CURRENT TRENDS IN SUBSTANCE ABUSE AND ADDICTIONS ON COLLEGE

CAMPUSES

BY JEAN BASILE, LMSW, CASAC

Statistics

According to statistics from the Higher Education Center for Alcohol and Other Drug (AOD) Abuse and Violence Prevention

1,700 College students die from alcohol related causes1,300 deaths involve drinking and driving600,000 suffer non fatal injuries from AOD abuse696,000 victims of assault from another student on AOD500,000 have unprotected sex100,000 are to intoxicated to know if they consented to sex97,000 are victims of AOD related sexual assault or date rape1.2-1.5 percent attempt suicide due to AOD use150,000 develop health related problems from AOD use11 percent damage property while under the influence AOD2.8 million drive while under the influence of AOD25 percent miss classes, do poorly on tests and have declining grades

48 percent of collegiate alcohol consumption is done by underage students44 percent of college students are binge drinkers6 percent of college students are diagnosed as alcohol dependent and one third with

alcohol abuse44 percent of students have at least one symptom of abuse or dependence54 percent of binge drinkers experienced at least one blackout Statistics from UMADD• According to Lela Davidson in an article on HubPages, young people have found a

new way to get high by inserting vodka soaked tampons into the vagina. And just so the boys won't be left out, it works rectally as well. Keep in mind that many vaginal medications are routinely administered via tampon, and that the unprotected membranes of the vagina and anus would allow alcohol to enter the bloodstream faster than the acid protected gastrointestinal tract.

**Although these are national statistics, they are indicative of our locality as well. Alcohol, Marijuana, Rx and OTC meds, cocaine, and heroin are heavily abused throughout the country. The other drugs are a bit more territorial, for example E is still used, but concentrations are higher in more populated/urbanized areas and the club scenes. Methamphetamines are primarily used on the west coast, but are making its way east. Date rape and ‘Happy Cocktails’ (Alcohol, Xanax and Vicodin) are more prevalent in campuses with dorms and fraternities.

Alcohol

• Alcohol is still the most abused drug on the college campus.• Alcohol is usually taken with other substances. Often students will pop a Xanax before going

out to intensify the effect of drinks so that two drinks /beers will feel like twelve.• Alcohol is the central ingredient in socializing. There are many websites that have recipe’s,

drinking games with rules and modifications to board games transforming games such a Chutes and Ladders to drinking party games, or Beer Pong… etc. All you need do is Google ‘Drinking Games’.

• Jaeger Bombs are also big on campuses; that is mixing Jaegermeister & Beer. Recipe’s are on the internet- You take a shot glass of Jaegermeister & drop it in a mug of Beer; mostly Corona’s or Bud light; however the cheaper the beer the better- as “the cheaper beers mess you up faster”.

• Grey Goose vodka is popular because it is known to leave less of a hangover.• Also very popular on campus is mixing Alcohol and Energy Drinks such as Red Bull. The energy

drinks contain legal stimulants such as Caffeine, Guarana which contains three times the caffeine than coffee beans, Taurine which is an amino acid and cardiac stimulant, Ginseng which stimulates the nervous system, Insitol which participates in the action of serotonin, Choline which improves neuromuscular transmission, Sugar, and Carnitine which is also an amino acid. These can be dangerous when combined with alcohol , as the stimulant effects can mask intoxication; once the stimulant effect wears off, the depressant effects of alcohol remain and causes vomiting during sleep or respiratory depression. Dehydration is intensified as both alcohol and energy drinks are diuretics. Companies market these products as ways to ‘party all night’

• Alco pops are popular with the sorority crowd and female collegians. They are bottled alcoholic beverages that resemble soft drinks such as Mike’s Hard Lemonade.

21 BIRTHDAY CELEBRATIONS• Eighty-three percent of the students said they'd consumed alcohol to celebrate this

milestone birthday, by consuming excessive amounts of alcohol. Twelve percent of men and women reported consuming exactly 21 drinks, while an additional 22 percent of males and 12 percent of females said they'd exceeded that number.

• Based on the information supplied by the students, the researchers estimated that 49 percent of the men and 35 percent of the women had estimated blood alcohol contents of 0.26 or higher, a level that could cause serious health problems such as disorientation, coma and death. That means an average size woman would have to drink between seven and nine drinks an hour to attain a blood alcohol content of 0.26, and an average man would have to drink between 10 and 12 drinks!

• Since our bodies are designed for self preservation, we are normally protected by passing out before you get too drunk and get to the stage of death. According to Dr. Evaristo Akerele, vice president and director of medical and psychiatric affairs at Phoenix House in New York City. "What happens here is somebody keeps the mouth open and keeps putting more and more alcohol so you override [the tendency to pass out first]. It's potentially fatal."

• '21 for 21': A Deadly Binge Drinking Ritual on College Campuses, By Amanda Gardner- June 6, 2008

• Just last week, (Sunday, November 10, 2008) there was an incident on the news where a local college student was at a frat party and died of alcohol poisoning.

SECONDARY EFFECTS OF OTHER STUDENTS AOD• 65 percent of students experience secondary effects of others

drinking such as:• 60.0 percent had study or sleep interrupted.• 47.6 percent had to take care of a drunken student• 29.2 percent have been insulted or humiliated by a student

under the influence• 19.5 percent of females experienced unwanted sexual advances

again, by a student under the influence.• 19.0 percent had a serious argument or quarrel…• 15.2 percent had their property damaged• 8.7 percent had been pushed, hit or assaulted• 1.0 percent of female respondents had been a victim of sexual

assault or acquaintance rape. (www.higheredcenter.org)

THE SCOPE OF THE PROBLEM

• A survey done by Monitoring the Future (MTF) of only 1,350 college students in 2006 report percentages of use by specific drugs: (Many large campuses can have close to that amount of students in one lecture hall)- Not included are Alcohol, Rx and OTC medications

• Marijuana: 30.2 percent• Ecstasy: 2.6 percent• Hallucinogens: 5.6 percent• Amphetamines: 6.0 percent• Tranquilizers: 5.8 percent• Cocaine: 5.1 percent• Barbiturates: 3.4 percent• Inhalants: 1.5 percent• Methamphetamine: 1.2 percent• Heroin: 0.3 percent

MARIJUANA Marijuana use is still huge on campuses, there are shops such as “East West” &

“Utopia” in Hicksville, on 454, and on Old Country Rd in Centereach that sell drug paraphernalia. The use of bongs is huge and there are websites filled with instructions on how to easily make all sorts of bongs and bowls. Students like to smoke blunts, which is a cigar wrapper filled with Marijuana which will intensify their high.

• Students believe that if a student studies high, then they need to take the test high, the theory is that however you study, you need to take the test the same way. Recently I was told of a professor that was not going to allow a student to take a test because they were high; however, when the student explained that since he was high when he studied, he needed to take the test high as well, was allowed to take the test.

• The old cooking with Marijuana has taken on a new look – they still bake with it, but they will also add it as an ingredient to any dish.

• Younger students will grind up Marijuana leaves and fold it into gum slices, then put the gum back in the wrapper so that they can chew it while in school.

• The harmful effects of Marijuana is especially great for teens and young adults, as they may develop more slowly and are less able to master coping skills or make healthy choices. Young people are more likely to get into car accidents under the influence due to impaired judgment and perception; and are more likely to have unprotected sex which can result in unwanted pregnancy or STD.

AS YOU KNOW….• THC is a mind altering psychoactive drug, psychologically addictive which

comes in three forms: Marijuana- from the leaves, flowers and stems of the hemp plant, Hash- a concentrated form of marijuana made by compressing marijuana resin into small blocks, and Hash Oil made by soaking marijuana in chemical solvents such as rubbing alcohol and then evaporating the solvent to obtain a concentrated oil.

• Side effects include short term memory loss, dry mouth/throat, sleepiness, increased heart rate, paranoia, hallucinations, panic attacks, psychosis, loss of sexual drive, bronchitis, lung cancer and brain damage.

• Studies show an association between chronic marijuana use and increased anxiety, depression, suicidal ideation and schizophrenia; although it isn’t clear if the marijuana causes mental problems, exacerbates them, or is used as an attempt to self medicate existing symptoms. Heavy users impair important achievement in physical and mental health, cognitive abilities, social life, increased absenteeism, lateness, accidents.

• Marijuana affects hormones and regular use can delay onset of puberty and reduce sperm production in men, women may disrupt the normal menstrual cycles and inhibit ovulation. If used while pregnant, there is a higher risk of low birth weight babies with health problems.

• (Samhsa.gov)

SALVIA DIVINORUM• Salvia divinorum is a common herb in Southern Mexico and Central and South America. Salvia is

growing very popular among young adults and teens, largely due to hallucinogenic effects, legal status, undetectable in drug screen tests Salvinorum A is the potent activator of kappa opioid receptors in the brain. It is ingested by chewing fresh leaves or drinking extracted juices, or the dried leaves smoked as a joint or water pipe. Salvia is not a regulated drug by the Controlled Substances Act and is legal.

• Effects: include hallucinations or delusional episodes that mimic psychosis, psychedelic-like changes in visual perception, mood and body sensations, emotional swings, feelings of detachment and a highly modified perception of external reality and the self. The effects are intense but short lived and start within 1 minute and last less than 30 minutes.

• When smoked, it is not uncommon for Salvia divinorum to produce a very physical sensation of pressure on the body. This is a relatively unique effect of S. divinorum. Described variously as a pulling or pushing of the body in a particular direction, some people find themselves pinned to the floor for the duration of their experience, known as "Salvia gravity".

• Some people find it extremely difficult, to achieve effects with Salvia divinorum. It is not clear at this time whether this is primarily the result of differing body chemistry, smoking techniques, material, or some other factor; however some people find combining with Cannabis or MAOI’s more effective. (NIDA)

• Recently Dr. Phil had a mother (who was a teacher) and her son that smoked Salvia together. They both experienced negative effects in their functioning from the drug, but continue to use TOGETHER!

There are websites such as www.erowid that give information on drugs of abuse, how to use them, and what to use them with to intensify the high. It also has detailed instructions on how to make bongs, bowls and how to invalidate drug tests

The following is an excerpt from the site: “If going to a test: 1. Have a friend fill a Bard Dispoz-a-Bag Drainage Bad,

and tape it to your abdomen. Run the tube down to your fly. The piss must be fresh. 2. For women, a urine filled condom or vanilla extract bottle inserted into the vagina can work wonders. 3. Distract the distributor, or bribe him. 4. If your really fucked, add toilet water to your sample, or a few draino crystals to lower your pH. After you've been tested: 1. List over the counter drugs medications which are cross-reactive, such as Advil, Nuprin, Motrin, or Mydol. Remember: Using drugs at work is wrong when you are operating heavy equiptment, or are responsable for people's lives. PS2- Caught by your parents? Don't admit it! There's no way they can prove your st0ned, just say you feel sick!.”

** content taken directly from the website, no corrections have been made

PRESCRIPTION MEDICATIONS- PAIN KILLERS Abusing Rx meds is one of the most popular drugs of abuse- especially vicodin, percosett & oxycotin.

Often they will take a bunch of them with the goal of getting totally ‘messed up’ and take them with an alcohol chaser; or with coffee or espresso shots to intensify the high. It is easy to get Rx; as they are sold all over campuses.

Unlike the trends of previous generations - which often followed drugs providing brief euphoria's; the 18-to-25 set today are far more likely to use pharmaceuticals to enhance pleasure, vary their conscious experience, self medicate, cope with trauma, relieve anxiety, depression and insomnia, relieve pain, enhance social interaction, stimulate creativity and performance, increase physical and mental acuity, lose weight , have fun and fend off withdrawal symptoms.

• According to www.drugfree.org, Nearly 1 in 5 students have used Vicodin, 1 in 10 oxy, 1 in 10 Ritalin or Adderall for non medical purposes; and 1 in 11 get high on cough medicines. Rx and OTC’s are the new ‘party drugs’. ‘Pharming’ is a popular party activity- that is when each person contributes Rx drugs, all the drugs are mixed and each person grabs a handful; most often mixing them with alcohol.

• Pain Medications: Vicodin- Oxycontin, Percocet, Darvon (propoxyphene) for pain, abused to feel pleasure or sensations of well-being. Dangers: highly addictive, tolerance develops, if stopped suddenly- may go through withdrawal (horrible physical experience of intense restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, & cold flashes)

• Overdose: breathing slows down & eventually stops, death may occur, time release OxyContin (designed to deliver pain relief into the system slowly over hours) is crushed & snorted causing the drug to enter the system all at once, & can result in death.

• Cocktails are made of Vicodin or Percocet, to “numb out”, Xanax to reduce anxiety and Alcohol- mostly Tequila. This combination is popular on the campus and is known as “Happy” Cocktails.

• Often it is taken in combination with other Rx or OTC drugs or alcohol, or stimulants like coffee or espresso. These increase the risk of risks life threatening respiratory depression.

HEROIN• Heroin crosses the blood brain barrier quickly and is converted into morphine and absorbed into the

opioid receptors in the brain. These receptors are specifically sensitive to morphine and are involved with the perception of pain and reward. Users report feeling a ‘rush’ and the intensity of the ‘rush’ depends on how much of the drug is used and how rapidly it enters the brain.

• EFFECTS: Histamines are released into the bloodstream and can produce itching all over the body, reddening of the eyes, dry mouth and flushing of the skin, heaviness of extremities, nodding out, constriction of the pupils, diminished sex drive, depression of breathing and blood pressure, slows the GI tract causing constipation. Long term use includes physical dependence, tolerance, change in brain chemistry, withdrawal symptoms, increased risk of HIV, Hepatitis etc…, collapsed veins, infections of the heart lining and valves, abscesses, pneumonia, and toxic additives clog blood vessels and cause permanent damage to vital organs

• Withdrawal can occur within a few hours of use and includes restlessness, heavy sweating, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes and goose bumps, kicking movements, severe cravings. Symptoms peak between 48-72 hours and subside in a week. (NIDA)

• Heroin is still very big on campus; in fact in June Natalie Ciappa,18, a Plainedge High School senior, died of a heroin overdose at a Seaford party.

• Faced with an increase in heroin use among young people, a Nassau County legislator is proposing that police be required to notify school officials of arrests for the narcotic. Legis. David Mejias (D-Farmingdale) said he hoped the bill would become known as Natalie Ciappa's Law, after the 18-year-old Massapequa girl who died of a heroin overdose at a Seaford party in June."The initial signs of heroin use are not easily detectable, and this would give schools and parents a heads-up about a problem before it's too late," Mejias said the names of those arrested would not be revealed to the schools. But police would notify the district about anyone arrested for heroin possession within the district boundaries or the arrest of a district's student anywhere in the county

• Natalie Ciappa's Law would require police to notify schools about drug arrests in their districts in an effort to stem student heroin use. (Newsday)

STIMULANTS• (www.drugfree.org) Stimulants: (Ritalin & Concerta (classified as methylphenidates), Adderall (mixed

amphetamine salts) & Dexedrine (classified as dextroamphetamines) are prescribed for ADHD. Although stimulants, these drugs have a reverse- calming & focusing effect on those with a hyperactivity disorder. Those without ADHD use the drugs for the stimulant effect. They increase the amounts of circulating brain chemicals that raise blood pressure & heart rate, speed up breathing, decrease appetite, increase concentration & wakefulness, gives a sense of euphoria & causes insomnia. Students often abuse these drugs to stay awake & alert so that they can study or party beyond their natural ability. They may take them orally or crush the tablets & snort or inject them.

The pressures of college coursework often moves students to depend on drugs like Adderall as a substance for academic success rather than for an occasional high, and as many as 20 percent of college students have used Adderall or Ritalin.,according to a study released by the National Center on Addiction and Substance Abuse in 2004. The big thing on campuses now is abusing Adderrall and Ritalin; taking two pills at a time to stay up and study, or with a chaser. "I don't know what I would do without it," said Catherine, who earlier had taken a dose of Adderall. "There's no way I could have kept my scholarship if I didn't use it."Supply of these drugs is readily available through students who are prescribed them may hoard the pills & sell them, may fake symptoms & get a prescription, or get them through online pharmacies. There may be a false sense of safety because the pills are prescribed, however when used for intensive studying or recreationally for partying, are dangerous. The side effects include headaches, fatigue, depression, sleep disorders, anxiety, paranoia, malnutrition, cardiac irregularities, convulsions, seizures. When mixed with AOD, especially decongestants, the effects are exaggerated.

• Dangers: addictive, high doses taken over a short time can lead to feelings of hostility, intense fear & paranoia. High doses may result in dangerously high body temperatures & irregular heartbeat w/ possible cardiovascular failure. If injected the risks include infection, HIV, hepatitis, blood vessel blockages & risk of toxic overdose. (www.higheredcenter.org)

• Prevention: limit access by prescribing small quantities, requiring confirmation of ADHD diagnosis, investigating reports of loss of pills & requests of replacement Rx, block access to online pharmacies.

COCAINE• Cocaine is a crystalline white powder from the coca plant that acts as a central nervous

system; by interfering with the body’s re-absorption of dopamine, a chemical in the brain that controls pleasure, alertness, and movement.

• Cocaine is used for its exhilarating and intense high, its anesthetic properties can be felt without a sense of intoxication. Students who abuse the drug do so for its high, increased energy and confidence they feel on the drug. Cocaine can be snorted or injected, or crack cocaine—cocaine mixed with baking soda—can be smoked. The fumes from crack cocaine are said to reach the brain in as quickly as ten seconds

• Cocaine depletes all of the body’s feel-good chemicals after the user’s high is over, thus causes depression and other symptoms, called a cocaine crash. It is often mixed with marijuana, heroin, and alcohol. Alcohol, a depressant, can cause serious interference with cocaine, a stimulant.

• The drug is often processed with dangerous and volatile solvents like benzene, gasoline, and kerosene, combined with talcum powder to reduce its purity, and mixed with other substances like amphetamines and anesthetics.

• The drug’s high lasts only about five to 30 minutes, and side effects include nausea, increased blood pressure, headaches, and insomnia. Cocaine can cause seizures and erratic heart beat, the heart may even stop beating while a user is on cocaine. Cocaine also causes permanent and severe liver, heart, and lung damage, addiction, and compromises the immune system.

• Cocaine is still big in the college crowd and is very vogue to continue to use after graduation and into their professional lives. One student I interviewed spoke of a young teacher who graduated 2 years ago who is still using coke. Since coke leaves the system within a few days; it may not be picked up in occasional drug screenings.

SEDATIVES, SEDATIVE-HYPNOTICS & TRANQUILIZERS Affects brain systems to produce a drowsy or calming effect, sometimes to the point of

inducing sleep.• Benzodiazepines: Valium(diazepam), Xanax (alprazolam), Ativan (lorazepam), Klonopin

(clonazepam), Restoril (temazepam)• Non-Benzodiazepine Sedatives: Ambian (zilpidem), Lunesta (eszopiclone) Ambian abuse is

very big on our college campuses now.• Barbiturates : Mebaral(mephobarbital) and Nembutal (pentobarbital)• Used for treating anxiety, reduce stress, panic attacks, insomnia, seizure disorders and

muscle spasms. • Abused to feel calm and sleepy, less tension, reduce anxiety or panic, feelings that go away

as the body becomes drug-tolerant• Xanax is another drug that is highly abused; students will take Percocet or Vicodin, Xanax

and chase with alcohol; to reduce anxiety, numb out feelings and give a sense of euphoria or happiness.

• To study, they will mix Xanax and Adderall to decrease test anxiety and help to stay focused.

• Stimulants, Ritalin and Adderrall, are also crush and snorted; all the time, but especially during midterm and final weeks.

• Dangers: addictive, when use is reduced or stopped- seizures and withdrawal symptoms may follow; can be deadly

DATE RAPE DRUGS• Particularly disturbing is the popularity of Date Rape Drugs including GHB, Rophynol

and combinations of Xanax bars with alcohol. These are particularly popular in the fraternities and club scenes.

• Rohypnol: Fluritzrazepam, is a CNS depressant ten times stronger than Valium; and is ingested orally in pill form or dissolved in a beverage. It may also be ground up and snorted. It is known as the ‘Date Rape Drug’ due to it’s high association with sexual assaults due to the drug leaving it’s victims in a coma like state and amnesia after the attack.

• GHB: Gamma Hydroxylbuteric acid is a Benzodiazepine and a CNS depressant that sometimes cause hallucinations. It’s a clear liquid with a slightly salty taste, but can also come in a small tablet or capsule which disolve quickly; and is sold by capful which equals one ‘dose’. AKA Georgia Home Boy, Liquid X, Gamma X, Gook, Fantasy and Grievous Bodily Harm.,

• Side Effects for both are generally are felt within an hour of ingestion and include Dizziness, nausea, slurred speech, vertigo/sight problems, reduced inhibitions, grogginess and Coma sometimes even death.

• Often bartenders are given cash to slip it into drinks, or it is put into drinks while at a party or when a young woman is on the dance floor. There is a slight taste and if a drink is shaken, the drug will cause it to fizz on the top, making it somewhat detectable to the educated consumer.

• Xanax bars (4 doses) and alcohol are also used to induce a coma like state and used in date rape attacks.

OTHER DRUGS STILL ON CAMPUSES• STEROIDS: Anabolic steroids effect the growth of the skeletal muscle, the androgenic

effects promote the development of male sexual characteristics and enhances an athlete’s performance. They are taken orally by pill or liquid, intravenously or rubbed into the skin as a gel. Mixing different types to increase effects is called ‘Stacking’. Side effects are baldness, sterility, brain damage, blood clotting, high blood pressure, hepatitis, liver cancer, eye infections, kidney disease, depression, memory loss and ‘Roid Rage’- over aggressive sometimes homicidal attitude.

• SHROOMS: Psilocybin or ‘magic mushrooms’ are very popular on the campus, they contain hallucinogenic properties and alter states of consciousness. They can be eaten raw or cooked, made into a tea or soup and drank, or ground into a powder and smoked, often on top of marijuana. Side effects include stomach pain, increased heart rate, nausea/vomiting, diarrhea, anxiety/panic attacks, mental disorders, flashbacks and impaired judgment. One college student I interviewed spoke of how his friends just stared at an object for hours as it changed shapes and colors.

• MDMA: (E) is a psychoactive drug similar to methamphetamine and mescaline. It effects the neurons in the brain that use serotonin, by causing excessive release of serotonin which produces an energizing effect and feelings of euphoria, emotional warmth and distortions in time perception and tactile experiences. Side effects include confusion, depression, insomnia, drug craving and severe anxiety. It is popular on campus and club scenes or long dance parties; raves are still around to some degree.

HAZING- FRATERNITIES AND SORRORITIES • Hazing: Higher Education Center) Initiating new members into

sororities or fraternities, gangs. Studies conducted by Alfred university reported , 76 percent of students in fraternities or sororities were hazed & 22 percent of students in art, music or theatre groups were subject to hazing. The psychological, & emotional effects of Hazing including depression, discomfort, low self-esteem, negative feelings, sense of hurt, betrayal, worthlessness, loneliness & hatred. Hazing may also be physically dangerous when initiation rites include substance abuse & illegal or dangerous acts. Hazing often goes unreported because they don’t want to or are afraid to ‘rat’ on their peers. Hazing has decreased over the past several years however, it is still a very real part of campus life as demonstrated by the recent report of a student dying of alcohol poisoning at the University of Delaware at a fraternity function.

• Prevention: Campus administration & staff need to investigate & discipline hazing on campuses, & provide avenues for positive bonding activities to include those that are physically & intellectually challenging. (www.higheredcenter.org)

OVER THE COUNTER MEDICATIONS• DXM (Dextromethorphan) is a synthetically produced substance related to codeine; an over the counter

cough suppressant which, when taken in high doses, can produce effects similar to PCP and Ketamine. This dissociative drug acts by altering distribution of the neurotransmitter glutamate throughout the brain. Glutamate is involved in the perception of pain, responses to the environment and memory. DXM is found in over 100 OTC medications, often combined with antihistamines, expectorants, decongestants or pain relievers.( ie: Coriciden cough & cold, Alka Seltzer plus cold & cough medicine, TheraFlu cough products, several Robitussin cough products, Tylenol cold & cough products & many store brands. Products will list dextromethorphan in the list of ingredients. Teens and young adults get high by taking excessive amounts of cough/cold medications. DXM produces feelings of euphoria, enhanced awareness, distortions of color & sound, visual hallucinations & “out of body” sensations, a feeling of loss of contact with their senses. DXM effects last 3-6 hours . It is also thought that DXM can cause the release of serotonin, which if used with a SSRI antidepressant , can cause a fatal condition known as Serotonin Excess Syndrome.

• Dangers: rapid heartbeat, high blood pressure, diarrhea, seizures, panic, drowsiness, confusion, dizziness, blurred vision, impaired physical coordination & coma. Side effects worsen if combined with other medications or AOD. Combining multiple medications can be dangerous even if abiding by the recommended dosages to treat medical conditions. Overdoses of other ingredients found in DXM products include: Acetaminophen (pain reliever)= liver damage, Chlorpheniramine (antihistamine) = increased heart rate, lack of coordination, seizures & coma, Guaifenesin (expectorant)=vomiting, Pseudoephedrine (decongestant)= irregular heartbeat, headaches, difficulty breathing, anxiety & seizures..

• Information from internet sites give explicit instructions on how to “trip” using DXM, called “roboing”, “robo-tripping”. The sites also provide access for purchasing purified pharmaceutical-grade powdered DXM via mail order; complete with instructions in mixing the powder with juice to avoid the bitter taste, or how to obtain gelatin capsules to fill with DXM.

• Prevention: Educate yourself about recreational use of prescription & OTC drugs. Look for drug paraphernalia in the home, learn about abusable drugs at www.drugfree.org.

INHALANTS• Most inhalants are readily available, inexpensive or free and legal to purchase and possess,

and give an instantaneous high. Therefore, are extremely popular among younger students. However, according to studies conducted by SAMHSA 13.4 percent of young adults (18-25) continue to use inhalants. The most popular among this age group is nitrous oxide or ‘whippets’, amyl nitrite ‘poppers’ and Locker Room Odorizers or ‘Rush’.

• Inhalants are breathable chemical vapors and gases that produce psychoactive effects; and include a wide range of volatile solvents- (such as paint thinners, dry-cleaning fluids, gasoline, glues and some felt-tip markers); aerosols (propellants in spray paints, deodorants, vegetable oil sprays, fabric protector strays), gases and nitrites (butane lighters, propane tanks and refrigerants). Most of these act directly on the Central Nervous System (CNS) and activate the brain’s dopamine system which result in mood altering effects – an instant ‘rush’ and euphoria, followed by CNS depression.

• EFFECTS: Deep breathing of the toxic vapors result in losing touch with their surroundings, loss of self-control, violent behavior, nausea, unconsciousness, giddiness, loss of inhibition, loss of appetite, and hallucinations.

• Nitrites, dilate blood vessels and relax muscles and are abused for sexual enhancement.• Inhalants are abused by ‘sniffing’ through the nose, ‘Huffing’ which is inhaling fumes through

the open mouth, ‘bagging’ by spraying the substance into a bag and huffing or placing the bag over their head or ‘dusting’ by inhaling compressed air from sprays used for cleaning computer keyboards. The median ages of those who died from Inhalant abuse is between 19-24.

Gambling

Gambling is increasing popular among college students. Occasional betting on a sports team or during a card game poses little harm. However, when a student starts gambling in excess and going into debt, it becomes a problem. College students may develop an addiction to gambling to win money, for excitement, for intellectual challenge, and to have something to do away from the regular routine of college life. Online gambling only takes a credit card or debit card and an Internet connection. Which puts pretty every college student at risk. Poker has grown increasingly popular over the last few years, even ESPN covers the World Series of Poker, which is an annual poker tournament in Las Vegas.

• Warning signs may include: Constantly thinking about gambling, using financial aid money for gambling or to replace money lost at gambling , relies on others to get out of debt, uses credit cards for cash advances, has unexplained money or new possessions. Frequently missing, or late for classes and decline in academic performance, lying about the extent of gambling, gambles for longer periods of time, and despite negative consequences.

• Legal gambling age varies throughout the United States from age 18 to age 21, minors are participating in all forms of wagering activities beyond sports betting, including cards, especially Texas Hold’em poker, games of skill (like basketball or pool), lottery games and gambling on the Internet. Some students, both athletes and non-athletes, are experiencing severe difficulties due to gambling, some forced to leave school. Pressures brought about by gambling, such as debts owed, at times can prompt some students with significant gambling problems to consider illegal acts or to abandon their beliefs and principles for what may be perceived as an easy pathway to fame and/or fortune. It is also true that people with serious gambling problems often consider or attempt suicide as a way out. Greg Hogan Jr., a 19-year old sophomore went from class president, chaplain assistant, academic and musician (who had performed twice at Carnegie Hall by age 13), to bank robber within a 16-month period to pay off debts accrued from playing poker online. (The New York Times Magazine article, “The Hold-‘Em Holdup”)

• According to an article in the Associated Press, another example is Max Pergament, a well-mannered 19-year old Long Island, Nassau County Community College student, who staged a chase with police officers, resulting in his death (i.e. suicide by cop), on account of a $6,000 debt he incurred while gambling on sports.

EATING DISORDERS

• Anorexia NervosaAnorexia nervosa (AN) is a disorder in which individuals exhibit significant weight loss and extreme restrictions in their food intake.

• While it has been estimated that up to 90%1 of those suffering from this disorder are women and girls, the prevalence rate of eating disorders among men is on the rise. Although not limited to, this disorder is primarily seen among individuals of middle and high socioeconomic statuses2.

• It has been estimated that 0.5 to 3.7% % of the population suffers from anorexia nervosa 3. However, this prevalence rate does not consider the amount of individuals who exhibit extreme restrictions in their food intake, but who do not qualify for a formal diagnosis. Additionally, with the mortality rate of females with AN estimated to be around 10%, AN is considered to have the highest mortality rate among any psychological disorder4.

• The Diagnostic and Statistical Manual, 4th Edition (DSM-IV) lists the following criteria for diagnosis of anorexia nervosa:• • Refusal to maintain what is considered a normal body weight for that person’s age and height

• Intense fear of gaining weight • Distorted view or denial of their actual body weight and/or shape • Loss of menstrual cycle

• Anorexia nervosa is specified into two types:• 1. Restricted Type:

• This type of anorexia is categorized as a severe restriction of food intake with the absence of binge-eating or purging.• 2. Binge-Eating/Purging Type:

• This type of anorexia is categorized as engaging in binge eating or purging behavior while exhibiting behaviors classified as anorexia. Purging is characterized as a way to eliminate food from your body either through self-induced vomiting, excessive exercise, or through laxatives, diuretics, or enemas.

• In addition to the diagnostic criteria, the following are considered warning signs, or possible precursors, of anorexia nervosa:

• • Restricting certain types of food and the amount of food intake• Preoccupation with weight, body shape, and calorie and fat content of food• Dramatic weight loss• Excessive exercise • Distress over body weight and shape• Withdrawal from previously enjoyed activities, and from family and friends.

EATING DISORDERS• Estimates suggest that 5-10 million men and women of all ages suffer from eating disorders

annually. College students commonly express concerns with body image, body shape, body size and weight control.

• Disordered eating behaviors and attitudes are increasingly prevalent among undergraduate students, athletes, and sorority women. Over the last decade awareness of eating disorders has increased, Health Educators and National Prevention Agencies have implemented eating disorder awareness and prevention campaigns from elementary age children through college students. Specialized treatment centers have become increasingly available with various treatments to aid those with eating disorders in their recovery. However, eating disorders, and body-image concerns continue to be a major concern for college students.

• The most common features associated with eating disorder and body image concerns amongcollege students is a pattern of distressing or dysfunctional over-concern about body image and self-esteem, usually with day-to-day stress and intermittent depression. These distressing and consuming issues threaten the health and wellness of college students and has a negative impact on their academic success.

• " 91 percent of women on college campuses report dieting; • 22 percent have dieted often or always• " 35 percent of normal dieters progress to pathological dieting• " 95 percent of ALL dieters will regain their lost weight in one to five years• " 5-10 million women and men suffer from an eating disorder or borderline conditions

DRUNKOREXIA

• One of the latest phenomenon afflicting those trying to stave off pounds, especially on the college campuses is known as drunkorexia. It is a trend in which women skip meals in order to spend their daily calorie intake on alcohol.

• Many weight-loss clubs assign food points to edible items, with dieters sticking to a daily point limit, The Telegraph reports. Experts believe this is contributing to the drunkorexia problem, with women consuming the same number of points, but replacing food points with alcohol points.

• Fear of consuming the high-calorie count in alcohol, coupled with the pressure on young women to binge drink, contributes to the problem. A large glass of wine holds as many calories as an average light lunch, the Telegraph reports.

• Professor Janet Treasure, the head of the eating disorder unit at the Institute of Psychiatry in London, told the Daily Telegraph drunkorexia is very dangerous because it effectively combines binge drinking and disordered eating patterns.

• "They get fully hooked, it is an extremely noxious thing,” Treasure told the Daily Telegraph. “It is more common with bulimia than anorexia but you get the combination of empty calories with no nutritional value and the risky behavior that goes with being drunk."

• Bulimia NervosaBulimia nervosa (BN) is a disorder in which individuals eat excessive amounts of food in a short period of time and afterwards eliminate this food from their body through some type of purging behavior. It is estimated that 1.1 to 4.2% of the female population suffers from BN5. However, less is known about the population of males suffering from BN. As is the same with estimates of AN, prevalence rate does not consider the amount of individuals who are experiencing similar behaviors as seen in BN, but who do not qualify for a formal diagnosis.

• The Diagnostic and Statistical Manual, 4th Edition (DSM-IV) lists the following criteria for diagnosis of bulimia nervosa:

• • Recurring episodes of binge eating, characterized as an uncontrollable consumption of food in a short period of time• Episodes of purging behavior following binging episode in which the individual tries to prevent weight gain through self-induced vomiting, laxatives, diuretics, enemas, fasting, or excessive exercise• Self-evaluation is influenced by weight and body shape.

• Bulimia nervosa is specified into two types:• • Purging Type: In this type of bulimia, purging behavior is in the form of self-induced vomiting or

through the use of laxatives, diuretics, or enemas.• Nonpurging Type: In this type of bulimia, fasting or excessive exercise is the compensatory behavior that is used to prevent weight gain. There is no self-induced vomiting.

• Binge Eating DisorderRecent attention has been paid to another category of eating disorder, binge eating disorder. Similar to those suffering from BN, individuals with binge eating disorder consume large quantities of food in a short amount of time. However, these individuals do not use compensatory behavior in an attempt to eliminate their food. Prevalence of binge eating disorder is on the rise; however, more research is needed to fully understand the scope and nature of this disorder.

• © 2008 Reaching Out Against Eating Disorder • Site Designed by Adam Wanderman Design

• A review of the research on the impact of under-nutrition found :• Detrimental effects on cognitive development in children;• Negative impact on student behavior and school performance;• Makes students feel irritable, decreases ability to concentrate and focus, decreases ability to listen

and process information, may cause nausea, headache, and makes students feel fatigued and have lack of energy;

• Students with disordered eating behaviors less able to perform tasks as well as their adequately nourished peers;

• Leads to deficiencies in specific nutrients, such as iron, which has an immediate effect on students’ memory and ability to concentrate;

• Can make students become less active and more apathetic, withdrawn, and engage in fewer social interactions;

• Impairs the immune system and make students more vulnerable to illnesses; and• Increases absenteeism in affected students because of the above impairments. • Despite malnourishment, the perfectionist attitude of those who suffer from anorexia and bulimia

may compel them to maintain a high level of academic performance, which is even more difficult given their compromised physical and mental status.

• In addition to the effects described above, preoccupation with food often dominates the life of a student with an eating disorder. A study on people with eating disorders indicated a preoccupation with food.

• In our clinical practice we surveyed over 1,000 people with clinically diagnosed eating disorders. We found that people with anorexia nervosa report 90 to 100 percent of their waking time is spent thinking about food, weight and hunger; an additional amount of time is spent dreaming of food or having sleep disturbed by hunger. People with bulimia nervosa report spending about 70 to 90 percent of their total conscious time thinking about food and weight-related issues. In addition, people with disordered eating may spend about 20 to 65 percent of their waking hours thinking about food. By comparison, women with normal eating habits will probably spend about 10 to 15 percent of waking time thinking about food, weight, and hunger.

• NEEDA- 2008

• NEDA-LI runs several support groups, led by professionals in the field. There is no fee required, but donations are accepted. Women and men with eating problems, and their families and friends are invited.

If you are looking for support groups outside of the greater Long Island area, you can get help today with a list of support groups and care providers on the national NEDA website.

For additional information on the Mather and Manhasset Groups, please call NEDA-LI at 516-794-0415.

Local support groups:

John T. Mather Hospital75 North Country RdPt Jefferson, NY 117777:00-8:30 pm-Conference Room 3 Meetings are held on the 1st Monday of the month.

North Shore University Hospital at Manhasset300 Community DriveManhasset, NY 11030Main Entrance to the Hospital 10:00 - 11:30 AM Third Sat of each month Monte Conference RoomEnter the main entrance of the hospital for all meetings.

• For treatment professionals – Learn about our training series• NEDA-LI 2008-2009 PROFESSIONAL CASE DISCUSSION WORKSHOPS - OUT ON THE LIMB SERIES

all workshops are held at: 50 Charles Lindbergh BlvdLower Level Conference RoomUniondale, NY 11553

Friday, December 5, 2008 - 10:30 am - 12:30 pm

DID I SAY THAT: DEALING WITH TRANSFERENCE AND COUNTER TRANSFERENCE IN THE TREATMENT OF EATING DISORDERSfacilitator: Robert Fox, PHD, CEDA, President, NEDA-LI

Friday, February 6, 2009 - 10:30 am - 12:30 pm• BEYOND TALK THERAPY: USING THERAPEUTIC EATING SESSIONS, MEALS AND TECHNIQUES IN TREATMENT

facilitator: Sondra Kronberg, MS, RD, CDN, National Liaison, NEDA-LI, Nutritional Director of the Eating Disorder Associates Treatment and Referral Centers

SELF INJURY

• Self Mutilation, self injury or self inflicted violence is defined as the intentional harm of one’s own body tissue without conscious suicidal intent. The vast majority of self mutilators or ‘cutters’, are often young middle to upper class adolescent or young adult women.

• May 6, 2008, Jane E. Brody of The New York Times reported on an increasingly prevalent phenomenon among our teenagers. That phenomenon is that teenagers and college students are cutting themselves. The reasons these young people give for this self harming behavior range from reporting that it reduces their anxiety, to allowing them to feel a sense of control over their bodies when they feel they have no other kind of control over their lives. Others state that it expresses emotional pain for which they have no words or that pain is better than feeling nothing.

• One of the most worrisome things about self injury is that it can become addictive. Self injury leads to neurons in the brain releasing endorphins that act like opioids in creating a pleasant and high feeling. The release of these natural brain opioids then becomes reinforcing of the self harming behavior.

THE PEDERSON KRAG CENTER• Over 25 years of outpatient treatment experience; we have

seen the need and provide individual and group sessions for all stages of recovery. We offer a wide range of chemical dependency outpatient services from one to five times a week, which includes:

• Alcohol and Drug Psycho-education• Adolescent Programs• Women’s Day Intensive Program• Evening Phase Groups for Dependent Adults• Dual Recovery-Co Occurring Disorders• Significant Other and Family Treatment• Relapse Prevention• Psychiatric Evaluation and Medication Management

• Three locations to choose from• Huntington –(631) 920-8036• Smithtown –(631) 920-8300• Wyandanch-(631) 920-8250• Day and evening hours available. Length of

stay is dependent on diagnosis.