Counselor Roundtable

1. Counselor Roundtable STUDENT DRUG USE: Trends, Impact, Parent Training BRADFORD HEALTH SERVICES Janna Donovan, LPCA Clinical Counselor for Adolescents

2. BRADFORD AT THE INNERVIEW We treat the approximately 11% of the population who struggle with an addictive reaction to drugs or alcohol with an: INTENSIVE OUTPATIENT PROGRAM FOR ADULTS, ADOLESCENTS, AND FAMILIES AFFECTED BY SUBSTANCE ABUSE AND DEPENDENCE.

3. WHAT, WHO, WHEN ARE TEENS USING?

4. Experimentation begins Early Average age a child is exposed to alcohol & drugs out side the home is 9. 40% of new experimentation with cigarettes, alcohol & drugs are between 6th & 9th grades June and July are highest months of first use for THC December is the highest month of first use for alcohol IV drug use has increased Number of teens dying from drug use and overdose now exceeds number from car wrecks in US

5. Addiction Risk Factors Two main questions: Does the adolescent smoke? Is there a family history of addiction? Age of first use (younger, higher risk) Learning disabilities, behavioral problems, psychological disorders (brains wired differently, don’t fit in, more at-risk) Trauma (abuse, divorce) & Depression Stress (can lead to feelings of inadequacy & insecurity) Parent Acceptance (parents who use or sanction use have kids who use) 75% of adolescents in treatment come from fatherless homes Genetic history = 4x more likely to become addicts

6. Other Risk Factors Teens with these more likely to use: Risk takers and low fear response Failure to plan before they act Like to experiment with how things feel Higher tolerance Early school failure and peer rejection at age 7 to 9 Ducci & Goldman, 2008, as cited in Kalat, 2013

7. 27 % of Sophomores, 40% of Seniorsused Alcohol in the Last Month 18% of Sophomores22% of Seniors used Marijuana in the Last Month

8. Age of Onset correlation to Dependency Overall, every year you can postpone the first drink, the risk for lifetime alcohol abuse decreases by 8% NIAAA

9. Positives to Later Use vs. Early Use

10. ALCOHOL AND TEENS

11. Alcohol and Teens The drug most often abused by teenagers Most frequent source – family, friends, adult purchasers – especially older siblings, and parties. Parties, and in some cases Picnics are high risk for binge drinking and associated alcohol problems Correlated with rape and assault

12. Community Tolerance Parents and other adults have a high tolerance for underage drinking parties Myth that underage drinking is inevitable and safer if it is in a controlled residential setting Misconception that alcohol is harmless compared to other drugs Misconception that alcohol use is a right of passage (Remember, “Only” 27% of Sophomores and 40% of Seniors have had a drink this month)

13. MARIJUANA

14. Today’s Marijuana: 5-8 Times More Potent • Today’s drug leads to a higher high • Can prepare brain for opiates • “3 years from marijuana to opiates” like Loritab, Oxycontin • Opiate highs can open the door to heroin

15. Marijuana and Teens Teens who frequently use marijuana are almost 4x more likely to act violently or damage property Teens who frequently use marijuana are almost 5x more likely to steal than those who do not use Parties, and in some cases Picnics are high risk for binge drinking and associated alcohol problems

16. Effects of Marijuana/Cannabis Chronic useassociated with: • Lung, sinus irritation • Difficulty thinking, problem solving • Difficulty learning and REMEMBERING • Amotivation • Anxiety • Depression • Suicidal thoughts • Schizophrenia symptoms Retrieved from: http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/marijuana_fact_sheet_jw_10-5-10.pdf Intoxication: Red eyes Increased appetite Dry mouth Heart racing Distorted perceptions Impaired coordination Impaired judgment Anxiety Social withdrawal

17. Effects of Cannabis Withdrawal Retrieved from: http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf Withdrawal can include: Irritability, anger or aggression Nervousness or anxiety Sleep difficulties (insomnia) Decreased appetite or weight loss Restlessness Depressed mood Stomach pain, shakiness or tremors, sweating, fever, chills, and headache

18. Social Acceptance of Marijuana Use “It’s natural, good for you…Not as bad as cigarettes or alcohol” “It’s legal and should be” – Not for a developing brain Myth: “You cannot become addicted to marijuana” “Lots of famous, high achieving people smoke weed” – but they did not smoke 15% THC hourly at age 15 4:20 – Universal Smoke Time (“It’s 4:19, got a minute”) Popular Figures in Marijuana Culture: Wiz Khalifa or Wiz K, Mac Miller, Snoop Lyon (formerly Snoop Dogg), Lil Wayne

19. Common Slang for Marijuana • Dro, Hydro (hydroponically grown, synonym for “good”) • Reg (not very good, 2% THC) • Indo, Kaya • Mary Jane • Sess • Tree, Greenery • Hotbox (fill car with smoke) • “Buttered” Clinical Names: • Cannabis • THC Pot Grass Weed Kush Chronic Blunt (hollowed out cigar with marijuana in it) Fatty/Joint/Doobie

20. CONTRIBUTING FACTORS& PREVENTATIVE ACTIONS

21. 75% teens say that seeing pictures of others using drugs or alcohol encourages them to use drugs or alcohol 4x more likely to use marijuana 3x more likely to use alcohol 3x more likely to use nicotine Legalization & Favorable Attitude Many are prepared to fight, debate, & argue, for their use of it; it makes things “all good”. In their mind marijuana use is totally ok. Peer Pressure on Social Media

22. HOW TO PROCEED …If I think my child/student is drinking or using drugs

23. Warning Signs Physical Problems: fatigue, repeated health complaints, red hazy eyes, lasting cough. Emotional: personality change, sudden mood changes, irritability, irresponsible behavior, low self esteem Family: starting arguments, breaking rules, withdrawal School: decreased interest, negative attitude, drop in grades, absences, truancy, discipline problems Social Problems: new friends who are less interested in standard home and school activities, problems with the law, less conventional styles in dress and music

24. My child is drinking/using drugs Be willing to ask the extra question Trust your gut Watch their eye contact (they do not typically make eye contact) Provide boundaries The bigger the reaction, the closer you are to the truth

25. Why Do People Use in The First Place? To Feel Better To lessen: anxiety worries fears depression hopelessness pain To Feel Good To have novel: feelings sensations experiences AND to share them

26. Common Responses to Addiction Rationalizing Slow Progression Relating DENIAL IGNORING MINIMIZING Avoiding Hiding Pretending Normalizing When denial is heavy and we ignore and minimize, this can lead to a steady and dangerous progression

27. Common Responses to Addiction Exclusion Attack (War on Drugs) PAIN ANGER FEAR Preach or Moralize Make Laws Judge Blame Others Criticize Scare People Punish People When pain, anger and fear are the motivation, efforts to control others tend to evolve

28. Best Response to Addiction CONNECTION ACCEPTANCE SEEING OTHERS AS THEY ARE Inclusion Listening Modeling Supporting Sharing Touching Mentoring Teaching Non-Judgmental Discipline Accepting Feeling When connection, acceptance and seeing others as they are is the motivation, more influential (successful) efforts evolve.

29. Rules and Relationships Rules without Relationship Lead to Rebellion Relationship without Rules Lead to Revolt Relationship and Rules Lead to Respect

30. PREVENTION’S IMPACT Teens with these less likely to use: Academic effort/support Good communication skills Assertiveness, self-efficacy • (“If it’s to be, it’s up to me”) Social problem-solving Developed SELF-control Reinforcement of anti-drug attitudes and personal commitments against use NIH, 2003

31. FAMILY’S IMPACT NIH, 2003: these helps prevent use, recover: Stronger bond with nurturing parent(s) Effective, involved parenting Moderate, consistent, clear discipline Structure in the home environment Relationship with 1+ caring adult(s) Caregivers who: • Don’t abuse alcohol, drugs • Don’t engage in criminal behavior • Get help with mental illness struggles

32. GOOD NEWS: PARENTS’ IMPACT Parents have the most significant influence on their kids’ use of drugs. It’s not enough to be neutral, you must take a negative stance.

33. PARENTS’ IMPACT 2011 Study, Columbia University National Center on Addiction and Substance Abuse: Parents who expect their children to drink and use drugs will have children who drink and use drugs. Parents who send their 12- to 17-year-olds a message that it’s okay to smoke, drink, get drunk and use illegal drugs like marijuana become enablers.

34. FATHERS’ IMPACT Father’s impact on alcohol use: Young people who believe their father tacitly approves of their drinking are 2.5x more likely to get drunk in a typical month than teens who believe their father disapproves of their drinking CASA 24 (Results of parent restriction of use on outcome).

35. PARENTS’ IMPACT Parents who are unsure about use of marijuana: Teens almost 2x more likely to use marijuana …compared to teens whose parents say this decision is a major concern.

36. Even if it’s Painful…Take the Risk When we are in the midst of the pain we must do what it takes and risk much to save lives. • Get Professional Help • T-6 RESPONSE TIME • 80% VS 20% • DENIAL INCREASES • PAIN AND CONSEQUENCES DECREASE

37. Progression of Care Step 1: Event or Crisis (DUI, caught by parent) Step 2: Free Consult, drug screen, reco Step 3: No need, IOP or Inpatient Step 4: In-patient, Alabama (homework done) Step 5: IOP, Louisville, 4:30-7:30, M-Th, 6 wks Step 6: Mandatory Family Night every Monday Step 7: Contract for abstinence, grades Step 8: Continuing Care, Mon, Paid 2 Years Step 9: Referrals to Counseling, Services

38. Question & Answer

39. BRADFORD AT THE INNERVIEW 502-491-3799 Intensive Outpatient Program for adults, adolescents and families affected by substance abuse and dependence. The Chrysler Building 4229 Bardstown Road, Suite 311 Louisville, KY 40218

40. CONCERNED PERSONS Support group for those concerned about a loved one’s alcohol or drug use. Open to the public at no cost Every Tuesday Night 6:00 PM-8:00 PM Bradford at the InnerView The Chrysler Building 4229 Bardstown Road, Suite 311 Louisville, KY 40218 502-491-3799

41. RESOURCES FAMILIES ANONYMOUS • 800-736-9805 • Thursdays, 7:30 PM, St. Michael’s Catholic Church, 3705 Stone Lake Drive, Jeffersontown ALANON • 502-458-1234 • www.kyal-anon.org • Various meetings around town every day of the week

42. REFERENCES Califano, Joseph. 2011 Casa Survey. CASA – The National Center on Addiction and Substance Abuse at Columbia University. Ducci & Goldman, 2008 as cited in Kalat, 2013) National Institutes of Health. (2003). Preventing Drug Use among Children and Adolescents. NIH Publication No. 04-4212(A). U.S. Department of Health and Human Services. NIAAA (National Institute of Alcohol Abuse and Alcoholism). 2012. Kalat, J. 2013. Biological Psychology 11th Ed. Belmont, CA: Wadsworth, Cengage Learning. 75-76. Epidemic: Responding to America’s Prescription Drug Abuse Crises. www.whitehouse.gov . SAMSHA. (2008, 2003, 2002). National Surveys on Drug Use & Health.

43. Back-up Slides

44. Myths about Adolescents Myths about teens • An age of raging hormones • Immaturity - Just hold on and survive • They need total independence – let them go

45. The Adolescent Brain The ESSENCE of Adolescence • ES – Emotional Spark • SE – Social Engagement • N – Novelty • CE – Creative Explorations

46. The Adolescent Brain The ESSENCE of Adolescence Dopamine baseline is low (bored) Dopamine comes in spikes This results in: • Impulsiveness- Act first, Think later • Hyper-rationality – Over emphasize the PROs of an experience • Susceptibility to addictions – behaviors and substances that trigger dopamine releases

47. Where do most of the problems occur? People who have no clear rules about use People that send permissive messages about use People that send mixed messages about use People that tolerate use to the point of drunkenness or being high

48. LIFETIME USE

49. PRESCRIPTION DRUGS Prescription drugs are the fastest growing drugs of choice in the U.S.

50. Prescription Drugs-Fastest Growing Drug of Choice Include narcotics or opioids, depressants – usually benzodiazepines, and stimulants • Valium, Xanax, Klonopin, Ritalin, Concerta, Adderall, OxyContin, Opana Percocet, Lortab, Fiorinol, Fioricet, Vicodin, Hydrocodone,, Demerol, Dilaudid, Methadone, Suboxone, Codeine, etc. Overdose – Kentucky is #6 in the Country. Someone in Kentucky overdoses every 3 days. Nationwide in 2007, 100 people per day dying by overdose.