Counselor Roundtable
STUDENT DRUG USE:
Trends, Impact, Parent Training
BRADFORD HEALTH SERVICES
Janna Donovan, LPCA
Clinical Counselor for Adolescents
BRADFORD AT THE INNERVIEW
We treat the approximately 11% of the population who
struggle with an addictive reaction to drugs or alcohol
with an:
INTENSIVE OUTPATIENT PROGRAM FOR
ADULTS, ADOLESCENTS, AND FAMILIES
AFFECTED BY SUBSTANCE ABUSE AND
DEPENDENCE.
WHAT, WHO, WHEN
ARE TEENS USING?
Experimentation begins Early
 Average age a child is exposed to alcohol & drugs out
side the home is 9.
 40% of new experimentation with cigarettes, alcohol &
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drugs are between 6th & 9th grades
June and July are highest months of first use for THC
December is the highest month of first use for alcohol
IV drug use has increased
Number of teens dying from drug use and overdose
now exceeds number from car wrecks in US
Addiction Risk Factors
 Two main questions: Does the adolescent smoke? Is there a
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family history of addiction?
Age of first use (younger, higher risk)
Learning disabilities, behavioral problems, psychological
disorders (brains wired differently, don’t fit in, more at-risk)
Trauma (abuse, divorce) & Depression
Stress (can lead to feelings of inadequacy & insecurity)
Parent Acceptance (parents who use or sanction use have
kids who use)
75% of adolescents in treatment come from fatherless homes
Genetic history = 4x more likely to become addicts
Other Risk Factors
Teens with these more likely to use:
 Risk takers and low fear response
 Failure to plan before they act
 Like to experiment with how things feel
 Higher tolerance
 Early school failure and peer rejection at
age 7 to 9
Ducci & Goldman, 2008, as cited in Kalat, 2013
27 % of Sophomores, 40% of Seniors
used Alcohol in the Last Month
8TH
10TH
12TH
40
35
30
25
20
University of Michigan
Monitoring the Future
Annual High School Survey
N= 46,700
Monitoring the future.org
15
10
5
0
ALC CIG ANY THC Rx
HAL ECS
18% of
Sophomores
22% of
Seniors used
Marijuana in
the Last
Month
Age of Onset correlation to Dependency
Alcohol Dependency
Before Age 15
Age 17
Age 21-22
40.1%
24.5%
10%
Overall, every year you can postpone the
first drink, the risk for lifetime alcohol
abuse decreases by 8%
NIAAA
Positives to Later Use vs. Early Use
ALCOHOL AND TEENS
Alcohol and Teens
 The drug most often abused by teenagers
 Most frequent source – family, friends, adult
purchasers – especially older siblings, and parties.
 Parties, and in some cases Picnics are high risk for
binge drinking and associated alcohol problems
 Correlated with rape and assault
Community Tolerance
 Parents and other adults have a high tolerance for
underage drinking parties
 Myth that underage drinking is inevitable and safer
if it is in a controlled residential setting
 Misconception that alcohol is harmless compared to
other drugs
 Misconception that alcohol use is a right of passage
 (Remember, “Only” 27% of Sophomores and 40% of
Seniors have had a drink this month)
MARIJUANA
Today’s Marijuana: 5-8 Times More Potent
 Today’s drug
leads to a
higher high
 Can prepare
brain for
opiates
 “3 years from
marijuana to
opiates” like
Loritab,
Oxycontin
 Opiate highs
can open the
door to heroin
Marijuana and Teens
 Teens who frequently use marijuana are almost
4x
more likely to act violently or damage property
 Teens who frequently use marijuana are almost 5x
more likely to steal than those who do not use
 Parties, and in some cases Picnics are high risk for
binge drinking and associated alcohol problems
Effects of Marijuana/Cannabis
Intoxication:
 Red eyes
 Increased appetite
 Dry mouth
 Heart racing
 Distorted perceptions
 Impaired coordination
 Impaired judgment
 Anxiety
 Social withdrawal
Chronic use associated
with:
• Lung, sinus irritation
• Difficulty thinking,
•
•
•
•
•
•
problem solving
Difficulty learning and
REMEMBERING
Amotivation
Anxiety
Depression
Suicidal thoughts
Schizophrenia symptoms
Retrieved from:
http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/marijuana_fact_sheet_jw_10-5-10.pdf
Effects of Cannabis Withdrawal
Withdrawal can include:
 Irritability, anger or aggression
 Nervousness or anxiety
 Sleep difficulties (insomnia)
 Decreased appetite or weight loss
 Restlessness
 Depressed mood
 Stomach pain, shakiness or tremors, sweating,
fever, chills, and headache
Retrieved from:
http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf
Social Acceptance of Marijuana Use
 “It’s natural, good for you…Not as bad as cigarettes or
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alcohol”
“It’s legal and should be” – Not for a developing brain
Myth: “You cannot become addicted to marijuana”
“Lots of famous, high achieving people smoke weed” –
but they did not smoke 15% THC hourly at age 15
4:20 – Universal Smoke Time (“It’s 4:19, got a minute”)
Popular Figures in Marijuana Culture: Wiz Khalifa or
Wiz K, Mac Miller, Snoop Lyon (formerly Snoop Dogg),
Lil Wayne
Common Slang for Marijuana
Pot
Grass
Weed
Kush
Chronic
Blunt (hollowed out cigar
with marijuana in it)
• Fatty/Joint/Doobie
•
•
•
•
•
•
Clinical Names:
• Cannabis
• THC
• Dro, Hydro (hydroponically
•
•
•
•
•
•
•
grown, synonym for “good”)
Reg (not very good, 2% THC)
Indo, Kaya
Mary Jane
Sess
Tree, Greenery
Hotbox (fill car with smoke)
“Buttered”
CONTRIBUTING
FACTORS
& PREVENTATIVE
ACTIONS
Peer Pressure on Social Media
•75% teens say that seeing pictures of others
using drugs or alcohol encourages them to use
drugs or alcohol
•4x more likely to use marijuana
•3x more likely to use alcohol
•3x more likely to use nicotine
•Legalization & Favorable Attitude
•Many are prepared to fight, debate, & argue, for
their use of it; it makes things “all good”. In their
mind marijuana use is totally ok.
HOW TO PROCEED
…If I think my
child/student is
drinking or using
drugs
Warning Signs
 Physical Problems: fatigue, repeated health
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complaints, red hazy eyes, lasting cough.
Emotional: personality change, sudden mood changes,
irritability, irresponsible behavior, low self esteem
Family: starting arguments, breaking rules, withdrawal
School: decreased interest, negative attitude, drop in
grades, absences, truancy, discipline problems
Social Problems: new friends who are less interested
in standard home and school activities, problems with
the law, less conventional styles in dress and music
My child is drinking/using drugs
 Be willing to ask the extra question
 Trust your gut
 Watch their eye contact (they do not
typically make eye contact)
 Provide boundaries
 The bigger the reaction, the closer you are to
the truth
Why Do People Use in The First Place?
To Feel
Good
To have
novel:
feelings
sensations
experiences
AND
to share them
To Feel
Better
To lessen:
anxiety
worries
fears
depression
hopelessness
pain
Common Responses to Addiction
Relating
Hiding
Normalizing
Rationalizing
DENIAL
IGNORING
MINIMIZING
Slow
Progression
Avoiding
Pretending
When denial is heavy and we ignore
and minimize, this can lead to a
steady and dangerous progression
Common Responses to Addiction
Exclusion
Attack (War on Drugs)
Make
Laws
Blame
Others
Preach or Moralize
PAIN
ANGER
FEAR
Judge
Criticize
Scare People
Punish People
When pain, anger and fear are the motivation,
efforts to control others tend to evolve
Best Response to Addiction
Modeling
Inclusion
Listening
Supporting
Sharing
CONNECTION
ACCEPTANCE
Mentoring SEEING OTHERS AS THEY ARE
Touching
Teaching
Non-Judgmental
Discipline
Accepting
Feeling
When connection, acceptance and seeing others as they are
is the motivation, more influential (successful) efforts evolve.
Rules and Relationships
 Rules without Relationship Lead to Rebellion
 Relationship without Rules Lead to Revolt
 Relationship and Rules Lead to Respect
PREVENTION’S IMPACT
Teens with these less likely to use:
 Academic effort/support
 Good communication skills
 Assertiveness, self-efficacy

(“If it’s to be, it’s up to me”)
 Social problem-solving
 Developed SELF-control
 Reinforcement of anti-drug attitudes
and personal commitments against use
NIH, 2003
FAMILY’S IMPACT
NIH, 2003: these helps prevent use, recover:
 Stronger bond with nurturing parent(s)
 Effective, involved parenting
 Moderate, consistent, clear discipline
 Structure in the home environment
 Relationship with 1+ caring adult(s)
 Caregivers who:
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Don’t abuse alcohol, drugs
Don’t engage in criminal behavior
Get help with mental illness struggles
GOOD NEWS: PARENTS’ IMPACT
Parents have the most
significant influence on
their kids’ use of drugs.
It’s not enough to be
neutral, you must take a
negative stance.
PARENTS’ IMPACT
2011 Study, Columbia University National
Center on Addiction and Substance Abuse:
 Parents who expect their children to
drink and use drugs will have children
who drink and use drugs.
 Parents who send their 12- to 17-yearolds a message that it’s okay to smoke,
drink, get drunk and use illegal drugs
like marijuana become enablers.
FATHERS’ IMPACT
Father’s impact on alcohol use:
 Young people who believe their father
tacitly approves of their drinking are 2.5x
more likely to get drunk in a typical month
than teens who believe their father
disapproves of their drinking
CASA 24 (Results of parent restriction of use on outcome).
PARENTS’ IMPACT
Parents who are unsure about use
of marijuana:
 Teens almost 2x more likely to
use marijuana
 …compared to teens whose
parents say this decision is a
major concern.
Even if it’s Painful…Take the Risk
When we are in the midst of the pain we
must do what it takes and risk much to
save lives.
•Get Professional Help
•T-6 RESPONSE TIME
• 80% VS 20%
• DENIAL INCREASES
• PAIN AND CONSEQUENCES DECREASE
Progression of Care
 Step 1:
 Step 2:
 Step 3:
 Step 4:
 Step 5:
 Step 6:
 Step 7:
 Step 8:
 Step 9:
Event or Crisis (DUI, caught by parent)
Free Consult, drug screen, reco
No need, IOP or Inpatient
In-patient, Alabama (homework done)
IOP, Louisville, 4:30-7:30, M-Th, 6 wks
Mandatory Family Night every Monday
Contract for abstinence, grades
Continuing Care, Mon, Paid 2 Years
Referrals to Counseling, Services
Question &
Answer
BRADFORD AT THE INNERVIEW
502-491-3799
Intensive Outpatient Program for adults,
adolescents and families affected by
substance abuse and dependence.
The Chrysler Building
4229 Bardstown Road, Suite 311
Louisville, KY 40218
CONCERNED PERSONS
Support group for those concerned about a
loved one’s alcohol or drug use.
Open to the public at no cost
Every Tuesday Night 6:00 PM-8:00 PM
Bradford at the InnerView
The Chrysler Building
4229 Bardstown Road, Suite 311
Louisville, KY 40218
502-491-3799
RESOURCES
 FAMILIES ANONYMOUS
 800-736-9805
 Thursdays, 7:30 PM, St. Michael’s Catholic Church,
3705 Stone Lake Drive, Jeffersontown
 ALANON
502-458-1234
 www.kyal-anon.org
 Various meetings around town every day of the
week

REFERENCES
 Califano, Joseph. 2011 Casa Survey. CASA – The National Center on
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Addiction and Substance Abuse at Columbia University.
Ducci & Goldman, 2008 as cited in Kalat, 2013)
National Institutes of Health. (2003). Preventing Drug Use among
Children and Adolescents. NIH Publication No. 04-4212(A). U.S.
Department of Health and Human Services.
NIAAA (National Institute of Alcohol Abuse and Alcoholism). 2012.
Kalat, J. 2013. Biological Psychology 11th Ed. Belmont, CA:
Wadsworth, Cengage Learning. 75-76.
Epidemic: Responding to America’s Prescription Drug Abuse Crises.
www.whitehouse.gov .
SAMSHA. (2008, 2003, 2002). National Surveys on Drug Use &
Health.
Back-up Slides
Myths about Adolescents
 Myths about teens
 An age of raging hormones
 Immaturity - Just hold on and
survive
 They need total independence – let
them go
The Adolescent Brain
 The ESSENCE of Adolescence
 ES – Emotional Spark
 SE – Social Engagement
 N – Novelty
 CE – Creative Explorations
The Adolescent Brain
The ESSENCE of Adolescence
Dopamine baseline is low (bored)
Dopamine comes in spikes
This results in:
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Impulsiveness- Act first, Think later
Hyper-rationality – Over emphasize the
PROs of an experience
Susceptibility to addictions – behaviors
and substances that trigger dopamine
releases
Where do most of the problems occur?
 People who have no clear rules about use
 People that send permissive messages about use
 People that send mixed messages about use
 People that tolerate use to the point of
drunkenness or being high
LIFETIME USE
70
8TH
10TH
12TH
60
50
40
30
20
10
0
ALC
CIG
ANY
THC
Rx
HAL
ECS
PRESCRIPTION DRUGS
Prescription drugs are the fastest
growing drugs of choice in the U.S.
Prescription DrugsFastest Growing Drug of Choice
 Include narcotics or opioids, depressants –
usually benzodiazepines, and stimulants

Valium, Xanax, Klonopin, Ritalin, Concerta, Adderall,
OxyContin, Opana Percocet, Lortab, Fiorinol, Fioricet,
Vicodin, Hydrocodone,, Demerol, Dilaudid, Methadone,
Suboxone, Codeine, etc.
 Overdose – Kentucky is #6 in the Country.
Someone in Kentucky overdoses every 3
days. Nationwide in 2007, 100 people per
day dying by overdose.
Prescription Drugs
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Viewed as “safe” by teenagers.
2 in 5 teens agree that Rx medicines, even if they are not
prescribed by a doctor, are “much safer” to use than illegal
drugs.
3 out of 10 teens believe prescription pain relievers – even if
not prescribed by a doctor – are not addictive.
More than half of teens don’t agree strongly that using cough
medicines to get high is risky.
Where Do They Get Them?
 70% percent got them free from a relative
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or friend.
Some of these are “Accidental Dealers”
19.1 percent got them from just one doctor.
3.9 percent got them from a stranger.
0.1 percent bought them on the Internet.
Other Drugs
DXM - Dextromethorphan
 Robitussin DM, Coricidin, Nyquil DM, Mucinex
DM, Over 100 OTC Meds Contained.
BATH SALTS –
 Highly Addictive, Similar to a cross between
Methamphetamine & LSD
SPICE – Synthetic Cannabinoids
 “Herbal Incense”, 10% Used to avoid Drug
Screens
Opana
 Opana is the brand name for oxymorphone, a
potent narcotic used to treat severe pain.
 2011 $40/pill (40 mg)
 2012 $145/pill (40 mg)

Decreasing availability
 Other Opioids
Bath Salts
 Ivory Wave, Purple Wave, Vanilla Sky, Bliss
 Similar to a cross between Meth & LSD
 Easy to get
 Highly Addictive

Snorted
Smoked
Injected
Ingested
Harmful Effects of Bath Salts
 Agitation
 Psychotic episodes
 Paranoia
 Hallucinations
 Suicidality
 Increased Blood Pressure
 Increased Pulse
 Chest Pain
Spice
 K2, Spice Gold, & "herbal incense“, etc.
 Effects similar to those of marijuana.
 Synthetic cannabinoids: JWH-018
 JWH-018 inventor John W. Huffman, PhD, puts it
bluntly. "It is like Russian roulette to use these
drugs. We don't know a darn thing about them for
real,"
Signs & Symptoms of Spice
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Denial when concerns are expressed regarding drinking or drug use
Sneaking alcohol and drugs
Unusual sleeping patterns
Lighters in the laundry/burns on hands/clothes .
Change in Personality
Social Withdrawal
Ongoing Use
Going to Great Lengths to Obtain Money & Prescriptions
Items Missing from the Home – theirs and yours
Change in Appearance
Desensitized Emotions
Increased Inactivity
Blackouts and Forgetfulness
Defensiveness
Marijuana Usage Trends
 Rates of marijuana use among 8th, 10th, and 12th
graders are higher than rates for any other illicit drug
 NSDUH also shows that from 2008 to 2009, the rate of
current illicit drug use among young adults aged 18 to 25
climbed 8 percent, from 19.6% to 21.2%, driven largely by a
10 percent rise in marijuana use
 In 2009, there were 2.4 million new past‐year users of
marijuana. The average age of initiation dropped from 17.8
in 2008 to 17.0 in 2009
Retrieved from: http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/marijuana_fact_sheet_jw_10-510.pdf
Strawberry Diesel Kush
Adults use the Cerebral Cortex,
Adolescents use the Amygdala
Deborah Yurgelon-Todd 2000.
How we Address These:
 Authoritative Parenting (Baumrind, 1967)
 Moderate, consistent clear discipline
 Not harsh, inconsistent, vague punishment
 Mastery Orientation, Internal Locus of Control (Rotter, 1975)
 Goal is to improve, not to prove something
 Self-efficacy
 Motivational Enhancement (Miller & Rollnick, 2013)
 Identity Development, What do you Want?
 Future Planning Skills, How are you going to Get it?
 Logic, How is it Going?
 SELF-Control, not Other-Control
 Identity Development vs Role Confusion (Erickson, 1950)
 Family Therapy (SAMHSA, 2005)
 Power Shift to Parents, Needs/Healing
 Improved Communication and Environment for Coping