Adolescent Substance Abuse and AddictionsYouth Transition Program Statewide ConferenceMarcus Poppen, B.A., QMHA

University of OregonFebruary 23rd, 2012

Substance Use and Addictions

What is a substance?Something we use to change

how we feel, or act, which affects both our minds and bodies.

Drug Classifications and What are they?

NarcoticsStimulants (Uppers)Depressants (Downers)HallucinogensNicotine

-- Reduce pain while providing an intense sense of pleasure

-- Speed up or excite our brains-- Slow down our brains

-- Alter our perceptions of reality-- Combine properties of stimulants and depressants

Milkman, H., & Wanberg, K. (2005). Pathways to Self-Discovery and Change.

Drug Classifications and Examples

NarcoticsStimulants (Uppers)Depressants (Downers)HallucinogensNicotine

-- Heroin, Codeine, Morphine-- Methamphetamines, Cocaine, Caffeine

-- Alcohol, Barbiturates, Xanax, Valium

-- MDMA, Marijuana, LSD

-- Cigarettes, Chewing Tobacco

Milkman, H., & Wanberg, K. (2005). Pathways to Self-Discovery and Change.

Effects of Substances

Substances affect us both directly and indirectly.

Milkman, H., & Wanberg, K. (2005). Pathways to Self-Discovery and Change.

Direct effects This is what is happening to us when we are

using a substance. Indirect effects

This is what is happens to us after we are using a substance.

Effects of Substances

Milkman, H., & Wanberg, K. (2005). Pathways to Self-Discovery and Change.

Substances affect us physiologically.

Liver Increases build up of fatty tissues, getting in the way of

healthy cells and blood supply, leading to dead cells. Your body replaces the dead cells with scar tissue (cirrhosis), preventing your liver from working right.

Stomach and Gut Alcohol can burn holes in the lining of your stomach and

gut (also known as creating stomach ulcers).Heart and Blood Heavy drinking can increase your blood pressure and can

cause heart problems.Brain and Nerves Alcohol can damage and kill brain cells.

Lets take alcohol for example:

Effects of Substances

Tolerance

Milkman, H., & Wanberg, K. (2005). Pathways to Self-Discovery and Change.

Over time our bodies require an increase in the amount of the substance we put into our bodies because our bodies will give us less of the feelings we want.

Effects of Substances

Withdrawal

Milkman, H., & Wanberg, K. (2005). Pathways to Self-Discovery and Change.

Substances are poison to our bodies. When a substance leaves our body, our body has to try and return to normal. Sometimes this rebalancing can cause shock to our body and is also known as withdrawal. Most often this effect is psychological, however, this effect and also be physiological.

Milkman, H., & Wanberg, K. (2005). Pathways to Self-Discovery and Change.

Class Physical Withdrawal

Psychological Withdrawal

NarcoticsNausea, tremors, chills, sweating,

crampsIrritability, panic,

anxiety

Stimulants (Uppers)

Cravings, tiredness, headaches

Depressions, paranoia,

aggression, anxietyDepressants (Downers)

Loss off appetite, insomnia, tremors

Delirium, anxiety, psychosis

Hallucinogens

Hyperactivity, loss of appetite

Paranoia, anxiety, irritability, depression

NicotineCravings,

headaches, fatigue, insomnia

Irritability, depression,

restlessness, feelings of

frustration and anger

Adolescents and Substances and AddictionsSubstance use vs. Substance abuse

McWhirter, J., et al. (2007). At-Risk Youth, Chapter 8.

Substance use often linked to social influence

Substance abuse often linked to internal processes

For adolescents, most of the correlates of substance use are identical to substance abuse.

Adolescents and Substances and

Addictions

Environmental and Social

Peer Influence Family

PersonalAdolescen

t Substance

Use

DSM-IV Definition

DSM-IV does not make separate provisions for children and adolescents when defining substance abuse and dependence.

McWhirter, J., et al. (2007). At-Risk Youth, Chapter 8.

DSM-IV Definition

Based on behaviors and physiological effects occurring within a specific time frame.

Abuse (1 or more in a 12-month period) Impaired social, school, or occupational

functioning Recurrent use in physically hazardous situations Recurrent substance related legal problems Continued use despite persistent or recurrent

social or interpersonal problems caused or exacerbated by substance

www.csam-asam.org/pdf/misc/DSM_criteria_for_diagnosis.doc

DSM-IV Definition Based on behaviors and physiological effects occurring

within a specific time frame.Dependence (3 or more in a 12-month period)

Tolerance (increased dosage needed to maintain physiological effects)

Symptoms of withdrawal Substances taken in a larger amount and for longer periods

of time than intended Persistent desire and repeated attempts to quit Planning around obtaining substances, use and recovery Use continues despite knowledge of adverse consequences

www.csam-asam.org/pdf/misc/DSM_criteria_for_diagnosis.doc

Substance Use in Adolescents

Important to Understand Patterns of Use:FrequencyQuantitySingle-Substance vs. Poly-substance

UseWhen, Where and with Whom?Emotional state of the userConsequencesMcWhirter, J., et al. (2007). At-Risk Youth, Chapter 8.

Case Study

Case Study

Identify Patterns of Use using the Case StudyFrequencyQuantitySingle-Substance vs. Poly-substance UseWhen, Where and with Whom?Emotional state of the userConsequences

Case Study

Why might it be challenging for this person to change their behaviors around using alcohol and other drugs?

What could you do to support this person in making a positive behavior change?

Wrap-Up: Case Study

Center for Family Development

Day Treatment and Reporting Center

ASAM Level III Intensive Outpatient Alcohol and Other Drug Treatment Program (12+ hours of treatment each week)

High Risk Adolescents (ages 15-18) with a history of alcohol or other drug use and involvment in the Juvenile Justice System

Can be a transition program from residential back into the community.

Gender Specific Services Titrated Phase System Addresses risk factors and enhances resiliency

Center for Family Development

Day Treatment and Reporting Center

Center for Family Development

Day Treatment and Reporting Center

Gender Specific

Skills Group

Individual Tutoring

Creative and Expressive Arts

Component

Individual Drug and

Alcohol Check In’s

Drug and Alcohol CBT

Skills Group

Family Therapy

Individual Therapy

YOUTH

Department of Youth Services

Day Treatment and Reporting Center

Master Service Plan

Team Meetings

Daily Coordinated

Planning with Juvenile

Counselors