drug trends in youth 2013 - community unit school district 200
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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
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.
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.
Physiological Effects
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.
Physiological Effects
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
Monitoring the Future Survey
• 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.
Monitoring the Future Survey
• 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%.
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
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
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
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
Trends & Treatments for Adolescents
• 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.
Trends & Treatments for Adolescents
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.
Trends & Treatments for Adolescents
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.
Trends & Treatments for Adolescents
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.
Trends & Treatments for Adolescents
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.
Trends & Treatments for Adolescents
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
Trends & Treatments for Adolescents
• 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.
Trends & Treatments for Adolescents
• 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.
Trends & Treatments for Adolescents
• 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.
Trends & Treatments for Adolescents
Drug risk factors in the Community
Poor family support
Drug availability
Poverty
Crime
Trends & Treatments for Adolescents
• 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.
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.