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Turns Out That Under-25s Are Smarter and Safer Than Ever

Turns Out That Under-25s Are Smarter and Safer Than Ever

Young adults today might not be able to find a job, but they’re better behaved than they have been in the past 20 years. Less badass or more mature? You decide

“It’s an old axiom that every generation is more rebellious than the one that came before it. Ask any member of Generation X (or “the Olds,” as we call them) and they might rip out the tired cliché that kids today—what with their sexting gadgets and twerking pop stars—are cause for moral panic.

The reality is that compared with the previous generation, a relatively large proportion of young people are unemployed, saddled with loan debt and still living with their parents. Millennials, it might seem, despite being better educated than their forebearers, are failing at life.

But not so fast. According to data Vocativ culled from sources ranging from the Economic Policy Institute to the U.S. Department of Justice to the Centers for Disease Control, young adults in the U.S. are actually far more straight-laced than they were 20 years ago. When it comes to general shenanigans—including alcohol and drug use, teen pregnancy, violent crimes and more—rates have declined across the board over the past 20 years, except when it comes to smoking weed (which has risen 38 percent).

We took 20 years of data, from 1993 to 2013, taking the midpoint (2003) as a baseline set at zero for all categories. Red lines on our charts denote that things got worse, while the blue lines indicate that things improved.

Click through the various tabs below to see how 15- to 25-year-olds have been keeping their act together over the past two decades.

Overview

THE DEEP DIVE

Shenanigans

This should be a comfort to any parents who worry about their kids: According to the National Institute on Drug Abuse, today’s young adults are consuming less alcohol and illicit drugs (cocaine, MDMA, heroin, etc.) than ever before. This excludes marijuana use, which has shot up, in line with America’s liberalized stance on weed, including the recent wave of legalization in a handful of states. Also, more kids are graduating from high school and fewer are committing violent crimes or getting knocked up than they were 20 years ago. So maybe weed isn’t so much a bad thing?

Unemployment

Unemployment figures tell a different, depressing story. According to a 2014 report from the Economic Policy Institute, unemployment for college graduates is 8.5 percent, while the rate for all 15- to 24-year-olds is a whopping 16.5 percent—more than twice the national average.

Education

Regardless of the shitty job prospects for Americans under 25, young people today are staying in school longer than Gen Xers. Relative to 1993, more high school seniors are enrolling in higher education according to the report by the Economic Policy Institute, while the total undergraduate and graduate school enrollment continues to climb.

Sources:

Drug and Alcohol Use: The National Institute on Drug Abuse; Teen Pregnancy:Center for Disease Control and Prevention; Abortion Rate: The Guttmacher Institute; High School Dropout Rate: National Center for Education Statistics; Youth Crime Rate: Office of Juvenile Justice and Delinquency Prevention; Youth Unemployment Rate: The Economic Policy Institute; Higher Education Enrollment: The Economic Policy Institute

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How Well Does A Drug Work? Look Beyond The Fine Print

July 25, 2014 4:35 PM ET
 
 
Traditional warning labels on medicine boxes tend to be long on confusing language, critics say, but short on helpful numbers.

Traditional warning labels on medicine boxes tend to be long on confusing language, critics say, but short on helpful numbers.

iStockphoto

 

“Anybody who has ever seen a drug advertisement or talked over the pros and cons of a medicine with a doctor can be forgiven for being confused.

Sorting out the risks and benefits of taking a medicine can be complicated even for professionals.

This 2007 ad for the sleeping pill Lunesta stresses insomnia relief — not the relative usefulness of the drug.This 2007 ad for the sleeping pill Lunesta stresses insomnia relief — not the relative usefulness of the drug.

Lunesta

This spring, the Institute of Medicine convened a workshop with the Food and Drug Administration. The topic: How best to communicate to doctors and patients the uncertainty in the assessment of benefits and risks of pharmaceuticals.

The FDA not only approves drugs, it also approves the prescribing instructions that come along with them. For some drugs, the wad of paper filled with fine print about the risks and benefits of using the drug is accompanied by a medication guide that is supposed to summarize the main points.

During one question-and-answer session, Dr. Robert Temple of the FDA’s Center for Drug Evaluation and Research, acknowledged that those guides are full of information. “But it’s remarkably nonquantitative for the most part,” he said. “And I think we should try to think about whether there are quantitative ways of presenting that stuff.”

He then referred to Drs. Steven Woloshin and Lisa Schwartz, two of his fellow panelists, who have said it’s possible to pull that off.

The husband-and-wife team from Dartmouth are on a decade-long mission. They have been pushing the FDA to get useful and readable quantitative data about drugs to doctors and their patients.

Schwartz and Woloshin have designed a format they call a drug facts box. It shows the gist of what they say is buried in all the fine print: How does the drug compare to a placebo?

Drs. Lisa Schwartz and Steven Woloshin designed this "fact box" as a prototype to show how package inserts for medicines could be more helpful.

Drs. Lisa Schwartz and Steven Woloshin designed this “fact box” as a prototype to show how package inserts for medicines could be more helpful.

Courtesy of Dr. Steven Woloshin

That’s in contrast to what usually happens, Schwartz says. “The prescribing info is written by industry, and then negotiated with FDA, and then FDA ultimately approves it. And we have documented examples where important info — like how well the drug works — is not in the label.”

This drives Schwartz and Woloshin crazy.

Better Than A Sugar Pill

So, here’s their experiment: They showed people ads for two competing heartburn drugs, one plainly more effective than the other.

They also showed people two of their drug facts boxes, one for each of those two heartburn drugs, showing how each drug fared against a placebo (a sugar pill) in testing.

“When the people are presented with the standard information they see — like a drug ad — about 30 percent of people chose the better drug,” Woloshin says. “But when we showed them information in the drug facts box form, 68 percent of people were able to choose the objectively better drug. So that’s a really dramatic improvement. It just shows you that if you show people information in a way that’s understandable, they can use it, and it can improve their decision.”

Using FDA data, Woloshin and Schwartz developed a drug facts box for the sleep aid Lunesta.

Two columns compare people with insomnia who took Lunesta and people with insomnia who, unknowingly, took a sugar pill.

The results? Those who used Lunesta took 30 minutes to fall asleep. Those who got a sugar pill took 45 minutes — a difference of 15 minutes. Those who took Lunesta stayed asleep 37 minutes longer than those who took a sugar pill.

Woloshin and Schwartz say some people might consider those benefits worth taking the drug, and some might not.

“That’s the whole point of the drugs facts box,” Woloshin says, “to let people look at the evidence and come to their own judgments. But you can’t make those judgments without the facts.

He and Schwartz believe passionately in the numeracy of patients. They say we can handle numbers, like percents. It’s just that too often we’re given incomplete or misleading information.

How Good A Deal Is That Sale?

For example, a claim that some drug reduces the likelihood of a particular disease by 50 percent can be misleading.

Woloshin explains why. “If you heard about a sale, and it said 50 percent off, would you travel a great distance to go to the sale? Well, you might if it was on things that are really expensive, like a flat-screen TV or something,” he says. “But what if the thing that was on sale was gum, and you save only a couple of cents? So when you hear 50 percent reduction, you have to ask 50 percent of what?”

The doctors’ dream is to get those drug facts boxes into health systems and electronic medical records, so that doctors and patients can study the information and decide what’s best before the drug is prescribed.

“What we hope is that the box will encourage people to take drugs that are effective and that work, and discourage people from taking drugs that don’t work or are just harmful,” Woloshin says. “And also that just having this information in front of people will stimulate better drug research, because drug companies realize people are paying attention and looking at these numbers — and then we’d have a better quality of drug trials.”

Woloshin and Schwartz say medical information should be as quantitative as other information. And we digest quantitative data all the time.

“If you were reporting on an election, you wouldn’t say Obama won by a little,” he says. “You’d give the numbers. If you were reporting sports scores, you wouldn’t say the Celtics, won, hopefully won, by a bit. You’d give the score.”

Why should health care be different?

He and Schwartz are convinced that we can understand risk described by numbers, provided the numbers are clearly and honestly presented.

They have been lobbying the FDA to develop drug facts boxes, but say that seems unlikely. So they started their own company to do it — Informulary. It’s funded by the Robert Wood Johnson Foundation, which also supports NPR.

This is the final part of an All Things Considered series on Risk and Reason.”

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A Beginner’s Guide to Ingesting Marijuana

A Beginner’s Guide to Ingesting Marijuana

How many high school and college students end up in the emergency room because they didn’t know their drinking limits? How many minors raid their parent’s medicine cabinets for prescription drugs? How many parents limit the amount of sugar their kids eat? Moderation is not a novel concept.

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There’s an Alarming Epidemic Stretching From Louisiana to Michigan

There’s an Alarming Epidemic Stretching From Louisiana to Michigan

“The news: Americans are hooked on pain killers.

The U.S. consumes far more opioid pain relievers, like Percocet and Vicodin, than any other nation. But the problem is far worse in some states than in others. In a strip stretching from Louisiana to Michigan, doctors write between 96 and 143 prescriptions for every 100 people, averaging more than one prescription per person. There’s no national policy to govern how doctors should prescribe the drugs, from when to give them out to how many pills to provide and how long the treatment should last.

 

Researchers from the Centers for Disease Control and Prevention published an early edition of their comprehensive study of the problem on Tuesday. Southern states ranked highest for all individual opioids except hydromorphone, fentanyl and methadone. For those drugs, Vermont, North Dakota and Oregon led the pack.

Why it matters: Drug overdose deaths in the U.S. — 75% of which are the result of prescription painkillers — have been on the rise since 1990, with three times more people dying in 2008 than just two decades earlier. In 2011, nearly 17,000 people died after popping too many highly addictive pills.

Soldiers returning home from war take even more painkillers than civilians. A study released on Monday in the Journal of the American Medical Association estimates that 1 in 6 American veterans regularly takes opioids after returning from the battlefield.

The problem might have a simple fix: When doctors in New York and Tennessee were mandated to record all the prescriptions they wrote for highly abused drugs, prescriptions for those drugs plummeted. In New York, they fell 75% and in Tennessee they dropped by more than a third: Seems like an easy solution to a deadly problem.”

 

I will continue saying this until it’s no longer a problem:
100,000 Americans die every year from KNOWN side effects of prescription drugs. Furthermore, the use of opiod pain killers in the leading cause of heroin use.

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America Probably Uses Way More Drugs Than We Previously Thought

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June 24, 2014 · 5:31 pm

‘Crack baby’ study ends with unexpected but clear result

By Susan FitzGerald, For The Inquirer

POSTED: July 22, 2013

“Jaimee Drakewood hurried in from the rain, eager to get to her final appointment at Children’s Hospital of Philadelphia.

Ever since her birth 23 years ago, a team of researchers has been tracking every aspect of her development – gauging her progress as an infant, measuring her IQ as a preschooler, even peering into her adolescent brain using an MRI machine.

Now, after nearly a quarter century, the federally funded study was ending, and the question the researchers had been asking was answered.

Did cocaine harm the long-term development of children like Jaimee, who were exposed to the drug in their mother’s womb?

The researchers had expected the answer would be a resounding yes. But it wasn’t. Another factor would prove far more critical.

 

A crack epidemic was raging in Philadelphia in 1989 when Hallam Hurt, then chair of neonatology at Albert Einstein Medical Center on North Broad Street, began a study to evaluate the effects of in-utero cocaine exposure on babies. In maternity wards in Philadelphia and elsewhere, caregivers were seeing more mothers hooked on cheap, smokable crack cocaine. A 1989 study in Philadelphia found that nearly one in six newborns at city hospitals had mothers who tested positive for cocaine.

Troubling stories were circulating about the so-called crack babies. They had small heads and were easily agitated and prone to tremors and bad muscle tone, according to reports, many of which were anecdotal. Worse, the babies seemed aloof and avoided eye contact. Some social workers predicted a lost generation – kids with a host of learning and emotional deficits who would overwhelm school systems and not be able to hold a job or form meaningful relationships. The “crack baby” image became symbolic of bad mothering, and some cocaine-using mothers had their babies taken from them or, in a few cases, were arrested.

It was amid that climate that Hurt organized a study of 224 near-term or full-term babies born at Einstein between 1989 and 1992 – half with mothers who used cocaine during pregnancy and half who were not exposed to the drug in utero. All the babies came from low-income families, and nearly all were African Americans.

Hurt hoped the study would inform doctors and nurses caring for cocaine-exposed babies and even guide policies for drug prevention, treatment, and follow-up interventions. But she never anticipated that the study, funded by the National Institute on Drug Abuse, would become one of the largest and longest-running studies of in-utero cocaine exposure.

One mother who signed up was Jaimee’s mom, Karen Drakewood. She was on an all-night crack binge in a drug house near her home in the city’s West Oak Lane section when she went into labor. Jaimee was born Jan. 13, 1990, weighing an even 7 pounds.

“Jaimee was beautiful when she was born. A head full of hair. She looked like a porcelain doll,” Karen Drakewood, now 51, said recently in her Overbrook kitchen. “She was perfect.”

But Drakewood knew looks could be deceiving.

“My worst fear was that Jaimee would be slow, mentally retarded, or something like that because of me doing drugs,” she said. She agreed to enroll her baby in the cocaine study at Einstein. Drakewood promised herself that she would turn her life around for the sake of Jaimee and her older daughter, but she soon went back to smoking crack.

 

Hurt arrived early at Children’s Hospital one morning in June to give a talk on her team’s findings to coworkers. After nearly 25 years of studying the effects of cocaine and publishing or presenting dozens of findings, it wasn’t easy to summarize it in a PowerPoint presentation. The study received nearly $7.9 million in federal funding over the years, as well as $130,000 from the Einstein Society.

Hurt, who had taken her team from Einstein to Children’s in 2003, began her lecture with quotations from the media around the time the study began. A social worker on TV predicted that a crack baby would grow up to “have an IQ of perhaps 50.” A print article quoted a psychologist as saying “crack was interfering with the central core of what it is to be human,” and yet another article predicted that crack babies were “doomed to a life of uncertain suffering, of probable deviance, of permanent inferiority.”

Hurt, who is also a professor of pediatrics at the University of Pennsylvania, is always quick to point out that cocaine can have devastating effects on pregnancy. The drug can cause a problematic rise in a pregnant woman’s blood pressure, trigger premature labor, and may be linked to a dangerous condition in which the placenta tears away from the uterine wall. Babies born prematurely, no matter the cause, are at risk for a host of medical and developmental problems. On top of that, a parent’s drug use can create a chaotic home life for a child.

Hurt’s study enrolled only full-term babies so the possible effects of prematurity did not skew the results. The babies were then evaluated periodically, beginning at six months and then every six or 12 months on through young adulthood. Their mothers agreed to be tested for drug use throughout the study.

The researchers consistently found no significant differences between the cocaine-exposed children and the controls. At age 4, for instance, the average IQ of the cocaine-exposed children was 79.0 and the average IQ for the nonexposed children was 81.9. Both numbers are well below the average of 90 to 109 for U.S. children in the same age group. When it came to school readiness at age 6, about 25 percent of children in each group scored in the abnormal range on tests for math and letter and word recognition.

“We went looking for the effects of cocaine,” Hurt said. But after a time “we began to ask, ‘Was there something else going on?’ “

While the cocaine-exposed children and a group of nonexposed controls performed about the same on tests, both groups lagged on developmental and intellectual measures compared to the norm. Hurt and her team began to think the “something else” was poverty.

As the children grew, the researchers did many evaluations to tease out environmental factors that could be affecting their development. On the upside, they found that children being raised in a nurturing home – measured by such factors as caregiver warmth and affection and language stimulation – were doing better than kids in a less nurturing home. On the downside, they found that 81 percent of the children had seen someone arrested; 74 percent had heard gunshots; 35 percent had seen someone get shot; and 19 percent had seen a dead body outside – and the kids were only 7 years old at the time. Those children who reported a high exposure to violence were likelier to show signs of depression and anxiety and to have lower self-esteem.

More recently, the team did MRI scans on the participants’ brains. Some research has suggested that gestational cocaine exposure can affect brain development, especially the dopamine system, which in turn can harm cognitive function. An area of concern is “executive functioning,” a set of skills involved in planning, problem-solving, and working memory.

The investigators found one brain area linked to attention skills that differed between exposed and nonexposed children, but they could not find any clinically significant effect on behavioral tests of attention skills.

Drug use did not differ between the exposed and nonexposed participants as young adults. About 42 percent used marijuana and three tested positive for cocaine one time each.

The team has kept tabs on 110 of the 224 children originally in the study. Of the 110, two are dead – one shot in a bar and another in a drive-by shooting – three are in prison, six graduated from college, and six more are on track to graduate. There have been 60 children born to the 110 participants.

The years of tracking kids have led Hurt to a conclusion she didn’t see coming.

“Poverty is a more powerful influence on the outcome of inner-city children than gestational exposure to cocaine,” Hurt said at her May lecture.

Other researchers also couldn’t find any devastating effects from cocaine exposure in the womb. Claire Coles, a psychiatry professor at Emory University, has been tracking a group of low-income Atlanta children. Her work has found that cocaine exposure does not seem to affect children’s overall cognition and school performance, but some evidence suggests that these children are less able to regulate their reactions to stressful stimuli, which could affect learning and emotional health.

Coles said her research had found nothing to back up predictions that cocaine-exposed babies were doomed for life. “As a society we say, ‘Cocaine is bad and therefore it must cause damage to babies,’ ” Coles said. “When you have a myth, it tends to linger for a long time.”

Deborah A. Frank, a pediatrics professor at Boston University who has tracked a similar group of children, said the “crack baby” label led to erroneous stereotyping. “You can’t walk into a classroom and tell this kid was exposed and this kid was not,” Frank said. “Unfortunately, there are so many factors that affect poor kids. They have to deal with so much stress and deprivation. We have also found that exposure to violence is a huge factor.”

Frank said that cocaine – along with other illicit drugs, alcohol, and cigarettes – “isn’t good for babies,” but the belief that they would “grow up to be addicts and criminals is not true. Some kids have stunned us with how well they’ve done.”

 

Jaimee Drakewood came to her last visit at Children’s with her 16-month-old son KyMani in tow. It was the 31st time she had met with the researchers.

“We do appreciate everything you’ve done, because it’s not easy to get to all these appointments,” said team member Kathleen Dooley, as she handed Drakewood a framed certificate of appreciation. “We are proud of you and we feel you are family, because you are.”

The team plans to stay in touch with study participants each year. They have started a new study that uses MRI and other tools to explore the neural and cognitive effects of poverty on infant development.

“Given what we learned,” Hurt said, “we are invested in better understanding the effects of poverty. How can early effects be detected? Which developing systems are affected? And most important, how can findings inform interventions for our children?”

The team considers Jaimee and her mother, Karen, among their best success stories. Jaimee is heading into her senior year at Tuskegee University in Alabama and hopes to become a food inspector. She is home for the summer with her son and working as a lifeguard at a city pool.

After a few starts and stops, including a year in jail, Karen Drakewood is off drugs and works as a residential adviser at Gaudenzia House. Her older daughter just received a master’s degree at Drexel University; her son is a student at Florida Atlantic University. Even in the worst moments, Karen Drakewood said she tried to show her kids “what their future could hold.” “If a child sees the light, they will follow it.”

Jaimee Drakewood credits her big sister and mother for keeping her on track. “I’ve seen my mom at her lowest point and I’ve seen her at her highest. That hasn’t stopped me from seeing the superwoman in her regardless of where she was at,” Jaimee said.

Despite her family’s history, Jaimee believes she and her siblings are “destined to have accomplishments, to be greater than our parents.”

 


Susan FitzGerald, a former Inquirer reporter, has written periodically about the cocaine study. Now an independent journalist, she is coathor of a parenting book, Letting Go With Love and Confidence and can be reached at sfitzgerald610@msn.com .”

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July 23, 2013 · 11:12 pm

Debauchery and the American Experience (Woo-Hoo!)

Image: www.fanpop.com

 

 

By 
Published: March 14, 2013

“Just before the candy-colored apocalypse comes to Harmony Korine’s “Spring Breakers” you hear the peaceable murmurings of a beach, of lapping water, calling gulls and playing children. They’re nice, these sounds of summer, promises of carefree, youthful pursuits like building sand castles and shrieking at waves. The first image of what looks like a beach party keeps the happy vibe going. Dozens, hundreds of gyrating, dancing young women and men are basking in the honeyed light — as the beat goes on and the smiles sour into sneers — though it becomes evident that they’re also marinating in a tsunami of beer.

The beer doesn’t flow, it floods: over heads, writhing torsos and the bared breasts that wiggle like puppies and wag at the camera like the middle fingers that more and more revelers raise. Welcome to the party, dude, Mr. Korine seems to be saying (or is he snickering?), now sit back, relax and enjoy the show. He proves an excellent ringmaster and a crafty one too. In “Spring Breakers” he bores into a contested, deeply American topic — the pursuit of happiness taken to nihilistic extremes — but turns his exploration into such a gonzo, outrageously funny party that it takes a while to appreciate that this is more of a horror film than a comedy.

If the laughter at times catches in your throat, well, that’s part of the queasy, transfixing experience that is “Spring Breakers,” which plays with some of the same ideas in Mr. Korine’s last feature, “Trash Humpers.” In that movie, shot on VHS tape, four characters in rubber masks run amok, getting down and dirty as they compulsively, even ritualistically grind their pelvises against anything — garbage, of course, included — in a creepy, joyless yet also amusing burlesque. In “Spring Breakers” Mr. Korine has traded in his plug-uglies for a far more seductive and commercially viable female quartet that includes two former Disney teen queens, Selena Gomez (as Faith) andVanessa Hudgens (Candy), along with Ashley Benson (Brit) and his wife, Rachel Korine (Cotty).

Introduced shortly after the opening bacchanal, the four play students at a nondescript school somewhere warm that’s ornamented with palm trees and bored young people smoking weed, hanging out, sometimes reading and even attending classes. Over a number of dreamy, elliptical scenes that slide from day to night and back, it emerges that the four friends want to go on spring break but don’t have enough cash. While Faith prays on her problems — “Are you crazy for Jesus?” her church leader calls out — the other three opt for a more direct approach: armed with squirt guns and a lady-sized sledgehammer, they go full-on gangsta and rob a restaurant. “Pretend it’s a video game,” one giggles. “Act like it’s a movie.” So they do.

There are consequences of a kind, but first: paaarty! The four later take off for spring break in St. Petersburg, Fla. There they join an invading army that has seemingly commandeered every inch of sand, surf and hotel. From rooms and halls these tanned, groomed, white-teethed paragons of American youth and orthodontics spill onto balconies and into pools, laughing and yelling as they drink, snort, dance, grind, thrash and jump jump jump up, moving together like a single pulsing organism. They’re beautiful and monstrous, enthralling and repellent. For those who don’t belong to their tribe (never wanted to, never did), they may be exotic, worrisome, frightening or representatives of the decline of the West in hot-pink bikinis.

Just kids or children of the damned? Take your pick. Mr. Korine, a pasticheur and cultural vulgarian (part Dada, part European art cinema, part MTV’s “Jackass”), isn’t interested in making up your mind for you. Instead he tosses out his ideas like puzzle pieces and lets you see how or if they fit. The women want to go on spring break and want to have fun, and he seems to want the same. He splashes on the gorgeous, gaudy color and bends the story line, adding brief flash-forwards and flashbacks that make it seem as if time were incessantly skipping forward and backward, almost swirling. Gestures, bits of dialogue and moody moments are repeated like old songs, like dreams, rituals and highlight reels.

Mr. Korine clearly digs frolicking with his visiting celebrities, and the actresses seem happy to do things that would make Uncle Walt spin in his grave. They’re almost giddy, at least at first, and given that both Ms. Gomez and Ms. Hudgens have put in time working for Disney it’s no wonder that they cut loose. In “Spring Breakers” they have the chance to simulate the behavior that feeds the tabloids without the humiliations and career-crushing price paid by the likes of Lindsay Lohan. For his recent, putatively adult role in “The Paperboy” Zac Efron (Ms. Hudgens’s co-star in Disney’s “High School Musical” series) played a scene in which Nicole Kidman urinated on him. The female stars of “Spring Breakers” get to shoot guns and hang out with James Franco.

The fantastic Mr. Franco, wearing grillz and long cornrows, rolls up with guns and a white Camaro convertible with red rims. His character, a rapper from “St. Pete” called Alien, is a hustler, dealer and self-anointed gangsta. He walks the bad-boy walk and talks the talk, but he’s strictly thug lite, a white caricature in a cartoonish masquerade of black masculinity. For the women he becomes something of a sleazy Prince Charming — not all the princesses are equally charmed — in a story that has metamorphosed into a feverish fairy tale. “Look at all my” stuff, he boasts, almost self-amazed, in a startling, deliriously funny riff on “The Great Gatsby” — except that instead of throwing shirts in the air he’s brandishing machine guns, bricks of dope, wads of cash, animal-print shorts.

Alien’s masquerade as well as his feud with a black gangster bring the film back to an earlier scene that indicates Mr. Korine has more on his mind than surface shocks. Brit and Candy are sitting in a class in which a professor is murmuring words like Reconstruction, war and African-Americans. One of them draws a heart and the words “I want penis” on some paper. They laugh and, as the professor keeps talking, one pantomimes giving oral sex. It doesn’t matter that they’re not paying attention to their history lesson. Because, at that point, they haven’t yet pretended to be gangstas and robbed the restaurant, giggling as they held a squirt gun to a black man’s head — playing thugs without the burden, without the history, without the cost.

Mr. Korine originally shows the robbery from the exterior and through the restaurant’s windows so that the assault, the women’s movements and violence, are seen inside a frame as if you were watching a film within a film. The whole episode looks preposterous, like a bad music video, and the women in their black ski masks just seem silly. Much later, when Mr. Korine loops back to the crime, he takes you inside so you can see the terrified customers cowering as Brit and Candy smash up the place, waving their “weapons.” The squirt guns are fakes, but both the women’s pleasure and the rage that pumps through the scene and increasingly through the film — feeding the excesses, the posturing and escalating violence like a poisoned river — feel eerily real, familiar and very American.

At once blunt and oblique, “Spring Breakers” looks different depending on how you hold it up to the light. From one angle it comes across as a savage social commentary that skitters from one idea to another — white faces, black masks, celebrity, the American dream, the limits of self-interest, the search for an authentic self — without stitching those ideas together. From another it comes off as the apotheosis of the excesses it so spectacularly displays. That Mr. Korine appears to be having it both (or many) ways may seem like a cop-out, but only if you believe that the role of the artist is to be a didact or a scold. Mr. Korine, on the other hand, embraces the role of court jester, the fool whose transgressive laughter carries corrosive truth. He laughs, you howl.

“Spring Breakers” is rated R (Under 17 requires accompanying parent or adult guardian). Gun violence and enough naked breasts to supply material for a second Seth MacFarlane song.

Spring Breakers

Opens on Friday in New York and Los Angeles.

Written and directed by Harmony Korine; director of photography, Benoît Debie; edited by Douglas Crise; music by Cliff Martinez and Skrillex; production design by Elliott Hostetter: costumes by Heidi Bivens; produced by Chris Hanley, Jordan Gertner, David Zander and Charles-Marie Anthonioz; released by A24. Running time: 1 hour 34 minutes.

WITH: Vanessa Hudgens (Candy), Selena Gomez (Faith), Ashley Benson (Brit), Rachel Korine (Cotty), James Franco (Alien) and Gucci Mane (Archie).”

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March 17, 2013 · 4:20 pm