Avoiding Drug Abuse by SouthwestIowaNews.com

Avoiding Drug Abuse

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The City of Denison and the Denison Police Department, Manning Family Recovery Center, Denison Bulletin & Denison Review, and the co-sponsors on the following pages.

AddicƟon and Abuse Can Take on Many Forms, Sizes and Shapes. Manning Family Recovery Center is here to help. MFRC oﬀers treatment for alcohol, drug, gambling and cross addic�ons. Service and treatment op�ons include:  Inpa�ent and outpa�ent treatment op�ons  Family counseling  OWI, DHS, school and MANNING FAMILY court ordered evalua�ons RECOVERYCENTER . Call today to learn more or 1550 6th Street, Manning talk with a cer�ed (712) 655‐2072 counselor, (712) 655‐2072. www.mrhcia.com

A SPECIAL SECTION OF THE DENISON BULLETIN AND DENISON REVIEW | Friday, January 23, 2015

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Avoiding Drug Abuse

January 23, 2015

Recovery from substance abuse a matter of abstinence and change

Dr AlTo (Drug, Alcohol & Tobacco) Coalition has placed a message on this billboard on Highway 30 in Denison near Kum & Go. The billboard can be seen while traveling east on the highway. Photo by Bruce A. Binning

Dr AlTo helps reduce use of drugs, alcohol and tobacco through public education Crawford County’s Drug, Alcohol &Tobacco (Dr AlTo) Coalition was established in 2005 after a community survey showed drug, alcohol and tobacco use and abuse to be the second highest concern for those that responded to the survey. Child abuse and domestic violence ranked first in the survey, which could also be a result of drug and alcohol use and abuse. Dr AlTo’s mission is to help reduce the use of drugs, alcohol and tobacco through public education and awareness initiatives and to assist in making Crawford County a healthier and safer community. Situations involving child abuse and domestic

violence often have drug and alcohol abuse associated with it as well. Dr AlTo is working towards increasing the awareness of the effects and consequences of the use and abuse of drugs, alcohol and tobacco. The Coalition’s goal is to increase the accessibility of resources to the schools and community organizations working with youth in Crawford County. Ultimately, Dr AlTo wants to collaborate with community partners to educate the youth in Crawford County and is attempting to bring people and resources together to better serve the community. Last year, Dr AlTo’s

focus was on helping to getting the word out regarding the newly passed Crawford County Social Host Ordinance. A social host is an adult, age 21 or over, who provides a location for minors to consume alcohol. The Social Host Ordinance will subject a first-time offense fine of $750, whether on or off the premises. Subsequent charges will carry a fine of $1,000. Crawford County may seek reimbursement for enforcement services provided by emergency responders related to the event in which case restitution would be required. The Dr AlTo billboard regarding “Parents Who

Talk to your children today about the dangers of drugs and alcohol.

DENISON COMMUNITY SCHOOL 819 North 16th Street Denison, IA 51442 712-263-3101

Host, Lose The Most” has been in place for over a year on Highway 30 by Kum & Go. “Parents Who Host, Lose the Most: Don’t be a party to teenage drinking” strives to create consistent parental and community norms that underage drinking is not only illegal, but is unsafe, unhealthy and unacceptable. By increasing parental awareness and understanding of the health, safety and legal consequences of allowing underage drinking, this effort helps reduce the number of parents who allow underage drinking on their premises and property, which decreases underage access to alcohol. Dr AlTo regularly par-

ticipates in events, such as the Denison homecoming parade, Denison freshmen orientation, 7th Grade Ag Days and at health fairs, and provides speakers to local schools. Funding to assist with these activities has come through grants obtained from Community Partners for Protecting Children (CPPC), which come down locally through the Iowa Department of Human Services Decategorzation initiative. For more information or to become a member of the Dr AlTo Coalition, call Crawford County Home Health, Hospice & Public Health at 712-263-3303 or stop by the office at 105 North Main in Denison.

Many people view alcohol/substance abuse as an acute condition that can be effectively treated with short-term detoxification. The truth of the matter is that addiction does not end just because the drug is removed from the body (detoxification) or when the acute post-drinking/drugging illness (withdrawal) ends. Instead, the underlying addictive disorder persists, and this persistence invites relapses. But when substance abuse is viewed as a chronic disorder, it brings the realization and expectation that recovery is a matter of both abstinence and change. Talking therapy, when combined with a commitment on the part of the patient to change, helps to identify the factors that contribute to addiction and modify them. If you are wrestling with addiction to a substance, it’s vital that you get the help you need. We know how addiction can touch every aspect of your life and the lives of your loved ones. It’s a damaging and corrosive thing, and you need to deal with this chronic disorder. The compassionate counselors at Plains Area Mental Health understand how complex and difficult this problem can be, and we can provide a safe space for you to talk and proven techniques that can help. In addition to help with addiction, we can provide relief for those dealing with anxiety, grief, or depression. A drug- or alcoholaddicted individual must commit to treatment for internal reasons if he or she is to have a chance of recovery.

January 23, 2015

Avoiding Drug Abuse

Page 3

Parents’ influence important in preventing teen use of alcohol and drugs Adolescence is an exciting time for both the child and the parent, but it is also a time that is characterized by change and stress. Being a teenager or being a parent of a teenager is not always easy. Teens are trying to develop their independence and identity. Fitting in and being accepted is very important. Mood swings are not uncommon. Several factors can lead to impulsivity and poor decision making. Poor decisions can provide opportunity for tremendous learning, yet some result in death or change the trajectory of the teen’s life. Alcohol use and/or drug use are two examples of poor decisions that can have devastating permanent consequences. Parents are responsible for the safety and well-being of their teen and often ask, “What can I do to prevent my kid from using alcohol or drugs?” At Jackson Recovery Centers, our

signs of substance abuse. Additionally, it is helpful to know that alcohol is the most commonly used substance amongst teens, followed by marijuana. Again, knowing what to look for may allow for early intervention, thus avoiding devastating consequences associated with substance abuse. Early signs of substance abuse: • Change in friends • Withdrawal from activities • Decline in academic performance, truancy, etc. • Change in personality, attitude or increased irritability or mood swings • Changes in appetite or sleep patterns • Unexplained need for money or money missing in the home • Change in physical appearance, i.e.: neglect in hygiene Specific signs of substance abuse: • Smell of alcohol, marijuana or tobacco • Legal problem related

response is “A lot!” First, parents need to recognize they still have the ability to influence their teenager. Teens need to know alcohol and drug use will not be tolerated. Parents must be role models for appropriate behavior, and if they drink alcohol, do so responsibly. Rules, expectations and the consistent delivery of consequences that are related to the rule violation are necessary. In addition, parents need to spend quality time with their teen on a regular basis and ask them about their day, week, world, etc. When possible, eat together as a family. Get to know your teen’s friends and their parents. If you are aware that your teen has used alcohol or drugs, it is important to immediately address the issue. Research has shown that the younger one first uses, the higher the chance of developing an addiction to drugs or alcohol. Early intervention depends on being able to identify the

Dr AlTo’s mission is to help reduce the use of drugs, alcohol and tobacco through public awareness initiatives.

to alcohol or drugs, i.e. Minor in Possession Charge • Finding drug paraphernalia, i.e. glass pipe or lighter • Red eyes, constricted or dilated pupils If you notice any of these signs, it’s time to talk to your teen and a professional. When talking to your teen, use a non-confrontational manner, otherwise they’ll cut off all or honest effective communication. Seek the help of a professional. Most teens use drugs and alcohol to escape something. It’s important to identify what is causing the use and address that issue. Jackson Recovery Centers is available to help you. Call 712-234-2300 for help. Remember, early intervention can prevent the chronic life-threatening disease of addiction. At Jackson, we provide a wide range of services from prevention to residential treatment.

YOU Can Help ... Here’s How

Social Host ordinance • Definition of a Social Host: Crawford County

adult, age 21 and over, who provides a location for minors to consume alcohol. • The Social Host Ordinance will subject a ﬁrst time offense fine of $750, whether on or off the premises. • Subsequent charges will carry a $1,000 ﬁne. • Crawford County may also seek reimbursement for enforcement services provided by emergency responders related to the event in which case restitution would be required.“

•Keep your child active. Students that have a goal they are working toward in life or are busy with sports or music are much less likely to get involved with drugs.

•Help provide drug and alcohol free places for kids to gather and socialize.

•Let them know there IS help! Such as Quitline Iowa for quitting tobacco: 1.800.QUITNOW.

cohol

bacco Crawford County Drug, Alcohol & Tobacco Coalition

•Teach children positive values (i.e. sex, violence and honesty) and help them to build VHOIFRQÀGHQFH

•Talk to your child about drugs, and do it early. An ongoing dialog is the best way for your teen to know that you have an understanding of the temptations they face, and are going to do what you can to help them.

DrAlTo “Those who host ... Lose the most!”

Spending time with your teen on a regular basis and asking them about their day can help lessen the chance that he or she will turn to drugs.

Healthy Choices, Healthy Kids

Dr AlTo...Contact Crawford County Public Health at 712-263-3303 or email: cchha@frontiernet.net for more information

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Avoiding Drug Abuse

January 23, 2015

Quitline Iowa offers free Make 2015 services for smoking cessation the year Quitline Iowa offers free telephone and online service to Iowa residents 14 years of age and over. The service connects callers with expert coaches that assist callers with overcoming common barriers, such as dealing with stress, fighting cravings, coping with irritability and controlling weight gain. Those over 18 who enroll can be eligible for up to eight weeks of free nicotine replacement therapy, ie., patches, gum or lozenges. Individuals can access Quitline Iowa by calling the 1-800 QUIT NOW number or by logging onto www.quitlineiowa.org. Quitline Iowa’s telephone service is available 24 hours a day, seven days a week. Services are available to callers in English and Spanish. Translation services are available in 200 other languages. Out-ofstate callers who phone 1-800-784-8669 will be directed to the state in which they live. The Quitline Iowa website (http://www.tobaccofreeqc.org/quitting/ quitline-iowa/) offers the following myths and facts about tobacco. Myth: Tobacco is not a drug. Fact: The nicotine found in tobacco products is very addictive. Addiction to nicotine has been compared to having an addiction to cocaine or heroin.

you quit

Myth: Only adults smoke cigarettes and they’re old enough to know what they are doing. Fact: The average age a person begins smoking is 13. The average person begins using smokeless or spit tobacco at 12 to 25 years. Most new tobacco users are adolescents, not adults. Myth: Once you are addicted to tobacco, it doesn’t matter whether you quit or not. The damage is already done. Fact: When a person quits smoking/dipping the body immediately starts repairing itself. Blood pressure and

pulse rates go back to normal range after 20 minutes of not using tobacco. Nerve endings start growing back and lung function improves after one week of not smoking. After 10 to 15 years of not smoking, risks of all tobacco-related diseases are greatly reduced. Myth: Smoking helps me to relax/relieve stress. Fact: Nicotine is a stimulant. Stimulants speed up your body; they do not calm your body down. Plus, no other drug keeps a user as busy as smoking. For instance, a two-packa-day cigarette smoker spends three to four hours

a day with a cigarette in his/her mouth, hand or ashtray. (Remember that there are many positive ways to relax without smoking.) More facts A person can become addicted after just a few days of using tobacco. Carbonated drinks, coffee and alcohol can increase your craving for tobacco. It takes most people five to 10 tries before they can successfully stop smoking once they start. Withdrawal from nicotine can cause symptoms of irritability, insomnia, and nervousness.

The Iowa Department of Public Health is encouraging those who smoke to make a resolution to stop in 2015. Some resolutions are quickly forgotten or abandoned after the first temptation. For Iowans who smoke, giving up tobacco may be the hardest, yet most rewarding resolution they will ever make. According to the 2013 Iowa Behavioral Risk Factor Survey System (BRFSS), one in five adult Iowans (450,000 or 20 percent) smokes cigarettes. Of the 28,000 deaths in Iowa each year, 4,400 (16 percent) are caused by cardiovascular disease, chronic lung disease, and cancer related to smoking. Almost 75 percent of all Iowa adult cigarette smokers smoke every day and almost one-third smoke one or more packs per day. Encouragingly, almost half of smokers want to quit and more than half (56 percent) try to quit each year. Between five percent and 15 percent succeed and become former smokers. It is clear ending the addiction to tobacco is difficult, but possible. Research has shown a smoker is more likely to be successful in their quit attempt if they have a support system that includes family, friends and experts to help with advice and information about managing withdrawal symptoms. Quitline Iowa pairs tobacco users with a Quit Coach to help them develop an individualized quitting plan and determine which nicotine replacement therapy (NRT) offering is best to help them stay tobacco-free. Any participant over the age of 18 who enrolls could be eligible for eight weeks of free NRT, including patches, gum or lozenges. A Quit Coach also helps by: Preparing participants for their quit date Providing tips and support to live in a smoke-free environment Offering advice and information on medications that may help with withdrawal symptoms Tobacco users can call 1-800-QUIT-NOW (1-800-7848669) or visit www.quitlineiowa.org to enroll in the program and talk to a Quit Coach. Coaches understand the challenges of ending tobacco addiction and are committed to helping tobacco users begin and maintain their resolution to live a tobacco-free life. Registration specialists and Quit Coaches are available 24 hours a day.

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Crawford County Drug, Alcohol & Tobacco Coalition is on a mission to help reduce the use and abuse of drugs, alcohol and tobacco through public education and awareness initiatives. Ultimately the goal is to collaborate with community partners to educate the youth in Crawford County and bring people and resources together.

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Drug and Alcohol Abuse Matters to Everyone!

Walmart supports the Crawford County Drug/Alcohol/Tobacco Coalition program on substance abuse to educate children and teens on the dangers of drugs, alcohol and tobacco. DMU is proud to support the Crawford County Drug, Alcohol & Tobacco coalition in its effort to prevent drug and alcohol abuse in the Denison Community.

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January 23, 2015

Avoiding Drug Abuse

CDC report says alcohol poisoning kills six people in the U.S. each day More than 2,200 people die from alcohol poisoning each year in the United States, an average of six deaths each day, according to a new Vital Signs report from the Centers for Disease Control (CDC) and Prevention. Three in four alcohol poisoning deaths involve adults ages 35 to 64 years, and most deaths occur among men and nonHispanic whites. American Indians/Alaska Natives have the most alcohol poisoning deaths per million people. Alcohol poisoning deaths are caused by drinking a large amount of alcohol in a short period of time. This can result in very high levels of alcohol in the body, which can shut down critical areas of the brain that control breathing, heart rate, and body temperature, resulting in death. More than 38 million U.S. adults report binge drinking an average of four times per month and consume an average of eight drinks per binge. Binge drinking is defined as consuming four or more drinks for women and five or more drinks for men on an occasion. The more you drink, the greater your risk of death. “Alcohol poisoning deaths are a heartbreaking reminder of the dangers of excessive alcohol use, which is a leading cause of preventable deaths in the United States,” said CDC Principal Deputy Director Ileana Arias, Ph.D. “We need to implement effective programs and policies to prevent binge drinking and the many health and social harms that are related to it, including deaths from alcohol poisoning.” Alcohol poisoning death rates varied widely across states, from 46.5 deaths per million residents in Alaska to 5.3 per

million residents in Alabama. The states with the highest death rates were in the Great Plains, western United States and New England. CDC scientists analyzed deaths from alcohol poisoning among people aged 15 years and older, using multiple cause-ofdeath data from the National Vital Statistics System for 2010 to 2012. Alcohol dependence (alcoholism) was identified as a contributing factor in 30 percent of these deaths, and other drugs were noted to have been a factor in about three percent of the deaths. While this study reveals that alcohol poisoning deaths are a bigger problem than previously thought, it is still likely to be an underestimate. “This study shows that alcohol poisoning deaths are not just a problem among young people,” said CDC Alcohol Program Lead and report coauthor Robert Brewer, M.D., M.S.P.H. “It also emphasizes the importance of taking a comprehensive approach to reducing binge drinking that includes evidence-based community strategies, screening and counseling in healthcare settings, and high-quality substance abuse treatment for those who need it.” Vital Signs is a report that appears each month as part of the CDC journal, Morbidity and Mortality Weekly Report. The report provides the latest data and information on key health indicators. These are cancer prevention, obesity, tobacco use, motor vehicle passenger safety, prescription drug overdose, HIV/AIDS, alcohol use, health care-associated infections, cardiovascular health, teen pregnancy, food safety, and viral hepatitis.

Page 5

NIH study reveals many Americans at risk for alcoholmedication interactions Nearly 42 percent of U.S. adults who drink also report using medications known to interact with alcohol, based on a study from the National Institutes of Health (NIH) released on January 16. Among those over 65 years of age who drink alcohol, nearly 78 percent report using alcohol-interactive medications. Such medications are widely used, prescribed for common conditions such as depression, diabetes and high blood pressure. The research is among the first to estimate the proportion of adult drinkers in the United States who may be mixing alcohol-interactive medications with alcohol. The resulting health effects can range from mild (nausea, headaches, loss of coordination) to severe (internal bleeding, heart problems, difficulty breathing). “Combining alcohol with medications often carries the potential for serious health risks,” said Dr. George Koob, director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of NIH. “Based on this study, many individuals may be mixing alcohol with interactive medications and they should be aware of the possible harms.” The study, led by Dr. Rosalind Breslow, Ph.D., appears in the February 2015 issue of Alcoholism: Clinical and Experimental Research, now online at the journal’s website. “Our findings show that a substantial percentage of people who drink regularly, particularly older adults, could be at risk of harmful alcohol and medication interactions,” said Dr. Breslow, an epidemiologist in NIAAA’s Division of Epidemiology and Prevention Research.

“We suggest that people talk to their doctor or pharmacist about whether they should avoid alcohol while taking their prescribed medications.” Older adults are at particular risk of experiencing alcohol-medication interactions. Not only are they more likely to be taking medications in general, but certain alcohol-interactive medications, such as diazepam (Valium), are metabolized more slowly as one ages, creating a larger window for potential interactions. The researchers analyzed data from more than 26,000 adults ages 20 and older who participated in the National Health and Nutrition Examination Survey (1999-2010). The survey asks participants about alcohol use in the past year and prescription drug use in the past month. Dr. Breslow said that the results of the study indicate potential (rather than actual) rates, because the researchers could not confirm whether drinking and medication use overlapped based on the available data. However, it is likely that those who drink regularly and take medication regularly are doing so in a similar time frame. The main types of alcohol-interactive medications reported in the survey were blood pressure medications, sleeping pills, pain medications, muscle relaxers, diabetes and cholesterol medications, antidepressants and antipsychotics. Based on recent estimates, about 71 percent of U.S. adults drink alcohol. For more on alcohol-medication interactions, see an NIAAA fact sheet at http://pubs.niaaa.nih.gov/publications/ Medicine/medicine.htm.

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Avoiding Drug Abuse

January 23, 2015

Use of alcohol and a number of illicit drugs declines among U.S. teens % seeing "great risk" in having 5+ drinks in a row once or twice each weekend

100

8th Grade 10th Grade 12th Grade

PERCENT

Illicit drugs A number of measures of illicit drug use showed declines in use in 2014. The greatest decline was in students’ use of synthetic marijuana, a particularly dangerous class of abusable substance. Synthetic marijuana (K-2, “Spice”), sold over the counter in many state, particularly in gas stations, convenience stores and head shop, has synthetic chemical components of marijuana sprayed onto shredded plant material that is then smoked. It is manufactured and sold in an unregulated system, often being imported from overseas, and it can be very potent and unpredictable in its effects. Side effects are many and are reported to be as severe as acute psychosis and heart attacks. “Most students still do not recognize synthetic marijuana as a dangerous class of drugs, although the proportion of 12th graders reporting it as dangerous to use did rise significantly in

Risk

Use*

% who used in last 30 days

0 '74 '76

'78 '80 '82 '84 '86

'88 '90 '92 '94 '96 '98

'00 '02 '04 '06 '08

'10 '12 '14

'74 '76 '78 '80 '82 '84 '86 '88 '90 '92 '94 '96 '98 '00 '02 '04 '06 '08 '10 '12 '14

YEAR

Disapproval

Availability

% disapproving of having 5+ drinks in a row once or twice each weekend

% saying "fairly easy" or "very easy" to get

100

PERCENT

Alcohol use Alcohol use by the nation’s teens continued its long-term decline in 2014. All three grades showed a decline in the proportion of students reporting any alcohol use in the 12 months prior to the survey. The three grades combined dropped from 43 percent to 41 percent, a statistically significant change. “Since the recent peak rate of 61 percent in 1997, there has been a fairly steady downward march in alcohol use among adolescents,” said Lloyd Johnston, the study’s principal investigator. “The proportion of teens reporting any alcohol use in the prior year has fallen by about a third.” Of perhaps greater importance, the proportion of teens who report “binge drinking,” consuming five or more drinks in a row at least once in the two weeks preceding the survey, fell significantly again in 2014 to 12 percent for the three grades combined. The statistic is down from a high point of 22 percent in 1997.

FIGURE 1 Alcohol: Trends in 30-Day Use, Risk, Disapproval, and Availability Grades 8, 10, and 12

PERCENT

A national survey of students in U.S. middle schools and high schools shows some important improvements in levels of substance use. Both alcohol and cigarette use in 2014 are at their lowest points since the study began in 1975. Use of a number of illicit drugs also showed declines in 2014, according to the University of Michigan’s Monitoring the Future study. The study tracks trends in substance use among students in 8th, 10th and 12th grades. The national study surveys 40,000 to 50,000 students in about 400 secondary schools throughout the United States. It has been conducted for 40 years.

The investigators said this is an important improvement but pointed out that roughly one in five (19 percent) 12th graders report binge drinking at least once in the two weeks prior to the survey. Some 12th graders drink even more heavily, reporting having 10 or more, or 15 or more, drinks in a row on at least one occasion in two weeks prior to the survey. Since 2005, the first year that “extreme binge drinking” was included in the study, these measures also have declined, from 11 percent to seven percent in 2014 for 10 or more drinks, and from six percent to four percent for 15 or more drinks. Peer disapproval of binge drinking has been rising since 2000 among teens. Declines in availability may be another contributing factor to the drops in teen drinking.

PERCENT

However, problems of substance use and abuse still far from going away

0 '74 '76

'78 '80 '82 '84 '86

'88 '90 '92 '94 '96 '98

'00 '02 '04 '06 '08

'10 '12 '14

YEAR

'74 '76 '78 '80 '82 '84 '86 '88 '90 '92 '94 '96 '98 '00 '02 '04 '06 '08 '10 '12 '14

YEAR

Source. The Monitoring the Future study, the University of Michigan. *Beginning in 1993, a revised set of questions on alcohol use was introduced, in which a drink was defined as "more than just a few sips."

2014,” Johnston said. “Efforts at the federal and state levels to close down the sale of these substances may be having an effect.” The proportion of 12th graders reporting use of synthetic marijuana in the 12 months prior to the survey fell by nearly half. It was 11 percent when first included in the survey in 2011 and was down to six percent in 2014. “Bath Salts,” another class of synthetic drugs sold over-the-counter and of particular concern a few years ago, also have declined in use, with the percentages of students in all three grades now down to less than one percent. “Fortunately, students have come to see these synthetic stimulants as more dangerous, which they are, and that appears to have limited their use,” Johnston said. Marijuana use, after five years of increasing among teens, actually declined slightly in 2014, with use in the prior 12 months declining from 26 percent to 24 percent for the three grades combined. “The belief that regular marijuana use harms the user, however, continues to fall among youth, so chang-

es in this belief do not seem to explain the change in use this year, as it has done over most of the life of the study,” Johnston said. Personal disapproval of use is also down some in 8th and 12th grades. Reported availability, on the other hand, is down significantly since 2013 in the two lower grades (and unchanged in 12th grade), which may help to explain the modest decline in use this year. An index of using any illicit drug other than marijuana in the prior 12 months declined by 1.9 percent (not a statistically significant change) to 15.9 percent in 12th grade; but in 8th and 10th grades the prevalence was virtually unchanged and stood at 6.4 percent and 11.2 percent, respectively. Ecstasy (MDMA) use showed a statistically significant decline in 2014. For the three grades, combined use in the prior 12 months dropped from 2.8 percent in 2013 to 2.2 percent in 2014. In 2001, the peak year of use, the rate had reached six percent. Salvia, another drug used for its hallucinogenic properties, has fallen to quite low levels of use, and it continued to fall significantly in

2014. For example, it was used in the prior 12 months by 5.7 percent of the 12th graders in 2009, but by less than two percent in 2014. Use of hallucinogens other than LSD, which, for the most part involves the ingestion of hallucinogenic mushrooms (Psilocybin or “shrooms”), is continuing a longer-term decline. Availability of these drugs has been falling since 2001 and continued to decline in 2014. Any prescription drug misuse includes use of narcotics, sedatives, tranquilizers, and/or amphetamines without medical supervision. It has been of considerable public health concern in recent years, because most of these drugs showed a substantial increase in use in the 1990s, which then continued into the first decade of the 2000s, when many of the illegal drugs already were in decline. Only 12th graders report on their use of all of these drugs; they show a statistically significant decline between 2013 and 2014, from 16 percent to 14 percent, saying that they used one or more of these prescription drugs in the 12 months prior to the survey. The gradual turnaround began after 2005, when 17 percent indicated misuse of any of these drugs. Narcotic drugs other than heroin, among the most dangerous of the prescription drug, have been declining in use by 12th graders since 2009, when nine percent indicated using them without medical supervision in the prior 12 months. Their use continued to drop significantly, from seven percent in 2013 to six percent in 2014. Use of these drugs is reported only for 12th grade; students are reporting that these drugs are increasingly difficult to obtain. Use in the prior 12 months of the specific narcotic analgesic OxyContin also declined in 2014, significantly so in 8th grade.

OxyContin use reached a recent peak among adolescents around 2009 and use has declined since then in all three grades. The 2014 reports of use in the past 12 months stand at 1.0 percent, 3.0 percent and 3.3 percent in grades 8, 10 and 12, respectively. Cough and cold medicines constitute a class of drugs available over-thecounter in most drug stores. These medicines usually contain the drug dextromethorphan which, when taken in large quantities, as teens sometimes do to get high, can be dangerous. Abuse of these drugs has been falling among teens since 2006 and declined significantly again in 2014, with annual prevalence declining from 4.0 percent to 3.2 percent for the three grades combined. Use of a number of the other illicit drugs remained essentially unchanged between 2013 and 2014, including some particularly dangerous ones like heroin, crack, methamphetamine and crystal methamphetamine. Other drugs for which use remained unchanged in 2014 include Ritalin and Adderall, both stimulants used in the treatment of ADHD, as well as LSD, inhalants, powder cocaine, tranquilizers, sedatives and anabolic steroids. However, most of these drugs are now well below their recent peak levels of use according to the investigators. “In sum, there is a lot of good news in this year’s results, but the problems of teen substance use and abuse are still far from going away,” Johnston said. “We see a cyclical pattern in the 40 years of observations made with this study. When things are much improved is when the country is most likely to take its eye off the ball, as happened in the early 1990s, and fail to deter the incoming generation of young people from using drugs, including new drugs that inevitably come along.”

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January 23, 2015

Avoiding Drug Abuse

Page 7

E-cigarettes surpass tobacco cigarettes among teens FIGURE 1 Cigarettes: Trends in 30-Day Use, Risk, Disapproval, and Availability Grades 8, 10, and 12 Risk

Use

% seeing "great risk" in smoking a pack or more per day

% who used in last 30 days 100

100

8th Grade 10th Grade 12th Grade

PERCENT

0 '74 '76

'78 '80 '82 '84 '86

'88 '90 '92 '94 '96 '98

'00 '02 '04 '06 '08

'10 '12 '14

'74 '76

'78 '80 '82 '84 '86

YEAR

'88 '90 '92 '94 '96 '98

'00 '02 '04 '06 '08

'10 '12 '14

YEAR

Disapproval

Availability

% disapproving of smoking a pack or more per day

% saying "fairly easy" or "very easy" to get

100

PERCENT

cigarette • 16 percent of 10th graders reported using an ecigarette • 7 percent of 10th graders reported using a tobacco cigarette • 17 percent of 12th graders reported using an ecigarette • 14 percent of 12th graders reported use of a tobacco cigarette The older teens report less difference in use of ecigarettes versus tobacco cigarettes. “This could be a result of e-cigarettes being relatively new,” said Lloyd Johnston, principal investigator of the project. “So today’s 12th graders may not have had the opportunity to begin using them when they were younger. Future surveys should be able to tell us if that is the case.” E-cigarettes are batterypowered devices with a heating element. They produce an aerosol, or vapor, that users inhale. Typically, this vapor contains nicotine, although the specific contents of the vapor are proprietary and are not regulated. The liquid that is vaporized in e-cigarettes comes in hundreds of flavors. Some of these flavors, such as bubble gum and

PERCENT

In 2014, more teens use e-cigarettes than traditional, tobacco cigarettes or any other tobacco product, the first time a U.S. national study shows that teen use of e-cigarettes surpasses use of tobacco cigarettes. The findings come from the University of Michigan’s Monitoring the Future study, which tracks trends in substance use among students in 8th, 10th and 12th grades. Each year, the national study, now in its 40th year, surveys 40,000 to 50,000 students in about 400 secondary schools throughout the United States. “As one of the newest smoking-type products in recent years, e-cigarettes have made rapid inroads into the lives of American adolescents,” said Richard Miech, a senior investigator of the study. The survey asked students whether they had used an e-cigarette or a tobacco cigarette in the past 30 days. More than twice as many 8th- and 10thgraders reported using e-cigarettes as reported using tobacco cigarettes. • 9 percent of 8th graders reported using an e-cigarette • 4 percent of 8th graders reported using a tobacco

0 '74 '76

'78 '80 '82 '84 '86

'88 '90 '92 '94 '96 '98

'00 '02 '04 '06 '08

'10 '12 '14

YEAR

'74 '76

'78 '80 '82 '84 '86

'88 '90 '92 '94 '96 '98

'00 '02 '04 '06 '08

'10 '12 '14

YEAR

Source. The Monitoring the Future study, the University of Michigan.

milk chocolate cream, are likely attractive to younger teens. E-cigarettes may serve as a point of entry into the use of nicotine, an addictive drug. The percentages of past 30-day ecigarette users who have never smoked a tobacco cigarette in their life range from four percent to seven percent in 8th, 10th and 12th grades. For these youth, ecigarettes are a primary source of nicotine and not a supplement to tobacco cigarette use. Whether youth who use e-ciga-

rettes exclusively later go on to become tobacco cigarette smokers is yet to be determined by this study,

Of particular concern is the possibility that ecigarettes may lead to tobacco cigarette smoking, and reverse this hard-won, long-term decline. “Part of the reason for the popularity of e-cigarettes is the perception among teens that they do not harm health,” Miech said. Only 15 percent of 8thgraders think there is a great risk of people harming themselves with regular use of e-cigarettes. This compares to 62 percent of 8th-graders who think there is a great risk of people harming themselves by smoking one or more packs of tobacco cigarettes a day. Because e-cigarettes are relatively new, a comprehensive assessment of their health impact, especially their long-term consequences, has yet to be developed.

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and is of substantial concern to the public health community. E-cigarette use among youth offsets a long-term decline in the use of tobacco cigarettes, which is at a historic low in the life of the study. In 2014, the prevalence of smoking tobacco cigarettes in the past 30 days was eight percent for students in 8th, 10th and 12th grades combined. This is a significant decline from 10 percent in 2013, and is less than a third of the most recent high of 28 percent in 1998. One important cause of the decline in smoking is that many fewer young people today have ever started to smoke tobacco cigarettes. In 2014, only 23 percent of students had ever tried tobacco cigarettes, as compared to 56 percent in 1998.

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Avoiding Drug Abuse

National Drug Facts Week uses science to dispel myths National Drug Facts Week was launched in 2010 by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, to counteract myths teens receive from the internet, television, movies, music or from friends. NIDA scientists encourage events in communities so teens can learn what science teaches about drug abuse and addiction. National Drugs Facts Week in 2015 will take place January 26 through February 1. The week is celebrated as many teens are not aware of the risks posed to their health, their success in school and the dangers while driving under the influence, according to information from NIDA. NIDA says about one-third of high school seniors reported using an illicit drug in the past year, more than 10 percent reported the non-medical use of a potentially addictive prescription painkiller and more than 20 percent reported smoking marijuana in the

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past month. NIDA hopes that when teens are given the scientific facts about drugs, they will be better prepared to make good decisions and will share the information with others. Those who do not plan an event for National Drug Facts Week can still help promote the effort by becoming a partner with NIDA, by giving National Drug Facts Week a shout out on social media or by using National Drug Facts Week brochures and posters to help spread the word. Brochures and posters can be found at http://teens. drugabuse.gov/nationaldrug-facts-week/order-

free-materials. During National Drug Facts Week and throughout the year, teens can test their knowledge about drugs and drug abuse by taking the interactive National Drug IQ Challenge quiz, which can be found at http://teens.drugabuse. gov/quiz/national-drugfacts-week/take-iq-challenge/2014. A new challenge is posted annually during National Drug Facts Week. More information can be found by logging onto http://teens.drugabuse. gov/national-drug-factsweek or by calling 301443-1124.

2011. Visits among those age 18 to 20 increased fourfold, from 1,881 visits in 2010 to 8,212 visits in 2011. In 2011, males accounted for nearly 79 percent (19,923 visits) of all emergency department synthetic cannabinoid-related visits. A threefold increase occurred between 2010 and 2011, however, in the level of emergency department visits involving females using synthetic cannabinoids. Reported adverse effects of synthetic cannabinoids include severe agitation, anxiety, nausea vomiting, racing heartbeat, elevated blood pressure, tremors, seizures, hallucinations, paranoid behavior, unresponsiveness and even death. Regular use of the drug can result in withdrawal symptoms. “Synthetic cannabinoids are a growing public health risk, made even more dangerous by the widespread misconception that they are safe and legal,” said SAMHSA Administrator Pamela S. Hyde. “These injury reports compel us to

get the word out to all segments of the community, especially youth, that these products can cause significant harm.” In July 2012, The Synthetic Drug Prevention Act of 2012 was enacted. It specifically prohibited the sale or possession of some synthetic cannabinoids. The U.S Drug Enforcement Administration and nearly all the states have also taken some regulatory action against these products once they have been identified. However, manufacturers of these compounds continue to modify their chemical structures in an attempt to evade current laws. The report, “Drug-Related Emergency Department Visits Involving Synthetic Cannabinoids,” is based on data drawn from SAMHSA’s Drug Abuse Warning Network, a public health surveillance system that monitored drug-related morbidity and mortality. The full report can be viewed at: http://www. samhsa.gov/data/sites/ default/files/SR-1378/SR1378.pdf.

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Emergency department visits linked to “synthetic marijuana” products rise From 2010 to 2011 the number of emergency department visits involving synthetic cannabinoids, so-called “synthetic marijuana”, more than doubled. Visits rose from 11,406 in 2010 to 28,531 in 2011, according to a report released October 16, 2014, by the Substance Abuse and Mental Health Services Administration (SAMHSA). Overall, there were 1.2 million emergency department visits in 2011 related to illicit drugs. Synthetic cannabinoids are substances that are not derived from the marijuana plant but purport to have the same effect as marijuana. The synthetic cannabinoids are known by such street names as “K2” or “Spice,” and contain varying amounts of different ingredients, including contaminants that can result in the products having unpredictable effects on users. Emergency department visit involving adolescents (ages 12 to 17), who used synthetic cannabinoids doubled from 3,780 visits in 2010 to 7,584 visits in

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