1. Preventing Drug Abuse in Your Community Identifying and Preventing Drug Abuse in Student School Populations and Your Community By Rosa M. Torres Ed.S., M.A. & Amanda Steiner M.A.

2. Teen Drug Abuse Prescription Medications Addiction Identifying and Preventing Drug Abuse in Student School Populations and Your Community Next to marijuana, the most common illegal drugs teens are abusing are prescription medications.

5. Current Trends in Drug Abuse Marijuana Synthetic marijuana Synthetic Cathinones “Bath Salts” DXM (cough medicine) Rx drug abuse

6. Did you know? Hookah The First Tobacco Trend of the 21st Century... Teens were 8 times more likely to experiment with cigarettes if they had ever used a hookah. www.mcosa.net/Hookah/Hookah.ppt Many parents may have heard the term "e-cig" at some point. The use of electronic cigarettes is on the rise among middle and high school students, who mistakenly view them as "safe" alternatives to traditional tobacco/nicotine forms such as cigarettes. Hookah The First Tobacco Trend R X A BUSE P REVENTION T OOLKIT - from awareness to action E Lites Keychain, pen, laser pointers are some styles for electronic cigarette

7. Did you know?  E-cigs come in many forms, some look like pens, laser pointers, or even faux cigarettes. Along with the actual electronic cigarette, parents should keep their eyes open for small bottles of flavored drops that contain varied amounts of nicotine. In addition, many parents do not realize that e-cigs may also be used as "drug delivery devices" when used with synthetic marijuana drops. R X A BUSE P REVENTION T OOLKIT - from awareness to action

8. Bath Salts: The New Designer Drug Legal in almost every state, “bath salts” are the latest designer drug to be sweeping the nation. Never intended to be put in bathwater, this powdery substance is packaged as “bath salt” to circumvent drug laws. Bath salt is a hallucinogen that can cause - Intense paranoia delusions - Days of anxiety and paranoia Easily found at gas stations and convenience stores, it is important to learn the many names of this drug to protect against its dangerous effects.

9. Alternative Names for Bath Salts Bloom White Dove Ocean Snow

10. How Are Bath Salts Abused? Bath salts are typically taken: orally inhaled injected OR with the worst outcomes being associated with snorting or needle injection.

11. Teen DXM Abuse Identifying and Preventing Drug Abuse in Student School Populations and Your Community DXM or Cough Medicine Abuse Teen Drug Abuse DXM, or dextromethorphan, is a common ingredient in cough and cold medicines Teens, however, have found another use for cough medicine -- getting high. Shocking Facts: A recent study found that one in 10 American teenagers has abused products with DXM to get high, making it more popular in that age group than cocaine, ecstasy, LSD, and meth.

12. Understanding DXM Abuse Dextromethorphan affects the brain, specifically the region that controls coughing. However, at high doses – as much as 10 to 50 times the suggested amount DXM can cause hallucinatory and dissociative effects similar to those of PCP or ketamine (special K.) Why Is It Popular? DXM is easy to get. DXM is cheap DXM seems safer DXM is popular Hard for the parents to detect DXM Abuse:

13. How Is DXM Abuse Harming Teens ? What Are the Risks? Impaired vision Sweating and fever Rapid breathing Increased heart rate and blood pressure Nausea, vomiting, and diarrhea Slurred speech Impaired judgment and mental function Memory loss Rapid eye movements Hallucinations and dissociative effects Coma Overdoses: High amounts can shut down the central nervous system. Toxins: Combination cold and flu drugs often contain cough suppressants, decongestants, antihistamines, and painkillers that can be quite toxic. Impairment. altered consciousness, impaired vision, and hallucinations can lead to irrational and dangerous behavior.

14. Teens’ Rx Drugs of Choice For Abuse How they workAbused by teens to:Drug names Strong pain relievers Used to relieve moderate-to-severe pain, these medications block pain signals to the brain Get high, increase feelings of well being by affecting the brain regions that mediate pleasure Vicodin, OxyContin, Percocet, Lorcet, Lortab, Actiq, Darvon, codeine, morphine, methadone Stimulants Primarily used to treat ADHD type symptoms, these speed up brain activity causing increased alertness, attention, and energy that comes with elevated blood pressure, increased heart rate and breathing Feel alert, focused and full of energy—perhaps around final exams or to manage coursework, lose weight Adderall, Dexedrine, Ritalin, Concerta Sedatives or tranquilizers Used to slow down or “depress” the functions of the brain and central nervous system pressure, increased heart rate and breathing Feel calm, reduce stress, sleep Valium, Xanax, Ativan, Klonopin, Restoril, Ambien, Lunesta, Mebaral, Nembutal, Soma R X A BUSE P REVENTION T OOLKIT - from awareness to action

15. Did you know?  Next to marijuana, the most common illegal drugs teens are abusing are prescription medications.  Twenty percent of U.S. high school students say they have taken Rx drugs without consulting a doctor.  1 in 5 teens has abused Rx drugs.  1 in 3 teens say there is “nothing wrong” with abusing Rx medications “every once in a while.”  Every day, almost 2,500 teens abuse an Rx medication for the first time. R X A BUSE P REVENTION T OOLKIT - from awareness to action

16. Teens say that… R X A BUSE P REVENTION T OOLKIT - from awareness to action Agree strongly/somewhat % Rx drugs, even if they are not prescribed by a doctor, are much safer to use than illegal drugs. 40% There is nothing wrong with using Rx drugs without a doctor’s prescription once in a while. 31% Rx pain relievers, even if they are not prescribed by a doctor, are not addictive. 29%

17. Rx Medications are All Around Us…and Teens Notice The Teen – Rx Abuse Connection  Patients leave the doctor’s office with a prescription in hand in 7 out of 10 visits.  Direct-to-consumer advertising on TV and in magazines is pervasive.  Many people don’t know how to safely use these medications or ignore their doctor’s instructions. R X A BUSE P REVENTION T OOLKIT - from awareness to action

18. Rx drugs are part of teen culture. Teens: As a result…  It normalizes this form of drug abuse.  Take these meds for legitimate reasons – with or without a prescription – to stay awake, remain alert or to go to sleep.  Purposely abuse these drugs to get high. They participate in “pharming” and “bowling” parties.  Are often unaware that these activities can lead to disastrous results. R X A BUSE P REVENTION T OOLKIT - from awareness to action

19. Teenagers don’t know that abusing Rx drugs can:  Increase blood pressure or heart rate.  Damage the brain and other organs.  Lead to accidental overdose / poisonings.  Cause physical dependency and / or addiction.  Disrupt breathing (respiratory depression).  Lead to risks associated with mixing multiple drugs or combining with alcohol.  Cause seizures and even death. R X A BUSE P REVENTION T OOLKIT - from awareness to action

20. Watch for Physical Warning Signs  Sudden mood changes, including irritability, negative attitude, personality change.  Extreme changes in groups of friends or hangout locations.  Lying or being deceitful, unaccounted time away from home/missed school days, avoiding eye contact.  Losing interest in personal appearance, extracurricular activities or sports.  Poor performance at school.  Borrowing money or having extra cash.  Visiting and even purchasing from pro-drug abuse (illegal) web sites. EDUCATE R X A BUSE P REVENTION T OOLKIT - from awareness to action

21. Watch for Physical Warning Signs  Excessive sweating, urination or thirst  Nausea and vomiting  Uncontrollable diarrhea  Spastic shaking  Drowsiness, dizziness and insomnia  Loss of consciousness  Physical dependence  Addictive behavior  Violence, fights in classrooms with students, teachers  Stealing  Disruptive classroom behavior  Domestic violence EDUCATE R X A BUSE P REVENTION T OOLKIT - from awareness to action

22. What causes dilated pupils? Dilated pupils not resulting from a normal response to low light are typically caused by drugs, medications, poisons, Medication or other drug causes of dilated pupils A number of therapeutic medications, as well as illicit drugs, may cause dilated pupils including: Amphetamines Antihistamines such as diphenhydramine (for example, Benadryl, Allermax, Allergia-C) or chlorpheniramine (for example, Chlor-trimeton, Aller-Chlor, Allerlief)Benadryl Atropine Cocaine Decongestants such as pseudoephedrine (Sudafed) Eye drops such as tetrahydrozoline (Visine) LSD Marijuana Methamphetamines Withdrawal from heroin and other narcotics R X A BUSE P REVENTION T OOLKIT - from awareness to action

23. Signs of Addiction People with drug problems might act differently than they used to. They might: Spend a lot of time alone Lose interest in their favorite things Get messy—for instance, not bathe, change clothes, or brush their teeth Be really tired and sad Be very energetic, talk fast, or say things that don't make sense Be nervous or cranky (in a bad mood) Quickly change between feeling bad and feeling good Sleep at strange hours Miss important appointments Have problems at work Eat a lot more or a lot less than usual According to the National Institution on Drug Abuse (2013)

24. R X A BUSE P REVENTION T OOLKIT - from awareness to action Rx Access Points— Friends & Family Source of Concern SAMHSA. (2008). Results from the 2007 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series: H-34, DHHS Publication No. SMA 08-4343). Rockville, MD. Available at: www.oas.samhsa.gov/nsduh/2k7nsduh/2k7Results.pdfwww.oas.samhsa.gov/nsduh/2k7nsduh/2k7Results.pdf

25. Parental/Guardian Beliefs & Attitudes  Many parents aren’t aware of the dangers of Rx and drug/alcohol abuse – it’s just not on their radar screen.  Rx medicines can be found in homes of family or friends, and parents don’t realize the connection between teen Rx drug/alcohol abuse and easy availability.  Many parents do not know how to effectively talk with their teens about Rx drug/alcohol abuse.  They often find out about an Rx/Drug/alcohol problem when it is too late. R X A BUSE P REVENTION T OOLKIT - from awareness to action

26. COMMUNICATE Talk to teens about Rx/Drug/alcohol abuse  Teens learn by example. Peer Pressure, Fellow Students, Friends, Family, even Foes influence students and teenagers. When they see mom, dad, a sibling or grandparent taking a pill – even responsibly – it doesn’t seem so bad.  Many teens report that their parents have the greatest influence on their drug use attitudes and decisions.  Kids who continue to learn about the risks of drugs at home are up to 50% less likely to use drugs than those who are not taught about these dangers. R X A BUSE P REVENTION T OOLKIT - from awareness to action

27. COMMUNICATE Talking to teens “DENORMALIZE” THE BEHAVIOR While 1 in 5 teens are abusing Rx drugs/alcohol, 4 in 5 are not. DEBUNK COMMON MYTHS: Rx Drug/Alcohol abuse is just as dangerous as abusing other substances; it can be addictive; and it’s not OK to misuse these drugs even “once in a while.” PROVIDE CLEAR GUIDELINES If you’re a parent, let teens know you will be disappointed if they abuse Rx Drug/Alcohol with medications and watch how you use medicines in front of teens. GIVE TEENS ESCAPE ROUTES Teach them how to get out of bad situations; and suggest responses they can use so they don’t feel “uncool.”  “No, thanks – not into it.”  “Not today.”  “I’m not interested.” R X A BUSE P REVENTION T OOLKIT - from awareness to action

28. SAFEGUARD Keep track of your meds Parents (and other family members) are in the best position to reduce access to prescription drugs by locking up medicines and properly disposing of expired or unused medicines. Monitor all medications in the home—prescription and OTC medicines. Safely store medicines out of children’s reach and sight. Consider locking them up. Get rid of old or unused medicines. R X A BUSE P REVENTION T OOLKIT - from awareness to action

29. Guidelines for Rx drug disposal FEDERAL GUIDELINES  Refer to October 15, 2009 FDA Guidelines for Disposal by Flushing.  Do not flush down toilet or drain unless label or accompanying patient information specifically instructs you to do so.  Dispose of Rx drugs not labeled to be flushed through community drug take-back programs. If a program is not available, dispose of medications appropriately: 1. Take medication out of its original packaging and place it into a disposable container with a lid or into a sealable bag. 2. Mix drugs with an undesirable substance (e.g., cat litter or used coffee grounds). 3. Place sealed container with the mixture and original packaging (be sure to remove all personal information from the packaging) in the trash. SAFEGUARD Office of National Drug Control Policy. Proper Disposal of Prescription Drugs. 2009. Available at: www.whitehousedrugpolicy.gov/publications/pdf/prescrip_disposal.pdf R X A BUSE P REVENTION T OOLKIT - from awareness to action