Ulster Prevention Council Blog 12-9-13: SAMHSA News Release: Ecstasy-related emergency department visits

SAMHSA News Release: Over a six-year period, Ecstasy-related emergency department visits rose 128 percent for those younger than 21                                                                                       
Date: 12/3/2013 12:05 AM 
Media Contact: SAMHSA Press Office
Telephone: 240-276-2130

Hospital emergency department visits related to the dangerous hallucinogenic drug Ecstasy, sometimes known as “Molly,” increased 128 percent between 2005 and 2011 (from 4,460 visits in 2005 to 10,176 visits in 2011) for visits among patients younger than 21 years old, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA). Overall in 2011, there were approximately 1.25 million emergency department visits related to the use of illicit drugs. Ecstasy (3,4-methylenedioxy-methamphetamine) has both stimulant and hallucinogenic properties, and produces feelings of increased energy and euphoria among users. Abuse of Ecstasy can produce a variety of undesirable health effects such as anxiety and confusion, which can last one week or longer after using the drug. Other serious health risks associated with the use of Ecstasy include becoming dangerously overheated, high blood pressure, and kidney and heart failure. Recently there have been several deaths associated with Molly, a variant of Ecstasy, among young people taking it at concerts and raves. Another key finding shows that a substantial proportion of hospital emergency departments visits associated with Ecstasy during the six year period also involved underage drinking. In each year from 2005 to 2011, an average of 33 percent of emergency department visits among those younger than age 21 involved Ecstasy and involved alcohol. This unsafe combination causes a longer-lasting euphoria than Ecstasy or alcohol use alone and may increase the risk for potential abuse. “These findings raise concerns about the increase in popularity of this potentially harmful drug, especially in young people,” said Dr. Peter Delany, Director of SAMHSA’s Center for Behavioral Health Statistics and Quality. “Ecstasy is a street drug that can include other substances that can render it even more potentially harmful. We need to increase awareness about this drug’s dangers and take other measures to help prevent its use.”    The report, titled Ecstasy-Related Emergency Department Visits by Young People Increased between 2005 and 2011; Alcohol Involvement Remains a Concern, is based on 2005 to 2011 findings from the Drug Abuse Warning Network (DAWN). DAWN is a public health surveillance system that monitors drug-related hospital emergency department visits and drug-related deaths to track the impact of drug use, misuse and abuse in the United States. The complete survey findings are available on the SAMHSA website at:http://www.samhsa.gov/data/spotlight/spot127-youth-ecstasy-2013.pdf For more information about SAMHSA, visit: http://www.samhsa.gov

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Cheryl DePaolo

Director of Ulster Prevention Council

Ulster Prevention Council Blog 11-26-13: Marijuana Part 4

As we continue this series about marijuana, national data regarding emergency room visits and treatment admissions linked to use of marijuana are helpful in exploring the risks.

The amount of THC in marijuana samples confiscated by police has been increasing steadily over the past few decades. In 2012, THC concentrations in marijuana averaged nearly 15 percent, compared to around 4 percent in the 1980s. For a new user, this may mean exposure to higher concentrations of THC, with a greater chance of an adverse or unpredictable reaction. Increases in potency may account for the rise in emergency department visits involving marijuana use. For experienced users, it may mean a greater risk for addiction if they are exposing themselves to high doses on a regular basis. However, the full range of consequences associated with marijuana's higher potency is not well understood.

While overdoses of cannabis are not themselves acutely life-threatening to healthy individuals, high doses of sativa or other THC-rich strains can induce temporary symptoms of paranoia or panic in some people, with accompanying rise in blood pressure and heart rate. Very high doses of any strain can also cause temporary loss of consciousness(“greening out”). Clearly, either of these effects could have serious consequences based on other factors, such as a pre-existing heart condition or simply falling and hitting your head.

According to the Substance Abuse and Mental Health Services Administration's Drug Early Warning Network (Dawn), marijuana-related Emergency Room visits totaled 455,268 in 2011. The average patient age for marijuana-related visits was 30 years. 58 percent of marijuana-related visits involved patients aged 12 to 29, with 12 percent in the 12 to 17 age group. 66 percent were males, and 31 percent of visits in involved combining marijuana with other drugs.

SAMHSA's Treatment Episode Data Set (TEDS)  is a national data system of annual admissions to substance abuse treatment facilities, and can be used to identify differences between treatment admissions involving persons who started using marijuana at age 17 or younger and those that initiated as adults. TEDS involves actual counts rather than estimates.

According to the National Institute on Drug Abuse (NIDA), estimates from research suggest that about 9 percent of users become addicted to marijuana; this number increases among those who start young (to about 17 percent, or 1 in 6) and among daily users (to 25-50 percent).

TEDS data shows that in 2010 there were 687,531 substance abuse treatment admissions aged 18 to 30. Of these, 340,212 reported marijuana abuse at treatment intake. The majority of marijuana admissions reported early initiation. 86.8 percent started using marijuana at age 17 or younger and the remaining 13.2 percent reported adult initiation (started using marijuana at age 18 or older). 12.1 percent began using at age 11 or younger. These proportions remained relatively constant between 2000 and 2010.  Among adult initiates, 95.9 percent reported initiating marijuana use between the ages of 18 and 24.

Next we'll look at some recent research regarding the potential for sustained, and possibly permanent, cognitive problems because of early age at initiation and long periods of use.

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Cheryl DePaolo

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Ulster Prevention Council Blog 11-4-13: Marijuana Part 3

Adolescent brains are just learning how to think logically, but they strive to make decisions for themselves. They are less likely than adults to be fully wired to notice errors in decision-making.  Some skills have to be taught.  A crucial skill for adolescents and adults is evaluating the source of their information.

Youth often fail to question the accuracy of information received from friends, relatives or acquaintances. They are likely to be adept at finding information through Google searches, Wikipedia, Erowid (an online library containing  information about psychoactive drugs, plants, and chemicals) and other sources, but fail to evaluate the reliability of the source.

However, when watching educational materials regarding marijuana featuring research scientists or doctors, they sometimes state that they "don't trust" the information presented. Perhaps it's their version of "Don't trust anyone over 30"! Discussing their mistrust can be crucial to having a true dialog with them.

Let's consider the following paragraph from the NIDA (National Institute on Drug Abuse) website:

Research clearly demonstrates that marijuana has the potential to cause problems in daily life or make a person's existing problems worse.

The above "Research clearly demonstrates" should prompt both adults and adolescents to ask what research? when? where? what problems? worse in what way?

Over the next few weeks as we look at research regarding marijuana, keep in mind the importance of evaluating source materials, presenting accurate information, considering all sides, and providing adolescents with the information and tools that they need to make informed decisions.  This assists us is working with adolescent development. not against it.

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Cheryl DePaolo

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Ulster Prevention Council Blog 10/9/13: Marijuana Part 2

Ulster Prevention Council blog: Marijuana Part 2


In my last blog I stated that unless we, the adults, are clear about the harm from marijuana, we will be sending mixed messages to youth. Let's talk about our approach.


In discussing potential harm, it is very important to work with adolescent development and not against it. I spent many years in the substance abuse treatment world, but it took a while to find a way to work with adolescents and not feel like I was banging my head, or theirs, against the wall. No wonder! I entered the field when confrontation and "breaking denial" were the biggest tools in the treatment arsenal. A key task of adolescence is struggling for autonomy. Arguing with youth generally leaves them even more entrenched in their original position. 

 So how do we work with adolescent brain development? We come alongside them, as a problem solving partner. We slow down and build trust, demonstrating that we respect them, can look at the issue from all sides and are willing to consider new information. We must actively undo their expectation that we intend to argue them out of their beliefs and behaviors. This process can't be rushed. At the same time, we continue to establish and maintain firm boundaries for safe behaviors.
  In addition, new research regarding adolescent brain research is very exciting and serves as a great starting point for discussions.

 The prefrontal cortex is a section of the brain that weighs outcomes, forms judgments and controls impulses and emotions. This area is the last to develop and, in fact, isn't fully developed until the early 20s. Use of mood altering substances during this period can be very damaging. An area of the teenager's brain that is fairly well-developed early on, though, is the nucleus accumbens,  the area of the brain that seeks pleasure and reward. 

 For most adults, climbing hotel balconies of skateboarding off roofs of houses sound like awful ideas. Their prefrontal cortex curbs any impulse to do so, because the possible negative outcomes outweigh any potential thrill. But teenagers may try these things because they're seeking a buzz to satisfy that reward center, while their prefrontal cortex can't register all the risks these actions entail.
 It's the combination of the developing prefrontal cortex and the heightened need for reward that leads to behavior that has adults asking "Why in the world did you do that?" and adolescents truthfully answering "I don't know!" 

Cheryl DePaolo
Director of Ulster Prevention Council

Ulster Prevention Council Blog 9-18-13: Marijuana Part 1

Most students should be settling back into a school routine nicely by now. However, for those whose use of marijuana increased in frequency and amount over the summer, the transition may not be going so smoothly. Sometimes students who intended to stop smoking marijuana once September rolled around have trouble sticking to that decision. Research shows that approximately 9 percent, or about 1 in 11, of those who use marijuana at least once will become addicted. This rate increases to 16 percent, or about 1 in 6, if you start in your teens, and goes up to 25-50 percent among daily users. Among young people in drug abuse treatment, marijuana accounts for the largest percentage of admissions: 61 percent of those under age 15 and 56 percent of those 15-19.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) provides standard criteria for the classification of disorders. Criteria for Substance Use Disorders include taking the substance in larger amounts or for longer than you meant to, wanting to cut down or stop using the substance but not managing to, cravings and urges to use the substance, and not managing to do what you should at work, home or school because of substance use.
For heavy users who are trying to go curtail using marijuana, they are likely to experience quite a bit of discomfort. The DSM-5 includes new diagnostic criteria for Cannabis Withdrawal, caused by cessation of cannabis use that has been heavy and prolonged, and results in significant distress or impairment in social, occupational, or other important areas of functioning, and is characterized by at least three of these symptoms: irritability, anger or aggression; nervousness or anxiety; sleep difficulties; decreased appetite or weight loss; restlessness; depressed mood; and or physical symptoms such as stomach pain, shakiness or tremors, sweating, fever, chills, and headache.
What can we do for youth? First, take marijuana use seriously. It's not a harmless rite of passage. Second, know what interventions are available and effective in addressing marijuana use disorders. Over the next few weeks we'll explore the ins and outs of marijuana and discuss what the most current research shows about the short term and long term consequences of marijuana use. Unless we're clear about the harm, we will certainly be sending mixed messages to youth.

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Cheryl DePaolo

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Ulster Prevention Council Blog 8-27-13: Dancing with Miley? or Molly?

For the last several weeks I've addressed drug references in song lyrics. This week Miley Cyrus is in the news for a decidedly raunchy performance at the MTV Video Music Awards. However, I was already planning to write about the lyrics to her song "We Can't Stop". While at first she claimed that the lyrics were "dancing with Miley", she eventually conceded that she was referring to the drug Molly, which is often billed as a "pure" form of the club drug ecstasy.
So la da di da di, we like to party
Dancing with Molly
Doing whatever we want
This is our house
This is our rules
And we can’t stop
And we won’t stop
Can’t you see it’s we who own the night
Can’t you see it we who bout’ that life
Miley Cyrus is not the only performer to openly refer to using Molly. Madonna named her 2012 album MDNA and, on stage at the Ultra Music Festival in Miami that same year, she asked the crowd: "Has anyone seen Molly?"
 
Molly has also became popular with hip-hop artists and rappers as well. NBA star LeBron James was caught on camera rapping "popped a Molly, I'm sweatin'" from Trinidad James "All Gold Everything" during a warmup. The video went viral.  "The impact that that song had is what really turned things around for it," said Devron Kelly, one of the hosts of  "Hip-Hop Flavors" on WMNF. "Basically, it's just a new drug, so you're going to have kids experimenting with whatever they hear the latest rappers talking about."  2 Chainz, Nicki Minaj and Kanye West also sing about Molly.
Musical references to "Molly" misrepresent its dangers. It is often billed as a safe high with no side effects. Ecstasy normally comes in a tablet form and is mixed with caffeine or even other illegal drugs. Molly is the same basic drug (MDMA) but without any other ingredients mixed in. The illusion of "purity" gives users a false sense of security. With demand starting to drive up the price of Molly, dealers sometimes are tampering with the pure MDMA, cutting it with other things before selling it. As with other illegal drugs, users never really know the amount taken, and high levels can cause extreme hallucinations, heart trouble and organ failure.
Molly gives people a sense of euphoria. Users report a false sense of calm, lowered anxiety levels, and a skewed view of the world around them. This false sense of well-being can easily be a user's worst enemy by causing them to overlook dangers, leading to injury to themselves and others.
Physical symptoms include high blood pressure, sweating, insomnia, nausea, and uncontrolled teeth-grinding. Teeth grinding contributes to the fad of using pacifiers when out clubbing; lollipops and gum are also often used.
MDMA causes long-lasting damage to the serotonin system, which regulates processing of information and emotions. Use may result in permanent damage to one's ability to learn, pay attention and remember, difficulty sleeping and ongoing depression.
Molly is a Schedule 1 drug, meaning that it is absolutely illegal to sell, distribute, buy, ingest, or own.

Cheryl DePaolo
Director of Ulster Prevention Council

Ulster Prevention Council Blog: 8-20-13

The red Solo cup is arguably the cup of choice for youth and young adults. Can you sing along with the following chorus from the Toby Keith song?
Red Solo cup, I fill you up
Let's have a party, let's have a party
I love you red Solo cup, I lift you up
Proceed to party, proceed to party

To view today's blog, please head on over to our Facebook page at Ulster Prevention Council and check out some visuals for reducing alcohol intake by counting standard drinks, including one using the red Solo cup.

While you are there, please "Like" us on Facebook, take the drink count quiz and check out some of our media messages.