Trends in Adolescent Addictions

Transcription

1 Goal: Describe trends in adolescent behavior related to harmful substance use Trends in Adolescent Addictions Kate Speck, PhD MAC, LADC Objectives: Summarize adolescent substance use recent trends Review behaviors associated with substance abuse in adolescents. Explain effective prevention approaches with the adolescent population 4 Out of 10 U.S. AIDS Deaths Are Related to Drug Abuse Neurotoxicity AIDS, Cancer Mental illness Homelessness Crime Violence Health care Productivity Accidents Substance Abuse and Addiction: #1 Public Health Problem Addiction Is A Developmental Disease that starts in adolescence and childhood % in each age group who develop first-time dependence 1.8% TOBACCO 1.6% 1.4% 1.2% 1.0% 0.8% 0.6% 0.4% 0.2% 0.0% CANNABIS ALCOHOL Age 5 Age at tobacco, alcohol, and cannabis dependence per DSM IV National Epidemiologic Survey on Alcohol and Related Conditions,

2 Addiction is a Developmental Disease: It Starts Early % 26% When Reading Emotion Adults Rely More on the Frontal Cortex While Teens Rely More on the Amygdala % 1.5% 1 Child Teen Young Adult Adult < >25 Deborah Yurgelon-Todd Do Adolescents React Differently than Adults to Substances of Abuse? Rats Exposed to Nicotine in Adolescence Self-Administer More Nicotine Than Rats First Exposed as Adults Advances in science have revolutionized our fundamental views of drug abuse and addiction. Collins et al, Neuropharmacology, 2004, Levin et al, Psychopharmacology,

3 Genetics is a Big Contributor to the Risk of Addiction And The Nature of this Contribution Is Extremely Complex What Environmental Factors Contribute to Addiction? Stress Early physical or sexual abuse Witnessing violence Peers who use drugs Drug availability Percent Other Biological Factors Contribute to Addiction-- Prevalence of Drug Disorders Comorbidity Percent Prevalence of Nicotine Addiction COMORBIDITY Why do Mental Illnesses and Substance Abuse Cooccur? Why Can t Addicts Just Quit? Non-Addicted Brain Addicted Brain Self-medication substance abuse begins as a means to alleviate symptoms of mental illness Causal effects Substance abuse may increase vulnerability to mental illness Common or correlated causes the risk factors that give rise to mental illness and substance abuse may be related or overlap Saliency Control Drive Memory NO GO Saliency Control Drive Memory Because Addiction Changes Brain Circuits GO Adapted from Volkow et al., Neuropharmacology,

4 The Problem 2013 Monitoring the Future Survey Every day in the United States, 2,000 teenagers abuse Rx drugs for the first time. Rx drugs are the most abused drug by teens after alcohol, marijuana, and tobacco. Past Year Use of Adderall and Perceived Risk of Occasional Use among 12 th Graders Tobacco Use 10% 10% Use by Grade 8th 10th 12th 8% * 6% 4% 2% 0% Use vs. Perceived Risk 12 th Grade Use *Significant increase from 2009 ^Significant decrease from previous year 8% * Use 6% Risk 4% 2% 0% % 60% 50% 40% 30% 20% 10% 0% Perceived Risk Most smokers initiate in adolescence; 1/3 are current smokers (Randall & Upadhyaya 2009) Early onset smokers more like to develop SUDS Approx 50% of the risk for nicotine dependence is genetic Effective pharmacological tx little is known Adolescent smokers at significantly greater risk for relapse following tx (de Dios et al, 2009; Meyers & Prochaska, 2008) Source: University of Michigan, 2013 Monitoring the Future Study Commonly Abused Rx Drugs Drinker Definitions (1) Opioids Usually prescribed to treat pain Binge drinking: Four or more drinks for Stimulants Most often prescribed to treat ADHD a female and five or more drinks for a male at one sitting Central nervous system (CNS) depressants Prescribed to treat anxiety and sleep disorders For more facts, visit PEERx at Click to see data on binge drinking in your state 4

5 Studies on Teen Drinking Risk Factors A risk factor is defined as: Occurring before the criterion behavior (temporally precedes it) Statistically associated with increased probability of the criterion behavior occurring Risk factors are not necessarily: Causes or determinants of the behavior/problem Specific or unique to the behavior/problem Always associated with the behavior/problem Risk Factor Typology Palcohol Palcohol, or powdered alcohol, was approved by the Alcohol and Tobacco Tax and Trade Bureau, part of the U.S. Treasury Department. Powder packets that can turn water into a mixed drink have already been banned by several states amid fears that Palcohol can be easily abused. Although alcohol in powdered form has been around for decades long before a 1976 patent for it was issued to the General Foods Corporation the announcement of a new product tabbed for the market has pushed the topic back to the forefront. Source: Hawkins et al., 1992; Petraitis et al., 1995 Palcohol Palcohol, when used as directed, by adding six ounces of liquid to it, is equal to a standard mixed drink. Content varies per version but basically, alcohol...and in the cocktail versions, natural flavorings and Sucralose as a sweetener. Palcohol is gluten free. The powder by itself is about 80 calories per bag 5

6 Online Fact Sheets Online and printable fact sheets provide information about commonly abused Rx drugs and their effects. Opioids Also known as: oxy, percs, happy pills, hillbilly heroin, OC, or vikes Opioids - pill form, are prescription medications used to reduce pain Prescription after surgery/injury or to help patients with severe/chronic Taken as prescribed by a medical professional, they are relatively safe effective. Dependence and addiction are still potential risks when taking prescription opioids especially when these drugs are abused. Painkillers are one of the most commonly abused drugs by teens, after tobacco, alcohol, and marijuana. Taking someone else s prescription opioid medication. Taking a prescription opioid medication in a way other than prescribed Taking the opioid prescription to get high Prescription Drugs After marijuana and alcohol, prescription drugs are the most commonly abused substances by Americans age 14 and older. Teens abuse prescription drugs for a number of reasons, such as to get high, to stop pain, or because they think it will help them with school work. Most teens get prescription drugs they abuse from friends and relatives, sometimes without the person knowing. Boys and girls tend to abuse some types of prescription drugs for different reasons. For example, boys are more likely to abuse prescription stimulants to get high, while girls tend to abuse them to stay alert or to lose weight. Cough/Cold Medicine Also known as: robotripping, robo, tussin, triple c, dex, skittles, candy, velvet, and drank Cough syrups and capsules containing dextromethorphan (DXM). These over-the-counter (OTC) meaning they can be bought without a prescription cough medicines are safe for stopping coughs during a cold if you take them as directed. Taking more than the recommended amount can produce euphoria (a relaxed pleasurable feeling) and dissociative effects (like you are detached from your body). Promethazine-codeine cough syrup. These prescription medications contain an opioid drug called codeine, which stops coughs, but when taken in higher doses produces euphoria. Cannabis Marijuana - Also known as: weed, pot, bud, grass, herb, Mary Jane, MJ, reefer, skunk, boom, gangster, kif, chronic, and ganja Marijuana is a mixture of the dried and shredded leaves, stems, seeds, and flowers of Cannabis sativa the hemp plant. The mixture can be green, brown, or gray. Stronger forms of the drug include sinsemilla (sin-seh-meyah), hashish ( hash for short), and hash oil. Of the approximately 400 chemicals in marijuana, delta-9- tetrahydrocannabinol, known as THC, is responsible for many of the drug s psychotropic (mind-altering) effects. It s this chemical that changes how the brain work The amount of THC in marijuana has increased over the past few decades from an average of about 4 percent for marijuana and 7.5 percent for sinsemilla in the early 1990 s to almost 10 percent for marijuana and 16 percent for sinsemilla in s, distorting how the mind perceives the world. 6

7 Spice Also known as: K2, fake weed, Bliss, Black Mamba, Bombay Blue, Genie, Zohai, Yucatan Fire, Skunk, and Moon Rocks Spice is a mix of herbs (shredded plant material) and manmade chemicals with mind-altering effects. It is often called synthetic marijuana because some of the chemicals in it are similar to ones in marijuana; but its effects are sometimes very different from marijuana, and frequently much stronger. It is most often labeled Not for Human Consumption and disguised as incense. Because the chemicals used in Spice have a high potential for abuse and no medical benefit, the Drug Enforcement Administration has made many of the active chemicals most frequently found in Spice illegal. However, the people who make these products try to avoid these laws by using different chemicals in their mixtures. Sellers of Spice products try to lead people to believe they are natural and therefore harmless, but they are neither. Bath Salts Also known as: Bloom, Cloud Nine, Vanilla Sky, White Lightning, and Scarface Bath salts is the name given to a family of drugs that have one or more manmade chemicals related to cathinone. Cathinone is an amphetamine-like stimulant found naturally in the khat plant. Chemically, they are similar to other amphetamines such as methamphetamine and to MDMA (Ecstasy or Molly). Common manmade cathinones found in bath salts include 3,4- methylenedioxypyrovalerone (MDPV), mephedrone ( Drone, Meph, or Meow Meow ), and methylone, but there are many others. Use of bath salts sometimes causes severe intoxication (a person seems very drunk or out of it ) and dangerous health effects. There are also reports of people becoming psychotic (losing touch with reality) and violent. Although it is rare, there have been several cases where bath salts have been the direct cause of death. In addition, people who believe they are taking drugs such as MDMA (Molly or Ecstasy) may be getting bath salts instead. Methylone, a common chemical in bath salts, has been substituted for MDMA in capsules sold as Molly in some areas. 7

8 Inhalants Current, past-year, and lifetime use of inhalants among 10th and 12th graders is at its lowest levels in the history of the survey. Rates of inhalant use are traditionally highest among the youngest adolescents (unlike most other drugs); in 2014, 5.3 percent of 8th graders reported using inhalants in the past year, down from 8.1 percent in 2009 and 12.8 percent in 1995, when use peaked. Methamphetamine Also known as: Meth, Speed, chalk, and tina ; or for crystal meth, ice, crank, glass, fire, and go fast Methamphetamine known as meth is a very addictive stimulant drug. Stimulants are a class of drugs that can boost mood, increase feelings of wellbeing, increase energy, and make you more alert but they also have dangerous effects like raising heart rate and blood pressure. Methamphetamine is a manmade, white, bitter-tasting powder. Sometimes it's made into a white pill or a shiny, white or clear rock called a crystal. Most of the meth used in the United States comes from superlabs big illegal laboratories that make the drug in large quantities. But it is also made in small labs using cheap, over-the-counter ingredients such as pseudoephedrine, which is common in cold medicines. Other chemicals, some of them toxic, are also involved in making methamphetamine. Methamphetamine is classified as a Schedule II drug, meaning it has high potential for abuse and is available only through a prescription that cannot be refilled. What is Prevention? Prevention Defined The role of prevention is to create healthy communities where people enjoy a quality life: Healthy environments at work and in school Supportive communities and neighborhoods Connections with families and friends Drug and crime-free Source: Center for Substance Abuse Prevention, SAMHSA Current Tactics: Target Behavior Change Domains Individual Peer Groups/Target Groups Society At- Large Prevention Initiatives Neighborhoods & Communities School Environments The 6 CSAP Prevention Strategies 1. Information Dissemination 2. Education 3. Alternatives 4. Problem ID and Referral 5. Community Based Processes 47 Family Environments Environmental (Source: Center for Substance Abuse Prevention, 1993) 8

9 How Do I Know if Someone Has a Drug Problem? There are questions people can ask to gauge whether or not a person has a drug problem. These may not mean that someone is addicted, but answering yes to any of these questions may suggest a developing problem, which could require follow up with a professional drug treatment specialist. These include: Have you ever ridden in a car driven by someone (including yourself) who had been using alcohol or drugs? Do you ever use alcohol or drugs to relax, to feel better about yourself, or to fit in? Do you ever use alcohol or drugs when you are alone? Do you ever forget things you did while using alcohol or drugs? Do family or friends ever tell you to cut down on your use of alcohol or drugs? Have you ever gotten into trouble while you were using alcohol or drugs? 9