The Sentinel: Substance Abuse

Online alcohol delivery fuels concerns in Illinois Youth Survey, Marijuana use surges

New survey data shows a concerning rise in teen substance abuse in Illinois, including the impact of online alcohol delivery and marijuana trends among Illinois teens in the 2024 Youth Survey.

CHAMPAIGN - A new report on youth substance use in Illinois paints a sobering picture of emerging trends and longstanding challenges as more adolescents experiment with drugs and alcohol—and in some cases, suffer serious consequences.

The 2024 Illinois Youth Survey (IYS), released this spring, revealed that while overall youth substance use has not spiked dramatically, troubling new behaviors and increased accessibility are raising red flags for parents, educators, and policymakers alike.

Photo: R+R Medicinals/Pixabay

Among the most startling findings: Illinois teens are drinking at nearly double the national rate. Thirteen percent of Illinois youth reported consuming alcohol in the past 30 days, compared with just 6.9% nationally. The data, collected by the Center for Prevention Research and Development (CPRD) at the University of Illinois Urbana-Champaign, also showed a growing number of youth engaging in binge drinking, acquiring substances online, or misusing prescription drugs.

The IYS, a biennial self-report survey first administered in 1993, is funded by the Illinois Department of Human Services and designed to provide both local-level insights and a scientific estimate of health and social behaviors statewide. It surveys eighth, 10th, and 12th graders on a wide range of issues including bullying, school climate, and substance use. This year’s sample included responses from more than 10,490 students.

Doug Smith, CPRD director and a professor of social work at the University of Illinois, said one unexpected pattern to emerge was teens acquiring liquor through home delivery services.

Clinicians are seeing an uptick in cases of cannabinoid hyperemesis syndrome—a condition tied to heavy cannabis use that causes extreme nausea and vomiting.

“This is a newer trend that started when retailers moved to online delivery during the pandemic,” Smith told the University of Illinois News Bureau. “It may be time to think about what regulatory approaches, if any, are needed to prevent kids from ordering alcohol online.”

Substance access is also a concern when it comes to marijuana, especially highly potent products such as edibles. Among surveyed students, 1% of eighth graders, 3% of 10th graders, and 5% of 12th graders reported using cannabis 20 or more times a month.

The risks of cannabis products among children were underscored just last month when a 14-year-old was arrested at Urbana Middle School for possessing more than 500 grams of cannabis-infused edibles. Urbana police reported that the child may have been attempting to distribute the edibles, and that another student required medical attention after ingesting one. Experts note these products often contain THC levels up to six times the adult dosage, making them particularly harmful to young users.

Smith said clinicians are seeing an uptick in cases of cannabinoid hyperemesis syndrome—a condition tied to heavy cannabis use that causes extreme nausea and vomiting. “We’re getting increasing reports of teens experiencing cyclical vomiting syndrome,” he said. “It’s something we didn’t talk much about even five years ago.”

The IYS data also highlighted the continued presence of more dangerous narcotics among youth. While fewer students reported using illicit drugs like heroin or LSD—just 1% of eighth and 10th graders and 2% of 12th graders—these numbers still translate to thousands of teens across the state. Prescription drug misuse was also flagged, with some students reporting using medications not prescribed to them.

Many students acknowledged that their substance use was not without consequences. Fourteen percent of 12th graders and 8% of sophomores said their use had led to fights, injuries, or poor academic performance. Ten percent of seniors and 6% of sophomores reported experiencing blackouts. Others admitted to riding with or driving under the influence—11% of seniors and 6% of sophomores.

The reality of addiction has already touched some students. About 5% of high school sophomores and seniors said they were in recovery from a substance use problem.

In terms of perception, many teens seem to underestimate the risks of regular alcohol or marijuana use. While most students viewed daily cigarette smoking as dangerous, far fewer expressed concern over marijuana or moderate drinking. Only 61% of seniors thought using marijuana once or twice a week was harmful. And when asked about daily alcohol use, 21% of eighth graders and nearly one in five high schoolers saw little or no risk in having one or two drinks a day.

Still, the survey also found encouraging signs: More than 90% of students reported that their parents or guardians had talked to them about substance use in the past year, and a similar percentage said their families had clear rules around these behaviors.

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Despite these preventative conversations, the reality of addiction has already touched some students. About 5% of high school sophomores and seniors said they were in recovery from a substance use problem. Smith noted this seemingly small percentage represents thousands of young people in Illinois who might benefit from alternative education options like recovery high schools, which offer a structured environment for students overcoming addiction.

While Illinois currently has no such schools, other states have implemented them with promising results.

“This data tells a much bigger story than just who’s using what,” Smith said. “It’s about the environments young people are navigating, the access they have to substances, and the types of supports they need to move toward healthier choices.”

The survey’s findings underscore the need for continued investment in prevention, education, and recovery programs for youth. The research was supported by the Illinois Department of Human Services’ Division of Substance Use Prevention and Recovery through funding from the Substance Abuse and Mental Health Services Administration.

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Op-Ed |
New study reveals obesity ages individuals by 27 years

Findings highlight wide-ranging health impacts and alarming cost implications

by Patty Starr
President and CEO, Health Action Council

Newly released claims data from more than 220,000 people reveal the latest evidence on the role obesity plays in health and health care costs, underpinning the need for supportive measures and interventions.

The new study, which analyzed Health Action Council (HAC) members with health plans administered by UnitedHealthcare, found that people with obesity cost their employers 2.3 times more than those without the condition and paid 66% more out-of-pocket ($662) per year than their peers without obesity. Notably, Millennials with obesity incurred over 8% higher per member per month (PMPM) costs than Baby Boomers without obesity who were 27 years older, due to the increased likelihood of chronic condition diagnoses.

Multifaceted health consequences

Comorbidities such as diabetes, hypertension, high cholesterol, and musculoskeletal issues were major cost drivers. The more comorbidities a person with obesity experienced, the higher their costs became. Obesity significantly increased the risk of various cancers, including breast, colon, rectum, and upper stomach cancers, and increased the risks for anxiety, substance use disorders, and depression.

Obesity among women of childbearing age

The report highlighted a 19-percentage-point rise in obesity rates between Gen Z women (9%) and Millennial women (28%), the largest generation in today’s workforce. This was particularly concerning due to the heightened maternal mortality risks and mental health issues associated with obesity.

The ripple effect on children

Children of parents with obesity are generally twice as likely to develop the condition themselves, but this risk tripled for children of HAC members if at least one parent had obesity. These children were also 44% more likely to experience depression, 39% more likely to have ADHD, and had higher rates of developmental disorders, asthma and diabetes.

Whole person weight management solutions

Effective strategies will require more than GLP-1s, which are unlikely to meaningfully impact obesity rates due to their high costs and low compliance rates. Consistent with the Food and Drug Administration’s label, these medications should be used in tandem with a life-style modification program for the treatment of obesity.

Strategies for employers

Following are a few steps employers can take to build a healthier workplace culture.

Understand your population. Analyze claims to determine the percentage of your workforce and dependents impacted by obesity. Identify prevalence, most impacted groups, as well as other health risks and social drivers of health.
Foster a healthy environment. Encourage a positive relationship with food, activity, and stress management by offering classes on exercise, nutrition, and mindfulness and providing non-processed foods at meetings, events, and in common areas. Encourage daily physical activity, less screen time, and quality sleep.
Offer comprehensive health solutions. Implement wellness solutions that integrate whole-person health by providing access to virtual providers such as network dietitians, digital health tools like mental health apps, and wearable technologies such as continuous glucose monitors.

About the author ~

Patty Starr, CEO of Health Action Council

Patty Starr is President and CEO of Health Action Council and is responsible for driving the strategic direction of the organization--build stronger, healthier communities where business can thrive.

Holiday celebrations are filled with triggers and temptations for those in recovery

by Lindsey Salvatelli
Rosecrance Health Network

CHAMPAIGN - It’s that time of the year when gift-giving, family gatherings, and cheers for the new year bring people together. Though it is perfectly normal to enjoy celebrations that are common around this time of year, the holidays can also be challenging for those in or new to recovery.

The holiday season is usually packed with social events, but this can cause people in recovery to feel lonely or anxious about the possibility of relapsing. For those who may have those concerns, it’s important they know that they are not alone - millions of Americans who are in recovery are also spending their holidays sober.

Although some individuals may have more experience staying sober than others, everyone needs to start somewhere. Those ready to have a safe, sober holiday should join the festivities with a plan.

During recovery, it is crucial to have a strong support network that includes 12-step meetings, sponsors, treatment centers, and loved ones, especially during the holidays. Individuals can benefit from having a list of AA or NA meetings ready and predetermined check-in calls with a sponsor or loved one to stay on track. Doing so can help establish the lifeline they need to step away from stressful social situations that could put their recovery in harm's way.

Planning how to get to holiday celebrations is crucial. Individuals need to have control over their transportation to leave quickly if needed. For those who don't have access to a vehicle, bringing a plus one who can support their recovery and be the designated sober driver can be beneficial. In an emergency, having a commuter app or a friend on speed dial who can help escape the situation can also be helpful.

Another helpful tip to prevent a relapse is to always have a non-alcoholic drink in hand. Holding a drink means there is less opportunity to be offered one, more control over what is being consumed, and avoiding a potentially awkward conversation about sobriety.

Though holiday celebrations can indeed be filled with relapse triggers and temptations, that doesn't mean that people in recovery should avoid enjoying these celebrations altogether. Spending the holidays with loved ones, free from any substances or alcohol, is worth a try. Still, it’s understandable if those new to recovery think they should avoid holiday celebrations.

A few things you might want to know about fentanyl and treatment

Photo provided

StatePoint Media - The overwhelming majority of opioid overdose deaths are due to illicitly manufactured fentanyl. Here’s what physicians at the American Medical Association (AMA) want you to know as the drug overdose and death epidemic continues to devastate communities nationwide:

• Opioid use disorder (OUD) is a treatable, chronic disease: Two-thirds of U.S. adults say either they or a family member have been addicted to alcohol or drugs, experienced homelessness due to addiction, or experienced a drug overdose leading to an emergency room visit, hospitalization or death, according to a KFF Tracking Poll. “Despite their prevalence, drug use disorders are the most stigmatized health conditions worldwide, impacting treatment and policy, and even individuals’ willingness to seek treatment,” says Bobby Mukkamala, MD, chair of the AMA Substance Use and Pain Care Task Force.

• Prescriptions are down, overdoses are up: The 2022 AMA Overdose Epidemic Report shows a 46.4% decrease in opioid prescribing nationwide in the past decade, in large part due to physician efforts to ensure appropriate prescribing, but also state laws and health insurer and pharmacy policies that deny opioid therapy to patients, even those that need it. Nevertheless, the nation’s drug overdose and death epidemic continues to worsen. According to the Food and Drug Administration (FDA), in the 12-month period that ended in February 2023, more than 105,000 people died from fatal overdoses that were primarily driven by synthetic opioids, like illicit fentanyl.

• Deaths are preventable: Centers for Disease Control and Prevention (CDC) data indicates that nearly 40% of all overdose deaths occur with a bystander present. For this reason, increasing the availability of opioid-related overdose-reversal medications will save lives. Thanks to advocacy from the AMA and other public health leaders, the FDA approved the first-ever over-the-counter naloxone product, and now pharmacies, supermarkets, convenience stores and gas stations are able to sell this safe, effective treatment. The AMA is urging retailers to price the medication responsibly and stock naloxone in prominent places. The AMA continues to urge health insurance companies to cover opioid overdose reversal medications at low- or no-cost.

• Preparation saves lives: Consider having naloxone or another overdose reversal medication on hand in case you witness someone overdosing. If you come across someone slumped over and showing signs of possible overdose, an overdose reversal medication is as easy to use as inserting it into the person’s nose and depressing the plunger. Don’t hesitate -- whether they’ve taken fentanyl or not, there’s no downside to giving naloxone when an overdose is suspected.

• Young people are dying: Among 14-18-year-olds, overdose deaths increased 94% from 2019 to 2020 and 20% from 2020 to 2021, according to the CDC. Physicians urge parents to talk to their children about alcohol, drugs and other substances.

“Making opioid overdose reversal medications widely available in educational settings can save young lives,” says Dr. Mukkamala.

The AMA urges schools and universities to stock the medications and let students know it’s available if necessary.

• Treatment works: Opioid use disorder is a treatable, chronic disease that can help individuals lead long, productive lives.

“Having an opioid use disorder requires medical help just like any other chronic disease,” says Dr. Mukkamala, who advises checking with your primary care provider if you have concerns or questions about how to get help. You also will need to talk with your insurance provider about coverage requirements and restrictions, which continue to be a barrier for many with an OUD.

• Risk can be reduced: If you receive opioid therapy or have an acute injury, talk with your physicians about the expected level of pain and optimal strategies for pain control. Safely and securely store your medications and remove unused and unwanted opioids and other medications from your home.

“We have to be honest that in order to truly reverse the overdose epidemic, much more work will need to be done to reduce stigmas and increase access to life-saving drugs,” says Dr. Mukkamala. “There is a way forward, and it requires a cooperative effort from all of us.”

It is never too late to kick excessive drinking habits to the curb

Photo: Pavel Danilyuk/PEXELS

There’s no magic number of drinks to have on a night out that will make you immune to alcohol problems.

by Tim Ditman
OSF Healthcare

URBANA - "Days of Our Lives" actor Cody Longo recently died of alcohol abuse, again raising awareness of the issue.

The dangers

How quickly can binge drinking turn problematic?

“Very easily,” says Andrew Zasada, MD, an internal medicine physician at OSF HealthCare.

Dr. Zasada says for women, binge drinking is defined as five or more drinks on one occasion, like a night out on the town that lasts three to four hours. For men, it’s 15 drinks. That takes into account the differences in how men’s and women’s bodies metabolize alcohol.

Dr. Zasada says the internal issues linked with excessive alcohol use can be devastating.

“It can cause brain dysfunction. It can cause liver disease and stomach ulcers,” Dr. Zasada says. “It’s just not a good thing. It can cause a wide variety of problems.”

Not to mention the outward symptoms like: acne, redness on your nose and palms and dry, wrinkled skin that makes you look older. And drinking during pregnancy can lead to a host of problems for the child, like facial abnormalities and developmental deficits.

“A lifetime of misery” for the little one, as Dr. Zasada puts it.

Safety, recovery

Just like there’s no magic way to prevent or cure a hangover, there’s no magic number of drinks to have on a night out that will make you immune to alcohol problems. But for Fourth of July revelers, Dr. Zasada has this advice: take it slow.

“If you’re an average size gentleman, probably a beer an hour is just about the max you can drink,” he says.

Dr. Zasada says are there many ways to help people who are drinking in excess. In the short term, such as during a party, call 911 if the person needs immediate medical attention. If they just need a break, take the person away from the clatter to rest. Take their car keys, and give them some water. A painkiller like Tylenol in appropriate doses can help with that hangover headache the next day.

Long term, a patient’s primary care provider can link them with resources to curb drinking, such as Alcoholics Anonymous or treatment centers. The National Institute on Alcohol Abuse and Alcoholism also has resources. And within OSF HealthCare’s footprint, Illinois and Michigan have phone numbers to call for behavioral health issues.

“If the person is trying to deny that they drink at all; if they are drinking alone when there is nobody else around; if they're trying to hide or cover up their drinking, those are all fairly serious warning signs that this person needs help,” Dr. Zasada says.

Dr. Zasada says it’s never too late to kick the habit of excessive drinking, but sooner is better.

“It's easier to mitigate any problems that have already occurred earlier, rather than wait for the problem to get very, very serious, very bad, and then quit,” he says. “Yeah, you'll get better. But you won't go back to what you were.”

That “getting better” looks like a lot of things.

“You might lose weight. You might lower your blood pressure. It may increase heart health,” Dr. Zasada says. “You'll think clearer. You'll sleep better.”