counselor roundtable student drug use: trends, impact, parent training bradford health services...
TRANSCRIPT
Counselor Roundtable
STUDENT DRUG USE:Trends, Impact, Parent Training
BRADFORD HEALTH SERVICES
Janna Donovan, LPCAClinical Counselor for Adolescents
BRADFORD AT THE INNERVIEW
We treat the approximately 11% of the population who struggle with an addictive reaction to drugs
or alcohol with an:
INTENSIVE OUTPATIENT PROGRAM FOR ADULTS, ADOLESCENTS, AND FAMILIES AFFECTED BY SUBSTANCE ABUSE AND
DEPENDENCE.
Experimentation begins Early
Average age a child is exposed to alcohol & drugs
out side the home is 9.40% of new experimentation with cigarettes,
alcohol & drugs are between 6th & 9th gradesJune and July are highest months of first use for
THCDecember is the highest month of first use for
alcoholIV drug use has increased Number of teens dying from drug use and overdose
now exceeds number from car wrecks in US
Addiction Risk Factors
Two main questions: Does the adolescent smoke? Is there a family history of addiction?
Age of first use (younger, higher risk) Learning disabilities, behavioral problems, psychological
disorders (brains wired differently, don’t fit in, more at-risk)
Trauma (abuse, divorce) & DepressionStress (can lead to feelings of inadequacy & insecurity) Parent Acceptance (parents who use or sanction use
have kids who use) 75% of adolescents in treatment come from fatherless
homes Genetic history = 4x more likely to become addicts
Teens with these more likely to use:Risk takers and low fear responseFailure to plan before they actLike to experiment with how things
feel Higher tolerance Early school failure and peer rejection
at age 7 to 9
Ducci & Goldman, 2008, as cited in Kalat, 2013
Other Risk Factors
27 % of Sophomores, 40% of Seniors used Alcohol in the Last Month
0
5
10
15
20
25
30
35
40
ALC CIG ANY THC Rx HAL ECS
8TH10TH12TH
University of Michigan Monitoring the FutureAnnual High School SurveyN= 46,700Monitoring the future.org
18% of Sophomore
s22% of Seniors used Marijuana in the Last Month
Age of Onset correlation to Dependency
Before Age 15Before Age 15 Age 17Age 17 Age 21-22Age 21-22
Alcohol DependencyAlcohol Dependency 40.1%40.1% 24.5%24.5% 10%10%
Overall, every year you can postpone the first drink, the risk for lifetime alcohol abuse decreases by 8%
NIAAA
Alcohol and Teens
The drug most often abused by teenagers
Most frequent source – family, friends, adult purchasers – especially older siblings, and parties.
Parties, and in some cases Picnics are high risk for binge drinking and associated alcohol problems
Correlated with rape and assault
Community Tolerance
Parents and other adults have a high tolerance for underage drinking parties
Myth that underage drinking is inevitable and safer if it is in a controlled residential setting
Misconception that alcohol is harmless compared to other drugs
Misconception that alcohol use is a right of passage
(Remember, “Only” 27% of Sophomores and 40% of Seniors have had a drink this month)
Today’s Marijuana: 5-8 Times More Potent
Today’s drug leads to a higher high
Can prepare brain for opiates
“3 years from marijuana to opiates” like Loritab, Oxycontin
Opiate highs can open the door to heroin
Marijuana and Teens
Teens who frequently use marijuana are
almost 4x more likely to act violently or damage property
Teens who frequently use marijuana are
almost 5x more likely to steal than those who do not use
Parties, and in some cases Picnics are high risk for binge drinking and associated alcohol problems
Effects of Marijuana/Cannabis
Intoxication:Red eyesIncreased appetiteDry mouthHeart racingDistorted perceptions Impaired coordinationImpaired judgmentAnxietySocial withdrawal
Retrieved from: http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/marijuana_fact_sheet_jw_10-5-10.pdf
Chronic use associated with:
• Lung, sinus irritation • Difficulty thinking,
problem solving• Difficulty learning and
REMEMBERING• Amotivation• Anxiety • Depression• Suicidal thoughts • Schizophrenia
symptoms
Effects of Cannabis Withdrawal
Withdrawal can include:Irritability, anger or aggressionNervousness or anxiety Sleep difficulties (insomnia) Decreased appetite or weight lossRestlessnessDepressed moodStomach pain, shakiness or tremors,
sweating, fever, chills, and headache
Retrieved from: http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-
5.pdf
Social Acceptance of Marijuana Use
“It’s natural, good for you…Not as bad as cigarettes or alcohol”
“It’s legal and should be” – Not for a developing brainMyth: “You cannot become addicted to marijuana”“Lots of famous, high achieving people smoke weed” –
but they did not smoke 15% THC hourly at age 154:20 – Universal Smoke Time (“It’s 4:19, got a minute”)Popular Figures in Marijuana Culture: Wiz Khalifa or
Wiz K, Mac Miller, Snoop Lyon (formerly Snoop Dogg), Lil Wayne
Common Slang for Marijuana
• Pot • Grass• Weed• Kush• Chronic• Blunt (hollowed out cigar with marijuana in it)• Fatty/Joint/Doobie
• Dro, Hydro (hydroponically grown, synonym for “good”)
• Reg (not very good, 2% THC)
• Indo, Kaya• Mary Jane• Sess• Tree, Greenery• Hotbox (fill car with
smoke)• “Buttered”
Clinical Names:• Cannabis• THC
•75% teens say that seeing pictures of others using drugs or alcohol encourages them to use drugs or alcohol•4x more likely to use marijuana•3x more likely to use alcohol•3x more likely to use nicotine•Legalization & Favorable Attitude•Many are prepared to fight, debate, & argue, for their use of it; it makes things “all good”. In their mind marijuana use is totally ok.
Peer Pressure on Social Media
Warning Signs
Physical Problems: fatigue, repeated health complaints, red hazy eyes, lasting cough.
Emotional: personality change, sudden mood changes, irritability, irresponsible behavior, low self esteem
Family: starting arguments, breaking rules, withdrawal
School: decreased interest, negative attitude, drop in grades, absences, truancy, discipline problems
Social Problems: new friends who are less interested in standard home and school activities, problems with the law, less conventional styles in dress and music
My child is drinking/using drugs
Be willing to ask the extra questionTrust your gutWatch their eye contact (they do not
typically make eye contact)Provide boundariesThe bigger the reaction, the closer
you are to the truth
Why Do People Use in The First Place?
To Feel Good
To have novel:
feelingssensations
experiencesAND
to share them
To Feel Better
To lessen:anxietyworries
fearsdepression
hopelessnesspain
DENIALDENIALIGNORINGIGNORING
MINIMIZINGMINIMIZING
Relating
Normalizing
Rationalizing
Hiding
Slow Progression
Avoiding
Pretending
When denial is heavy and we When denial is heavy and we ignore and minimize, this can ignore and minimize, this can
lead to a steady and lead to a steady and dangerous progressiondangerous progression
Common Responses to Addiction
PAINPAINANGERANGERFEARFEAR
Judge
Criticize
Punish PeopleScare People
Preach or MoralizeAttack (War on Drugs)
Make Laws
Blame Others
When pain, anger and fear are the When pain, anger and fear are the motivation, efforts to control others motivation, efforts to control others
tend to evolvetend to evolve
Exclusion
Common Responses to Addiction
CONNECTIONCONNECTIONACCEPTANCEACCEPTANCE
SEEING OTHERS AS THEY ARESEEING OTHERS AS THEY ARE
Listening
Teaching
Feeling
Supporting
Modeling
Sharing
Mentoring
When connection, acceptance and seeing others as they are is the motivation, more influential (successful) efforts evolve.
Accepting
Inclusion
Non-Judgmental Discipline
Touching
Best Response to Addiction
Rules and Relationships
Rules without Relationship Lead to Rebellion
Relationship without Rules Lead to Revolt
Relationship and Rules Lead to Respect
Teens with these less likely to use:Academic effort/supportGood communication skills Assertiveness, self-efficacy
(“If it’s to be, it’s up to me”)Social problem-solvingDeveloped SELF-controlReinforcement of anti-drug attitudes
and personal commitments against use
NIH, 2003
PREVENTION’S IMPACT
NIH, 2003: these helps prevent use, recover:Stronger bond with nurturing parent(s)Effective, involved parentingModerate, consistent, clear disciplineStructure in the home environmentRelationship with 1+ caring adult(s)Caregivers who:
Don’t abuse alcohol, drugs Don’t engage in criminal behavior Get help with mental illness struggles
FAMILY’S IMPACT
GOOD NEWS: PARENTS’ IMPACTParents have the most significant influence on their kids’ use of
drugs. It’s not enough to be neutral, you
must take a negative stance.
2011 Study, Columbia University National Center on Addiction and Substance Abuse:
Parents who expect their children to drink and use drugs will have children who drink and use drugs.
Parents who send their 12- to 17-year-olds a message that it’s okay to smoke, drink, get drunk and use illegal drugs like marijuana become enablers.
PARENTS’ IMPACT
Father’s impact on alcohol use:Young people who believe their
father tacitly approves of their drinking are 2.5x more likely to get drunk in a typical month than teens who believe their father disapproves of their drinking
CASA 24 (Results of parent restriction of use on outcome).
FATHERS’ IMPACT
Parents who are unsure about use of marijuana:
Teens almost 2x more likely to use marijuana
…compared to teens whose parents say this decision is a major concern.
PARENTS’ IMPACT
When we are in the midst of the pain we must do what it takes and risk much to save lives.
•Get Professional Help
•T-6 RESPONSE TIME• 80% VS 20%• DENIAL INCREASES• PAIN AND CONSEQUENCES
DECREASE
Even if it’s Painful…Take the Risk
Progression of Care
Step 1: Event or Crisis (DUI, caught by parent)Step 2: Free Consult, drug screen, recoStep 3: No need, IOP or InpatientStep 4: In-patient, Alabama (homework done)Step 5: IOP, Louisville, 4:30-7:30, M-Th, 6 wksStep 6: Mandatory Family Night every MondayStep 7: Contract for abstinence, gradesStep 8: Continuing Care, Mon, Paid 2 YearsStep 9: Referrals to Counseling, Services
BRADFORD AT THE INNERVIEW
502-491-3799Intensive Outpatient Program for adults, adolescents and
families affected by substance abuse and dependence.
The Chrysler Building4229 Bardstown Road, Suite 311
Louisville, KY 40218
CONCERNED PERSONS
Support group for those concerned about a loved one’s alcohol or drug use.
Open to the public at no costEvery Tuesday Night 6:00 PM-8:00 PM
Bradford at the InnerViewThe Chrysler Building
4229 Bardstown Road, Suite 311Louisville, KY 40218
502-491-3799
RESOURCES
FAMILIES ANONYMOUS 800-736-9805 Thursdays, 7:30 PM, St. Michael’s Catholic
Church, 3705 Stone Lake Drive, Jeffersontown
ALANON 502-458-1234 www.kyal-anon.org Various meetings around town every day of
the week
REFERENCES
Califano, Joseph. 2011 Casa Survey. CASA – The National Center on Addiction and Substance Abuse at Columbia University.
Ducci & Goldman, 2008 as cited in Kalat, 2013) National Institutes of Health. (2003). Preventing Drug Use
among Children and Adolescents. NIH Publication No. 04-4212(A). U.S. Department of Health and Human Services.
NIAAA (National Institute of Alcohol Abuse and Alcoholism). 2012.
Kalat, J. 2013. Biological Psychology 11th Ed. Belmont, CA: Wadsworth, Cengage Learning. 75-76.
Epidemic: Responding to America’s Prescription Drug Abuse Crises. www.whitehouse.gov .
SAMSHA. (2008, 2003, 2002). National Surveys on Drug Use & Health.
Myths about Adolescents
Myths about teens An age of raging hormones Immaturity - Just hold on and
survive They need total independence –
let them go
The Adolescent Brain
The ESSENCE of Adolescence ES – Emotional Spark SE – Social Engagement N – Novelty CE – Creative Explorations
The Adolescent Brain
The ESSENCE of AdolescenceDopamine baseline is low (bored)Dopamine comes in spikesThis results in:
Impulsiveness- Act first, Think later Hyper-rationality – Over emphasize
the PROs of an experience Susceptibility to addictions –
behaviors and substances that trigger dopamine releases
Where do most of the problems occur?
People who have no clear rules about usePeople that send permissive messages
about usePeople that send mixed messages about
usePeople that tolerate use to the point of
drunkenness or being high
Prescription Drugs-Fastest Growing Drug of Choice
Include narcotics or opioids, depressants – usually benzodiazepines, and stimulants Valium, Xanax, Klonopin, Ritalin, Concerta,
Adderall, OxyContin, Opana Percocet, Lortab, Fiorinol, Fioricet, Vicodin, Hydrocodone,, Demerol, Dilaudid, Methadone, Suboxone, Codeine, etc.
Overdose – Kentucky is #6 in the Country. Someone in Kentucky overdoses every 3 days. Nationwide in 2007, 100 people per day dying by overdose.
Prescription Drugs
Viewed as “safe” by teenagers. 2 in 5 teens agree that Rx medicines, even if they
are not prescribed by a doctor, are “much safer” to use than illegal drugs.
3 out of 10 teens believe prescription pain relievers – even if not prescribed by a doctor – are not addictive.
More than half of teens don’t agree strongly that using cough medicines to get high is risky.
Where Do They Get Them?
70% percent got them free from a relative or friend.
Some of these are “Accidental Dealers” 19.1 percent got them from just one
doctor. 3.9 percent got them from a stranger. 0.1 percent bought them on the
Internet.
Other Drugs
DXM - DextromethorphanRobitussin DM, Coricidin, Nyquil DM,
Mucinex DM, Over 100 OTC Meds Contained.
BATH SALTS – Highly Addictive, Similar to a cross
between Methamphetamine & LSDSPICE – Synthetic Cannabinoids“Herbal Incense”, 10% Used to avoid Drug
Screens
Opana
Opana is the brand name for oxymorphone, a potent narcotic used to treat severe pain.
2011 $40/pill (40 mg)2012 $145/pill (40 mg)
Decreasing availability
Other Opioids
Bath Salts
Ivory Wave, Purple Wave, Vanilla Sky, BlissSimilar to a cross between Meth & LSDEasy to getHighly Addictive
Snorted
Smoked Injected Ingested
Harmful Effects of Bath Salts
AgitationPsychotic episodesParanoiaHallucinationsSuicidalityIncreased Blood PressureIncreased PulseChest Pain
Spice
K2, Spice Gold, & "herbal incense“, etc.Effects similar to those of marijuana.Synthetic cannabinoids: JWH-018JWH-018 inventor John W. Huffman, PhD,
puts it bluntly. "It is like Russian roulette to use these drugs. We don't know a darn thing about them for real,"
Signs & Symptoms of Spice
Denial when concerns are expressed regarding drinking or drug use
Sneaking alcohol and drugs Unusual sleeping patterns Lighters in the laundry/burns on hands/clothes . Change in Personality Social Withdrawal Ongoing Use Going to Great Lengths to Obtain Money & Prescriptions Items Missing from the Home – theirs and yours Change in Appearance Desensitized Emotions Increased Inactivity Blackouts and Forgetfulness Defensiveness
Marijuana Usage Trends
Rates of marijuana use among 8th, 10th, and 12th graders are higher than rates for any other illicit drug
NSDUH also shows that from 2008 to 2009, the rate of current illicit drug use among young adults aged 18 to 25 climbed 8 percent, from 19.6% to 21.2%, driven largely by a 10 percent rise in marijuana use
In 2009, there were 2.4 million new past‐year users of marijuana. The average age of initiation dropped from 17.8 in 2008 to 17.0 in 2009
Retrieved from: http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/marijuana_fact_sheet_jw_10-5-10.pdf
Deborah Yurgelon-Todd 2000. Deborah Yurgelon-Todd 2000.
Adults use the Cerebral Cortex, Adolescents use the Amygdala
Authoritative Parenting (Baumrind, 1967) Moderate, consistent clear discipline Not harsh, inconsistent, vague punishment
Mastery Orientation, Internal Locus of Control (Rotter, 1975) Goal is to improve, not to prove something Self-efficacy
Motivational Enhancement (Miller & Rollnick, 2013) Identity Development, What do you Want? Future Planning Skills, How are you going to Get it? Logic, How is it Going? SELF-Control, not Other-Control
Identity Development vs Role Confusion (Erickson, 1950)Family Therapy (SAMHSA, 2005)
Power Shift to Parents, Needs/Healing Improved Communication and Environment for Coping
How we Address These: