2 substance abuse trends & classroom implications

2

Substance Abuse Trends

& Classroom

Implications

Learning Objectives

This session will help the participant:

•Increase awareness about the impact of Increase awareness about the impact of various drugs of use/abuse in WVvarious drugs of use/abuse in WV•Increase knowledge of perinatal substance Increase knowledge of perinatal substance exposure and effects on children and exposure and effects on children and classroom implicationsclassroom implications

ALCOHOLSYMPTOMS AND EFFECTS

• Alcohol depresses the central nervous system, lowers inhibitions, and impairs judgment and coordination.

• Adults who had first use of alcohol before age 15 are five times as likely to be dependent on alcohol as adults who first used at age 21 or older.

• Impaired brain development, learning, and memory

National Institute on Alcohol Abuse and Alcoholism 2006

ALCOHOL AND SOCIETAL ATTITUDES

• Alcohol is often a traditional part of culture

• Alcohol is used to celebrate, relax, and socialize

• Stigma attached to receiving treatment.

• Strong legislative lobby

• Availability and Accessibility

• Not illegal for adults

• Change of societal norms past 30 years

Prescription CNS Depressants

• Slow brain activity Slow brain activity

• Prescribed for anxiety, tension, panic Prescribed for anxiety, tension, panic attacks, acute stress reactions, sleep attacks, acute stress reactions, sleep disorders, and can be used for disorders, and can be used for anesthesia (high doses)anesthesia (high doses)

SAMHSA, 2005

What do they look like?

Klonopin

Valium

ProSom

Ativan

Halcion

Street drugs.org

Street drugs.org

Prescription Stimulants

• Increase alertness and energyIncrease alertness and energy

• Prescribed for attention-deficit Prescribed for attention-deficit hyperactivity disorderhyperactivity disorder

• NarcolepsyNarcolepsy

• ObesityObesity

• Some forms of DepressionSome forms of Depression

SAMSHA., 2005

Dexedrine

What do they look like?

Ritalin

Street drugs.org

2010 TOP ABUSED PRESCRIPTION DRUGS REPORTED IN WV

Drug Name Brand Names Drug Class Percentage*Oxycodone Oxycontin, Tylox, Percodan,

Percocet, CombunoxOpioid 39%

Hydrocodone Loret, Lortab, Norco, Vicoprofen, Vicodin

Opioid 28%

Alprazolam Xanax Benzodiazepine 10%Morphine MS Contin, Oramorph, MS-IR,

Kadian, Aviniza, Roxanol, Duramorph

Opioid 4%

Hydromorphone Dilaudid Opioid 2%

*Percentage of the total drugs abused in 2010

WV Behavioral Health Profile, 2011

*2011 is Preliminary

WV Behavioral Health Profile, 2011

Synthetics

Bath Salts and K2

Bath Salts

DEA,

Huffington Post.com

● Crystalized powder that can be white to brown, with shades in between and even speckled.

● Typically an attractive package about the size of a tea bag.

● The label says “Not for Human Consumption”.

● Manufactured mainly in China or India.

What does it look like?

www.erowid.org

• Paranoia • Hallucinations• Anger• Intense cravings to

re-dose• Profuse Sweating• Hyper alertness• Violence

• Elevated Blood pressure

• Jaw clenching/tooth grinding (Bruxism)

• Delusions• Mood swings

Common Symptoms

National Institute on Drug Abuse, 2012

What does K2 look like?

DEA, 2012

Slang Names for K2

SpiceK2BlazeRed X DawnBilssZoh

Black Mamba Bombay Blue

Fake Weed GenieSpice

DEA, 2012

Common Symptoms• Vomiting• Intense Hallucinations • Rapid Heart Beat• Increased Blood Pressure• Seizures• Loss of Consciousness • Paranoid Behavior• Anxiety• Agitation

Spicester.com

HEROIN

• Heroin abuse is associated with serious health conditions, including fatal overdose, spontaneous abortion, collapsed veins, and, particularly in users who inject the drug, infectious diseases, including HIV/AIDS and hepatitis.

SAMHSA, 2005

HEROIN

Erowid.org

THE FALLOUT

• Societal Implications?

• Classroom Implications?

DRUG ABUSE DURING PREGNANCY

• Illegal substance exposure in childbearing women is approximately 11% nationwide

• Incidence of prenatal substance abuse ranges from 375,000 – 625,000 infants exposed annually

• Women tend to become addicted in less time than men and develop larger habits

WV PERINATAL EXPOSURE TO SUBSTANCES

NEONATAL WITHDRAWAL SYNDROME

CNS› Disturbed sleep patterns› Hyperactivity› Hyperreflexia› Tremors› Increased muscle tone› Myoclonic jerks› Shrill cry› Convulsions

Metabolic› Fever› Hypoglycemia› Mottling› Sweating› Yawning› Vasomotor instability

BABIES EXPERIENCING NAS

ALCOHOL RELATED BIRTH DEFECTS TERMINOLOGY

• Fetal Alcohol Spectrum Disorders is an umbrella term used to describe the range of effects that can occur in an individual whose mother drank alcohol during pregnancy

• Fetal Alcohol Syndrome is a specific diagnosis with specific criteria, a disorder of permanent birth defects that occurs in the offspring of women who drink alcohol during pregnancy Fetal Alcohol Effects is an outdated term used to describe individuals who had problems associated with prenatal alcohol exposure, but did not have enough of the outward signs to be eligible for the medical diagnosis of FAS

• Alcohol Related Neurodevelopmental Disorder has been widely used to describe the specific damage that prenatal alcohol exposure can have on the central nervous system

DEVELOPMENTAL DELAYS, LEARNING DISABILITIES & BEHAVIORAL PROBLEMS• Mental Retardation

• Attention deficits

• Hyperactivity

• Poor Impulse Control

• Problems in Social Perception

• Speech and Language Delays or Deficits

• Poor Capacity for Abstract Thinking

• Specific Deficits in Math Skills

• Problems in Memory, Attention, or Judgment

• Problems Changing Behavior or Response in Different Situations

• Problems Anticipating Consequences

• Problems with Cause and Effect

EFFECTS OF PRESCRIPTION DRUG ABUSE

• Women who abuse opiates during pregnancy greatly increase their risk of serious pregnancy complications.

• poor fetal growth

• premature rupture of the membranes (the bag of waters that holds the fetus breaks too soon)

• premature and still births

DRUG EXPOSED BABIES...

50% of all babies of opiate users are born with low birth weight

Many of these babies are premature and often suffer from serious health problems during the newborn period, including breathing problems

They also are at increased risk of lifelong disabilities

Babies exposed to heroin before birth also face an

increased risk of sudden infant death syndrome (SIDS)

TREATMENT FOR NAS• Minimize external stimuli (light and sound) in a dark, quiet

environment, careful swaddling, adopting comforting and positioning techniques (swaying, rocking), and a high caloric diet

• Buprenorphine is increasingly used for treatment also, because of the potential to reduce the severity of Neonatal Abstinence Syndrome Scores

• Most babies of opiate abusers show withdrawal symptoms during the 3 days after birth, including fever, sneezing, trembling, irritability, diarrhea, vomiting, continual crying and seizures usually subsiding by 1 week of age

• http://www.adoptmed.org/topics/prenatal-opiate-exposure.html Dorothy Minch, MSW

“SYSTEM FALL OUT”

• Mental health issues – 90%

• Disrupted school experience – 60%

• Trouble with the law – 60%

• Confinement – 50%

• Inappropriate sexual behavior – 49%

• Alcohol and drug problems – 35%• Streissguth, Understanding the Occurrence of Secondary Disabilities August

CRIMINAL JUSTICE SYSTEM

• VICTIMIZATION

• Known predators a problem

• Unreliable witness

• Social Functioning Lower

• Gang Activity “Patsy” or “fall guy”

• Brain damage hinders the inability to deal with usual life demands

• Unable to resist sexual advances72% of adolescents & adults with FAS/FAE have been physically or sexually abused.

Streissguth

PLANNING FOR CLASSROOM SUCCESS

• Student Prevention Education

• Understanding the “Cause” of the Problem

• Learning about Current Initiatives and Resources

• http://www.ocali.org/topic/fasd/

SIMPLE STRATEGIES THAT WORK!

• Concrete

• Consistency

• Repetition

• Routine

• Simplicity

• Specific

• Structure

• Supervision 8 Magic Keys Deb Everson & Jan Lutke 1997

EDUCATIONAL & ENVIRONMENTAL STRATEGIES

• Organizing the Physical Space

• Reinforcing Routines and Assisting with Transitions

• Making Learning Accommodations

• Assisting Social Development and Improving Behavior

WHAT PROFESSIONALS CAN DO TODAY?

• Modify the environment.

• Modify expectations.

• Think younger or think “stage not age.”

• Think perpetual innocence.

• Make the world make sense.

• Rethink, reteach, respect.

WV INITIATIVES

• Regional Prevention Trainings

• Physician Guidance Documents

• Maternal Addiction and Recovery Center (MARC)-Dr. Chaffin

• WV Moms and Babies Recovery Project

• Lilly’s Place

QUESTIONS?

Kathy Paxton, Director

WV Division on Alcoholism and Drug Abuse

Kathy.L.Paxton@wv.gov