Transcript Kevin Leehey M.D. Child, Adolescent, and Adult Psychiatry

Salpointe Catholic High School
Community of Concern
What’s Brain Got To Do With It ?
Kevin Leehey M.D.
Child, Adolescent, and Adult Psychiatry
Board Certified
leeheymd.com
296-4280
2014 Trends
Teen birth rate lowest in 70 years
HS grad rates are up
MVA deaths lowest in 60 years. Teens down 65% since 1975
Teen use of methamphetamine, alcohol, ecstasy, cocaine,
cigarettes are slightly down
Youth suicide rate is down again
Rate of violent crime decreased again
Prescription medicine abuse and Marijuana abuse continue to rise
Youth : #1 alcohol, #2 marijuana, #3 tobacco, #4 “pills”= Adderall
(stimulants), opiates, benzos, Ambien, DXM, Soma
Spice, K-2= cannabanoids, “bath salts”, synthetic “Research
Chemicals” (legal) hallucinogens;
E-cigs, e-hookahs, hookah pens, vape pipes, “vaping”
Drugs kill more than cars do now
Legal drugs are as dangerous as illegal drugs
Youth drink to get “buzzed”, drunk; binge = 5 for M, 4 for F in 2 hrs
A negative drug screen does not mean they’re not using
The left side of the brain is shown.
Source: Shaywitz – Overcoming Dyslexia
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.
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 in as a tendency for life. This is in
addition to any genetic predisposition.
Healthy Subject
watching video of
using
Substance abuser in
remission watching
video of using
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 1719, “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.
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” !
Causes of death ages 15-24 :
Accidents -primarily motor vehicle,
many are substance impaired.
Suicide
Homicide
Unintentional Drug Overdoses
These 4 account for 75% of all deaths in
our kids. Suicide and homicide are
mostly by guns and many are
substance impaired.
Firearm Injuries and Deaths
30,000 deaths per year (2/3 = 20k of those
are suicides); tens of thousands more are
seriously injured annually.
Similar number deaths by motor vehicles.
The presence of a firearm in the home, rather
than protective, is associated with a 3 times
greater risk of homicide and 5X suicide risk.
If you keep any firearm at home, Childproof
locks, gun safes, storing firearms locked
unloaded and separate from ammo lowers
risk.
•Teen traffic deaths dropped 62% 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.
The more you use marijuana the more likely you are to use multiple other drugs.
Most substance abusers use many different drugs, not just one or two.
Marijuana, pot, grass, weed
Perceptual distortions
Short term memory and slower processing
Apathy, lack of motivation
The point of substance use is to alter feelings, thoughts,
perceptions, reality
Out of touch with own feelings, denial of sad, mad,
down, concerns re social, family, future; Self medication
of MH and life problems. Delays development.
Relationship problems
MJ can cause or worsen mental illness
MJ use in teens may lower Intelligence
15% MJ users < 25yo become dependent; ~same as
alcohol and cocaine, opiates higher, tobacco #1- 30%
Yes, there is MJ Withdrawal
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. It lessens substance use, promotes healthier weight,
overall and heart health and mental health.
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.
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.”
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
Teen Driving –True or False
Car crashes kill more teens than, homicide,
suicide, AIDS, cancer, and all disease together
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.
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 just trust what my teen says about _____ .
I only have to worry about illegal drugs.
Teens get drugs from dealers.
Parenting Teens 101 – True or False ?
My kids don’t need a computer or Facebook, etc. till
at least college.
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 phone, iPod, 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.
Adults should limit, monitor, and supervise teens
stepwise as they attain and demonstrate growth in
their brain and overall developmental abilities.
Parenting Tips
Cell phones 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.
2% 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”
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” !
Synapses that are used often are kept
and reinforced.
Those that are not used are lost.
How you spend your time and the
experiences you have or don’t have
are critical.
Actual Causes of Preventable Deaths
Most of the increase is due to prescription opiate pain
meds. This increase parallels increased prescriptions.
Some is due to cocaine. Some is due to heroin.
Studies show “not living in an intact 2 bio parent home increases a child’s
past, current, and future risk for trauma exposure and PTSD”. Single parents
often do great, it’s just a lot harder with more challenges.
Social Mobility (the American Dream) has been declining in the US. Studies
show that “countries and the parts of the US that invest heavily in all their
children’s health care, nutrition, and education end up with a much stronger
ladder of opportunity”.