drug trends in youth 2013 - community unit school district 200

Drug trends in Youth 2013

Linda Lewaniak, L.C.S.W, CAADC

Clinical Director of Outpatient Services

Director, Center for Addiction Medicine

847-755-8039

Current Trends in Adolescent

Substance Use and Abuse

“US teens are less likely

to use cigarettes and

alcohol, but more

likely to use illicit

drugs”

However, teen drinking

is still one of our

largest problems!!!!

June 2nd, 2012 Press release from

Monitoring the Future (MTF)

• Daily Marijuana use increased among 8th, 10th,

and 12th graders from 2009 to 2010.

• Among 12th graders it was at its highest point

since the early 1980s at 6.1%.

• In 2012 perceived risk of regular marijuana use

also declined among 10th and 12th graders

suggesting future trends in use may continue

upward.

• In addition, most measures of marijuana use

increased among 8th graders between 2009 and

2010 (past year, past month, and daily).

Monitoring the Future Survey

Monitoring the Future (MTF)

Prescription and over-the-counter medications

• Account for most of the top drugs abused by 12th

graders in the past year.

• Among 12th graders, past year nonmedical use of

Vicodin decreased from 9.7% to 8%.

• Past year nonmedical use of OxyContin remains

unchanged across the three grades and has

increased in 10th graders over the past 5 years.

• Past-year nonmedical use of Adderall and over-

the-counter cough and cold medicines among

12th graders remains high at 6.5% and 6.6%,

respectively.

Heroin

Heroin

Common street terms for heroin include:

Big H

China White

Mexican brown

Smack

History

1862 – synthesized by Charles Alder Wright at St Mary’s

Hospital Medical School

1898 – medical use as cough suppressant and lung

stimulant by Bayer Pharmaceutical Co.

1900’s - available to the public, concerns raised over

addictiveness and medical benefits

1924 – banned from the US

1960’s – heroin started to become a major social problem

1970’s-- needle exchange programs

1990’s – late in the decade – snort and cheaper

2011- Cheap and the typical user has changed

What Are Opioids?

Opioids are natural or synthetic substances that act

on the brain’s opiate receptors.

Opioids dull pain and relieve anxiety that

comes from thinking about pain.

People abuse opioids because they provide a

feeling of euphoria (a “rush”).

What is Heroin?

Heroin is an opiate drug that is synthesized from morphine,

a naturally occurring substance extracted from the seed

pod of the Asian opium poppy plant.

Heroin usually appears as a white or brown powder or as a

black sticky substance, known as “black tar heroin.”

It often is mixed with other substances (sugar, starch) or

poison (strychnine).

What is Heroin?

Most heroin is illegally manufactured and imported.

When sold on the street it is likely to have been mixed with a

variety of similar powders.

Costs about $10 to $20 a bag

Heroin is a Class A drug.

This means that possessing it can lead to prison

Sentence of up to 7 years and an unlimited fine.

Supplying (which includes giving it to a friend) could lead to a

life sentence and another unlimited fine

Where does it come from?

South America

Mexico

Increase in purity

2004 - 8.6

2005 - 8.0

2006 - 13

2007 - 18

2008 - 38

Afghanistan, Pakistan, West Africa, and India.

Heroin effects

With regular heroin use tolerance develops:

physiological (and psychological) response to the drug

decreases, and more heroin is needed to achieve the

same intensity of effect.

Heroin users are at high risk for addiction—it is

estimated that about 23 percent of individuals

who use heroin become dependent on it.

Physiological Effects

Heroin effects the central nervous system by depressing it.

Heroin depresses nerve transmission in sensory pathways

of the spinal cord and brain that signal pain. • Making it an effective pain killer.

Heroin also inhibits brain centers controlling coughing, and

breathing.

Heroin is particularly addictive because it enters the brain

so rapidly.


Soon after injection (or inhalation), heroin crosses the blood-

brain barrier.

Abusers typically report feeling a surge of pleasurable

sensation, a "rush."

The intensity of the rush is a function of how much drug is taken and

how rapidly the drug enters the brain and binds to the natural opioid

receptors.


Heroin, the rush is usually accompanied by:

A warm flushing of the skin

Dry mouth

Heavy feeling in the extremities, which may be

accompanied by nausea, vomiting, and severe

itching.

Psychological effect

Tolerance develops – needing more

Inability to self assess

Increase feelings of isolation and non-caring - no regard for

consequences

Get involved in the drug culture - the drug excludes people,

so people avoid them - the result is increased isolation –

a vicious circle.

In the longer term, the heroin user becomes totally

dependent on the drug until his whole life revolves

around the effort to get the next ‘fix’.

Major Mortality Trends in the

Chicago Metropolitan Area

There have been large increases in heroin overdoses in the

collar counties:

In Lake County, deaths increased by 130 percent from 2000 to

2009.

In three years, deaths in McHenry County increased by 150

percent.

In just two years, deaths in Will County have doubled.

Major Trends in Heroin Use

Heroin has become the second most common drug after

alcohol and the most common illegal substance for

which individuals enter treatment in Illinois.

In 1998, heroin use was the fourth most common reason

Illinoisans entered publicly funded treatment.

Public Treatment Admissions in Illinois by Number and Rank

2008 to 1998 (TEDS)

Withdrawal

Dilated pupils

Goose bumps

Watery eyes

Runny nose

Yawning

Loss of appetite

Tremors

Panic

Chills

Nausea

Muscle cramps

Insomnia

Stomach cramps

Diarrhea

Vomiting

Shaking

Chills or profuse

sweating

Irritability


• After several years of decline, current and

past year use of Ecstasy has risen among

8th and 10th graders.

• From 2009 to 2010, lifetime use of ecstasy

among 8th graders increased from 2.2% to

3.3%, past year use from 1.3% to 2.4%,

and current use 0.6% to 1.1%.

• This follows declines in perceived risk

associated with MDMA use seen over the

past several years.


• Alcohol use has continued to decline among high school

seniors with past-month use falling from 43.5% to 41.2%

and alcohol binge drinking (defined as 5 or more drinks

in a row in the past 2 weeks) declining from 25.2% to

23.2%.

• Declines were also observed for all measures among

12th graders reporting the use of flavored alcoholic

beverages. Past-year use fell from 53.4% to 47.9%.


Heroin

Methamphetamine

GHB, Ketamine, and Rohypnol

Khat

Salvia

Khat

• (pronounced “cot”) is a stimulant drug derived

from a shrub (Catha edulis) that is native to East

Africa and southern Arabia.

• The khat plant itself is not scheduled under the

Controlled Substances But - because one of its chemical constituents, cathinone, is a

Schedule I drug, the Federal Government considers its use

illegal.1

• Chewed – producing a state of euphora and elation

and increased in alertness and arousal

• Structurally similar to, but less potent than,

amphetamine, yet result in similar psychomotor

stimulant effects

Salvia (Salvia divinorum)

• Herb common to southern Mexico and Central and

South America.

• Main active ingredient in Salvia, salvinorin A, is a potent

activator of kappa opioid receptors in the brain.1,2

These receptors differ from those activated by the more

commonly known opioids, such as heroin and morphine.

• Traditionally, S. divinorum has been ingested by chewing

fresh leaves or by drinking their extracted juices.

• The dried leaves of S. divinorum can also be smoked as

a joint, consumed in water pipes, or vaporized and

inhaled.

Salvia (Salvia divinorum)

• Salvia currently is not a drug regulated by the

Controlled Substances Act, several States and

countries have passed legislation to regulate its

use.3

• The Drug Enforcement Agency has listed Salvia

as a drug of concern and is considering

classifying it as a Schedule I drug, like LSD or

marijuana.

Synthetic Cannabis

• Describe as a diverse family of herbal mixtures marketed

under many names, including K2, fake marijuana, Yucatan

Fire, Skunk, Moon Rocks, and others.

• Contain dried, shredded plant material and presumably,

chemical additives that are responsible for their

psychoactive (mind-altering) effects.

• Spice products are labeled “not for human consumption”

they are marketed to people who are interested in herbal

alternatives to marijuana (cannabis).

• Spice users report experiences similar to those produced

by marijuana, and regular users may experience

withdrawal and addiction symptoms.

Synthetic Cannabis

• Known by various brand names (K2, Spice, Purple

Magic, Funky Monkey, Black Mumba) is a plant

based substance marketed and sold at “head

shops” and gas stations.

• Labeled and sold as potpourri, it is widely known to

be smoked for an intense hallucinogenic like high.

• Developed in research on cannabinoid receptors, it

has been found to mimic the effects of natural

cannabinoids in the brain.

• Chemicals are sprayed on plant-based materials,

which makes it cheap and easy to produce and

procure.

Psychoactive Effects

Marketed as similar to cannabis:

Euphoria

Sociability

Anxiolytic

Relaxation

Stimulant

Cross tolerance with THC?

http://buyk2spice.net/

K2/Spice Health Risks

Symptoms/Side-Effects may include:

mimics marijuana “high” (often induced more quickly/more intense than “real” marijuana)

hallucinations

seizures/tremors

coma/unconsciousness

numbness/tingling

http://buyk2spice.com/wp-content/uploads/2010/04/k2spice.jpg

K2/Spice Health Risks

Symptoms/Side-Effects may include: increased respiration rate elevated blood pressure (reported up to

200/100-medically dangerous) elevated heart rate (reported up to rate

of 150-medically dangerous) increased level of anxiety/agitation

leading to panic attacks possible suicide attempts

http://buyk2spice.com/wp-content/uploads/2010/04/k2spice.jpg

Side Effects of SC Products

Anxiety

Paranoia

Headache

Vomiting

Psychosis

Diaphoresis

Seizures

Rapid breathing

http://investigationmiami.blogspot.com/2011/01/be-afraid-really-afraid.html

Synthetic Stimulants

Bath Salts

Synthetic

Stimulants

Effects on the Body

The desired effect by the person using this substance is

increased arousal, diminished need for food or sleep, and

sexual arousal. However, the risks are significant.

• Anxiety

• Agitation

• Elevated blood pressure

• Panic attacks

• Trismus (inability to open mouth)

• Psychosis

• Hallucinations

• Suicidal ideation

• Depression

• Tachycardia, hypertension

• Death

Methylendioxypyrovalerone

(MDPV)- sold and marketed as

“Bath Salts”.

Available over the counter at

convenience stores and smoke

shops, it appears as a white or light

brown crumbly powder.

Used by smoking, through the

rectal cavity, by snorting, and

through IV injection.

CNS that is very similar to cocaine

and methamphetamine.

Produces a 3-4 hour high

Product Marketing

Mtv

MDPK

Magic

Super Coke

Peevee

Energy-1 (NRG1)

Charge Plus

White Lightning

Scarface

Cloud 9

Ocean

Ivory Wave

A Brief Review of Adolescent

Brain

Development

Frontal Cortex:

decision-making,

self-control

Limbic System:

learning, emotions

New Knowledge

The human brain develops into the early/mid 20’s

The limbic system that governs emotions matures

earlier

The frontal cortex, responsible for

planning, self-control, and decision making matures

later

Adolescent Brain

Development, Decision-

Making, and Risk

Immaturity of cognitive processing may lead to risky

decisions.

Strong emotions may override rational decision-

making.

Risk-taking may facilitate adolescent transitions.

Increased reward sensitivity may lead to “sensation

seeking”

Teens 2012

Parents working longer

Materialism

Narcissism

Technology- information explosion

Cell phone and texting

Multi-tasking

Adolescent Media Usage

Almost 90 percent of 12- to 17-yearolds use the

Internet (50% use it daily)

About 19 million teens instant message

60 percent of teens have their own cell phone

Risky Behavior and the

Internet

• 64 percent of teens who use the internet say that most teens do things on the Internet that they wouldn't want their parents to know about.

• Nearly half (48%) of 16- to 17-year-olds report that their parents or guardians know "very little" or "nothing" about what they do on the Internet

• Nearly one-third (29%) of students surveyed said their parent or guardian would disapprove if they knew what they were doing on the Internet

Drugs and the Internet

• Drug Information

• How to grow marijuana

• Drug Purchasing

• Websites selling prescription drugs

• Social Norm Setting

• Social networking that promoted ATOD

use

• Gambling and the internet

Texting

Where do I begin?

Text more the talk

Addictive behavior

Method of staying constant in touch

Phones now can track your physical location

www.facebook.com

Facebook, which started off as a social networking Web site for college students, recently expanded, offering high school and co-worker directories.

To register, users must have a valid e-mail address from a supported college, high school or company; this is the user’s primary network and they can only join interest groups within their network.

http://www.youtube.com/

You Tube is a website that allows members to

upload, comment on, and view videos.

You Tube originally started as a personal video

sharing service, and has grown into an

entertainment destination with people watching

more than 70 million videos on the site daily.

For More Information

http://www.theantidrug.com/

http://www.mediacampaign.org/

http://www.computeruser.com/resources/dictionary/e

moticons.html

http://www.whitehousedrugpolicy.gov/pdf/street_ter

ms.pdf

http://www.netlingo.com/emailsh.cfm

http://www.computeruser.com/resou

http://www.whitehousedrugpolicy.go/

Trends & Treatments for Adolescents

What is the most abused Drug

for teens?


Alcohol


• The average age when youth first try alcohol is 11 years for boys and 13 years for girls.

• According to research by the National Institute on Alcohol Abuse and Alcoholism, adolescents who begin drinking before age 15 are four times more likely to develop alcohol dependence than those who begin drinking at age 21.

Consequences Associated with

Underage Drinking

• Heavy alcohol use can impair brain function in adolescents. It is unclear at present whether the damage is reversible.

• interference with learning, social, other competencies,

• Their inhibitions and memory soon become affected—so they may say and do things that they will regret and possibly will not remember doing at all.

• unintentional injuries,

• homicide, suicide, and early, more frequent, and less safe sexual activity

The Myth of Adolescent Responsible Drinking

Loss of balance, slurred speech, and blurred

vision.

Normal activities—even crossing a busy

intersection—can become truly dangerous.

Depending On the amount teens consume

reflexes like gagging and breathing can be

suppressed. That means they could vomit

and choke to death or just stop breathing.

They may even be at risk for alcohol

poisoning

Critical signs of alcohol poisoning

Mental confusion

Stupor

Coma, or the person cannot be roused

Vomiting

Seizures

Slow (fewer than eight breaths per minute) or

irregular (10 seconds or more between

breaths) breathing; and hypothermia (low

body temperature), bluish skin color, and

paleness.


Addiction is a brain disease

Progressive

Relapsing

Chronic

A developmental disorder that starts in

childhood and or adolescents

Potential Risks

•Illness and mortality rates increase 200-

300% in this population.

•The number one cause of death

continues to be motor vehicle accidents,

followed by death by suicide and

homicide.

•Use during adolescent brain development

may cause injury to the brain, which can

increase dependence on substances and

continued problems later in life.

•Risk of other high risk behaviors such as

risky sexual behaviors, texting while

driving, and thrill seeking type behaviors.


National Institute on Drug Abuse States: Drug

addiction is a complex illness

Characterized by compulsive, at times uncontrollable, drug

craving, seeking, and use that persist even in the face of

extremely negative consequences.

Over time, a person’s ability to choose not to take drugs is

compromised. Drug seeking becomes compulsive, in large part

as a result of the effects of prolonged drug use on brain

functioning and, thus, on behavior. The compulsion to use drugs

can take the individual’s life.


Teen and Young Adult

Substance Abuse


Experimental Use

One time use of any substance.

Motivated primarily by curiosity and/or risk taking.

Use may occur alone, but typically it takes place in a

social context.


Abuse (Social or Instrumental)

Use substance for “Getting High,”

boredom, or relief of any kind.

Hedonistic-pleasure seeking and lack of

inhibition.

Compensatory Use: the use of

substances to inhibit or suppress

emotions.

Continued use despite any negative

consequences.

Any more than one time use.


Dependency

Substance use becomes the youth’s primary means of

recreation, of coping, or both.

Tolerance and withdrawal

Negative consequences begin to develop as patterns

Substance often taken in larger amounts

Time is spent in activities: to get, to do,to recovery

Continues use despite negative consequences


What makes Adolescent

substance abuse different????


• Effects of drugs are similar for school-aged children and adults, the difference being that the same dose causes much higher blood content level. The body absorbs substances much faster, the liver metabolizes less efficiently, and kidneys excrete them more slowly.

• Children and adolescents have difficulty understanding the short and long-term effects of substance abuse.

• Higher percentage of adolescent usage is experimental in nature

• Children and adolescents problem-solving and reasoning skill development are delayed when under the influence of drugs and alcohol.


• Progression of the symptoms can be more rapid

due to the rapid physical development during

adolescence.

• Children and adolescent brains are growing at a

rapid rate with the last 1/3 growing during

adolescence.

• When Adolescents abuse substances, cell

functioning can be impaired.


Risk Factors


• Chaotic home environments.

• Ineffective parenting (no clear

limits, poor follow through,

inconsistent expectations).

• Parental substance

use/abuse (current use,

beliefs/attitudes for

substance).

• Lack of family roles.

• Lack of parents involvement

in child’s life

• Lack of mutual attachments

and nurturing/parents and

adults.

• Failure in school

performance.

• Risk taking behavior.

• Poor social coping skills.

• Affiliations with deviant peers

or peers around deviant

behavior.

• Perceptions of approval of

drug cueing behaviors in the

school and community

environments.

• Lack of any community

involvement.

• Age of onset of first use.

• Lack of impulse control.

• Existing mental issues.


Drug risk factors in the Community

Poor family support

Drug availability

Poverty

Crime


Protective Factors


• Strong bonds with

family.

• Experience of parental

monitoring with clear

rules of conduct and

consistent and

reasonable

consequences within

the family unit and

involvement of

parents in the lives of

children.

• Success in school

performance.

• Strong bonds with

prosocial institutions

such as school and

religious

organizations.

• Adoption of

conventional norms

about drug use,

abuse, dependency.

• Positive peer

affiliations.


Warning Signs of Teen and Young Adult

Substance Abuse

Physical

• Fatigue

• Repeated health complaints

• Red and glazed eyes

• A lasting cough

• Wearing of sunglasses at inappropriate times

• Continual wearing of long-sleeved garments particularly in

hot weather or reluctance to wear short-sleeved attire

when appropriate

• Appearance changes

• Sudden jitteriness or nervousness

• Sudden increase or decrease in appetite

• Smell of alcohol or marijuana on breath or body

Emotional

• Personality change

• Sudden mood changes unexplainable mood swings

• Irritability

• Unusual flare-ups or outbreaks of temper

• Irresponsible behavior

• Poor judgment

• Depression - a general lack of interest

• Difficulty in concentration, paying attention

• Overly tired or hyperactive

Behavioral

• Stealing

• Cheating

• Always needs money, or has excessive amounts

of money

• Lies about whereabouts

• Gets arrested or gets a ticket

• Sharing few if any of their personal problems

• Finding the following: cigarette rolling papers,

pipes, roach clips, small glass vials, plastic

baggies, remnants of drugs (seeds, etc.)

School

• Decreased interest in school

• Truancy

• Many absences

• Drop in grades

• New friends who are less interested in standard home and school activities

• Changes to less conventional styles in dress and music and Increased secretiveness

• Poor attitude toward sports or other extracurricular

activities

• Reduced memory and attention span

• Poorly concealed attempts to avoid attention and suspicion such as frequent trips to storage rooms, restroom, basement.

Family • Starting arguments

• Breaking rules

• Not coming home on time

• Withdrawing from the family.

• Disappearance of valuable items or money

• Secretive behavior regarding actions and possessions

• Not telling you where they are going

• Constant excuses for behavior

drug trends in youth 2013 - community unit school district 200

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