Building Understanding of American Indians using Synthetic Cannabinoids

Transcription

1 Building Understanding of American Indians using Synthetic Cannabinoids Sean Bear Sr., BA, CADC, Sac and Fox Tribe of Mississippi in Iowa Senior Behavioral Health and Training Coordinator, National American Indian & Alaska Native ATTC Behavioral Health is Essential to Health Prevention Works Treatment is Effective People Recover American Indian & Alaska Native Behavioral Health Webinar Series This webinar is provided by the National American Indian & Alaska Native ATTC, a program funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse Treatment (CSAT). For more information on the ATTC Network, visit: attcnetwork.org To find your regional center, visit: attcnetwork.org/findregcenter.asp For more information on the National American Indian & Alaska Native ATTC, visit: attcnetwork.org/americanindian, or call

2 Upcoming webinars from the National American Indian & Alaska Native ATTC To Be Announced presented by: To Be Announced Introduction to the American Indian & Alaska Native Leadership Academy presented by: Brent Lierman, PhD Basic Counseling Skills presented by: Dee Le Beau-Hein, MS, Cheyenne River Sioux Tribe Group Counseling presented by: Matt Ignacio For more information about our webinar series, contact Kate Thrams at or Continuing Education Hours (CEH) Webinar Follow-Up CEHs are available upon request for $15 per session. This session has been approved for 1.0 CEH s by: NAADAC: The National American Indian & Alaska Native ATTC is a NAADAC (The Association for Addiction Professionals) certified educational provider, and this webinar has been pre-approved for 1.0 CEH. To obtain CEHs for this session, submit a CEH Request Form and payment to the National AI & AN ATTC. A request form is available for download in the Files pod in the webinar screen. If you choose to download a file, a new tab will be opened in your browser, and you will have to click on the webinar window to return to view the webinar. Participants are responsible for submitting state specific requests under the guidelines of their individual state. Presentation handouts: A handout of this slideshow presentation is also available by download. If you are unable to download the documents from the webinar, please contact Kate Thrams at kate-thrams@uiowa.edu or

3 Webinar Follow-Up Evaluation: SAMHSA s GPRA This webinar is provided by the National American Indian & Alaska Native ATTC, a program funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse Treatment (CSAT). Participation in our evaluation lets SAMHSA know: How many people attended our webinar How satisfied you are with our webinar How useful our webinars are to you Immediately following this webinar, you will be redirected to a customer satisfaction survey. Please take a few minutes to give us your feedback on this webinar.. You can skip any questions that you do not want to answer, and your participation in this survey is voluntary. Through the use of a coding system, your responses will be kept confidential and it will not be possible to link your responses to you. We appreciate your response and look forward to hearing from you. Participation instructions: To alternate between full screen mode, please click on the full screen button on the top right of the presentation pod. (It looks like 4 arrows pointing out) To ask questions or share comments, please type them into the Q&A pod and hit Enter. Adobe Connect Overview 3

4 Adobe Connect Overview Please note: The webinar system records participant attention time. If you have other windows open and active, or have the webinar minimized, the system will deem you as inattentive, which may be reflected in the number of CEHs received. Disclaimer Please note: The National American Indian & Alaska Native Addiction Technology Transfer Center is supported by a grant from SAMHSA The content of this publication does not necessarily reflect the views or policies of SAMHSA or the Department of Health and Human Services (HHS). 4

5 Today s Speaker Sean A. Bear, Sr., BA, CADC, Sac and Fox Tribe of Mississippi in Iowa, is the Senior Behavioral Health Consultant and Training Coordinator for the National American Indian & Alaska Native ATTC. Sean has worked in behavioral health and substance abuse for many years, including adolescent programs. Building Understanding of American Indians using Synthetic Cannabinoids Keys to Understanding Unique Challenges and Strengths of American Indian Clients in Substance Abuse Treatment Anne Helene Skinstad, PhD Sean A Bear Sr, BA, CADC Mandy Conrad, PhD Student Behavioral Health is Essential to Health Prevention Works Treatment is Effective People Recover 5

6 Synthetic Cannabinoids Behavioral Health is Essential to Health Prevention Works Treatment is Effective People Recover News Flash The trend of using Synthetic Cannabis has lead many youth to the Emergency rooms with various medical concerns including: Continuous vomiting, Psychosis, Desire to commit suicide. Serious Medical concerns include: Heart attacks and Death 6

7 History of Synthetic Cannabinoids John Huffman, PhD Cancer research, used synesthetic marijuana as treatment for pain in Cancer Patients Alternative synthetic marijuana However No studies on human consumption were done. Not meant for recreational use. Common Names Spice K2 Gold Spice Diamond Yucatan Fire Solar Flare Crazy Clown 7

8 Street Names Kronic Bliss Spice Blaze K-2 G-Force Voodoo Blue Haze Kaos Dark Night Kush Dank Black Mamba Earth Quake Zombie Yucatan Fire Demon Passion Magma Accessibility Vendors Online, gas stations, head shops, convenience stores Cost Approximately $40 for 3 grams 8

9 How do we get this? Sold as Incense, Potpourri Labeled as Not for Human Consumption The Legal High Marketed as herbal incense, potpourri, and/or not intended for human consumption Active compounds not detectable in drug screenings Not scheduled, but psychoactive compounds have been detected However, there is a federal ban on 5 compounds (3/2011) 9

10 Properties Man-made artificial Chemicals that are often sprayed onto plant matter, that mimic THC Chemicals utilized in the process are often untested, unregulated, and dangerous for human consumption. Chemicals are often sprayed on plant matter Spraying is often the process of adding Chemical to the Plant matter in large containers. The overlap of chemicals sprayed on cannot be regulated. Some areas have more concentrated chemicals sprayed on than others. Example: One Pass = 1x One overlap = 2x 2nd overlap = 3x 3rd overlap = 4x 10

11 Public Health Risks Lack of quality control and oversight results in constantly changing chemical composition, which means that the effects are not always predictable. Signs of Use Strong Clove Scent Paraphernalia Increased agitation - mild to severe Pale skin Lack of pain response Profuse sweating Loss of physical control Seizures 11

12 Effects of Use The Duration normally lasts One to Eight hours with a three to Five minute onset Dysphoria: the user may experience intense Visions of Hell Hallucinations Paranoia, similar to PCP Delusions Long term effects are unknown General Effects of Synthetic Cannabinoids Severe agitation Anxiety Nausea Vomiting Tachycardia Tremors Seizures Hallucinations Pupil dilation Suicidal thoughts Overdose Effects Panic attacks Psychosis Synthetic cannabinoids are 10X stronger than cannabis, resulting in severe toxicity and potential for overdose. Treating acute symptoms is equally as important as treating addiction. 12

13 Exposures to Synthetic Marijuana Year Number of Cases , through May 31, American Association of Poison Control Centers Synthetic Cannabinoid Addiction The potency and psychoactive effects of these agents make them potentially addictive and hazardous compounds. (Harris & Brown, 2013) However, sparse data regarding toxicology or epidemiology data on overdoses/general use exists in current research. 13

14 Objectives Pharmacology Physiological Effects Cannabinoid receptors in our brain why? Animal studies show that without these receptors Experience more pain Can t control appetite More anxious Less able to cope with stress 14

15 Pharmacology 85 Different Cannabinoids Different Specific Effects Tetrahydrocannabinol (THC) Psychoactive compound of Cannabis Synthetic Cannabinoids Variety of chemical classes Pharmacology Interruption of normal brain function Alteration of neuro transmitters Tolerance Adaptation to substance Alteration of Brain chemistry 15

16 Physiological Effects Why do people try synthetic cannabis? Curiosity Experimentation Peer/Social Pressure Legal Alternative Access easier (can buy in gas stations) Cost effective 16

17 Why do they continue use? Cope/Relieve Stress Have Fun/Relax A Legal alternative to Marijuana. Are not detectable on standard drug screenings How do they become addicted? Drug use alters the way the Brain normally operates Psychological Cravings Physiological Cravings/Tolerance Family history of substance use disorders Mental distress or mental health disorders Medical disorders: starting to use substance to treat pain 17

18 Effects of substances on neurotransmitters 18

19 Adolescence is a period of profound brain maturation. We thought brain development was complete by adolescence We now know maturation is not complete until about age 25 Maturation occurs from back to front of brain Images of Brain Development in Healthy Youth (Ages 5 20) Earlier: Limbic system Processing emotions Processing social info Experience reward, punishment Later: Prefrontal cortex Deliberative thinking Logical reasoning Planning ahead Weighing costs and benefits Regulating impulses Source: PHAS USA 2004 May 25; 101(21): Epub 2004 May 17. Blue represents maturing of brain areas 19

20 Implications of brain development for adolescent behavior Preference for physical activity high excitement and rewarding activities activities with peers that trigger high intensity/arousal novelty Less than optimal control of emotional arousal consideration of negative consequences Greater tendency to be attentive to social information take risks and show impulsiveness Risk-taking Based on science of brain development, a modern view of risk taking in adolescence is normative; important to development evolutionarily adaptive significant individual differences is due primarily to emotional and contextual, not cognitive, factors 20

21 Brain homeostasis Master control center of bodily functions Regulatory Balance Neurotransmitters Chemical messenger which transmits messages between neurons 0ver 100 known messengers identified, and play major roles in the lives of our life everyday. Essential to the Brain s response to the environment and our experience in life. 21

22 Substance use effects neurotransmitters Dopamine - Pleasure A main neurotransmitter activated in Substance Use/Abuse. Serotonin - Mood Marijuana s effects on cognitive functioning 22

23 IQ changes among diagnosed users Meier et al., 2012; PNAS IQ Changes Among Former Persistent Users who Had Stopped Using Meier et al., 2012; PNAS 23

24 Neurocognitive disorders Early marijuana use and risk for substance use disorder 24

25 Early marijuana use and risk for psychosis Psychosis Prevalence of Past Year Serious Mental Illness Among Lifetime Marijuana Users Aged 18+ (SAMHSA, 2005; data collected ) 25 Percentages < age 12 age age > age 17 Age of marijuana onset 25

26 Cannabis and Progression to Substance Use in Young Adults 13-year longitudinal cohort study with recruitment in secondary school students in Victoria, Australia. There were six waves of adolescent data collection (mean age years) followed by three in young adulthood (mean age 20.7, 24.1 and 29.0 years). Never use of marijuana provided the strongest protection from use of all other drugs. Weekly cannabis users during adolescence had two to three times the rates of illicit drug use uptake during young adulthood, while daily users had six times the rate of uptake of cigarette smoking. Potential treatments for a drug with changing compounds 26

27 It takes a village Recoveryoriented care Continuum of care Recovery schools Community engagement It takes a village a community to curb the drug epidemic. Community-based participatory program/research 27

28 Communities identify a problem Communities need to identify the issues they want to focus on. Communities can choose to implement a change themselves. Communities can choose to hire a consultant to support the assessment and implementation of a plan. Collect objective data to measure change from before to after the implementation of a change. Community-driven asset identification and issue selection Core principles and considerations Start where the people are Address issues that really matter to the community. Community concerns shape and determine the topic chosen, how it is explored, and to what ends. Listening for and honoring hidden transcripts. Recognize and begin with community strengths and assets. How communities collect information. Encourage creativity of community members. Engage in authentic dialogue Facilitate co-learning by community members and researchers. Key stakeholder interviews Opinion leader identification and interviews 28

29 Tools and resources Creative arts Capture visual and oral expressions in a culturally appropriate way. History Theatrical performances Sources of pride Poetry, drawings Shared concerns of people Way of life Community examples Urban versus rural/frontier community examples Tools and resources Use of technology Computers, phones, etc. Use of social networking sites Communicating in the legislative arena The politics of community plans Characteristics of the community Issue focused Obesity Walkways Workout clubs/ymcas 29

30 Implications for prevention and treatment I favor programs that focus on teaching skills associated with thoughtful, planned decision making: impulse control second thought processes social decision making dealing with risk situations taking healthy risks Contact information Anne Helene Skinstad, PhD Clinical Associate Professor Program Director, National American Indian and Alaska Native ATTC Department of Community and Behavioral Health, University of Iowa College of Public Health anne-skinstad@uiowa.edu 30

31 Thank you! Questions and Discussion Please type your questions or comments for the presenter in the Q&A pod at this time 31

32 Follow-up Within the next 24 hours, you will receive an from the National AI & AN ATTC which will include: Link to the recording of this webinar Link to the survey in case you were unable to access it Handouts of the presentation CEH request form We appreciate your participation in our survey, it should take you no more than 10 minutes to complete, and lets SAMHSA know: How many people attended our webinar How satisfied you are with our webinar How useful our webinars are to you Upcoming webinars from the National American Indian & Alaska Native ATTC To Be Announced presented by: To Be Announced Introduction to the American Indian & Alaska Native Leadership Academy presented by: Brent Lierman, PhD Basic Counseling Skills presented by: Dee Le Beau-Hein, MS, Cheyenne River Sioux Tribe Group Counseling presented by: Matt Ignacio For more information about our webinar series, contact Kate Thrams at or

33 Thank you for taking time out of your very important work to ensure quality service through education in collaboration with the persons you serve Behavioral Health is Essential to Health Prevention Works Treatment is Effective People Recover 33