COLUMBUS, Ohio - The holiday season has officially started, and one group is encouraging Ohio parents to make a special effort to check in with their teens to help them avoid risky behaviors.

With days off school, parties and distracted parents, experts say underage drinking tends to increase during the holidays. Rick Birt, president and chief executive of Students Against Destructive Decisions, said alcohol is the most widely used substance among teens, with 14 the average age for a first drink. He encouraged parents to set ground rules to manage expectations, and to not make discussions about risky behaviors as "one and done."

"We've talked with parents all across Ohio who try to have regular, routine check-in," he said. "Maybe when you're driving 'em to the bus stop, go beyond the 'How's school?' conversation; dig into the 'How are you feeling?' The more that you talk with your young person, the more able they are to have that ongoing conversation with you."

Because risk-taking is a typical part of teenage development, Birt recommended avoiding scare tactics. He said the best conversations focus on education about healthy choices and how to make smart decisions in the face of peer pressure.

Other important topics to touch on, Birt added, include the illegal use of prescription medications, tobacco and marijuana. With medical marijuana legal in Ohio as well as efforts to legalize recreational use, Birt said, teens may have misconceptions about its dangers.

"The marijuana of today is not the marijuana from the '60s and '70s," he said. "It's been genetically modified and is much stronger. It is different depending on how it's ingested - whether it's smoked or used as a dab, or used in an edible or in some other way."

Birt also noted that it's important to keep a check on a teenager's mood.

"While the holidays are full of lights and glamour and special moments, and while we're oftentimes more together during the holidays, we don't always feel that way," he said. "They can be lonely seasons for many young people. There's anxiety, and all sorts of other things that come into play."

Parents who are concerned about a teen's mental health can contact their primary-care physician. Online resources are available, too, at nami.org, ohiosadd.org and preventionactionalliance.org.


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Expanded treatment for opioid addiction is now available in New Mexico.

The state's Department of Health is offering medication-assisted treatment for opioid use disorder in four regions around the state.

Josh Swatek, harm reduction program manager for the New Mexico Department of Health, said medication to treat the addiction should help reduce opioid cravings.

"This is really designed to help reach some of the most rural communities, to really create a safety net," Swatek explained. "Folks have options for substance-use treatment in their local communities."

Swatek noted more than 2 million people in the U.S. have an opioid-use disorder. New Mexico previously offered outpatient disorder treatment in Las Cruces, Albuquerque and Roswell but has now expanded treatment to 30 public health offices. He pointed out in 2022, the state recorded slightly more than 700 deadly opioid overdoses.

Swatek emphasized his department is focused on harm reduction -- acknowledging people use drugs for a variety of reasons -- but can also live healthy, self-directed and purpose-filled lives by adopting specific strategies. He added research shows people are five times more likely to enter substance treatment programs and three-and-a-half times more likely to succeed if they have first participated in harm-reduction programs.

"We're working closely with the New Mexico department of corrections," Swatek stressed. "They're going to be required to offer substance-use treatment as well in their facilities, so that when folks are discharged there's a plan. No matter where they are in New Mexico, we can hopefully continue their treatment in a public health office, if need be."

Swatek acknowledged those struggling with addiction often are stigmatized by their community and harm-reduction programs can minimize risks until they're ready to take steps toward treatment or recovery. He observed some patients have told researchers telehealth has helped them have a greater sense of autonomy and control over their treatment.


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Often celebrated in popular culture, Wisconsin's relationship with alcohol continues to give way to troubling statistics that center around excessive drinking and there are calls to step up prevention efforts.

The Badger State still ranks high for beer production.

Maureen Busalacchi, director of the Wisconsin Alcohol Policy Project at the Medical College of Wisconsin, said consumption levels for all types of alcohol overshadow market gains. For example, all Wisconsin counties exceed the national average for excessive alcohol use. In 2022, the state recorded more than 3,300 alcohol-related deaths.

"This has been an ongoing problem in Wisconsin, in part, I think, how our regulatory system works, how our culture works," Busalacchi observed. "There's maybe not as much enforcement of policies as there are in other states."

She pointed out binge drinking is a major problem, and boosting age compliance checks at places that sell alcohol could help curb the activity among young adults. Busalacchi sees hope at the local level with stronger enforcement at community events, as police agencies take notice of the ripple effects of people being overserved or minors gaining access to these products.

However, she reported people who have developed a drinking problem often encounter waiting lists for treatment programs.

Faith Gladem, executive director of the Harbor Recovery Center, a nonprofit in central Wisconsin emphasizing family support in transitioning to recovery. She said they are able to meet demand through their services but referrals for more intensive help can be an issue.

"When someone needs treatment, we do not have enough treatment beds in Wisconsin," Gladem asserted. "We do not have enough detox facilities that detox with dignity."

Her team wants to help foster a mindset in Wisconsin where alcohol is put on the same level as other substance use disorders. The State Council on Alcohol and Other Drug Abuse recommends more evidence-based education and Busalacchi added it is important to understand not just the short-term effects, such as traffic fatalities but the cumulative impact as well.

"The long-term impact of alcohol use can be cancer. It can also be high blood pressure, heart disease, liver disease, stroke," Busalacchi outlined. "And then there's the social and wellness issues; your family gets frustrated or you're losing work."


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More than 1,000 New Mexicans die from drug overdoses each year, and while there's been a slight drop in overdoses from opioids nationwide, it's mostly offset by those from cocaine and other stimulants.

James Besante, chief medical officer at the Santa Fe Recovery Center, said the opioid crisis is evolving - sometimes described as "waves." Now in its fourth wave, he said the nearly 4% decrease reported by the Centers for Disease Control and Prevention is good news, but doesn't reflect what he's seeing on the ground. He noted that it's common that multiple drugs are involved in overdose deaths.

"Increasingly we are seeing individuals overdose on substances other than opioids," he said, "where their substance has been adulterated with an opioid like fentanyl."

When the United States' opioid crisis was at its peak, New Mexico was sixth among the 50 states for overdoses - about 50 individuals per 100,000 people. If preliminary CDC data showing opioid deaths decreased in 2023 is confirmed, it would be the first annual decrease in drug-overdose deaths since 2018. Besante said any success is good news and offers hope to suffering individuals and families.

About 30% of New Mexico residents live in rural counties, which Besante said are medically underserved - with fewer treatment centers and providers prescribing life-saving medications.

"While in some areas of the country we've seen an explosion of tele-medicine, tele-addiction treatment - that has not found its way into very rural communities," he said, "and oftentimes the local pharmacy is not stocking the medications that are prescribed."

In 2021, almost 107,000 drug-overdose fatalities occurred in the United States. West Virginia was the hardest-hit state, approaching twice the number in New Mexico. Besante saif approximately 25% of clients at the Sante Fe treatment center are unhoused and don't have health insurance.