Tag Archives: Addiction

University of California San Francisco study: E-cigarettes, as used, aren’t helping smokers quit

17 Jan

Some children consider smoking a rite of passage into adolescence. According to Tobacco Facts most teenage smoking starts early. Among the statistics cited at Tobacco Facts are the following:

Each day 3,000 children smoke their first cigarette.

Tobacco use primarily begins in early adolescence, typically by age 16.

At least 3 million adolescents are smokers.

20 percent of American teens smoke.

Almost all first use occurs before high school graduation.

Roughly 6 million teens in the US today smoke despite the knowledge that it is addictive and leads to disease.

Of the 3,000 teens who started smoking today, nearly 1,000 will eventually die as a result from smoking.

Of every 100,000 15 year old smokers, tobacco will prematurely kill at least 20,000 before the age of 70.

Adolescent girls who smoke and take oral birth control pills greatly increase their chances of having blood clots and strokes.

According to the Surgeon’s General, Teenagers who smoke were:

* Three times more likely to use alcohol.

* Eight times are likely to smoke marijuana.

* And 22 times more likely to use Cocaine.

Although only 5 percent of high school smokers said that they would definitely be smoking five years later, close to 75 percent were still smoking 7 to 9 years later.

Kids who smoke experience changes in the lungs and reduced lung growth, and they risk not achieving normal lung function as an adult.

A person who starts smoking at age 13 will have a more difficult time quitting, has more health-related problems and probably will die earlier than a person who begins to smoke at age 21.

Kids who smoke have significant health problems, including cough and phlegm production, decreased physical fitness and unfavorable lipid profile.

If your child’s best friends smoke, then your youngster is 13 times more likely to smoke than if his or her friends did not smoke.

Adolescents who have two parents who smoke are more than twice as likely as youth without smoking parents to become smokers.

More than 90 percent of adult smokers started when they were teens.                                       http://www.tobacco-facts.net/smoking-facts/teen-smoking-facts

It is important to prevent teens from beginning to smoke because of health issues and the difficulty many smokers have in quitting the habit.

Science Daily reported in E-cigarettes, as used, aren’t helping smokers quit, study shows:

Electronic cigarettes are widely promoted and used to help smokers quit traditional cigarettes, but a new analysis from UC San Francisco found that adult smokers who use e-cigarettes are actually 28 percent less likely to stop smoking cigarettes.

The study — a systematic review and meta-analysis of published data — is the largest to quantify whether e-cigarettes assist smokers in quitting cigarettes.

The findings will be published online January 14, 2016 in The Lancet Respiratory Medicine.

“As currently being used, e-cigarettes are associated with significantly less quitting among smokers,” concluded first author Sara Kalkhoran, MD who was a clinical fellow at the UCSF School of Medicine when the research was conducted. She is now at Massachusetts General Hospital and Harvard Medical School.

“E-cigarettes should not be recommended as effective smoking cessation aids until there is evidence that, as promoted and used, they assist smoking cessation,” Kalkhoran wrote.

Electronic cigarettes, known by a variety of names including vapor pens, are battery-powered devices that heat nicotine and flavorings to deliver an aerosol inhaled by the user. While they are promoted as a way to quit traditional cigarettes, they also are promoted as a way to get nicotine in environments where traditional cigarettes are prohibited, even though more than 430 cities and several states ban their use in smoke free sites where conventional cigarettes are also prohibited.

In 2015, the U.S. Preventive Services Task Force concluded that there was insufficient evidence to recommend the devices to help adults quit smoking. No e-cigarette company has submitted an application to the U.S. Food and Drug Administration to approve e-cigarettes for smoking cession, and the FDA has not taken any action against companies that claim e-cigarettes are effective for quitting smoking….                                                                                                            http://www.sciencedaily.com/releases/2016/01/160114162544.htm

Citation:

E-cigarettes, as used, aren’t helping smokers quit, study shows

New analysis found ‘vapers’ are 28 percent less likely to stop smoking

Date:     January 14, 2016

Source: University of California – San Francisco

Summary:

Electronic cigarettes are widely promoted and used to help smokers quit traditional cigarettes, but a new analysis found that adult smokers who use e-cigarettes are actually 28 percent less likely to stop smoking cigarettes.

Journal Reference:

  1. Sara Kalkhoran, Stanton A Glantz. E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. The Lancet Respiratory Medicine, 2016; DOI: 10.1016/S2213-2600(15)00521-4

Here is the press release from the University of San Francisco:

E-Cigarettes, As Used, Aren’t Helping Smokers Quit, Study Shows

New Analysis by UCSF Found “Vapers” Are 28 Percent Less Likely to Stop Smoking

By Elizabeth Fernandez on January 14, 2016

Electronic cigarettes are widely promoted and used to help smokers quit traditional cigarettes, but a new analysis from UC San Francisco found that adult smokers who use e-cigarettes are actually 28 percent less likely to stop smoking cigarettes.

The study — a systematic review and meta-analysis of published data — is the largest to quantify whether e-cigarettes assist smokers in quitting cigarettes.

The findings will be published online January 14 in The Lancet Respiratory Medicine.

“As currently being used, e-cigarettes are associated with significantly less quitting among smokers,” concluded first author Sara Kalkhoran, MD who was a clinical fellow at the UCSF School of Medicine when the research was conducted. She is now at Massachusetts General Hospital and Harvard Medical School.

“E-cigarettes should not be recommended as effective smoking cessation aids until there is evidence that, as promoted and used, they assist smoking cessation,” Kalkhoran wrote.

Electronic cigarettes, known by a variety of names including vapor pens, are battery-powered devices that heat nicotine and flavorings to deliver an aerosol inhaled by the user. While they are promoted as a way to quit traditional cigarettes, they also are promoted as a way to get nicotine in environments where traditional cigarettes are prohibited, even though more than 430 cities and several states ban their use in smoke free sites where conventional cigarettes are also prohibited.

In 2015, the U.S. Preventive Services Task Force concluded that there was insufficient evidence to recommend the devices to help adults quit smoking. No e-cigarette company has submitted an application to the U.S. Food and Drug Administration to approve e-cigarettes for smoking cession, and the FDA has not taken any action against companies that claim e-cigarettes are effective for quitting smoking.

In their analysis, the UCSF team reviewed 38 studies assessing the association between e-cigarette use and cigarette cessation among adult smokers. They then combined the results of the 20 studies that had control groups of smokers not using e-cigarettes in a meta-analysis that concluded that the odds of quitting smoking were 28 percent lower in smokers who used e-cigarettes compared to those who did not.

There were no language restrictions imposed on the studies, which included both real-world observational as well as clinical studies. The studies included smokers who both were and were not interested in quitting, and included people as young as 15 years old.

The studies included in the analysis controlled for many variables, including demographics, past attempts to quit, and level of nicotine dependence.

“The irony is that quitting smoking is one of the main reasons both adults and kids use e-cigarettes, but the overall effect is less, not more, quitting,” said co-author Stanton A. Glantz, PhD, UCSF professor of medicine and director of the UCSF Center for Tobacco Control Research and Education. “While there is no question that a puff on an e-cigarette is less dangerous than a puff on a conventional cigarette, the most dangerous thing about e-cigarettes is that they keep people smoking conventional cigarettes.”

“The fact that they are freely available consumer products could be important,” Glantz added.

E-cigarette regulation has the potential to influence marketing and reasons for use, the authors wrote:

“The inclusion of e-cigarettes in smoke-free laws and voluntary smoke-free policies could help decrease use of e-cigarettes as a cigarette substitute, and, perhaps, increase their effectiveness for smoking cessation. The way e-cigarettes are available on the market — for use by anyone and for any purpose — creates a disconnect between the provision of e-cigarettes for cessation as part of a monitored clinical trial and the availability of e-cigarettes for use by the general population.”

Kalkhoran’s research was supported by the National Institutes of Health National Research Service Award T32HP19025. Glantz’s work in the project was supported by grant 1P50CA180890 from the National Cancer Institute and the FDA Center for Tobacco Products.

UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy, a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences, as well as a preeminent biomedical research enterprise and UCSF Health, which includes two top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco, as well as other partner and affiliated hospitals and healthcare providers throughout the Bay Area.                                                                                                                                                              https://www.ucsf.edu/news/2016/01/401311/e-cigarettes-used-arent-helping-smokers-quit-study-shows

Family Doctor.org has some excellent tips about quitting smoking at Tobacco Addiction Treatment:

How can I stop smoking?

You’ll have the best chance of stopping if you do the following:

  • Get ready.
    •Get support and encouragement.
    •Learn how to handle stress and the urge to smoke.
    •Get medication and use it correctly.
    •Be prepared for relapse.
    •Keep trying….
    Remember, you will need some help to stop smoking. Nine out of 10 smokers who try to go “cold turkey” fail because nicotine is so addictive. But it is easy to find help to quit.
    http://familydoctor.org/familydoctor/en/diseases-conditions/tobacco-addiction/treatment.html

Prevention is the best course of action.

Resources:

Smokeless Tobacco

http://kidshealth.org/PageManager.jsp?dn=KidsHealth&lic=1&ps=207&cat_id=20138&article_set=20424

A Tool to Quit Smoking Has Some Unlikely Critics
http://www.nytimes.com/2011/11/08/science/e-cigarettes-help-smokers-quit-but-they-have-some-unlikely-critics.html

Where information leads to Hope. © Dr. Wilda.com

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http://drwildareviews.wordpress.com/

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University of Buffalo study: Caffeine affects boys and girls differently

22 Jun

Moi wrote about caffeine and children in Energy drinks may pose a danger:
The American Academy of Pediatrics is reported at its site, Healthy Children.Org in the study, Energy Drinks Can Harm Children:

Energy drinks may pose a risk for serious adverse health effects in some children, especially those with diabetes, seizures, cardiac abnormalities or mood and behavior disorders.
A new study, “Health Effects of Energy Drinks on Children, Adolescents, and Young Adults,” in the March issue of Pediatrics (published online Feb. 14), determined that energy drinks have no therapeutic benefit to children, and both the known and unknown properties of the ingredients, combined with reports of toxicity, may put some children at risk for adverse health events.
Youth account for half of the energy drink market, and according to surveys, 30 percent to 50 percent of adolescents report consuming energy drinks. Typically, energy drinks contain high levels of stimulants such as caffeine, taurine, and guarana, and safe consumption levels have not been established for most adolescents. Because energy drinks are frequently marketed to athletes and at-risk young adults, it is important for pediatric health care providers to screen for heavy use both alone and with alcohol, and to educate families and children at-risk for energy drink overdose, which can result in seizures, stroke and even sudden death.

Several deaths have been attributed to energy drinks.

The Washington Post reported in the article Energy drink popularity booms at college, despite health concerns:

A 2008 study of undergraduates at a large public university found that 39 percent of students had consumed at least one energy drink in the past month, with considerably higher rates for males and white students. The study, funded with a National Institute on Drug Abuse grant, noted that energy drink marketing tactics are “similar to those used to sell tobacco and alcohol to youths….”
Red Bull, which hit the country in the late 1990s, is credited with creating this industry using a Thai recipe. Today there are hundreds of energy drinks on the market, ranging from 1.93-ounce 5-Hour Energy shots to 32-ounce cans of Monster. Even Starbucks has gotten into the game, producing sparkling energy drinks and canned espresso beverages.
That proliferation has intensified debate about a long-standing question: Are energy drinks safe?
The focus of that question is often one of the main ingredients: caffeine. Energy drinks contain from 2.5 to 35.7 milligrams of caffeine per ounce; energy shots may have as much as 170 milligrams of caffeine per ounce, according to researchers. http://www.washingtonpost.com/local/education/energy-drink-popularity-booms-at-college-despite-health-concerns/2012/12/18/740e994e-45f8-11e2-8e70-e1993528222d_story.html

As more young people consume energy drinks, more problems are occurring. https://drwilda.com/2012/12/18/energy-drinks-may-pose-a-danger/

Alexandra Sifferlin reported in the Time article, Boys and Girls Are Impacted By Caffeine Differently:

New research shows even low doses of caffeine impact kids, and bodies of boys and girls react differently
Boys and girls’ bodies react differently to caffeine after they hit puberty, new research shows.
It’s established that caffeine consumption can increase blood pressure and lower heart rate in adults, and researchers from University at Buffalo in Buffalo, New York, have shown in the past that the same side effects happen in kids. This new research, published in the journal Pediatrics, found that the different ways caffeine affects males and females starts at puberty, with boys’ hearts more affected than girls’.
The researchers are unsure why exactly there are reaction differences—it could be due to hormones or other physiological factors—but it’s concerning since doses were low, at 1 and 2 mg/kg, and since caffeinated energy drinks are popular among kids and teens….
Currently, the FDA does not require the amount of caffeine in a product to be included on food labels. Since the FDA says caffeine is a natural chemical found in items like tea leaves and coffee beans, it’s regulated as an ingredient not a drug. Energy drinks are not regulated because they are sold as dietary supplements. A 2012 Consumer Reports review of 27 best-selling energy drinks found that 11 do not list caffeine content. Among those that do, the tested amount was on average 20% higher than what was on the label.
The FDA says 400 milligrams a day, about four or five cups of coffee, is generally not considered dangerous for adults. The American Academy of Pediatrics discourages caffeine consumption among young kids and adolescents.
The latest study did have weaknesses, since its study group was primarily among white, middle class, and well educated, and they could not completely confirm that control groups were totally abstinent when it came to consuming caffeine. Still, the research is important as medical and governmental groups take a closer look at how the stimulant may be impacting children’s health. http://time.com/2878504/boys-and-girls-are-impacted-by-caffeine-differently/

Citation:

Cardiovascular Responses to Caffeine by Gender and Pubertal Stage
1. Jennifer L. Temple, PhDa,b,
2. Amanda M. Ziegler, MPHa,
3. Adam Graczyk, MSa,
4. Ashley Bendlin, BSa,
5. Teresa Sion, BSa, and
6. Karina Vattana, BSa
+ Author Affiliations
1. aDepartment of Exercise and Nutrition Sciences, and
2. bCommunity Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
Abstract
BACKGROUND: Caffeine use is on the rise among children and adolescents. Previous studies from our laboratory reported gender differences in the effects of caffeine in adolescents. The purpose of this study was to test the hypotheses that gender differences in cardiovascular responses to caffeine emerge after puberty and that cardiovascular responses to caffeine differ across the phases of the menstrual cycle.
METHODS: To test these hypotheses, we examined heart rate and blood pressure before and after administration of placebo and 2 doses of caffeine (1 and 2 mg/kg) in prepubertal (8- to 9-year-olds; n = 52) and postpubertal (15- to 17-year-olds; n = 49) boys (n = 54) and girls (n = 47) by using a double-blind, placebo-controlled, dose-response design.
RESULTS: There was an interaction between gender and caffeine dose, with boys having a greater response to caffeine than girls. In addition, we found interactions between pubertal phase, gender, and caffeine dose, with gender differences present in postpubertal, but not in prepubertal, participants. Finally, we found differences in responses to caffeine across the menstrual cycle in postpubertal girls, with decreases in heart rate that were greater in the midfollicular phase and blood pressure increases that were greater in the midluteal phase of the menstrual cycle.
CONCLUSIONS: These data suggest that gender differences in response to caffeine emerge after puberty. Future research will determine the extent to which these gender differences are mediated by physiological factors, such as steroid hormones, or psychosocial factors, such as more autonomy and control over beverage purchases.

Here is the press release from the University of Buffalo:

Caffeine affects boys and girls differently after puberty, study finds
Jennifer Temple
“In this study, we were looking exclusively into the physical results of caffeine ingestion.”
Jennifer Temple, associate professor of exercise and nutrition science
University at Buffalo
BUFFALO, N.Y. – Caffeine intake by children and adolescents has been rising for decades, due in large part to the popularity of caffeinated sodas and energy drinks, which now are marketed to children as young as four. Despite this, there is little research on the effects of caffeine on young people.
One researcher who is conducting such investigations is Jennifer Temple, PhD, associate professor in the Department of Exercise and Nutrition Sciences, University at Buffalo School of Public Health and Health Professions.
Her new study finds that after puberty, boys and girls experience different heart rate and blood pressure changes after consuming caffeine. Girls also experience some differences in caffeine effect during their menstrual cycles.
The study, “Cardiovascular Responses to Caffeine by Gender and Pubertal Stage,” will be published online June 16 in the July 2014 edition of the journal Pediatrics.
Past studies, including those by this research team, have shown that caffeine increases blood pressure and decreases heart rate in children, teens and adults, including pre-adolescent boys and girls. The purpose here was to learn whether gender differences in cardiovascular responses to caffeine emerge after puberty and if those responses differ across phases of the menstrual cycle.
Temple says, “We found an interaction between gender and caffeine dose, with boys having a greater response to caffeine than girls, as well as interactions between pubertal phase, gender and caffeine dose, with gender differences present in post-pubertal, but not in pre-pubertal, participants.
“Finally,” she says, “we found differences in responses to caffeine across the menstrual cycle in post-pubertal girls, with decreases in heart rate that were greater in the mid-luteal phase and blood pressure increases that were greater in the mid-follicular phase of the menstrual cycle.
“In this study, we were looking exclusively into the physical results of caffeine ingestion,” she says.
Phases of the menstrual cycle, marked by changing levels of hormones, are the follicular phase, which begins on the first day of menstruation and ends with ovulation, and the luteal phase, which follows ovulation and is marked by significantly higher levels of progesterone than the previous phase.
Future research in this area will determine the extent to which gender differences are mediated by physiological factors such as steroid hormone level or by differences in patterns of caffeine use, caffeine use by peers or more autonomy and control over beverage purchases, Temple says.
This double-blind, placebo-controlled, dose-response study was funded by a grant from the National Institute on Drug Abuse of the National Institutes of Health.
It examined heart rate and blood pressure before and after administration of placebo and two doses of caffeine (1 and 2 mg/kg) in pre-pubertal (8- to 9-year-old; n = 52) and post-pubertal (15- to 17-year-old; n = 49) boys (n = 54) and girls (n = 47).
Co-authors are Amanda M. Ziegler, project coordinator for the Nutrition and Health Research Lab, and graduate student Adam Gracyzk, both in the UB Department of Exercise and Nutrition Sciences, UB School of Public Health and Health Professions; Ashley Bendlin, undergraduate student in the Environmental Studies Program and the Department of Psychology, UB College of Arts and Sciences; Theresa Sion, undergraduate student in family nursing, UB School of Nursing; and Karina Vattana, who recently graduated with a BS in biomedical sciences, UB School of Medicine and Biomedical Sciences.
For an embargoed copy of the study, contact Noreen Steward, nstewart@aap.org, American Academy of Pediatrics Department of Public Affairs. For an interview with the lead author, contact Patricia Donovan, Office of Communications, University at Buffalo, 716-645-4602 or pdonovan@buffalo.edu.
Media Contact Information
Patricia Donovan
Senior Editor, Arts, Humanities, Public Health, Social Sciences
Tel: 716-645-4602
pdonovan@buffalo.edu
– See more at: Caffeine affects boys and girls differently after puberty, study finds – News Center

Because children are still growing and developing, caffeine affects their development.

Diet Health Club has some excellent information in the article, Caffeine and Teenagers:

Café shops have become a common place for teen’s hangout. But they don’t realize that they are just sitting with a cup of fat, sugar and caffeine, unless they choose skim milk instead of cream in their coffee.
Side effects of caffeine on teenagers
1. Caffeine when taken in moderate amounts can increase mental alertness. However when taken in higher doses, it can cause anxiety, headaches, moods, dizziness and may also interfere with normal sleep. Caffeine when taken in very high dose can be very harmful to the body.
2. Caffeine is addictive and if stopped abruptly can cause many withdrawal symptoms like headache, irritability, temporary depression and muscle ache.
3. Regular caffeine consumption can reduce caffeine sensitivity that means the caffeine required is higher to achieve the same effects. Thus more caffeine a teenager consumes the more will be its need to feel the same effects.
4. Caffeine is a diuretic it causes water loss from the body (through urination). Especially in summers caffeine is a very bad choice and it may cause dehydration.
5. Caffeine is not stored in the body and is passed through the urine, but if the person is sensitive to caffeine he/she might feel its effects up to six hours.
6. Caffeine when consumed in large amounts can cause loss of calcium and potassium from the body that can lead to sore muscles and delayed recovery time after any exercise.
7. Some teenagers may be unaware of the fact that caffeine in high amounts can cause nervous disorders and may also aggravate heart problems.
Try to cut down the caffeine in your diet gradually; moderation is the key (amounts less than 100 milligrams). Include healthy options like fresh fruit juices, water, milk, flavored seltzer, decaffeinated soda or tea instead of caffeinated beverages, soft drinks, sodas and other caffeine rich drinks. Make sure to read the nutritional fact labels for caffeine content before consuming the product. http://www.diethealthclub.com/caffeine/caffeine-and-teenagers.html

Children and teens should limit their caffeine intake.

Resources:

Energy Drinks (Audio Description) http://www.healthychildren.org/English/healthy-living/nutrition/pages/Energy-Drinks.aspx

Nutrition and Sports http://www.healthychildren.org/English/healthy-living/sports/pages/Nutrition-and-Sports.aspx

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

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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