Trends and issues of adolescent substance abuse

1. Trends and issues of adolescent substance abuse • Rx and OTC’s • Caffeine • Bath Salts • Synthetic Marijuana • Methamphetamine • Family Substance Abuse Presented By: Stacey O’Dell, Prevention Educator Steuben Council on Addictions

2. Prescription and OTC’s http://www.youtube.com/watch?v=4KHGcDZuz7Q

3. Prescriptions and OTC’s • 2nd most popularly used illicit drug among teens and adolescents behind marijuana • Adolescents see it as a “safer” way to get high • Easily accessible • Lax attitudes on medications and when to use them • Narcotics are overprescribed

4. Prescriptions and OTC’s • Every day 2,500 youth age 12 to 17 abuse a pain reliever for the very first time. • More teens abuse prescription drugs than any illicit drug except marijuana. • Among 12- and 13-year-olds, prescription drugs are the drug of choice. • Over 30 million Americans report using medications for non-medical reason

5. Prescriptions and OTC’s Commonly abused: • Opioids – narcotic pain relievers • Most sought after class of Rx drugs • CNS Depressants – tranquilizers and sedatives • 81 million prescriptions for CNS are written annually • Stimulants – ADHD, Narcolepsy, Depression • 2.5 million children have a prescription for Ritalin in the US • Dextromethoraphan DXM – cough suppressant

6. Signs/Symptoms Stimulants • Hyperactivity • Shaking • Sweating • Dilated pupils • Fast or irregular heart beat • Elevated body temperature • Seizures • Paranoia/nervousness • Repetitive behaviors • Loss of appetite or sudden and unexplained weight loss Depressants • Loss of coordination • Respiratory depression • Slowed reflexes • Slurred speech • Coma Opioids • Sleep deprivation or “nodding” • Pinpoint/constricted pupils • watery or droopy eyes • Nausea, vomiting • Constipation • Slow slurred speech • Slow gait • Dry skin, itching • Constant flu-like symptoms

7. Behavioral Changes • Sudden mood changes • including irritability, negative attitude, personality change • Extreme changes • groups of friends or hangout locations • Forgetfulness or clumsiness • Lying • being deceitful, skipping classes, avoiding eye contact • Losing interest • personal appearance, extracurricular activities or sports • “Munchies” or sudden changes in appetite • Unusually poor performance • school, on the field, clubs or other activities • Money • Borrowing or having extra cash (out of ordinary) • Acting especially angry or abusive, or engaging in reckless behavior

8. 1 2 3 Deception… 4 • Rohypnol • Xanax • Walgreens Ibuprofen Junior Strength • Tylenol with Codeine • Benadryl Sinus Headache relief • Aspirin • Generic Acetaminophen • Vicodin • Adderall • Percocet 5 6 7 8 10 9

9. Caffeine

10. Caffeine • It is the most widely used legal drug in America • Adolescents should not consume more than 100mg of caffeine daily • Energy drinks have as much sugar and roughly 3x the caffeine of soda. • Most highly caffeinated energy drinks are not FDA regulated as they are marketed as dietary supplements. • Caffeine is present in some over-the-counter pain relievers, cold medications, and diet pills • Caffeinated products are introduced all the time • Soaps, shampoos, foods, pills, drinks, lotions, etc.

11. Caffeine & Learning • Consuming too much caffeine can interfere with learning, concentration, attention, behavior • Short-term effects: • Increased body temp • Increased urination • Irritability & restlessness • Increased alertness • Increased heart rate • Withdrawal symptoms • Restlessness • Agitation • Headaches • Sleepy or lethargic • Lower retention of information • Long-term effects: • Caffeine poisoning • Insomnia • Ulcers, stomach/ digestive issues • Tremors • Panic attacks

12. New “breakfast” drink • Kickstart not produced as an “energy drink” • 92 milligrams of caffeine per 16 oz. can • 20 more milligrams than a comparable amount of Mountain Dew • About the same amount as a cup of coffee. • “Proving their dedication to a healthy, balanced breakfast, PepsiCo made sure to cut Kickstart’ssugar content by using artificial sweeteners.” • Each can has 80 calories, about half the amount in a regular soda.

13. Inhalable Caffeine • Sold on the internet and stores • 100 mg of caffeine per inhalation (4-6 inhalations per tube) • Marketed as enhanced with vitamins for “health” • “Quick to use, quick to work” • “No calories to fill you us, no liquids to hold you down” • Now marketed in chocolate flavors

14. Caffeine

15. Bath Salts ILLEGAL LEGAL

16. ABC News Video http://www.youtube.com/watch?v=bXo-0iFj8Ys

17. Bath Salts • Not the same legitimate bathing and beauty products • Synthetic drugs with stimulant highs similar to amphetamines and PCP • One brand tested at a 4x higher potency than Ritalin • Typically smoked, snorted, injected or orally • Cannot be detected on “standard” drug screens • Average age of users is age 28 but not limited to this demographic • CK levels in blood Increase dramatically, upwards of 400 in some users

18. Legality • July 15, 2011, Gov. Andrew Cuomo signed a Public Health Law that bans products labeled as “Bath Salts” from being sold across New York State . • As of October 21, 2011, due to the imminent threat to public safety, the Drug Enforcement Administration (DEA) has banned many chemicals needed to make “Bath Salts.” • August 2012, NYS law has a molecule component factor, in it which makes the 5 known substances known as “Bath Salts”, illegal to process. Expired Nov. 4th.

19. How do they “work?” • Onset – 3 to 5 minutes • Durationof high - 1 to 8 hours • Short term effects: • Dysphoria(opposite of euphoria) • Paranoia (similar to PCP) • Delusions, hallucinations, agitation • Mild High can last days • Long-term effects are not know at this time but: • Have seen mental illness last as-well-as psychosis • Most do not make a full recovery from the effects

20. Bath Salts • Symptoms and Side Effects may include: • Severe paranoia • Extreme violence • Increase blood pressure & heart rate • Manic behaviors • Nakedness • Emotionally unstable • Rambling, incoherent, unrealistic • Violent behavior (combative) • Hallucinations • Chest pain • Seizures • Lack of appetite • Prone to self-mutilation • Decreased need for sleep • Sensation of touch and clothing is reported as “painful” • Suicidal thoughts increase with a higher likelihood to attempt

21. Synthetic Marijuana

22. Synthetic Marijuana Variations in Packaging

23. Synthetic Marijuana • Often Called K2/K3 or Spice • March 29, 2012 Public Health Law makes sale illegal in stores and via the internet • Depending on compound combinations it is 4 to 100 times more potent than marijuana • Marketed as “incense” or “plant food” marked “not for human consumption” • Very cheap and will still be around for sale, now as a black market drug • Has a stimulant effect vs. a depressant effect like marijuana

24. Synthetic Marijuana • Hallucinogenic effect (PCP), nothing like marijuana • High has quick onset • Often smoked, combined with tobacco, mixed with food or drink • Most drug tests cannot screen for synthetics • More specific screens are being used but still are unable to be very specific on what is present • Most likely users • 14-27 year olds • Prisoners/probationers

25. Synthetic Marijuana • Symptoms and Side Effects may include: • Hallucinations • Seizures/tremors • Unconsciousness/ coma • Vomiting • Numbness/tingling • Increased respiration rate • Elevated blood pressure • Elevated heart rate • Anxiety/ agitation often leading to panic attacks • Acute renal failure

26. Synthetic Marijuana • Long-term effects on the brain and body are currently unknown • Metabolism of the chemicals is hard to tell due to so many different combinations of chemicals • Increase in overdose is common • Rapid and powerful addiction is likely • Poison control calls en route to ED have drastically increased due to synthetics

27. NY introduces synthetic drug hotline number • To combat the synthetic drug problem and the proliferation of these dangerous drugs, NYS has established the Synthetic Drug Hotline. • This hotline can be used to report manufacturing, distribution, sale and possession of synthetic drugs, such as "bath salts" and "synthetic marijuana." • Many of these dangerous synthetic drugs may act as stimulants and/or hallucinogens. • Bath salts and other synthetic drugs pose a direct, serious threat to public health and safety. Synthetic Drug Hotline Established 1-888-99-SALTS (1-888-997-2587)

28. Teen brain dead after K2 use http://www.whas11.com/video/featured-videos/186457591.html

29. Methamphetamine

30. Methamphetamine • Increase production and use by adults • 98% of those who try meth will become addicted within a year • Dramatic issue in rural areas, including Steuben, Schuyler, Chemung, etc. • Takes little to no skill to manufacture meth and is inexpensive • Can be smoked, injected, inhaled, orally or ingested • 1/3 of all burn patients are a result of meth in some way

31. Methamphetamine • New production techniques require less chemicals, heating and can be made anywhere “Shake and Bake Meth” • Colors range from pure white to reddish brown can be powder, crystal or liquid in form • Thousands of recipes are accessible on line to learn how to make and use meth

32. Methamphetamine • Exposure to the manufacturing can cause: • Headaches • Nausea • Dizziness • Fatigue • Shortness of breath • Cough • Chest pain • Lack of coordination • Burns • Death

33. Methamphetamine • In 2007 NY State had 12 meth lab “busts” including labs, dumpsites and chemical/glassware seizures • In 2011 there were 42 labs were found • In 2012 there were 148 labs found • 17,000 meth labs & dump sites were found last year (nationally)

34. Faces of meth

35. Substance Abuse in the Home • Almost 14 million American adults abuse alcohol • The number of illicit drug users exceeds 12 million • Child welfare records indicate that substance abuse is one of the top 2 problems exhibited by families in 81% of reported cases • Of the 1.2 million confirmed victims of child maltreatment, an estimated 480,000 children are mistreated each year by a caretaker with alcohol or other drug problems. • Children whose parents abuse drugs or alcohol are 3x more likely to be abused and 4x more likely to be neglected

36. Family Substance Abuse • It is often difficult to tell if a child lives where substances are being abused. • There is an increased risk of neglect, physical abuse and sexual abuse. • Often the child is labeled as ADD/ADHD or “hyper” • Developmental delays are more likely • Facts…

37. Working with these children • Be aware! • Pay attention to interactions the child has with others • Don’t be quick to assume the worst • Address your concerns with others • Contact agencies for information for these situations • Don’t pass judgment • Be positive towards the child • Know of places to refer families (2-1-1) • Be someone the child can trust

38. PREVENTION WORKS!!! Research shows that kids who are talked to by parents and adults about the risks of drug abuse are less likely to abuse drugs than those that are not talked to.

39. References • Drugfreekids.org • Justice.gov/dea • OASAS.state.ny.us • Teens.drugabuse.gov • Abovetheinfluence.com • New York State DOH, Narcotic Enforcement • Upstate Poison Control Centers • National Association of School Nurses