Salpointe Catholic High School Community of Concern

1. Salpointe Catholic High SchoolCommunity of Concern What’s Brain Got To Do With It ? Kevin Leehey M.D.Child, Adolescent, and Adult PsychiatryBoard Certified leeheymd.com 296-4280

2. Half of 15-24 Unintentional Injury deaths are MVCs; ~ 4k ODs, 4th for 15-24

3. 2017 Trends • Teen birth rate down again; lowest in 75 years. Contraception up • HS grad rates are up but not enough • MVC deaths up. Phones, texting, social media, cheap gas – drive more + faster, impaired, bikes, peds. Teens down 60% since 1975 • Suicide rate up in last 10 yrs. #2 cause death age 15-34, firearms • Homicide all ages down > 50% since 1990 - 17k vs 44k suicide, 37k MVC • 2016 All drugs all ages OD deaths 52k; opiates 60% = 33k (scripts, heroin, fentanyl); also cocaine, meth, benzos, OTC, scripts. • OD deaths up from 41k in 2015 to 52k in 2016 despite 17% less prescriptions and > 2x prescription monitoring. Heroin and recently fentanyl are up the most. Heroin 4X 1999. This is truly a crisis. • Legal drugs are as dangerous as illegal drugs • MJ use flat (but passed cigarette use) despite Med MJ, legalization, and seen more by public as a minor or helpful drug. • A negative drug screen does not mean they’re not using

4. 2017Trends– page 2 • Tobacco use and E-cigs, (e-hookahs, hookah pens, vape pipes, “vaping”) are decreasing • Youth : #1 alcohol, #2 marijuana, #3 tobacco, #4 “pills”= Adderall (stimulants), opiates, benzos, Ambien, DXM, Soma • Spice, K-2 = synthetic cannabanoids; “bath salts”; synthetic “Research Chemicals” (legal) hallucinogens • Youth drink to get “buzzed”, drunk; binge = 5 for M, 4 for F in 2 hrs • 50% increase in Alcohol Use Disorders since 2001 • Education about health, drugs, alcohol, and mental health helps • The “Dark Web”, “TOR = The Onion Router” • “Have Smartphones Destroyed a Generation?” by Jean Twenge in Atlantic Magazine Sept 2017 issue. Twin rise of smartphones and social media as mixed good and a lot bad.

6. The left side of the brain is shown. Source: Shaywitz – Overcoming Dyslexia

7. Brain development proceeds from the back and base of the brain toward the front and top. The Cerebellum governs coordination of movement and develops early. This is one reason teens are often driven to be active, to take their new bodies out for a test drive.

8. The Amygdala is part of the Limbic system and is located in the Temporal Lobe next to the Hippocampus close to our ears. It promotes emotions, fear, risk taking, lability, and volatility. The Amygdala is partly developed in teens and not yet balanced by the Frontal Cortex.

9. The Nucleus Accumbens is a collection of neurons within the Striatum that play a major role in reward, pleasure, addiction, and motivation. Its only partially developed status in teens contributes to why teens often prefer high reward, stimulating, thrilling, lower effort activities (eg. video games). It is also not yet balanced by the Frontal Lobe.

10. The Pre-frontal cortex is the last area to reach adult maturity. It is our reasoning center which we use to ride herd on our impulses and emotions via “Stop and Think”. The cortex is the main part of the brain that humanizes us.

12. The Teen brain is wired for seeking sensation, novelty, new experience, excitement, thrills, and risk. • Although this includes impulsivity, sensation and thrills are often carefully planned. • “Teens take more risk not because they don’t understand the dangers but because they weigh risk vs. reward differently; …if risk can get them the reward they want, they value reward more heavily than adults do.” • And especially in the company of peers. (“peer pressure”) • They don’t think it will happen to them. • Overall this has evolutionary advantages for the greater population but injury or death for at least some individuals. • Peak risk taking is 12-18, highest around age 17. • Peak substance use is around age 18. • The part of the brain that makes teens responsible is still under construction.

13. The teen brain is more vulnerable to the stimulating, damaging, and addicting effects of nicotine, alcohol, and other drugs. • Tobacco is #1 preventable cause of death in US. • One in three teens who start smoking as a teen will die of a tobacco related disease. • 90% of adult smokers and substance users began as teens. • Almost half of kids who start drinking alcohol by 13 will become alcoholic, while only 10% of those who wait till 21 will. • Substance use in youth thus becomes hard wired as a tendency for life. This is in addition to any genetic predisposition.

14. Healthy Subject watching video of using Substance abuser in remission watching video of using

15. Thus you must parent. • You are the most powerful and important environmental (“nurture”) force. • Remember it’s the interaction between nature (biology) and nurture (environment) that determines the outcome. • Parenting is “hands on” thru 11-13, “hands around” thru 17-19, “hands under” thru 18-25, then “hands off”. • Parenting is the building of character, instilling values and self discipline, and teaching independent living skills. This develops and changes the brain’s structure. • Teach self control (stop and think) and perseverance (…try, try again). These traits best predict success and happiness.

16. Parenting Tips • Cell phones and social media make “flash” parties possible. • Call other parents. • If you’re the host check what’s up. • Have your teen wake you up when they come home. Talk to them, get close. • 3% of us over age 40 smoke marijuana daily. • Teens know homes where parents allow or give alcohol, “weed”, other drugs, or sex to your kids. • > 33% of teens “sext”

17. Parenting Tips • YOU are your child’s + teen’s #1 influence ! • If they see you drunk/impaired/partying they are 33% more likely to drink or use. • If you say, imply, or even think it’s OK or inevitable that they’ll drink or use, then they are 10X more likely to do so. • If you repeatedly (not nag) tell them not to, then they are 10X less likely to drink or use. • Say “No”, Don’t try to be the “Cool” parents, and don’t try to be your kids’ “Best Friends” !

18. The more you use marijuana the more likely you are to use multiple other drugs. MJ impairs driving, can harm memory and learning, can worsen mental health 15% of youth who use MJ become dependent, 25-50% if use daily MJ does have withdrawal “Big Marijuana” (and eCigs vaping) are becoming a huge growth industry like tobacco and alcohol before it Most substance abusers use many different drugs, not just one or two.

19. Normal Sleep Architecture REM is most important. Optimal sleep promotes attention, memory, creativity, decision making, judgment, impulse control, memory ST and LT, social skills, and lessens irritability. Getting 8 hours of sleep lessens substance use, promotes healthier weight, overall and heart health, and mental health.

20. Youth drink to get drunk - binge on as much as possible as fast as possible. Drinking games. • > 60% HS seniors have had intercourse. • > 50% HS seniors drink regularly. • 20% HS seniors smoke cigarettes. • 25% HS seniors smoke marijauna. • 33% HS seniors use other drugs including “pills”. • > 60% teens will try other drugs by end of HS. • Suicides kill 60% more youth and adults than homicides

21. Bad things can happen to Good kids • People don’t say, “I think I’ll get a DUI and ruin lots of lives today.” • No one says or thinks, “Gee, today I’m gonna drink, smoke, or use a drug so I can become an alcoholic or addict.”

22. Teen traffic deaths dropped 60% since 1975. • AZ- 15 ½, written test for permit >6 month, 20 hr day+10 hr night, • “G” Graduated DL- unless guardian in front passenger seat can’t drive MN to 5 AM for 6 months or have >1 passenger except sib till 18 • Parental involvement. Eg, Ford’s MyKey limits speed, radio volume, no radio till seat belt. Supervised practice/teach/coach. • Advanced (defensive) driver training courses. • Safer Cars.

23. Teen Driving –True or False • Car crashes are the #1 killer of our kids • The #1 reason teens get into car crashes is speeding. • Teens are less likely to crash at night because there’s less people on the road. • It’s best for teens to drive the old clunker. • A teen who knows better will not get into a car with a drunk or drugged driver. • Texting while driving is safer than calling.

24. Parenting Teens 101 – True or False ? • Asking my teen about suicide will put the idea in their head • There’s nothing a parent can do about texting and calling in school or sleep hours. • Adult supervised teen drinking results in less teen alcohol use problems. • > 50% teens go thru adolescence with hardly a ripple. • What I say as a parent matters more than what I do. • “Nothing good ever happens after midnight” • Sleepovers and campouts are fine for teens. • It’s not worth upsetting my teen or troubling her friends’ parents to ask if _____ is really happening and supervised. • I can trust without verifying what my teen says about ____ . • I only have to worry about illegal drugs. • Teens mainly get drugs from dealers.

25. Parenting Teens 101 – True or False ? • Don’t be silly, a phone is not a computer. • I don’t need to know how to supervise or check their phone, computer, gaming consoles, or handhelds. • If I had a 24 hour smartphone, computer, TV, and Xbox in my room as a teen I’d never come out either. • My teen’s responsible. We can leave her home when we go away and we can rent him a hotel room after formal or prom or whenever they want. • Adults should not hold teens accountable because their brains are not fully developed.

26. More Useful Information • drugfree.org “Six Componets of Effective Parenting” and “A Parent’s Guide to the Teen Brain” • The Whole Brain Child by Daniel Siegel MD and Tina Payne Bryson PhD • The Social Animal by David Brooks • Yes, Your Teen Is Crazy  by Michael Bradley Ed.D. • Parenting With Love and Logic  by  Foster Cline M.D. and Jim Fay (Get the Teen version) • Read the C of C booklet - it’s very useful ! Thank you and Good Luck ! Kevin Leehey MD leeheymd.com 296-4280