methamphetamine use among adolescents & young adults rachel gonzales, pre-doctoral fellow ucla...
TRANSCRIPT
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Methamphetamine Use Among Adolescents & Young Adults
Rachel Gonzales, Pre-Doctoral FellowUCLA Integrated Substance Abuse Programs
NPI - Semel Institute for Neuroscience
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Presentation Objectives
• Examine MA use trends among youth specific to the West
• Highlight unique gender differences
• Examine plausible risk factors associated with use
• Future directions for research
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What do we know about the problem?
• Most widely used sources:
–National Survey on Drug Use and Health (NSDUH)
–Monitoring the Future Study (MTF)
–Youth Risk Behavior Survey (YRBS)
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Past Month Drug Use Rates
05
101520253035404550
Alcohol Cigarettes Any IllicitDrug
Marijuana Meth Inhalants
Perc
ent
of R
esp
ondents
8th grade10th grade12th grade
Source: NIDA, Monitoring the Future, Nat’l Results on Adolescent Drug Use, 2004.
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Measurement Challenges
• While beneficial, national surveys tend to underrepresent youth at risk for drug use:
Dropouts and delinquent youthHomeless and runawaysFoster care youth
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Other Sources
• Adolescent Treatment Programs
• Juvenile Justice System
• Emergency Room Data
– Reveal that MA use is a problem by young people.
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12%
2%
59%
2%25%
AlcoholMethamphetamineCocaineMarijuanaOtherHeroin
14%
36%
11%
26%
4%
9%
Primary Drug Problem Among Adolescent & Young Adult Treatment Admissions: 2004
17 years and under 18-25 years old
Source: LA County ADPA, July 2003-April 2004
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Juvenile Justice Data
• Since 2000, a significant proportion of juveniles aged 12 to 18 in CA have tested positive for dangerous drugs (including MA, PCP, and LSD) upon arrest.
• In the second half of 2002, 22% of male arrestees aged 18 to 21 in Los Angeles County tested positive for MA.
Source: Arrestee Drug Abuse Monitoring (ADAM) System
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Extent of Adolescent Drug Use Mentioned in DAWN ED System, LA-Long Beach, 2002
12-17 year olds* 18-25 year olds*
Inhalants 72.5% 10.0%
Marijuana 12% 11.8%
Meth 8.1% 32.6%
Alcohol 4.7% 17.6%
PCP 4.4% 30.4%
Cocaine 1.9% 15.1%
Heroin 0% 10.0%
*Percent of all mentions for each substance
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Gender Differences
MA use has become increasingly problematic among adolescent
and young adult females
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Adolescent (<18) Treatment Admissions by Gender July 2003-April 2004
30.9
2.3
41.3
21.7
3.8
0
10
20
30
40
50
60
70
Perc
ent
of
Fem
ale
Resp
ondents
Alcohol Cocaine Marijuana Meth Other
22.1
2.2
66.4
7.71.6
0
10
20
30
40
50
60
70
Perc
ent
of M
ale
Res
pond
ents
FEMALES
MALES
Source: LA county ADP
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Treatment Studies
• Research on drug treatment outcome studies among adolescents is limited.
• Very few published studies specific to MA and youth.
• Recent articles on MA and youth in Taiwan growing.
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Matrix Treatment Study N=305 adolescents 13 to 18 years old
14.3
63.6
81.3
45.5
30.8
12.18.8
12.1
0
10
20
30
40
50
60
70
80
90
Meth THC Alcohol Poly
Males
Females
Source: Rawson et al., 2005N=90 N=215
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Matrix Treatment Study found:
• Older teens (ages 17-18) more likely to use than younger youth.
• Greater psychological & legal dysfunction than non-MA users.
• More alcohol and drug use during treatment than non-MA users.
• Greater drop out rates than non-MA users.
• No injectors (14% smoke, 12% smoke/snort, 4% snort)
Source: Rawson et al., 2005
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Phoenix House Treatment Found:
• MA accounted for 42.3% of teen treatment admissions in 2005.
• 16% increase in MA admissions between 2002 and 2005 (172 to 210).
• More youth females are presenting for treatment with MA problem than males.
Year Boys Girls
2002 25% 43%
2003 23% 51%
2004 27% 53%
Source: CBS2 News Story, 2006
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2005 Tarzana Treatment Centers Admissions by Drug of Choice, Gender, and Age
0%
10%
20%
30%
40%
50%
60%
70%
Alcoho
l
Cocain
e/Crac
k
Heroin
Mari
juan
a
Meth
amph
etamin
esOthe
r
Primary Drug
Per
cent
Adm
issi
ons
Female age 12-17 (n=293)
Male age 12-17 (n=546)
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MA Admission Trends: LA County 2000-05
93%
7%
93%
7%
88%
12%
79%
21%
74%
26%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
00 01 01 02 02 03 03 04 04 05
No Meth Use
Meth Use
Source: LA County ADP, 2006
N=5,527
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Gender Differences: LA County
67%
33%
90%
10%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Female (N=1,637) Male (N=3,890)
No Meth Use
Meth Use
Source: LA County ADP, 2006
N=5,527
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MA Use by Ethnicity: LA County
26%
2%
23%
10%
17%16%
0%
5%
10%
15%
20%
25%
30%
Whi
te (n
=107
8)
Black
(n=5
63)
Asian
(n=1
95)
Nativ
eAm
(n=2
9)
Latin
o (n=3
380)
Other
(n=2
75)
Meth Use
Source: LA County ADP, 2006
N=943
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3 year CASA study on adolescents 8 to 22 years old found:
• Females became dependent upon MA faster.
• Females suffered more adverse effects sooner than males.
Source: National Center on Addiction and Substance Abuse at Columbia University, 2003
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Risk Factors for MA Use
Largely understudied area
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• Clinicians indicate low self-esteem, depressive symptoms, & eating disorder make girls especially vulnerable to use and continued misuse of MA
• Deviant behavioral problems in males – ASPD, ADHD make males vulnerable to MA use (Yen & Chung, 2006)
Anecdotal Reports
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MA Abuse
Low SelfEsteem
Sexual Abuse
Depression
Weight Concerns
Tension
Physical Abuse
CASA Study: Female Risk Factors
Source: National Center on Addiction and Substance Abuse at Columbia University, 2003
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Risk Factors among adolescents in Matrix Treatment
40
65
18
48
0
10
20
30
40
50
60
%
Depression Suicidality
Males Females
(Matrix Sample); p<.001
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Other Factors to Consider
• Readily available to youth
• Simple, home-made manufacturing
• Cheap
• Easy access to primary chemicals at local merchants
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Adolescent Story
• One teen resident at Phoenix House who shared his story of MA addiction said:
“When I first tried crystal meth, I automatically fell in love. I had finally found the drug that I was looking for. The stuff was pretty cheap and it was very easy for me to get.”
Source: CBS2 News Story, 2006
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Clinical Characteristics
• Cognitive dysfunction
• Rapid mood swings
• Hyperactivity & Impulsivity
• Lesion-marked skin
• Depression
• Paranoia & Psychoses (auditory hallucinations)
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Risky Behaviors
• Agitation & Aggressive Behaviors
• Partner Violence
• Multiple sex partners & unprotected sex
• Suicide
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Relapse Antecedents for MA Use
• Social pressure & Social In-adaptation
• Lack of emotional stability
• Low educational level
• Psychiatric Disorder Status
Yen & Chang, 2005 (Taiwanese sample, N=60)
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Summary: Key Points
• Researchers need to be aware of other critical data sources to understand the scope of MA use among youth
• It remains unclear which risk factors are occurring for MA use and between the sexes
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Future Research
• More studies to look at specific risk factors for MA use & relapse
• Other study populations should include:– Homeless/runaway youth– Juvenile justice system youth– Child welfare system (foster care) youth
• Issues of HIV Risk Behaviors and Violence
• Developmental processes
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Acknowledgments
Richard Rawson
Beth Rutkowski
CA Department Alcohol & Drugs
LA County Department Alcohol & Drugs
Jim Peck
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For copies of slides or a reference list, please contact me at:
(310) 445-0874 ext. 346
Questions?