University of Washington study: Heroin use among young suburban and rural non-traditional users on the increase

13 Oct

Tina Patel of Q13 Fox News reported in the story, The New Face of Heroin Part 1: Much younger suburban, rural teens:

The trouble, according to the research, begins in high school when most kids start experimenting with prescription drugs from somebody’s family medicine cabinet.
Joelle Puccio, the women’s director at the needle exchange, saw that herself.
“So many kids I knew growing up as a teenager were doing OxyContin and Percocet,” she said. “And they were like, ‘It’s safe, they’re prescription, it’s fine.’ ”
The problem arises when those kids become addicted. Then, you need more and more to get the same experience, and now that drugs like OxyContin and Percocet are harder to get, many young people are turning to heroin.
“It’s very logical — if you look at a molecule of OxyCodone and a molecule of heroin, they’re virtually identical,” Banta-Green said. “The brain sees them as identical.”
Heroin is cheaper, which also makes it attractive to young people. Some said they can get high for as little as $5. But it’s a lot more dangerous, and Banta-Green said you can never be sure of what you’re buying and the risk of overdose is extreme.
“You have no idea what’s in it, you have no idea the purity is. It could be 5 percent, it could be 30 percent. It’s very hard to say this much is going to get me high, this much is going to kill me.”
“A lot of the kids coming up are wildly uninformed about what the drugs are, how they work, what to do in an overdose, safe injection practices,” Puccio said. “Because these are kids that didn’t necessarily grow up in the drug-using culture, they were sort of shoved there from the middle class, and you don’t really learn about that kind of thing in the normal middle-class upbringing.”
The best-case scenario is to keep kids away from the drugs in the first place.
“We have a young group who needs to not get exposed to opiates, that’s really important,” Banta-Green said.
His advice is to not leave old pain medication around the house, and to make sure children understand the dangers involved with taking prescription drugs.
As for the people who are already involved with narcotics, treatment programs can work… http://q13fox.com/2013/10/10/needle-exchange-sees-change-in-heroin-users/#ixzz2hY5gm8SC

See, Close Up September 2013: Caleb Banta-Green http://sph.washington.edu/news/closeup/profile.asp?content_ID=2140

What is Substance Abuse?

HELPGUIDE.ORG defines substance abuse and also describes some of the traits of a substance abuser.

Drug abuse, also known as substance abuse, involves the repeated and excessive use of chemical substances to achieve a certain effect. These substances may be “street” or “illicit” drugs, illegal due to their high potential for addiction and abuse. They also may be drugs obtained with a prescription, used for pleasure rather than for medical reasons.
Different drugs have different effects. Some, such as cocaine or methamphetamine, may produce an intense “rush” and initial feelings of boundless energy. Others, such as heroin, benzodiazepines or the prescription oxycontin, may produce excessive feelings of relaxation and calm. What most drugs have in common, though, is overstimulation of the pleasure center of the brain. With time, the brain’s chemistry is actually altered to the point where not having the drug becomes extremely uncomfortable and even painful. This compelling urge to use, addiction, becomes more and more powerful, disrupting work, relationships, and health. http://helpguide.org/mental/drug_substance_abuse_addiction_signs_effects_treatment.htm

Although, the focus of this article is children and teens who abuse various substances, there is a widespread problem with their parents and caretakers. A recent report found that many children live with parents who are substance abusers.

Almost 12 percent of children in the United States live with a parent who has a substance abuse problem, says a federal government study released this week.
Living in this type of home environment can cause long-lasting mental and physical health problems, according to the U.S. Substance Abuse and Mental Health Services Administration, which did the study.
The analysis of national data from 2002 to 2007 also showed that:
• Almost 7.3 million youths lived with a parent who was dependent on or abused alcohol
• About 2.1 million children lived with a parent who was dependent on or abused illicit drugs
• About 5.4 million children lived with a father who met the criteria for past-year substance dependence or abuse
• About 3.4 million children lived with a mother who met these criteria http://www.mentalhelp.net/poc/view_doc.php?type=news&id=118688&cn=28

Often children who evidence signs of a substance abuse problem come from homes where there is a substance abuse problem. That problem may be generational.

eMedicineHealth lists some of the causes of substance abuse:

Substance Abuse Causes
Use and abuse of substances such as cigarettes, alcohol, and illegal drugs may begin in childhood or the teen years. Certain risk factors may increase someone’s likelihood to abuse substances.
Factors within a family that influence a child’s early development have been shown to be related to increased risk of drug abuse.
• Chaotic home environment
• Ineffective parenting
• Lack of nurturing and parental attachment
Factors related to a child’s socialization outside the family may also increase risk of drug abuse.
• Inappropriately aggressive or shy behavior in the classroom
• Poor social coping skills
• Poor school performance
• Association with a deviant peer group
• Perception of approval of drug use behavior http://www.emedicinehealth.com/substance_abuse/article_em.htm

Substance abuse is often a manifestation of other problems that child has either at home or poor social relations including low self esteem. Dr. Alan Leshner summarizes the reasons children use drugs in why do Sally and Johnny use drugs?

How Can You Recognize the Signs of Substance Abuse?

The Mayo Clinic provides general signs of substance abuse and also gives specific signs of alcohol abuse, and several different drugs, narcotics, and inhalants. The general warning signs are:

Recognizing drug abuse in teenagers
It can sometimes be difficult to distinguish normal teenage moodiness or angst from signs of drug use. Possible indications that your teenager is using drugs include:
• Problems at school. Frequently missing classes or missing school, a sudden disinterest in school or school activities, or a drop in grades may be indicators of drug use.
• Physical health issues. Lack of energy and motivation may indicate your child is using certain drugs.
• Neglected appearance. Teenagers are generally concerned about how they look. A lack of interest in clothing, grooming or looks may be a warning sign of drug use.
• Changes in behavior. Teenagers enjoy privacy, but exaggerated efforts to bar family members from entering their rooms or knowing where they go with their friends might indicate drug use. Also, drastic changes in behavior and in relationships with family and friends may be linked to drug use.
• Spending money. Sudden requests for money without a reasonable explanation for its use may be a sign of drug use. You may also discover money stolen from previously safe places at home. Items may disappear from your home because they’re being sold to support a drug habit.

http://www.mayoclinic.com/health/drug-addiction/DS00183/DSECTION=symptoms

Remember, these are very general signs, specific drugs, narcotics, and other substances may have different signs, it is important to read the specific signs.

What Steps Should a Parent Take?

The Drug Enforcement Agency (DEA) has a series of questions parents should ask:

Should I monitor my child?
Monitoring is an effective way you can help your teen or tween stay drug-free, and an important thing to do — even if you don’t suspect your teen is using drugs. The idea of “monitoring” your tween or teen may sound sinister, but it’s actually a very simple idea that leads to great things: You know where your child is at all times (especially after school), you know his friends, and you know his plans and activities. ….Because monitoring conflicts with your child’s desire to be independent, he is likely to resist your attempts to find out the details of his daily whereabouts. Don’t let this deter you from your goal. He may accept the idea more easily if you present it as a means of ensuring safety or interest in who he is and what he likes to do, rather than as a means of control. You need to be prepared for your child’s resistance — because the rewards of monitoring are proven. …The most important time of day to monitor is after school from 3 p.m. to 6 p.m. Kids are at the greatest risk for abusing drugs during these hours….
If I know my child is using drugs, should I alert the principal or the guidance counselor — or try to keep the information from the people at school?
Before discussing the situation with anyone at the school, it can help to seek assistance from a professional who has experience with adolescent substance use, such as a mental health professional, family therapist, pediatrician or family physician, substance use counselor, or employee assistance professional. Ask for an in-person evaluation with your child, or a meeting to discuss your concerns and get advice about how to proceed. Perhaps counseling, a support group, or a treatment program is warranted. If your child refuses help and continues to use substances, contacting the school is an option, but should be used with great caution. School officials want to keep alcohol and other drugs off school premises, and ensure that students are not coming to school high or using during school. They are required to punish students who violate these rules by suspending or expelling them. Notifying the school about your teen’s behavior will likely put them on a ‘to be watched’ list. Other times the school is the immediate source of feedback on problems – drugs or alcohol found in lockers or used during the school day, etc. and you’ll need to speak with someone at the school right away. The school may have resources available to help, such as a staff substance abuse counselor who can work with your child. For some teens, this strategy can be very positive — school authorities’ monitoring can give you concrete help in keeping a child with a problem on track in changing his behavior. Some children, however, need to suffer serious consequences before they will seek or accept help.
Should I try to make my teen give up friends?
It is very difficult to get teens to give up their friends. However, you can express your concerns. Tell your child what it is about the friend that worries you. Support developing a variety of friends and not relying too much on any one. Remember that teen drug use is basically a social behavior. If you know certain friends of theirs are using substances, minimize your child’s social contact with those friends by not giving them car rides, allowing visits or sleepovers with them or attendance at parties where they will be involved. This will send a strong message to your own child about how seriously you take health risks of substances.
On the other hand, go out of your way to encourage and facilitate your child’s contact with any friends who you believe are not using substances. These ties can be all incredibly important support for a child trying to change his behavior.
What limits should I set?
Work at setting limits only on behaviors you can control. For example, a rule that a teen cannot smoke pot is nearly impossible to enforce, but a rule that says a teen who gets caught smoking pot will be grounded or cannot use the family car for a month is one that you can enforce.
What should the penalties be for violation of those limits?
Choose consequences that can be applied without expressing a lot of critical or angry feelings. Parents frequently be¬tray their sense of helplessness by resorting to angry outbursts that are much more punitive than a consequence administered without anger or rage. A relatively short-term punishment carried out to the letter is much more effective than a long-term punishment that parents eventually ignore because they feel guilty. Make sure the penalties can be enforced by you on a practical basis – if they involve supervision or monitoring, change them for times you can be there.
If your child continues to violate limits, impose more severe consequences. http://www.getsmartaboutdrugs.com/content/default.aspx?pud=a8bcb6ee-523a-4909-9d76-928d956f3f91

If you suspect that your child has a substance abuse problem, you will have to seek help of some type. You will need a plan of action. The Partnership for a Drug Free America lists 7 Steps to Take and each step is explained at the site.

Parents, grandparents and other family members often feel tempted to wait things out and see if they get better. Sometimes they confront the child only to be accused of being distrustful or they hear angry denial, leaving them more confused than before.
It is important to remember that you don’t have to do it alone. Following are crucial steps that will ease getting help for you and your child.
1. Involve a professional to help determine what to do next….
2. Document as much evidence as you can.
§ Use checklists to record all the behaviors that concern you. Carefully record every behavior that concerns you during this period. Documenting your observations is important because your child will work hard to convince you that things didn’t happen the way you remember.
§ Some parents search their child’s room looking for evidence of drugs or paraphernalia. You should expect that your child will be offended at your invasion of privacy. If you do find contraband, oftentimes your child will claim that it belongs to someone else…..
3. Prepare what you want to say to your child….
4. Plan to talk with your child at a time in a setting where you can have uninterrupted discussion. Strengthen your interaction by using the following talking points:
§ Describe specific behaviors you and others have observed and when they occurred. The more specific you are, especially if you have written your observations down, the harder it will be for your child to deny, disagree, or argue.
§ Express your love and concern and your desire to help your child.
§ Emphasize your firm, non-negotiable position that you will not tolerate drug use and that you intend to determine if these behaviors are indications of drug use.
§ It is not useful simply to ask if your child if he or she is using drugs. Almost always, children will deny using. But it’s not a bad idea to voice your suspicions at some point.
§ If you haven’t observed very many warning signs and believe that your child has just begun using, emphasize that any use of alcohol or other drugs at all is unacceptable. Describe the consequences for further behaviors that concern you. Use strong leverage; consequences might include no driver’s license, no use of the family car, an earlier curfew. ….
5. Make an appointment for a drug assessment for your child.
§ A drug assessment is the surest way to determine the extent of your child’s problem with alcohol and other drugs. When you make the appointment, make sure that the agency understands that the evaluation is for an adolescent; also that the evaluation includes a drug test. Don’t alert your child that a drug test will be part of the assessment…..
6. Keep the appointment no matter what.
7. Don’t give up if things don’t go the way you want — go the distance.
§ If ignored, alcohol-other-drug use will progress. Your efforts to this point have been an effective intervention. Hopefully, it will work early on. Often, parents have to continue to discuss the situation with the child, document evidence and work with other significant adults in the child’s life to turn things around. This difficult intervention may take more time than you want. Persevere.
§ Get help for yourself. Parent support groups such as Families Anonymous, Tough Love, and Alanon can provide effective help as you strive to provide effective help to your child. http://www.drugfree.org/intervene

If your child has a substance abuse problem, both you and your child will need help. “One day at a time” is a famous recovery affirmation which you and your child will live the meaning. The road to recovery may be long or short, it will have twists and turns with one step forward and two steps back. In order to reach the goal of recovery, both parent and child must persevere.

Questions to Ask a Treatment Facility

The U.S. Department of Health and Human Services, Center for Substance Abuse Treatment (Center), lists the following questions that should be asked of a treatment center.

Here are 12 questions to consider when selecting a treatment program:
Does the program accept your insurance? If not, will they work with you on a payment plan or find other means of support for you?
Is the program run by state-accredited, licensed and/or trained professionals?
Is the facility clean, organized and well-run?
Does the program encompass the full range of needs of the individual (medical: including infectious diseases; psychological: including co-occurring mental illness; social; vocational; legal; etc.)?
Does the treatment program also address sexual orientation and physical disabilities as well as provide age, gender and culturally appropriate treatment services?
Is long-term aftercare support and/or guidance encouraged, provided and maintained?
Is there ongoing assessment of an individual’s treatment plan to ensure it meets changing needs?
Does the program employ strategies to engage and keep individuals in longer-term treatment, increasing the likelihood of success?
Does the program offer counseling (individual or group) and other behavioral therapies to enhance the individual’s ability to function in the family/community?
Does the program offer medication as part of the treatment regimen, if appropriate?
Is there ongoing monitoring of possible relapse to help guide patients back to abstinence?
Are services or referrals offered to family members to ensure they understand addiction and the recovery process to help them support the recovering individual?

The U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment (CSAT) provides a toll-free, 24-hour treatment referral service to help you locate treatment options near you.
For a referral to a treatment center or support group in your area, http://www.samhsa.gov/healthprivacy/docs/ehr-faqs.pdf

The Center also has a facility locator http://findtreatment.samhsa.gov/faq.htm and links to answer the following questions:

Questions about Treatment
• Where can a person with no money and no insurance get treatment?
• What can be done for a family member who needs treatment but refuses to get it or leaves treatment before it is completed?
• What facilities accept court-ordered clients?
• How can I find a facility that specializes in treating abuse of a particular drug (e.g., cocaine, inhalants, etc.)?
• Can you recommend a particular treatment program in my area?

Assuming you are not one of those ill-advised parents who supply their child with alcohol or drugs like marijuana in an attempt to be hip or cool, suspicions that your child may have a substance abuse problem are a concern. Confirmation that your child has a substance abuse problem can be heartbreaking. Even children whose parents have seemingly done everything right can become involved with drugs. The best defense is knowledge about your child, your child’s friends, and your child’s activities. You need to be aware of what is influencing your child. Back in the day, my mother would have put a CIA intelligence officer to shame. I thought she and my dad were two crazy old coots. I thank them for being my parents and not wanting to be my friends.

Resources

1. Adolescent Substance Abuse Knowledge Base

http://www.crchealth.com/troubled-teenagers/teenage-substance-abuse/adolescent-substance-abuse/signs-drug-use/

2. Warning Signs of Teen Drug Abuse

http://parentingteens.about.com/cs/drugsofabuse/a/driug_abuse20.htm?r=et

3. Al-Anon and Alateen

http://www.al-anon.alateen.org/

4. The National Institute on Drug Abuse (NIDA) has a web site for teens and parents that teaches about drug abuse NIDA for Teens: The Science Behind Drug Abuse

http://teens.drugabuse.gov/

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3 Responses to “University of Washington study: Heroin use among young suburban and rural non-traditional users on the increase”

Trackbacks/Pingbacks

  1. Northwestern University study: Young adolescent use of marijuana results in changes to the brain structure | drwilda - December 23, 2013

    […] University of Washington study: Heroin use among young suburban and rural non-traditional users on the increase http://drwilda.com/2013/10/13/university-of-washington-study-heroin-use-among-young-suburban-and-rur… […]

  2. University of Pennsylvania Annenberg Public Policy Center study: Drug testing high school students might not be effective | drwilda - January 14, 2014

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