Prevention Profiles: Take Five - Dr. John Schulenberg (University of Michigan)

Rich Lucey: Hi, this is Rich Lucey.

I am a Senior Prevention Program Manager in the Drug Enforcement Administration's Community Outreach and Prevention Support Section.

And welcome to this episode of our podcast series Prevention Profiles: Take Five.

I'm very excited about today's guest, Dr. John Schulenberg.

Let me tell you a little bit about Dr. Schulenberg before we get into our interview.

Dr. John Schulenberg is Professor of Developmental Psychology in the Department of Psychology and Research Professor in the Institute for Social Research at the University of Michigan.

Dr. Schulenberg has published widely on several topics concerning adolescents and the transition to adulthood, bringing a developmental perspective to understanding health risks and adjustment difficulties.

As principal investigator of the NIDA funded National Monitoring the Future Panel Study on the etiology and epidemiology of substance use from adolescence through middle adulthood, he focuses on individual and contextual risk factors, course, comorbidity, consequences and historical variation across adolescence and adulthood.

Dr. Schulenberg has served on numerous advisory and review committees including chairing the National Institutes of Health Psychosocial Development and Risk Prevention Study Section.

He was a member of the National Academy of Medicine's Consensus Committee on health and wellbeing during the transition to adulthood which recently published Investing in the Health and Wellbeing of Young Adults.

He is a fellow of the American Psychological Association and a previous president of the Society for Research on Adolescence.

And with that, John, welcome to the podcast.

John Schulenberg: Rich, thank you very much.

I appreciate the introduction and being involved in this.

Lucey: Yeah, this is really exciting and it's timely because by the time this episode airs later in September the press release and the news about these findings will have come out, and I'm sure everybody will be talking about them and excited to hear your perspective in some of these key findings.

So before we actually get into the meat of the interview, John, I'd like you if you could, please tell our listeners a little bit about the Monitoring the Future Study and its history.

Schulenberg: Sure, sure, happy to, thanks.

So Monitoring the  Future, it's an ongoing multi-component U.S. national study designed as you mentioned to examine the epidemiology, etiology of substance use across adolescence and adulthood.

It's conducted by a team of research professors at the University of Michigan funded by two competitive grants from NIDA.

MTF was initiated by Professor Lloyd Johnston and he led it for many years.

It began in 1975 when actually I was a senior in high school.

And it started with naturally representative angle surveys of 12th-graders, and this has continued through today.

Now from these 12-grade cohorts we select representative samples and follow them every two years up to age 30, and then every five years, and now the oldest group is age 60.

And we're going to keep going.

Next up is 65.

So these multi-cohort panel, they can help advance understanding of the long-term course, causes, consequences of substance use across a life course and how all this varies by history.

We're starting to learn how etiology varies by history.

And I lead this panel component of MTF.

The other component of MTF includes surveys of 8th, 10th and 12th-graders.

And this is led by Professor Richard Miech.


Lucey: So this is, it really is an honor for me to have you on the podcast because throughout my 30-year career working specifically in preventing drug misuse at the state government and federal government level, no matter what setting I'm talking about but with a particular focus of my career looking at preventing drug misuse among college students, I know how important data is, whether it's at the national level, state level or local level.

In fact one of my mantras is that data drives programming, and so Monitoring the Future is one of the two or three national surveys that I have continued to monitor, pun intended, throughout my career and I talk about it in presentations and keynotes and such.

And so to have you on to talk about these key findings, it really is, it's a thrill for me because this study is just very important to the work that we do.

So thank you for that brief history of the study.

So let's get to it.

What are the top three key findings from the most recent administration of the study?


Schulenberg: Okay, great, thank you.

And again it's very helpful for me to be in on this.

We love to get the word out and so much appreciated to be involved.

So these are, this is one of the first looks at our new 2020 data.

And I'm very happy to be giving that in this talk.

So right, so this is based on our 2020 data collection.

I'm going to focus here on findings regarding fulltime college students and same age youth not in college, so age 19 to 22.

And annual data for this age group now cover from 1980 all the way up to 2020.

So the first main finding in 2020 is a continued increase of marijuana use, and particularly daily marijuana use which is to find is 20 or more occasions in the past 30 days increased to 8% in 2020 among college students.

This was a significant rise of three percentage points over the course of five years.

And this is the highest it's been since the study began.

Now among those same age youth not in college daily use was at 13% in 2020, just below the all-time high of 15% in 2019.

And I should mention that it's also annual use that's gone up in 2020.

So in this age group it's 43 to 44%, kind of the highest it's been since the early 1980's.

Now we're worried quite a bit about daily marijuana use.

And it's a clear health risk.

The science has told us that.

The brains stop developing in the early 20's and the Surgeon General and others have reported that the scientific evidence indicates that heavy marijuana use can be detrimental to cognitive functioning and development.

It's a high level of use and we're starting to see negative consequences.

But also we know from our research and that of others that for college students heavy marijuana use is associated with dropping out of college and poor academic performance.

And then those not in college, getting through the transition to adulthood, the tasks and responsibilities is tough enough, and I imagine daily marijuana use does not help.

Now I've got to say that the landscape of cannabis use is changing in this country.

And I already mentioned the point that etiology varies by history.

So we need continued research to understand if these long-term consequences are shifting based on frequent marijuana use.

So let me move onto a second main finding and that is among college students a rise in hallucinogen use.

And this includes LSD, psilocybin mushrooms and other psychedelic substances.

Annual use of any hallucinogen increased significantly for college students between 2019 and 2020 to 9%, the highest it's been since 1982.

Now among same age youth not in college annual use was 10% in 2020, the highest it's been for two decades.

Now this rise in hallucinogen use corresponds with a decrease we've seen for a few years and the perception that hallucinogens [inaudible 8:32].

Okay, let me move onto a third main finding and that is college student drinking declined in 2020.

Among college students, 30-day use decreased a significant six percentage points between 2019 and 2020.

That's huge.

We never hear.

We hardly ever see it drop that fast.

So it went from 62% in 2019 to 56%.

At the same time 30-day drug use also decreased significantly, seven percentage points, from 35% in 2019 to 28%.

So it's important to note that from 2015 to 2019 both of these measures were fairly steady.

So this big drop between 2019 and 2020 is likely due to COVID.

That is, they had less time with their social time with [inaudible 9:24].

And we know that college drinking is a big part of social time.

Now among those not in college we did not see the same kind of drop, which further suggests that perhaps the move off campus is what contributed this among college students.

At the same time more troublesome is binge drinking, and that's five or more drinks at least once in the past two weeks.

And this declined a significant eight percentage points between 2019 and 2020, to 24%.

24% is an all-time low in the past four decades for binge drinking in college students.

That's also 24% among same age youth not in college in 2020.

Now binge drinking among college students has been declining for years, but this large drop between 2019 and 2020 probably had something to do with the pandemic in terms of just reduced social time.

And 2020 was the first time since 1981 that college students and non-college youth had similar levels of binge drinking.

Usually college students have higher and often way higher levels of binge drinking.

So let me add one more, one more main finding, and that is annual nonmedical use of amphetamines climbed significantly among college students over the past five years to 7% in 2020.

And I'm happy to see this.

It showed some uneven change among non-college youths in the past five years which is at 6% in 2020.

So let me stop there.

You said three and I gave you four.

I hope that's okay.

Lucey: No, that's a bonus point.

I'm happy with that.

So John, a lot to unpack there.

So when I hear the data that you just presented, I'm immediately struck by a bit of a bad news, good news scenario in one respect.

So let's take the good news.

Let's focus on the good news first.

So certainly alcohol use, binge drinking went down 8% to 24%, almost as you said, the first time in history that we've gone that low.

And for as long as I've been doing this, I mean, we have, I'll say there was a high at one time of 39 to 44%.

It was up that high.

And then it seemed like we plateaued for a bit as far as programming goes.

And it was almost like I would somewhat make the analogy when you're on a diet and you just can't lose that last five or ten pounds.

You've kind of plateaued and you can't make the breakthrough.

But it seems like we've made that breakthrough.

Unfortunately perhaps the worldwide effects of what we've been dealing with with COVID might have had an influence on that.


Schulenberg: Right, right, definitely it does.

I mean that's the clearest case in our data so far, that in terms of COVID.

And two comments.

One, we need to do more controlled studies to really lay this on COVID.

And then the second thing is if it truly is a COVID effect then we're probably going to see a rebound this coming academic year.

And I guess that would be good news, bad news, mostly bad news [inaudible 12:36] but probably help us understand that it was indeed COVID.

But who knows?

 I think that's what's particularly exciting.

As devastating as this pandemic is, it's opening up the ways of thinking about social change.


Lucey: Yeah, and as we are at the beginning of a new academic school year, we know that the first six weeks are typically a high risk period of time.

And we also know that the colleagues I talk to around the country are the concern and apprehension they have this year as students return to campus is this idea of almost two sets of first-year students.

You have your sophomores who missed out typically on the in-person experience of college life, and then you have the genuine, like I say my term, first-year students coming onto campus.

So you almost have these two cohorts of students who are experiencing college life in person for the first time, and it's really I'd say got prevention professionals a little bit on guard, for what that might mean.

Back to the data then I'll slip into the bad news part of it, the two points that you mentioned that I'd like to highlight.

So the marijuana use first of all is really disconcerting.

So you provided the data for both college and non-college young adults.

I guess it's not a surprise is how I presented it whenever I talk about these data in presentations.

Perhaps it's not a surprise that it's higher among those who are not in college.

Maybe we shouldn't be surprised by that.

But the fact that among college students it's now risen to an historical high, again no pun intended there, of 8% of daily or near daily use.

And we're talking 20 or more occasions in a month.

That's really disconcerting for our efforts.

And you've been looking at these data for a really long time.

Schulenberg: Right.

It is for me.

Again the changing landscape of cannabis use, it's hard to pinpoint say annual use as being particularly troublesome.

Do we need to get up in arms about annual use?

 I'm not sure.

Do we need to get up in arms about daily use?

 Absolutely.

This is where I start to get real concerned.

And this is not a moral issue.

This is a scientific issue.

We know from the evidence what's going on.

Now part of; when we see the consequences of drug use, part of that is what's happening in society.

So again this could be changing as the landscape of cannabis use changes.

But I don't know.

The brain is pretty hardwired and I do worry about the effect of daily use on the brain.

So yeah.

But I do want to just for a minute say something about that you have sort of like new sophomores and new freshmen on the campus and how difficult that must be.

And I suspect that prevention specialists are thinking of them as two separate groups.

That extra year at home probably made a difference to the 19-year-olds.

And that year in general makes a difference.

When they are sophomores, as college personnel know, sophomores are way different than freshmen.

In fact sophomores make fun of freshmen.

So I definitely; I guess this is the first time I've heard that as a problem, but I definitely [inaudible 16:21].

Lucey: So the other thing I wanted to mention before I have another follow-up question for you, but first the other piece of the bad news I'm going to categorize it is the increase in hallucinogen use.

I think you said it was 9% among college students, the highest it's been in almost four decades.

Is this surprising?

Because it was surprising to me when I heard it because that seems to have come from a little bit out of left field that all of a sudden hallucinogen use is now squarely on the radar screen.

We know that our work is never done.

I mean we'd never completely eliminate a substance use issue if you will.

But did this surprise you in seeing this particular increase?


Schulenberg: A little bit.

But then when we look at the data and see what's happening in society, maybe not so much.

So it's been trending up anyway unevenly.

And this is how social change happens where [inaudible 17:21] starts and all of a sudden it gathers itself and we see an uptick.

And one could say, well, is this COVID influence?

 And I've got to think no.

First, it's hard to imagine that hallucinogens would be a drug of choice during a pandemic.

It's usually not an individual drug.

It's usually one you use with friends, and social time was reduced.

And plus, one gets; we ask about how high one gets in various drugs, and hallucinogens makes one just about the highest that they can get.

And so all that suggests we're probably not talking about a pandemic effect.

What's happening in society is sort of the perception that hallucinogen use, maybe the detriments are not that huge.

Maybe the harm's not that huge and maybe there are some medical benefits.

This is happening in the society we're in now, as a way to cure depression.

It's a way to think about end of life in terms of putting things in order in one's mind.

I'm certainly not advocating it, just saying this is what's happening I think in society.

So yeah, it's a bit of a shock.

And my daughter is a junior in college now, and she helped provide context for our findings, as terrifying as that is.

It's also helpful.

And she does say that, yes, it does not seem that people she knows view LSD and other hallucinogens as a particularly dangerous drug.

And that's kind of scary because it is in terms of how high one can get.

And if you're not ready for that, I can just imagine all kinds of problems.

And I particularly worry about my brand new freshmen or maybe brand new sophomores too that really haven't had a lot of experience if this is one of the first drugs they start with.

That's probably not going to be it.

So yeah, so yeah, it's a bit of a shock because I don't want to see this.

But at the same time it's not too much of a surprise.


Lucey: Okay, so before I got into the good news, bad news piece of this, I do have a follow-up question for you.

And I think it speaks directly for those who might be questioning the validity and the reliability of the survey data that's been collected during a pandemic.

So could you talk a little bit about what effect if any the COVID-19 pandemic had on your ability to collect data?

 And you actually touched on this point a little bit in reporting the data.

Were there any pandemic effects that are reflected in the students' drug use?


Schulenberg: Sure, great, great, thank you, yes, yes.

I want to say that one of the primary features of Monitoring the Future is that we try to keep measuring the same, keep the procedures the same and the measuring the same.

We are resistant to changing things because just changing the survey context sometimes can make your data go one way or the other and we really try to keep the measuring and the procedures the same.

At the same time we have to keep updated.

We can't be asking questions about drugs that are outdated.

We need to ask new questions about new drugs.

We need to change how we do things.

And luckily over the past couple years we've transitioned from mail surveys to web-based surveys so the pandemic really did not have much effect on our ability to collect the data.

We've already gone to the web.

So that was helpful.

It's a lot easier to keep in touch with moving people when they're moving around because of the pandemic, doing it by web [inaudible 21:09].

And I've got to say what we picked up in terms of alcohol use probably is a pandemic effect.

And we need more controlled analyses to know that as well as to know if maybe the pandemic accelerated such things as daily marijuana use and also helped the decline in amphetamines.

We need more controlled analyses, but it's possible.

And I want to say when we collected our data.

It was from March 2020 just as the shutdown happened through November 2020.

So we've not caught all of the possible pandemic.

We'll catch more with our 2021 data collections which are underway now through October.

Also for 2020 data collections, given that we were starting data collection just as the shutdown happened, we literally had two hours one afternoon to add in COVID-related questions before the shutdown.

Things were happening that fast.

We're not built to move real fast.

 We're built; we're like an ocean liner.

It's hard to turn an ocean liner real fast.

So for us that was a big thing.

So we had a couple questions about COVID that we can look at in the upcoming surveys.

But really for our data collections that are underway, we have a lot more questions about COVID.

How did it influence your living arrangements?

 What's it do for your future plans, your mental health and of course your drug use?

 So we'll have more to say in the future about possible COVID effects.

And in particular the difference between kind of blips and long-term change in course.


Lucey: So the second formal question I have for you in the interview has to do with the decline in amphetamines that you mentioned.

So given that the evidence suggests that college students sometimes use amphetamines, Adderall in particular, as a study aid as students like to call it, could this drop in 2020 be a pandemic effect with students needing to leave campus?

 
Schulenberg: Sure, it's a possibility especially getting out of the context of campus or maybe not having such easy access.

So it's a possibility.

But, and of course we did see a drop in amphetamine use, Adderall specifically.

It wasn't a large drop, but it was.

We call it non-significant but still a recognizable drop between 2019 and 2020.

And again moving off campus probably did something to this.

But again we've seen declines in amphetamines including Adderall in the past five years so probably not much of a pandemic effect.

And again if it was, now we're going to see an uptick in amphetamine use this coming academic year so we will see.


Lucey: And that's another reason why I say the data are so important because the declines that we see, when the next round of data comes out, we're going to want to pay particular attention to any and all of these to see if there are any upticks.

And if there is, is it an anomaly?

What does the following year show?

That's why it's so important to stay on top of the data.

Again whether it's national level, state level, your own community level data because it really does provide you with the picture that you need to figure out where you're going to focus your efforts.


Schulenberg: Absolutely.

Lucey: So the third question I have, I'm going to now switch over to opioids for a moment.

You know as well as I do that our country has had an opioid crisis for many years now.

But among college students opioid use seems lower than other classes of prescription drugs including prescriptions stimulants and sedatives.

What do the data show for opioid misuse among college students?


Schulenberg: Yeah, great.

This is such an important question and topic, and I appreciate the opportunity to talk about this.

So we've been seeing a decline in opioids as measured by narcotics other than heroin for the past decade for college students.

And this includes a five-year significant decline in the annual misuse of prescription narcotics to 1.3% in 2020.

This is an all-time low.

For not college youth, the five-year decrease was also significant, dropping to 3.5% in 2020.

And this is the lowest it's been since the 1990's.

It's also been dropping for 12th-graders.

So what's going on here is what we call a period effect.

That is young people at least somehow are indeed getting the message about the dangers of these drugs or the message is getting out and they're receiving it.

But I want to.

This is why it's important to talk about this.

To recognize that opioid misuse remains a major threat to the health of the nation.

But it does tend to affect older adults.

In fact while we're not talking about this today, our data covers up to age 60 and opioid use is more common among middle-aged adults.

But even there we're seeing a trend down.

So even though deaths have been going up or maybe have stabilized a bit, what we're seeing based on our surveys are that it's trending down.

Nonetheless it remains a major health concern for our nation.

I'm happy to see how much attention this is getting.


Lucey: Absolutely.

And I know that when I talk about the various classes of prescription drugs among college students, typically the three classes, prescription stimulants is highest followed by sedatives and opioids.

And that while we do have an opioid crisis in our country, it's not typically the class of prescription drugs being misused among college students.

But that's also not to say that it's not an issue on college campuses.

What I'd like to say is that, not to over generalize it but perhaps for student athletes for example.

For sports injuries and such there is perhaps more opportunity for misuse, for pain management and such, within that population of students.

So I think it's important to mention that.

Schulenberg: That's definitely a good point, and I'll just mention this.

A part of taking a developmental perspective is being careful not to over generalize.

So I should know better.

I should not be over generalizing it to all college students.

So I think you're right.

There are going to be pockets, [inaudible 27:55].


Lucey: Absolutely.

So my fourth question and I'm curious.

So with all of the research that you've conducted on drug use among college students, are there any specific areas that you haven't studied yet that you would like to?


Schulenberg: Great, great, thank you, yes, yes.

We always need to be wondering what's next.

So I've been real lucky to examine all kinds of aspects of substance use among adolescents and adults on my research of my students.

And I want to say again that my main motivation is to bring a developmental perspective to all this.

And this means tracking substance use and risk factors over developmental and historical time.

[Inaudible 28:39] developmentally, especially with the transition to college.

But one aspect that I haven't gotten into as much yet as I would've liked is the pure context of substance use and how substance use is used to meet developmental tasks and social goals in real time.

So this takes more of a social context, micro burst data collection approach in our data [inaudible 29:08].

And I want to mention Professor Christine Lee at the University of Washington and my colleague here, Professor Megan Patrick.

They've been doing this with micro burst data, looking at daily data collections and how these day to day transitions can impact changes in substance use.

And these are fascinating results.

I also want to say something about the interesting work especially among high school students regarding the perceived social benefits of substance use.

And this is for example the work of Professor Rob Crosno at the University of Texas.

And I think we need more of this among college students as well.

So often what we as adults think of as a detriment, young people might see it as a benefit.

And right there we need to understand that whole [inaudible 30:06].

We're not going to.

If we're not talking about the same thing when we're working with young people, then that's a problem.

So I'm very attracted to this idea of trying to understand how young people think about substance use and what goals they're meeting by [inaudible 30:22].

 I also want to say that it's conventional wisdom to think of colleges inheriting substance use, and that's fair.

And probably for the most part they are.

But we also know that not all substance use and misuse starts before college, that for some young people, especially heavy, long-term heavy use, this comes with entry into college.

And we need to understand that better because that's probably the most scary thing for people working with young people is highly inexperienced.

Not that you want to promote experience with substance use but I imagine it's very scary to be dealing with someone who is confronting or using substances for the first time in their first six weeks of college.

So more on the whys to consequences of this.

And finally for me using our data and others need to better understand the extent to which what happens in college matters in the long run in terms of health, adult health and wealth.

We know from decades of earlier research that colleges associating with all around better health in adulthood but determining for whom and under what long-term outcomes the college experience matters the most, especially due to substance use.

We just need to be more about this.

And now this is possible with our long-term data and everyone else's.

And Rich, if I can just take a moment, I meant to say it before.

I do want to say that our data, including the panel data, are available, all of our research through NAHDAP which stands for the National Addiction and HIV Data Archive Program.

And that's where our data are located.

Qualified researchers can apply to use it.

Mostly it's at no cost or minimal cost.

This is through ICPS [inaudible 32:28].

So I wanted to make sure I got that plugged in.

We want people to use our data.

And I would be delighted [inaudible 32:36] consequences of looking at, say, college experience and seeing how that influences adult health will be in 30's, 40's, 50's and 60's.


Lucey: Well, we'll certainly make sure that that repository of info is in the episode notes of the transcript so that people who watch will be able to see that and go there if they would like to use the data.

A couple of things that you mentioned really stood out to me.

So the one point is when I worked in New York state for state government there and we did a statewide survey of college student drug misuse, what we knew from research around the country too is that there were a percentage of students who did not engage in drug use or binge drinking, say, in high school but they did when they got to college.

And so as much as we should focus on the risk and protective factors, help inform our work and prevention, to me that always stood out as attending college is a little bit of a risk factor in one respect, right?

 I mean we have to take a look at what is it about the college environment that might lend to student use?

 Whether it's initiation of use or the exacerbation or continuation of use.


Schulenberg: Absolutely, yeah, and so often a branch a new change of context.

And I do want to just say one more thing about developmental perspective and that is for the most part functioning and adjustment is continuous across a lifespan.

So if one does well during childhood, they do well during adolescence and they do well with transitioning to adulthood.

In the other direction, not doing well in childhood often sets the stage for not doing well through the rest of life.

But there are important discontinuities.

People are not doing well and they get turned around.

And then the other way.

Things are going well in childhood and adolescence, and then the transition to adulthood.

Perhaps in part of the transition to college things start going awry.

And those are the things we need to understand, those discontinuities and as you say, specifically related to the transition to college.

What is it about college that brings about possible changing course?

Sometimes it can be for the good, bringing around someone who's having a hard time.

But I'm mostly worried about the other way, where people are doing fine during adolescence and all of a sudden college brings out problems that had not been seen before.


Lucey: Absolutely.

The other thing I wanted to mention that you brought up is I think a misperception that people have about drug use in college, alcohol and drug misuse in college is that it's a rite of passage.

All students participate.

And we know that's just not true.

But there's also this feeling that for students that do engage in alcohol and drug misuse in college that they will age out of it, that as they get further along in college the use will decline.

And perhaps that is true on some campuses and such, but I think what I heard you say is that we also shouldn't lose sight of the fact that for some students, the behavior they're engaging in in college, they do not age out of that.

And in fact some of them do meet the criteria for a substance use disorder, an alcohol use disorder.

Maybe not particularly while they're in college, but it's setting the foundation unfortunately for when they leave college and for later in life.

And I think I heard you say that that's something that we also should look at.

Schulenberg: Oh, absolutely.

And in fact this comes from our research and our research in the field that, right, there are people that kind of wait till college or the transition to adulthood to start experiencing with substances.

And some do age out and others do not.

And what we have found and others have found is that you can't really tell in advance which one you're going to do.

So one has an uptick in substance use problems.

Some continue on into adulthood with problems.

Some get over it.

And we can't, we don't know in advance which way you're going to go.

That's really scary.

That is it's unpredictable based on individual characteristics which puts more of the onus on kind of the college experience.

So yes, the main thing is that some will get over it, but we can't just dismiss this as a rite of passage.

It's really not that.

Some people are going to end up on a lifelong train track that they just can't get off of.


Lucey: Absolutely.

So as we come to the end of the interview, the final question that I have for you, it's going to be an interesting variation on a question that I ask of all of the guests.

And most of the time these folks are prevention professionals or they're prevention scientists and such, so it's great to get your perspective as a researcher.

So as a researcher, what advice can you provide to our listeners who are working to prevent drug misuse among college students?


Schulenberg: Okay, great, thanks.

Well, this is humbling.

I'm not a prevention specialist.

I've done prevention research in the past, but it's really hard.

It's hard to affect change.

So, but I want to say there's a whole lot of successful programs out there, and college student personnel have a tough job.

The fact that college binge drinking continues to decline as we talked before, it's a testament to their good work.

This is not happening by magic.

This is happening by people on the ground.

So as a researcher I admire what prevention specialists are able to do, and I hope that our ongoing tracking of substance use among college students is useful to them.

I do want to mention that in Monitoring the Future we often see a leading edge of attitudinal change and advance of behavioral change at the [inaudible 38:37].

So changes in seeing certain substances are more or less dangerous than to have advances of changes in use.

A good example would be that in 2020 we saw a halt to the recent rapid increases in vaping nicotine, vaping marijuana among college students.

And this halt probably had something to do and probably corresponded with the growing recognition of potential dangers of vaping.

So at a more aggregate public health level, messaging can help turn the tide.

But at the individual level, taking a whole personal approach which is consistent with the development perspective is coming.

And I think this is beneficial.

The point is to try and see substance use within the context of all that's going on in college.

And a key element to taking a developmental perspective is to see what, in this case drug use, looks like from the developmental, developing person's perspective in terms of current and future selves.

And this is a part of such approaches as motivational interview.

Now such approaches are going online, and probably the pandemic sped that up and so they could be more widely available, and I think that's good.

And then one lesson I learned in doing prevention research and just making general research for a while was it's important to keep trying.

We all know there's no magic bullet to prevention.

There's no one approach that works for everyone.

And we know it's a matter of persistence.

Moving from a place where substance use is a problem to where it's either managed or eliminated is often a long-term process.

And I think sometimes prevention specialists may not always see the longer term effects of their efforts, even though they may have helped set the foundation for the effectual change.

So they might not always see their successes.

And it's frustrating enough to not be able to see your successes to be a prevention specialist so all my respect for them.

Lucey: Well, wow, the things that you said as I was furiously taking some notes.

So I think first of all, thank you, because you're absolutely right in the advice that you gave.

First of all, you mentioned the decline in alcohol use.

Absolutely this is truly the result of the work that's being done federally, nationally, state, right on down to the campus and community levels.

That truly is a prevention success story, and we should absolutely celebrate it.

And like you said, not necessarily sure if the impact of the pandemic had that, but you know what, we take the wins where we can get them in the prevention business.

By the same token we talked about the rise in near daily marijuana use and hallucinogen use.

The flip side of that is we also know that you have to be in it for the long haul in prevention.

You are going to; the pendulum swings.

Like I said, I've been working in the prevention field at the government level for three decades, and I know that, you know, heroin was an example.

We didn't; you never really solve the drug problem.

Let's put it that way.

You never completely eliminate it.

But I have to say that we thought that we had a really good handle on the heroin issue after the '90's and yet here it came back in full force as a result of prescription drug misuse and as people diverted away from that toward heroin use, then those numbers started going up.

So it really is some ebbs and flows in the prevention business.

But the thing that you touched on, you just ended with that really resonates with me and I have to remind myself of this as well is for someone who's been in this field for a while is we may not see our successes, and you have to be, you have to come to terms with that.

That's part of the challenge of working in prevention.

People want to see tangible results that we cannot necessarily provide.

It's not like treatment beds for example.

And so we do have to hang our hat on the successes of the declines in use that we see and declines in fatal and nonfatal overdoses for example and such.

But you know, I hate to make the cliche if it helps one person, but you may have an impact on an individual or more, whether they hear a presentation you've done or they've attended an event, and you'll never know about it.

But you may have had an impact on their life.

And you know, you just have to have some faith that the work that we're doing, which is really important and critical work, is making a difference.

So from a researcher's perspective, I'm glad that you've picked up on that and that you've mentioned that.

That means a lot to me as someone who's worked in the prevention field.


Schulenberg: Well, thanks for saying that.

We're all working together, and I learn from you all.

And it's just, it's nice to be all moving the same together with what we're trying to do.

So, yeah, I appreciate all that you've done over the years too.

Lucey: Well, thank you, John.

And again, thank you for joining the podcast.

This has been everything that I'd hoped it would be.

We're hearing brand new data that is just getting out now and that we'll be using for at least the next months to come in our presentations and the work that we're doing both in federal agencies, in state agencies, on college campuses and community coalitions.

So to hear it coming directly from you as a lead researcher really has been an absolute, real pleasure to have you here, and I really thank you for that.
Schulenberg: Well, yeah, certainly my pleasure.

I much appreciate you involving me in this.

We're only good if we're useful to people out there, and we want to make sure that our funding is used to help.

So the tracking  is what we do and I just hope it's useful to people.

And it's up to us to make sure that those data are as good as they possibly could be and out there in a timely fashion.

So that's another reason why I'm really happy to be involved in this.

Lucey: And as a reminder to our listeners again, John mentioned this earlier but the Monitoring the Future Study is funded by NIDA, the National Institute on Drug Abuse, an excellent partner and collaborator with DEA on various initiatives and efforts, and we always appreciate the work that NIDA does, and certainly through Monitoring the Future.

So John, again thank you so much for joining us.

And to our listeners, I hope you've found this episode as informative and important as I did, and I really appreciate you tuning in to listen to not only this episode but all of the episodes over the last four and a half, three and a half seasons I should say of Prevention Profiles: Take Five.

So listeners, thank you once again and I wish you a great day.