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Current trends in substance abuse

Current trends in substance abuse. MICHAEL NERNEY and ASSOCIATES P.O. Box 93 Long Lake, NY 12847-0093 (518) 624-5351 mcnerneyLL@frontiernet.net. The Adolescent Brain Factor. Emotional Intensity Ages 11 – 24 years Amygdala Hormones Larger and more active 2 to 4 times.

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Current trends in substance abuse

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  1. Current trends insubstance abuse • MICHAEL NERNEY and ASSOCIATES • P.O. Box 93 • Long Lake, NY 12847-0093 • (518) 624-5351 • mcnerneyLL@frontiernet.net

  2. The Adolescent Brain Factor • Emotional Intensity • Ages 11 – 24 years • Amygdala • Hormones • Larger and more active • 2 to 4 times https://images.nonexiste.net/popular/2012/03/30/diffusion-spectrum-imaging-reveals-an-orderly-weave-of-nerve-fibers-in-the-brain/

  3. The Adolescent Brain Factor, con’t. • Risk Taking and Peers • Change at 13 years old • New sites appear in brain • Emotional reward for risk taking • Peer influence

  4. Brain Factor, con’t. • Social Media • YouTube, Tumblr, Facebook, Twitter • Instant information • Personal communication • Possibly anonymous • Nearly every young person has access

  5. The Products:Marijuana Synthetics • Cannabinoids • 3 experimental strands: • JWH-073, JWH-018, 200, 250 • CP 47, CP 80 • HU-210 • Clemson University • John W. Huffman

  6. Marijuana synthetics: Research Application • Animal Studies • Medical Use of Cannabinoids • Pain management • Appetite regulation • No human clinical trials • Tested on primates and rodents

  7. Marijuana synthetics:Diverted to the Public • K2, Spice, Blond, Standard, Spice Gold, Zohai, Serenity • 3-4 years under radar • 2009 testing showed few herbal compounds • New synthetic cannabinoids discovered (knockoff)

  8. Marijuana, marijuana synthetics:Effects • Physical • Rapid onset • Dilated pupils • Time distortion • Speech may be confused and non-responsive http://saypeople.com/2011/11/04/pupil-reflexes-without-brain-messaging/

  9. Marijuana, marijuana synthetics:Effects, con’t • Social/Emotional • Bouts of laughter • Interference with color and sound http://beckyland.wordpress.com/tag/synesthesia/

  10. Marijuana, marijuana synthetics:Effects, con’t • Behavioral • Increased appetite • Cognitive deficiencies • In vulnerable individuals: • May lead to psychosis • May deepen depression

  11. Marijuana synthetics:significant risks • Addiction • Anandamide influence • High potency – more activity in CB1 and CB2 sites • May lead to dependency and addiction • Tolerance • Withdrawal • Compulsion • Loss of Control • Continued Use Despite Consequences

  12. Marijuana synthetics:significant risks, cont • Non-responsive • High dose – no divided attention • Operation of anymoving vehicle • Not attentive to environmental risks • Cognitive impact • Measurable impact on memory and learning • Potential paranoia and/or psychotic break • Testing • Requires specialized and sophisticated drug testing

  13. Marijuana substitutes • Wicked X, Posh, Dank, K2 Compliant, Shakabuku, Kush, Bombay Blue, Aztec Gold • “Not for human consumption” • Sold as potpourri or aromatherapy • Discreet shipping • Blend of herbal compounds may include: • Canavalia rosea, Clematis vitalba, Nelumbo nucifera, Pedicularis grandifolia, Heimia salicifolia, Leonurus sibiricus and Ledum palustre, Damiana, Lavender, Baybean, Yerba Mate

  14. Marijuana substitutes:effects • Physical • Mild mental stimulation • Body relaxation • Social/Emotional • Relaxation • Laughter • Behavioral • Disconnected

  15. Marijuana substitutes:risks • Lung function • Joints, blunts, pipes, bongs • Vaporizers • Unknown herbal products • Damiana • Yerba Mate • Loaded Blunts • Herbals plus smokable: • Marijuana • Heroin • Cocaine • Methamphetamine • Ketamine

  16. Salvia divinorum • Diviner’s Sage • Legal Status • Source – Mexico/Florida Sun Pharm • Potency ratings • 5x, 10x, 15x, 20x, 30x • Salvinorin A • Extract available • Psychoactive compound

  17. Salvia divinorum:effects • Physical • Mild to moderate stimulation • 5-10 minute duration • Uncoordinated • Social/Emotional • Tactile, auditory and visual hallucinations • Extended bouts of laughter • Confusion and fearfulness

  18. Salvia divinorum:effects, cont. • Behavioral • Restless • Non-responsive • No impulse control • At risk when unsupervised • Motor control • Depth perception

  19. Salvia divinorum:Risks and testing • YouTube – Salvia Bad Trips • Highly unpredictable • Random rapid movements • Injury to self or others • Non-responsive to intervention • Fatal accidents and falls • Testing is limited

  20. Bath salts • Vanilla Skye, Red Dove, Blue Silk, Ocean Burst • Not for Human Consumption • Smoked, snorted, oral • Injected

  21. Bath salts, cont • Contents: • Mephedrone • Plant food • Similar to amphetamine • MDPV • Similar to Ritalin • Party enhancer • Mimics ecstasy • TFMPP • Hallucinogenic • Less powerful

  22. Bath salts:effects • Physical • Increased heart rate and blood pressure • Stimulant, high energy • Restlessness • Decreased appetite • Impaired sleep • Social/Emotional • Euphoria • Excitement • Alertness • Increased sexuality • Behavioral • Manic • Repetitive behaviors

  23. Bath salts:risks • Unpredictable • Agitation and fearfulness • Sleep deficits • Aggressive paranoia • Psychosis • Seizures • Coma • Suicidal ideation

  24. Bath salts:legal status and testing • Illegal to distribute or possess • Except for TFMPP • Testing is specialized

  25. Empathogens • Molly • MDMA

  26. Empathogens • 2c-I Smiles • Several Fatal Events

  27. hallucinogens • DMT • Dimethyltriptamine • Businessman's Lunch

  28. From the kitchen • Nutmeg • Long lasting • Side effects • Hallucinogenic

  29. Alcohol: social learning • Mood • Conflict/stress • Celebration

  30. Adolescent Brain Factors, cont. • Differential response to alcohol • Liver enzyme production • Childhood medication regulations

  31. Adolescent brain factors, cont. • Duke University study • Low negatives • High positives • At-Risk population • Genetics • High sensitivity • One-third to one-half as likely • 10% - 20% of population CYP2E1 enzyme

  32. At-risk • Family environment • Emotional disorder • Mental health issue • Learning disorder • School failure

  33. Alcohol: new products • Alcohol treats • Pocket Shots

  34. Alcohol: new products, cont. • Whipped Cream • Jell-O Shots

  35. Alcohol: new products, cont. • Malt Beverages • Malt brewed beer • Sugars • Flavors • 20 – 24 ounces • 7 – 13% alcohol

  36. Alcohol: combinations • Robo-shots • Dextromethorphan • Opioid cough suppressant • Plus alcohol • Rapid and powerful intoxication • Motor control • Impulse control • Delusional

  37. Alcohol andprescription pain medications • Oxycontin • Vicodin • Roxanol • Opana

  38. Alcohol and heroin • Pain Medication • Street Drug • Routes of Administration

  39. RISK FACTORS • Addiction • Infection • Overdose

  40. Alcohol and Caffeine mix. • Impact on Brain • Two systems activated • Stimulatory – caffeine • Biphasic – alcohol • Harvard University study • “Wide Awake Drunk”

  41. Alcohol and caffeine: Risk factors • Physical • Energized • Uncoordinated • 30% drop in glucose uptake in motor cortex • 30% drop in glucose uptake in visual cortex • Slower reaction time

  42. Alcohol and caffeine: Risk factors • High risk when operating any moving vehicle • Auto/motorcycle • 32% of all crashes alcohol-related • Boat • 60% of fatalities alcohol-related • Bike/skateboard • High risk: • Swimming • Heights • Parties

  43. Alcohol and caffeine: Risk factors, cont. • Behavioral • Sense of competence • Aggressive social interactions • Twice as likely to suffer physical injury • Twice as likely to get in fights • Twice as likely to be either a victim or a perpetrator of sexual assault

  44. Alcohol: Other products • Hand Sanitizer • Infused Marijuana

  45. Alcohol: Route of administration • Oral • Mucous membranes • Inhalation

  46. Alcohol: impact onadolescent brain • Duke University study • NMDA pathways • Adult brain • Calming effect • Adolescent brain • Biphasic – excitatory effect • It’s a party!

  47. Alcohol: impact onadolescent brain, cont. • NMDA pathways • 48 hours – calcium overrun • Cell death • One year of binge drinking • 10% loss of PFC volume • Logic, reason, executive function

  48. Alcohol: impact onadolescent brain, cont. • One year of binge drinking • 10% loss of hippocampus volume • Memory • Motivation • Social behaviors • Learn how to study • Appropriate social interaction • Ask for help

  49. Alcohol: Social behaviors • Heavy drinkers in adolescence: • 7 times more likely to have multiple sexual partners • 6 times more likely to cut class in college; skip school in middle and high school • 4 times more likely to engage in vandalism and theft • 3 times more likely to get in fights • 3 times more likely to be self-injurious

  50. Alcohol: the costs • Nine teens die each day in the US • 600,000 HS and college students injured per year • 70,000 alcohol-involved sexual assaults per year • Drop outs/Flunk outs • Unwanted pregnancies • Addiction potential

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