Opioids & The Young Adult
Population
MARY-K O’SULLIVAN, LMFT, LADC, LPC
Capital Region Mental Health Center
Adolescence & Young Adulthood
Developmental Stage that Transitions the Child to an Adult
Age Range is between 10 – 24 and referred to as “teenagers,”
“adolescents,” “youth,” and “young people”; The associated
age spans are variously 13-19, 10-19, 15-24, even 10-24.
Focus is Upon Developing Adult Coping Skills and Abstract
Problem Solving in Varying Situations
Young Adulthood Risk
Factors
• Exposure To Drug Users In
Social/Work Environments
• Relationship & Work Instability
• Unemployment
• Psychological/Psychiatric Symptoms
Nucleus Accumbens
• promotes the drive for new experiences
• seeks activities with low effort for high
yield
• enhances maturity
• pushes away from family to the outside
world
The peer group becomes
increasingly important to teenagers
because
1. They have a greater understanding of others
2. They have a great capacity for mutual
understanding
3. They have an increased capacity for intimacy
and true friendship
4. All of the above
Young Adults Have a Unique Culture of
Their Own With Peer Structures, Belief Systems, &
Developmental Goals
Young Adult Context
• What Role Do Peers Play in the Development Process of
Adolescents?
• What Role Does School Play in the Development
Process of Adolescents?
• What Role Does Community Play in the Development
Process of Adolescents?
• What Role Does Family Play in the Development
Process of Adolescents?
Peers tend to influence more ______,
parents tend to influence more _______.
1. Decision making; basic values
2. Superficial behavior; basic values
3. Basic values; superficial behavior
4. Basic values; cultural mores
` The Amygdala
Contributes to:
Impulsive Behavior
Inappropriate Behavior
Missed Social & Emotional Cues
Miscommunication
Contributes to Rapid & Highly
Emotional Reponses
Behaviors Not Outgrown With Aging
FRONTAL LOBE
Poor Organizational Skills
Poor Decision-making
Poor Processing of Abstract Concepts
Rule Breaking
Reckless Behavior
Emotional Outbursts
HIPPOCAMPUS
Difficulty with Memory
Difficulty Learning
The Washington Post Reviewed the
CDC Data for 2015 and Found:
• Heroin death rates were
highest in Ohio, West Virginia,
and Connecticut, where the
rates were between 10 and
13.3 deaths per 100,000
residents
• The analysis showed that
synthetic opioids—including
Fentanyl and Carfentanil—
almost exclusively affect the
East Coast
Narcotics
• OPIATES: Directly Derived From The Opium Poppy
• SEMI-SYNTHETIC OPIATES: Partially Derived From The Opium Poppy, Partially Man-made
• OPIOIDS: Completely Synthetic/Man-made
NARCOTICS
OPIATES
OPIUM - Schedule II or III (Diluted)
MORPHINE – Schedule II
CODEINE – Schedule III
THEBAINE – Schedule II
NARCOTICS
SEMI-SYNTHETIC OPIATES
Heroin: Schedule I
Hydrocodone: Schedule III (ex: Vicodin)
Hydromorphone: Schedule II (ex: Dilaudid)
Oxycodone: Schedule II (ex: OxyContin, Percodan, Tylox)
NARCOTICS
OPIOIDS – (Fully Synthetic)
Buprenorphine (Subutex,
Suboxone): Schedule V
Fentanyl: Schedule II
Meperidine (Demerol):
Schedule II
Methadone (Dolophine):
Schedule II
Pentazocine (Talwin):
Schedule IV
Propoxyphene (Darvon):
Schedule IV
Tramadol (Ultram, Ultracet):
(Not Yet Scheduled)
“Pharm-parties” are introducing adolescents and
young adults to the world of prescription drug
use at an alarming high rate. It is not considered
“drug use” by many of those engaged in the
behavior as the medication comes from a
pharmacy
Often unable to afford illicit sources of the
prescription medication, and now
physically addicted, individuals turn to
heroin
Heroin costs 1/3 to 1/2 that of Oxycodone
purchased illicitly on the street
Deaths Due To Narcotics • King George V – Monarch (cocaine and morphine)
• John Belushi – Actor/Musician (Speedball)
• River Phoenix – Actor (Speedball)
• Jim Morrison – Musician (Heroin)
• Chris Farley – Comedian/Actor (Speedball)
• Elvis Presley – Singer/Actor (Prescription Drugs)
• Janis Joplin – Singer (Heroin)
• Kurt Cobain – Musician (Heroin)
• Sigmund Freud – Physician (Morphine)
• DJ AM – Disc Jockey (Prescription Medications and Cocaine)
• Howard Hughes – Aviator (Codeine)
• Michael Jackson – Musician (Propofol and Other Prescription Meds)
• Heath Ledger – Actor (Prescription Medications)
• Sid Vicious – Musician/Sex Pistols (Heroin)
• Brad Renfro – Actor (Heroin and Morphine)
• Dana Plato – Actress (Lortab)
Emerging Trend – U-47700
• A synthetic opioid drug that
was developed in the 1970s
but never made available to
the public is being sold
online
• The designer drug has
gained popularity through
drug forums and websites,
where it is sold as a powder
or granules. One website
offers 1 gram for $40, or up
to 1 kilogram for $7,000.
Emerging Trend – Grey Death
• A new drug called "grey
death" has been linked
to a handful of lethal
overdoses in the South -
- but no one knows
exactly what's in it or
where it's coming from.
• The drug, a mix of
opioids, can kill in very
small doses and looks
like concrete mixing
powder.
Emerging Trend - Cheese
• A mixture of heroin and OTCs such as Tylenol PM
• The heroin-Tylenol PM combination of "cheese" sells for
approximately $2 a pill
• Users commonly take the powder by insufflation
("snorting") rather than by intravenous injection.
• This mixture is also known as "Tylenol With Smack"
Emerging Trend - Krokodile
• Krokodil (pronounced crocodile) is a homemade substitute for heroin, invented in rural Russia and
has recently been featured in news reports alleging its appearance in parts of the United States
although the DEA has not yet confirmed any krokodil in this country.
• The chemical name for the main ingredient is desomorphine.
• The drug is made from codeine mixed with household chemicals like paint thinner and gasoline.
It’s injected and can reportedly cause a high “ten times more powerful than morphine,” It’s also
three times as toxic.
• Krokodil gets its name from the scaly, gray-green dead skin that forms at the site of an injection.
The flesh destroyed by krokodil becomes gangrenous, and, in some cases, limb amputation has
been necessary to save a user’s life.
Emerging Trend - Hysingla ER
• Purdue Pharma has
announced that
its prescription opioid
medication Hysingla ER
(hydrocodone bitartrate) is
ready to hit the market.
• The drug is the first
hydrocodone product that
contains abuse-deterrent
properties
Emerging Trend W-18
• A new drug that is considered to be
10,000 times more powerful than
morphine has hit the market in the US
after being discovered in Canada
• The synthetic opiate-like W-18 is a
psychoactive substance and
opioid similar to heroin, but is 100 times
more powerful than fentanyl.
• W-18 is yet to be prohibited in Canada
or the US. It was made illegal in Sweden
on January 26, 2016.
• It was originally developed as a
painkiller by scientists at the University
of Alberta in 1981.
• After being deemed too strong, it was
never picked up by pharmaceutical
companies and was largely forgotten
about.
Current Trend - Zohydro
• The introduction of the powerful new opioid painkiller Zohydro has
spotlighted the nation’s growing prescription drug abuse problem.
• A powerful new prescription painkiller known as Zohydro ER hit the market
in March 2014 amidst widespread concern that the drug could trigger a
disastrous spike in overdoses and deaths. Zohydro is a potent extended-
release formulation of hydrocodone without the additives of aspirin or
acetaminophen and without anti-abuse formulation.
Current Trend - Opana
.
Opana (oxymorphone) is an opioid pain
medication. Opana is used to treat moderate
to severe pain.
The extended-release form of this medicine
is for around-the-clock treatment of severe
pain.
Law enforcement officials are alarmed by the rise of Opana abuse, which they
said started after Oxycontin was changed in late 2010 to make that drug more
difficult to snort or inject for a heroin-like high.
Opana abuse can be deadly because it is more potent, per milligram, than
Oxycontin, and users who are not familiar with how strong it is may be
vulnerable to overdosing.
Opana, known by such street names as "stop signs," "the O bomb," and "new
blues," is crushed and either snorted or injected up to four to ten times per day.
Current Trend - Carfentanil
• Carfentanil or
carfentanyl is an analog
of the synthetic opioid
analgesic fentanyl. It is
10,000 times more
potent than morphine,
making it among the
most potent
commercially used
opioids
Current Trend - Acetyl Fentanyl • Mixing fentanyl with heroin isn’t new; however, the development of a synthetic
fentanyl has just started to make headlines.
• Three overdose deaths in North Carolina have been linked to acetyl fentanyl, a
designer opioid drug closely related to the prescription pain killing opioid fentanyl.
Two deaths occurred in Jefferson Parish, La. due to the drug and the use of acetyl
fentanyl seems to be spreading throughout the country.
• Acetyl fentanyl is often marketed as heroin but it is five times more potent than
heroin, 16 times more potent than morphine. Therefore, it is leading to many
overdose deaths, particularly in Rhode Island and Pennsylvania. The pills are also
peddled as oxycodone.
• Acetyl fentanyl is difficult to detect and easy to miss in drug overdose cases.
• Acetyl fentanyl is not scheduled under the Controlled Substance Act.
Current Trend “Syrup,” “Purple Drank,” “Sizzurp,” “Lean”
• Drinking prescription-strength cough syrup containing codeine and promethazine
mixed with soda was referenced frequently in some popular music beginning in the
late 90s and has now become increasingly popular among youth in several areas of
the country, according to recent CEWG data. Codeine is an opioid that can produce
relaxation and euphoria when consumed in sufficient quantities. Promethazine is an
antihistamine that also acts as a sedative. Users may also flavor the mixture with the
addition of hard candies.
• Demand for the syrup has sent its price soaring on the streets. Syrup that typically
costs $12 per pint is sold to street dealers for $300 per pint. Dealers sell it by the
ounce for $40-$80.
• The drink produces euphoria and causes motor skill impairment that make users
move slowly or lean over. Overdosing on the syrup is potentially fatal.
Current Trend P-Dope
• Often Called Designer Heroin
• Molecular Similarities to
Fentanyl in Some Areas of the
Country; Purer Heroin Mixed
With Procaine/Lidocaine in
Other Areas
• Over-rides Methadone
Allowing Users to Get High
• Users Call it the “Crack of
Heroin” due to its addictive
potential
Psychological
Effects of
Narcotics
• Mood swings
• Depression
• Anxiety
• Irritability
• Lethargy
• Exhaustion
• Sedation
• Memory
problems
• Hallucinations
• Delusions
• Paranoia
Heroin
Opium
Morphine
Codeine
Hydrocodone (ex: Vicodin,
Zohydro)
Hydromorphone (ex: Dilaudid)
Oxycodone (ex: OxyContin,
Percodan, Tylox)
Oxymorphone (Opana)
Buprenorphine (Subutex,
Suboxone)
Fentanyl
Meperidine (Demerol)
Methadone (Dolophine)
Pentazocine (Talwin)
Propoxyphene (Darvon)
Definitions of Mood vs. Mind Altering
• Mood- Altering: Client Becomes Their Own Pharmacist. Focus is on
a Temporary or Short-term Emotional or Feeling State; Can Involve
Perception of Outside Stimuli; Deregulates Brain Chemistry; Getting
High is the Goal
• Mind Altering: Medical Personnel are Pharmacists. Focus is on
Long-term Feeling or Emotional State; Targets Intellect, Judgment,
Cognition, Intellect; Re-regulates Brain Chemistry; Getting High Is
Not the Goal Nor Part of the Perception of the Client
Top Related