Prevention of Alcohol

and Other Drug

Problems
What We Can Do!
A Program for Parents
 Prescription Drug Abuse is
a Growing Problem
• More teens and young adults
are abusing prescription
drugs
• Kids say; they are easy to
get, they’re legal, and they
aren’t addictive

National Survey on Drug

Use and Health
Where are they getting the
prescription drugs?
“Pharming” – taking prescription
drugs
“Rainbow parties”
Popping pills in school and
throughout the day
 Why are they using drugs ?
• Might be peer pressure or it might be
more basic:
- Who they are and what they are dealing with:
- Depression, anxiety
- Weight control
- Self esteem
- Wanting to fit in
• Help them find productive ways to fit in.
 Prescription Drug Abuse
When prescription
drugs are abused
they can be just as
dangerous as street
drugs and they can
be addictive!
Prolonged drug use changes
the brain in fundamental
and long-lasting ways
 Over-the-Counter Drugs

DXM
3.1 million 12-25 yr olds used
Dextromethorphan products
to get high the last year

It's called robo-tripping, skittling, tussin or triple-c

 DXM Effects
• Pupil dilation
• Dizziness, nausea
• Confusion, disorientation, lack of
coordination
• Robotic, zombie-like walking,
"robo-walk"
• Dissociative effects may last 6
hours
 Methamphetamine
• Powerful CNS
stimulant!
• Easy to make
• Extreme danger of
combustion and burns
• Health risks are
enormous with these
chemicals
 Why Methamphetamine?
• Cheaper and longer
lasting than other
stimulants!
– High lasts can last
6 to 12 hours
• An extremely
dangerous and
powerfully
addictive drug!!!
 Dilated pupils
Burns on
thumb
Cards for crushing
Red or irritated
Hollowed out pens
nostrils

Butane lighters
Straws, gum
wrappers
Stimulants “Performance Enhancing”
or Smart Drugs”

cok
a i n e e
coc
crank
Ritalin
d e rall meth
Ad
 Behavior Warning Signs
• Erratic behavior
• Constantly misplacing things
• Lying
• Skipping school
• Isolation
• Paranoia
• Weird eating & sleeping patterns
www.drugfree.org/
 Alcohol
• Most widely abused OTC drug
Underage Drinking:
Percent of 8th, 10th,and 12th graders
reporting alcohol use
38.9
32.1 Lifetime
8th 15.9
8.1 Annual
58.3 Past Month
52.5
10th 28.8 Binge Drinking
16
71.9
65.5
12th 43.1
24.6

0 20 40 60 80
Monitoring the Future 2009 Data
 Dangers of Teen Binge Drinking
• Binge drinkers are 5X more likely to have sex
• 18X to smoke cigarettes
• 4X to smoke marjuana
• 4X to get into physical fights w other teens
• Have a higher rate of suicide
• Causes them to make rash and dangerous
decisions; loss of internal control
• Alcohol leading cause of accidents, murder and
rape among teens
• Alcohol causes 150,000 ER visits by teens
THE MOST DANGEROUS DRUG OF ALL
Center for Disease Control and Prevention
 Alcohol
• is a drug
• is a drug
• is a psychoactive
addictive drug
 Underage drinkers are at
greater risk for:
• Learning problems
• Trouble at school and home
• Becoming sexually active
• Mental & social development
consequences
• Using other drugs (53% vs. 3%)
JAMA.289:989-995,2003; Pediatrics.119: 76-85, 2007
Normal Pleasure Response
nucleus accumbens

substantia nigra

Increased Dopamine
locus ceruleus
Release

Pleasure/Motivation Response
 Brain Reward Pathway

substantia nigra

locus ceruleus

Psychoactive Addictive
Drugs Act on this Pathway
Brain Reward Pathway

Wow!!!

substantia nigra

locus ceruleus
Drug
Dopamine surge!!!
Reward Pathway

Drugs act on the

Brain Reward
Pathway

The “Wow!!!” is
a big reason
people take
drugs but other
things also
happen…
Reward Pathway

Areas
Emotional & behavioral
learning
Control of body movement

Early learning and

memory processing
Recognize the Signs and
Attention states and
automatic function Symptoms

There is no safe “High”

 What happens with continued
drug use?
Wow!!!

substantia nigra

locus ceruleus
Drug

Healthy Drug
Control Abuser

Tolerance and Withdrawal Develop

 Finally the System Breaks

Wow!!!

substantia nigra

Brain cellslocus
become
ceruleus
damaged Drug
A “molecular switch” is thrown in the brain
• The person becomes a drug addict
• Loss of control over drug use
• Compulsive drug seeking behavior
Addiction is a Brain Disease

substantia nigra

Opiates
locus ceruleus Alcohol
Depressants
Cocaine
Amphetamines
Marijuana
 Addiction
• A disease characterized by
continued use and abuse of drugs
despite recurring negative
consequences in a person’s life

• Loss of control over taking a

substance
Risk Factors
www.drugabuse.gov
www.drugabuse.gov

Drugs, Brains, and Behavior: The

Science of Addiction; NIDA, March 2007
Risk Factors - Science Based Data
 Family history of alcohol or other
drug abuse
• Children of Alcoholics have a four
times greater risk of becoming
addicted to drugs
Risk Factors
 Favorable attitude toward alcohol
and other drugs
• Groups that accept and
encourage heavy drinking or
other drug use
• Beliefs like:
It can’t happen to me”, “I can
handle it” are very dangerous
Risk Factors
 Parental drug misuse and/or
abuse
 Early onset of drug use
 The Progression of Use
tobacco
inhalants alcohol
Rx drugs party drugs marijuana

cocaine
heroin
MAJOR PROBLEMS
 Young brains are
especially susceptible to
alcohol and other
psychoactive addictive
drugs

Norm Volkow Ph.D., Director of Natl. Inst. Drug Abuse

 Prefrontal Cortex -
last area to develop
5 24
Images of Brain
Development in
Healthy Children,
Teens and
Young Adults

Blue represents maturing of brain areas

Brain development is ongoing during adolescence and

continues into the early twenties contrary to what was
previously thought
 Dangers of Drug Use

substantia nigra

locus ceruleus
Perfrontal Cortex seat of judgment,Drug
reasoning,
problem solving; enables us to assess situations,
make decisions, plan for the future and keeps our
emotions and desires under control (governs
impulsivity, aggression,…)
 Dangers of Drug Use

substantia nigra

locus ceruleus
Drug
Limbic system involved in the pleasure response;
also regulates emotions and motivations, such as
fear, anger, and is involved in early learning and
memory processing,…
 Young brains are especially
Frontal Cortex
susceptible to alcohol and other
psychoactive addictive drugs

substantia nigra

locus ceruleus

• Less planned thinking

Limbic System • More impulsive
• Less self control
• Higher risk takers
Brain Research Conclusions
1. Young brains are more susceptible to
drug use than adults
2. Using drugs while the brain is still
developing may have profound and long-
lasting results:
• Learning ability & emotional development
3. Implications of these studies are
enormous for parents

Nora Volkow M.D., Director NIDA, Drug Addiction, 2006

 Teens who begin drinking
before age 15 years are 4X
more likely to develop
alcoholism

Archives of Pediatric and Adolescent Medicine 160(7):739, 2006

 Young adults may be less
likely to develop serious alcohol
and other drug problems
if the age of first use is
delayed beyond childhood or
adolescence
  Beliefs & attitudes

www.drugabuse.gov
Risk Factors
 Association with drug-using peers
 Family conflict or stress
 Poor parent-child relationship:
• lack of monitoring and supervision
• inconsistent or excessive discipline
• lack of caring and support
Risk Factors
 Little commitment to academic
achievement
 Lack of involvement in school
and community
 Lack of clear, enforced school
policy about drug use
Risk Factors
 Portrayal of ATOD on TV and
in movies
 Advertising impact on norms
and behavior
Commercials, Advertisements,
and Internet
 Deceptive ads on the Internet …
• “Valium releases stress on spot,
allowing more self confidence”
• Web sites detail a drugs synthesis
information, list of ingredients and
how much you should pay for a dose
Make Some Rules
Keep computers in a
central area
Tell your kids,
despite what they may
see on the Internet,
there is no safe way to
get high
Tell them about the
dangers of drug use
Risk Factors
 Availability and cost of alcohol
and other drugs
 Poor enforcement of laws
concerning alcohol and illegal
drug use
The more risk factors a
person has the greater
their risk for developing
alcohol, tobacco, or other
drug problems
Impairment Consequences
of Alcohol Use
 Impairment
Any slowing of thought or physical
reaction beyond the initial relaxation
effect of alcohol
 At 0.01% BAC
• Mild euphoria, sense of relaxation

At 0.08% BAC
• Legal impairment
At 0.08% BAC - Physical and mental
impairments, decreased coordination
& thinking ability, poor judgment,
volatile mood,…
Impairment begins long
before someone is
legally drunk
 Impairment begins at 0.03% BAC

• Divided attention
problems
• Impaired eye
balance coordination
• Slower eye tracking
ability

AMA Council on Scientific Affairs, Moskowitz, Zador

 At
0.05 %BAC
• Impaired cognitive functions and
coordination:
– Information processing problems
– Impaired visual perception
– Increased reaction time

AMA Council on Scientific Affairs, Moskowitz, Zador

# of drinks per hour
 U.S. Dietary Guidelines on
Alcoholic Beverages
• Current evidence suggests that light to
moderate drinking is associated with a lower
risk for coronary heart disease in some
individuals

• Higher levels of alcohol intake

raise the risk for serious health
and impairment problem
Chronic alcohol use may result in:
Memory loss, impaired judgment,
headaches, depression, anxiety,
blackouts, insomnia

Cancers of the esophagus,

mouth, throat

Heart disease, high blood

pressure, stroke

Liver disease, liver cancer

Chronic stomach problems, GI

bleeding, diarrhea , ulcers, malnutrition

Impotency, reproductive disorders

Muscle damage, osteoporosis

 Heroin
• Most infamous product
of opium poppy
• Current resurgence in
use: white powder &
black tar heroin
• High purity and
skyrocketing profits
• Cheaper than “Oxy”
and other pain meds
 Snorting Heroin
or Opiates
• Since IV injection
is more difficult
and dangerous
many users start
by snorting

But as tolerance develops

progression
to IV use becomes necessary!
 Serious Complications of IV use
• Danger of rapid injection
• Damage to blood vessels
• Viral infections
– Hepatitis and HIV
• Bacterial infections
– Meningitis, infections, abscesses,
gangrene
 Opiate Overdose
• Breathing can slow to the point that it
ceases
• Overdose can be lethal
• It can happen with first time use
Medical intervention is critical
Call 911
 Marijuana
Most widely abused and
readily available illicit
drug in the U.S.
Marijuana - high-potency
forms
Commercial grade
• 3% 9-THC in early 90’s
• Today As high as 10+%

Significant increase in
potency in recent years
 Impairment of Learning Ability
• Compromises the
ability to learn and
remember information
• Students who smoke
marijuana:
– Get lower grades
– Less likely to graduate
from high school

Lynskey, Addiction 95(11):1621-1630, 2000

Thinking, movement, memory
functions are all impaired:
• Poor coordination
• Harder to sustain
attention
• Errors in judgment, time
and space coordination
• Distorted perception
(sights, sounds, time,
touch)
• Delayed reaction
times – in sports
• Increased risk for
accidents And it’s ADDICTIVE
Health Problems of Smoking Marijuana
Brain
Harder to sustain attention, errors
in judgment, delayed reaction
times in sports & gaming,
increases risk for accidents
Respiratory System
Decreases lung function and

exercise tolerance
Reproductive System:
Decreased testosterone levels;
decreases sperm count; disrupts
menstrual cycle
Inhalants:
They're Just
Under Your Nose
 Inhalant Abuse
• Many parents are unaware of the
potential dangers of some
common household products if
they are inhaled by their children
• Young people abuse inhalants
because they are readily
available, easy to get, legal….
Inhalants
 Effects of Inhalants
• Produces a “rush”, intoxicated or
euphoric state
• Uninhibited and impulsive behavior
• Dizziness, distorted perception,
slurred speech
• Confusion, inability to coordinate
movements
• Impaired judgment
Intoxication
 Inhalant Abuse

• How do we know if a young person

has been sniffing or huffing?

• What can we look for?

• What are the signs and symptoms?

 Signs and Symptoms of
Inhalant Abuse
• Unusual breath odor

• Chemical odor or stains on clothing

• Discovery of hidden cache of spray

paint or solvent containers,
chemical-soaked rags …
 Flu-like Symptoms:
• Headache, nausea, vomiting, loss of
appetite, congestion, coughing,
abnormal drowsiness

• Red or runny nose and eyes

• Skin around mouth can be irritated or

sore
Intoxicated Appearance:

• Dazed or dizzy, slurred speech,

lack of coordination, tremors,
inability to concentrate

• Chronic abusers exhibit anxiety,

excitability, restlessness,
irritability
 National Inhalant
Prevention Coalition

• www.inhalants.org

• Video and brochures

 How to Prevent
Prescription, OTC, and
Other Drug Problems

What We Can Do!!!

What We Can Do!
• Know the Risk Factors
• Adopt a Resiliency Approach
Resiliency/Protective Factors
• A sense of purpose and future
• Healthy expectations and a positive
outlook
– Spiritual foundations and relationships
• Having an opportunity to contribute
and be seen as a resource
– A sense of belonging, spiritual
connectedness
Resiliency/Protective Factors
• Effectiveness in work, play and
relationships
– “Playing together”, having fun together
• Self-esteem and an internal locus of
control
– Caring, support, acceptance, respect,
openness, honesty, trust, inter-
independence
Resiliency/Protective Factors
• Problem solving/critical thinking
skills
• Self-discipline
– Reinforce healthy behavior
• A relationship with a caring adult
role model
– Positive role models affect emotional
growth
Resiliency/Protective Factors
• Supportive networks and social
bonds
• A sense of humor
– Healthy teasing, not ridicule; help
them break out of seriousness
• Norms and public policies that
support non-use
– Parent Alert Program
What We Can Do!
• Know the Risk Factors
• Adopt a Resiliency Approach
• Look for Early Sn and Sx
Early Sn & Sx of Drug Use/Abuse
• Behavioral changes
• Pay attention to child’s attitude:
– Argumentative, hostility
• Disregard for household rules, curfew
• Isolating and withdrawing from family
and friends
• Change in friends, deteriorating
relationships
• Evidence of lying or secrecy
• Decline in academic performance
 Signs & Symptoms of Drug Use/Abuse
• Decreased interest in sports
and other activities
• Changes in weight,
eating/sleeping
• Depression, fatigue, even
anxiety
• Missing household money,
medication or alcohol
• Bloodshot eyes, consistent
runny nose, cough, bronchitis
– Incense, eye drops, odors on
clothing, hair or in bedroom
 Signs & Symptoms of Drug Use/Abuse
• Dizzy and trouble
walking
• Difficulty remembering
recent events
• Carelessness with
grooming
• Drug paraphernalia:
clothing, posters, jewelry, ...
promoting drug use
www.drugfree.org/Parent
We need to be aware of the
signs and symptoms of
abuse and take positive
action when there is a
problem
What we can do!
• Know the Risk Factors
• Adopt a Risk/Resiliency
Approach
• Look for Early Signs and
Symptoms
• Give Prevention Messages
 General Approach
• Support healthy lifestyle choices:
– Encourage good health habits, eating a
healthy diet, stress reduction,
exercising, getting enough sleep,
relaxing, bonding activities
• Incorporate drug prevention activities
wherever possible:
– Look for “teachable moments”
 Parents
• Understand the resiliency factors and
support your adolescents in:
– School performance
– Setting goals
– Positive expectations
– Structuring free time
– Evaluating peer groups
– Building self-esteem
– Community service
– Social skills and decision-making ability
 Parents
• Educate your children/adolescents
about the risks of drug use:
– Impairment risks:
• Judgment problems, increased risks for
accidents, risky sexual behavior
– Health problems
– Life consequences
• It’s illegal, …
 What do you tell them?
Dangers of Drug Use
• High potency:
– Altered state – no longer in control
– Disinhibitory effect
• Adulterants
• Unpredictable effects
• Problems in sporting activities:
– Decreased coordination and performance
ability
– Reduced exercise tolerance
 Dangers of Drug Use
• High risks for:
– impairment and
accidents
– health problems
– addiction
• Effects on the
mind and
emotions
 Past Month Use vs. Parents’
Feelings About Substance Abuse

Past Month Strongly Somewhat

Substance Use Disapprove Disapprove or
Neither Approve nor
Disapprove

Marijuana 4.9% 26.9%

Cigarettes 8.3% 45.3%

Alcohol 13.0% 40.0%

SAMHSA 2002 data
 Tips for Parents

• Be a good listener
 Tips for Parents

• Give clear no-use messages about

alcohol and other drugs
– Start early, be ongoing
– Change the nature of your discussion
as your child’s brain develops through
the years
 Tips for Parents
• Help your child deal with peer
pressure to use drugs
• Example:
– If 85% of the students know someone who
regularly uses marijuana then…
• Role play situations of refusing
to use ATOD
 Tips for Parents
• Get to know your
child’s friends and
parents
 Tips for Parents

• Monitor your child’s

whereabouts
– Call other parents,
find out what’s going
on…
 Tips for Parents
• Supervise teen activities
– When parents impose rules and
standards of behavior, their teens are
at much lower risk …
• Maintain an open and honest
dialogue with your child
 Parents
• Talk to adolescents about their
intentions and attitudes, peer
pressure, evaluating peer group

• Use this opportunity as a lead into a role

playing situation for refusing to use
drugs
 Educational campaigns that
stress personal responsibility
and immediate health and
impairment dangers
of alcohol and other drugs use
are effective prevention tools
 Parents
• Recognize your own use as a risk
factor for drug use in their children

• If you use alcohol follow the U.S.

Dietary Guidelines for Alcohol
Consumption
Drug Information Web Sites
www.drugfree.org
www.theantidrug.com
www.whitehousedrugpolicy.gov
www.teendrugabuse.gov
www.Abovetheinfluence.com
www.ProjectAlert.com
www.casacolumbia.org
www.theantidrug.com
 Remember:

Everybody isn’t doing

drugs!
Let’s Work Together
and
Really
Make a Difference!
Thank you!