Substance Abuse
Trends
&
Classroom
Implications
2
Learning Objectives
This session will help the participant:
• Increase awareness about the impact of
various drugs of use/abuse in WV
• Increase knowledge of perinatal substance
exposure and effects on children and
classroom implications
ALCOHOL
SYMPTOMS AND EFFECTS
• Alcohol depresses the central nervous
system, lowers inhibitions, and impairs
judgment and coordination.
• Adults who had first use of alcohol before age
15 are five times as likely to be dependent on
alcohol as adults who first used at age 21 or
older.
• Impaired brain development, learning, and
memory
National Institute on Alcohol Abuse and Alcoholism 2006
ALCOHOL AND SOCIETAL ATTITUDES
• Alcohol is often a traditional part of culture
• Alcohol is used to celebrate, relax, and socialize
• Stigma attached to receiving treatment.
• Strong legislative lobby
• Availability and Accessibility
• Not illegal for adults
• Change of societal norms past 30 years
Prescription CNS
Depressants
• Slow brain activity
• Prescribed for anxiety, tension, panic
attacks, acute stress reactions, sleep
disorders, and can be used for
anesthesia (high doses)
SAMHSA, 2005
What do they look like?
Valium
Street drugs.org
Klonopin
Ativan
Halcion
ProSom
Street drugs.org
Prescription Stimulants
• Increase alertness and energy
• Prescribed for attention-deficit
hyperactivity disorder
• Narcolepsy
• Obesity
• Some forms of Depression
SAMSHA., 2005
What do they look like?
Ritalin
Street drugs.org
Dexedrine
2010 TOP ABUSED PRESCRIPTION
DRUGS REPORTED IN WV
Drug Name
Oxycodone
Brand Names
Drug Class
Oxycontin, Tylox, Percodan,
Opioid
Percocet, Combunox
Hydrocodone Loret, Lortab, Norco,
Opioid
Vicoprofen, Vicodin
Alprazolam
Xanax
Benzodiazepine
Morphine
MS Contin, Oramorph, MS-IR,
Opioid
Kadian, Aviniza, Roxanol,
Duramorph
Hydromorphone Dilaudid
Opioid
*Percentage of the total drugs abused in 2010
WV Behavioral Health Profile, 2011
Percentage*
39%
28%
10%
4%
2%
*2011 is Preliminary
WV Behavioral Health Profile, 2011
Synthetics
Bath Salts and K2
Bath Salts
Huffington Post.com
DEA,
What does it look
like?
● Crystalized powder that can be white to
brown, with shades in between and even
speckled.
● Typically an attractive package about the
size of a tea bag.
● The label says “Not for Human
Consumption”.
● Manufactured mainly in China or India.
www.erowid.org
Common Symptoms
•
•
•
•
Paranoia
Hallucinations
Anger
Intense cravings to
re-dose
• Profuse Sweating
• Hyper alertness
• Violence
• Elevated Blood
pressure
• Jaw clenching/tooth
grinding (Bruxism)
• Delusions
• Mood swings
National Institute on Drug Abuse, 2012
What does K2 look like?
DEA, 2012
Slang Names for K2
Spice
K2
Blaze
Red X Dawn
Bilss
Zoh
Black Mamba
Bombay Blue
Fake Weed
Genie
Spice
DEA, 2012
Common Symptoms
•
•
•
•
•
•
•
•
•
Vomiting
Intense Hallucinations
Rapid Heart Beat
Increased Blood Pressure
Seizures
Loss of Consciousness
Paranoid Behavior
Anxiety
Agitation
Spicester.com
HEROIN
• Heroin abuse is associated with serious
health conditions, including fatal overdose,
spontaneous abortion, collapsed veins, and,
particularly in users who inject the drug,
infectious diseases, including HIV/AIDS and
hepatitis.
SAMHSA, 2005
HEROIN
Erowid.org
THE FALLOUT
• Societal Implications?
• Classroom Implications?
DRUG ABUSE DURING PREGNANCY
• Illegal substance exposure in childbearing women
is approximately 11% nationwide
• Incidence of prenatal substance abuse ranges from
375,000 – 625,000 infants exposed annually
• Women tend to become addicted in less time than
men and develop larger habits
WV PERINATAL EXPOSURE TO
SUBSTANCES
West Virginia women aged 35 and older reported the highest
use of alcohol during the last 3 months of their pregnancy.
PRAMS 2009
West Virginia women who had an annual income of $50,000 or
more reported the highest use of alcohol during the last 3
months of pregnancy.
In 2009, women in West Virginia who are pregnant report a
higher incidence of smoking at 28.9% than the general
population as a whole at 25.6%.
A 2009 umbilical cord study in eight West Virginia hospitals
concluded that almost 20% of babies tested had been exposed to
drugs. A newer 2010 study revealed that this number had
increased in one hospital to 33% (study includes alcohol and
other drugs), compared to a national average of 4%.
Stitely, Michael.L., Calhoun,
Byron, MD, Maxwell, Stephan.
MD, Nerhood, Robert. MD.
Chaffin, David. MD.
Prevalence of Drug Use in
Pregnant West Virginia
Patients. WVMedical Journal.
Vol.106. 2010.
NEONATAL WITHDRAWAL SYNDROME


CNS
›
›
›
›
›
›
›
›
Disturbed sleep patterns
Hyperactivity
Hyperreflexia
Tremors
Increased muscle tone
Myoclonic jerks
Shrill cry
Convulsions
›
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›
›
›
›
Fever
Hypoglycemia
Mottling
Sweating
Yawning
Vasomotor instability
Metabolic
BABIES EXPERIENCING NAS
ALCOHOL RELATED BIRTH DEFECTS
TERMINOLOGY
• Fetal Alcohol Spectrum Disorders is an umbrella term used
to describe the range of effects that can occur in an
individual whose mother drank alcohol during pregnancy
• Fetal Alcohol Syndrome is a specific diagnosis with specific
criteria, a disorder of permanent birth defects that occurs in
the offspring of women who drink alcohol during pregnancy
Fetal Alcohol Effects is an outdated term used to describe
individuals who had problems associated with prenatal
alcohol exposure, but did not have enough of the outward
signs to be eligible for the medical diagnosis of FAS
• Alcohol Related Neurodevelopmental Disorder has been
widely used to describe the specific damage that prenatal
alcohol exposure can have on the central nervous system
DEVELOPMENTAL DELAYS, LEARNING
DISABILITIES & BEHAVIORAL PROBLEMS
• Mental Retardation
• Attention deficits
• Hyperactivity
• Poor Impulse Control
• Problems in Social Perception
• Speech and Language Delays or Deficits
• Poor Capacity for Abstract Thinking
• Specific Deficits in Math Skills
• Problems in Memory, Attention, or Judgment
• Problems Changing Behavior or Response in Different Situations
• Problems Anticipating Consequences
• Problems with Cause and Effect
EFFECTS OF PRESCRIPTION DRUG
ABUSE
• Women who abuse opiates during pregnancy
greatly increase their risk of serious
pregnancy complications.
• poor fetal growth
• premature rupture of the membranes (the
bag of waters that holds the fetus breaks
too soon)
• premature and still births
DRUG EXPOSED BABIES...
50% of all babies of opiate users are born with low
birth weight
 Many of these babies are premature and often
suffer from serious health problems during the
newborn period, including breathing problems
 They also are at increased risk of lifelong
disabilities
 Babies exposed to heroin before birth also face an
increased risk of sudden infant death syndrome
(SIDS)

TREATMENT FOR NAS
• Minimize external stimuli (light and sound) in a dark,
quiet environment, careful swaddling, adopting
comforting and positioning techniques (swaying,
rocking), and a high caloric diet
• Buprenorphine is increasingly used for treatment also,
because of the potential to reduce the severity of Neonatal
Abstinence Syndrome Scores
• Most babies of opiate abusers show withdrawal symptoms
during the 3 days after birth, including fever, sneezing,
trembling, irritability, diarrhea, vomiting, continual crying
and seizures usually subsiding by 1 week of age
•
http://www.adoptmed.org/topics/prenatal-opiate-exposure.html Dorothy Minch, MSW
“SYSTEM FALL OUT”
• Mental health issues – 90%
• Disrupted school experience – 60%
• Trouble with the law – 60%
• Confinement – 50%
• Inappropriate sexual behavior – 49%
• Alcohol and drug problems – 35%
•
Streissguth, Understanding the Occurrence of Secondary Disabilities August
CRIMINAL JUSTICE SYSTEM
• VICTIMIZATION
• Known predators a problem
• Unreliable witness
• Social Functioning Lower
• Gang Activity “Patsy” or “fall guy”
• Brain damage hinders the inability to deal with usual life
demands
• Unable to resist sexual advances72% of adolescents & adults
with FAS/FAE have been physically or sexually abused.
Streissguth
PLANNING FOR CLASSROOM SUCCESS
• Student Prevention Education
• Understanding the “Cause” of the Problem
• Learning about Current Initiatives and
Resources
• http://www.ocali.org/topic/fasd/
SIMPLE STRATEGIES THAT WORK!
• Concrete
• Consistency
• Repetition
• Routine
• Simplicity
• Specific
• Structure
• Supervision
8 Magic Keys Deb Everson & Jan Lutke 1997
EDUCATIONAL & ENVIRONMENTAL
STRATEGIES
• Organizing the Physical Space
• Reinforcing Routines and Assisting with
Transitions
• Making Learning Accommodations
• Assisting Social Development and Improving
Behavior
WHAT PROFESSIONALS CAN DO
TODAY?
• Modify the environment.
• Modify expectations.
• Think younger or think “stage not
age.”
• Think perpetual innocence.
• Make the world make sense.
• Rethink, reteach, respect.
WV INITIATIVES
• Regional Prevention Trainings
• Physician Guidance Documents
• Maternal Addiction and Recovery
Center (MARC)-Dr. Chaffin
• WV Moms and Babies Recovery
Project
• Lilly’s Place
QUESTIONS?
Kathy Paxton, Director
WV Division on Alcoholism and Drug Abuse
Kathy.L.Paxton@wv.gov