UNDERSTANDING

TEENAGE DRUG USE

Dr DES CORRIGAN

Sligo Oct 13th 2012

Drug Left School Early Still in School National Survey

(18-64)

Cigarettes 70% 27% 28%

Alcohol 66% 56% 71%

Cannabis 34% 8% 3%

Headshop Drugs 3% 0.2% 3.5%*

Cocaine 5% 0.2% 0.5%

Ecstasy 7% 0.2% 0.1%

Solvents 0.8% 0% 0.1%

LAST MONTH USE (CURRENT USE)

* USE IN LAST YEAR

OUR FAVOURITE DRUG

The Pharmacology of Alcohol

Alcohol is unique because it acts as a

Stimulant Drug: Risky behaviour magnified

Anti-Anxiety Drug: Inhibitory mechanisms removed

Pain Killing Drug: Increased aggression

Depressant Drug : Inappropriate responses

Because of these effects it has a major role in violent crime

Effect of ALCOHOL on the

Brain

1-2 Drinks

Affects

Reason,

Caution,

Intelligence

& memory

3-4 Drinks

Affects Self-

Control &

Judgement

5-6 Drinks Affects

the Senses

7-8 Drinks

Affects

Coordination

& Balance

10 or more

Affects the

Vital Centres

Gender and B.A.C Content

(Legal Limit 0.05%)

Male 2 pints Guinness 0.11%

Female 2 glasses wine 0.12%

Male 4 pints Guinness 0.24%

Female 4 glasses wine 0.32%

Source Irish Times Motor Supplement

Nov. 15th 2006

ALCOHOL-RELATED HARMS

Alcohol Related Problems

2. Psychological

Depression

Suicide

Anxiety

Amnesia

Insomnia

Impaired Relationships

Alcohol Related Problems

3. Social

Presenteeism

Violence

Drunk Driving

Theft

Unwanted Pregnancies

Gateway link between Binge-drinking & illicit

drugs

BINGE DRINKING

Cannabinoids

PhytoCannabinoids- only in Cannabis plants

Endocannabinoids – naturally occurring in the

Human Body

Synthetic Cannabinoids – developed as pain-

killing drugs – found in some “SPICE”-type

smoking mixtures

The Complexity of Cannabis

500 different Chemicals in Cannabis plants

70 Cannabinoids

Most relevant: THC – Euphoriant/ Psychotogenic

CBD – Anti-Anxiety/Anti-psychotic

3 Visually identical Cannabis plants

Fibre (Hemp) Type Rich in CBD

Almost no THC

Drug Type: Rich in THC

almost no CBD

Intermediate Type: THC + CBD

Equal amounts

TYPES OF CANNABIS DRUGS

Herb (1-2%)

( Grass, Marijuana)

Resin (10%)

( Hash,Hashish)

Oil ( Hash Oil)30-60%

High THC-Content

Cannabis & Headshops

1. Sale of Skunk-type seeds

2. Advice on Sinsemilla Technique

3. Sale of Hydroponics & Intense

Lighting

.

Afghan No 1

HYDROPONIC CULTIVATION HYDROPONIC CULTIVATION

SKUNK or WEED

Home-Grown or from Grow Houses

Huge Increase in level of THC

No CBD to counterbalance THC

Increases mental health risks

Increases addiction risks

HASH Contains both THC & CBD

Cannabis Potency

expressed as % THC Content

Ireland

Herb 8% (4-16%*) Hash 3%

UK

Herb* 12-18% Hash 3%

Netherlands

Herb* 16.5% Hash 30% * Skunk or Weed-type

Cannabis V Alcohol

Benchmarking risk of a pint vs a joint not

possible

As you are not comparing like with like

Because exposure levels different

Because speed of elimination different

Because mode of action in Brain different

The Speed at Which Drugs Leaves the Body

Alcohol Marijuana

1 Hour 6 Hours 30 Days

Amount left

in body after

a single dose

SHORT TERM EFFECTS OF CANNABIS

DRUGS

Memory & Learning

Reactions & Coordination

Cannabis, Learning & Memory

All tests of learning disrupted

High levels of distractability

While learning

While driving

While using complex machinery

Solowij 1998

Cannabis use 20 + times per month:

19% more short-term memory

Problems than non-users.

Rodgers et al 2003

CANNABIS USE & SCHOOL PERFORMANCE

Monshouwer et al 2006 Dutch Children (12 – 16)

“Those using Cannabis reported lower than average school

performance”.

Ferguson et al 2003. (New Zealand)

“Cannabis use may act to decrease educational achievement

in young people”

Lynskey and Hall 2000 (Australia)

“Early Cannabis use may significantly increase risks of

subsequent poor school performance”.

Patton et al 2007(Australia)

“ Drug of choice for life’s future losers”

Cannabis Use & Later Life

Outcomes New Zealand Study from Birth to Age

25

High levels of use associated with

Poorer educational outcomes

Lower income

Greater welfare dependence

Greater unemployment

Lower relationship & life satisfaction

Meier et al Proc Nat Acad Sci August 27th 2012

**

Regular Cannabis use results in a 6 point drop in IQ

Cannabis and Driving

THC impairs psychomotor function and driving

performance.

RECENT use of THC doubles risk of fatal

crash.

Damaging effects most likely on motorways and

in single vehicle crashes.

Combined use of THC and Alcohol produces

more severe driving impairment.

CHRONIC EFFECTS OF CANNABIS

DRUGS

Respiratory Problems

Gateway Drug

Dependence

Mental health

CRITERIA FOR CANNABIS

DEPENDENCE Tolerance

Withdrawal symptoms

Loss of control over use

Persistent desire to use

Great deal of time spent obtaining, using and or recovering from use

Giving up or reducing other important activities

Continued use despite physical or psychological problems

Complaints by spouse/partner about use and its effects.

CANNABIS WITHDRAWAL CRITERIA

Common Symptoms

Anger or aggression

Decreased appetite or weight loss

Irritability

Nervousness/anxiety

Restlessness

Sleep difficulties

Strange dreams

Budney et al

Am. J. Psychiat.2004

Cannabis Dependence Questions

Did you think your use was out of control?

Did the prospect of missing a joint make you anxious or worried?

Did you worry about your use of Cannabis?

Did you wish you could stop using?

How difficult did you find it to stop or go without?

NACD Population Survey 2010/2011

Adolescents who use Cannabis

1 in 6 may develop dependence ( 1 in 10 for

adults)

More likely to use other drugs

Perform poorly at school

Leave school early

Report psychiatric symptoms & disorders ( Wayne Hall, Addiction Summer 2008)

Typical Scenario

Young Man 17 yrs old

Primary drug weed ( smokes 10-15 joints a day)

Lack of motivation-drop out school & youth centre

Self harm/suicidal thoughts

Dysfunctional background

Enablement from parent who is also chemically

dependent & violent

Drug Debts & threats of violence

The Adolescent brain – a work in progress

Giedd et al, 1999, Nature Neuroscience, 2, 861-863 Blue colour represents grey matter in brain

Cannabis & Mental Health

Risk Factors

Genetic susceptibility (11 x Risk)

Childhood Trauma (21 x Risk)

Age of first use – 15 years -4.5 x Risk

Length of use

Amount used

Type of Cannabis used (Skunk/Weed)

Di Forti et al Neuroscience & Biobehavioural Reviews 2011

Skunk-Type Cannabis & Psychosis

Use for 5 years – 2 x risk

Daily use - 6 x risk

Compared to Hash smoking controls

Skunk use - 7 x risk

Daily Skunk use - 12 x risk

Di Forti et al . Br. J. Psychiatry 2009

Cannabis & Mental Health

“There is now sufficient evidence to

warn young people that using

cannabis could increase their risk of

developing a psychotic illness later in

life”.

Moore etal

The Lancet 2007; 370: 319-28

NACD STUDY

RISK FACTORS

SUBSTANCE USE BY OTHER FAMILY

MEMBERS

FRIENDS WHO USE DRUGS

EARLY EXPERIMENTATION WITH

ALCOHOL & TOBACCO

LOW SELF-ESTEEM

NACD STUDY

PROTECTIVE FACTORS

PARENTAL INVOLVEMENT & CONCERN

INFORMATION ON SUBSTANCE USE

FOR PARENTS

FRIENDS WHO DON’T USE DRUGS

POSITIVE SCHOOL EXPERIENCE