Transcript Healthy Relationships and teen dating violence

Current Trends in
Drug Use Among Youth
August 14, 2014
Jeff R. Temple, PhD
@DrJeffTemple
OVERVIEW
 Discuss common drugs/substances abused by adolescents
 Describe the impact of drug use on adolescent development
 Identify the importance of screening for adolescent drug use
Monitoring the Future Study:
National Survey on Drug Use Among Youth
 Since 1975, the MTF (Monitoring the Future) survey
has measured drug, alcohol, and cigarette use and
related attitudes among 12th graders, nationwide.
 41,675 students from 389 public and private schools
in the 8th, 10th, and 12th grades participated in the
2013 survey.
 The survey is funded by NIDA (National Institute on
Drug Abuse; under NIH) and conducted by the
University of Michigan. Results from the survey are
released each December.
Results of the MTF:
Current Trends in Drug Use Among Youth
 Illicit Drug Use
A . Marijuana
● I l l i c i t d r u g u s e r e m a i n s h i g h d u e to t h e p o p u l a r i t y o f m a r i j u a n a u s e
● I n 2 01 3 , 7. 0 p e r c e n t o f 8 t h g r a d e r s , 1 8 . 0 p e r c e n t o f 10 t h g r a d e r s , a n d 2 2 . 7 p e r c e n t o f
12th graders used marijuana in the past month, up from 5.8 percent, 13.8 percent, and
19.4 percent in 2008.
B. Synthetic Marijuana (also known as K2 or Spice)
● I t s u s e i s n o t i n c r e a s i n g . I n 2 01 1 , 1 1 . 4 % o f h i g h s c h o o l s e n i o r s r e p o r te d u s i n g i t ; i n
2 01 3 , i t d r o p p e d to 7. 9 % .
C. Non-medical Use
● U s i n g o v e r - t h e - c o un ter d r u g s a n d p r e s c r i p t i o n d r u g s w i t h o ut m e d i c al r e a s o n s i s a
s i g n i fi ca n t c o n c e r n f o r yo ut h d r u g u s e
D. Cocaine
● Po s i t iv e t r e n d s i n t h e p a s t s ev e r a l ye a r s i n c l ud e r e d uc e d u s e o f i n h a l a n t s a n d l e s s
u s e o f c o c a i n e ( s e e n ex t s l i d e )
Monitoring the Future Study 2014
National Institute on Drug Abuse_NIH
Results of the MTF:
Current Trends in Drug Use Among Youth
 Alcohol
Consumption has significantly decreased. In 2013:
 8 th graders: 3.5%
 10 th graders: 12.8%
 12 th graders: 26% reported getting drunk in the past month
 Tobacco
Fewer teens smoke cigarettes than smoke marijuana. In 2013:
 marijuana smokers: 22.7%
 cigarette smokers: 16.3%
Monitoring the Future Study 2014
National Institute on Drug Abuse_NIH
Current Trends in Drug Use
→ Indicating reduced
use of inhalants and
less use of cocaine,
especially crack
cocaine
Monitoring the Future Study 2014
National Institute on Drug Abuse_NIH
Current Trends in Drug Use
→ Recently,
more teens use
marijuana than
cigarettes
Monitoring the Future Study 2014
National Institute on Drug Abuse_NIH
Dating it Safe
(Temple et al., 2013)
Demographics: Dating It Safe Study
 A total of 1 ,042 high school students ( n=1042, 583 female,
459 male) between the ages of 13 and 18 years old ( mean
age=15.09) are the analytic sample for year 1 (2010)
 Ethnicity included:
31 .4% Hispanic,
29.4% White, non-Hispanic
27.9% Black or African American
3.6% Asian and Pacific Islander
7.7% other ethnic groups
Ethnicity
3.6
7.7
31.4
27.9
29.4
Hispanic
White(non
-Hispanic)
African
American
Longitudinal Result:
Dating It Safe Study
80
70
Percent (%)
60
Alcohol
Marijuana
Cigarette
Illicit Substances
50
40
30
20
10
0
Wave 1
Wave 2
Wave 3
Wave 4
Identification of Risk Factors
for Drug Abuse
 Adolescents are more likely to use drugs if:
1.
2.
3.
4.
5.
6.
There is a history of substance abuse in their family
They are depressed or impulsive
Have experienced a trauma
Have low self-ef ficacy
Do poorly in school
Associate with alcohol/drug using peers/partners
Effects of Substance Abuse on
Adolescent Development
 Negative ef fects on adolescents’ brain development
→ Alcohol, consumed early adolescence, can disrupt endocrine
development
→ Marijuana is known to adver sely af fect learning and memor y
per formance of adolescents measured by standardized testing
 Adolescents engage in sexual activities more frequently
→ Adolescents engage in sexual activities af ter using substances or
alcohol, and less likely to use contraception
→ Teens who smoke marijuana are four times more likely to have been
pregnant or to have gotten pregnant
Effects of Substance Abuse on
Adolescent Development
 Accident Risk Increase
→ Substance abuse can be added to driving inexperience, leading auto
accident to increase among youth
 Risk of Addiction
→ One out of four people star ting drugs or alcohol as a teenager becomes
addicted
 Arrested Development
→ When teens star t using drugs or drinking alcohol during the developmental
year s, their social and emotional development stops
Long-term Effects of Marijuana Use on
Development Of Youth
Prolonged drug use, especially marijuana, changes the brain in
fundamental and long-lasting ways:
 Long-term effects of marijuana use among youth
1. Ability to do complex tasks could be compromised (e.g., poor
coordination, lowered concentration)
2. People who use marijuana over the long term report less life
satisfaction, poorer education & job achievement, and more
interpersonal problems
3. Approximately, 9 percent of people who use marijuana become
dependent on it, and the number increases to about one in six
among those who start using it at a young age, and to 25 to 50
percent among daily users
Specific Effects of Alcohol Abuse on
Development Of Youth
 Alcohol impacts adolescents differently than it does adults
→ Recent brain research with MRI(Magnetic Resonance Image)
suggests that young people are more vulnerable to the negative
effects of alcohol on the hippocampus, the part of the brain that
regulates working memory and learning.
1. Heavy use of alcohol and other drugs during the teen years
can result in lower scores on tests of memory and attention in
one’s early to mid-20s.
2. People who begin drinking before age 15 are four times more
likely to become alcohol -dependent than those who wait until
they’re 21 .
3. Teens also tend to be less sensitive to Alcohol’s sedative
qualities. Teens are able to stay awake longer than adults,
which enables them to drink more and be more vulnerable to
cognitive impairment and perhaps brain damage from alcohol
poisoning than adults.
Do Adolescents Really React Differently Than
Adults To Substances Use?
→ rats exposed to nicotine
in adolescence
self-administer
more nicotine than rats
first exposed as adults
Collins et al, Neuropharmacology, 2004, Levin et al, Psychopharmacology, 2003
Addiction is a Developmental Disease:
It Starts Early
Why Is It Impor tant To Screen For
Adolescent Alcohol And Substance Abuse?
 Alcohol and substance use are associated with three major
causes of youth mortality : accidents (primarily motor vehicle
accidents), homicide, and suicide. Among youth, more than 30
percent of all deaths from injuries can be directly linked to
alcohol.
 In addition, cocaine use can produce acute cardiovascular and
other complications (e.g., arrhythmias, myocardial infarction,
seizures), and chronic use of marijuana has been associated with
respiratory inflammation and increased risk of airway cancer.
 Indirect legal, social, and economic consequences of drug use
need to be noted. (e.g., cost of crime and incarceration, reduced
productivity, etc.)
Screening for Adolescents Drug Use:
Introducing CRAFFT
 Health ser vice providers, juvenile justice worker s, educators, and
other professionals who work with adolescents at risk should be
able to screen and refer to fur ther assessment
 The CRAFFT is a behavioral health screening tool for use with
children under the age of 21 and is recommended by the American
Academy Of Pediatrics’ Committee on Substance Abuse for use with
adolescents
 It consists of a series of 6 questions developed to screen
adolescents for high risk alcohol and other drug use disorders
simultaneously. It is a shor t, ef fective screening tool meant to
assess whether a longer conversation about the context of use,
frequency, and other risks and consequences of alcohol and other
drug use is warranted.
CRAFFT: Example of Screening Questions
→ Screening using the
CRAFFT begins by asking the
adolescent to answer these
next questions honestly;
reminding him or her
confidentiality; and then ask
three opening questions
Timely Management:
Referral or Intervention
 Adolescents who screen as high risk(e.g., CRAFFT score of 2
or more) should have further assessment to determine
whether they have developed dependence (addiction) to
alcohol or another drug
 Adolescents who are high-risk users but have not developed
an addiction may benefit from a brief intervention – 1 or 2
brief intervention sessions either conducted by a primary care
provider or allied mental health professional to discuss the
impact of drugs or alcohol on their lives or their futures
Prevention of Alcohol/Substance Abuse
 motivational inter viewing (or
change talk) skill is valuable
for healthcare provider s
→ change talk is meant to be
self-motivating dialogue
→ change is facilitated by
communicating in a way that
elicits the per son’s own reasons
for and advantages of change
→ can be helpful in assisting
patient to resolve his/her
ambivalence towards the impact
of using alcohol and other drugs
Preventing Drug Use Among Youth
 For families:
1. Evidence-based family skills training programs (e.g.,
Strategic Prevention Framework of fered by the Substance
Abuse and Mental Health Service Administration) have been
found to be the most ef fective way to prevent substance use
among children and adolescents
2. Programs target the whole family and of fer skills -building
for parents on monitoring and supervision of children's
activities, communication and setting age appropriate
limits.
Preventing Drug Use Among Youth
 For Schools/Communities:
 Organize a Kick Of f Event
To garner community -wide attention, organize a walk or run culminating
in a rally featuring presentations from community leaders on the
impor tance of preventing drug use before it begins
 Utilize Social Media
Post information about substance abuse and initiate discussions, media
feeds, and open forums about prevention on your coalition’s Facebook
page and Twitter feed
 Promote Alternative Activities
Spor ts, ar t, and other healthy and fun activities such as a substance -free
tailgate before a school football game or a safe homecoming af ter -par ty
in a community center or gymnasium are great ways to deter youth from
substance use and other risky behaviors
Any Questions?
THANK YOU!
Jef f R. Temple, PhD
Associate Professor and Psychologist
Director, Behavioral Health and Research
Department of Ob/Gyn
UTMB Health
------------------------409.747.8560
[email protected]
@DrJeffTemple