Ulster Prevention Council Blog 6/1/12: Eyeballing, Vodka Tampons, and Drinking Hand Sanitizer

Eyeballing vodka is a practice that has gained popularity with college and high school students in Europe and the U.S. It involves either pouring a shot of vodka directly on the eyeball or holding the bottle to the eyeball and upending it. Those who do it claim that vodka eyeballing induces drunkenness faster than drinking it can, because it passes easily through the mucous membrane and enters the bloodstream directly through veins at the back of the eye, although some experts are skeptical about the claims and believe that those who do it simply convince themselves that it's having such an effect. Vodka eyeballing can cause sore, weepy, bloodshot eyes and lead to permanent eye damage.

Vodka tampons may have originated in Germany.  Youth believe that it gives them a quicker, longer high, and that they can avoid detection as they will have no alcohol on their breath. Females insert the tampons in their vaginas, and males insert them in their rectums. A super tampon holds about a shot of vodka. The alcohol gets absorbed directly into the bloodstream fairly quickly, because of the vascular structure.  There is no gag reflex, so youth won’t throw up if they have alcohol poisoning, and if they lose consciousness health professionals won’t necessarily know what is wrong, delaying treatment. Using a beer bong rectally follows the same concept, and is referred to as “butt chugging”.

Drinking hand sanitizer is another troublesome practice, particularly as the product is readily available to underage youth. Hand sanitizer is 62-65% ethyl alcohol (120 proof). Drinking 2 ounces of it is equivalent to drinking 3 ounces of 80-proof tequila. The American Association of Poison Control Centers say that nationwide in 2011 they received 622 calls related to hand sanitizer exposure. Thus far in 2012, the number of calls is already over 200.

The trend has become mainstream enough for Jimmy Kimmel and John Kusack to drink Purell in celebration of Cinco de Mayo on Jimmy Kimmel Live. Later in the show Cusack asked Kimmel, "Do you feel the Purell kicking in?". "I feel cleaner inside," Kimmel said. Cusack agreed, adding, "It's lemony. It's fresh."

Youth are finding ways to separate the alcohol from the gel, making it more palatable. An internet search showed that simply using salt appears to be the most common method. Diluting the gel is also common. Others distilled it to isolate the disinfectant’s ethyl alcohol, leading to a shot that can be three times as alcoholic as vodka. Using less appealing foam sanitizer rather than gel serves to deter youth.

Granted, youth have used mouthwash, cough medicine and vanilla extract in the past in order to obtain alcohol. However, teens who are engaging in behaviors such as these to get an alcohol high should be evaluated for larger substance abuse problems.

--
Cheryl DePaolo
Director, Ulster Prevention Council
85 Grand St.
Kingston, NY 12401
Voice: 845-458-7406
Fax: 845-458-7407
Cell: 845-392-4714
Email: cdepaolo@familyservicesny.org

Ulster Prevention Council Blog 5/25/12: Krokodil

I worked in chemical dependency treatment programs for over 25 years. A common phenomonon would occur after the overdose death of a heroin addict. Other addicts would inquire what “brand” of heroin had been used and they would seek it out, rather than avoid it.
Recently I’ve received several inquiries about Krokodil, and I’d like to share some thoughts with you. Often when adolescents hear about a new drug or drug use trend, they don’t react in the same way that you and I probably would. Their brains are wired to seek out novel experiences and they see risky behaviors as exciting, not frightening.
Therefore, after an initial exploration I decided to conduct a secondary search as a curious adolescent would, Googling terms such as “Krokodil recipes”, “how to make Krokodil” and the like. Fortunately, most of the sites turning up in the search basically said “What are you, crazy? This stuff will make your flesh fall off and kill you!”
I couldn’t find information supporting manufacture and use in the U.S.  However, Krokodil is a huge problem in Russia, and worth knowing about. In October 2011, indications of krokodil use were found in Germany, with some media outlets claiming several dead users.

Desomorphine is an opiate analogue invented in 1932 in the United States that is a derivative of morphine. It has sedative and analgesic effects, and is around 8-10 times more potent than morphine. To produce the potentially deadly drug, which has a comparable effect to heroin but is much cheaper to make, users mix codeine with gasoline, paint thinner, iodine, hydrochloric acid and red phosphorous (obtained from matchboxes). The process is similar to the manufacture of methamphetamine from pseudoephedrine, but desomorphine made this way is highly impure and contaminated with various toxic and corrosive byproducts.

 The street name in Russia for home-made desomorphine made in this way is "krokodil" reportedly due to the scale-like appearance of skin of its users, and it is used as a cheaper alternative to heroin.Since this mix is routinely injected immediately with little or no further purification, "krokodil" has become notorious for producing severe tissue damage, phlebitis and gangrene, sometimes requiring limb amputation in long-term users. The amount of tissue damage is so high that addicts' life expectancies are said to be as low as two to three years.

Photographs of late-stage krokodil addicts are disturbing in the extreme. Flesh goes grey and peels away to leave bones exposed. Those large pieces of dead skin are referred to as eschars, leaving the user prone to infection, amputation and other complications.

Krokodil users are instantly identifiable because of the iodine smell that infuses all their clothes.  Unlike heroin, where the hit can last for several hours, a krokodil high only lasts between 90 minutes and two hours. Given that the "cooking" process takes at least half an hour, being a krokodil addict is basically a full-time job.

The recent recession in the United States has driven many drug users - particularly teens and the poor - to find cheaper alternatives to their drug habits. Illegal street drugs are likely to be too expensive for teens that don’t usually have regular incomes. Many young people and adults have turned to abusing prescription drugs and over-the-counter (OTC) medications to support their habits.
Krokodil has 3 things going for it that could attract users in the U.S.:

• It has roughly the same effect as heroin (a depressant that affects the brain’s pleasure systems and interferes with the brain’s ability to perceive pain), but is more powerful.
• The cost is three times cheaper than heroin.
• It is easy to make (cook) from items found in most households.

 Parents, families, neighbors and anyone else concerned about teens taking drugs, are strongly encouraged to take action—even if it’s no more than reading and keeping up with the latest designer drugs that young people find attractive. Students with otherwise clean drug histories often try getting high from prescription medications and OTC drugs found in the home medicine cabinet.
Too many kids think taking OTC drugs in excess won’t hurt them, but they couldn’t be more wrong. Keep ALL medicines and like items locked up where kids and young people can’t access them. Don’t leave meds in your purse, on the nightstand or on the breakfast table where a teen can easily take a few at a time without anyone noticing.
Keep paint thinners, gasoline and other products locked up in the garage where no children or teens can gain access to them. Be sure to keep track of your keys to padlocks, too. Keep a locked gas cap on your vehicles. Don’t leave matchboxes lying around and dispose of them by tearing up the striking pads.
Watch your teen for any tell-tale signs of drug use: strong odors of cleaners, solvents or anything abnormal. Listen for drug slang terms. Look for sores on the skin and notice if he or she wears long-sleeves or pants even in hot weather. It’s the little things often overlooked that will stand out as clues to the parent who’s well-aware and informed.
If you think your teen, child or other loved one is secretly (or openly) using drugs, get professional help immediately through the family doctor or local treatment center.

UPC Weekly Blog: 4-30-12 Situations involving alcohol that youth may face during spring and summer

Tonight my daughter Grace is heading to the prom, and within the next few weeks she will be attending graduation and assorted parties and celebrations. This has me thinking about the many situations involving alcohol that youth may face during spring and summer.

When your teen is going to a party, there are several steps that you can take to increase the likelihood that they will return to you safety.

Keep in mind that the average age of first use of alcohol for Ulster County youth surveyed in 2010 was 12. Don’t wait until your child is a teen to implement these strategies!

First of all, make sure that there will be adult supervision and that no alcohol will be served.  A tactful call to the host will suffice to clarify these details.

Second, make sure that you know where your child is going and with whom. When taking your teen to a party, go to the door and introduce yourself. If you already know the family, at least wait until your child is inside the house.

Third, make it easy for your teen to leave a party.  Agree that they can call you (or another adult) to come for them if there is any reason why staying is uncomfortable.

Fourth, urge your teen never to ride home with a driver who has been drinking.

Fifth, be awake to greet your teen when they come home.

These are not “cool parent” rules. Your child may protest that you are embarrassing or even humiliating him/her.  However, it is imperative to put them in place for his/her safety.

The Ulster Prevention Council has available a brochure from the New York State STOP-DWI Foundation entitled Teens and Alcohol: What Parents Need to Know.  This excellent publication reviews the Social Host law and the 21 legal purchase age, and contains the information discussed above. Call or email me if you would like an electronic copy or some paper copies.

Regards,

Cheryl

4/13/12: Promoting Alternative Thinking Strategies

I’ve spent the last few days with six wonderful teaching assistants from the Kingston City School District. I am so impressed by their professionalism and passion for what they do! We spent our time together discussing Promoting Alternative Thinking Strategies (PATHS®), an elementary school curriculum that has been shown to significantly improve children's social and emotional skills

Schools are charged with helping students to master academic content and become able to succeed in an increasingly complex world. Yet, many students lack the social and emotional skills they need to learn and grow, or they possess them but require ongoing reinforcement to reach their full potential.

Teaching students effectively is difficult when pupils are unable to properly engage in the learning process. Some students have difficulty managing emotions, act out in unhealthy and potentially harmful ways, detract from the healthy functioning of the school environment and/or create conflict in the classroom, playground, cafeteria or school bus.

The PATHS® program teaches skills that allow children to calm themselves when angry, make friends, resolve conflicts respectfully, and make ethical and safe choices. Social and emotional competence underlies both effective behavior and academic success.

PATHS® supports federal requirements that mandate schools to provide safe and effective learning environments, helping to reinforce a bully-free climate. The program can also help students meet Common Core State Standards for English Language Arts and can support goals for reading, writing, listening and speaking. The PATHS® program was one of only 12 SAMHSA Model Programs that had documented academic achievement outcomes - and one of only two programs designed for children ages 5-12.

According to the Collaborative for Academic, Social, and Emotional Learning, classroom and school interventions that make the learning environment safer, more caring, more participatory, and that enhance students’ social competence have been shown to increase student attachment to school. In turn, students who are more engaged and attached to school have better attendance, higher graduation rates, higher grades and standardized tests scores and decreased rates of high-risk behaviors including alcohol and drug use, violence, truancy, and bullying.

In rigorous clinical studies, the PATHS® program has been shown to:

•         reduce teachers' reports of students exhibiting aggressive behavior by 32%

•         increase teachers' reports of students exhibiting self-control by 36%

•         increase students' vocabulary for emotions by 68%

•         increase students' scores on cognitive skills tests by 20%

•         significantly improve students' ability to tolerate frustration plus their ability -- and willingness -- to use effective conflict-resolution strategies

•         reduce depression and sadness among special-needs students

For more information regarding PATHS®, please contact me.

Regards,

Cheryl

4/6/12: Local Doctor Arrested for Prescribing Large Quantities of Painkillers

Last week the Woodstock Times and Daily Freeman both reported that a Woodstock doctor was arrested by federal agents on a charge of unlawful distribution of a controlled substance. He is accused of prescribing large quantities of the powerful painkiller hydrocodone (Vicodin®), among other drugs, without a legitimate medical purpose.

The doctor only accepts cash payments and was among the top five prescribers of hydrocodone in the area covered by the FBI’s Albany division.  The doctor wrote 9,940 hydrocodone prescriptions between December 15, 2010 and January 17, 2012 accounting for nearly 85 percent of all of the prescriptions that he wrote during that period. The complaint states that approximately 4,520 of these prescriptions were for patients under 35 years old.

Many residents have rushed to his defense, and the doctor has stated that he is innocent of the charges and believes that he will be exonerated. We can’t and shouldn’t rush to judgment and will wait to see how this case plays out in the legal system.

However, this event provides an opportunity to talk about the role of physicians in preventing prescription drug abuse. The Centers for Disease Control declared in 2011 that prescription painkiller overdoses are a public health epidemic.  Overdose deaths from prescription painkillers have skyrocketed during the past decade.

Nearly three out of four prescription drug overdoses are caused by prescription painkillers such as hydrocodone (Vicodin®). The CDC states that this parallels a 300% increase since 1999 in the sale of strong opioid pain relievers.

Almost all prescription drugs involved in overdoses come from prescriptions originally; very few come from pharmacy theft. However, once they are prescribed and dispensed, prescription drugs are frequently diverted to people using them without prescriptions.

Enough prescription painkillers were prescribed in 2010 to medicate every American adult around the clock for one month.  Most prescription painkillers are prescribed by primary care and internal medicine doctors and dentists, not specialists. Roughly 20% of prescribers prescribe 80% of all prescription painkillers.

Clearly prescribers are the first line of defense in preventing prescription drug abuse.

The CDC recommends that health care providers follow guidelines for responsible prescribing, including:

·        Screening and monitoring for substance abuse and mental health problems.

·        Prescribing painkillers only when other treatments have not been effective for pain.

·        Prescribing only the quantity of painkillers needed based on the expected length of pain.

·        Using patient-provider agreements combined with urine drug tests for people using prescription painkillers long term.

·        Talking with patients about safely using, storing and disposing of prescription painkillers.

·        Use Prescription Drug Monitoring Programs to identify patients who are improperly using prescription painkillers.

Effective prevention strategies must include engaging all key community members such as doctors, physician’s assistants, nurse practitioners, nurses, pharmacists, dentists, counselors, first responders, hospital personnel, teachers, counselors, school nurses, coaches, administrators, parents, youth, youth activity leaders and faith communities in the dialog to educate all sectors of the community and address local prescription drug misuse conditions.

Regards,

Cheryl DePaolo

Director, Ulster Prevention Council

3/30/12: Banning the sale of synthetic marijuana products in New York State

On March 29, 2012, New York State Health Commissioner Nirav R. Shah, M.D., M.P.H. issued an order of summary action banning the sale of synthetic marijuana products in New York State. These substances, generally referred to as "synthetic marijuana", consist of plant material coated by chemicals that mimic THC, the active ingredient in marijuana. These products are being sold as a "legal alternative" to marijuana in convenience stores, smoke shops, and tobacco stores with brand names such as "Spice", "K2", "Mr. Nice Guy", and "Galaxy Gold".
Governor Andrew M. Cuomo called upon the Department of Health to take action to ban the sale of these dangerous products.
The order states, "synthetic cannabinoids have been linked to severe adverse reactions, including death and acute renal failure, and commonly cause: tachycardia (increased heart rate); paranoid behavior, agitation and irritability; nausea and vomiting; confusion; drowsiness; headache; hypertension; electrolyte abnormalities; seizures; and syncope (loss of consciousness).
The Commissioner's order calls for sales and distribution of these products to cease immediately and it calls upon local health officials to distribute the order and check for compliance.
Last week, the Commissioner sent special health alerts to local health departments, emergency departments and other health care providers to make them aware of the dangers of these products.
The New York State ban is much stronger than the current temporary DEA ban on 5 synthetic cannabinoid compounds in that it encompasses products with a wide variety of chemical compounds that are synthesized to mimic the actions of THC.
In Ulster County, the town and village of Saugerties are currently in the process of conducting public hearings to move forward with laws that would ban the sale of all synthetic drugs, and county officials have expressed support for a county-wide ban.
The New York State order is available here: http://www.health.ny.gov/press/releases/2012/docs/synthetic_cannabinoids_order_summary_action.pdf
Regards,
Cheryl

--
Cheryl DePaolo
Director, Ulster Prevention Council
85 Grand St.
Kingston, NY 12401
Voice: 845-458-7406
Fax: 845-458-7407
Cell: 845-392-4714
Email: cdepaolo@familyservicesny.org

3/23/12: Alcohol Acts Like a Computer Virus in a Teen Brain

 Alcohol Acts Like a Computer Virus in a Teen Brain

Discussing brain science can sometimes put even seasoned professionals to sleep, but understanding this material is crucial in making the case for youth delaying drinking. This week I was looking for ways to explain the effects of alcohol on the developing brain.

I found a great resource at www.parentsempowered.org, a site is sponsored by the state of Utah. While the site is designed primarily for parents, I recommend it to educators, human services providers and all those interested in alcohol prevention.

Among the wealth of materials on this site, I found a wonderful series of brain science lessons entitled How Alcohol Can Damage a Teen’s Developing Brain Causing Brain Impairment and Early Addiction at http://parentsempowered.org/files/resources/teaching_tools.pdf. This lesson packet contains posters, lesson plans, worksheets and a fact sheet from the AMA. The lessons are grounded in research and a bibliography is provided.

One of the lessons used an analogy that I think is brilliant in discussing this topic with teens: Alcohol acts like a computer virus in a teen brain!

The lesson explains the role of the prefrontal cortex in governing good judgment, planning ahead, decision-making and impulse control, helping youth to avoid antisocial behavior and become thoughtful, responsible adults. The majority of prefrontal cortex brain wiring takes place during the ages of 12 to 16, and continues to develop until about age 24.  The hippocampus is responsible for learning and memory, and goes through a developmental “spurt” during the ages of 12 to 24.

The lesson goes on to explain that alcohol is a chemical which, if consumed before our brains are fully developed, interferes with chemical neurotransmitters and damages our brain neuron wiring. Alcohol acts like a computer virus in our brain. It slows or shuts down brain activity, thus keeping a teen brain from making connections and properly wiring. Drinking alcohol as a teen is like turning off the power when you are trying to download new software.

What would happen if you had a power-outage right when you were trying to load new software on your computer? It wouldn’t be there when the power came on.

Alcohol acts the same way on a still-developing brain. Important neural connections that we need to be a responsible, thoughtful adult may not be wired into our brains, making life more difficult for us, and those who will depend on us. We may be harmed in ways we cannot predict, becoming less than we could be.

Alcohol damage can cause young people to:

- develop social problems.

- have poor judgment.

- get into trouble.

- struggle in school.

- experience failure in achieving life-long goals.

Most alcohol brain damage doesn’t show up right away, until your brain is needed to handle complex jobs or relationships, and then it may be too late. Why is it important for teens to understand brain development and wiring? So they can protect their brain while it is developing.

Alcohol use not only harms a teen’s brain wiring, it also hijacks the brain’s pleasure-reward system, causing the brain to crave alcohol pleasure and leading to a great increase in the risk of alcohol addiction. 40% of kids who begin drinking at age 15 will become alcohol dependant as adults.

I hope that you find this analogy, and the rest of the materials at www.parentsempowered.org, as helpful as I did!

Regards,

Cheryl