Drugs on the Street

Steven G. Liga

MSW, LSW, LCADC, CPS, CCS

© 2017 Liga

Differentiate between myths and facts

regarding the trends of youth drug use over

the past decade

Identify the true "gateway" drugs and how

those drugs have changed over time

Understand emerging trends in drug use and

implications for practice

© 2017 Liga

Aunt Nora

Bernice

Binge

Blow

Bump

Candy

Charlie

Dust

Flake

Mojo

Nose Candy

Paradise

Rock

Sneeze

Sniff

Snow

Toot

White

© 2017 Liga

Cocaine

© 2017 Liga

© 2017 Liga

© 2017 Liga

© 2017 Liga

1996 2006 2016

Past-month alcohol use 38.8% 31% 19.8%

Past-month cigarette use 28.3% 14.4% 5.9%

Past-month marijuana use 17.7% 12.5% 13.7%

Past-month ecstasy use 1.5% 1%

0.5%

Past-month cocaine use 1.7% 1.6% 0.5%

Past-month heroin use 0.6% 0.4% 0.2%

Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future national

survey results on drug use,1975-2015: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social

Research, The University of Michigan.

© 2017 Liga

2002 2008 2015

Past-month alcohol use 60.5% 61.1% 58.3%

Past-month smoking rates 40.8% 35.7% 26.7%

Past-month marijuana use 17.3% 16.6% 19.8%

Past Month cocaine use 2.0% 0.7% 0.6%

Past-month ecstasy use 1.5% 1% 0.5%

Past-month heroin use 0.1% 0.2% 0.3%

Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States:

Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51).

© 2017 Liga

Brown sugar

Dope

Hell dust

Horse

Junk

Nose drops

Skag

Skunk

Smack

Thunder

White horse

Cheese

© 2017 Liga

Heroin

© 2017 Liga

0

1000

2000

3000

4000

5000

Number in Thousands

2015 National Survey on Drug Use and Health, SAMHSA

For their first illicit drug, twice as many youth tried prescription drugs as marijuana.© 2017 Liga

80% of heroin users start with prescription drugs

4.3 million Americans engaged in non-medical use of prescription painkillers in the last month.

Rx medications are expensive – 30mg oxycodone $30

Heroin as low as $5/hit

Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.

© 2017 Liga

© 2017 Liga

13,000 Rx overdose deaths

20,000 heroin overdose deaths

Expected to increase at LEAST by 25% in 2016 and again in 2017!

For perspective: Peak gun deaths = 39,000 in 1993 Peak HIV deaths = 47,000 in 1995 Peak car crash deaths = 54,000 in 1972 Peak overdose deaths = 65,000 in 2017

Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths —United States,

2010–2015. MMWR Morb Mortal Wkly Rep 2016;65:1445–1452.

© 2017 Liga

Josh Katz, New York Times. June 5, 2017

© 2017 Liga

A Fatal dose of fentanyl next to a penny (DEA)

© 2017 Liga

© 2017 Liga

Captain Cody

Cody

Doors and fours

Lean

Loads

Pancakes and syrup

Purple drank

Schoolboy

Sizzurp

D

Dillies

Footballs

Juice

Smack

O.C.

Oxy 80

Oxycat

Oxycet

Oxycotton

Oxy

Hillbilly heroin

Percs

Perks

Biscuits

Blue heaven

Blues

Heavenly blues

Mrs. O

O bombs

Octagons

Stop signs

Codeine Hydromorphone Oxycodone Oxymorphone

© 2017 Liga

In medical terms, these are opioid

analgesics, and in legal terms, narcotics.

Confusion Opiates: A Natural Pain Remedy

Opioids: Synthetic Pain Medications

Opioid is now used for the entire family of opiates including natural, synthetic and semi-synthetic.

© 2017 Liga

Adam

Beans

Cadillac

California sunrise

Clarity

Essence

Elephants

Eve

Hug

Love pill

Lover’s speed

Peace

Roll

Scooby snacks

Snowball

© 2017 Liga

More commonly known as Ecstasy, X, or Molly.

Past-month use of ecstasy by 12th graders dropped 70% from its peak in 2000 to 2015.

Still the same level as cocaine and nearly 4x the level of heroin

Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future

national survey results on drug use,1975-2015: Overview, key findings on adolescent drug use. Ann Arbor: Institute for

Social Research, The University of Michigan.

© 2017 Liga

Bennies

Black beauties

Crosses

Hearts

LA Turnaround

Speed

Truck drivers

Uppers

Diet coke

JIF

Kiddie cocaine

Kiddie coke

MPH

Poor man’s cocaine

R-ball

Skippy

Skittles

Smarties

The Smart Drug

Vitamin R© 2017 Liga

Stimulant used to treat ADHD

Used by teens, young adults and

professionals to sharpen concentration and

stay awake

© 2017 Liga

Arctic blasts

Aura

Avalance or Avalanche

Bliss

Blizzard

Bloom

Blue silk

Bolivian bath

Cloud nine

Cotton cloud

Drone

Dynamite or Dynamite plus

Euphoria

Glow stick

Hurricane Charlie

Ivory snow

Ivory wave or Ivory wave ultra

Lunar wave

Mexxy

Mind change

Monkey dust

Mystic

Natural energy powder

Ocean snow

Plant food

Purple wave

Quicksilver

Recharge

Red dawn

Red dove

Rock on

Rocky Mountain High

Route 69

Sandman Party Powder

Scarface

Shock wave

Snow day

Snow leopard

Speed freak miracle

Stardust

Super coke

Tranquility

UP energizing or UP Supercharged

Vanilla Sky

White burn

White China

White dove

White lightning

White rush

White Sands

Wicked X or XX

Zoom© 2017 Liga

Powder sold as “bath salts”

Snorted, smoked or injected like cocaine

Can cause violent hallucinations

© 2017 Liga

Synthetic form of marijuana – advertised as safe, legal alternative to marijuana

Dried herbal blend marketed as potpourri or incense

Myth: Because Spice products are natural, they are harmless.

© 2017 Liga

Joe

No Doz

Juice

Hard stuff

Sauce

Hooch

Moonshine

Vino

Draft

Suds

Liquid bread

Oats soda

Tummy

buster

Liquid

courage

12 oz. curl © 2017 Liga

Caffeine Alcohol

FDA imposes a 71 mg caffeine limit in soda – NO LIMIT in energy drinks

2nd most popular dietary supplement for teens and young adults (NIH 2017)

Energy drinks are consumed by one-third of adolescents 12-17 (NIH 2016).

© 2017 Liga

Affects thinking, emotion, and coordination

Teen pregnancy, sexual behavior, assaults

Contributing factor in the top three causes of death

Impacts brain development

Start at 15 =

15% develop alcoholism

Wait until 21 =

2.5% develop alcoholism

© 2017 Liga

Almost 88,000 people die from alcohol-

related health problems every year. This number does not include the 10265 alcohol-impaired

driving fatalities in 2015.

Alcohol’s consequences often extend beyond

the user and into society.

Department of Transportation (US), National Highway Traffic Safety Administration (NHTSA). Traffic

Safety Facts 2014 data: alcohol-impaired driving. Washington, DC: NHTSA; 2015© 2017 Liga

What is the worst substance a pregnant

woman can use?

Alcohol - physical, mental, behavioral, and

learning disabilities that can last a lifetime

Tobacco – preterm birth, placenta abruption, small

at birth, risk of SIDS

Narcotics – withdrawal can cause miscarriage

Cocaine – placental abruption, miscarriage, low

birth weight, 25% increase risk of premature labor

American Congress of Obstetricians and Gynecologists. FAQ170, December 2013

© 2017 Liga

What if she is already using?

Alcohol – stop, medical detox if addicted

Tobacco – stop, nicotine replacement only under

Dr’s care if necessary

Narcotics – don’t stop, switch to methadone

maintenance under a Dr’s care

Cocaine – stop

Forray, Ariadna. “Substance Use during Pregnancy.” F1000Research 5 (2016): F1000 Faculty Rev–887. PMC.

Web. 3 Sept. 2017.

© 2017 Liga

Most effective therapeutic intervention

during pregnancy is Contingency Management

Based on the principle of positive reinforcement

as a means of operant conditioning to influence

behavior change.

The premise behind CM is to systematically use

reinforcement techniques, usually monetary

vouchers, to modify behavior in a positive and

supportive manner.

Forray, Ariadna. “Substance Use during Pregnancy.” F1000Research 5 (2016): F1000 Faculty Rev–887. PMC.

Web. 3 Sept. 2017.

© 2017 Liga

Iowa, Minnesota, and North Dakota’s

health care providers are required to test for

and report prenatal drug exposure.

Kentucky health care providers are only

required to test.

American Pregnancy Association. Using Illegal Drugs During Pregnancy, July 2015. © 2017 Liga

Some states consider prenatal

substance abuse as part of their child welfare

laws. Therefore, prenatal drug exposure can

provide grounds for terminating parental

rights because of child abuse or neglect.

These states include: Arkansas, Colorado,

Florida, Illinois, Indiana, Iowa, Louisiana,

Minnesota, Nevada, Rhode Island, South

Carolina, South Dakota, Texas, Virginia, and

Wisconsin.

American Pregnancy Association. Using Illegal Drugs During Pregnancy, July 2015. © 2017 Liga

Alaska, Arizona, Illinois, Louisiana,

Massachusetts, Michigan, Montana,

Oklahoma, Utah, Rhode Island, and Virginia’s

health care providers are required to

report prenatal drug exposure.

Reporting and testing can be evidence

used in child welfare proceedings.

American Pregnancy Association. Using Illegal Drugs During Pregnancy, July 2015. © 2017 Liga

Some states have policies that enforce

admission to an inpatient treatment program

for pregnant women who use drugs.

These states include: Minnesota, South

Dakota, and Wisconsin.

American Pregnancy Association. Using Illegal Drugs During Pregnancy, July 2015. © 2017 Liga

Currently, Tennessee is the only state in

which a woman can be prosecuted for using

illegal drugs while pregnant.

Women are offered a choice between serving

time in jail or joining a rehab program.

American Pregnancy Association. Using Illegal Drugs During Pregnancy, July 2015. © 2017 Liga

© 2017 Liga

© 2017 Liga