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.

WHAT, WHO, WHEN ARE TEENS USING?

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

Positives to Later Use vs. Early Use

ALCOHOL AND TEENS

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)

MARIJUANA

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

CONTRIBUTING FACTORS

& PREVENTATIVE ACTIONS

•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

HOW TO PROCEED

…If I think my child/student is

drinking or using drugs

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

Question & Answer

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.

Back-up Slides

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

LIFETIME USE

0

10

20

30

40

50

60

70

ALC CIG ANY THC Rx HAL ECS

8TH10TH12TH

PRESCRIPTION DRUGS

Prescription drugs are the fastest

growing drugs of choice in the U.S.

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

Strawberry Diesel Kush

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: