Transcript Document

Medicine Cabinet to
Heroin Addiction:
a brief and deadly journey
The Problem
• 1 in 5 teens has abused Rx drugs.
• 1 in 3 teens reports there is “nothing wrong”
when using Rx drugs “every once and a
while.”
• 1 in 3 teens report knowing someone who
abuses Rx drugs.
• Every day, almost 2,500 teens abuse a
prescription drug for the first time.
• Prescription drugs are abused more than
cocaine, heroin, ecstasy and
methamphetamine combined.
What is Rx drug abuse?
• The misuse of Rx drugs is a growing, under-recognized problem that puts
young lives at risk.
• Misuse includes:
• Rx drugs serve an important purpose when used under a doctor’s care.
• Misuse can lead to overdose, addiction and even death.
Why Are Teens Abusing Rx Drugs?
• They’re easy to get
• Thrill seeking
• Friends are doing it
• Escape problems or self-medicate
• Lack of self-esteem
• Seen as safer alternative with fewer side
effects
• Less stigma associated with Rx drugs
• Parents less likely to disapprove
Other Factors Driving Trend: Accessibility
• Rx medicines can be found in homes of
family or friends.
• Many parents aren’t aware of the
dangers.
• Many parents do not know how to
effectively talk with their children about
Rx drug abuse.
Other Factors Driving Trend: Invincibility
• Teens mistakenly believe:
• It’s safer to abuse Rx drugs than illicit drugs,
even if they’re not prescribed by a doctor.
• Rx drugs have fewer side effects and are not as
addictive.
• It’s okay to share these drugs.
Other Factors Driving Trend: Pill-Taking Society
• Rx medications are all around us…and teens
notice.
• Patients leave the doctor’s office with a
prescription in hand in 7 out of 10 visits.
• Direct-to-consumer advertising on TV and
in magazines.
• Many people don’t know how to safely use
these medications or ignore their doctor’s
instructions.
Where Do Teens Get These Drugs?
Source: SAMHSA, 2008 National Survey on Drug Use and Health
All People who use substances are
at risk for two types of problems
Impairment
Problems
Addiction
Problems
Addiction Problems
+
Biology
Quantity &
Frequency
Choices
Addiction
=
No Addiction
Unhealthy Risks...
Vs.
....Healthy Risks
Multiple Contexts/Domains
Individual
Family
Community
(School/Work)
Society
(Community)
Substance Abuse and Mental Health Services Administration’s
Center for the Application of Prevention Technologies contract.
Reference #277-08-0218.
This is Your Brain on
Adolescence
Resource for presentations to parents
Tammy Rhein LMSW, CASAC, CPP
Director of Mental Health and Chemical
Dependency
Orange County Department of Mental Health
Source:
Ken Winters, Ph.D.
[email protected]
Department of Psychiatry
University of Minnesota
2011
Emerging Science:
Teen Brains Are Still “Under Construction”
New insights about:
• Risk taking by teenagers
• How teenagers may be highly
vulnerable to drug abuse
Emerging Science:
Brain Imaging
New insights because:
• 1990’s information explosion
due to the development of
brain imaging techniques (e.g.,
CT, PET and MRI).
What Have We Learned?
•
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!
Source: Giedd, 2004.
Brain Development
When the pruning is complete, the brain is faster and more
efficient.
But… during the pruning process, the brain is not functioning
optimally.
Source: Giedd, 2004.
Brain Development
Maturation Occurs from Back to Front of
the Brain
Images of Brain Development in Healthy
Youth (Ages 5 – 20)
Blue represents maturing of brain areas
Source: Gogtay, Giedd, et al., 2004.
Alcohol, tobacco and other drug use starts early and
peaks in the teen years
First Drug Use (number of initiates)
Evidence from surveys
Infant
Child
Teen
Adult
Older Adult
Opportunities for Parents
• There is also the need to educate parents –
both because they better explain adolescent
behavior and because they present cautionary
signs that parents may want to heed.
• If the seemingly irresponsible behaviors of
teens are not truly willful acts but are the result
of the brain still “under construction,” parents
will want to be more tolerant of such annoying
behaviors common during adolescence.
Opportunities for Parents
• Rather than the message:
• “I need to know where you are and
who you are with.”
• Use this more scientifically justified
message is:
• “Let’s discuss how you are going to
handle a risky situation.”
Take Home for Parents
Promote activities that capitalize on the strengths of the developing
brain
Assist your child with challenges that require planning
Reinforce their seeking advice from you and other adults
Encourage lifestyle that promotes healthy brain development
Never underestimate drug effects on developing brain
Tolerate “oops” behaviors common during the teens
Key Protective Factors that Improve the Likelihood of a
Drug-Free Child
1. Many opportunities for conventional involvement, positive
family involvement
2. Good impulse control
3. Follows rules and avoids delinquent peers
4. Negative attitudes toward drugs
5. Low availability of drugs
6. High commitment to school
7. High perceived risk of drug use
8. Rewarded for involvement in conventional activities
9. Family attitudes do not favor drug use
10. Family is close
Take Home for Parents
Adolescent signs of Substance Use:
 Change s in appetite or sleep patterns
 Deterioration of physical appearance .
 Withdrawal from social or important activities
 Unexplained need for money or secretive about
spending habits.
 Sudden change in friends or locations.
Take Home for Parents
Adolescent signs of Substance Use:

Increased interpersonal or legal problems.
 Change in personality or attitude
 Neglecting responsibilities.
 Using despite knowing it is dangerous.
Description of Opioid Intoxication:
Opioids can stop a person’s breathing and, in rare cases, lead to heart
rhythm abnormalities (QT prolongation and
torsades de pointes).
The duration of action of opioids varies. Close monitoring is required
when a person overdoses on long-acting opioids,
especially methadone.
Early warning signs:
1. drowsiness with “nodding off” or falling asleep when left alone for a
few minutes
2. conjunctival injection
3. euphoria.
Description of Opioid Intoxication cont.:
Diagnosis:
Opioid intoxication should be suspected in patients presenting with the following
clinical triad:
1. depressed level of consciousness,
2. respiratory depression, and
3. pupillary miosis (“pin-point pupils”). However, pupillary miosis not always
present.
Even if patients appear alert for brief moments, they must be monitored by a
health professional as the progressive nature
of overdose may lead to death, especially when patients fall asleep. Opioids
prolong GI transit times, causing delayed and
prolonged absorption of ingested opioids.
Note that if the person uses opioids orally or by snorting there will be no needle
marks.
Take Home for Parents
Signs of opiate withdrawal:
Early symptoms of withdrawal include:
Late symptoms of withdrawal include:

Agitation
 Abdominal cramping
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





Anxiety
Muscle aches
Increased tearing
Insomnia
Runny nose
Sweating
Yawning
 Diarrhea
 Dilated pupils
 Goose bumps
 Nausea
 Vomiting
Paraphernalia
Proper Disposal
• New York State Police – Anytime
• Orange County Sheriffs Dept. – Business Hours
• Semi Annual DEA drop-off events – Check with local Law
Enforcement or
Substance Abuse Coalition
• Hospitals - Check with your local Hospital
Treatment Modalities
Detoxification: Monitored Withdrawal
• Medically Managed (Hospital)
• Medically Monitored (Crisis Center)
Inpatient Rehabilitation: Short term intensive
inpatient experience / Long Term treatment
Day Treatment (Day Rehab): Day-long
treatment, activities, multiple days, outpatient
Intensive Outpatient: Multiple sessions per
week, individual & group therapy
Treatment Modalities (cont.)
Outpatient Clinic: Occasional treatment sessions,
one- three times per week
Residential:
•Half-way house
•Supportive living
Recovery Coaching:
Self-help, support groups, twelve-step
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