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

Director of Ulster Prevention Council

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.

Ulster Prevention Council Blog 8-12-13: Purple Drank

I have two young adults at home and they are almost always in charge of the music selection in the car. Although they listen to a wide variety of genres I confess that just like my own parents, much of the time I can't decipher the words. Sometimes when I can, I don't understand the meaning behind the words. To their dismay, I usually sing along anyway.
Today I've been doing some research into current drug trends, and as I wandered around the internet I began to look at song lyrics about drug use written by some well known artists.  Of course there have been plenty of drug references in lyrics for decades.  My thought about these particular songs, though, is that they are contributing to the spread of a dangerous regional drug trend that might otherwise have been contained: Purple Drank.
Mixing soda, prescription cough syrup and candy, often Jolly Ranchers, with crushed ice in a white styrofoam cup to make "Purple Drank" started in Houston, Texas, now known as the “City of Syrup”. Drinking it makes you "lean"- unsteady on your feet. While use dates back several decades, Purple Drank has recently gone mainstream in tracks by Eminem, Paul Wall, Kanye West, Ludacris, 2 Chainz, Drake, Nicki Manaj and scores of others.
Let's take a look at Lil' Wayne's song Me and My Drank. He references codeine (a narcotic), promethazine (an antihistamine) and Sprite as ingredients that he has in his cup in the studio. Lil' Wayne's lyrics acknowledge several artists who have died due to using Purple Drank including Big Moe, Pimp C, and DJ Screw.  Here are some lyrics from the song:

[Short Dawg:]
Yea..Uhuh..Yea
I usually don't do this but...
Ahem...
Yea T you gotta feel me
Sippin on some drink the color purple like silly
Really they say I should chill before it kills me
But so will a car crash or a nine milli
And I aint even mention cigarettes or airplanes
So grab a sprite heres a pint we can share Wayne
Yea Mayne...tastes so sweet and I aint gonna have a seat
Cuz I don't wanna fall asleep
So just pour it in my drink and ima sip until I lean hard
Drink got me moving slower than a retard
So press record and hear these hot raps
Im in the booth cup on me like a jock-strap
And I will not nap until the bottles empty
Then I pour a little more for past Screw and Pimp C
And I would stop but believe it I cant
So till Short is gone its just me and my drink
[Chorus:]
Up in the studio me and my drank, me and my drank, me and my drank
Uh uh Up in the studio me and my drank, me and my drank, me me and my drank
On March 15, 2013, it was reported that Wayne had been admitted to the Intensive Care Unit in Los Angeles after being discovered shaking uncontrollably and unconscious. Doctors found a high amount of codeine in his system and his stomach had to be pumped three times. He was released from the hospital three days later.
Two NFL players have been arrested for possessing codeine based syrups without a prescription, and Terrence Kiel, a San Diego Chargers player, was arrested during practice for possession with intent to sell prescription cough syrup for use in making the drink.
Several legal commercial products loosely based on "purple drank" are marketed in the United States including "Drank", "Purple Stuff", "Sippin Syrup", and "Lean".

What's so bad about Purple Drank? Codeine can make people feel a sense of euphoria, but can also cause hypoventilation, a potentially fatal inability to breathe properly. Abuse of codeine can lead to physical dependence and significant withdrawal symptoms. Promethazine is an antihistamine that is typically used to fight nausea and to induce sedation. In low doses, promethazine can enhance the effects of codeine, causing more euphoric feelings than codeine alone. However, high doses of promethazine can also cause potentially deadly central nervous system depression and hypoventilation, extreme weakness and drowsiness. Using these substances at higher amounts than those prescribed for legitimate medical purposes can be very dangerous. Add alcohol or other substances to the mix, and they are even more dangerous.
So what does this mean for the Hudson Valley?  Purple Drank is now part of pop culture, and simple instructions for mixing it are as close as the internet. Adolescents are likely to be curious about it and perhaps give it a try. Let's ask them if they've heard of it, what they think about it, and if they know anyone who has tried it. Adolescents often experience danger as exciting rather than as a deterrent to experimenting. If unable to procure prescription syrup, youth are likely to try mixing other syrups with soda, including over the counter cough and cold syrups that are also dangerous when abused. So, when remembering to lock up your meds, include any liquid medications, and dispose of unused prescription and over the counter syrups.

Cheryl DePaolo
Director of Ulster Prevention Council

Ulster Prevention Council Weekly Blog 7-19-13: Mourning Another Loss

When we use "icebreaker" activities with a group, one of my favorite exercises is sharing something that no one in the group knows about you. Today I have two things to share.

First, I am a Gleek.  A Gleek is a fan of the Fox TV show Glee. Cory Monteith, 31, was one of the stars of this musical comedy, playing football quarterback and glee club member Finn Hudson. Cory died this week from an overdose of heroin and alcohol, after sharing his struggle with addiction when he entered treatment this spring. You may be a bit more surprised to learn that I was also a fan of Amy Winehouse, the British singer and songwriter who tied the record for Grammy Award wins in a single night. The BBC called her "the pre-eminent vocal talent of her generation". However, her struggles with addiction were well publicized, as evidenced by her hit single "Rehab". By summer 2011, she had fallen into a pattern of abstaining for a few weeks and then relapsing. One such relapse led to her death by alcohol intoxication. Her blood alcohol content was 0.416% at the time of her death.
While your "favs" may differ from mine, today I decided to stop and reflect on some of the celebrities we have lost to overdoses and the brain disease of chemical dependency. This list is not at all exhaustive, but it speaks for itself.
Marilyn Monroe – American actress, model, singer, sex symbol, 36. Her death, due to an overdose of barbiturate sleeping pills, was ruled as a “possible” suicide, 1962.
Janis Joplin - American musician, 27, heroin overdose, 1970.
Jimi Hendrix - American musician and singer-songwriter, 27. Respiratory arrest, asphyxia due to alcohol and barbiturate overdose; vomit inhalation, 1970.
 Bruce Lee - Martial artist, actor, film director, Prescription drug overdose at 32 in 1973.
John Belushi – Actor, comedian, musician. Died in 1982 at age 33 after injecting a mixture of cocaine and heroin.
River Phoenix – American actor. Died at 23 of a heroin an cocaine overdose while in the presence of his younger brother Joaquin in front of the trendy Viper Room, 1993.
Heath Ledger – 28. Died of an accidental overdose of oxycodone, hydrocodone, alprazolam, diazepam, temazepam and doxylamine, 2008.
Mary Anissa Jones –Buffy from “Family Affair.” Drugs found in her system include Seconal, PCP, methaqualone and cocaine.
Lani O’Grady –Mary on “Eight is Enough,” died in 2001 at the age of 46.  Found in her system at the time of her death were Vicodin and Prozac.
Chris Farley – Overdosed in 1997; combination of morphine and cocaine; complicated by heart disease.
Judy Garland – American actress and singer.  Died in 1969 at the age of 47 of an overdose of barbiturates (Seconal). Possible suicide.
Anna Nicole Smith – American model, Playboy playmate, actress, 40. Died in 2007 of “combined drug toxicity" due to chloral hydrate and benzodiazepines.
Elvis Presley – Found dead in his bathroom at 42. Heart arrhythmia, possibly aggravated by multiple prescriptions (methaqualone, codeine, barbiturates, cocaine), 1977.
Nick Cantor – The Dirty Dancing actor died after injecting a shot of pure heroin in 1991.
Robert Pastorelli – The Murphy Brown actor died of a heroin overdose in 2004 at the age of 50.
Brad Renfro – American actor, 25. Died of a heroin overdose in 2008.
Christopher Bowman - American figure skater, 40, Mixed alcohol, cocaine, diazepam and cannabis, 2008.
Christopher Wiley Antley - Jockey; 2-time Kentucky Derby winner. Overdose of clobenzorex, paroxetine, methamphetamine, carbamazepine and trauma (accidental),  age 34, 2000.
Darrel Porter - Professional baseball player, cocaine overdose, 2002, age 50.
Derek Boogaard - left wing, New York Rangers, 28, alcohol and oxycodone overdose, 2011.
Douglas Glenn Colvin, aka Dee Dee Ramone - American songwriter and musician (The Ramones), 50.  Heroin overdose (accidental), 2005.
Edward Fatu “Umaga” - Samoan-American professional wrestler, 36. Overdose of hydrocodone, carisoprodol, diazepam, 2009.
Michael Carl Baze - Horse jockey, 24. Overdose of cocaine and oxymorphone, 2011.
Michael Jackson - American Pop Singer and icon, 50. Cardiac arrest, acute propofol intoxication; midazolam, lidocaine, diazepam, lorazepam also noted in autopsy report, 2009.
Whitney Houston - American singer, actress, 48. Drowning; complications of cocaine and heart disease; Flexeril, marijuana, Xanax and Benadryl also found in body but did not contribute to death, 2012.
Chris Kelly - of the 90s hip-hop group Kriss Kross, died at the age of 34 of an overdose that included heroin and cocaine, 2013.


Cheryl DePaolo
Director of Ulster Prevention Council

Ulster Prevention Council Weekly Blog 6-25-13: Will I See You in September?

With summer in and school out, unsupervised youth may be in danger of accessing and/or consuming alcohol in their homes and in the homes of their friends.  These dangers are real and possibly deadly.
Through the 2012 Ulster County Youth Development Survey, we asked youth in grades 7-12 how they obtained alcohol and where they drank it. While 56.8% reported not drinking at all in the past year, 25.4% reported drinking in their own home, and 26.1%  reported drinking in the home of a friend.  
In almost every case involving underage drinking, somewhere along the way an adult broke the law. 35% of Ulster County youth reported obtaining alcohol with the aid of an adult. The Ulster County Social Host law holds parents accountable for drinking parties involving under-age participants in their home.  However, many adults still believe that allowing youth to drink in the home is "safer" and that they can teach youth to drink "responsibly". 10.3% of Ulster County youth reported drinking with parental permission.
Although many still view underage drinking as a rite of passage, it is a dangerous practice that should be discouraged. Every three minutes someone under the legal drinking age in the US has to go to the emergency room because they drank underage.
Youth ages 15 and younger who drink alcohol are 4 times more likely to become dependent on alcohol and 5 times more likely to abuse alcohol later in life than those who wait until they are 21 or older. Alcohol use can interfere with adolescent brain development. Adolescent brains do not discriminate between alcohol used without permission and alcohol used with permission.
In addition, adolescents may make the poor choice of getting behind the wheel of a car after drinking. It is no coincidence that during June, July and August the greatest number of teenagers perish in car crashes, according to the National Highway Traffic Safety Administration.
This summer and all year, adults should monitor and secure alcohol at home in order to help prevent underage drinking. Parents are urged to have a frank discussion with teens about the dangers of underage drinking and set rules, including not getting into a car with someone who has been drinking.
If you have had the talk with your teen about drugs, but not alcohol, now’s the time to have it. 

Cheryl DePaolo
Director of Ulster Prevention Council