Adolescent Substance Use: Parent/Caregiver Guidance

Transcription

1 Adolescent Substance Use: Parent/Caregiver Guidance Shannon Mountain-Ray MSW, LICSW Clinical Director of Social Work Adolescent Substance Use and Addiction Program Center for Adolescent Substance Use Research Children s Hospital, Boston Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

2 Objectives Present Overview of Teen Substance Use Describe the Teen Brain Present Parent/Caregiver Guidance Prevention Strategies Identifying Potential Substance Use What to do if a parent/caregiver is concerned.

3 Substances Used by 12 th Graders, 2016 Substance Lifetime (%) Past 30 Days (%) Alcohol (any) Alcohol (been drunk) Any illicit drug Marijuana Inhalants Hallucinogens Cocaine Amphetamines Heroin Other Narcotics While experimentation with alcohol is common, less than half of 12 th graders are current (past 30 days) drinkers. Some kids and adults think that all high schoolers use marijuana, but the truth is that only a quarter (44.5%) of seniors have ever tried it and only 22.5% are current smokers. Sources: 1) Monitoring the Future. Trends in Lifetime Prevalence of Use of Various Drugs in Grades 8, 10, and 12. Drug and Alcohol Press Release, ) Monitoring the Future. Trends in 30-Day Prevalence of Use of Various Drugs in Grades 8, 10, and 12. Drug and Alcohol Press Release, 2016.

4 Leading Causes of Mortality among Persons Ages Years United States, 2014 Motor vehicle crashes 23% Other unintentional injuries 17% Suicide 17% Homicide 14% TOTAL 71% The four leading causes of death among adolescents shown above are all linked to alcohol and other drug use. Source: Kann L, McManus T, Harris WA, et al. Youth Risk Behavior Surveillance United States, MMWR Surveill Summ 2016;65(No. SS-6):1 174.

5 Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

6 Correlates of Substance Use During Adolescence Injuries (intentional, unintentional) Emergency room visits Sexual assaults Unprotected intercourse Violence STIs, including HIV Arrests, incarceration School failure Alcohol and other drug use is correlated with significant morbidity during adolescence.

7 % Lifetime Dx. Of Alc. or MJ Dependency Prevalence of Lifetime Diagnosis of Alcohol or Marijuana Dependence by Age of Use Initiation <= >=21 Age Began Drinking or Smoking Approximately 43,000 adults aged 18 and older were surveyed about their current and past alcohol use by the National Institute on Alcohol Abuse and Alcoholism as part of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). A younger age of alcohol initiation is associated with increased lifetime risk of alcohol dependence (addiction). A similar trend is seen with marijuana. Adolescence appears to be a window of vulnerability for developing substance use disorders; delaying initiation into early adulthood seems to be protective. Hingson RW et al. Arch Pediatr Adolesc Med. 2006;160(7): Substance Abuse and Mental Health Services Administration. (2010). Results from the 2009 National Survey on Drug Use and Health: Volume I. Summary of National Findings (Office of Applied Studies, NSDUH Series H-38A, HHS Publication No. SMA Findings). Rockville, MD. Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

8 S2BI In the past year, how many times have you used Tobacco? Alcohol? Marijuana? No substance use No substance use disorder (SUD) Mild/moderat e SUD Severe SUD Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

9

10 Sensitivity of Parent Report % of Parents Who Correctly Identified Teen s Use % 30% 47% 28% 27% 26% 0.2 Fisher SL et al., Alc Use Alc Intox MJ Use Other Drug Use Alc D/O MJ D/O 0% Other Drug D/O

11 If you think there *might* be a problem, there is a BIG problem. Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

12 Misconceptions about Alcohol Silveri, M.M., Spear, L.P. Ontogeny of rapid tolerance to the hypnotic effects of ethanol. Alcohol: Clinical and Experimental Research. 1999; 23(7): Murgraff, V., Parrott, A., Bennet, P. Risky single-occasion drinking amongst young people definition, correlates, policy, and intervention: a broad overview of research findings. Alcohol & Alcoholism. 1999; 34(1): 3-14.

13 Taken from with express permission from Dr. John Knight, Center for Adolescent Research CeASAR Boston Children s Hospital

14 Parenting Guidance: Prevention

15 Parent Involvement is Fundamental and Protective Thank You Taken from with express permission from Dr. John Knight, Center for Adolescent Research CeASAR Boston Children s Hospital

16 Parent Involvement is Fundamental and Protective Thank You Taken from with express permission from Dr. John Knight, Center for Adolescent Research CeASAR Boston Children s Hospital

17 Parent Involvement is Fundamental and Protective Express disapproval of marijuana and other drugs Supervise homework frequently (ages 12-17) Be a role model Use developmentally appropriate monitoring and discipline Praise frequently SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

18 Know where your kids are and who they are with Meet your kids friends and their parents Assure parties and events are adequately supervised. Ask W questions What are you going to do? Where? With who? When will you be back? Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

19 Social Media Monitor electronic communications. Friend your child on Facebook; Follow your child on Twitter, Instagram, etc. Ask for his/her password. Talk about the permanence of electronic communications. Limit electronic communications ( , texting, Google hang outs, XBox) at night. Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

20 Monitor Medications Discuss the misuse potential of medications Set a good example. Don t share medications or take meds that are not prescribed to you. Supervise all short-term medications. Provide oversight for long-term medications. Teach kids to take exactly as prescribed. Clean out the medication cabinet frequently. Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

21 Talk about Driving/Riding While Impaired Contract for Life Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

22 Parent Guidance: Substance Use Boston Children s Hospital All Rights Reserved. For permissions contact SBIRT project manager at

23 Signs of Substance Use Physical: Changes in sleeping Changes in eating Weight loss Glassy or red eyes Nasal congestion Headaches and/or flu-like symptoms

24 Signs of Substance Use Psychological: Mood swings Depression Anxiety Panic attacks Suicide attempts Cognitive: Memory impairment Decreasing grades Loss of interest in activities

25 Signs of Substance Use Social: Changes in dress and grooming Changes in peer relationships Isolation Behavioral: Lying Truancy Running away Delinquency

26 Educate Yourself and Act Quickly: Try to respond calmly Have your adolescent screened and/or assessed Remember that addiction is a brain disease Explore both psychotherapy and psychopharmacology

27 For further evaluation and treatment: Adolescent Substance Use and Addiction Program (ASAP) Boston Children s Hospital 300 Longwood Ave. Boston, MA *Locations in Boston and Waltham

28 Resources for Parents ; ; Goodman K, Simon K. Safe Road Home. New York: Sterling Publishing. 2005:26-37.

29 Acknowledgements John Knight Sharon Levy Patricia Schram Miriam Schizer Diana Deister Julie Lunstead Dylan Kaye Louise Breen Leslie Green Jesse Schram Katie Welsh Lon Sherritt Marianne Pugatch Sion Harris Nicholas Chadi