child & youth Mental Health Series - CHEO ED Outreach · Often added to other powders (e.g. heroin,...

Todayrsquos topic Youth Substance Use Drug Trends and How to Help

Speakers Liz Parsons amp Sandy Botham

child amp youth

Mental Health Series

February 8 2017

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Visit our website to download slides and view archived events

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Questions mentalhealthseriescheoonca

You may also want tohellip

Declaration of Conflict

Speaker has nothing to disclose with regard to commercial support

Speaker does not plan to discuss unlabeled investigational uses of commercial product

Partner Presentation

CHEO and the Royal work closely and actively with many community agencies and health care providers

This presentation is brought to you by one of our local partners The information and views presented today represents that of our partner organization

Rideauwood Overview

School Based Program

Ontario Statistics (OSDUHS)

The Stages of Substance Use

The Mood Swing Chart

Youth Substance Use - Trends

Strategies to support caregivers

Resources

7

Founded in 1976 Rideauwood Addiction and Family Service is a non-profit agency serving

adults adolescents and family members We provide group and individual treatment on an out-

patient basis as well as training and consultation

We currently provide the following programs

Adult Family Parent

School-Based Teen Young Adult

Adult Drug Treatment Court

Youth Mental Health Court Youth Probation

Gambling

Public Education Training amp Consultation

8

All English high schools in the Ottawa area

Onsite weekly during school year

Available at Rideauwood during the summer months

Catholic Board (OCSB) Grades 7-12

Public Board (OCDSB) Grades 9-12

All Senior Elementary Schools (OCDSB) Delivering presentations to all grade 7 and 8 classes -

RPEP

9

Referrals

Consent

Confidential Counselling

Parent Involvement

School Staff Support amp Collaboration

Class Presentations

10

RPEP

Provides an important aspect of life learning that students can build on as they progress through school

Builds resilience self awareness coping skills refusal skills and the understanding of potential risk factors as well as habit forming behaviours

Earlier identification of counselling needs

Assists in bridging services to the high school program

11

Alcohol 46 of students report drinking in the past year

14 mixed alcohol with an energy drink in the past year

18 report binge drinking in the past month

16 report getting drunk in the past month

22 played drinking games in the past month

20 report drinking hazardously in the past year

19 could not remember their activities in the past year

9 were injured or injured someone else because of their drinking in the past

year

27 are allowed to drink at home with their friends

grades 9-12

12

Cannabis

21 report using cannabis in the past year

2 report using cannabis daily in the past month

2 have symptoms of cannabis dependence

28 usually obtained cannabis from a friend

5 report vaping cannabis in the past year

grades 9-12

13

Cigarettes

9 of students report smoking cigarettes in the past year

3 report smoking daily in the past year

62 of smokers obtain cigarettes from friends or family

3 report smoking contraband cigarettes in the past year

6 report using smokeless tobacco in the past year

12 report using use electronic cigarettes in the past year

14

These surveys include only youth attending school who were able to participate Given these

limitations the actual rates of both past-year and heavy cannabis use among Canadian youth

are likely to be higher than reported

In Canada as in most western societies the 15- to 24-year-old segment of the population has

much higher use of cannabis than those aged 25 and over At the same time youth have

relatively high levels of alcohol use but much lower use of tobacco

Canadian youth lack knowledge and have misconceptions about the effects of cannabis that

contribute to favourable attitudes towards its use

Adolescents are more sensitive than adults to the adverse effects of regular heavy use of

cannabis including cognitive impairment dependence poor psychosocial development

impaired school and work performance drug-related psychiatric illness and generally poorer

treatment outcomes

15

Stage 1 Experimentation

Limited substance use (2-4x)

Poly substance use

Using in a group

Usually parents unaware

Usually no trouble as a result of use

Canrsquot remain in this stage

Stage 2 Regular Social Use

Actively plans use

Sets own limits (rules)

No real pattern of use

Some planned misuse

Sometimes unplanned misuse

Learns from mistakes of misuse

Uses for fun

Uses with others

16 Adapted from Johnson 1986

Stage 3 Problematic Use

Plans use ahead of time

Wants use to be part of social life

Using effects others around them

May change peer group

Drops other activities in favour of using

Begins to surpass own limits (breaks rules)

Defense mechanisms start

May attempt to cut down or quit

Able to make positive changes with help


Stage 4 Addiction

Using is the goal

Many unsuccessful attempts to quit

Loss of control

Many relationships have been damaged

Family and friends are frustrated

Becomes more isolated

Increased concern for mental health issues

Has moments of clarity regarding the need to get help

Treatment often required at this stage

Canrsquot make change on their own anymore


19

Normal

Pain Euphoria

Adapted from Joseph A Muldoon 1988

20

Stage 1 Learning the Mood Swing = Experimentation

Stage 2 Seeking the Mood Swing = Regular Social Use

Stage 3 Harmfully Involved = Problematic Use

Stage 4 Using to Feel to Normal = Addiction

Adapted from Johnson 1986

21

A decline in grades

Personality changes

Mood swings

Change in peer group

Secretive

Uncommunicative

Spends more time alone

Confused disoriented andor lethargic

Dishonesty (lying over trivial things)

Extremely defensive

Illusive about whereabouts friends and activities

Problems in the community (law)

Unexplained financial drain

Money or items missing from home

Dropping extra curricular activities

Becoming irresponsible towards household duties job house rules

Increase school problems skipping classes increased lateness

Changes in sleeping andor eating habits (weight)

Changes in self-care and appearance

Possession of drug paraphernalia

22

Alcohol rule based and socially acceptable

Cannabis normalized points of view

Increase in prescription use not prescribed

ex percocets xanax adderall

Increased poly drug use ndash pills ++

23

Often added to other powders (eg heroin Ketamine)

pills(eg oxy and benzos) liquids and marijuana in order to boost there potency

It is roughly 50 ndash 100 times more toxic than morphine

When fentanyl is cut into other drugs you canrsquot see smell or taste it

Also known as white china murder 8 dance fever and good-fella

When naloxone is in communities it has been shown to reduce overdose rates by 50

24

BCCDC (Bristish Columbia Centre for

Disease Control)

Used by veterinarians for very large animals

Not for human use

Is 100 times more toxic than fentanyl

Is 10000 times more toxic than morphine

Therefore can be deadly in extremely small amounts

Has been found in Ontario

Added the same way as fentanyl to other drugs (ex green

pills stamped lsquoCDNrsquo on one side and rsquo80rsquo on the other)

25 (Ottawa Public Health)

Severe sleepiness Trouble breathing Slow heartbeat Slow shallow breathing or snoring may sound like

gurgling Cold clammy skin Trouble walking or talking Unresponsive even when shaken Pin point pupils vomiting

26 Ottawa Public Health

Community collaboration ndash combined efforts police public health community centers schoolshelliphellip

Public awareness ndash media news reportshellip

Crisis response ndash hospitalsEmergency mobile health units increased availability of naloxone in pharmacy training on the use of naloxone provided to anyone

27

Examine your own views on drugalcohol use

Be informed about drugs and their effects

Establish clear expectations and consequences with your youth

As caregiver present a clear unified position

Discuss differences in strategies apart from your child

Set consequences with which you are able to follow through

28

Acknowledge amp Validate positive behavior out loud

Choose your battles

Ask open ended questions

Limit screen time (time limit dinner table bedtime family time)

Allow yourself time to reflect before answering requests from your youth

Itrsquos okay to make mistakes or be unsure and acknowledge that to your youth

Remember that it matters to your child what you think

29

You donrsquot have to agree with the situation behavior perspective you need to validate the feelings then problem solve

Dysregulated Child + Overwhelmed Parent = Co-Dysregulation Need 3 Rrsquos Regulate Relate Reason(Bruce Perry 2013)

Emotion Family Focused Therapy (website in resource section)

Emotion Coaching Skills 1 Attend to emotion 2label and express

the emotion 3 validate the emotion 4meet the need 5Fix itproblem solve

30

Expectations are important aspects of relationship because they communicate the behavior and roles that support boundaries and health

Actively encourage your teen to be involved in influencing the outcome of challenges by eliciting their participation

Inviting them to be involved in family conversations asking for there ideas amp supporting them to follow through on ideas in a way that gets them proactively involved

31

https

wwwyoutubecomwatchv=1Evwgu369Jw

Having considered all these strategies and recognizing that perhaps many of these you already practice what could be next steps your practice or organization could do to improve on assisting youth and families

33

httpwwwdrugrehabcaontario-teen-drug-rehabhtml

httpwwwdrugandalcoholhelplineca

httpwwwcamhcaenhospitalcare_program_and_servicesOutreach_ServicesPagesguide_psychiatric_outreachaspx

httpwwwhealthycanadiansgccatask-force-marijuana-groupe-etudeframework-cadreindex-engphp

34

httpwwwcamhxcaPublicationsOSDUHS2015

httpwwwccsacaEngtopicsMental-Health-and-Substance-AbusePagesdefaultaspx

35

Emotion-Focused Family Therapy emotionfocusedfamilytherapyorg

Books

1ldquoA survival Guide to Parenting Teensrdquo by Joani Geltman

2 ldquoBeyond Addictionrdquo by Jeffery Foote

3ldquoThe Awakened Familyrdquo by Shefali Tsabary

36

37


Questions or Comments

Video-conferencers Unmute your system to ask a question

Webcasters Type your question

for participating in todayrsquos


Join us next time February 16 2017 With Dr Erin Kelly

Thank you

mentalhealthseriescheoonca


If you are connected by videoconference Please mute your system while the speaker is presenting
















Rideauwood Overview







Resources

7





Adult Family Parent




Gambling


8







RPEP

9

Referrals

Consent


Parent Involvement


Class Presentations

10

RPEP





11









year


grades 9-12

12

Cannabis






grades 9-12

13

Cigarettes







14












treatment outcomes

15



Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you

















Rideauwood Overview







Resources

7





Adult Family Parent




Gambling


8







RPEP

9

Referrals

Consent


Parent Involvement


Class Presentations

10

RPEP





11









year


grades 9-12

12

Cannabis






grades 9-12

13

Cigarettes







14












treatment outcomes

15



Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you






Adult Family Parent




Gambling


8







RPEP

9

Referrals

Consent


Parent Involvement


Class Presentations

10

RPEP





11









year


grades 9-12

12

Cannabis






grades 9-12

13

Cigarettes







14












treatment outcomes

15



Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you








RPEP

9

Referrals

Consent


Parent Involvement


Class Presentations

10

RPEP





11









year


grades 9-12

12

Cannabis






grades 9-12

13

Cigarettes







14












treatment outcomes

15



Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you


Referrals

Consent


Parent Involvement


Class Presentations

10

RPEP





11









year


grades 9-12

12

Cannabis






grades 9-12

13

Cigarettes







14












treatment outcomes

15



Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you


RPEP





11









year


grades 9-12

12

Cannabis






grades 9-12

13

Cigarettes







14












treatment outcomes

15



Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you










year


grades 9-12

12

Cannabis






grades 9-12

13

Cigarettes







14












treatment outcomes

15



Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you


Cannabis






grades 9-12

13

Cigarettes







14












treatment outcomes

15



Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you


Cigarettes







14












treatment outcomes

15



Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you













treatment outcomes

15



Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you




Poly substance use

Using in a group





Actively plans use



Some planned misuse



Uses for fun

Uses with others













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you













Stage 4 Addiction

Using is the goal


Loss of control









19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you


19

Normal

Pain Euphoria


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you


20






21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you


21

A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you


A decline in grades

Personality changes

Mood swings


Secretive

Uncommunicative




Extremely defensive











22






23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you







23







24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you








24


Disease Control)


Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you



Not for human use














27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you








27







28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you








28


Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you



Choose your battles






29






30




31

https



33





34



35


Books




36

37








Thank you







30




31

https



33





34



35


Books




36

37








Thank you





31

https



33





34



35


Books




36

37








Thank you


https



33





34



35


Books




36

37








Thank you



33





34



35


Books




36

37








Thank you






34



35


Books




36

37








Thank you




35


Books




36

37








Thank you



Books




36

37








Thank you


37








Thank you









Thank you


child & youth Mental Health Series - CHEO ED Outreach · Often added to other powders (e.g. heroin,...

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Transcript of child & youth Mental Health Series - CHEO ED Outreach · Often added to other powders (e.g. heroin,...