Ir.'
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At\1ERICAN UNIVERSITY
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....
)V;TfCE PROGR.....\IS OFFICE
SCHOOL OF PCIl:.IC AFfAIKS
OJP Drug Court Clearinghouse and Technical Assistance Project
Adolescent Pharmacology in Drug Courts
Shelby Campus
University of Louisville
Founder's Union Building - Room 218 A & B
Louisville, Kentucky
January 20, 2000
Faeultv:
MICHAEL F. NERt\'EY
Sponsored by the OJP Drug Court Clearinghouse and Technical Assistance Project and
the Kentucky Administrative Office of the Courts
These workshop malerials were prepared under the auspices of (he Office ofJustice Programs Drug Court
Clearinghouse and Technical Assistance Projecl at American University. Washington D.C. This project is
supported by Gram Nos. 9j-DC·A1X-K002 and 98·NU·VX·KOJ8, awarded by the Drug Courts Program
Office, Office ofJustice Programs, US Department ofJustice. Points of view or opinions in this document
are those of the authors and do not necessarily represent the official position or policies 0.1 the Us.
Department ofJustice.
OJP Oat"(; COURT CLE~RI'I;CHOl.:SE"''I;I) TECH:-.;ICAl As.sIST.~.''T PROJECf
4400 MASSACHL:SE1TS A\'E:-.'t.:E.;-JW
\'('ASHI'I;GTO:-.:. DC 10016·81;9 ~Ol-885-1g:5 F",'{. 201-885-1885
E-\L~ll; )l STICE@\.'IERlU-":.EDL
WE8 5rr£: 1l"\l;"«".\.\!£RlC ~'''.EDL:/Jl'mCl
Adolescent Pharmacology in Drug Courts
.\1ichael F.
~erney,
Faculty
COi'OTE'iTS
Program Announcement
Agenda
Pre-Test
Diagram: CortexILimbic/Stem
Adolescent Focus Chart
Adolescent Substance Abuse: Reasons for Drug Use
Top five Drugs of Choice
The Adolescent Agenda
Treatment Issues: Critical Differences (Adolescents/Adults)
Components of Trust
Update on Current Drugs of Abuse
Michael :'\'erney and Associates
P.O. Box 93
Long Lake, :"iew York 128-4i
Tel: 5181624-5351
Dru~
Adolescent PhRrmacology in
Court!
./ltnuar)' 20, 2UOO
Mchllel f. Nerncy
Pre~cnler:
Funded ~.lhe Drug ~ourt Clcllring:hol1&c and TcchnlQI Assislance ProJec: o~ Amertcan Uni.... erslty whi~h is
l'ul1~d by the Drug Coun! Progfllm Orne::, OOic: of Justlcc Prognl.lns, U.~. Department of Jusllce, llnd ill
cunlundon with the AdlTlllIJstrutive Office of the Courts.
What is the ProgrAm? A training to familiarize participants with current information regarding drug
addiction and the phanTIacology of commonly Ilsed illeg!!! drug;;.
WllD shpuld !:Htend? 1l1Cl Program 15 intended to reach Judgos, Anorneys, Law Enfurcem~f1[. Probation
and Parole,! SlibSlanCf:! Abuse.}Mental Health {prafes.l'/onais}, and ctJlor interested persons: regarding
Drug Courts and drug {addlctfon}.
Why me? D1'11[i Court is already.il part of your [oclli community or is about to be. If you lire to be
effective in your job, you must be fully cognizant of the tr8atm~l1t of drug (addiction} and the
pharmacology of dnlgS.
Wbp j! the ,oenker? Michael Nerney is a consliitant in Substance AbllSe Prevention and Education, With
17 yee,r~ of cxperimce In the field. He is the former DIrector ofche Training [mtitute of Narcotic and Drug
M"earch, Inc. Hi~ expertise includes Psychopham.. 9. coJogy, adolcscent chemical d~BI'1dency. managing
violent Lt'lcidanti. Post Tr<lumatlc SHell' Diiorders and Relapiile PrtlventiCll He holds!! graduate de~r~ in
Adolescent Development from Harvard University; a degroo in Psychopharmacology from Russell Sage
ColloH~; and a degrge In Secondary EduCiltiCfl from State Univer;;;it)' of New York.
Thtl worklhofl hu OI'<1n
~Ilrnwef.l \hrouih~
C(l.llI/..~tktrJ'l:
DjYh[nn Qr SIlJatunu AUI,IU for 6 hOUri uf euntlnuln\: ",,Jucllt!on/trll.lnlnll fnr
(Cw/jl.tJ Alcohl.lllUld DruK
,I
erel
II UppnlYt
for 4.:5 Cuntlnulnll. Judlthll
..
b
PlH\
nil W!I
y
E,Ju'~llon
I
IY
h,lurtj
~niJ
con!lnulng educllclon
....
Shelby Citmjlu~
Unlventty of Luul8vtllc
FOllnr.ler'~
Onion Bulldlng:-Ruum 21g J\ &: 8
(nlllp enc1ow0d)
Regislration
9:]0
3.m - 10:00 A.m. (EST)
Introduction
Ovcrvie=w
Pharmacology
Phy!iolog.ical effects
New dnIgs !lnd drug tc.5ting
10:00 - 12:00
Lunch
12:IJO-1.0(l
AdolescenL devdopmcnL
PhysioJogi::lll effects of sub!;tlUlC:: abuGC:
How \0 enHJ;lge and rc~uln yomh In drug couns
How drug couns may be: effectivc
F!lmily inlluencc& lwd ~ubstnncc nbuic
Dl1'ferences belween Rmtll and juvenile drui, courts
Observe Jc1!orson Co. Juyenlle Drug Court
I :OQ - 4:.10
4:45 - 5:45
R::g.hltrntion for Jalluary 20, 20110
NllmeIJitle
_
Org;:lnjzllllon:
_
AOOI<'&:
_
Clly. StOle. Zip:
_
PhO:le:
Fax:~==-"'V="";;"="'''',..,,,,_
Relurn lO: DnlS CO\lr1.~ 149 N. Limestone SI
.. Lc:~lngton, KY 40507- (ISM) 246-'}Jo! qr Fux (606) 246-B(}]
ADOLESCENT PHAR.VlACOLOGY fN DRUG COURTS
January 20, 1999
Agenda
Funded by the Drug Court Ckaringhouse and Technical Assistance Project of American
Univt:rsity which is funded by the Drug Courts Program Otl11.:c, Office of Justice Progra.. ns. V,S.
Department of Justice, and in conjunction with the Administrative Office of the Couns
9:30 a.m .. 10:00 I.m.
~gist!ation
Introduction
Housekeeping
Overview
10:00 a.m.· 12:00 p.m. (Break from 11:00· 11:15)
PharTl1l:1cology
PhysioJoll;icaJ EJfects
NdW drugs on street In conjunction with drug
le~tinB
Frequency injudiciaJ sessions
12:00 p.m .• 1:00 p.m.
Lunch
1:00 p.m. - 4:15 p.m. (Break 2:15·2:30 and 3:15-3:30)
Adolescent devolopment
Physiological effects of subl:ltance abuse on adolescent dcveltlpment
How to enge.ge and retain youth in drug court
How can drug court be effective in youth's life
Family influence on adolescent substflllce abuse
Difference between adult and juvenile drug courts
4:<\~
p.m. - 5:45 p.m.
Observe Jefferson 1uvenile Drug Court
ADOLESCE:-',ISSL"ES
PRE-TEST
The: pa..i1 of 2.!l ldolcscem's body that groW'S the fus:es: is.
.\1usc!es
Skeleton
8 .... 101
L'11ema! orga.ns
,.l,_
B
C
o
:2
The age
.A-
13 - i S
8
19-j~
C
.3 S-55
55-
D
3
C
D
\5
.
.-'.ovemSlr.g
Role models
Emotional needs
Peer pressure
The number of adolescents eacn year who dnnk
:.l."..
8
C.
D.
5.
which uses drugs most he..:.vdy
The reaso:; adolesce:1\.5 give most aRenlO explaln!!':e!; alcohoI2..'10 drug consumptlon 1$
B
4
gTOup
10
tntoxication at least quarterly
IS:
Two mtlllon
four mdlror'!
Six million
Eight million
The three drugs
are:
mOSt
commonly abused by Junior High students,
A
LSD, marijua..'1a, alcohol
B.
C.
D.
Inhalants, alcohol, marijuana
.AJcohol, marijuana., inhalants
Alcohol, PCP, marijuana
tn order of preference,
PRE-TEST
Page 2
6
7
,.;.co[esc~:1\.S
A,
[t 111te~er:?:s v,t'],:.h concentratlon
8
I, medicates for anxiety and boredom
C
D
Ie resolves conf..,l510n
It stimu!ales agsresslve behavior
C::.:, lee, Crank and Gi3.SS are all-
;-\.
8
C
D
8
9
De;;ressani.S
:-i1:tucliloger.s
Deslgner c!rJgs
Sumulan:..s
The drug responsloie for most emergency rOOr:1
.~.
LSD
3
\. G.. ! lj u.3..:"1a
C
Ket.arnlne
D
XTC
VISits
The drug ShOW1:1g L!,e greatest increase In popula..'"1:-.
High srudents
10.
I1ke :0 use manjU2.I1a because
in males ages 6-17 tS
:'l
the last rwo years arTlong Junior
IS:
A
PCP
3
M~~iju..ana
C.
L,hala..r,ts
D
GHB
The most popular oveHhe-counter drug abused by teenagers is:
A
B.
C.
D.
Coriciden 0
Dextromethorphan
Ephedra
Dramamine
~
CORTEX
LIMBIC
~
'7--~
-
--..
-\
·ADOLESCENT FOCUS CHART
0'
At dlHer.nt staga.
davllopmlnt, til. human brain has dIflerent
lav.', 01 neuronal natwork. (NW); ""urotran.mltt... (NT) to link
those natworks and the anargy (E) to drlva thosa dIffer9ncu.
ADOLESCENT SUBSTANCE ABUSE
Reasons for Drug Use
o Belonging
o Coping
o Pleasure
o Creativity
o Aggression
TOP FIVE DRUGS OF CHOICE
High School
1.
1.
3.
4.
5.
Middle School
1.
2.
3.
4.
5.
THE ADOLESCENT AGENDA
I. Individual Identity
2. Separation from Family
3. Formation of Relationships
4. Skills and Judgment
s.
Acceptance of Physical Self
6. Adult Roles
TREATMENT ISSUES:
Critical Differences
Adolescents
Implicit Ys. Explicit
Learning
Adults
Abstract Learning
Capacity
o Group Setting
o Generalize
o War Stories
o Internalize
o Specific Details
o Concepts
Treatment _ eeds
Treatment Needs
TREATMENT ISSUES:
Critical Differences
Page 2
Adolescents
Emotional Status
Adults
Emotional Status
o ?x Intensity
o Stability
o Frequent Change
o More Constant
o Filter
o Filter
Treatment Needs
Treatment Needs
TREATMENT ISSUES:
Critical Differences
Page 3
Adolescents
Adults
Social Bonding
Social Bonding
o Narrow
o All Adults
o Activities
o Beliefs
Treatment Needs
Treatment Needs
TREATMENT ISSUES:
Critical Differences
Page 4
Adolescents
Adults
Family Dynamics
Family Dynamics
o Dysfunctional
o Dysfunctional
o Proximate
o Distant
o Current
o Retrospective
Treatment Needs
Treatment Needs
TREATMENT ISSUES:
Critical Differences
Page 5
Adolescents
Adults
Social Ecology
Social Ecology
o Broad
o
arrow
o Peers
o Peers
o School
o Work
o Home
o Home
o Neighborhood
o Media
Treatment Needs
Treatment Needs
COMPONENTS OF TRUST
I. Reliability
2. Predictability
3. Faith
UPDATE
on
CURRENT
DRUGS OF ABUSE
Michael F. Nerney
1999
Michael Nerney and Associates
Post Office Box 93
Long Lake, NY 12847
(518) 624-535 I
UPDATE ON MARUlANA
Now they call
It
skunk, boom, chrooic or indigo. and they smoke
It 10
shotguns, blunts or
Phillles. After the lOtoxlcJ.tmg effects take over, they talk about gettlOg lifted, booted or choked out.
It's not a new drug, but It is a new trend that drug experts say mdicates a rise
10
the popularity of
manJuana among Junior high school students. For the first time in over a decade, manJuana use
.
rose shamly
1997. Bv all indIcators, 1999 will see a continuation in the
. from 1991 throu2:h
- '
increase of marijuana use,
While there are many reasons for thiS change in the pattern of marijuana abuse, researchers
llke Lloyd Johnston of the UniversIty of Michigan POint to the perceptIOn of marijuana among
students as a relatively harmless, non-addictmg recreational drug. In pan, that perception comes
about from Amenca's "war on drugs" fascination and emphasIS on crack cocaine, ice and heroin.
Vllth all the anention on the "big" drugs, mformation about the problems of manjuana abuse falls by
the wayside
Not only are teens and preteens difficult to conVlOce about marijuana, but then parents are
often unv.illmg to get excIted about somethlOg they may have tried and llked themselves, in college
or In the service. The issue, of course, is that comparing the pot ofIhe seventies to the "high tech"
cannabis of the nmeties is like comparing the old Royal rypev.T1ter that I used
10
high school to a
Pentium III word processor It's Just not the same thmg.
Usmg smgle plant clomng techniques, better growing and har\/esting procedures, and
hybndizatlOn, growers today can produce plants wHh one to two pounds of resinated buds or colas
that are 10 to 20 ttmes more powerful than the POt of the seventies. It costs more to buy, but it takes
less of it to get intoxicated But it isn'tJust the marijuana that's different, it's also the user.
In the seventies, most marijuana smokers were betvYeen 17 and 19 ye3Js old. Today the age
of onset (the Erst time a drug
IS
used) is often 11 ~ 13 years. There is a sigmficant dItlerence in the
physical maturation of a 19 year old and an II ye::.r old. Of cnucal importance are the differences
in liver function, sexual development and emotional and intellectual function. The negative effects
of marijuana haven't really changed, they have become more intense as the potency of the plant has
tOcreased. In addition, the bodies of younger users are affected differently than those of their older
predecessors. There are newer studies that suppon much of what we assumed about the negative
consequences of manjuana, such as damage to the lungs.
Michael Nerney 1999
1
In a recent study at the University of Arizona, researchers documented the tmpact of
prolonged manJuana use on lung function Marijuana smoke closes bronchial pathways, damages
lung tlssue, reduces oxygen exchange, and le:lves the lungs more vulnerable to viral and bactenal
Infections. The authors of the study speculate about poss1ble lung cancer fiOm long term eXDosure
.
since manjuana has more benzopyrene (A), a carcinogen, than tobacco
.
L1ke tobacco, manJuana
has poly nucleu aromatlc hydrocarbons, or tars, Wh1Ch are also caI1cer causing
The potential damage from manJuana smoke IS not bmited to the lungs Some oflhe 450 or
so chemIcals
10
marijuana smoke are sImilar to human reproductrve hormones. \Vhen the bram
registers too many of these hormone-like chemicals, it shuts dov,.n its o'Wn supply source. This car.
lead 1O a reducnon of the chemistry cnt1cal to sexual maturatlon. Iftnere
IS
one thing an II - 13
year old body needs, 1l's hormones. Since it 1S uneth1cal to srudy the effects of drugs on children or
women of child bearing age, researchers must rely on anecdotal evidence and antmal srudles 1O
predict the effects of manjuana on the human reproductive system. The poss1bilit1es Include delayed
or IOcompiete phYSIcal and sexual maturation, reduced fenilny in both males and females, and
reduced sexual function In males. Depending upon how much, how often and how long a person has
smoked marijuana, these effects mayor may not be revers1ble.
Ln addition to the effects on reproduetlon and lung function, manjuana also generates a iapId
increase in hean rate and blood pressure. Th1s change in cardIac function
IS
related to the presence
of carbon monOXide in marijuana smoke. The comblOation of substantial increases 10 heart rare and
blood pressure, along with the psychoaetlve effect of manJuana on percept1on, often leads to
emergency room vIsits on the pan Ofmtoxlcated teens who beheve their heans are about to leap out
of their chests. This problem is particularly acute when the smokers have been indulging in a
praetlce they call "Clam baking" which takes place when four or five kids pile into a small car, close
the ,vindows, set the ventIlation system on recirculate and fire up a Philly or a Dutcnmaster blunt.
An additional chance for a tflP to the hospital occurs when "loaded" blunts are present at the party or
concert. Other drugs llke crack cocaIne, smokable herolO, angel dust, or more recently ketamine
may be added to the blunt. Some of the users may not be aware afthis since the strong smell and
bitter taste of the CIgar 'WTapper mask the additional chemical. Too big a hit on one of these and
th1ngs might go seriously \';Tong.
Better "realhfe" research has outlined the additional dangers of dnviog stoned. With visual
distortions, and reductions in depth perception and spatial relationships, the potential for short term
damage (as in dnviog around town) dramatically increases. Because manjuana cuts dO,",,11 00
divided attention skdls, drivers lose the abllity to see the big picture which IOcreases the risk of
accidents. More and more often the aCCIdent victim 1S a pre teen out there on a dirt bike, skateboard,
or rol1erblades who provides the driver with a sudden unexpected obstacle. There is some level of
truth in the statement stoned drivers make to the pollee during the acc1dent investigation when they
say "I never saw that kid".
MichJel Nerney 1999
2
There are also problems \VhlCh lnevnably come In school loss of mterest In studies, spans
or extra mural actiVitIeS, aC:ldemic failure: absenteeism and truancy: and often a conflict wlth school
officials and parents This IS the beginmng of what r believe IS a long term senous problem.
Conflicts about drug abuse WIth parents and schools are often managed by kids through a pattern of
deception, cheating and mampulatlon. All of these behaVIOrs make family maners worse and
sometimes end up wIth eariy acnmonlous deparrures from home
With all these problems, It's a wonder that anyone would get involved wlth thIS drug, but
people are - in escalatmg numbers People who don't use or abuse drugs often have dlfTiculty
understandIng those who do \\!hen kids and adults smoke ma.'lJuana, they don't do It to get the
problems, they do it to get what they perceive are the benefits, Researchers and kids agree on
several points about the perceived benefits. Manjuana reduces anxier): in most users. Withm the
past few years, actual sites of action for marij uana were discovered. These numerous sites have
been called anandamide receptor sites after the neurotransmitter that IS somehow stImulated by
mariJuana. The ltmblc system IS nch In anandamide Sttes. Kids see this as a substantia! benefit.
The chemicals that produce anxiety and apprehension eXist at higher levels in the brain ofa teenager
than m an adult. Couple this higher intensity wtth a world filled Wlth STDs, HIV, homelessness,
poverty, envIronmental disaster, school failure, social disconnection and Violence in and our of
school and there is more than enough anxiety to go around A secondary effect of marij uana IS
depersonalization, a stepping back from an all-tao-intrusive world, leavlOg the user mellow and laid
back, but unav,:are of any rIsks In the Immediate environment.
Most teens are well aware of the other major anxiety reducing drug used by their age group:
alcohol Taken together, the combInation of alcohol and manjuana can be disastrous: Researchers
discovered compounds in manjuana which could reduce nausea and vomiting in cancer patients
undergoing chemotherapy. These same compounds create a hazard when teens drink to excess a:.'i:er
smoking marijuana, The mechanIsm 10 the brain that SIgnals L~e stomach to dump stored amounts
of alcohol, usually by throl,',1ng up,""';l1 not function under the lOfluence ofmaflJuana. The outcome
IS often a toxlC bulld-up that may result In an emergency room visit or worse, a fatal overdose of
alcohol.
Wnen kids aren't anxious, they are often bored. One chemicalm manJuana impacts on
the cortex of the brain, narrowmg irs range of focus. Under the influence of marijuana, the most
mundane thmgs become Interesting, fascmating, intrigumg... at least for four to six hours.
So for teens and preteens suffering from the twin perils of adolescence, aILxiety and boredom,
manjuana provides a pretty qUick fix. The trouble comes as the effects of the drug clear, and all the
problems come back· only bigger, The problems may seem bigger for two reasons: unresolved
problems tend to snowball, and the effects of rebound magnify the uncomfor..able feelings from
which the user was trying to escape in the first place. Well, that's easy enough to fix: just tire up the
bong again. An.d so begins drug dependency.
IvGchnd Nerney 1999
3
All the whtle leenag~rs are usmg mJfJJuana to solve their problems, they are gening Imle or
no practIce at finding and uSing appropriate copmg mechamsms Several new research studies term
this lack of practice "compressed Adolescence" unhke theones of the past that assumed that
adolescents who \.vere heavily mto pot were delayed 10 their development, some researchers today
belte\ie that heavy manJuana users skip over Impor~nt social and emotional skdl building
expenences \Vhile these kids will onen be perceived by their peers as more independent and adult
they lack significant adult skdls like environmental confronuHon This IS the kind of skill that helps
us figure out the things that are not going welt in our lives, confront the issues and find ways to
resolve them. Kids, or young adults who lack this skill but smoke a lot of marijuana, donIt confront
the problems, they get stoned every time a problem comes along Serious quality of life problems
loom on the horizon for these young people
Drug abuse prevention IS a long term, complex, ongomg process It seems clear that the
middle schoo! and JUnior high school students who are turning to marijuarla are telling us something
Important We need to Invest the time, the money and the energj' to help them achieve emotional
literacy_ We need to help them develop the skills to ide!1t!fy, surface, amculate and manage the
powerful emotions that are pan ofthetr everyday lrves.
Mich:lcl NerneJ 1999
4
Even 10 Its ne\ver formac LSD IS stdl such a po\\erful chemical that the effectIve dose IS
me:l.sured In micrograms not millIgrams. That means that each gram of LSD must be divided into
one mtllion units called "m1CS" The dose sold lOdJ.y IS generally 20-80 mlCS It IS not possible to
tell If the dose purch:1sed IS a 20 mlc dose or four times more powerful This difference in dose
r:lnge IS one of the factors 10 the high number of emergency room VISits
Places In addltton to concertS where LSD IS commonly used are "house parties" at the homes
of college students or younger smdents whose parents are out of to\VTI, or at "Rave" partles, often
held In empty warehouses or other large ncilttles that are rented for the weekend The auractlon of
these parties mcludes the mUSIC, the light show, the other kids, and the absence of adult supervisIon,
In general. LSD IS an ~occaslonal~ or "weekend" drug Because tolerance to LSD develops
qUickly, dally use would be meffectlve In a shan pen ad of time in three to five days tolerance
wears off, Just 10 time for the upcoming weekend party. The tolerance factor, combined wah
relatively mild wlthdrawal symptoms, create a low potentlal for addiction to LSD ThiS does nor,
however, equate with a low potential for problems
The major problem With LSD remams behaVIOral tOXICity Under the mfluence of high
doses, when sensory dlstomons become overvvhelmlOg, the user re:lctions are unpredictable :lnd
often Jeopardize self or others. Fleeing to panic from the oncoming subway tra!n In a crowded
station that suddenly looks ilke a Sixty foot dragon can result In senous injury to the LSD abus~r or
to anyone In prOXimity Unlike the SixtIes or seventies, many of the current users have neither the
peer suppOrt systems nor the llfe expenences to deal With the Impact of a bad trip
While actual flashbacks, (that is, a re-entry IntO the bloodstream of active metabolites), are
rare with LSD, powerful negative involuntary memories are not. When an eighth grader has a bad
trtp on aCid one weekend at a fnend's house and believes that the chandeller in the entrance hallway
has turn into a giant kId-eating spider, the next tIme he visits his friend, the memory of that
expenence might be activated, bnnging with It all ar some of the panic associated with the anginal
event,
Since even experimental use for research was prohibited in the United States in the late
seventIes, we don't really know much about the long term consequences of LSD abuse. Recently
ophthalmologists In the Eastern United States have had the unusual experience of young adult
clients commg in for treatment ofa visual disorder known as strobing or trailing. Since these are
common visual effects that happen under the influence of LSD, an alen practitioner investigated
the drug uking panems of these patients. Sure enough, all of them were long term users of LSD.
At thiS POlOt it IS not known if treatment will be effective or if this bizarre VIsual defect will be a
long term problem.
Michael l':emey 1999
6
Even wlthoui the 100g teml consequence, the short term Impact IS wornsame enough. HIgh
doses of LSD. or even low doses combIned wIth alcohol or XTC (a desIgner drug), can generate
Slates of dlS0nentluon, delusIOn and psychosis This can be particularly dangerous for adolescent
males. considering their propensity for risk taking behavIors,
A number of ne\\,- hallucinogens have been developed In the last few ye3.rs seekIng the
powerful! \'Isual effects of LSD without the potential for such o\e;v.rhelmlng Impact as to cause bad
tripS Drugs In thIs class are often called enactogens be~use ofthelf effect on senses and perception.
Some of the newer ones are ET, which IS a more recent versIOn ofDYlT ,a drug someumes favored
by those looking for a powerfull bm shan acting tnp back in the Sixties ET or alpha ethyl
trtptamme has most of ItS Impact on the VIsual system. and like ItS precurser IS much shoner in ItS
duration than LSD
rv1ich.:lel. 'emcy 1999
7
UPDATE 0:'1' H£ROI:\i
Woile some drugs like LSD and marijuana have gone through bmh highs and lows in
popularity and are now 5wingIOg back Into favor among drug users, other drugs like heroin have
maintained a stable but slowly rising degree of popularity. There are a number of factors that
mfluence this rise. Perhaps the most sIgnificant factor is the current availabiilry of tow poced, high
qualIty heroin.
From the "Black Tar" smokable heroin of the West Coast, to the crystalline white "Golden
Triangle" of the ?'Jol1heast, heroin can be purchased in any medium-sized CIty in the U.S. The
tradmonal suppliers of Southwest Asia, in Afghamstan, Iran and Pakistan, are in fierce competitIon
with the Southeast Asian "GDlden Triangle" of Bunna, Laos and Thatland for the dollars of those
already addicted and those who can be seduced by the power of the drug. This rlvalry is not new,
but the chan.ge in Intensity· has put herOin on the streets at preVIOusly unheard of potencIes. Last
year in ~ew York City, Southeast ASian herom averaged 54.3 per cent purity, while Southwest
Asian averaged 69.7 per cent. ConSidering that W"ithin the last ten years, herOin has ranged from 6
to 19 per cent punty, this is a remarkable Increase - and without a corresponding increase in price.
Expens from the U S Drug Enforcement Agency believe that the fevensh plfch of
compemlOn IS driven by the need to expand and consolJdate the illegal drug market before the new
kid in town does. The new kid comes from Colombia. where for the past five years the cocaine
canel has been planting, growing and harvesting opium. In the past two years, they have perfected
the extraction techniques necessary to produce hIgh grade herOin. This heroin is already showing up
on the streets, brought to the U.S. by those same folks who bring in the cocaine.
A second factor
In
the rise of heroin abuse is the abihry of the producers to furnish the
product in a smokable format. With the advent of AIDS, and the level of public education
regarding AIDS transmIssion through the use of dirty needles, most new users prefer to smoke
heroin. Two groups, women and college students, are smoking heroin at unprecedented levels.
Smoking a drug is much more familiar and inviting than puning a needle into a vein.
Once in the bloodsrream, heroin finds and occupies sites in the brain normally reserved for
our internal supply of morphine, calted endorphin. Like endorphin and morphine, heroin is a
powerful pam reliever, not only for physical pain, but for emotional and social pain as well. Under
the influence of heroin, a person can recognize that his/her life is falling apart, but not be concerned
about it at all (for the next six hours, at least). \-V"hen that high is over and rebound
W"ithdra........al) occurs, all of the pain comes back· with a vengeance. Both parts ofmis experience are
reinforcers for further drug taking.
Nuchael Nerney 1999
8
In addltlon [0 dealmg with rebound, herom users qUIckly develop tolerance to the effects of
the drug Soon the dose th:!.t once gener::tted freedom from pam, anxIety and the Stress of dally Itfe
doesn't cut It anymore It wlil take larger and larger doses to get the same effect. Thls IS what leads
[0 trouble for most herOin abusers. To get more herom, they need more money, That money can
usually be acquired through some form of cnmmal behavlOc dealing, steJ.lLng or wheeling
(nonprofessional prostitution). Other changes take place In the way the addict now uses the drug
As the hIgh loses Its power, money becomes scarce, and the addict is trymg to score just to avoid
being sick. the route of admmistering the herom WIll often change from snIffing and smoking to
injecting. Reasearchers now estimate that half of all heroin smokers end up Injecting within two
years. Many of them will avoid intravenous injecting at first, thinking it unsafe, and will use
techniques like subcutaeneous injection, knov.rn on the street as skin popping. Recent findings in
California point out the senous dangers for poppers. Of the 200 or so known cases of flesh eating
disease, 100 or fifty percent have been skin popping heroin users, Researchers are unclear if the
bactena that causes thiS disease is in the heroin itself, the contarmnated works, or to the water used
to mix the drug into liqUId format. It is Important to keep 10 mind that even seventy percent pure
heroin is thil1Y percent cut with something else Along with the traditional cuts of mdk sugars, baby
lax:ltlves, and quinine, there are new cuts now bemg !OtToduced A recent herom o....erdose death of a
fifteen year old boy In Plano, Texas '.'.--as probably caused by the combinatIOn of high potentcy
MeXican herotn called "Chlva" and the antihistamines that were used to cut It On the East Coas;; a
run of emergency room Visits caused by drug overdose mcluded several 'Nlth herom cut with
scopolamme
Besides the legal problems that often await herOin abusers, the dangers of overdose,
addiction, liver damage, endocarditis (an inflammation of the mitral valve of the heart), and
pulmonary dysfunction also loom. Serious problems usually develop In persona! relationships, at
home and at work. As many as haIfa millIOn people in the UOlted States are currently addicted to
herom, and that number is expected to nse,
Michael Nerney
19~9
9
UPDA TE ON COCAf'iE A'\D CRACK
The dangers of crack/cocame have been repeated often enough 10 drug education classes, on
televisIon and in the popular press that most Amencans are fully aware of the flsks. New users of
crack are decllning In the adult population. Even high school students seem to have gotten the
message: the number of new users ofcoc3.me In grades 10 through 12 has declined, according to a
nationalsuiVey. That's dte good news. The bad ne\,ys 15 a thirt:>', percent increase 10 the use of
cocaine/crack among eighth graders, as reported by an annual survey administered by Lloyd
Johnston at the Umversity ofr.'lichigan.
Perhaps we have concentrated too exclusively on sendmg the message to older teens and
young adults Or perhaps younger teens have a seemmgly unshakable belief In their own
invincIbility. In any case, eighth graders in small but Increasing numbers are WIlling to gamble with
the drug that most experts rate as number one in addiction potential. The widespread availability
and affordability of crack, and the fact that it is smokable (a iQute of administratIOn With WhlCh they
are familiar) guarantee in some areas of the country that when junior hIgh kids try cocatne, crack
will be dIe format they encounter
As If crack weren't enough to deal with, readily made versIOns of methamphetamme are now
avatlable in most of the U.S Other advances to stimulant technology are also showing up for the
first orne: "CAT" IS the name of a smokable drug made by chemically converting oveHhe-coumer
Sudafed into a moderately powerful stimulant.
ArlOther stimulant problem shOWing up IS the abuse ofa popular drug for the treatment of
ADD and ADDIHD; Ritalin. When older students buy Ritalin from theIr younger counterparts,
crush It ,then snort It mto the nasal caVIty, the resulting effect is highly stimulawry.
One of the clear lessons emerging from the latest survey is this: it is never too early to start
drug abuse prevention programs. Rather than banning the sale of Herbal XTC, or Cloud Nine, as
New York State has proposed, wouldn't it make more sense to teach kids that any drug taken 10
high doses is dangerous. Children need continuous, up to date information from a credible source
regarding the dangers of drug abuse. But they also need, and we must provide them with, positive
role models, alternative drug·free actlvltleS and the resources necessary for emotional literacy,
healthy peer setecuon and peer refusal skills.
Michael Nerney 1999
10
UPDATE 0:\ XTC
Picture this. All the parents h3.ve gone home, leavmg most Dfche freshmen feeling
incredibly lonely, Isolated and insecure. The upper class students walk around campus like they
own the place. To make maners worse, this afternoon the college president told mem that 300/n of
them would flunk out or drop out by the end of the year. Is It any wonder that this group finds
anractive a popular new drug that makes them feel affection for, truSt of, and affiliation with their
fellow students?
XTC
an analog of a drug from the 60's knOV.ll as :\OWA., or the "love drug" The slightly
altered version known as \'vIDi'v1A was first used in the euly 80's In psychotherapy, specifically in
counseling mamed cQllples_ Counselors found that the drug created a sense of truSt, bonding and
intimacy that helped couples quickly break through the barners Ll,at normally slow down the
therapeutic process Use of thiS drug to enhance therapy became so popular that it ""'as featured on
the Donahue Show After the show, the network was deluged wlth calls from VIewers wanting more
mfonnatlon about where [0 get the drug and how [0 use It at home Thousa..rIds of callers \Named to
know if they could give a dose to a spouse or paiuter and cre:!.te Immediate intimacy.
IS
The drug quickly became popular with young adultS and a number of overdose fatalities
occurred. The FDA banned the drug m 1984. Since that time, ~IDM.A. has moved from uptov.n
apartmentS to college donn rooms, where it is known as XTC, ADA..I\If, or Rhapsody.
The problems with XTC lie in its chemical construction. i'vIDM.A., or methylenedioxy
methamphetamine, is a powerful stimulant similar to the "speed" of the 60's. The methamphetamme
component generates enough energy to dance or party all night, but it also has the potential to cause
cardiac problems or seizures at high doses.
A more powerful attraction is created by the first component, methylene dioxide, which
impacts on the emotional center ofl~e brain, generating a sense of bonding, trust, affection and
intimacy. Let's go back to the college campus and all those lonely studentS. Here is a ready made
market for this drug, sold and consumed at dorm and fraternity parties, or off campus at "RA.VE"
parties. in a progression we have seen before v.ith other drugs, this drug has already moved into the
high schools. A5 is often the case when a screet drug gains in popularity, misrepresentation and
substitutions have already appeared with regard to XTC. A cornman combination is heroin and
methamphetamine, or heroin, LSD, and methamphetamine.
lvtlchael Nerney 1999
II
The dangers of XTC include rebound, addiction and impaired judgment. SInce rebound
consists of feelmgs oppostte of those that the drug mduces at a greater Intensity, wlthdrawal from
XTC involves even more lonehness, depressIOn and al1enation. The potential for suicide increases
dramatically at this time. Of course, users soon figure out that the way to avoid rebound IS to take
more of the drug. ThIs sets up a pattern which can quickly lead to addiction.
Another serious problem may happen when the desired effects of trust and intImacy senously
impaIr good judgment. Young people may become vulnerable to trusting the wrong person at a
party, At many colleges, an increase in the popularity ofXTC has been accompanIed by an mcrease
In the inCIdence of date rape.
Two other "date rape" drugs currently used on campus IOclude Rohypnol ("Roofies") and
Gamma Hydroxy Butyrate ("GHB"). Roofies are structurally Similar to Xanax. While often used
for anxiety reduction or disinihibition, at high doses it will generate a zombIe-like state; that is, the
bram stem continues to functIOn but the cortex virtually shuts dovlll. Anyone who has been given
this drug Without their knowledge is highly vulnerable to rape or other victimizations. A common
after·effeet is diminished recall, which makes identifying assadants difficult. Last year the
manufacturer ofRohypnol agreed to include a chemical that wtl! tum a distinctive blue color when
added to a alcohollc beverage. ThiS is a great step forward but will prOVide no warning for the
young people who are at the club, bar, or party and dnnkmg non alcoholic soft drink.s.
Less is known about GHB, but one of its street names, "Easy Lay", is indicitive of the
motivation of those who give the drug to unsuspecting people GHB is an odorless, colorless,
tasteless liquid, which renders it undetectable, and generate a highly vulnerable victim. At high
doses the drug can and has caused fatalities. Since a person giving thiS drug to a victim IS hlghly
unlikely to match dose to size and weight, l~e flsk of fatality IS hlgh.
Nuchael Nerney 1999
12
UPDATE ON ALCOHOL
When one third of Amencan adolescents readily admIt to being Intoxicated in the past ninety
days, there can be no doubt that alcohol continues to be the most popular drug among teens. This
trend has Its begmnlngs in very early adolescence: thineen percent of fifth graders say they have
used alcohol at le.!St once to get intoxic:ued. The increase in these numbers is st:lnling: 390/0 of 7th
and 8th graders, 56% of 9th and lOth graders, and a whopping 74% of 11 th and 11th graders have
used alcohol in the past 6 months for the purposes of intoxication. Even the Hbes! and brightest",
reasonably responsible kids that we send off to college are nOE immune to the lure of alcohol.
Between 50% and 75% of college students admit to regular bmge drinking. .\1ost expens agree that
alcohol plays a major role in accidental deaths of adolescent and young adul15, including auto
fauillies, drownings and fatal fal1s Alcohol is also involved In 30% of suiCides and as many as
50% of homiCides Involving adolescen15.
In spIte of these problems, alcohol continues to be one of the drugs most readily accessible to
adolescents. Adolescen15 have remarkable access to beer, wine coolers and "hard liquor". Seven
out of ten mmors are able to purchase alcohol themselves Fake identification cards are realistiC and
readily available. Older kids and adul15 are often wtlhng to provide teens with alcohoL Parents are
often unwittingly providing alcohol at home. raiding the household liquor cabinet is a common
aCl1Vlty for some teens.
Also, much has changed in the alcohol market: new alcoholic beverage products such as
"2ima", "Breezers" and "Cisco" are often sweet or fruity tasting, and marketing strategies target
young people. Distillers like St. Ides have led the way in producing clarified malts. "Special
Brew", for example has five different flavors containing fruit punch, lemon a'1d llme, orange,
coconut and pineapple, and mixed fruIt. All sweet and fruity with a 6% alcohol kick in a 20 ounce
bottle. Roughly 35% of all clarified malts an,d mne coolers purchased are consumed by teenagers.
"lello Shots" have become popular at parties: flavored gelatin is made with vodka and .....-ater and
allowed to set, then is cut into cubes, roughly equivalent to a shot glass of liquor. Unsuspecting
parents may assume thejello is a harmless snack, right up there with pretzels and pOtato chips.
In addition, many parents don't consider alcohol a drug, so dley are not as worried about it as
they should be. Adults need to understand the impact of alcohol on the underdeveloped adolescent
nervous system, A "red flag" should go up for parents and other adults who find themselves
minimizing children's behavior by thinking or saying things like, "as long as he's not doing drugs";
"it's OK ifshe drinks in the house"; a!1.d "kids will be kids". ThiS reinforces that alcohol is merely a
social drug, and therefore low risk. Nearly every weekend, a fatality involving alcohol and teens
tells us otherwise. Also, adults need to be av.rare of the dangerous impaCl of mixing alcohol with
other drugs such as mari.juana.
~lichaei
Nerney 1999
13
Sometimes adults simply acqUIesce to the social climate which encourages alcohol use by
adolescents This posture of powerlessness is characterized by beliefs such as "what's the use"";
"every kid is gomg to find a way to dnnk"; and "how can I compete against the influence of peers,
the media, athletes and other role models:"_ ThiS Stance can also Include the assignment of blame:
"the police, the schools, and/or the other parents aren't doing their jobs)" We must remember that in
the same way we climb a mountain one step at a time, we can beglO to work in our own families,
which will contnbute to the movement toward a drug-free neighborhood, county, state, country, and
world. Youth leaders, youth officers, counselors, teachers and other adults who work with kids can
exemplify the followmg char2.cteristics, ar1d can be instrumental 10 teaching them to parents.
Parents need to be.
Assemve ~ as a parent, you have the responsibility to prOVide not just matenal goods, but
values, beliefs and role models of good character. As such, you have the nght to know about your
kids' hves, the nght to intervene, set limits and boundanes. and the nght to enforce consequences.
YOU, after all, are the grown up
Aware - hello adolescence. goodbye commumcatlon Use a vanety oftechmques to keep
aware of the following full names and addresses of any frtends, and the names of Iheir parents;
your chdd's whereabouts at all times, if your child is sleeping at a friend's house. call the parents
and ask: can limy en tid bnng snacks. pillow and blanket, anythlOg else? ""';11 you be there at all
times? would you mind if I call once during the evening to see how my child IS domg? What v.rill
the kids be doing? If they are to see a movie, which one? If the parents will not be home, your child
should not vislt. By all means, offer to be the host of a sleep over. You need to know: where is the
dance, concert or party? If they are going to a concert, go along (sit elsewhere, but drive them there
and meet them at a deSignated SpOt Immediately after the show). Be the dnver as often as you can·
this allo\¥S you to get to know the people. places and thlOgS in your child's life.
Alert - be observant of any changes in behavior beyond the range of normal adolescence,
e.g.. trouble in school. secret friends, deception, manipulation, clothing and hair style changes
beyond the fringe, increase in sleep beyond normal needs. gross changes in musIc/video tastes.
Awake - keep in touch with them. As children get older. they are out more often without
you, so make the effort [0 stay in contact. Greet them personally when they come home with a hug.
Many teens have teamed to hold their breath for the duration of the homecoming hug, so interacting
for a few minutes of conversation is advisable ("did you have fun?". "what was the movie about?",
"see you in the morning")
Michael
~eroey
1999
l~
t1[f,nmn;:.
~eptem"er
!he JoufT1al Of the '\rnencal'l \"ledlcal ~SSOC"!!!Ofl r'ut'llsneo an ;!''1lcle 0"
11.1, 144/ varloanng what mOSI parents know K,Os need. us to ShOw through worO ana
actIOn that we love them, ..."'ant them, ana care tor It'lem
circumStances
mar coula pm them
In
aanger
I hiS means I(eepmg tt'lem sate trom
1he message must t"e clear tMt you love your ch!laren
ana mar you 00 wmH you ao out CIt LIlat love K.laS neea to know that you love them so much you
are WlHlng to rtSK melr anger, their s;::om. melr SUlKing, ana their "Ma moutnmg"" Mom you to theli
menas • tlecause you are Ul'!W!!!mg to lose mem to the aangers or alconOI ana other arugs
Perhaps mere may ima!!y be a resea.r;::t1 rmalng mar will help parems tlreak througn the
aemal mat has tor 50 long enatlleo ramliles [0 Ignore tne early aOuse O! alcohol t"y UIe!r mldC!Le
S;::hool ctnlaren, "The ;\JatlOflal !nst1!ute on AlCOholism ana AlCOhOl A,buse publlshed the results or a
long term smay tt'l<!t reveals tt'le nsk ot ea,!y annlo;lflg wnh Star::!tng Clarity, It chlltjren begm to
arm\( al<:o.,ol Ol'l a regular baSIS at age thmeen or younger, torty three ~ercent or them develop
alCOholism, and anomer ten percent aevelop lOllS term alcohol abuse proble'llS Compare t!"at to
cielay annkmg IJntJi a..."1er age !;Wenry, WIt!! Iewer man ten percem aevelopmg elther
.I:lcohollsm or alCOhol aDuse F._I'J.::,one C·a.!l Clearly see tnat a parent wno ChOOSes not to Intervene In
early anrLlong IS setting their COl!(Uen up tor pmentlal ILIe long strlJggles ""'"lth alcono!.
mose who
MICI'I:'Iel -':emev 1 '1'/'1
15
UPDATE 0:\ f'iH.-\LA:\TS
What do spray paInt. naLl polish remover, llghrer flUid, "Sco£ch-gard" and ~Wlte-out" have
in common'" These:md Other solvents constiture a group of substances which are readily accesslble
to people who wish to get hIgh on inhalants. This class of drugs gets its name from the route of
administration used to get the chemical into the brain: the vapors from volatile hydrocarbons are
mhaled deeply into the lungs, quickly absorbed, pass into the bloodstream and Impact dIrectly on the
brain. As is true with many drugs, inhalants produce a range of effects. Some are perceived by the
user as positive, and some as negative.
Initial effeciS perceived as beneficlal include feelings of weIghtlessness, disonemation,
euphoria, giddiness and exhilaration. The negative effects are nausea., numbness, nosebleeds, loss of
motor control and severe headache_ Because tolerance to inhalants usually develops in.... a short
period of time, users wil1 requIre larger and larger doses to get high.
~
As the dose IOcreases, so does the risk of additional adverse effects. At high doses, loss of
motor control can result in "dead weight falls". These are Incidents in which the user has lost not
only motor control but spatial or three dimenslonal a\Nareness. The result might be a fall in which
the person does nothing to protect him or herself from Impact. in many cases, the person who falls
while high on Inhalants sustains head or spinal cord injury.
Another risk of high dose inhalant abuse comes from hallucinatIOns or delusiOnal thought
distortions Users become paranoid and often act i:I an aggressive, hostile or even VIolent manner.
This behaviOr can be problematic by itself, but in combination wlt.'1 another nsk factor, it can result
in fatality. Death may occur when an individual is highly susceptible to the effects of solvents on
the cardiovascular system, particularly in the presence of adrenaline. Adrenaline is a "fight or
flight" chemical, Increasing heart rate in everyone. For an Individual predisposed to this heightened
effect, solvents and adrenaline together can Increase heart rate to the point of cardiac failure. This is
known as "Sudden Sniffing Death". The Centers for Disease Control estimate that 800 to 1200
teens and preteens die through this mechanism each year.
The implications of this are alarming, as il is nearly impossible to know If a person is
predisposed to high sensitivity to inhalants and adrenaline. A recent example of this involved a
teenage girl from :M:assachuserts who died from Sudden Sniffing Death. While she v.taS inhaling
vapors from lighter fluid with twO other teens, she became frightened by the belief that they were
going to be caught. So if adult authority figures see teens abusing inhalants· in the shop classroom
in school, in the garage, or the basement at home- it is important to avoid an immediate
confrontation. Shouting, ru1U1ing toward the teens, or approaching them in any way while they are
using solvents may cause panic, and an increase in adrenaline. We can't predict which teen may be
sensitized and end up in cardiac arrest. Intervention mer the inhalant intoxication has cleared will
be safer and more effective.
:-'lichael Nerney 1999
16
Some SIgnS and symptoms of mhalant abuse might mclude the aroma of so Ivems or
petroleum products on clothing, the presence of rags Wlth spray paint, lighter fluid or nail polish
remover on them; and red and Imt.:ned skm around the mouth and nose.
Solvents are not the only chemio!s in the inhalant otegory. Others include Amyl Nitnte, a
prescripnon drug formerly used In the ueatment of angtn.a, Buryl ;..fitme, an analog of .'\.myl which
has no medical application and is often sold in ~adult" book Stores as a "room odorizer". Brand
names for Buryl Nitrite include: "Locker Room", "Rush", "Bullet", and "Jack·aroma". Amyl and
Butyl ;..fitrite are most often abused by young adults as companIOn drugs to sexual activity.
Nitrous oxide, the "laugh109 gas" used as an anesthetic in the dentist office, IS another form
of Inhalant drug. The same kind of euphoria that some dental patients expenence is a common effect
of thiS drug when its vapors are inhaled into the lungs Nitrous quickly enters. the bloodstream
replacmg oxygen in the brain. Oxygen deprivation, combmed With the mtoXIcatlon from nitrous,
creates a sensation of pleasant well-being and a free-floatmg detachment from the cares and warnes
of the real world. Adolescents and young adults get their supplIes of OIrrous oxide from medical
suppliers m thmy pound canisters, or in smaller C02 SiZed canisters known on the streets as
"whippets", purchased from restaurant suppliers. Nitrous OXide IS the propellant used In products
like "Redl Whip". MarlY supermarkets have moved canned whipped cream from the open shelves of
the refngerared section to the staffed deli section, because neighborhood kids have been open109 the
cans 10 the store, carefully releaslOg the OItrous oxide wtthout ejecting the whipped cream, then
discarding the now dead contamer on the "vay out the door. Along wah the possibility of deaLi} from
oxygen depnvation, nitrous oxide also affects mOtOr conuol and three dimenSIOnal spatial
relationships, making riding a bike or driving a car a dangerous endeavor.
Since IOhalants are legal, often household items, they are often overlooked by adults as a
source ofimoxication. A sound prevention strategy should educate parents, teachers and adults who
work with solvents that inhalants can readily be abused by adolescents. Household solvents should
be kept under lock and key, and foodstuffs 10 spray cans with propellants should be monitOred,
Nl..tchael Nemey 1999
17
(jPDATE 0"
~HALA-"TS
What do spray pamt, nail polish remover, lighter fluid, "Scotch-gard" and "Wlte Qut" have
4
in common? These and other solvents constitute a group of substances which are readi ly accessIble
to people who wish to get high on Inhalants. ThIs class of drugs gets its name from the route of
administration used to get the chemIcal into the brain: the vapors from volatile hydrocarbons are
Inhaled deeply into the lungs, quickly absorbed, pass into the bloodstream and Impact directly on the
braIn. As is true with many drugs, mhalants produce a range of effects. Some are perceived by the
user as positive, and some as negative.
Iniual effects perceived as beneficial include feelings of weightlessness, disonentation,
euphoria, giddiness and exhilaration. The negative effects are nause3., numbness, nosebleeds, loss of
motor control and severe headache. Because tolerance to inhalants usually develops m a short
"'.-;;
.
penod of time, users will require larger and larger doses to get high.
As the dose mcreases, so does the risk ofaddttional adverse effects. At high doses, loss of
motor control can result in "dead weight falls". These are Incidents In whIch the user has lost not
only motor control but spatial or three dimensional awareness. The result might be a fall in which
the person does nothing to protect him or herself from impact. In many cases, the person who falls
while high on Inhalants sustains head or spma! cord injury
Another nsk of high dose mhalant abuse comes from hallucinauons or delUSional thought
distOnions. Users become paranoid a..'1d often act in an aggressive, hostile or even Violent manner.
This behavior can be problematic by itself, but in combination vriLI.;. another flsk factor, it can result
in fata-hty. Death may occur when an individual
IS
hignly susceptible to the effects of solvents on
the ca.rdiovascular system, particularly In the presence of adrenaline. Adrenaline is a "fight or
flIght" chemical, mcreasing heart rate in everyone. For an indiVIdual predIsposed to this heightened
effect, solvents and adrenaline together can increase heart rate to the po lOt of cardiac failure. This is
known as "Sudden Sniffing Death". The Centers for Disease Conrro! estimate that 800 to 1200
teens and preteens die through this mechamsm each year.
___
The implications of this are alanning, as it is nearly unpossible to know If a person is
predisposed to high sensitivity to inhal311ts and adrenaline. A recent example of this involved a
teenage girl from Massachusetts who died from Sudden Sniffing Death. While she was inhaling
vapors from tighter fluid with
(\1.10
other teens, she became frightened by the belief that they were
going to be caught. So ifadult authority figures see teens abusing inhalants· in the shop classroom
tn school, in the garage, or the basement at
home~
it is important to avoid an immediate
confrontation. Shouting, running toward the teens, or approaching them in any way while they are
using solvents may cause panic, and an increase in adrenaline. We can't predict which teen may be
sensitized and end up in cardiac arrest. Intervention after the inhalant intoxication has cleared will
be safer and more effective.
Michael Nemey 1999
16
Some SignS and symptoms of mhalant abuse might melude the aroma of solvents or
petroleum productS on c1othmg; the presence of rags with spray paint, lighter flUId or nail polish
remover on them, and red and Imuted skm around the mouth and nose.
Solvents are not the only chemicals in the inhalant category. Others melude Amyl ~imte, a
prescription drug formerly used In the tre3.tmenr of angina, Butyl :-.ritrite, an analog of Amyl which
has no medical application and is often sold in "adult" book stOres as a "room odorizer". Brand
names for Butyl Nitrite mclude: "Locker Room", "Rush", "Bullet", and "Jack-aroma". Amyl and
Butyl Nitrite are most often abused by young adults as companion drugs to sexual activity.
Nitrous oxide, the "laughing gas" used as an anesthetic in the dentist office, is another form
of IOhalant drug. The same kind of euphoria that some dental patients experience is a common effect
ofmis drug when its vapors are Inhaled into the lungs. Nitrous quickly enters. the bloodstream
replacing oxygen in the brain. Oxygen deprivation, combmed with the intoxication from nitrous,
creates a sensation ofpleasanr well-being and a free-floating detachment from the cares and warnes
of the real world. Adolescents and young adults get their supplies of nitrous oxide from medical
supphers in thirty pound canisters, or in smaller C02 SiZed canisters known on the streets as
"whippets", purchased from restauram suppliers. Nitrous oxide!s the propellant used In products
hke "Redi Whip" MarlY supermarkets have moved canned whipped cream from the open shelves of
the refrigerated section to the staf:ed deli section, because neighborhood kids have been opening the
cans in the store, carefully releasmg rhe mtrous OXide WlIDout ejecting the whipped cream, then
discarding the now dead container on the v,-ay out the door. Along wnh the possibility of death from
oxygen deprivation, nitrous oxide also affects mOtor control and three dimenslonal spatial
relationships, making riding a bike or driving a car a dangerous endeavor.
Since mhalants are legal, often household items, they are often overlooked by adults as a
source of Intoxication. A sound prevention strategy should educate parents, teachers and adults who
work with solvents that inhalants can readily be abused by adolescents. Household solvents should
be kepr under lock and key, and foodstuffs in spray cans with propellants should be monitored.
tvlichael Nerney 199;
17
"DouseD,ISSl""ES
PRE-TEST
The
2
3
;Jar.. 0:!.1
1CO[esce::l's body
...:. .
.....1uscles
3
C
Sk::e:oil
Brain
D
L,,;:emal Qrg=..ns
The age g;oup
A-
i j.[ S
a
c
19-3.j
35·55
D
55-
"""1:IC:; '-'s~s
tn3t
dn..:gs most
:;roW'S the
fast~s: IS
h~v:ly IS
The r~O,l adol~s::e:i~ g;v~ most often co explain lheli alcohol 2..'10 cruS consumptIOn ~5
A
Advert:SI!1g
a
Role models
C
Emo110nal needs
D
Peer pressure
The number of adolescents eJ.ch ye.:..r who drink to intoXlcation arleasr quanerly IS:
5.
A.
Two milllon
B
C.
D
Four mJllion
Six million
Eight million
The three drugs most commonly abused by Junior High students, in order of preference,
are:
A
B.
C
D
LSD, ma....ijua..,a., alcohol
Inhala.1ts, alcohol, ma.'"'ijua..'1a
Alcohol, marijuana, inhalants
Alcohol, PCP, marijuam.
PRE-TEST
Pa.g:= 2.
6
.';'dolesc~:1:S
A.
a
C
o
7.
8
9
It Huerferes 1,.l.1r..r, concentIatJon
I: meG1CJ.te5 for an.x..!ery and boredom
i, ,esolves confusIon
Ii stimulates aggressive behavlor
Cae, Lee, Crank and Glass 2.fe all
,-\,.
8
C
Depressan<.s
Hallucinogens
DesIgner crugs
o
Stimulants
The drug ,espor..sible for mOst emergency room
-'-
LSD
"C"
~ 1..a.'1j U2.r.a
Ket.a.rnine
D
XTC
The drug sho\.V1ng the greateSt tncrease
HIgh students
10.
like ,0 use marijuana bec';H!Se'
In
VtSlts
in males ages 6-1 7
popular'"!:,. ;1 the l2..5t \\'(0 years arnong JLJfllor
IS:
~
•
PCP
8
MatlJ \J..U1 a
C.
D.
inhalants
GHS
The most popuJu over-the-counter dr,;g abused by teenagers is:
A
B
eericiden D
Dextromethorpha.n
C.
Ephedra
D.
Dramamine
15
If".
iU.J
At\1ERlCAN UNIVERSITY
JL"STlCE PROGRA.'t~ OFFICE
SCHOOL OF P:";811C .\H:\..iRS
OJP Drug Court Clearinghouse and Technical Assistance Project
Adolescent Pharmacology in Drug Courts
Sponsored by Ihe OJP Drug Court Clearinghouse and Technic::!l AssiSlance Projecl and
the Kentucky Admin iSlr1Itive Office of the Cou rts
Shelby Campus. I;niversiry of Louisville
Founder's Union Building - Room 218 A & B
Louisville, Kentuck)'
January 20, 2000
Faculty: Michael F. Nerney
Workshop Evaluation and Attendee Comments
Please rate the degree to which you agree with each of the statements below, using a rating scale of "1"
(strongly disagree); 2 (agree somewhat); to "3" (strongly agree).
1.
This session enhanced my understanding of the physiological effects of substance abuse on
adolescent development.
3
2
2.
This session enhanced my understanding of thc differences betwcen dealing with adults and
adolcsccnts in a drug court setting.
3
2
3.
The knowledge 1 have gained at this session will have immediate utility to me
performance of my job.
3
2
1
4.
As a result of attending this session, I intend to:
5.
This session could have been improved by:
OJ!" DRl:G COt;1I.T CU_\R1SGHOUSE "'... D TECH"'ICAl A)~ISTA."'" PROJECT
«00 MASSACHL'5ETTSAVE~L:E..t\'W
W:\5HI:-:GTO~, DC 20016-81;9
E·\lAlL; Jl STICE@'-\IERIC>,.... FDl:
Wl8 SrI I: 'l"ll"ll',A\:fR1l·"'''.EDl-/rl'snCE
Comments:
Backoround
of Respondent:
o
1.
What is your position?
defense attorney
judge
law enforcement officer
orosecutor
202-885·2875 F.\.'c 202·885-2885
'"
the