Overview and Prevention of Substance Abuse in...
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Overview and Prevention of Substance Abuse in Children and Adolescents: D.ARE. to be Drug Free “It’s A Family Affair” : 42 nd Annual Clinical Pharmacy Symposium- March 8-10, 2019 Tallahassee, Florida Presenter: Ilese A. Weingarten, LICENSED CLINICAL SOCIAL Worker, Certified addiction Professional
Transcript of Overview and Prevention of Substance Abuse in...
Overview and Prevention of Substance Abuse in Children and Adolescents: D.ARE. to be Drug Free
“It’s A Family Affair” : 42nd Annual Clinical Pharmacy Symposium- March 8-10, 2019Tallahassee, FloridaPresenter: Ilese A. Weingarten, LICENSED CLINICAL SOCIAL Worker, Certified addiction Professional
Disclosure Statement
• I do not have a vested interest in or affiliation with any corporate organization offering financial support or grant money for this continuing education program, or any affiliation with an organization whose philosophy could potentially bias my presentation.
Learning Objectives for Pharmacists
By the end of this presentation Pharmacists should be able to:• Discuss the prevalence of substance use and abuse in
children and adolescents• Recognize strategies for prevention of substance abuse in
children and adolescents• Identify types of programs for children and adolescents
who suffer from substance use • Review special considerations and treatment options for
children and adolescents who suffer from addiction
Art work in this presentation by children Red Ribbon campaign
• National Family Partnership, formerly the National Federation of Parents for Drug Free Youth, was established as a grassroots, nonprofit organization in1980 by parents who were convinced they should begin to play a leadership role in drug prevention• Mission is to lead and support our nation’s families
and communities in nurturing the full potential of healthy, drug free youth
Assessing Substance Use in Children and Adolescents
• Abstinence• Misuse of prescribed meds• Experimental use• Potentially harmful use• Substance use disorder (SUD) (mild, moderate, severe)• Addiction• Recovery• Relapse prevention
Teen Vulnerability to SUD?• Brain is still developing in teen years• Pre-frontal cortex- (Pfc) assessing situations,
controlling emotions, impulses and making decisions• Pfc not mature until mid 20’s, especially for
males• Adolescent brain is like a car with a fully
functioning gas pedal (the reward system) but weak brakes (pre-frontal cortex)• Earlier drug use starts- more likely to lead
changes in the brain and to addiction
ASSESSMENT: According to the University Of Mich study which substances are showing evidence of trending down (lower use) from 1991-2018 amongst 8th- 12th graders
A. Marijuana and illicit drugsB. Cigarettes and marijuanaC. Cigarettes and alcoholD. Alcohol and illicit drugsE. None of the above
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In the U of Michigan Monitoring the Future Study 8th graders reported about the same % of illicit drug use in the past year, (other than marijuana) in 2009 and 2018
A. TrueB. False
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Risk Factors for AOD Abuse • chaotic home environment, particularly in which
parents abuse substances or suffer from mental illnesses and/or lack of supervision• community negative influences• lack of parent-child attachments and nurturing• Impulse control difficulty• failure in school performance, learning disability• poor social coping skills• affiliations with peers displaying rebellious
behaviors• depression, anxiety, ADHD/ADD trauma
Global factors which increase vulnerability to SA
• SA glorified by celebrities in social media, music, movies• Tobacco, E-cig, alcohol industries have
integrated social media platforms into marketing• Stats: 92 % of teens 13-17 report
going on- line daily• 21% of teens say they are on- line
constantly
Family Recommendations• Families to monitor social media viewing• For younger children use
blocking/password protection• Talk to children and teens about what they
are looking at and have them show you and discuss• Get children and teens involved in
activities and limit social media exposure
Which is NOT a protective factor in preventing a SUD?
A. Helping child to be successful in school
B. Belonging to positive peer group
C. Parents telling children drugs are bad, sharing stories of family members with drug/alcohol problems
D. Setting clear rules for behavior at home and in school Answ
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Protective Factorsagainst AOD use
• strong and positive family bonds• parental monitoring of children's activities and peers• clear rules of conduct that are consistently enforced within the
family• involvement of parents in the lives of their children• success in school performance; strong bonds with institutions,
such as school, extracurricular and religious organizations• adoption of conventional norms about drug use• Belongingness to a positive peer group or involvement in
activities
Special Considerations forChildren and Adolescents
•Developmental stages• Ethnicity and Culture•Gender and Sexual Orientation•Co-existing Mental Health
Conditions
Case Studies: M- 16 year old African American male with severe alcohol problem- found passed out several times, went to residential treatment for 6 months. Post treatment- AA and football team, good family support.
J- 14 year old Latina female with history of poly drug use-attended IOP -post treatment got involved in drama club
T- 13 year old Caucasian male with heavy marijuana use, past trauma of sexual abuse by male son of a babysitter. Was getting into fights. Received 6 months of outpatient individual and family therapy. Got involved with band, formed positive peer bonds.
Types of SA Treatment & Support/ Settings
• Modalities: Detox• Outpatient, Intensive OP• Inpatient• Residential• Settings: In community• Self-help groups• In juvenile detention centers• In hospitals• In DJJ programs
Motivational Interviewing- MI • MI is most researched and validated
SUD intervention (Miller and Rollnick)• Also effective for medical professionals and
pharmacists• Uses models of change theory• Roll with resistance, find person’s personal
reasons for change• Is collaborative, • Language is important
Drug and Alcohol Treatment/ Support groups in our area:
• TMRMC- detox and Chemical Dependency• Apalachee Center- detox• Outpatient: Private clinicians, sliding scale- DISC
Village, Inc, Turnabout, Teen Challenge• Young People’s AA and NA meetings• Inpatient programs (30 day- none in the Big Bend)
Closest in Panama City, Jax, Orlando
Most common types of legaldrugs used by teens
Alcohol (for adults)Tobacco, nicotine(for adults)(smoking, vaping, chewing)Adderall/ StimulantsBenzodiazepines (Xanax) knows as barsOTC Cough syrupPain pills (Oxy’s)
Most common illegal substances used by teens
• Cannabis (weed)-smoked, vaped, edibles, oil- (dabs)• Hallucinogens-psilocybin mushrooms, Ectasy, LSD• Cocaine• Heroin•Methamphetamines• Inhalants
Opioid Overdose Prevention Medication
• FDA approved naloxone, an injectable drug used to prevent an opioid overdose. According to the World Health Organization (WHO), naloxone is one of a number of medications considered essential to a functioning health care system.• Deaths for Opioid Overdose: 70,237 drug overdose deaths
occurred from the United States in 2017. • Opioids—mainly synthetic opioids (other than methadone)—are
currently the main driver of drug overdose deaths. In 2017, the states with the highest rates of death due to drug overdose were West Virginia (57.8 per 100,000), Ohio (46.3 per 100,000), Pennsylvania (44.3 per 100,000), the District of Columbia (44.0 per 100,000), and Kentucky (37.2 per 100,000).1
Which medication is used for both Opiate and Alcohol MAT?A. AcamprosateB. NaloxoneC. NaltrexoneD. Antabuse
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Medication Assisted Treatment
• There are three medications commonly used to treat opioid addiction:• Methadone – clinic-based opioid agonist that does not
block other narcotics while preventing withdrawal while taking it; daily liquid dispensed only in specialty regulated clinics• Naltrexone – office-based non-addictive opioid antagonist
that blocks the effects of other narcotics; daily pill or monthly injection• Buprenorphine (Suboxone) – office-based opioid agonist/
antagonist that blocks other narcotics while reducing withdrawal risk; daily dissolving tablet, cheek film, or 6-month implant under the skin
MAT for Alcohol Use Disorder
• Disulfiram (Antabuse): treats chronic alcoholism. It is most effective in people who have already gone through detoxification or are in the initial stage of abstinence. This drug is offered in a tablet form and is taken once a day.• Acamprosate (Campril): for people in recovery who
have already stopped drinking alcohol and want to avoid drinking. It works to prevent people from drinking alcohol, but it does not prevent withdrawal symptoms after people drink alcohol.• Naltrexone: (Revia and Vivitrol) blocks the euphoric
effects and feelings of intoxication. This allows people with alcohol addiction to reduce their drinking behavior enough to remain motivated to stay in treatment.
Recommended Websites• Center on Addiction: www.centeronaddiction.org• Florida Alcohol and Drug Abuse Association
www.fadaa.org• National Institute for Drug Abuse for Teens
www.drugabuse.teens.gov• Substance Abuse and Mental Health Services
www.SAMHSA.gov
