The “ IN ” Things What Everyone Needs to Know!!!

1. The “IN” ThingsWhat Everyone Needs to Know!!! Pamela Williams, MA, NCC Mercy Behavioral Health

2. Objectives • WHY!!!!!!!!!!!!!!!!! • Current Trends in Risky Adolescent Behavior • Warning Signs of Risky Behavior • What Can We Do to Help????

3. Statistics U.S. Students Enrolled in 9-12 Grade in 2001: • 47.1% Drank Alcohol • 23.9% Used Marijuana • 45.6% Had Sexual Intercourse at Least Once

4. Why Do Adolescents Engage in Risk-Taking Behaviors? • Poor Decision Making Process • External Forces such as: • Peer Pressure • Media • School Activities • Community • Need for Attention

5. GAME What is the Choking Game? • This activity is not a game • Is played in groups as well as by a single child • The object of this activity is asphyxiation, applying pressure to restrict oxygen and blood flow to the brain • This action creates a “high” sensation,described as a tingly and floaty feeling. When the child becomes unconscious the pressure is released and the secondary high is achieved

6. Choking Game: A.K.A Rising Sun Game American Dream Game Pass-out Game Sleeper Hold Natural High Space Monkey Flatliner Game Cloud Nine Hanging Game Black Out Game Black Hole Dreaming Game Gasp Teen Choking Game Suffocation Roulette Fainting Game California High Purple Dragon The Fainting Game California Choke Tingling Game Tingling Game Funky Chicken

7. Kids are Dying from This Game! • Deaths of the Adolescents Often Ruled as a Suicide • 9 out of 10 Students Know about this Game 2008-CDC-First Investigations: • 82 Probable deaths from 1995-10/2007 among 6-19 year olds • Peak age was 13.3 • 87% were male • 45 States have reported cases of the game.

8. REPORTED INCIDENTS(as of 7/1/09 10:00am)

9. Warning Signs • Any suspicious mark on the side of the neck, sometimes hidden by means of a turtle neck,scarf or turned up collar. • Changes in personality, such as overly aggressive or agitated. • Any kind of strap,belt or rope lying near the child without any reason – questions about this subject are often alluded. • Headaches, sometimes excruciatingly bad ones, loss of concentration, a flushed face. • Bloodshot eyes or any other noticeable stress on the eyes. • A thud in the bedroom against the wall-meaning a fall in cases of solitary practices. • Any questions about the effects,sensations or dangers of strangulation. • Unusual need for privacy, i.e. -locked bedroom door.

10. Who is Doing It? • The ages of kids that are participating in this activity is 9-14 years • Many kids participate in this game out of curiosity, not because they are rebellious, depressed, or angry • The game is played by kids that are not visibly at-risk, kids that do good in school, and are close with their families • These kids believe this game is not harmful like other forms of getting high • Kids from all socioeconomic status backgrounds • Kids from all cultures “THERE IS NO TYPICAL PROFILE”

11. Little Angels Chris P – 14 Dylan B – 11 Kodee A – 14 Braden E – 13 Gabriel M – 13 Evan O – 12 Jason L- 14 Nick S – 16 Stephen C – 16 Daniel S – 11 Jeffery P – 14 Cory M – 14 Louis B – 12 Shawntae C – 14 Leo M – 16 Daniel S – 11

12. “Robotripping” Robo Skittles Tussin Dexing • Kids as young as 12 years old are abusing over the counter cough medicine • At least 5 adolescent deaths have occurred in the past 2 years

13. Why? • Adolescents used to drink the medicine because of the alcohol contained in the syrup • Now it contains “Dextromethorphan” “DXM” • This cough suppressant can produce hallucinations, & loss of motor control similar to PCP. • Getting a hallucinogenic high • Since 2006 use among younger teens has increased 15 fold. • According to a survey done in May 2006 one in 10 U.S. teens abuse cough medicine.

14. Symptoms • Sweating • High Body Temperature • Dry mouth • Itchy or Flaky skin • Blurred vision • Hallucinations • Delusions • Nausea • Vomiting • Irregular Heartbeat • Red Face • Loss of consciousness • Numbness in toes & fingers

15. Dosage • A normal dose of DXM is 15-30 Milligrams. • Mind altering effects can occur at dose as low as 100 milligrams, but abusers consume much more (say ½ a 12oz bottle) to result in a dose of 240-360 milligrams.

16. Where Found? • DXM is used in more than 120 non-prescription medicines. • Robitussin • Coricidin HBP • Vicks Nyquil • Vicks Formula 44

17. Skittling NEW TREND: Teens are over dosing on Coricidin tablets. Since the pills look like candy kids are able to pass they off as candy. In large Doses Coricidin can cause hallucinations. In March 2007 5 teenagers overdosed on this. The Pills can cause kidney and liver damage and possible seizures.

18. SLOM ? Sticking Leeches On Myself

19. Why? • Adolescents feel that the blood sucking action can give them a high. This is not true.

20. SNIFFING

21. Huffing: A New Low Point for Kids Getting High Inhalant use refers to the intentional breathing of gas or vapors with the purpose of reaching a high. Inhalants are legal, everyday products which have a useful purpose, but can be misused. You're probably familiar with many of these substances -- paint, glue and others.

22. STATISTICS • One on five students in America has used an inhalant to get high by the time he or she reaches the eighth grade. • Parents don't know that inhalants, cheap, legal and accessible products, are as popular among middle school students as marijuana.

23. STREET TERMS • WHIPPETS • POPPERS • SNAPPERS • AIR BLAST • MOON GAS • OZ • POOR MAN’S POT • BULLET RUSH • SATAN’S SECRET • SHOOT THE BREEZE • TEXAS SHOE SHINE • TOILET WATER

24. How it affects us • Inhalants affect the brain with great speed and force. • They keep oxygen from reaching the lungs • The intoxication produced usually lasts just a few minutes; therefore, users often try to extend the “high” by continuing to inhale repeatedly over several hours.

25. Research • In addition to these physical and mental health problems, recent research shows that inhalant use is associated with symptoms of depression. Between 2004 and 2006, an estimated 218,000 youths aged 12-17 used inhalants and also experienced depression in the past year. The same research showed that depressed teens were more than three times as likely to start using inhalants than teens with no symptoms of depression.

26. Signs of Inhalant Use • There is a common link between inhalant use and problems in school -- failing grades, chronic absences and general apathy. Other signs include the following: • Paint or stains on body or clothing • Spots or sores around the mouth • Red or runny eyes or nose • Chemical breath odor • Drunk, dazed or dizzy appearance • Nausea, loss of appetite • Anxiety, excitability, irritability

27. They're all over your house. They're in your child's school. In fact, you probably picked some up the last time you went to the grocery store. Educate yourself. Find out about inhalants before your children do!

28. Adhesives model airplane glue, rubber cement, household glue Aerosols spray paint, hairspray, air freshener, deodorant, fabric protector, computer keyboard cleaner Solvents and gases nail polish remover, paint thinner, type correction fluid and thinner, toxic markers, pure toluene, cigar lighter fluid, gasoline, carburetor cleaner, octane booster Cleaning agents dry cleaning fluid, spot remover, degreaser Food products vegetable cooking spray, dessert topping spray (whipped cream), whippets Gases nitrous oxide, butane, propane, helium Products Abused as Inhalants Volatile Solvents

29. What to do When Someone is Huffing Remain calm and do not panic. • Do not excite or argue with the abuser when they are under the influence, as they can become aggressive or violent. • If the person is unconscious or not breathing, call for help. CPR should be administered until help arrives. • If the person is conscious, keep him or her calm and in a well-ventilated room. • Excitement or stimulation can cause hallucinations or violence. • Activity or stress may cause heart problems which may lead to "Sudden Sniffing Death.“ • Talk with other persons present or check the area for clues to what was used. • Once the person is recovered, seek professional help for abuser: school nurse, counselor, physician, other health care worker. • If use is suspected, adults should be frank but not accusatory in discussions with youth about potential inhalant use.

30. Drug Slang Amped - High on AmphetaminesBang - Inhalants; to inject a drugBanging - Under the influence of drugsBlunt - Marijuana inside a cigar; cocaine and marijuana inside a cigarCandy Blunt - Blunts dipped in cough syrupCare bears - Methylenedioxymethampehtamine (MDMA)Cat Valium - KetamineCocktail - Cigarette laced with cocaine or crack; partially smoked marijuana cigarette inserted in regular cigarette; to smoke cocaine in a cigaretteCoco rocks - Dark brown crack made by adding chocolate pudding during productionDime bag - $10 worth of drugsDirty joints - Combination of crack cocaine and marijuanaE (or) Ecstasy - Methylenedioxymethamphetamine (MDMA)Easy lay - Gamma hydroxybutyrate (GHB)Finger - Marijuana cigaretteGHB - Gamma hydroxybutyrate

31. Drug Slang • Hugs and Kisses - Combination of methamphetamine and methylenedioxymethamphetamine (MDMA)Jack - Steal someone else’s drugsJib - Gamma hydroxybutyrate (GHB)Joint - Marijuana cigaretteKiddie dope - Prescription drugsLegal speed - Over the counter asthma drug; trade name-MiniThinLoaded - High on drugsMagic mushroom - Psilocybin/psilocinMeth - MethamphetamineNail - Marijuana cigaretteNexus - 2-(4-Bromo-2,5 diethoxyphenyl)-ethylamine; also just know as 2CBOolies - Marijuana cigarettes laced with crackOz - InhalantsPink elephants - MethamphetaminePikachu - Pills containing PCP and Ecstasy

32. Drug Slang • Qat - MethcathinoneRib - Rohypnol; methylenedioxymethamphetamine (MDMA)Ritz and Ts - A combination of Ritalin and Talwin injectedRoach - Butt of marijuana cigaretteRoach clip - Holds partially smoked marijuana cigaretteRoofies - RohypnolRuffies - RohypnolRuffles - Rohypnol**Shebanging - Mixing cocaine with water and squirting it up noseSheet rocking - Crack and LSDShotgun - Inhaling marijuana smoke forced into one’s mouth by another’s exhalingSkin popping - Injecting drugs under the skin; to inject drugs on any part of the body without hitting a veinSkittling - Abuse of cold tablets containing dextromethorphan (a cough suppressant)Special “K” - KetamineStoned - Under the influence of drugs

33. Drug Slang • Thai sticks - Bundles of marijuana soaked in hashish oil; marijuana buds bound on short sections of bambooTHC - TetrahydrocannabinolTNT - FentanylToke - To inhale cocaine; to smoke marijuana; marijuanaTs and Rits - Talwin and ritalin combination is injected and produces an effect similar to the effect of heroin mixed with cocaine.Uppers - AmphetamineVitamin K - KetamineVitamin R - Ritalin (methylphenidate)Wigging - Odd behavior resulting from the use of mind-altering drugsWooly blunts - Marijuana and crack or PCPXTC - Methylenedioxymethamphetamine (MDMA)Ya Ba - A pure and powerful form of methamphetamine from Thailand; “crazy drug”Z - 1 ounce of heroinZen - LSD

34. HAPPY SLAPPING • an unprovoked physical attack on an individual, recorded by an accomplice with a camera, esp. a camera phone; the practice of slapping or punching an unsuspecting victim and recording it with a camera phone.

35. SEXTING • The act of sending explicit messages or photos electronically, primarily between cell phones.

36. Background • Reported as early as 2005. • Has been reported in Great Britain, Australia, New Zealand, United States, and Canada. • In January 2009 survey of 1,200 teenagers by a Burlington Vermont TV station claimed that one in five had sent explicit photos of themselves. • A 2009 UK survey found that 38% of under 18’s had “received an offensive or distressing sexual image via text or email.

37. CYBERBULLYING • when a child, preteen or teen is tormented, threatened, harassed, humiliated, embarrassed or otherwise targeted by another child, preteen or teen using the Internet, interactive and digital technologies or mobile phones. • It has to have a minor on both sides, or at least have been instigated by a minor against another minor. • Once adults become involved, it is plain and simple cyber-harassment or cyberstalking. Adult cyber-harassment or cyberstalking is NEVER called cyberbullying.

38. CYBERBULLYING • Cyberbullying is usually not a one time communication, unless it involves a death threat or a credible threat of serious bodily harm. • Kids usually know it when they see it, while parents may be more worried about the lewd language used by the kids than the hurtful effect of rude and embarrassing posts.

39. How it works There are two kinds of cyberbullying: • direct attacks (messages sent to your kids directly) • cyberbullying by proxy (using others to help cyberbully the victim, either with or without the accomplice's knowledge).

40. Direct Attacks • Instant Messaging/Text Messaging Harassment • Stealing Passwords • Blogs • Web Sites • Sending Pictures through E-mail and Cell Phones • Internet Polling • Interactive Gaming • Sending Malicious Code • Sending Porn and Other Junk E-Mail and IMs • Impersonation

41. The four types of cyberbullies • The Vengeful Angel • The Power-Hungry or Revenge of the Nerds • The “Mean Girls” • The Inadvertent Cyberbully or “Because I Can

42. How Can We Help? • Encourage Positive/ Healthy Risk Taking. Positive impact on development Includes: Participation in sports Making friends, volunteering, Artistic talents and abilities. • Model Healthy risk taking as a positive experience. Share your history of risk-taking. Encourage to make better choices than you made. • Teach adolescents to learn how to evaluate risk, anticipate choices and create strategies that place energy into healthier activities when necessary.

43. How Can We Help? • Know where your child is and who they are spending their time with. • Let your teen know you are interested, and you are willing to help with whatever they need. • Turn off television when your child wants to talk. • Practice good listening skills; do not interrupt your child. • Praise him or her for good communication skills.

44. Decision Making • Create rules for decision making. If your child wants to do something that is not safe, explain why he or she can not make that decision. • To help them understand how and why they make both healthy and unhealthy choices, ask them some or all of the following questions: • Do you feel pressured to make risky choices by friends? • Do you rush into decisions? • Do you think it is uncool to try things in a safe manner? • Are dangerous risks more exciting to you? • Does it feel as though it is happening “in a dream” when you make dangerous choices?

45. Tips • All teenagers take risks as a normal part of growing up. Risk taking is a tool an adolescent uses to define and develop his or her identity; healthy risk taking is a valuable experience. • Unhealthy risk taking may appear as rebellion or angry gesture directed at parents and teachers. However, risk taking, whether healthy or unhealthy, is simply part of a teen’s struggle to test out an identity and separation from others. • Parents and teachers should pay attention to their own current patterns of risk-taking behaviors. Adolescents are watching and imitating you.

46. THE CHALLENGE The Challenge for any person is to make sense of facts in ways that are meaningful in life – in ways that help them think and make wise choices!

47. This is happening in Our Area This presentation is in Memory of Christopher Pelican 1992-2006

48. QUESTIONS?

49. Pamela WilliamsMercy Behavioral Health412-246-2920