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Counselor Roundtable. STUDENT DRUG USE: Trends, Impact, Parent Training BRADFORD HEALTH SERVICES Janna Donovan, LPCA Clinical Counselor for Adolescents. BRADFORD AT THE INNERVIEW.

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counselor roundtable

Counselor Roundtable

STUDENT DRUG USE:

Trends, Impact, Parent Training

BRADFORD HEALTH SERVICES

Janna Donovan, LPCA

Clinical Counselor for Adolescents

bradford at the innerview
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
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 grades

June and July are highest months of first use for THC

December is the highest month of first use for alcohol

IV drug use has increased

Number of teens dying from drug use and overdose now exceeds number from car wrecks in US

addiction risk factors
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) & Depression

Stress (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

slide6

Other Risk Factors

Teens with these more likely to use:

Risk takers and low fear response

Failure to plan before they act

Like 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

27 of sophomores 40 of seniors used alcohol in the last month
27 % of Sophomores, 40% of Seniorsused Alcohol in the Last Month

18% of Sophomores22% of Seniors used Marijuana in the Last Month

age of onset correlation to dependency
Age of Onset correlation to Dependency

Overall, every year you can postpone the first drink, the risk for lifetime alcohol abuse decreases by 8%

NIAAA

alcohol and teens1
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
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)

slide14

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
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
Effects of Marijuana/Cannabis

Chronic useassociated with:

  • Lung, sinus irritation
  • Difficulty thinking, problem solving
  • Difficulty learning and REMEMBERING
  • Amotivation
  • Anxiety
  • Depression
  • Suicidal thoughts
  • Schizophrenia symptoms

Retrieved from:

http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/marijuana_fact_sheet_jw_10-5-10.pdf

Intoxication:

Red eyes

Increased appetite

Dry mouth

Heart racing

Distorted perceptions

Impaired coordination

Impaired judgment

Anxiety

Social withdrawal

effects of cannabis withdrawal
Effects of Cannabis Withdrawal

Retrieved from:

http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf

Withdrawal can include:

Irritability, anger or aggression

Nervousness or anxiety

Sleep difficulties (insomnia)

Decreased appetite or weight loss

Restlessness

Depressed mood

Stomach pain, shakiness or tremors, sweating, fever, chills, and headache

social acceptance of marijuana use
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 brain

Myth: “You cannot become addicted to marijuana”

“Lots of famous, high achieving people smoke weed” – but they did not smoke 15% THC hourly at age 15

4:20 – 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
Common Slang for Marijuana
  • 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

Pot

Grass

Weed

Kush

Chronic

Blunt (hollowed out cigar

with marijuana in it)

Fatty/Joint/Doobie

peer pressure on social media

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

slide22

HOW TO PROCEED

…If I think my child/student is drinking or using drugs

warning signs

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
My child is drinking/using drugs

Be willing to ask the extra question

Trust your gut

Watch their eye contact (they do not typically make eye contact)

Provide boundaries

The bigger the reaction, the closer you are to the truth

why do people use in the first place

Why Do People Use in The First Place?

To Feel Better

To lessen:

anxiety

worries

fears

depression

hopelessness

pain

To Feel Good

To have novel:

feelings

sensations

experiences

AND

to share them

slide26

Common Responses to Addiction

Rationalizing

Slow Progression

Relating

DENIAL

IGNORING

MINIMIZING

Avoiding

Hiding

Pretending

Normalizing

When denial is heavy and we ignore and minimize, this can lead to a steady and dangerous progression

slide27

Common Responses to Addiction

Exclusion

Attack (War on Drugs)

PAIN

ANGER

FEAR

Preach or Moralize

Make Laws

Judge

Blame Others

Criticize

Scare People

Punish People

When pain, anger and fear are the motivation, efforts to control others tend to evolve

slide28

Best Response to Addiction

CONNECTION

ACCEPTANCE

SEEING OTHERS AS THEY ARE

Inclusion

Listening

Modeling

Supporting

Sharing

Touching

Mentoring

Teaching

Non-Judgmental Discipline

Accepting

Feeling

When connection, acceptance and seeing others as they are

is the motivation, more influential (successful) efforts evolve.

rules and relationships
Rules and Relationships

Rules without Relationship Lead to Rebellion

Relationship without Rules Lead to Revolt

Relationship and Rules Lead to Respect

slide30

PREVENTION’S IMPACT

Teens with these less likely to use:

Academic effort/support

Good communication skills

Assertiveness, self-efficacy

  • (“If it’s to be, it’s up to me”)

Social problem-solving

Developed SELF-control

Reinforcement of anti-drug attitudes and personal commitments against use

NIH, 2003

slide31

FAMILY’S IMPACT

NIH, 2003: these helps prevent use, recover:

Stronger bond with nurturing parent(s)

Effective, involved parenting

Moderate, consistent, clear discipline

Structure in the home environment

Relationship with 1+ caring adult(s)

Caregivers who:

  • Don’t abuse alcohol, drugs
  • Don’t engage in criminal behavior
  • Get help with mental illness struggles
good news parents impact

GOOD NEWS: PARENTS’ IMPACT

Parents have the most significant influence on their kids’ use of drugs. It’s not enough to be neutral, you must take a negative stance.

slide33

PARENTS’ IMPACT

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.

slide34

FATHERS’ 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).

slide35

PARENTS’ 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.

slide36

Even if it’s Painful…Take the Risk

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
progression of care
Progression of Care

Step 1: Event or Crisis (DUI, caught by parent)

Step 2: Free Consult, drug screen, reco

Step 3: No need, IOP or Inpatient

Step 4: In-patient, Alabama (homework done)

Step 5: IOP, Louisville, 4:30-7:30, M-Th, 6 wks

Step 6: Mandatory Family Night every Monday

Step 7: Contract for abstinence, grades

Step 8: Continuing Care, Mon, Paid 2 Years

Step 9: Referrals to Counseling, Services

bradford at the innerview1
BRADFORD AT THE INNERVIEW

502-491-3799

Intensive Outpatient Program for adults, adolescents and families affected by substance abuse and dependence.

The Chrysler Building

4229 Bardstown Road, Suite 311

Louisville, KY 40218

concerned persons
CONCERNED PERSONS

Support group for those concerned about a loved one’s alcohol or drug use.

Open to the public at no cost

Every Tuesday Night 6:00 PM-8:00 PM

Bradford at the InnerView

The Chrysler Building

4229 Bardstown Road, Suite 311

Louisville, KY 40218

502-491-3799

resources
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
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 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 Adolescent Brain

The ESSENCE of Adolescence

  • ES – Emotional Spark
  • SE – Social Engagement
  • N – Novelty
  • CE – Creative Explorations
the adolescent brain1
The Adolescent Brain

The ESSENCE of Adolescence

Dopamine baseline is low (bored)

Dopamine comes in spikes

This 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
Where do most of the problems occur?

People who have no clear rules about use

People that send permissive messages about use

People that send mixed messages about use

People that tolerate use to the point of drunkenness or being high

prescription drugs
PRESCRIPTION DRUGS

Prescription drugs are the fastest growing drugs of choice in the U.S.

prescription drugs fastest growing drug of choice
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 drugs1
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
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
Other Drugs

DXM - Dextromethorphan

Robitussin DM, Coricidin, Nyquil DM, Mucinex DM, Over 100 OTC Meds Contained.

BATH SALTS –

Highly Addictive, Similar to a cross between Methamphetamine & LSD

SPICE – Synthetic Cannabinoids

“Herbal Incense”, 10% Used to avoid Drug Screens

opana
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
Bath Salts

Ivory Wave, Purple Wave, Vanilla Sky, Bliss

Similar to a cross between Meth & LSD

Easy to get

Highly Addictive

  • Snorted

Smoked

Injected

Ingested

harmful effects of bath salts
Harmful Effects of Bath Salts

Agitation

Psychotic episodes

Paranoia

Hallucinations

Suicidality

Increased Blood Pressure

Increased Pulse

Chest Pain

spice
Spice

K2, Spice Gold, & "herbal incense“, etc.

Effects similar to those of marijuana.

Synthetic cannabinoids: JWH-018

JWH-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
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
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

slide62

How we Address These:

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