Tag Archives: Drug Abuse

Rand Corporation study: Study questions link between medical marijuana and fewer opioid deaths

11 Feb

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.
o Chaotic home environment
o Ineffective parenting
o Lack of nurturing and parental attachment
Factors related to a child’s socialization outside the family may also increase risk of drug abuse.
o Inappropriately aggressive or shy behavior in the classroom
o Poor social coping skills
o Poor school performance
o Association with a deviant peer group
o 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? http://archives.drugabuse.gov/Published_Articles/Sally.html

Science Daily reported in: Depression among young teens linked to cannabis use at 18:

A study looking at the cumulative effects of depression in youth, found that young people with chronic or severe forms of depression were at elevated risk for developing a problem with cannabis in later adolescence.
The study led by UW Medicine researchers interviewed 521 students recruited from four Seattle public middle schools. Researchers used data from annual assessments when students were ages 12-15 and then again when they were 18. The results were published in the journal Addiction.
“The findings suggest that if we can prevent or reduce chronic depression during early adolescence, we may reduce the prevalence of cannabis use disorder,” said lead author Isaac Rhew, research assistant professor of psychiatry and behavioral sciences at the University of Washington School of Medicine.
What researchers called “a 1 standard deviation increase” in cumulative depression during early adolescence was associated with a 50 percent higher likelihood of cannabis-use disorder.
According to researchers, during the past decade cannabis has surpassed tobacco with respect to prevalence of use among adolescents. Cannabis and alcohol are the two most commonly used substances among youth in the United States. They pointed to one national study showing increases in prevalence of cannabis use disorder and alcohol use disorder in the United States, especially among young adults.
Longitudinal studies looking at the link between depression and later use of alcohol and cannabis, however, have been mixed. Some show a link. Others don’t. But most studies have assessed adolescent depression at a single point in time — not cumulatively, said the researchers. Further, there have been differences in how substance use has been measured ranging from the initiation of any use to heavier problematic forms of use.
The study oversampled for students with depressive and/or conduct problems. The researchers were surprised to see that the prevalence of cannabis and alcohol use disorder in this study was notably higher than national estimates with 21 percent meeting criteria for cannabis use disorder and 20 percent meeting criteria for alcohol use disorder at age 18.

What effect the easing of marijuana laws in Washington state had on the youth is unclear. Researchers said it would be informative to conduct a similar study in a state with more strict marijuana laws to understand whether the relationship between depression and cannabis misuse would still hold in areas where marijuana may be less accessible…. https://www.sciencedaily.com/releases/2017/07/170717151031.htm

Citation:

Depression among young teens linked to cannabis use at 18
Seattle-focused study suggests earlier intervention with depressed youths could reduce rate of cannabis-use disorder
Date: July 17, 2017
Source: University of Washington Health Sciences/UW Medicine
Summary:
Young people with chronic or severe forms of depression were at elevated risk for developing a problem with cannabis in later adolescence, found a study looking at the cumulative effects of depression in youth.

Journal Reference:
1. Isaac C. Rhew, Charles B. Fleming, Ann Vander Stoep, Semret Nicodimos, Cheng Zheng, Elizabeth McCauley. Examination of cumulative effects of early adolescent depression on cannabis and alcohol use disorder in late adolescence in a community-based cohort. Addiction, 2017; DOI: 10.1111/add.13907

Science Daily reported in Study questions link between medical marijuana and fewer opioid deaths:

The association between medical marijuana and lower levels of opioid overdose deaths — identified previously in several studies — is more complex than previously described and appears to be changing as both medical marijuana laws and the opioid crisis evolve, according to a new RAND Corporation study.
The report — the most-detailed examination of medical marijuana and opioid deaths conducted to date — found that legalizing medical marijuana was associated with lower levels of opioid deaths only in states that had provisions for dispensaries that made medical marijuana easily available to patients. Opioid death rates were not lower in states that just provided legal protections to patients and caregivers, allowing them to grow their own marijuana.
In addition, the association between medical marijuana dispensaries and fewer opioid deaths appears to have declined sharply after 2010, when states began to tighten requirements on sales by dispensaries.
“Our findings are consistent with previous studies showing an association between the legalization of medical marijuana and lower deaths from overdoses of opioids,” said Rosalie Liccardo Pacula, co-author of the study and co-director of the RAND Drug Policy Research Center.
“However, our findings show that the mechanism for this was loosely regulated medical marijuana dispensaries, and that the association between these laws and opioid mortality has declined over time as state laws have more tightly regulated medical dispensaries and the opioid crisis shifted from prescription opioids to heroin and fentanyl,” Pacula said. “This is a sign that medical marijuana, by itself, will not be the solution to the nation’s opioid crisis today….”
When the researchers narrowly focused on the time period from 1999 to 2010 and replicated a model used by other researchers, they obtained results similar to those previously published, showing an approximately 20 percent decline in opioid overdose deaths associated with the passage of any state medical marijuana law. However, these general findings were driven by states that had laws allowing for loosely regulated marijuana dispensary systems.
When researchers extended their analysis through 2013, they found that the association between having any medical marijuana law and lower rates of opioid deaths completely disappeared. Moreover, the association between states with medical marijuana dispensaries and opioid mortality fell substantially as well.
The researchers provide two explanations for the decline in the association between medical marijuana dispensaries and opioid harm. First, states that more recently adopted laws with medical marijuana dispensaries more tightly regulated them, in response to a U.S. Justice Department memo saying it would not challenge state-level medical marijuana laws so long as dispensary sales were in full compliance with state regulations. Second, beginning in 2010, the primary driver of the opioid crisis and related deaths became illicit opioids, mainly heroin and then fentanyl, not prescription opioids…. https://www.sciencedaily.com/releases/2018/02/180207090111.htm

Citation:

Study questions link between medical marijuana and fewer opioid deaths
Association appears to be changing as medical marijuana laws and opioid epidemic change
Date: February 7, 2018
Source: RAND Corporation
Summary:
Several studies have shown an association between legalizing medical marijuana and lower death rates from opioids. A new study finds that link is more complex than previously described and appears to be changing as both medical marijuana laws and the opioid crisis evolve.
Journal Reference:
1. David Powell, Rosalie Liccardo Pacula, Mireille Jacobson. Do medical marijuana laws reduce addictions and deaths related to pain killers? Journal of Health Economics, 2018; 58: 29 DOI: 10.1016/j.jhealeco.2017.12.007

Here is the press release from RAND:

Do Medical Marijuana Laws Reduce Addictions and Deaths Related to Pain Killers?
Published in: Journal of Health Economics Volume 58 (March 2018), Pages 29-42. doi: 10.1016/j.jhealeco.2017.12.007
Posted on RAND.org on February 08, 2018
by David Powell, Rosalie Liccardo Pacula, Mireille Jacobson
• Related Topics:
• Drug Markets and Supply,
• Marijuana,
• Substance Use Harm Reduction
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Read More
Access further information on this document at Journal of Health Economics Volume 58 (March 2018)
This article was published outside of RAND. The full text of the article can be found at the link above.
Recent work finds that medical marijuana laws reduce the daily doses filled for opioid analgesics among Medicare Part-D and Medicaid enrollees, as well as population-wide opioid overdose deaths. We replicate the result for opioid overdose deaths and explore the potential mechanism. The key feature of a medical marijuana law that facilitates a reduction in overdose death rates is a relatively liberal allowance for dispensaries. As states have become more stringent in their regulation of dispensaries, the protective value generally has fallen. These findings suggest that broader access to medical marijuana facilitates substitution of marijuana for powerful and addictive opioids.
Access further information on this document at Journal of Health Economics Volume 58 (March 2018)
Link Between Medical Marijuana and Fewer Opioid Deaths Is More Complex Than Previously Reported
FOR RELEASE
Tuesday
February 6, 2018
The association between medical marijuana and lower levels of opioid overdose deaths—identified previously in several studies—is more complex than previously described and appears to be changing as both medical marijuana laws and the opioid crisis evolve, according to a new RAND Corporation study.
The report—the most-detailed examination of medical marijuana and opioid deaths conducted to date—found that legalizing medical marijuana was associated with lower levels of opioid deaths only in states that had provisions for dispensaries that made medical marijuana easily available to patients. Opioid death rates were not lower in states that just provided legal protections to patients and caregivers, allowing them to grow their own marijuana.
In addition, the association between medical marijuana dispensaries and fewer opioid deaths appears to have declined sharply after 2010, when states began to tighten requirements on sales by dispensaries.
“Our findings are consistent with previous studies showing an association between the legalization of medical marijuana and lower deaths from overdoses of opioids,” said Rosalie Liccardo Pacula, co-author of the study and co-director of the RAND Drug Policy Research Center.
“However, our findings show that the mechanism for this was loosely regulated medical marijuana dispensaries, and that the association between these laws and opioid mortality has declined over time as state laws have more tightly regulated medical dispensaries and the opioid crisis shifted from prescription opioids to heroin and fentanyl,” Pacula said. “This is a sign that medical marijuana, by itself, will not be the solution to the nation’s opioid crisis today.”
The study was published online by the Journal of Health Economics.
Researchers from RAND and the University of California, Irvine, analyzed information about treatment admissions for addiction to pain medications from 1999 to 2012 and state-level overdose deaths from opioids from 1999 to 2013. They also identified state laws legalizing medical marijuana, examining provisions such as whether the regulations made marijuana easily accessible to patients by allowing dispensaries.
When the researchers narrowly focused on the time period from 1999 to 2010 and replicated a model used by other researchers, they obtained results similar to those previously published, showing an approximately 20 percent decline in opioid overdose deaths associated with the passage of any state medical marijuana law. However, these general findings were driven by states that had laws allowing for loosely regulated marijuana dispensary systems.
When researchers extended their analysis through 2013, they found that the association between having any medical marijuana law and lower rates of opioid deaths completely disappeared. Moreover, the association between states with medical marijuana dispensaries and opioid mortality fell substantially as well.
The researchers provide two explanations for the decline in the association between medical marijuana dispensaries and opioid harm. First, states that more recently adopted laws with medical marijuana dispensaries more tightly regulated them, in response to a U.S. Justice Department memo saying it would not challenge state-level medical marijuana laws so long as dispensary sales were in full compliance with state regulations. Second, beginning in 2010, the primary driver of the opioid crisis and related deaths became illicit opioids, mainly heroin and then fentanyl, not prescription opioids.
The study also found no evidence that states with medical marijuana laws experience reductions in the volume of legally distributed opioid analgesics used to treat pain. Even if medical marijuana patients were substituting medical marijuana for opioids in medical marijuana states, these patients did not represent a measurable part of the medical opioid analgesic market.
“While our study finds that medical marijuana dispensaries reduce some of the harms associated with the misuse of opioids, there is little evidence that this is happening because a large number of patients suffering from pain are using marijuana instead of opioid medications,” Pacula said. “Either the patients are continuing to use their opioid pain medications in addition to marijuana, or this patient group represents a small share of the overall medical opioid using population.”
The RAND study was conducted before any any states had begun to allow retail sales of recreational marijuana.
“Our research suggests that the overall story between medical marijuana and opioid deaths is complicated,” Pacula said. “Before we embrace marijuana as a strategy to combat the opioid epidemic, we need to fully understand the mechanism through which these laws may be helping and see if that mechanism still matters in today’s changing opioid crisis.”
Support for the study was provided by the National Institute on Drug Abuse. Other authors of the study are David Powell of RAND and Mireille Jacobson of UC Irvine.
RAND Health is the nation’s largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.
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The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous.
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• Rosalie Liccardo Pacula
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Rosalie Liccardo Pacula is a senior economist at the RAND Corporation and a professor at the Pardee RAND Graduate School. She serves as director of RAND’s BING Center for Health Economics, co-director of the RAND Drug Policy Research Center, and associate director of the data core for RAND’s new…
The Drug Enforcement Agency (DEA) has a series of questions parents should ask 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. 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.

Related:

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

Resources

Adolescent Substance Abuse Knowledge Base
http://www.crchealth.com/troubled-teenagers/teenage-substance-abuse/adolescent-substance-abuse/signs-drug-use/

Warning Signs of Teen Drug Abuse
http://parentingteens.about.com/cs/drugsofabuse/a/driug_abuse20.htm?r=et

Is Your Teen Using?
http://www.drugfree.org/intervene

Al-Anon and Alateen
http://www.al-anon.alateen.org/

WEBMD: Parenting and Teen Substance Abuse
http://www.webmd.com/mental-health/tc/teen-substance-abuse-choosing-a-treatment-program-topic-overview

The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment?
http://store.samhsa.gov/home

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/

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/

Columbia University study: Marijuana smokers 5 times more likely to develop an alcohol problem

18 Feb

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.
o Chaotic home environment
o Ineffective parenting
o Lack of nurturing and parental attachment
Factors related to a child’s socialization outside the family may also increase risk of drug abuse.
o Inappropriately aggressive or shy behavior in the classroom
o Poor social coping skills
o Poor school performance
o Association with a deviant peer group
o 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? http://archives.drugabuse.gov/Published_Articles/Sally.html

Science Daily reported in Marijuana smokers 5 times more likely to develop an alcohol problem:

Adults who use marijuana are five times more likely to develop an alcohol use disorder (AUD) –alcohol abuse or dependence– compared with adults who do not use the drug. And adults who already have an alcohol use disorder and use marijuana are more likely to see the problem persist. Results of a study by researchers at Columbia University’s Mailman School of Public Health and the City University of New York appear online in the journal Drug and Alcohol Dependence.

“Our results suggest that cannabis use appears to be associated with an increased vulnerability to developing an alcohol use disorder, even among those without any history of this,” said Renee Goodwin, PhD, associate professor of Epidemiology at the Mailman School of Public Health. “Marijuana use also appears to increase the likelihood that an existing alcohol use disorder will continue over time.”

The researchers analyzed data from 27,461 adults enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions who first used marijuana at a time when they had no lifetime history of alcohol use disorders. The population was assessed at two time points. Adults who had used marijuana at the first assessment and again over the following three years (23 percent) were five times more likely to develop an alcohol use problem, compared with those who had not used marijuana (5 percent). Adult problem drinkers who did not use cannabis were significantly more likely to be in recovery from alcohol use disorders three years later….. https://www.sciencedaily.com/releases/2016/02/160217112847.htm

Citation:

Marijuana smokers 5 times more likely to develop an alcohol problem

Date: February 17, 2016

Source: Columbia University’s Mailman School of Public Health

Summary:
Adults who use marijuana are five times more likely to develop an alcohol use disorder (AUD) — alcohol abuse or dependence — compared with adults who do not use the drug. And adults who already have an alcohol use disorder and use marijuana are more likely to see the problem persist.

Journal Reference:
1. Andrea H. Weinberger, Jonathan Platt, Renee D. Goodwin. Is cannabis use associated with an increased risk of onset and persistence of alcohol use disorders? A three-year prospective study among adults in the United States. Drug and Alcohol Dependence, 2016; DOI: 10.1016/j.drugalcdep.2016.01.014

Here is the press release from the Columbia’s Mailman School of Public Health:

Chronic Disease, Community Health

Feb. 17 2016

Marijuana Smokers Five Times More Likely to Develop an Alcohol Problem

Adults who use marijuana are five times more likely to develop an alcohol use disorder (AUD) —alcohol abuse or dependence— compared with adults who do not use the drug. And adults who already have an alcohol use disorder and use marijuana are more likely to see the problem persist. Results of a study by researchers at Columbia University’s Mailman School of Public Health and the City University of New York appear online in the journal Drug and Alcohol Dependence.

“Our results suggest that cannabis use appears to be associated with an increased vulnerability to developing an alcohol use disorder, even among those without any history of this,” said Renee Goodwin, PhD, associate professor of Epidemiology at the Mailman School of Public Health. “Marijuana use also appears to increase the likelihood that an existing alcohol use disorder will continue over time.”

The researchers analyzed data from 27,461 adults enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions who first used marijuana at a time when they had no lifetime history of alcohol use disorders. The population was assessed at two time points. Adults who had used marijuana at the first assessment and again over the following three years (23 percent) were five times more likely to develop an alcohol use problem, compared with those who had not used marijuana (5 percent). Adult problem drinkers who did not use cannabis were significantly more likely to be in recovery from alcohol use disorders three years later.

“From a public health standpoint we recommend that further research be conducted to understand the pathways underlying these relationships as well as the degree to which various potentially vulnerable population subgroups — youth, for example — are at increased risk,” noted Goodwin. “If future research confirms these findings, investigating whether preventing or delaying first use of marijuana might reduce the risk of developing alcohol use disorders among some segments of the population may be worthwhile.”
Co-authors are Andrea Weinberger, Yeshiva University and Yale University School of Medicine; and Jonathan Platt, Mailman School of Public Health.

The study was supported by the National Institutes of Health/National Institute on Drug Abuse (grant R01-DA20892). https://www.mailman.columbia.edu/public-health-now/news/marijuana-smokers-five-times-more-likely-develop-alcohol-problem#sthash.PuhZAXLD.dpuf

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

Related:

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

Resources

Adolescent Substance Abuse Knowledge Base
http://www.crchealth.com/troubled-teenagers/teenage-substance-abuse/adolescent-substance-abuse/signs-drug-use/

Warning Signs of Teen Drug Abuse
http://parentingteens.about.com/cs/drugsofabuse/a/driug_abuse20.htm?r=et

Is Your Teen Using?
http://www.drugfree.org/intervene

Al-Anon and Alateen
http://www.al-anon.alateen.org/

WEBMD: Parenting and Teen Substance Abuse
http://www.webmd.com/mental-health/tc/teen-substance-abuse-choosing-a-treatment-program-topic-overview

The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment?
http://store.samhsa.gov/home

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/

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/

American Academy of Pediatrics opposes drug testing in schools

5 Apr

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? http://archives.drugabuse.gov/Published_Articles/Sally.html The National Council on Alcohol and Drug Dependence lists Signs and Symptoms:

1. Physical and health warning signs of drug abuse
• Eyes that are bloodshot or pupils that are smaller or larger than normal.
• Frequent nosebleeds–could be related to snorted drugs (meth or cocaine).
• Changes in appetite or sleep patterns. Sudden weight loss or weight gain.
• Seizures without a history of epilepsy.
• Deterioration in personal grooming or physical appearance.
• Injuries/accidents and person won’t or can’t tell you how they got hurt.
• Unusual smells on breath, body, or clothing.
• Shakes, tremors, incoherent or slurred speech, impaired or unstable coordination.

2. Behavioral signs of drug abuse
• Drop in attendance and performance at work or school; loss of interest in extracurricular activities, hobbies, sports or exercise; decreased motivation.
• Complaints from co-workers, supervisors, teachers or classmates.
• Unusual or unexplained need for money or financial problems; borrowing or stealing; missing money or valuables.
• Silent, withdrawn, engaging in secretive or suspicious behaviors.
• Sudden change in relationships, friends, favorite hangouts, and hobbies.
• Frequently getting into trouble (arguments, fights, accidents, illegal activities).

3. Psychological warning signs of drug abuse
• Unexplained change in personality or attitude.
• Sudden mood changes, irritability, angry outbursts or laughing at nothing.
• Periods of unusual hyperactivity or agitation.
• Lack of motivation; inability to focus, appearing lethargic or “spaced out.”
• Appearing fearful, withdrawn, anxious, or paranoid, with no apparent reason.
Signs and symptoms of Drug Dependence:
Drug dependence involves all the symptoms of drug abuse, but also involves another element: physical dependence.
1. Tolerance: Tolerance means that, over time, you need more drugs to feel the same effects. Do they use more drugs now than they used before? Do they use more drugs than other people without showing obvious signs of intoxication?
2. Withdrawal: As the effect of the drugs wear off, the person may experience withdrawal symptoms: anxiety or jumpiness; shakiness or trembling; sweating, nausea and vomiting; insomnia; depression; irritability; fatigue or loss of appetite and headaches. Do they use drugs to steady the nerves, stop the shakes in the morning? Drug use to relieve or avoid withdrawal symptoms is a sign of addiction.
In severe cases, withdrawal from drugs can be life-threatening and involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous and should be managed by a physician specifically trained and experienced in dealing with addiction.
3. Loss of Control: Using more drugs than they wanted to, for longer than they intended, or despite telling themselves that they wouldn’t do it this time.
4. Desire to Stop, But Can’t: They have a persistent desire to cut down or stop their drug use, but all efforts to stop and stay stopped, have been unsuccessful.
5. Neglecting Other Activities: They are spending less time on activities that used to be important to them (hanging out with family and friends, exercising or going to the gym, pursuing hobbies or other interests) because of the use of drugs.
6. Drugs Take Up Greater Time, Energy and Focus: They spend a lot of time using drugs, thinking about it, or recovering from its effects. They have few, if any, interests, social or community involvements that don’t revolve around the use of drugs.
7. Continued Use Despite Negative Consequences: They continue to use drugs even though they know it’s causing problems. As an example, person may realize that their drug use is interfering with ability to do their job, is damaging their marriage, making problems worse, or causing health problems, but they continue to use…. https://ncadd.org/learn-about-drugs/signs-and-symptoms

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

Kathryn Doyle of Reuters wrote in Experts caution against random drug testing in schools:

Schools should not be using random drug tests to catch or deter drug abusers, the American Academy of Pediatrics advises in an updated policy statement.

The Academy recommends against school-based “suspicionless” drug testing in the new issue of the journal Pediatrics.

Identifying kids who use drugs and entering them into treatment programs should be a top priority, but there is little evidence that random drug testing helps accomplish this, said Dr. Sharon Levy, director of the adolescent substance abuse program at Boston Children’s Hospital and lead author of the new policy statement…

Scientifically, the best way to test the value of random drug tests would be to put some kids into a drug testing program and others not, in a single school, but practically, that is difficult to accomplish. Instead, researchers have compared schools with drug testing programs to similar schools without them – and found mixed results.

One study did find a short-term reduction in kids’ self-reported drug use at a school with random testing, but the kids were followed for a relatively short period and reductions in use applied only to the drugs included in the testing. This is a problem since most drug testing panels do not include alcohol, Levy said.
“It’s possible that you do get some prevention out of these programs, but on the other hand it seems very expensive, very invasive, and has pretty limited results,” she said.

Adolescent drug use is usually sporadic, so even a kid who does use illegal substances may easily pass a random annual test and then feel comfortable to use freely for the rest of the year, she said.

Drug tests can result in false positives, and even a true positive says nothing about frequency or quantity of drug use, according to Ken C. Winters of the psychiatry department at the University of Minnesota Medical School in Minneapolis, who is not in the AAP.
http://newsdaily.com/2015/03/experts-caution-against-random-drug-testing-in-schools/#eI8U6EOrbeuGbOZZ.99

Citation:

• From the American Academy of Pediatrics
Adolescent Drug Testing Policies in Schools
1. Sharon Levy, MD, MPH, FAAP,
2. Miriam Schizer, MD, MPH, FAAP,
3. COMMITTEE ON SUBSTANCE ABUSE
Abstract
More than a decade after the US Supreme Court established the legality of school-based drug testing, these programs remain controversial, and the evidence evaluating efficacy and risks is inconclusive. The objective of this technical report is to review the relevant literature that explores the benefits, risks, and costs of these programs.

Here is the AAP statement:

AAP Opposes In School Drug Testing Due to Lack of Evidence
3/30/2015
Drug testing can be useful for pediatricians and other health care providers to assess substance use or mental health disorders in adolescents, but random drug testing in schools is a controversial approach not recommended by the American Academy of Pediatrics (AAP).

In an updated policy statement and technical report, “Adolescent Drug Testing Policies in Schools,” in the April 2015 Pediatrics (published online March 30), the AAP encourages and supports the efforts of schools to identify and address student substance abuse, but recommends against the use of school-based drug testing programs, often called suspicionless or random drug testing.

Proponents of random drug testing refer to potential advantages such as students avoiding drug use because of the negative consequences associated with having a positive drug test results, while opponents of random drug testing agree that the disadvantages are much greater, and can include deterioration in the student-school relationship, confidentiality of students’ medical records, and mistakes in interpreting drug tests that can result in false-positive results.

The AAP recommends against the use of school-based drug testing programs because of limited evidence of efficacy and potential risks associated with this procedure. Pediatricians support the development of effective substance abuse services in schools, along with appropriate referral policies in place for adolescents struggling with substance abuse disorders.
# # #

The American Academy of Pediatrics is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.
https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Opposes-In-school-Drug-Testing-Due-to-Lack-of-Evidence.aspx

The National Institute on Drug Abuse (Institute) has some great information about drug testing. In Frequently Asked Questions About Drug Testing in Schools, the Institute discusses drug testing.

Why test teenagers at all?

Teens are especially vulnerable to drug abuse, when the brain and body are still developing. Most teens do not use drugs, but for those who do, it can lead to a wide range of adverse effects on the brain, the body, behavior and health.
Short term: Even a single use of an intoxicating drug can affect a person’s judgment and decisonmaking—resulting in accidents, poor performance in a school or sports activity, unplanned risky behavior, and the risk of overdosing.
Long term: Repeated drug abuse can lead to serious problems, such as poor academic outcomes, mood changes (depending on the drug: depression, anxiety, paranoia, psychosis), and social or family problems caused or worsened by drugs.
Repeated drug use can also lead to the disease of addiction. Studies show that the earlier a teen begins using drugs, the more likely he or she will develop a substance abuse problem or addiction. Conversely, if teens stay away from drugs while in high school, they are less likely to develop a substance abuse problem later in life….
Is random drug testing of students legal?
In June 2002, the U.S. Supreme Court broadened the authority of public schools to test students for illegal drugs. Voting 5 to 4 in Pottawatomie County v. Earls, the court ruled to allow random drug tests for all middle and high school students participating in competitive extracurricular activities. The ruling greatly expanded the scope of school drug testing, which previously had been allowed only for student athletes.
Just because the U.S. Supreme Court said student drug testing for adolescents in competitive extracurricular activities is constitutional, does that mean it is legal in my city or state?
A school or school district that is interested in adopting a student drug testing program should seek legal expertise so that it complies with all federal, state, and local laws. Individual state constitutions may dictate different legal thresholds for allowing student drug testing. Communities interested in starting student drug testing programs should become familiar with the law in their respective states to ensure proper compliance. http://www.drugabuse.gov/related-topics/drug-testing/faq-drug-testing-in-schools

The primary issue is whether students have privacy rights.

Your Debate.com summarizes the pros and cons of School Drug Testing:

PRO 1
The main purpose of random school drug testing is not to catch kids using drugs, it to keep them from ever using them. Once their using drugs its harder for them to break their addiction. With many employers drug testing its very important for a kid’s future not to use drugs. Drug use is responsible for many crimes. Its worth the inconvenience for all our future.
CON 2
One of the fundamental features of our legal system is that we are presumed innocent of any wrongdoing unless and until the government proves otherwise. Random drug testing of student athletes turns this presumption on its head, telling students that we assume they are using drugs until they prove to the contrary with a urine sample.
CON 3
“If school officials have reason to believe that a particular student is using drugs, they already have the power to require that student to submit to a drug test,” said ACLU-NJ Staff Attorney David Rocah.
CON 4
The constitutional prohibition against “unreasonable” searches also embodies the principle that merely belonging to a certain group is not a sufficient reason for a search, even if many members of that group are suspected of illegal activity. Thus, for example, even if it were true that most men with long hair were drug users, the police would not be free to stop all long haired men and search them for drugs.
PRO 5
Peer pressure is the greatest cause of kids trying drugs. If by testing the athletes or other school leaders, we can get them to say no to drugs, it will be easier for other kids to say no.
CON 6
Some also argue that students who aren’t doing anything wrong have nothing to fear. This ignores the fact that what they fear is not getting caught, but the loss of dignity and trust that the drug test represents. And we should all be afraid of government officials who believe that a righteous cause warrants setting aside bedrock constitutional protections. The lesson that our schools should be teaching is respect for the Constitution and for students’ dignity and privacy, not a willingness to treat cherished constitutional principles as mere platitudes. http://www.youdebate.com/DEBATES/school_drug_testing.HTM

See, What Are the Benefits of Drug Testing?http://www.livestrong.com/article/179407-what-are-the-benefits-of-drug-testing/

Substance abuse is often a manifestation of other problems that child has either at home or poor social relations including low self-esteem.

Resources:

Adolescent Substance Abuse Knowledge Base

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

Warning Signs of Teen Drug Abuse

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

Al-Anon and Alateen

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

National Clearinghouse for Drug and Alcohol Information

http://www.samhsa.gov/

The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment?

http://www.samhsa.gov/kap

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/

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/

Australian study: Frequent marijuana use among those under 17 may result in lower educational achievement

23 Sep

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.
o Chaotic home environment
o Ineffective parenting
o Lack of nurturing and parental attachment
Factors related to a child’s socialization outside the family may also increase risk of drug abuse.
o Inappropriately aggressive or shy behavior in the classroom
o Poor social coping skills
o Poor school performance
o Association with a deviant peer group
o 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? http://archives.drugabuse.gov/Published_Articles/Sally.html

Simon Makin reported in the Scientific American article, Does Marijuana Harm the Brain?

The Claim
Casual cannabis use harms young people’s brains.
The Facts
A study found differences in the brains of users and nonusers, but it did not establish that marijuana use caused the variations or that they had any functional significance.
The Details
Researchers at Northwestern University and Harvard Medical School conducted MRI scans of two groups of 20 young adults ages 18 to 25. One group reported using marijuana at least once a week, smoking 11 joints a week on average, whereas the other had used it less than five times total and not at all during the last year. Neither group had any psychiatric disorders, and the users were psychiatrically assessed as not dependent on the drug.
The study focused on two brain regions involved in processing rewards, the nucleus accumbens and the amygdala. These areas create pleasurable experiences of things such as food and sex, as well as the high associated with drugs, and have been shown to change in animals given THC, the main psychoactive component of cannabis.
The researchers found that cannabis users had more gray matter density in the left nucleus accumbens and left amygdala, as well as differences in the shape of the left nucleus accumbens and right amygdala. The left nucleus accumbens also tended to be slightly larger in users. They concluded that recreational cannabis use might be associated with abnormalities in the brain’s reward system. News reports have proclaimed that scientists have shown that even casual cannabis use harms young people’s brains.
The Caveats
The most obvious problem with leaping to that conclusion is that the scans were conducted at only one point. This approach can compare the two groups, but it cannot prove cannabis caused any differences between them—or even that the differences represent changes over time. They could be preexisting variations, or cannabis use and brain changes may both be related to a third factor, such as tobacco (although the study did attempt to take levels of smoking into account)…..
Reality Check—Cannabis use has been found to:
• Cause dependence, at some point in their lives, in about 9 percent of people who try it.
• Impair various aspects of cognitive function, particularly memory. Impairments can remain for several days. One study showed that performance returns to nonusers’ levels after 28 days of abstinence, but evidence is mixed about how long the impairments last.
• Potentially reduce the volume of the hippocampus, which is critical for memory—but only after heavy and prolonged use. The evidence linking cognitive impairments to specific brain changes is inconclusive, and the degree to which such changes are reversible is hotly debated. http://www.scientificamerican.com/article/does-marijuana-harm-the-brain/

Science Daily reported a longitudinal study from Australia and New Zealand.

In Frequent cannabis use in adolescence linked with reduced educational attainment, other problems in young adults, Science Daily reported:

Individuals who are daily users of cannabis before age 17 are over 60% less likely to complete high school or obtain a degree compared to those who have never used the drug, new research published in The Lancet Psychiatry journal shows. The large meta-analysis also indicates that daily users of cannabis during adolescence are seven times more likely to attempt suicide, have an 18 times greater chance of cannabis dependence, and are eight times as likely to use other illicit drugs in later life.
“Our findings are particularly timely given that several US states and countries in Latin America have made moves to decriminalize or legalize cannabis, raising the possibility that the drug might become more accessible to young people”, says Richard Mattick, study author and Professor of Drug and Alcohol Studies at the National Drug and Alcohol Research Centre, University of New South Wales, in Australia.
Cannabis is the most widely used illicit drug globally and recent statistics have shown that in some countries adolescents are starting cannabis use at a younger age and more adolescents are using cannabis heavily. In England, 4% of 11-15 year olds report cannabis use in the past month, roughly 7% of US high-school seniors are daily or near-daily cannabis users, and in Australia, around 1% of 14-19 year olds are daily users of the drug, whilst 4% use weekly.
In this study, a team of Australian and New Zealand researchers combined individual-level data on up to 3765 participants who used cannabis from three large, long-running longitudinal studies to find out more about the link between the frequency of cannabis use before the age of 17 years (never, less than monthly, monthly or more, weekly or more, or daily) and seven developmental outcomes up to the age of 30 years (completing high school, obtaining a university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence)….
http://www.sciencedaily.com/releases/2014/09/140909192001.htm

Citation:

Frequent cannabis use in adolescence linked with reduced educational attainment, other problems in young adults
Date: September 9, 2014

Source: The Lancet
Summary:
Individuals who are daily users of cannabis before age 17 are over 60% less likely to complete high school or obtain a degree compared to those who have never used the drug, new research shows. The large meta-analysis also indicates that daily users of cannabis during adolescence are seven times more likely to attempt suicide, have an 18 times greater chance of cannabis dependence, and are eight times as likely to use other illicit drugs in later life.

Copyright © 2014 Elsevier Ltd All rights reserved.
Young adult sequelae of adolescent cannabis use: an integrative analysis
Dr Edmund Silins PhD a Corresponding AuthorEmail Address, L John Horwood MSc c, Prof George C Patton MD d g, Prof David M Fergusson PhD c, Craig A Olsson PhD d e g h, Delyse M Hutchinson PhD a, Elizabeth Spry BA d, Prof John W Toumbourou PhD d e, Prof Louisa Degenhardt PhD a d f i, Wendy Swift PhD a, Carolyn Coffey PhD d, Robert J Tait PhD j k, Primrose Letcher PhD g, Prof Jan Copeland PhD b, Richard P Mattick PhD a, for the Cannabis Cohorts Research Consortium†

Summary

Background

Debate continues about the consequences of adolescent cannabis use. Existing data are limited in statistical power to examine rarer outcomes and less common, heavier patterns of cannabis use than those already investigated; furthermore, evidence has a piecemeal approach to reporting of young adult sequelae. We aimed to provide a broad picture of the psychosocial sequelae of adolescent cannabis use.
Methods

We integrated participant-level data from three large, long-running longitudinal studies from Australia and New Zealand: the Australian Temperament Project, the Christchurch Health and Development Study, and the Victorian Adolescent Health Cohort Study. We investigated the association between the maximum frequency of cannabis use before age 17 years (never, less than monthly, monthly or more, weekly or more, or daily) and seven developmental outcomes assessed up to age 30 years (high-school completion, attainment of university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence). The number of participants varied by outcome (N=2537 to N=3765).

Findings

We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. After covariate adjustment, compared with individuals who had never used cannabis, those who were daily users before age 17 years had clear reductions in the odds of high-school completion (adjusted odds ratio 0•37, 95% CI 0•20—0•66) and degree attainment (0•38, 0•22—0•66), and substantially increased odds of later cannabis dependence (17•95, 9•44—34•12), use of other illicit drugs (7•80, 4•46—13•63), and suicide attempt (6•83, 2•04—22•90).

Interpretation

Adverse sequelae of adolescent cannabis use are wide ranging and extend into young adulthood. Prevention or delay of cannabis use in adolescence is likely to have broad health and social benefits. Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse developmental effects.

Funding

Australian Government National Health and Medical Research Council.
Young adult sequelae of adolescent cannabis use: an integrative analysis : The Lancet Psychiatry National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, Australia
Young adult sequelae of adolescent cannabis use: an integrative analysis : The Lancet Psychiatry
Young adult sequelae of adolescent cannabis use: an integrative analysis. By – Dr Edmund Silins PhD, L John Horwood MSc, Prof George C Patton MD, Prof David M Fergusson PhD, Craig A Olsson PhD, Del…
View on http://www.thelancet.com
b National Cannabis Prevention and Information Centre, UNSW Australia, Sydney, NSW, Australia
c Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
d Centre for Adolescent Health, Murdoch Childrens Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
e School of Psychology, Deakin University, Geelong, VIC, Australia
f School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
g Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
h Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
i Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA
j National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
k Centre for Research on Ageing Health and Wellbeing, Australian National University, Canberra, ACT, Australia
Corresponding Author Information Correspondence to: Dr Edmund Silins, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW 2052, Australia
† Other members listed at end of paper

What Steps Should a Parent Take?

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

Related:

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

Resources

Adolescent Substance Abuse Knowledge Base http://www.crchealth.com/troubled-teenagers/teenage-substance-abuse/adolescent-substance-abuse/signs-drug-use/

Warning Signs of Teen Drug Abuse
http://parentingteens.about.com/cs/drugsofabuse/a/driug_abuse20.htm?r=et

Is Your Teen Using?
http://www.drugfree.org/intervene

Al-Anon and Alateen http://www.al-anon.alateen.org/

WEBMD: Parenting and Teen Substance Abuse http://www.webmd.com/mental-health/tc/teen-substance-abuse-choosing-a-treatment-program-topic-overview

The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment? http://store.samhsa.gov/home

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/

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

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

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University of Pennsylvania Annenberg Public Policy Center study: Drug testing high school students might not be effective

14 Jan

Moi wrote in Missouri high school to drug test students:
Fox News reported in the story, Missouri high school reportedly to use hair samples for random drug tests:
Beginning in the 2013-2014 school year, students at Rockhurst High School in Kansas City will be mandated to undergo random drug testing by submitting roughly 60 strands of hair to a staff member at the 1,000-student school, KSHB.com reports….
If a student tests positive for any substance, according to the new policy, a guidance counselor will be notified. The counselor will then notify the student’s parents to determine how to best help the child.
The student would then be given 90 days to be drug-free, with no notification sent to administrative personnel. The incident would only be noted in the student’s guidance file, which would later be destroyed upon graduation and will not be sent to colleges or universities. The document would only become public if subpoenaed, the website reports. http://www.foxnews.com/us/2013/01/31/missouri-high-school-reportedly-to-use-hair-samples-for-random-drug-tests/#ixzz2KXRqmSpX
The National Institute on Drug Abuse (Institute) has some great information about drug testing.
In Frequently Asked Questions About Drug Testing in Schools, the Institute discusses drug testing.
Why test teenagers at all?
Teens are especially vulnerable to drug abuse, when the brain and body are still developing. Most teens do not use drugs, but for those who do, it can lead to a wide range of adverse effects on the brain, the body, behavior and health.
Short term: Even a single use of an intoxicating drug can affect a person’s judgment and decisonmaking—resulting in accidents, poor performance in a school or sports activity, unplanned risky behavior, and the risk of overdosing.
Long term: Repeated drug abuse can lead to serious problems, such as poor academic outcomes, mood changes (depending on the drug: depression, anxiety, paranoia, psychosis), and social or family problems caused or worsened by drugs.
Repeated drug use can also lead to the disease of addiction. Studies show that the earlier a teen begins using drugs, the more likely he or she will develop a substance abuse problem or addiction. Conversely, if teens stay away from drugs while in high school, they are less likely to develop a substance abuse problem later in life….
Is random drug testing of students legal?
In June 2002, the U.S. Supreme Court broadened the authority of public schools to test students for illegal drugs. Voting 5 to 4 in Pottawatomie County v. Earls, the court ruled to allow random drug tests for all middle and high school students participating in competitive extracurricular activities. The ruling greatly expanded the scope of school drug testing, which previously had been allowed only for student athletes.
Just because the U.S. Supreme Court said student drug testing for adolescents in competitive extracurricular activities is constitutional, does that mean it is legal in my city or state?
A school or school district that is interested in adopting a student drug testing program should seek legal expertise so that it complies with all federal, state, and local laws. Individual state constitutions may dictate different legal thresholds for allowing student drug testing. Communities interested in starting student drug testing programs should become familiar with the law in their respective states to ensure proper compliance. http://www.drugabuse.gov/related-topics/drug-testing/faq-drug-testing-in-schools
The primary issue is whether students have privacy rights.
Your Debate.com summarizes the pros and cons of School Drug Testing:
PRO 1
The main purpose of random school drug testing is not to catch kids using drugs, it to keep them from ever using them. Once their using drugs its harder for them to break their addiction. With many employers drug testing its very important for a kid’s future not to use drugs. Drug use is responsible for many crimes. Its worth the inconvenience for all our future.
CON 2
One of the fundamental features of our legal system is that we are presumed innocent of any wrongdoing unless and until the government proves otherwise. Random drug testing of student athletes turns this presumption on its head, telling students that we assume they are using drugs until they prove to the contrary with a urine sample.
CON 3
“If school officials have reason to believe that a particular student is using drugs, they already have the power to require that student to submit to a drug test,” said ACLU-NJ Staff Attorney David Rocah.
CON 4
The constitutional prohibition against “unreasonable” searches also embodies the principle that merely belonging to a certain group is not a sufficient reason for a search, even if many members of that group are suspected of illegal activity. Thus, for example, even if it were true that most men with long hair were drug users, the police would not be free to stop all long haired men and search them for drugs.
PRO 5
Peer pressure is the greatest cause of kids trying drugs. If by testing the athletes or other school leaders, we can get them to say no to drugs, it will be easier for other kids to say no.
CON 6
Some also argue that students who aren’t doing anything wrong have nothing to fear. This ignores the fact that what they fear is not getting caught, but the loss of dignity and trust that the drug test represents. And we should all be afraid of government officials who believe that a righteous cause warrants setting aside bedrock constitutional protections. The lesson that our schools should be teaching is respect for the Constitution and for students’ dignity and privacy, not a willingness to treat cherished constitutional principles as mere platitudes. http://www.youdebate.com/DEBATES/school_drug_testing.HTM
See, What Are the Benefits of Drug Testing? http://www.livestrong.com/article/179407-what-are-the-benefits-of-drug-testing/ https://drwilda.com/2013/02/11/missouri-high-school-to-drug-test-students/
Maanvi Singh of NPR reported in the study, Drug Tests Don’t Deter Drug Use, But School Environment Might:
Schools that do random drug testing say it helps students say no to illegal drugs, while critics say it’s an invasion of privacy. But feeling good about school may affect students’ drug use more than the threat of testing.
A survey of high school students found that the possibility that they might face drug testing didn’t really discourage students from alcohol, cigarettes or marijuana. But students who thought their school had a positive environment were less apt to try cigarettes and pot.
Those students were about 20 percent less likely to try smoke pot and 15 percent less likely to light up a cigarette than students who didn’t feel that their school was a positive place, the survey found. And the trend held true, more or less, regardless of demographic or geographic factors.
Researchers from the University of Pennsylvania’s Annenberg Public Policy Center looked at 361 high school students across the country. The students were initially interviewed in 2008 as part of the more general National Annenberg Survey of Youth. A year later, researchers followed up and asked participants whether they had tried alcohol, or smoked cigarettes or marijuana.
The research was published Monday in the Journal of Studies on Alcohol and Drugs. Dan Romer, an author of the study who directs Annenberg’s Adolescent Communication Institute, says he wasn’t surprised by the results. “In a school with a good climate, the kids will respect what the teachers say more,” he tells Shots.
The key, Romer says, is that students need to understand why a school has certain disciplinary policies. “It basically boils down to how much respect everybody feels toward each other,” he says.
Proponents of random drug testing say it can act as a deterrent, or as a way to identify students in need of help. The Supreme Court has upheld the constitutionality of the practice twice, in 1995 and 2002. But the court limited its use to students participating in competitive extracurricular activities.
A school that has a positive climate might also practice drug testing, Romer said – the two aren’t mutually exclusive. But this study suggests that administrators concerned about substance abuse might want to try programs that encourage a more respectful school climate before turning to drug testing.
This study is by no means conclusive. It doesn’t distinguish between schools that implement randomized drug testing and those that only test students suspected of drug use. And it doesn’t look at whether other drug education programs might have influenced the results.
These findings reinforce previous research that casts doubt on the effectiveness of drug testing as a deterrent. A 2010 study from the University of Michigan found that in schools with drug testing, students were more likely to turn from marijuana to other illicit drugs.
One thing that neither a drug policy nor a positive environment seemed to affect was underage drinking. “It suggests to us that alcohol may be so accepted now in high school culture,” Romer says, “that kids think if you’re at a party you should be able to drink.” http://www.npr.org/blogs/health/2014/01/14/262466903/drug-tests-dont-deter-drug-use-but-school-environment-might?utm_medium=Email&utm_source=share&utm_campaign=
See, School drug tests don’t work, but ‘positive climate’ might http://www.health.am/psy/more/school-drug-tests-dont-work/#ixzz2qQ58LUDr
Here is the press release from University of Pennsylvania’s Annenberg Public Policy Center:
School drug tests ineffective but a ‘positive climate’ might work
Monday, January 13th, 2014
A national study of teenagers suggests that school drug testing did not deter them from starting to smoke tobacco or marijuana or drink alcohol. But in high schools that had a “positive school climate,” teens were less likely to start smoke cigarettes or marijuana.
Research published in the January issue of the Journal of Studies on Alcohol and Drugs compared the effectiveness over one year of school policies of student drug testing, which are in place in an estimated 20 percent of U.S. high schools, with a positive school climate.
“The bad news is that a policy of drug testing has no effect on students starting to use alcohol, cigarettes or marijuana,” said study co-author Dan Romer, associate director of the Annenberg Public Policy Center (APPC) at the University of Pennsylvania. “There’s also no effect on escalating the use of those substances.”
The study found, however, that students in schools with a positive school climate reported a lower rate of starting to use cigarettes and marijuana, and a slower escalation of smoking at the one-year follow-up interview. Students in schools with positive climates were 15 percent less likely to start smoking cigarettes and 20 percent less likely to start using marijuana than students at schools without positive climates, the study shows.
Student drug testing “is a relatively ineffective drug-prevention policy,” wrote the researchers, Dan Romer and Sharon R. Sznitman, an APPC Distinguished Research Fellow and a lecturer at the School of Public Health, University of Haifa, Israel. “On the other hand, interventions that improve school climate may have greater efficacy.” The study added that “whole school” health efforts that engage students, faculty and parents, and promote a sense of security and well-being have been found to reduce substance abuse.
Neither drug testing nor school climate affected the start of drinking alcohol.
For the complete news release click here. http://www.annenbergpublicpolicycenter.org/wp-content/uploads/Student-drug-tests-01-13-14.pdf
To read the study click here. http://www.jsad.com/jsad/article/Student_Drug_Testing_and_Positive_School_Climates_Testing_the_Relation_Bet/4893.html
And for APPC’s issue brief on student drug testing, click here. http://www.annenbergpublicpolicycenter.org/issue-brief-drug-prevention-in-schools/
Citation:
Journal of Studies on Alcohol and Drugs
Volume 75, 2014 > Issue 1: January 2014
Download PDF Document

Click to access 5232.pdf

Student Drug Testing and Positive School Climates: Testing the Relation Between Two School Characteristics and Drug Use Behavior in a Longitudinal Study [OPEN ACCESS]
Sharon R. Sznitman, Daniel Romer
Objective: Fostering positive school climates and student drug testing have been separately proposed as strategies to reduce student drug use in high schools. To assess the promise of these strategies, the present research examined whether positive school climates and/or student drug testing successfully predicted changes in youth substance use over a 1-year follow-up. Method: Two waves of panel data from a sample of 361 high school students, assessed 1 year apart, were analyzed. Changes in reported initiation and escalation in frequency of alcohol, cigarette, and marijuana use as a function of perceived student drug testing and positive school climates were analyzed, while we held constant prior substance use. Results: Perceived student drug testing was not associated with changes in substance use, whereas perceived positive school climates were associated with a reduction in cigarette and marijuana initiation and a reduction in escalation of frequency of cigarette use at 1-year follow-up. However, perceived positive school climates were not associated with a reduction in alcohol use. Conclusions: Student drug testing appears to be less associated with substance use than positive school climates. Nevertheless, even favorable school climates may not be able to influence the use of alcohol, which appears to be quite normative in this age group. (J. Stud. Alcohol Drugs, 75, 65–73, 2014)
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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.
Related:
University of Washington study: Heroin use among young suburban and rural non-traditional users on the increase https://drwilda.com/2013/10/13/university-of-washington-study-heroin-use-among-young-suburban-and-rural-non-traditional-users-on-the-increase/
Northwestern University study: Young adolescent use of marijuana results in changes to the brain structure https://drwilda.com/2013/12/23/northwestern-university-study-young-adolescent-use-of-marijuana-results-in-changes-to-the-brain-structure/
Resources
Adolescent Substance Abuse Knowledge Base http://www.crchealth.com/troubled-teenagers/teenage-substance-abuse/adolescent-substance-abuse/signs-drug-use/
Warning Signs of Teen Drug Abuse http://parentingteens.about.com/cs/drugsofabuse/a/driug_abuse20.htm?r=et
Is Your Teen Using? http://www.drugfree.org/intervene
Al-Anon and Alateen
http://www.al-anon.alateen.org/
WEBMD: Parenting and Teen Substance Abuse http://www.webmd.com/mental-health/tc/teen-substance-abuse-choosing-a-treatment-program-topic-overview
The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment? http://store.samhsa.gov/home
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/
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/

Northwestern University study: Young adolescent use of marijuana results in changes to the brain structure

23 Dec

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.
o Chaotic home environment
o Ineffective parenting
o Lack of nurturing and parental attachment
Factors related to a child’s socialization outside the family may also increase risk of drug abuse.
o Inappropriately aggressive or shy behavior in the classroom
o Poor social coping skills
o Poor school performance
o Association with a deviant peer group
o 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? http://archives.drugabuse.gov/Published_Articles/Sally.html

Anahad O’Connor reported in the New York Times article, Increasing Marijuana Use in High School Is Reported:

A new federal report shows that the percentage of American high school students who smoke marijuana is slowly rising, while the use of alcohol and almost every other drug is falling.
The report raises concerns that the relaxation of restrictions on marijuana, which can now be sold legally in 20 states and the District of Columbia, has been influencing use of the drug among teenagers. Health officials are concerned by the steady increase and point to what they say is a growing body of evidence that adolescent brains, which are still developing, are susceptible to subtle changes caused by marijuana.
“The acceptance of medical marijuana in multiple states leads to the sense that if it’s used for medicinal purposes, then it can’t be harmful,” said Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, which issued the report. “This survey has shown very consistently that the greater the number of kids that perceive marijuana as risky, the less that smoke it.” Starting early next year, recreational marijuana use will also be legal in Colorado and Washington.
Experts debate the extent to which heavy marijuana use may cause lasting detriment to the brain. But Dr. Volkow said that one way marijuana might affect cognitive function in adolescents was by disrupting the normal development of white matter through which cells in the brain communicate.
According to the latest federal figures, which were part of an annual survey, Monitoring the Future, more than 12 percent of eighth graders and 36 percent of seniors at public and private schools around the country said they had smoked marijuana in the past year. About 60 percent of high school seniors said they did not view regular marijuana use as harmful, up from about 55 percent last year.
The report looked at a wide variety of drugs and substances. It found, for example, that drinking was steadily declining, with roughly 40 percent of high school seniors reporting having used alcohol in the past month, down from a peak of 53 percent in 1997. Abuse of the prescription painkiller Vicodin is half what it was a decade ago among seniors; cocaine and heroin use are at historic lows in almost every grade.
Cigarette smoking has also fallen precipitously in recent years. For the first time since the survey began, the percentage of students who smoked a cigarette in the past month dropped below 10 percent. Roughly 8.5 percent of seniors smoke cigarettes on a daily basis, compared with 6.5 percent who smoke marijuana daily, a slight increase from 2010.
Studies show that the concentration of THC in marijuana, its psychoactive ingredient, has tripled since the early 1990s, and Dr. Volkow said there was concern that the rising use and increased potency could affect the likelihood of car accidents and could lower school performance.
“What is most worrisome is that we’re seeing high levels of everyday use of marijuana among teenagers,” Dr. Volkow said. “That is the type that’s most likely to have negative effects on brain function and performance.”
http://well.blogs.nytimes.com/2013/12/18/growing-marijuana-use-among-teenagers-spurs-concerns/?_r=1
Northwestern University researchers studied the effect of early marijuana use on adolescent brains.

Citation:

Cannabis-Related Working Memory Deficits and Associated Subcortical Morphological Differences in Healthy Individuals and Schizophrenia Subjects
Matthew J. Smith*,1,
Derin J. Cobia1,
Lei Wang1,2,
Kathryn I. Alpert1,
Will J. Cronenwett1,
Morris B. Goldman1,
Daniel Mamah3,
Deanna M. Barch3–5,7,
Hans C. Breiter1,6,7 and
John G. Csernansky1,7
+
Author Affiliations
1 Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL;
2 Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL;
3 Department of Psychiatry, Washington University, St Louis, MO;
4 Department of Psychology, Washington University, St Louis, MO;
5 Department of Radiology, Washington University, St Louis, MO;
6 Warren Wright Adolescent Center, Northwestern University Feinberg School of Medicine, Chicago, IL
7Denotes shared senior authorship on this article.
↵*To whom correspondence should be addressed; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, 13th Floor, Abbott Hall, Chicago, IL 60611, US; tel: 1-312-503-2542, fax: 1-312-503-0527, e-mail: matthewsmith@northwestern.edu
Abstract
Cannabis use is associated with working memory (WM) impairments; however, the relationship between cannabis use and WM neural circuitry is unclear. We examined whether a cannabis use disorder (CUD) was associated with differences in brain morphology between control subjects with and without a CUD and between schizophrenia subjects with and without a CUD, and whether these differences related to WM and CUD history. Subjects group-matched on demographics included 44 healthy controls, 10 subjects with a CUD history, 28 schizophrenia subjects with no history of substance use disorders, and 15 schizophrenia subjects with a CUD history. Large-deformation high-dimensional brain mapping with magnetic resonance imaging was used to obtain surface-based representations of the striatum, globus pallidus, and thalamus, compared across groups, and correlated with WM and CUD history. Surface maps were generated to visualize morphological differences. There were significant cannabis-related parametric decreases in WM across groups. Similar cannabis-related shape differences were observed in the striatum, globus pallidus, and thalamus in controls and schizophrenia subjects. Cannabis-related striatal and thalamic shape differences correlated with poorer WM and younger age of CUD onset in both groups. Schizophrenia subjects demonstrated cannabis-related neuroanatomical differences that were consistent and exaggerated compared with cannabis-related differences found in controls. The cross-sectional results suggest that both CUD groups were characterized by WM deficits and subcortical neuroanatomical differences. Future longitudinal studies could help determine whether cannabis use contributes to these observed shape differences or whether they are biomarkers of a vulnerability to the effects of cannabis that predate its misuse.
http://schizophreniabulletin.oxfordjournals.org/content/early/2013/12/10/schbul.sbt176.abstract

Here is the press release from Northwestern University:

Marijuana Users Have Abnormal Brain Structure and Poor Memory
Drug abuse appears to foster brain changes that resemble schizophrenia
December 16, 2013 | by Marla Paul
• The younger drug abuse starts, the more abnormal the brain
CHICAGO — Teens who were heavy marijuana users — smoking it daily for about three years — had abnormal changes in their brain structures related to working memory and performed poorly on memory tasks, reports a new Northwestern Medicine® study.
A poor working memory predicts poor academic performance and everyday functioning.
The brain abnormalities and memory problems were observed during the individuals’ early twenties, two years after they stopped smoking marijuana, which could indicate the long-term effects of chronic use. Memory-related structures in their brains appeared to shrink and collapse inward, possibly reflecting a decrease in neurons.
The study also shows the marijuana-related brain abnormalities are correlated with a poor working memory performance and look similar to schizophrenia-related brain abnormalities. Over the past decade, Northwestern scientists, along with scientists at other institutions, have shown that changes in brain structure may lead to changes in the way the brain functions.
This is the first study to target key brain regions in the deep subcortical gray matter of chronic marijuana users with structural MRI and to correlate abnormalities in these regions with an impaired working memory. Working memory is the ability to remember and process information in the moment and — if needed — transfer it to long-term memory. Previous studies have evaluated the effects of marijuana on the cortex, and few have directly compared chronic marijuana use in otherwise healthy individuals and individuals with schizophrenia.
The younger the individuals were when they started chronically using marijuana, the more abnormally their brain regions were shaped, the study reports. The findings suggest that these regions related to memory may be more susceptible to the effects of the drug if abuse starts at an earlier age.
“The study links the chronic use of marijuana to these concerning brain abnormalities that appear to last for at least a few years after people stop using it,” said lead study author Matthew Smith, an assistant research professor in psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. “With the movement to decriminalize marijuana, we need more research to understand its effect on the brain.”
The paper was published Dec. 16 in the journal Schizophrenia Bulletin.
In the U.S., marijuana is the most commonly used illicit drug and young adults have the highest — and growing — prevalence of use. Decriminalization of the drug may lead to greater use.
Because the study results examined one point in time, a longitudinal study is needed to definitively show if marijuana is responsible for the brain changes and memory impairment. It is possible that the abnormal brain structures reveal a pre-existing vulnerability to marijuana abuse. But evidence that the younger a subject started using the drug the greater his brain abnormality indicates marijuana may be the cause, Smith said.
The groups in the study started using marijuana daily between 16 to 17 years of age for about three years. At the time of the study, they had been marijuana free for about two years. A total of 97 subjects participated, including matched groups of healthy controls, subjects with a marijuana use disorder, schizophrenia subjects with no history of substance use disorders, and schizophrenia subjects with a marijuana use disorder. The subjects who used marijuana did not abuse any other drugs.
Few studies have examined marijuana’s effect on the deep regions in the brain — the ‘subcortical gray matter’ below the noodle-shaped cortex. The study also is unique in that it looked at the shapes of the striatum, globus pallidus and thalamus, structures in the subcortex that are critical for motivation and working memory.
The Marijuana and Schizophrenia Connection
Chronic use of marijuana may contribute to changes in brain structure that are associated with having schizophrenia, the Northwestern research shows. Of the 15 marijuana smokers who had schizophrenia in the study, 90 percent started heavily using the drug before they developed the mental disorder. Marijuana abuse has been linked to developing schizophrenia in prior research.
“The abuse of popular street drugs, such as marijuana, may have dangerous implications for young people who are developing or have developed mental disorders,” said co-senior study author John Csernansky, M.D., chair of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital. “This paper is among the first to reveal that the use of marijuana may contribute to the changes in brain structure that have been associated with having schizophrenia.”
Chronic marijuana use could augment the underlying disease process associated with schizophrenia, Smith noted. “If someone has a family history of schizophrenia, they are increasing their risk of developing schizophrenia if they abuse marijuana,” he said.
While chronic marijuana smokers and chronic marijuana smokers with schizophrenia both had brain changes related to the drug, subjects with the mental disorder had greater deterioration in the thalamus. That structure is the communication hub of the brain and is critical for learning, memory and communications between brain regions. The brain regions examined in this study also affect motivation, which is already notably impaired in people with schizophrenia.
“A tremendous amount of addiction research has focused on brain regions traditionally connected with reward/aversion function, and thus motivation,” noted co-senior study author Hans Breiter, M.D., professor of psychiatry and behavioral sciences and director of the Warren Wright Adolescent Center at Feinberg and Northwestern Memorial. “This study very nicely extends the set of regions of concern to include those involved with working memory and higher level cognitive functions necessary for how well you organize your life and can work in society.”
“If you have schizophrenia and you frequently smoke marijuana, you may be at an increased risk for poor working memory, which predicts your everyday functioning,” Smith said.
The research was supported by grants R01 MH056584 and P50 MH071616 from the National Institute of Mental Health and grants P20 DA026002 and RO1 DA027804 from National Institute of Drug Abuse, all of the National Institutes of Health.
– See more at: http://www.northwestern.edu/newscenter/stories/2013/12/marijuana-users-have-abnormal-brain-structure–poor-memory.html#sthash.coRZr6cm.dpuf

What Steps Should a Parent Take?

The Drug Enforcement Agency (DEA) has a series of questions parents should ask 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. 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 questions that should be asked of a treatment center. http://findtreatment.samhsa.gov/faq.htm 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

Related:

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

Resources

Adolescent Substance Abuse Knowledge Base
http://www.crchealth.com/troubled-teenagers/teenage-substance-abuse/adolescent-substance-abuse/signs-drug-use/

Warning Signs of Teen Drug Abuse http://parentingteens.about.com/cs/drugsofabuse/a/driug_abuse20.htm?r=et

Is Your Teen Using?
http://www.drugfree.org/intervene

Al-Anon and Alateen
http://www.al-anon.alateen.org/

WEBMD: Parenting and Teen Substance Abuse http://www.webmd.com/mental-health/tc/teen-substance-abuse-choosing-a-treatment-program-topic-overview

The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment? http://store.samhsa.gov/home

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/

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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Missouri high school to drug test students

11 Feb

Fox News reports in the story, Missouri high school reportedly to use hair samples for random drug tests:

Beginning in the 2013-2014 school year, students at Rockhurst High School in Kansas City will be mandated to undergo random drug testing by submitting roughly 60 strands of hair to a staff member at the 1,000-student school, KSHB.com reports.

Using a company called Psychemedics, officials at the Jesuit school said students will be tested for a variety of substances over the previous 90 days, including cocaine, PCP, opiates, methamphetamine, marijuana and binge alcohol.

Our point is, if we do encounter a student who has made some bad decisions with drugs or alcohol, we will be able to intervene, get the parents involved, get him help if necessary, and then help him get back on a path of better decision making, healthier choices for his life,” Rockhurst Principal Greg Harkness told the website.

If a student tests positive for any substance, according to the new policy, a guidance counselor will be notified. The counselor will then notify the student’s parents to determine how to best help the child.

The student would then be given 90 days to be drug-free, with no notification sent to administrative personnel. The incident would only be noted in the student’s guidance file, which would later be destroyed upon graduation and will not be sent to colleges or universities. The document would only become public if subpoenaed, the website reports.
http://www.foxnews.com/us/2013/01/31/missouri-high-school-reportedly-to-use-hair-samples-for-random-drug-tests/#ixzz2KXRqmSpX

The National Institute on Drug Abuse (Institute) has some great information about drug testing.

In Frequently Asked Questions About Drug Testing in Schools, the Institute discusses drug testing.

Why test teenagers at all?

Teens are especially vulnerable to drug abuse, when the brain and body are still developing. Most teens do not use drugs, but for those who do, it can lead to a wide range of adverse effects on the brain, the body, behavior and health.

Short term: Even a single use of an intoxicating drug can affect a person’s judgment and decisonmaking—resulting in accidents, poor performance in a school or sports activity, unplanned risky behavior, and the risk of overdosing.

Long term: Repeated drug abuse can lead to serious problems, such as poor academic outcomes, mood changes (depending on the drug: depression, anxiety, paranoia, psychosis), and social or family problems caused or worsened by drugs.

Repeated drug use can also lead to the disease of addiction. Studies show that the earlier a teen begins using drugs, the more likely he or she will develop a substance abuse problem or addiction. Conversely, if teens stay away from drugs while in high school, they are less likely to develop a substance abuse problem later in life….

Is random drug testing of students legal?

In June 2002, the U.S. Supreme Court broadened the authority of public schools to test students for illegal drugs. Voting 5 to 4 in Pottawatomie County v. Earls, the court ruled to allow random drug tests for all middle and high school students participating in competitive extracurricular activities. The ruling greatly expanded the scope of school drug testing, which previously had been allowed only for student athletes.

Just because the U.S. Supreme Court said student drug testing for adolescents in competitive extracurricular activities is constitutional, does that mean it is legal in my city or state?

A school or school district that is interested in adopting a student drug testing program should seek legal expertise so that it complies with all federal, state, and local laws. Individual state constitutions may dictate different legal thresholds for allowing student drug testing. Communities interested in starting student drug testing programs should become familiar with the law in their respective states to ensure proper compliance. http://www.drugabuse.gov/related-topics/drug-testing/faq-drug-testing-in-schools

The primary issue is whether students have privacy rights.

Your Debate.com summarizes the pros and cons of School Drug Testing:

PRO 1

The main purpose of random school drug testing is not to catch kids using drugs, it to keep them from ever using them. Once their using drugs its harder for them to break their addiction. With many employers drug testing its very important for a kid’s future not to use drugs. Drug use is responsible for many crimes. Its worth the inconvenience for all our future.

CON 2

One of the fundamental features of our legal system is that we are presumed innocent of any wrongdoing unless and until the government proves otherwise. Random drug testing of student athletes turns this presumption on its head, telling students that we assume they are using drugs until they prove to the contrary with a urine sample.

CON 3

“If school officials have reason to believe that a particular student is using drugs, they already have the power to require that student to submit to a drug test,” said ACLU-NJ Staff Attorney David Rocah.

CON 4

The constitutional prohibition against “unreasonable” searches also embodies the principle that merely belonging to a certain group is not a sufficient reason for a search, even if many members of that group are suspected of illegal activity. Thus, for example, even if it were true that most men with long hair were drug users, the police would not be free to stop all long haired men and search them for drugs.

PRO 5

Peer pressure is the greatest cause of kids trying drugs. If by testing the athletes or other school leaders, we can get them  to say no to drugs, it will be easier for other kids to say no.

CON 6

Some also argue that students who aren’t doing anything wrong have nothing to fear. This ignores the fact that what they fear is not getting caught, but the loss of dignity and trust that the drug test represents. And we should all be afraid of government officials who believe that a righteous cause warrants setting aside bedrock constitutional protections. The lesson that our schools should be teaching is respect for the Constitution and for students’ dignity and privacy, not a willingness to treat cherished constitutional principles as mere platitudes. http://www.youdebate.com/DEBATES/school_drug_testing.HTM

See, What Are the Benefits of Drug Testing?http://www.livestrong.com/article/179407-what-are-the-benefits-of-drug-testing/

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?

Resources:

Adolescent Substance Abuse Knowledge Base

Warning Signs of Teen Drug Abuse

Is Your Teen Using?

Al-Anon and Alateen

Center for Substance Abuse Publications

National Clearinghouse for Drug and Alcohol Information

WEBMD: Parenting and Teen Substance Abuse

The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment?

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

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/

A cautionary tale: Riding the 71 bus and the death of Whitney Houston

11 Feb

This is a portion of the Seattle Times article, Whitney Houston, superstar of records, films, dies:

Houston’s publicist, Kristen Foster, said the cause of death was unknown.

Rosen said police received a 911 call from hotel security about Houston at 3:43 p.m. Saturday. Paramedics who were already at the hotel because of a Grammy party unsuccessfully tried to resuscitate the singer, he said.

Houston’s end came on the eve of music’s biggest night – the Grammy Awards. It’s a showcase where she once reigned, and her death was sure to cast a heavy pall on Sunday’s ceremony…

At her peak, Houston was the golden girl of the music industry. From the middle 1980s to the late 1990s, she was one of the world’s best-selling artists. She wowed audiences with effortless, powerful, and peerless vocals that were rooted in the black church but made palatable to the masses with a pop sheen….

But by the end of her career, Houston became a stunning cautionary tale of the toll of drug use. Her album sales plummeted and the hits stopped coming; her once serene image was shattered by a wild demeanor and bizarre public appearances. She confessed to abusing cocaine, marijuana and pills, and her once pristine voice became raspy and hoarse, unable to hit the high notes as she had during her prime.

“The biggest devil is me. I’m either my best friend or my worst enemy,” Houston told ABC’s Diane Sawyer in an infamous 2002 interview with then-husband Brown by her side.

It was a tragic fall for a superstar who was one of the top-selling artists in pop music history, with more than 55 million records sold in the United States alone.

She seemed to be born into greatness. She was the daughter of gospel singer Cissy Houston, the cousin of 1960s pop diva Dionne Warwick and the goddaughter of Aretha Franklin....http://seattletimes.nwsource.com/html/entertainment/2017485885_apusobitwhitneyhouston.html

The 71 bus was crowded, it usually is. The run is from downtown to the university district. I don’t know how many thousands attend the University of Washington, but they all seem to be riding the bus at the same time. It promised to be an uneventful trip from city center to the “district.”

I was at the end of a seat because my seatmate took over half the bench seat. But, I was happy to be sitting down and not be a strap hanger. I just wanted to close my eyes and think about nothing in particular. The gangly, black guy across from me, said “hey, did you know that Whitney Houston died?” I said that that was the first I had heard about her death. Then I asked, drugs? He said “yeh, probably, but nobody said nothing about it.” I said I wondered what causes people to start with drugs. He began to tell me his story.

At this point, I didn’t know his name or even why he began talking to me. He said that he had taken just about every drug imaginable and had even come back from the dead a couple of times. He once had a wife, children, and other family. He had made a lot of money in the fishing industry in Alaska in the 70’s. Proudly he told me about managing a team of over 75 and being respected for that. “That was something for a black man in the 70’s.” he said he made over $1400 per week back then. What happened, I said. “We were young, reckless, and we wanted to try everything because we thought nothing could touch us.” Eventually he was using heavily and began dealing to support his habit. Other members of his family including his wife were using as well.

He asked me if I worked for METRO, the local bus company. No, I said, I’m a writer. Why did you think I worked for METRO? “Because your jacket has the METRO colors.” I’m guessing he probably likes hitting on bus drivers. The conversation continued. How do you get out of the drug life, I asked. “You die, you relapse, you struggle.” He talked about his struggles. The fact that the AA he liked to attend because it was a small group folded and how hard it was for him to go to a bigger group of thirty or so. Why, I asked. “Because out of thirty folks, about ten of them will relapse and that is discouraging.” He is currently on methadone and his tests have been coming up clean. Now, “I just want to tell the truth, I just want a real life.”

His bus stop approached. I asked him if I could have his first name and whether it would be OK if I wrote about his story. “My name is Ron and I just might read your blog.”

I’m guessing, Ms. Houston never made it to the point where she just wanted to tell the truth.

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