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5/18/16
1
“WhatTeensAreUpAgainst…AndWhatYou
CanDoAboutIt”UsingBrainScienceandParentKnowledge
toExploreTeenSubstanceUseRisksStephenBogan,M.A.,LMHC,CDP
Goalsfortonight…
• ENGAGE….(Ihope!?)• EDUCATE…(we’llallshareourwisdom)
• EMPOWER…parentstobeasvigilant(ormore)aboutdruguseastheyareaboutgradesandroomcleaning!!!
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Howmuchknowledgeandcomfortdoyouhaveintakingastand
against…• Methamphetamines?• Cocaine?• Opiates• Heroin?• PCP?• Tobacco?• Alcohol?• Marijuana?
Isithardertotakeastrongstanceagainstalcoholandmarijuana?
• Whatdrugcouldyoubestwarnyourteenagainstusing?
• Canmessagebetoostrongandunrealis?c….• OrtoosoB?• Ornomessageatall?• Trea?ngsomemoodalteringsubstancesas“soB”drugsfliesinfaceofbrainscience.
• Expressa“nouse”aKtude.
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ThemostpowerfulprevenXontools?
• ThestrengthandclarityofyourconvicXons….whatyousayanddon’tsayhavetremendouspower…whetheryouthinkyourteensarelisteningornot.
• Delayingtheonsetofearlyuseofalcoholandotherdrugs.
• Braindevelopmentinprocessandongoingun?latleastage26.
Thepowerthatparentshave…
• Teenswhohavecloserela?onshipwiththeirparentslesslikelytobecomealcoholinvolved.
• Children,teenswatchtheirparentscarefully.• Oneofthemostconsistentriskfactorsforadolescentdrinking/druguseisparentalapproval.
• Adolescentswhoreportlowparentalmonitoringaremorelikelytousesubstances.
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WhatparentsthinkaboutmarijuanausemaYerstotheirkids!!
Source:2014HealthyYouthSurveyFactSheetVHS
WhatparentsthinkaboutalcoholusemaYerstotheirkids!!
2014HealthyYouthSurveyFactSheetVHS
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Don’twaittoexpressyourconcernsaboutalcoholuse
Source: 2014 Healthy Youth Survey
Don’twaittoexpressyourconcernsaboutmarijuanause
Source: 2014 Healthy Youth Survey
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10thgrademarijuanausedownfrom2012
Source: 2014 Healthy Youth Survey
10thgradealcoholusewaydownsince2012
Source: 2014 Healthy Youth Survey
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TheAdapXveAdolescentis…
• LessaroughdraBthananexquisi?velysensi?ve,highlyadaptablebeingwiredalmostperfectlyforthejobofmovingfromthesafetyofhomeintothecomplicatedworldoutside.
OR• Bigengine,poordrivingskills,faultybreaks,andhigh-octanegas.
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Ageoffirstusepredictsadultdependence…
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TeenBrainsOvervalueReward,UndervalueRisk
• Chiefpredictorofadolescentbehaviorisnotthepercep?onofrisk,butthean?cipa?onofrewarddespitetherisk!
• Druguseinhibitsthedevelopmentofnewmemoriesandlearningintheteenbrain
• Neuralpathsforreasoning,judgment,andinhibi?ngimpulseshaveyettobefullyestablished.
• “What”wereyouthinkingvs.“HOW”
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Teenbrainsarewiredtotakerisks…
• Increasedrisk-takingdesignedtohelpteenslearnnewthings,becomeindependent.
• Risktakingtriggerstheamygdalatoreleasedopamineandadrenalinethatproduceanemo?onal“high”andafeelingofexcitement.
• Drugs“hi-jack”theamygdala• Teensweighrisksasmuchormorethanadults
TheAmygdala:flight,fight,freezeandemoXonalrelevance…
Ø Fullydevelopedatbirth!!!Ø Wonder,awe,passionØ Whywelikethingswedoalot.Ø Securityalarmforourlives;learnedfear.Ø “Caveboystory”;amygdalavs.PFC.
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Drugsshieldchildrenfromdealingwithreality…
• Andfrommasteringdevelopmentaltaskscrucialtotheirfuture.
• TheskillstheylackedthatleBthemvulnerabletodrugabuseinthefirstplacearetheveryonesthatarestuntedbydrugs.
• Youthwillhavedifficultyestablishingaclearsenseofiden?ty,masteringintellectualskills,andlearningself-control.
• Youthwillchronologicallymaturewhileremainingemo?onaladolescents.(RobertSchwebel)
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Theadolescentbrainondrugs
• Drugusedisruptsthepre-frontalcortex’scapacityforreasonandcontrol.
• Drugabusedisruptsthebrain’sinnatedriveforgrowth,andinterfereswithnaturalinterests.
• Floodsrewardsystemwithdopamine• Asmuchas2–10?mesthedopaminefromnaturalrewards.
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AddicXonisanonsetdisorderofyoungpeople
• Thevastmajorityofpeoplewhosufferfromaddic?onencounteredthebeginningsoftheirillnesswhentheywereteenagers.
• Ninetypercent(90%)ofpeoplewhoaredependentonalcoholorotherdrugsstartedbeforetheyweretwenty(20)yearsold.(HBOAddic?on)
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Howalcoholaffectstheteenbrain
• Canactasas?mulantaffec?nginhibi?ons• Isacentralnervoussystemdepressant• Cerebellum-coordina?on,thoughts,awareness.
• Cerebralcortex-slowsdownprocessing.• Hypothalamus-bodytemp.,heartrateincrease.
• Frontallobes-controlofemo?ons,urges.
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AlcoholandTeenBraincont’d.
• Hippocampus-short,longtermmemory,blackouts.
• Lowsensi?vity/hightolerancerisks.• Overdose-centralnervoussystemshugngdown.
• “lethimsleepitoff…”dangers.
Marijuana:Ageoffirstuse/addicXonpotenXal
• Ageoffirstuseearlyas10andavg.12-13.• Summerbetweengrade8and9!!!!• Usebeforeage15predicts63%willhaveadultdependence.(Dennis2002)
• RecentNPRreport:“Only1in6teensbecomesaddicted…”!?!?That’s17%.
• 50%ofdailyusersbecomeaddicted.• “Dabbing”THClevelsupto90%!!!!!! 26
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Proliferation of Images
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Adultvs.teenrisks
• Marijuanaislegalfor21yearolds• Medicalcannabismaybehelpfultosomeadultswithsomemedicalcondi?ons
• Verylilleprovenevidenceonefficacyandsafetyofcannabisuseforchildrenandteens.
• Shouldourmessagebeaffectedbysocialtrendsorbrainscience?
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Marijuanapotencywayup!!
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PercepXonofharmlowestsince1978
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EducaXonalandLifeOutcomes
• Lowersa?sfac?onwithlife• Academicpursuitsperceivedaslessrewardingandmeaningful.
• Lowergradesandexamscores.• LesslikelytograduatefromHighSchool• Lesslikelytoenrollincollege.• Morelikelytoearnlowerincome.• Morelikelytobeunemployed.• NoraVolkow-NIDA
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Earlypotusemaychangebrain
• Regularusebeforeage16causeschangesinbrainthatcanimpairabilitytofocus,learnfrommistakes,thinkabstractly.
• Earlyusersdidmorepoorlyontestsofcogni?vefunc?onsandmentalflexibility.
• Earlychronicusers“makerepe??veincorrectresponsesevenwhilebeingtoldtheyarewrong”;calledcogni?veinflexibility.
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UsecauseslasXngchangestoteenI.Qand“workingmemory”
• AverageI.Q.declineof8pts.(N.Z.studyofTeenuseavg.THC5%)
• “Workingmemory”consistsofbrainstructurescri?caltomemoryandreasoning.
• Asourceofreadyrecallforbasicinforma?onforsolu?onstoeverydayproblems.
• Workingmemoryisastrongpredictorofacademicachievement.
• NorthwesternUniversityFeinbergSchoolofMedicine 35
Everything“seems”beYerwhenhigh…
• Affectstheamygdala–partofbrainthatprovidesemo?onalrelevancetomemory.
• Percep?onthat“Idoeverythingbeler…”,oreverythingfeelsbeler…
• Ar?ficialpassionandmeaningover-ridesnaturalrewardsoftheac?vity.
• Affectsemo?onalregula?on.• Down-regulatesbrain–can’tfeelaweandwonder.
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EmoXons,socialskills
• Youthusedrugtocompensateforinadequatesocialskills
• Mayseedailyuseastheirown“medica?on”fordepression,sadness,anxiety.
• Connectthedrugusewithreduc?onsinstress,sadness,anxiety,wheninrealitythesefeelingsarebeing“masked”notreduced.
• Makeshappy,goodfeelingslessrewarding.
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THCandmentalhealth
• Depressedteensmorethan2Xmorelikelytohaveusedthannon-depressed.
• Teenswhosmokemarijuanaatleast1X/monthare3Xmorelikelytohavesuicidalthoughtsthannon-users.
• Teenswhousemarijuanato“self-medicate”depressionmayworsentheircondi?on.
• Teenusemaytriggerspsychosis,depression,andothermentalillness.
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Closingthoughts…
• Parentsneedtobethemature,calm,andreasonablePre-FrontalCortexfortheirkids.
• Guidingthemandintegra?ngemo?on,judgement,regula?on,reason.
Staycalm,focused,andconfident
• Parentswhobecomeawareofadolescentbraindevelopmentcanfeellessinjuredwhentheirgoodkiddoesabadthing.
• Braindevelopmentexplainswhyteensaresoquicktotrynewthingsandforgeintotheunknown…
• BUTalsoexplainswhytheys?llneedtheirparents!!!