July 17, 2017

E-Cigarettes, Nicotine, & Vaping

Nationally, teen cigarette smoking has been decreasing for many years and after a dramatic rise in e-cigarette use between 2011 and 2015, ecigarettes use by teens fell from 16% in 2015 to 11.3% in 2016 according to a report by the OOC. The decline is believed to be due to a combination of tobacco restrictions, public education, and taxes. An ecigarette sometimes called an electronic nicotine delivery system (ENDS), e-cig, hookah pen, hookah stick or vaping device is designed to mimic smoking a cigarette.

In NY State cigarette smoking by high school students fell to a record low of 4.3% in 2016, down from 27.1% in 2000. But e-cigarette use nearly doubled in the last two years from 10.5% in 2014 to 20.6% in 2016 according to the NYS Department of Health. This underscores the need for New York parents to reinforce the harmfulness of these products. The device can resemble a real cigarette or look more like a pen or marker. The device delivers nicotine or non nicotine “ejuice” or other substances to the smoker in a vapor form. A battery powers a heating element that vaporizes the liquid nicotine contained within a cartridge in the e-cigarette so that what’s inhaled and then exhaled looks like smoke, but is usually odorless. They often come in colorful packaging and have flavors marketed to young people such as strawberry, apple, bubblegum, or watermelon. For some teens the appeal is being able to compete with peers on who can “blow” the best smoke rings.

It is hard for parents to identify all forms of ENDs but currently a popular brand of e-cigarettes is Juul. The device is usually filled with a flavored nicotine, however, it can also be used for marijuana. The device can be plugged into a USB charger in order to work to vaporize the nicotine or other substances a teen chooses to put into the device. There is usually no odor when one chooses to use this device so if a parent is not aware of what this device is, they may think it is a flash drive. The reality is that it is delivering a harmful substance into the lungs. Previous studies have identified some troubling trends. In the first analysis of the relationship between e cigarette use and smoking among adolescents in the United States, University of California at San Francisco researchers found that adolescents who used the devices were more likely to smoke cigarettes and less likely to quit smoking.

The 2015 report on ENDS in New York State found the following:

  • The prevalence of ENDS use among high school students (10.5%) and young adults (12.7%) is about twice as high as the prevalence of ENDS use among adults (5.7%).
  • There is no evidence that youth are substituting ENDS for cigarettes. In fact, more than half of high school students and young adults who smoke cigarettes also use ENDS, making dual use of cigarettes and ENDS the norm.
  • Among the 7.3% of high school students who are current smokers, 56.5% also use ENDS.
  • Among the 14.2% of young adult smokers (age 18-24 years), 54.9% use ENDS.
  • Among the 17.3% of adult smokers (age 25 and older), ENDS use is significantly lower, at 24.0%.

E-cigarettes can contain various levels of nicotine a highly addictive drug. People who regularly use nicotine and then suddenly stop experience withdrawal symptoms, which may include cravings, anxiety, depression, moodiness, irritability, and inattentiveness.

The American Heart Association says that nicotine from smoking is one of the hardest substances to quit. According to the U.S. Food and Drug Administration, tests of e-cigarette samples found that they
contain carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in car antifreeze. The potential harm from exposure to secondhand vapor from e-cigarettes is unknown. Two initial studies have found formaldehyde and cancer causing substances coming from secondhand vapors (American Lung Association, 2011).

Source: Patricia Murphy Warble, LMSW, CPP, Parenting for Prevention June 2017

in iASK-CAB Notes
July 9, 2017

It’s Time to Rethink Prevention

By Robert DuPont

A recent national survey shows that among young people age 12 to 20 underage drinking and binge drinking
have declined significantly over the past decade.(1) While the survey report does not speculate about the reason for this trend, it is the result of decades of cumulative widespread prevention messages coupled with concerns about alcohol-related motor vehicle crashes, alcohol poisoning, and sexual assault, and as well as increased alcohol taxes.(2)

In the last decade tobacco use has also declined among youth. This reflects the lasting national impact of the
1964 Surgeon General’s report Smoking and Health(3)that was widely publicized and resulted in a law mandating warning labeling on all tobacco products. The report brought to the public’s attention the devastating
impact of tobacco use on health. The national anti-smoking campaign has been strident in labeling nicotine
as “addicting” and smokers as “addicted.”

Interestingly, use of illegal substances by adolescents has also declined. These three trend lines showing
broad declines are significant. They cannot be explained on a substance-by-substance basis because the trend
lines for alcohol, tobacco and other drugs are so similar. Instead this broad positive trend can be understood
as part of a shared cultural learning initiated by the epidemic of substance abuse that exploded in the late
1960s and early 1970s. In the 50 years since the 1964 report on Smoking and Heath, there has been a growing
awareness of the negative health and safety effects of addicting drug use. One of the contributors to this
cultural learning has been the definition of alcohol and nicotine as “addicting” drugs. This connection has
been reinforced by the federal government’s descriptive terminology that linked alcohol to illegal drugs under
the mantra-like phrase “alcohol and other drugs.”(4 )

New analysis of longitudinal data from the nationally representative annual Monitoring the Future study on
substance use by high school students shows a remarkably strong and sustained trend of abstinence from the
use of all addicting substances. These data have been there all along but the analysis resulting in this finding
is completely new. Among 12th graders, the percentage of students who never used alcohol, tobacco, marijuana or other drugs in their lifetimes rose from 2.9% in 1983 to 25% in 2013. The percentage of 12th graders who did not use any alcohol, tobacco, marijuana or other drugs in the prior 30 days rose from 16.1% in 1982 to 49.6% in 2013. Similar sizeable positive changes are reported for 8th and 10th graders who were first surveyed in 1991.

Problems with alcohol, tobacco, and other drugs remain gravely serious. However, this new evidence of an increasing percentage of American youth who choose not to use any of these addicting substances gives new hope for the future. This finding has the potential to reshape all prevention strategies away from substance-specific health-promoting campaigns to a single focus that promotes no use by adolescents of any addicting substances. The use of any and all of these substances is unhealthy for youth and the use of all of these drugs is illegal. (The legal age for tobacco is 18, for alcohol 21, and in the states with legal marijuana, 21). Since nearly all substance use, and addiction, begins during the teenage years, prevention of any use during this time is singularly important. Lowering the substance use rates of youth today will be reflected tomorrow in lowering the adult rates of addicting drug use.

The new focus on one decision by youth not to use any addicting substances, including alcohol, tobacco, marijuana and other drugs, holds great promise of a stronger, clearer and more effective goal for public education and prevention.

Written By Robert DuPont, MD
1. Substance Abuse and Mental Health Services Administration. (2015, June 11).
2 Kauffman, G. (2015, June 16). Underage drinking is down: Are teens partying less? Christian Science Monitor
3 US Department of Health, Education, and Welfare. (1964).
4 National Institute on Alcohol Abuse and Alcoholism. (1993). The Alcohol and Other Drug Thesaurus: A Guide to Concepts and Terminology in Substance
Abuse and Addiction.
in iASK-CAB Notes
July 2, 2017

Alcohol

In 2016, the US Surgeon General, Vivek Murthy, MD released the first report dedicated to substance misuse and related disorders entitled, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health. “Although substance misuse problems and use disorders may occur at any age, adolescence and young adulthood are particularly critical at-risk periods,” Dr. Murthy said.

“Preventing or even simply delaying young people from trying substances is important to reducing the likelihood of a use disorder later in life.” He went on to point out that people who use alcohol before the age of 15 are four times more likely to develop an alcohol use disorder later in life compared to those who have their first drink
at age 20 or older. It is not surprising to find that teens who use alcohol are more likely to engage in risky behaviors. Using alcohol or other drugs can lower a teen’s inhibitions and impact their judgement by influencing their ability to assess that a situation is dangerous or even deadly.

The Center for Disease Control and Prevention’s, Division of Adolescent and School Health collects data every year for their Youth Risk Surveillance System which monitors six categories of priority health-risk among adolescents at the national, state, territorial, tribal, and local levels. Their 2016 data showed that 22% of teens who are already sexually active, drank alcohol or used drugs before engaging in sexual intercourse which in turn put the teens at risk for pregnancy and sexually transmitted infections.

Using alcohol or other drugs can lead to serious problems for teens including poor performance at school, loss of friends and becoming alienated from their family. Substance abuse is also related to car crashes, suicides and injuries. The Centers for Disease Control and Prevention (CDC) reports that in 2010 excessive drinking was responsible for more than 4,300 deaths among underage youth and there were approximately 189,000 emergency department visits by persons under 21 for injuries and other conditions linked to alcohol.

Source: Patricia Murphy Warble, LMSW, CPP, Parenting for Prevention June 2017
in iASK-CAB Notes
July 1, 2017

Molly just makes you feel happy. Whats wrong with that?

Molly just makes you feel happy. Whats wrong with that? 

“Molly,” a popular drug at music festivals, is the powder or crystal form of MDMA, which is the chemical used in Ecstasy. The use of Molly — a stimulant drug — comes with serious health risks. The DEA notes that it can cause confusion, anxiety, depression, paranoia, sleep problems and drug craving. Learn more.

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June 25, 2017

Summer Safety 2017

Although we all think of summer as a more carefree and relaxed time, the summer can present challenges if you have teenagers. Summer is a time when parents need to be particularly alert to what their children are doing, where they are going and who they are spending time with during
their vacation.

This is not always easy to do as teens usually have more freedom during the summer and have more opportunities to gather in unsupervised settings where no responsible adults are present.

Times of transition can be difficult for students and the eighth to ninth grade and twelfth grade to college are identified as times when teens are more likely to begin or increase their use of alcohol and other drugs. Research also shows that the summer is the time that many teens try marijuana
for the first time.

Robert DuPont, MD, the former Director of the National Institute for Drug Abuse and the former “drug czar,” spoke at the Community AntiDrug Coalition of America conference in February and spoke last month at the Westchester Coalition for Drug and Alcohol Free Youth and meeting about the need to keep teens from using the three gateway drugs; alcohol, marijuana, and nicotine.

At a time when there is grave concern about the opioid crises, Dr. DuPont made the point that most opioid users begin their drug use with one of the three gateway drugs. Dr. Du Pont went onto say, “Drug prevention is not drug by drug, rather it is about any and all drug use by youth. Prevention needs to support the primary goal of no use of any alcohol, tobacco, marijuana or other drugs to maintain the health of our young people.”

During the summer, it is important for parents to understand that keeping teens away from the three gateway drugs will be a positive step to ensuring that their lives will not be impacted by the serious consequences of drug use and addiction.

The Five A’s Of Parenting
Mike Nerney, a prevention specialist, makes the following recommendations to parents about strategies they can implement to keep their children safe during the summer:

  1. Aware: Every family should have a strategy in place so that they know where their teen is and who they are with during the day and at night. Be sure to check-in with other parents and make sure that all the teens are in a supervised setting with a responsible adult. Empty houses with no adult supervision have proven to be very dangerous places for teens in Westchester County. It is usually in this unchaperoned setting that many teens first try alcohol and drugs or have their first sexual encounter. Text messaging, talking on the cell phone and even asking your teen to take a picture of where they are and then have them send it to you, have made the job of knowing where your child is much easier.
  2. Alert: Be alert to any behavioral changes in your child during the summer. Teens are much more likely to try alcohol, cigarettes, and other drugs for the first time during the summer months.
  3. Awake: When your children get home, give them a hug or a kiss and talk to them for a few minutes to
    make sure they are not under the influence of any substance. It may be a deterrent for your children to use alcohol or other drugs if they know that they will have to pass the “hug/kiss/talk” test later on in the evening. If anything in their behavior concerns you, make sure they are safely in bed and wait until the morning to address the issue. Important note: If your teen seems impaired, DO NOT LEAVE THEM ALONE “to sleep it off.” Keep them awake and talking. Call 911 immediately if your teen cannot keep their head up or stay awake.
  4. Assertive: Make sure you and your child have discussed appropriate consequences for inappropriate and unhealthy behavior. The consequences should be firm, respectful and related to the behavior. Furthermore, although this can be difficult, the consequences must be enforced.
  5. Affirming: Let your children know that you love them and want them to have a wonderful summer. Help them understand that they are the most precious people in your life and if they feel that you are being too protective, it is because it is your job to keep them safe.
Source: Patricia Murphy Warble, LMSW, CPP, Parenting for Prevention June 2017
in iASK-CAB Notes
June 19, 2017

Alcohol and Your Child

As a parent, it is important to understand your role in protecting children from the problems associated with underage drinking, and the laws related to this issue.  Underage alcohol use is a serious issue impacting communities across New York State, including the Village of Irvington. Adults play a role when they sell of serve alcohol to youth under the age of 21, when they host parties where young people are drinking, and when they condone underage alcohol use.

Every community member should be concerned about alcohol use by youth under 21 because it is associated with the three most common causes of teenage deaths: accidental deaths, homicides and suicides. In addition, high levels of alcohol use are associated with unplanned or unprotected sexual activity among adolescents, posting increased risk for teen pregnancy and sexually transmitted diseases. Alcohol use and higher levels of use among adolescents is associated with poor grades, absenteeism and higher school drop-out rates. In addition, children who start drinking before the age of 15 are four times more likely to develop alcohol dependence than those who  begin drinking at age 21.

The enforcement of the underage drinking laws requires an awareness and commitment from parents, schools, communities, clergy, healthcare and law enforcement professionals. The health and safety of our children, families and communities can not be compromised due to the devastating, and often fatal consequences of underage drinking. Everyone can play a role in reducing the use of alcohol in youth under 21.

Learn more about how you can make a difference as well as laws addressing underage drinking.

in iASK-CAB Notes
June 6, 2017

Prom Safety in Irvington

Prom Safety activities were executed throughout the month of May at Irvington High School.

In the beginning of May, there was a window display for “Prom Safety”, which included PSAs about prom night and facts about driving under the influence of alcohol or other drugs.

Additionally, the Westchester County Department of Public Safety provided an all-day drunk driving simulator for students. Westchester County police officer Christopher Grasso supervised the simulator and provided students with information about DWI laws and the “zero tolerance policy”. Students waiting for the simulator learned about the potential dangers of alcohol or drug-impaired driving.

On May 18th, the Westchester STOP DWI program displayed a crashed car at the High School. The Irvington police department also provided information about DWI laws and safety as well as conducted a mock DWI check point with students wearing the Fatal Vision alcohol goggles.

Prevention is key to a happy, safe, and sober prom night!

in iASK-CAB Notes
June 1, 2017

Why do people start taking drugs?

Why do people start taking drugs?

People take drugs for many different reasons: to feel better, to feel good, and because others are doing it. The most important thing to realize is that the younger a person begins to use drugs, the more likely it will lead to serious drug abuse. Learn more.

in Conversation Starters
May 7, 2017

Impact of Marijuana on Academic Achievement

Impact of Marijuana on Academic Achievement

Amelia M. Arria, Ph.D., from the University of Maryland School of Public Heath gave a compelling research-based presentation at the February, 2017 CADCA conference. Her talk was based on several recent research initiatives,  including an April, 2016 review article published in Biological Psychiatry by Broyd et al. which considered the effect of young people using marijuana and  their ability to be successful students.

This article in Biological Psychiatry, titled Acute and Chronic Effects of Cannabinoids on Human Cognition-a Systematic Review stressed the importance of realizing  that the marijuana that is being used today is significantly more potent than the marijuana in the past.  In 1995 the potency was 3.96% and today it is 11.84%.  In addition, the use of “dabs,” which are more concentrated doses of cannabis that are made by extracting THC and other cannabinoids using a solvent like butane or carbon dioxide, resulting in sticky oils also commonly referred to as wax, shatter, budder, and butane hash oil; edibles can have a higher concentration of THC.  The 2016 Biological Psychiatry article concludes that this increase in potency poses a higher risk for negative consequences to adolescents who use marijuana.

Learning involves many cognitive skills that allows one to focus, memorize, interpret and analyze information and internalize the concepts. Dr. Arria’s  presentation summarized the impact of marijuana on following cognitive and other skills.

Memory

According to the 2016 article in Biological Psychiatry, “Memory function has been the most consistently impaired cognitive domain affected by cannabis, and studies from the past 10 years continue to extend the evidence base. The most extensive evidence for impairment is within verbal learning and memory.” (Broyd et al., 2016)

Verbal Learning and Memory

The same article goes on to say, “Most often measured using word list learning tasks, with several immediate and delayed recall trials and a recognition trial, verbal learning and memory tasks have been identified as particularly sensitive to the acute and chronic effects of cannabis. Impaired verbal learning and memory continues to be consistently observed in chronic cannabis users, including adolescents and young adults with some exceptions and even in only occasional users.  Significant associations between poorer performance in regular users and frequency, quantity, duration, and age of onset of cannabis use have been reported. Consistent with previous findings, long-term users appear to be more affected than short-term users.” (Broyd, et al., 2016)

Attention

“Impaired attention has been considered a hallmark of the intoxicating effects of cannabis” according to the article in Biological Psychiatry They also point out that when there is a decrease in impairment, it might be explained by the development of tolerance among daily users.  Several recent studies report impairment in an adolescent remained even when they had not used cannabis for 30 days.    From that the researchers  drew the conclusion that “cannabis-related attentional impairment may reflect residual effects that dissipate gradually as cannabinoids are cleared from the body.’  (Broyd, et al., 2016)

Inhibition

Inhibition refers to go/no go or stop-signal reaction time.  The use of cannabis has consistently been reported to  increase reaction time in both occasional and heavy cannabis users. (Broyd, et al, 2016)

Psychomotor Function

In terms of psychomotor functioning, “finger tapping, critical tracking, choice reaction time tasks, and digit-symbol substitution tasks have been used to measure psychomotor function. In infrequent users, smoked or vaporized cannabis impaired critical tracking, affected reaction time and motor control in a dose-dependent manner,  and disrupted motor function in a task with a motivational component. In heavy users, high-dose smoked cannabis resulted in more collisions in a virtual maze task but did not affect critical tracking. The weight of evidence suggests that psychomotor function is affected by acute intoxication and that this likely persists for some time after chronic cannabis exposure.”  (Broyd, et al., 2016)

Dr. Arria and  Robert Du Pont, MD discuss the relationship between academics and marijuana in a post for  the Partnership for Drug-Free Kids entitled Commentary: Recognizing the Contribution of Adolescent Substance Use to Poor School Performance.

“Marijuana use negatively impacts academic outcomes by lowering the GPA and those students have higher rates of dropout than students who drink alcohol.” The authors speculate that this might be due to differences in the patterns of consumption between alcohol which is typically consumed on weekends and marijuana which is consumed throughout the week among adolescents. In addition, studies show that in recent years, as perceived risk of harm from marijuana has declined, marijuana use among youth has increased.

Several studies note that sometimes the use of marijuana precedes academic failure and other times early academic failure leads to use. There are many pathways that lead to negative outcomes from substance use during adolescence.

Students that show early signs of academic difficulties should be specifically screened for drug and alcohol use. Steps should be taken to ensure that at-risk students become and stay drug-and alcohol-free. Proper management must be comprehensive and may include assessments and interventions for behavioral problems and mental health disorders.

Cessation of substance use following treatment is associated with improvement in academic performance. This evidence shows that doing something about substance use is an important way to promote and improve academic success.  (2016, Biological Psychiatry.)

New neurobiological research tells us that there are short and longer-term effects of drug use on students’ ability to learn. Certainly, learning is compromised if students come to class under the influence. Motivation to study and achieve declines as the use becomes more regular. Too often, students with alcohol or drug problems aren’t even making it to the classroom.”

Dr Arria stressed in her présentation the concept of the brain being “hijacked” by the use of substances including marijuana.  Academic potential is much more than a GPA. It’s the ability to maintain interest and curiosity and continue to be motivated to succeed despite disappointment or failure.  It is the ability to be able to communicate the need for help from school personnel or other resources.

Source: Patricia M. Warble, CMSW, CPP
in iASK-CAB Notes
May 1, 2017

Effects of Drugs

Why are some people greatly affected by doing drugs when others aren’t?

You probably already know that individuals are different in every other aspect of life, so it is natural to expect that different people respond to drugs differently. Learn more.

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