the prevention community is large. You know, and I think whether it's, you know, looking for webinars to be a part of, whether it's attending conferences, whether it's just emailing and reaching out to folks that are doing this work, there are people there that have your back. And will always try to do what they can to support the efforts being done in prevention.
I love this field and I get, I do, I geek out about, about this. And I do say all the time, don't question for a second the value of that work. And I do all I can to make sure that I remind people of that in the very important work they do.
Rich: So I want to pick up on something that you just mentioned about tag teaming and partners and such. I know that you and I talked about this, you know, recently, over the last year and such; people who may have moved on from a traditional role in prevention, if you will, and you know, we try to, I don't know. I'm not exactly sure the right analogy I want to use, but we don't want to let them get away. I mean, it's like they, everybody has a role to play in this prevention business. Right? And I think we have to continue to hold people's feet to the fire and don't let them get off so easy. That's, you know, the way I want to put it. I don’t know what you want to say on that.
Jason: I believe I've said with you before and so my apologies if it sounds redundant, but I know the frustration I've had when providing even free or with no commute needed, because it's virtual, with Web-based conference attendance or webinar attendance. When people say I was going to attend, but I couldn't miss work for that. And it's like, this should be part of your work. When people say, well, yeah, but substance use, that's not what I do. It kind of is, everybody. So I think making sure that we can be competent in discussing these issues. No one's asking you if it's not your area of expertise to be an alcohol and other drug expert in your free time. But at least knowing what programs are out there, knowing who your partner is on campus are, knowing why it is important, knowing the harm that can be made when you make a joke about substances to students that are struggling with it, to students in recovery, to lifelong abstainers.
This fall's going to be an interesting one. You know, I've heard so many people say, yikes, this fall's going to be crazy. I would never say that in front of students because it sets in motion a potential self-fulfilling prophecy. We don't know how the fall is going to go.
I have a colleague that collected data on young adults from January 2020 to May 2020, and about a third of people, their substance use went up, about a third of people, it stayed the same, amount of thirty people, it decreased. When I hear people say things like everyone's drinking more during the pandemic, that is not true. And the potential danger of standing up in front of a group of students and saying, look, we know you're going to go crazy this fall with your partying. You don't know that and that's a, that's a dangerous normative misperception.
So well-intentioned folks who don't even realize how influential they could be in messaging around alcohol and drug prevention, need to realize they're part of the overall puzzle.
Rich: For me, the takeaway message that's been around for a while, but, you know, I try to reiterate it is that prevention is everyone's responsibility, directly or indirectly.
Jason: That’s right.
Rich: And sometimes I think people just need to be reminded of that, as you just so eloquently said. So, Jason, again, I love having you on the podcast. I appreciate being your friend and your colleague. I have loved the two sessions we've done previously, where we've titled Jason and Rich's Excellent Adventures in Prevention. It has been an excellent adventure. I look forward to us being able to do something similar like that again in the future. I know our attendees tend to get a kick out of it and enjoy it, and I know that we do as well. So thanks again for being on the podcast. Really do appreciate it.
Jason: People can't see me smiling. I'm smiling as you talk about that. That's a mutual sentiment. Rich, you're such a champion for people on college campuses. You're such a champion for prevention. You're so valuable to so many of us in the field. Thank you for all you do to, you know, make this something that, I was going to say a household topic, but you bring the science to people. And that's a special skill. And I commend you for that. And thank you for that.
Rich: Thank you. I really do appreciate it. And you and I know we have some great friends and colleagues doing this terrific work around the country and we're making strides. It's like you said, we are making strides and, you know, we hit potholes here and again. But we continue to drive right through them and do the best that we can.
So I look forward to hopefully seeing you in person in several months, if, you know, everything goes in the direction we hope it does. So with that, Jason, again, you know, thank you very much.
Jason: Thanks Rich, thanks, everybody.
Rich: And for all our listeners, I thank you for tuning in and listening to this episode of Prevention Profiles: Take five. With that, I will wish you a great day.
So let me tell you a little bit about Dr. Kilmer. So Dr. Jason is an Associate Professor in Psychiatry and Behavioral Sciences at the University of Washington and he serves as an investigator on studies evaluating prevention and intervention efforts for alcohol, cannabis and other drug use by college students. In addition to research and teaching, he has worked extensively with college students and student groups around alcohol and other drug misuse prevention programming and presentations throughout his career, both at UW and on over one hundred campuses across the United States. Jason also serves as the chairperson of Washington State's College Coalition for Substance Abuse Prevention. Jason was the 2014 recipient of the National Prevention Network's Award of Excellence for Outstanding Contributions to the Field of Prevention and was also the 2017 recipient of the Washington State Prevention Professional Award of Excellence. With that, Jason, welcome to the podcast.
Jason Kilmer: Thank you. What a treat to get to work with you again. I appreciate the invitation.
Rich: Absolutely. And so I got to ask you, before we get into the questions, how, what goes through your mind when you hear somebody reading your bio? I just had this experience last week for the Higher Ed Center's National meeting. They were reading my bio and my reaction live to everybody was, but I do so much more than that.
Jason: That's a good question. We do, do a lot more than that and there's also that element where I'm like, oh, I just make it stop.
Rich: Yeah, yeah.
Jason: I feel like I should try and get like a one sentence; this is Jason who does some stuff. Here's Jason [inaudible].
Rich: Yes. Well, a mentor of mine, early in my career and Fran Harding would also say it was her mentor. She had this great line that the most powerful person in the world, you know, the head of our country, is introduced by five words; Ladies and gentlemen, the president. So, you know, if you can just get it down to those number of words, I guess, then that's half the battle.
Jason: I'm going to work on the five words. We'll, have something by the end of this.
Rich: Yeah, okay, that sounds good. So let's get into it. As I said at the opening that you haven't been a solo guest on the podcast for about three years now. You were part of our retrospective episode this past January to kick off our fourth season of the podcast series. Thrilled to have you back, you know, on your own and delve into some of these issues.
So first question, I'm going to preface this by stating that under federal law, medical and personal or what some will call recreational use of marijuana is illegal. And yet during the past nine years, a number of states and the District of Columbia have legalized cannabis use for adults over the age of 21. In fact, Washington state was one of the first two states to move in that direction. So, Jason, from your perspective, what has been the biggest impact of this movement on the nation's colleges and universities?
Jason: I bet you have a different answer depending on what school you asked and what school you talk to. I'm confident it depends on, you know, potentially what state someone's in. I'm sure it depends on if they're, you know, in more of a city or farther away from large population centers, you name it. But I can say that when I look at the evolution of even in my own state, kind of the impacts. There was this initial sense of, well, you know, we have policies in place that should be, in quotes, good enough. And I think people learned that that wasn't necessarily true, that there needed to be more of a clear effort, in some ways, to do exactly what you did at the beginning, Rich, which is reminding folks that independent of what the state's done, it remains federally illegal and that, you know, for schools to stay compliant with drug free schools and campus regulations, which involve making sure that we're working to stop the use and possession of illegal drugs. And since it is federally illegal, nothing that happened with our state initiative changed any of that.
But even when, you know, our vice president of student affairs at the time, I thought did a great job of communicating that, but there was, there was almost not even so much confusion as there was the potential for mixed messages. You saw on campus clear statements being made about what was and wasn't allowed. But all you got to do is walk across the street and get off campus property and maybe you saw some different messaging in terms of what was being enforced, what wasn't. So that, I do think that made it very tough.
I think that there are some folks that are honestly potentially operating off of an old script. When people say, well, in quotes, it's just weed or, you know, in quotes, what's the big deal? If someone says, I used when I was younger and I turned out fine. They used different stuff. So, you know, the number of times I saw, almost jokingly, displays in a campus bookstore with, you know, cannabis games you can play with your friends or cannabis cookbooks set out during orientation week. It's like, wait, what? What are we doing? And they're like, but it's funny. It's like; it's not funny from an addiction standpoint, from an academic outcomes standpoint and so on.
Finally, you know, I mentioned the old script part. We have become a high potency market. If you look at what scientists call in quotes, the strong stuff, it's anything over 10 percent THC; 97 percent of the Washington market is over 10 percent THC. So what people were not aware of is products even 10 years ago have changed so dramatically. And what the science is suggesting is that high potency cannabis is associated with more cannabis use disorder, addiction, more mental health concerns. Certainly there's research that shows that cannabis is associated with poor academic outcomes.
So we really need to make sure that folks are realizing this is something we take seriously and anyone that says I want to be a champion for student success, I want to be a champion for mental health, also has to be a champion for prevention.
Rich: I love the way that you said that and tease out something that you mentioned about, you know, the legal age. So that's always been my...So, again, working for the federal government, our message is going to be what the federal position is. Right? And the way I also nuance that messaging is, look, I get it. Some of the states and the district, they've passed these legislative initiatives and such, but no matter what state you're in, it's still illegal if you're under the age of 21. So, you know, in an ideal world, you're prevention messaging, you're prevention strategy doesn't change, shouldn't change, I should say, because for that very reason.
Jason: That's right, and I think that, you know, on college campuses, we have a, as we do with alcohol, we have a blend. We have people under 21 when we have people over 21. But you're very, very right that that prevention messaging doesn't change. We just have, I feel like we're playing catch up though. I mean, we have over eight years of legalization in the state of Washington, yet, you know, people solidly get don't drink and drive. I don't know that everyone solidly understands, you know, don't drive with someone who's been using cannabis. Don't drive yourself if you've used cannabis recently. When you hear people say things like, I drive better when I'm high, not according to a single published study ever. And so we wouldn't be a passenger in a car with someone who's been drinking. Why are people getting in the car with someone who just used weed, things like that? We can certainly up our game in terms of the prevention message we do about dangers like that.
Rich: Yeah. I wonder if, as you say, that I don't feel like we missed the boat, if you will, on messaging, because we've always been pretty clear on that, that it does affect your, it does impair your driving skills, but maybe there's more amplifying of the message we need to do or something. I just don't understand the rationale of the individuals who have, they're holding on to this belief that it makes me a better driver. I just, you know...So what do we do to counter that? You know, that's, I guess that's for us to figure out.
Jason: Well, and the scientist in me says we get the science out there.
Rich: Yes.
Jason: People are big fans of cannabis, you know, are very passionate about both potentially, you know, defending their own use or talking about why it's in their eyes, maybe not so bad, but, you know. If you, when one article comes out, you go, huh? Well, there's one article. But when we get a number of studies and they start telling a fairly consistent message, it's important to start listening to those. And I think that, you know, the perfect single study doesn't exist. And that's why we look at a body of literature and if a body of literature starts to tell a consistent message, I mean, at some point, it's getting that out there and making sure people understand what the science is.
Rich: Right. This, I think, is a good segue to my second question for you, because it's also dealing with the cannabis issue. So you have a long history of studying the impact of alcohol misuse among college students, as well as looking at the impact of marijuana use among youth and young adults. I know for me, over the past few years, I've attended or presented at conferences and there's one that sticks out to me in particular, and it was a working lunch. And the campus staff who were engaged in conversation at that working lunch, they seem to want to treat marijuana as so much more different than alcohol when it comes to prevention. And it was kind of, you know, really just frustrating me that I ultimately finally had to say something. Basically, I said, stop it, stop doing that. So, you know, from your experience, what are some of the lessons learned around preventing alcohol misuse among college students that also apply to preventing marijuana use?
Jason: That a mix of strategies is best. I mean, the National Institute on Alcohol Abuse and Alcoholism, NIAAA, is College Alcohol Intervention Matrix, CollegeAIM, reviews over 60 individually and environmentally focused prevention strategies, based on their relative cost and relative effectiveness. And in the narrative leading up to it, it makes very, very clear a mix of strategies is best. If all you do is environmental approaches, you're missing some of the more individually focused things, particularly to folks that might be more high risk. If you only do individually focus things, you're missing the environmental part.
I think a blend of correcting misperceived norms of working with people who have made the choice to use and who may be experiencing some harms or unwanted effects. I think that consistent enforcement of policy. I think that, you know, looking at it from that type of mix of strategies approach is absolutely essential.
Where it is, where there are some differences is around strategies that people might use. I started working in Alan Marlatt's lab when I was a junior in college as an undergraduate research assistant. Dr. Marlatt was my advisor in grad school. He was the first alcohol researcher to start testing harm reduction approaches with college students. The first article on college student drinking was 1945. The first article showing, look, we can reduce drinking and-or consequences 45 years later, wasn't until 1990.
We don't have 45 years to wait for effective prevention policy.
Rich: Right.
Jason: But I didn't appreciate until Allen passed away in 2011, how controversial it was for him to do harm reduction at the time. At the time he was testing it, the number of published studies showing, again, significant reductions in drinking consequences or both, was none. But according to the Reagan National Library, at the end of the 1980's, the number of Just Say No clubs across the country was 12,000. So to do anything other than just say no was viewed as controversial, and not in line with where we were as a country.
So people say, well, can we do harm reduction with cannabis? The short answer is yes, but the longer answer is if you look at the research, Fisher and Colleagues wrote an incredible article that said lower risk guidelines, cannabis guidelines didn't say low risk. And the reason why is they reviewed 10 guidelines for lower risk use and the number one guideline was don't use. They said if you truly are saying, I want to avoid risks and harms, then abstinence is the only way to do that. Does the federal government have low risk guidelines for alcohol use for people over 21? Yes. Are there guidelines for low risk cannabis use? Not according to the science, because the Fisher and Colleagues article says people that make the choice to use just need to understand that they're engaging in a behavior that necessarily incurs risks and harms. So, once you get past that, I mean, obviously, any steps towards less frequent use, less potent use can be steps in the right direction. But that's where you're right, prevention approach, we wouldn't necessarily approach different. Prevention messaging, there needs to be something a little different because if someone, say, makes the choice to drink. Are there ways to do that in less dangerous or less risky way? Yes. If people make the choice to use cannabis, are there ways to do that in less dangerous, less risky way? There is going to encourage risk. We've got to make that clear.
Rich: Absolutely. There are two things I'm thinking of, as you were giving this excellent information. And one, I think what frustrated me so much, hearing these professionals working in prevention. And again, I don't know what length of time they've had in the field. I don’t know if they were entry level, I have no idea if they have the foundational training that they need in prevention science. I think that's a big issue for our field, quite honestly. But it all came back to the SPF for me, the Strategic Prevention Framework, which we have said all along, I don't care if you're talking about alcohol, marijuana, cocaine, heroin, you know, hallucinogens; the sciences, the science. You follow a strategic planning process that will help guide you to where you want to get to be.
So I felt like they were kind of pushing the SPF aside to, you know, to treat marijuana differently. But what you just mentioned about harm reduction. So that's been a slippery slope my entire career, which has been in government. I mean, state government, federal government, right, nine years in New York and then 21 years plus for the feds. And it's always been the slippery slope. And I tried to navigate it as well as I can by, and by doing that, what I hope to impart on the leaders I've had and every agency I've worked on, have to grasp the concept and say, yeah, nonuse, first and foremost, that's our number one message if you are under the age of 21. But for those students who ignore the law and we know there are those students who ignore the law when it comes to alcohol, when it comes to marijuana, prevention professionals on campus have to be able to turn to strategies to help those students.
Jason: That’s true.
Rich: You can't ignore them. You can't ignore that it's going to happen.
Jason: The messaging, though, you know, it's fresh in my mind because I just talked about CollegeAIM earlier today. We would never stand up in front of a group of students and say, look, I know you're going to drinks if you do, dot, dot, dot.
Rich: Right.
Jason: I know you're going to drink is a normative misperception. And if they're under 21, it kind of sounds like permission giving.
Rich: Yep.
Jason: So we always make clear; under 21, it's illegal to drink. Driving after drinking, not recommended. And if someone says I want to avoid all of alcohols unwanted effects completely, abstinence is the best way to do that. Yet if you make the choice to drink, there are ways to do it in less dangerous or less risky ways. We never say in a safe way. The boost; when these reviews of the published literature started looking at, here are evidence based strategies, showing that some of these harm reduction strategies are associated with reductions in use, on a federal website, certainly means yes, they work, but they work with that asterisk of how we describe them is really, really important. You know what you have on your own website with Campus Drug Prevention on a tool to help people with their planning for substances in general. As you bring up the SPF, this becomes important for people to utilize as a tool as well.
Rich: Right. Well, you and I have worked together, we've co-presented together. We've done this podcast together with friends and colleagues for a long time. So one would think that we've rehearsed this type of segue in transition, but it just naturally happens because what you're talking about leads perfectly into my third question. So I want to talk a little bit about evidence based strategies. We have more than three decades of prevention science, thanks in large part to the National Institute on Alcohol Abuse and Alcoholism. As you mentioned, researchers such as yourself. As a field, how do you think we're doing in implementing evidence based practices to prevent drug misuse among college students?
Jason: I want to, I mean, I'm an optimist, I want to say look at all that is being done and the challenge is, the challenges of the last 17 months, I don't want to do something that anchors where we are in time too much.
Rich: Right.
Jason: But you and I are talking about this on August 9th, 2021. The last 17 months have certainly been challenging. And I will quote our common friend and colleague, David Arnold, who says, prevention has to be a narrative, it has to be ongoing. The second we take our foot off the gas, we regress. And so, you know, if people said, well, we really didn’t have students at our campus for the last year or so, the hope is that doesn't mean that prevention stopped. It doesn't mean that prevention halted. Prevention maybe took on a different look or maybe more was done virtually or through Web-based formats than when we're all in person and things are, in quotes, normal. But it had to keep happening. So any one school, as they complete their biennial review, it's a chance to kind of say, how are we doing? What are we doing well? Where might there be gaps? What do we need to do differently? What story do our data tell us?
And so I do think that as long as people are willing to take that look at this...I heard Alicia Baker recently say from University of Florida say, it shouldn't just be a box to check. And I believe she may have even been quoting Eric Davidson in saying that. But it's going beyond the box to check is, are we doing the right thing? It's not just, are we doing stuff that looks good and is visible? Are we doing things that are going to benefit our student body? Are we doing things are going to help our students succeed?
And if a school can say, yeah, we're putting our best foot forward, this is worth investing in, we're doing all we can, then awesome. If the sense is, well, you know, maybe prevention hasn't gotten the attention it deserves, then I think they can be doing more. But it's, that's another question that's going to vary from school to school. I've got to believe, because it does depend on not only their general approach pre March 2020, but even, you know, what have they been thinking about and doing over these last 17 months becomes important too.
Rich: I know as someone whose particular area of focus in my entire career has been preventing alcohol and drug misuse among college students, I was so excited in 2002 when the NIAAA came out with the four tiers of effectiveness. I thought, great, we've got guideposts now. Schools are going to be following these. And what was it? About six years later when Dr. Tobin Nelson came out with his journal article that said, you know what? Not doing so great of a job. It was very disappointing to see that that was the case.
Jason: Tobin's article was interesting because it was challenging to be able to say how is, how this, I say in quotes a lot because I'm making air quotes and you can see that. But if you're just listening, you can't. So I apologize for my overuse of in quotes but I'm an air quote kind of person.
So, you know, they asked administrators, since the Call to Action Task Force report came out, how are things? What have you been doing at your campus? And, what was it, 21 percent of college administrators said, I don't know what report you're referring to?
Rich: Right.
Jason: But 79 percent of schools said, of course, I know about it. So that is, that is a good thing. Most were headed in the right direction. Is it concerning, that 21 percent didn't know what the report was? Yes. But is it optimistic and hopeful that 79 percent did? Absolutely. It's challenging. It is hard to make sense of that. I think the key is, again, it's not just do we do, do we put in a bunch of stuff in motion? How are we doing getting students connected to it? I'm going to read a quote. So I'm going to use quotes that captures this so beautifully. And it's never felt more poignant than during the summer of 2021. Fickson# and Colleagues from 2010, in a tool called Implementation of Evidence Based Treatment for Children and Adolescents, Research findings and Implications for the Future, said the use of effective interventions on a scale sufficient to benefit society requires careful attention to implementation strategies as well. One without the other is like serum without the syringe, the cure is available, but the delivery system is not. I don't think I've ever been more moved by a statement about syringes and cures than I am during the summer of 2021.
But if you have, for example, a gold standard evidence based approach for mandated students; in other words, once people violate a campus policy, they are referred and they get connected with an evidence based strategy. You've got the serum, do you have the syringe? If you don't have consistent enforcement of policy, if once students get to conduct, there's not a consistent pathway to get people there, then you may not have that delivery system. On almost every campus I have the honor of talking with, I ask them to critically think about their delivery system. So if you have a program that is required of incoming first year students, I've heard schools say, yeah, we require and we do pretty well. We get about 90 percent of students. My first reaction is yeah, well what's happening to the ten percent that didn't do it? If you are in fact following up with them and saying, you got to do this to register for the next quarter semester, great. But if it's like well, you know, we did our best shot, sadly, those 10 percent, what was their takeaway? Nothing is enforced around here. And that's a very bad unintended impact. So I really think that, you know, how are schools doing? If they go, well look, we have these nine things we're offering. Cool. What's your delivery system? Are you getting the people that need to get to them, to those programs?
Rich: So, you, yeah, you brought up the biennial review and I started my federal career at the US Department of Education and the Office of Safe and Drug Free Schools. The biennial review came up frequently and, you know, for many it was a box check, as Alicia might have said, as we talked about that. And I said, yeah, but aside from it being a compliance issue, it is just good prevention practice.
Jason: Absolutely.
Rich: Every two years to take a look at what you're doing to see if it's working. I mean, we didn't even talk about the SPF's at that point. I mean, some of us did, but, you know, it wasn't like it was written into the law that way or anything like that or in the regulations. It just said every two years, take a look and make sure your program's effective and you are consistently enforcing your disciplinary, you know, sanctions and such. But I really tried to get, impress upon people; get away from the box mentality. This is a, this is good prevention practice, right?
Jason: Yeah, perfectly said. And unfortunately, too often, the burden of going through that falls on one or two people shoulders and it's like multiple eyes should be on that biennial view so that everyone can take accountability for how we doing? What are we looking at? And it's a good chance to take the pulse of what needs to stay the same, what needs to change and so on.
Rich: Right. Well, this is not a, this is no doubt a shameless plug at all. So for any of you who are listening who are involved in dealing with your biennial reviews, since it's come up in our interview here with Jason, go to campusdrugprevention.gov and in the practitioner's toolbox, we have posted sample campus policies and biennial review reports for you to take a look at. As well as Jason, you mentioned, Eric Davidson was very kind enough to share the checklist they follow at Eastern Illinois University with preparing their biennial review report, which is just a really excellent, you know, guidepost to follow so.
Jason: Your website is an excellent guidepost to follow, and I'm not, that's a shameless plug it all about what you said, I think it's, people need tools in their toolbox. That's a, that's a tool that should be in peoples, in people's hands.
Rich: Thank you. All right. So we've talked about evidence based strategies. So now for the fourth question, I'm going to totally flip this on its ear and talk about nonsuccesses, you know, to not say the word failure sometimes. So let's call them what they are. So a few years ago, I had the pleasure of moderating a panel that you were on at the National Strategies Conference. And that session was called Epic Fails in Prevention, Learning from Efforts that Don't Work as Planned. From your perspective, why is it so important to not shy away from talking about epic fails in prevention?
Jason: All day to tell a story. And if your data say, well, when we did this, this and this, it worked, awesome. If you're data's say well, when we did this, this and this, it didn't work, I mean, we don't totally celebrate, but we also try and get that published and disseminate because what lessons can be learned from it? If there's something that you meant to, you target a large group of students and overall, it didn't work, well there's some students for whom it did work. What do we need to do differently next time? And that, that, those types of lessons learned are as important as the successes. And so I really do think any time there's an unintended impact, if there's no change over time, is that because literally nothing changes over time in behavior? Or is it that all the work we do in prevention kind of kept things steady? But without a control group, you would know that. Like with a control group, did things you increase in the wrong direction, for example?
We've talked for years about do your data do you justice? The data you're collecting, do they tell the right story? And if they do, well, there you go. But if they don't, what other data could you be collecting to get a greater understanding of what's happening?
But I do think that, you know, in research, when we have a hypothesis that's supported, we all say yeah, and we write it up and try and get it published. When we have one that's unsupported, we lose the yeah, but we still write it up and try and get it published because you can learn as much from an unsupported hypothesis as you can from one that is supported.
Rich: I know for me, well, one of the great things about that panel is so, I remember we had on the panel you and our good friends and colleagues from around the country, Dolores Cimini, Sally Linowski, Diane Padorchak, and it just, it's refreshing to me to look at people that I admire and consider leaders in this field, to sit there and shine a light on things that didn't work out as they had planned. We are so quick to want to celebrate our successes. Right. And yet sometimes we shy away from the nonsuccesses but they can be is just as important learning moments for people, as I think that's what I'm hearing you say.
Jason: Absolutely, absolutely, and not just for them, but we're all in this together and I say that not in a rah-rah way. Anyone that knows me knows I'm so proud to be a part of the prevention community. And we are all in this together. And so the chance to learn from what worked well and less well, across the board for all of us, is really important.
Rich: Absolutely. And one example you gave, you know, about, you know, behavior maybe didn't change over a period of time; one might look at that as a success, actually.
Jason: That’s right.
Rich: You know, if the rates are going up, you know, then maybe you are doing something right, if you will. So that could be, you know, celebrated. Don't always think of it as a, you know, that graph chart's going up or down, you know, a flat line sometimes is not a bad thing.
Jason: That's exactly right.
Rich: So as we wind down, I ask you the question I ask of all of the guests on the podcast series because it's more or less your opportunity to, you know, get out the message that you've been wanted to get out to the field. And that's, you know, what do you want to say to encourage your peers who are listening to the podcast?
Jason: Never question for a second, the value of the work that you do. Prevention is so important. And there's the old Benjamin Franklin quote, that an ounce of prevention is worth a pound of cure. I don't think prevention, the value has ever weighed more, truthfully, when you look at the challenges of the last year. Plus, when you look at, you know, all we face on college campuses and increasing studies that show how, if you do something about substance use, it pays dividends elsewhere.
Our friend and colleague, Laurie Davidson, when she did work with the Suicide Prevention Resource Center, said, want to be a school that does good suicide prevention, do good alcohol prevention, because alcohol prevention is suicide prevention.
Rich: Right.
Jason: You heard me say before what we do about substance use will pay dividends in the classroom. There is very clear science that shows that the more students report alcohol use, the lower their grades tend to be. The more they report being tired all the time, less faculty engagement you see. The more students report cannabis use, the lower their grade point average tends to be, the less likely they are to graduate on time if they even make it to graduation.
So never questioned for a second the value of the work you do and realize, you've got a lot of time partners out there. It's easy to feel outnumbered in prevention sometimes. And the prevention community is large. You know, and I think whether it's, you know, looking for webinars to be a part of, whether it's attending conferences, whether it's just emailing and reaching out to folks that are doing this work, there are people there that have your back. And will always try to do what they can to support the efforts being done in prevention.
I love this field and I get, I do, I geek out about, about this. And I do say all the time, don't question for a second the value of that work. And I do all I can to make sure that I remind people of that in the very important work they do.
Rich: So I want to pick up on something that you just mentioned about tag teaming and partners and such. I know that you and I talked about this, you know, recently, over the last year and such; people who may have moved on from a traditional role in prevention, if you will, and you know, we try to, I don't know. I'm not exactly sure the right analogy I want to use, but we don't want to let them get away. I mean, it's like they, everybody has a role to play in this prevention business. Right? And I think we have to continue to hold people's feet to the fire and don't let them get off so easy. That's, you know, the way I want to put it. I don’t know what you want to say on that.
Jason: I believe I've said with you before and so my apologies if it sounds redundant, but I know the frustration I've had when providing even free or with no commute needed, because it's virtual, with Web-based conference attendance or webinar attendance. When people say I was going to attend, but I couldn't miss work for that. And it's like, this should be part of your work. When people say, well, yeah, but substance use, that's not what I do. It kind of is, everybody. So I think making sure that we can be competent in discussing these issues. No one's asking you if it's not your area of expertise to be an alcohol and other drug expert in your free time. But at least knowing what programs are out there, knowing who your partner is on campus are, knowing why it is important, knowing the harm that can be made when you make a joke about substances to students that are struggling with it, to students in recovery, to lifelong abstainers.
This fall's going to be an interesting one. You know, I've heard so many people say, yikes, this fall's going to be crazy. I would never say that in front of students because it sets in motion a potential self-fulfilling prophecy. We don't know how the fall is going to go.
I have a colleague that collected data on young adults from January 2020 to May 2020, and about a third of people, their substance use went up, about a third of people, it stayed the same, amount of thirty people, it decreased. When I hear people say things like everyone's drinking more during the pandemic, that is not true. And the potential danger of standing up in front of a group of students and saying, look, we know you're going to go crazy this fall with your partying. You don't know that and that's a, that's a dangerous normative misperception.
So well-intentioned folks who don't even realize how influential they could be in messaging around alcohol and drug prevention, need to realize they're part of the overall puzzle.
Rich: For me, the takeaway message that's been around for a while, but, you know, I try to reiterate it is that prevention is everyone's responsibility, directly or indirectly.
Jason: That’s right.
Rich: And sometimes I think people just need to be reminded of that, as you just so eloquently said. So, Jason, again, I love having you on the podcast. I appreciate being your friend and your colleague. I have loved the two sessions we've done previously, where we've titled Jason and Rich's Excellent Adventures in Prevention. It has been an excellent adventure. I look forward to us being able to do something similar like that again in the future. I know our attendees tend to get a kick out of it and enjoy it, and I know that we do as well. So thanks again for being on the podcast. Really do appreciate it.
Jason: People can't see me smiling. I'm smiling as you talk about that. That's a mutual sentiment. Rich, you're such a champion for people on college campuses. You're such a champion for prevention. You're so valuable to so many of us in the field. Thank you for all you do to, you know, make this something that, I was going to say a household topic, but you bring the science to people. And that's a special skill. And I commend you for that. And thank you for that.
Rich: Thank you. I really do appreciate it. And you and I know we have some great friends and colleagues doing this terrific work around the country and we're making strides. It's like you said, we are making strides and, you know, we hit potholes here and again. But we continue to drive right through them and do the best that we can.
So I look forward to hopefully seeing you in person in several months, if, you know, everything goes in the direction we hope it does. So with that, Jason, again, you know, thank you very much.
Jason: Thanks Rich, thanks, everybody.
Rich: And for all our listeners, I thank you for tuning in and listening to this episode of Prevention Profiles: Take five. With that, I will wish you a great day.