Discussion: Adolescent Substance Abuse
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Increased funding for treatment and rehabilitation
Created the Office of National Drug Control Policy (“drug czar”)
Worked on a public health approach to drug control
National Institute on Drug Abuse (NIDA)
Science on drug abuse and addiction
Prevention
Treatment
Decreasing the spread of HIV/AIDS
Other priority areas
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
7Laws Impacting Substance Abuse (Cont.)
Substance Abuse and Mental Health Services Administration (SAMHSA)
Builds and sustains programs, policies, information and data, contracts, and grants toward helping the nation act on the knowledge that promotes behavioral health treatment through all levels of prevention
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
8Prevalence, Incidence, and Trends
Alcohol use by persons aged 12 or older:
Slightly more than half (52.8%) drink alcohol
Binge drinking at least once in prior 30 days— (22.6%)
Heavy drinking—6.2%
Young adults ages 18-25 had highest prevalence of binge and heavy drinking—39.8%
Drove under the influence of alcohol at least once in past year—11.1%
– SAMHSA (2011)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
Prevalence, Incidence, and Trends (Cont.)
Illicit drug use by persons aged 12 or older:
About 8.7% were current drug users, used an illicit drug during the past month
Illicit drugs used
Marijuana was the most commonly used drug
Others included cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics (pain relievers, tranquilizers, stimulants, and sedatives) used nonmedically
– SAMHSA (2011)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
10Prevalence, Incidence, and Trends (Cont.)
Nonmedical use of prescription-type psychotherapeutics
There is a significant increase in the lifetime nonmedical use of pain relievers—specifically Percocet®, Percodan®, Vicodin®, Lortab®, Darvocet®, Darvon®, Tylenol® with Codeine, Propoxyphene, or Codeine Products, Oxycodone, and Hydrocodone
– NIDA (2010)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
11Prevalence, Incidence, and Trends (Cont.)
Hallucinogen, inhalant, and heroin use
LSD (d-lysergic acid diethylamide)
Peyote cactus
Psilocybin
PCP (phencyclidine)
Inhalants of choice are amyl nitrite, “poppers,” followed by glue, shoe polish, or toluene; correction fluid, degreaser, or cleaning fluid; gasoline or lighter fluid; and spray paints and other aerosols.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
12Prevalence, Incidence, and Trends (Cont.)
Gender difference
Males more likely to be current illicit drug users
Female illicit drug use (12 and older) increasing
Geographic trends
Highest in West > Midwest > Northeast > South
Racial/ethnic groups
Highest among American Indians or Alaska natives > African Americans> whites > Hispanics > Asians
– SAMHSA (2010)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
13Trends in Substance Abuse
May or may not relate to classically or clinically defined dependence or addiction.
Many are turning to recovery before they have developed physiological dependence.
Need to differentiate between use and misuse/abuse.
Use of harmful substances is indirectly and directly related to all of the leading health indicators targeted in Healthy People 2020.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
14Methamphetamine (MA)
Most widely produced controlled substance in the United States.
Illegal street names of the drug (crank, crystal, meth, ice, or glass).
Can be injected, inhaled, taken orally, or smoked.
Used predominantly by white young persons, with an overrepresentation of females.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
15Methamphetamine (MA) (Cont.)
Pleasurable effects are caused by the release of high levels of dopamine in the brain, leading to increased energy, a sense of euphoria, and increased productivity.
Short-term effects: increased heart rate, insomnia, excessive talking, excitation, and aggressive behavior
Prolonged use results in tolerance and physiological dependence
Negative consequences range from anxiety, convulsions, and paranoia, to brain damage.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
16 Methamphetamine (MA) (Cont.)
The impact of MA abuse on communities, families, and social networks is considerable.
Young children of users are at risk for abuse and neglect.
Prenatal use puts children at risk for developmental problems, aggression, and attention disorders.
Exposure to combustible second-hand fumes.
Associated with increased incidence of violence (e.g., domestic abuse, homicide, and suicide)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
17 Steroids
Anabolic steroids are synthetic variants of male sex hormone testosterone
Build muscle and said to be androgenic
Most commonly used in athletes and other individuals willing to risk potential and irreversible health consequences to build muscle
Potentially fatal risks
Blood clots, liver damage, premature cardiovascular changes, increased cholesterol
Increased potential for suicide and aggressive and risky behaviors
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc
Inhalants
Contain volatile components with psychoactive properties
Many products found in home or workplace (e.g., spray paints, markers, glues, and cleaning fluids)
Produce a rapid high that may resemble alcohol intoxications; may progress to loss of sensation and even unconsciousness
Irreversible effects:
Hearing loss, limb spasms, CNS or brain damage, or bone marrow damage; may result in death from heart failure or suffocation
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
Adolescent Substance Abuse
Highest prevalence of illicit drug use during lifetime between 18 and 25 years
Teen use of cigarettes and smokeless tobacco has declined
Nearly half of teens try marijuana before they graduate—skepticism about drug’s danger
As harmful, illicit substances come in and out of vogue, CHN needs a good understanding of drug culture, terminology, and differing signs and symptoms
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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