-
Trends,TacticsandToxicity:MarijuanaMovementonMissouriCollegeCampuses
JanicePutnamPhD,RNAmyKigerMS,ABD
KellySkinnerDNP,FNP-C
1
-
Marijuana/Cannabis
• Marijuanauseisgrowinginpopularity
• Consumption:– Joints,blunts,vaporizers– Drinks–
Derivatives-wax,dabs,oilsandshatter
– Capsules– Tincturesandspray(undertongue)
– Edibles
-
2015AIHce
CurrentLawsinMissouri
• Marijuanapossession
-
CollegeandMarijuana• Mostprevalentusers18to25y.o.•
20%usinginthepastmonth(NIH,2016)
•
ERvisitsby13-21-year-oldsdoubledfrom1.7to4per1,000between2009and2015(U.ofCO)
• 30stateshaveadoptedlegalizedmarijuana•
studentrecruitmentcrossesthesestatelines
• Decreasesstudentperformancemeasuresandretentionrates
•
Effectshort-termmemoryimpairment,detachment,decreasedalertness,anddepression
http://health.usnews.com/health-care/articles/2017-05-05/pot-a-factor-in-more-er-admissions-for-colorado-teens-after-legalization
-
MissouriCollegeMACHBSurveyRacialDemographics
Other
Asian/PacificIslander
Hispanic
Black(non-Hispanic)
White(non-Hispanic)
201520162017
-
UseInCar—Missouri
0%
2%
4%
6%
8%
2015 2016 2017
3% 3%
5%5%
6%
7%
1% 1% 1%
Parkedoncampus ParkedoffcampusBeingdriven
-
Noteveryonewhousesmarijuanaexperiencesthefeelingofrelaxationandcalm.Insomeusers,itcancausefear,distrust,anxietyandevenafeelingofpanic.Thisismorelikelytooccurinsomeonewhotakestoomuchortoohighofaconcentration.Thesereactionsareserious,buttemporary,andmayresemblesymptomsofschizophreniawithonlyshortlastingpsychoticsymptoms
TheCorrelationBetweenUltra-PotentPotandPsychosis-video
https://www.youtube.com/watch?v=4zZXVjxBK4ghttps://www.youtube.com/watch?v=4zZXVjxBK4g
-
ProblematicUsageandIntervention
• Marijuanatoxicity•
fainting,passingout,extremeparanoia,excitement,thebodyfrozenintime,andlossofreality
• Marijuanaaddiction• usedmarijuanaatleastonce,riskis9%•
startingtouseinadolescence,riskis17%• usedaily,riskis25-50%.•
Chronicmarijuanauseislinkedtopsychosis,schizophrenia,anxiety,depression
-
DiagnosingCannabisUseDisorder•
Cannabistakeinlargeramountsoroverlongerperiodsoftimethandesired•
Desiretodecreaseorcontrolofcannabisuse•
Moretimethandesiredworkingtoobtain,useorrecoverfromtheeffectsof
cannabis• Strongcravingtousecannabis•
Useresultsinfailuretofulfillroleobligationssuchaswork,schoolorhome•
Continuedusedespiteinterferencewithsocialorinterpersonalrelationships•
Continuedusewiththeknowledgethatitcausesorexacerbatescurrentphysical
orpsychologicalproblems•
Withdrawalsymptomsdevelopwhennotused
• Mooddisorder• Behavioraldisorder• Nausea
Tolerance:• Needformorecannabistoachievethehigh•
Diminishedeffectwiththecontinueduseofthesameamount
-
WithdrawalSyndrome:
• Impairedmotorcoordination• Euphoria• Anxiety•
Impairedjudgement• Slowtimesensation• Socialwithdrawal•
Difficultysleeping• Irritability• Conjunctivalinjection•
Increasedappetite• Drymouth• Tachycardia
Perceptualdisturbances:•
Hallucinations,Auditorydisruption,Visualdisruption•
TactileIllusions(e.g.feelingasoftobjectbutnotbeingabletodescribeit)
-
Acuteintoxication:
ERtreatment
1. Closemonitoring
2. QuietEnvironment
• Dimlylitroom• Assignonecaretaker•
Calmandlimitedconversation
3.Benzodiazepinesifsevereagitationoranxietydevelops
-
MarijuanaCessationTechniques
• Cognitivebehavioraltherapy
• Contingencymanagement
• Motivationalenhancementtherapy
(NationalInstituteonDrugAbuse,2018)
-
MedicalUse–MARINOL/SYNDROS(dronabinol)
Acannabinoidindicatedinadultsfor:• Anorexia•
Nauseaandvomiting
AdverseEffects:• Dizziness• Drowsiness•
Confusionorfeeling“high”• Exaggeratedsenseofwell-being•
Nauseaandvomiting• Stomach/abdominalpain
-
2015AIHce
•
GivenPIPstrackrecordwithalcoholandsubstanceabuse,collegehealthcareprovidersandstaffareinastrongpositiontoanticipatetheneedsofcollegestudentswhoarelikelytostrugglewithproblematicmarijuanauseoraddiction
6/2/2015 19
-
WhatWeWantedToFindOut
Whatistheenvironmentofhealthassessmentskills,studentresources,andprofessionaldevelopmentformarijuanausebycollegestudentsinthestateofMissouri?
-
HowWeAnsweredtheQuestion
• 3PIPFocusGroups• 15schools• N=42• Questionscovered–
Assessment– Resources– Professionaldevelopment
-
VoluntaryParticipation
• IRB• Audiorecordings•
Anyinformationwhichidentifiedindividualschoolsorstaffwascoded
• Thematicanalysisbythreeresearchers•
DebriefedfindingswithPIPpriortodissemination
-
2015AIHce6/2/2015 23
-
2015AIHce6/2/2015 24
CampusPerceptionsofMarijuanaareAlreadyStrong
InMissouri,campus-widemarijuanaperceptionsarealreadystronglyinfluencedbymarketingandlow-riskhealthmessagesencounteredthroughthemediaandsocialinteractions.
Campus-wideperceptionsofmarijuanaas“justpot”and“harmless”issharedbymanyincludingstudents,staff,andfaculty.
Asanissue,marijuanauseisseenacrosscampusasasecondaryprioritytomanyissuesofhigherprevalence-specificallyalcohol.
Talkingtostudentsaboutmarijuanahasbeenreportedasvolatileingroupsettings,butnotinindividualdiscussions.
Thereisusuallylittlefacultyandparentalinvolvementwhencollegestaffworkonissuesofmarijuanausebystudents.
-
2015AIHce6/2/2015 25
ToneofMessageisDisciplinary
Studentsarenotvoluntarilyusingcollegeservicesfor“problems”withmarijuanause.
Studentsareusingpreventionservicesonlyifrequiredbydisciplinaryactions.
Anawarenessofadesiretouselesshasbeenheard,althoughrarely.
-
2015AIHce6/2/2015 26
PreventionandPracticeAlignswithSubstanceAbuse
Primarypreventiononcampusisvaried;participantsreportedusingeducationalbrochures,webinars,andsocialnorming.
Campusactivityrelatedtomarijuanahaveincludedactivitiessuchapublicburns(toeducatethecampus)anddrugdoguse(forlawenforcement).
Assessmentofstudentmarijuanauseisoftenpartofothersubstanceabuseassessments.
Motivationalinterviewingisrecommendasanavailabletreatmentinestablishedsubstanceabuseprograms.
-
2015AIHce6/2/2015 27
SpecificProfessionalDevelopmentNeedsRelatedtoMarijuana
Professionaldevelopmentneedsformarijuanaaregenerallybeingmetasitisincludedinsubstanceabusetopics.
Professionaldevelopmentneedsspecifictomarijuananotbeingmetincludevariabilityinmarijuanaforms,routes,anddosages,languageandadvocatingstatementsfordecreasedmarijuanause,hooksfordiscussion,andsafelevelsofuse.
-
2015AIHce
Discussion
•
TheresultsarevaluabletoMissouricolleges-theyprovideinsightintothecurrentattitudes,environment,skills,andpracticesrelatedtomarijuanausebycollegestudents
•
Theresultsmayprovideafoundationforfurtherstudiesrelatedtochannelsofcommunication,toneformessages,influentialsocialmodels,practicemodels,andprofessionaldevelopment
•
Programsmayfindtheresultshelpfulforfuturedecisionmaking,strategicplanning,andprogramimprovement
6/2/2015 28
-
2015AIHce
Limitations
• Smallsamplesizemaymaketheconclusionsnon-transferable
• Focusgroupstendtobelessdepthfulthanindividualinterviews
•
Focusgroupmembercontributionsmayhavebeeninfluencedbyothermembersofthegrouportheresearchersleadingthediscussions
6/2/2015 29
-
2015AIHce6/2/2015 30
• Questions?
