Aiken Center for Alcohol and Other Drug Services

1. Aiken Center for Alcohol and Other Drug Services Jennifer H. Burke, MS, LPC, CACII Director of Treatment Services

3. UPPERS • Energy drinks, caffeine, nicotine, cocaine, crack, amphetamines, meth, MDMA, diet pills, khat, betal nuts, ephedra , yohimbe • increase the chemical and electrical activity in the brain and central and peripheral nervous systems

4. EFFECTS • Boost energy • Raise heart rate, BP, core body temperature • Reduce appetite and thirst • Increase talkativeness, restlessness, irritability, insomnia • Possible paranoia, aggression, psychosis, & violence • Crank/crack bugs (formication), dental erosion, seizure, gastrointestinal problems • Crack/meth dancing (choreoathetoid movements) (long-term or high dosage use)

5. Warning Signs • Calluses on thumbs • Burns to hands or faces or bodies • Increased irritability, anxiety, insomnia, panic attacks • Increased concentration, energy, euphoria, feelings of grandiosity • Rapid weight loss • Sores on face and body that person picks at frequently • Sudden crashes, anhedonia, and anergia • Twitching, itching

6. DOWNERS • Used for sedative, hypnotic, or anxiolytic qualities • Large doses can have a paradoxical effect • Alcohol, benzodiazepines, barbiturates, opioids, sleep meds, muscle relaxers, antihistamines, GHB, DXM

7. WARNING SIGNS • GERD • Extreme sensitivity to sensory input (hangovers) • Brownouts/ Blackouts • Dehydration • Vomiting blood • Pinpoint pupils • Constipation/diarrhea cycle • Slurred or slowed speech, • Decreased coordination • “Nodding”

8. MORE WARNING SIGNS • Nausea • Itching • Needle marks in odd places/Constant long sleeves • Skin abscesses • Frequent use of laxatives • Flu-like symptoms during withdrawal • Occasionally, hallucinations • NOTE: with increasing tolerance, the warning signs may not be obvious, as the body is trying to reach stasis

9. ALL AROUNDERS • Marijuana, Cannabinoids, PCP Hallucinogens/psychedelics, mushrooms • Salvia, datura, jimson weed, mace, nutmeg • Alter perceptions of the world • Cough and cold meds w/ DXM, like Robitusson or Triple Cs

10. WARNING SIGNS • Red eyes, frequent use of eye drops • Dilated pupils w/ slowed pupil response or tracking • Pot laugh • Amotivational syndrome • Flashbacks • Slowed response time, thinking is slowed • Impaired short term memory • Frequent respiratory illnesses because of impaired immune system.

11. MORE WARNING SIGNS • Recent change in behavior • Avoiding adults/family even more than teens usually do • Change in social sets • Increased tardies and absences • Decrease in grades • Fogginess/sleepiness in school • Lethargy

12. MORE INFO • Some adolescents may be using alcohol or drugs for a variety of reasons. • There is a huge overlap between mental health and AOD problems • There may be mental health symptoms they are trying to self-medicate. • Certain AOD symptoms mimic certain mental health symptoms

13. Even More Info • Certain AOD symptoms mimic certain mental health symptoms. • Some students may be using to cope with traumatic events in their lives. • Sometimes symptoms like sleeping in class, lethargy, depression, can be attributed not to the student’s AOD use, but their parents’ use.

15. My Family? Victims (Chemically Dependent) YourFamily? Family Hero (Caretaker of Family) Scapegoat (Problem Child) Mascot (Family Clown) Lost Child (Forgotten child) Chief Enabler (Protector of Family)

16. Victim • Outward Manifestations Hostility Manipulation Self pity Aggression Blaming Charming • Inside Feelings Shame Guilt Fear Pain/hurt

17. Chief Enabler (Protector of Family) • Outward Manifestations Self-righteousness Super-responsibility Sarcasm Passive (really passive-aggressive) Physical illness Martyrdom • Inside Feelings Anger Hurt Guilt Low self-esteem Frustration because everyone won’t just do what they tell them to

18. Family Hero • Outward Manifestations Being the “good kid” High achieving Rule following Approval seeking Responsibility • Inside Feelings Guilt Hurt Inadequacy

19. Scapegoat • Outward Manifestations Hostility Defiance Rule-breaking Getting in trouble • Inside Feelings Rejection Hurt Guilt Jealousy Anger

20. Lost Child • Outward Manifestations Shyness; timidity Rich fantasy life Solitary pursuits Mediocrity Attachment to thingsnot people • Inside Feelings Rejection Hurt Anxiety

21. Mascot • Outward Manifestations Immaturity Being Cute Hyperactive Distracting others • Inside Feelings Fear Anxiety Insecurity

22. Lost Child • Outward Manifestations Shyness; timidity Rich fantasy life Solitary pursuits Mediocrity Attachment to thingsnot people • Inside Feelings Rejection Hurt Anxiety

23. Factors in Drug Abuse Risk Factors • Chaotic home environments • Ineffective parenting • Lack of parent-child attachments • Inappropriately shy or aggressive behavior in the classroom • Failure in school performance • Poor social coping skills • Affiliations with peers displaying deviant behaviors • Perceptions of approval of drug-using behaviors in family, work, school, peer, & community environments

24. Characteristics of Adult Children of Trauma and Addiction • 1. Learned Helplessness • 2. Depression • 3. Anxiety • 4. Emotional Constriction • 5. Distorted Reasoning • 6. Loss of Trust and Faith • 7. Hypervigilance • 8. Traumatic Bonding • 9. Loss of Ability to Take in Caring & Support

25. Cont’d from last slide • 10. Problems with Self Regulation • 11. Easily Triggered; hyper-reactive • 12. High Risk Behaviors • 13. Disorganized Inner World • 14. Survival Guilt • 15. Development of Rigid Psychological Defenses • 16. Cycles of Reenactment • 17. Relationship Issues • 18. Desire to Self Medicate • From Trauma and Addiction, Dayton 2000 (van der Kolk 1987, Krystal 1968)

27. Factors in Drug Abuse Prevention Protective Factors • Strong and positive family bonds • Parental monitoring of children’s peers and activities • Clear rules of conduct that are consistently enforced within the family • Involvement of parents in the lives of their children • Success in school performance • Strong bonds with institutions such as school and religious organizations • Adoption of conventional norms about drug use • Resiliance.

28. Resilience? What’s That? The ability to bounce back from negative events. Wolin & Wolin suggest resilient children comprise these traits • Humor • Morality • Initiative • Independence • Creativity • Relationships • Insight

29. What Leads to Resilience? Wolin and Wolin posit traits of resilient children include: • Likable personalities from birth that attract people to care for them. They recruit support and interest from others. • At least average intelligence, reading on or above grade level. • No siblings born within two years of their birth. • An inborn belief their lives will work out (positive attitude). • ID the problem and distance themselves from it.

30. Cont’d • Work through their problems. • Take responsibility for creating successful lives. • Have constructive attitudes toward themselves and their lives. • Avoid self-destructive activities. • Have at least ONE person with whom they develop a strong relationship.

31. How to Reach Them • Show your concern and support • Indicate you are ready to help • Avoid comments that may be perceived as judgmental • Engage parents when you can • Use reflective listening • Offer them a safe place for opening up

32. The ruin of a nation begins in the homes of its people

33. Other Information/ Questions • Adolescent Group meets Tuesdays at 5:15pm • Students 16 years old or older are treated as adults for the purposes of medical issues in SC • Students who have not reached their 16th birthday must bring a custodial parent or guardian with them to be assessed.

34. Contact Information Jennifer H. Burke Director of Treatment Services (803)649-1900 ext. 323 jburke@aikencenter.org Aiken Center for Alcohol and Drug Services 1105 Gregg Highway Aiken, SC 29801