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THE JUVENILE JOURNEY:

FROM MARIJUANA TO HEROIN

Alicen-J. McGowan LCPC PhD RPT-S CAS CMI-I CAGS CRADCCERTIFIED ADDICTION SPECIALIST

GLENVIEW, ILJanuary 2018

GOALS• TO EXPLAIN ADDICTION• TO IDENTIFY SIGNS OF ADDICTION• TO DEMONSTRATE THE WORKINGS OF

THE BRAIN• TO OUTLINE THE TRAJECTORY• TO EXPLAIN THE EFFECTS OF DRUG

ABUSE• TO IDENTIFY THE IMPACT ON CASA

WORK

IMPACT ON SOCIETY

• NIH AND CDC COMBINED DATA FOR 2015

• OVERDOSES 52,404• FEMALES 19,447• MALES 32,957\HEROIN 12,989• WHAT ABOUT CHILDREN AND

ADOLESCENT USE?

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SAMHSA• 22.2 MILLION CURRENT

MARIJUANA USERS AGES 12 AND OLDER

• ILLICIT DRUG USE IS PRIMARILY DRIVEN BY INCREASED MARIJUANA USE AND LOWER AGE OF USE

• 139.7 MILLION USED ALCOHOL IN PAST 30 DAYS

• ALCOHOL HAS STAYED FLAT SINCE 2002

THE FACTS• Nat’l Study of Drug Use 2014 – 27 MILLION

USED ILLICIT DRUGS IN PAST 30 DAYS –AGE 12 - use of HEROIN 1.6%

• 12-17 .3%• 18-25 1.7%• AGE 25+ 1.8%• MTF 2012• 8th grade .5%• 10th grade 1.1%

DATA• Alcohol 12th grade 69.4%• Cigarettes 39.4%• Illicit drugs 49.9%• Cocaine 4.9%• Hallucinogens 7.5%• LSD 3.8%• MDMA 7.2%• Marijuana 45.2% • RX 21.2%

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WHAT IS THE SHIFT?• Alcohol harder to get - flatlined• Risky behaviors have increased• Peer pressure replaced by stress• Fewer role models/boundaries• No coping strategies- everyone gets trophy• Economic situations/ 2 parents work• Less family time/values• Heads in the sand

ADOLESCENCE• Extended 10-29 WHY?• Early Puberty• Lack of employment• Moving back in after

college• No time for guidance• Social Media/

international connections

• Game playing from boredom

CURIOSITY• BOREDOM• STRESS• SOCIAL PRESSURE• AIM TO PLEASE• RISK IS FUN• ABOVE IT ALL• I CAN STOP• NOT ME - DENIAL

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MARIJUANA• First drug of choice• Not your parent’s MJ• 10x• Nicotine/7 cigs• Enhancers• Before school• Before bed• Often free

MARIJUANA + ALCOHOL

• DEPRESSANTS• CROSSES THE FRONTAL LOBE• POOR DECISION-MAKING• INABILITY TO REACT, DRIVING• LACK OF REMORSE• DELAYED PROCESSING• BLOCKS MOTIVATION

THE BRAIN• WE ARE BORN

NEEDING TWO THINGS

• HOMEOSTASIS• AND PLEASURE• WE ARE

PLEASURE-SEEKERS BUT WE WANT BALANCE!

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THE BRAIN• HOW IT WORKS• THE PLEASURE

CENTER• REWARDS• PAIN CENTER• CHANGING

FEELING• ADDICTION OR

SUD

REWARD CENTER• REWARD IS

ALSO LACK OF PAIN

• RELIEF OF PAIN CAN FEEL STIMULATING

• NEED MORE AND MORE AROUSAL

• HIGHER RISKS

SUBSTANCE USE DISORDER

• TOLERANCE

• WITHDRAWAL

• SUBSTITUTION

• BEHAVIOR CHANGE

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AM ACADEMY OF PEDS

• 2017 RESEARCH• PREVENT TEEN USE• CHANGES IN BRAIN STRUCTURE

AND CONNECTIVITY• RELATED TO ATTENTION AND

MOTIVATION CHALLENGES• FORMERLY A-MOTIV. SYNDROME• NO PRE-TEEN USE – EVER!

OUI, DUI, SO WHAT?

• Geared towards alcohol• Who does the test?• What are the consequences?• Diminish the use of marijuana• Lesser consequences• The Law is changing – Why?• What are the repercussions?• COLORADO

PRESCRIPTIONS• Pharm parties• Easy access• Curiosity• Exchange currency• Bring money• Risk is exciting• TRAJECTORY• More at home than

ever!

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OPIOIDS• P, M, V, O, M, D, O, H• ANALGESICS• ABUSE IF NOT TAKEN AS

PRESCRIBED• SPRINKLED ON MARIJUANA• CRUSHED/SNORTED• IV – SHOOTING - DABBING• PAIN – SHOULD I AVOID?

WHY HEROIN?• NEED TO CHILL• NEED TO AVOID• EASY ACCESS• INEXPENSIVE• CHEAPER THAN

OXYCONTIN• QUICKER RELIEF• COOL TO DO• RISKY BUSINESS

NIDA SEPT. 2017

• 43,000 USING MJ FOR RESEARCH• 20% STATES IN FAVOR OF

RECREATIONAL USE• 9% ADULTS ARE ADDICTED• TEENS WHO USED = 17% ADDICTED• 2X MORE LIKELY TO BECOME

OPIOID USE DISORDER ADULTS!• YES, POTENTIAL FOR ADDICTION!

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JULY 2017 U PITT• HIGHER RATES

OF DEPRESSION• LOWER

EDUCATIONAL OUTCOMES

• START AT 15 –ADDICTED BY 19

• REWARD CTR DYSFUNCTION

U WARWICK UK

• TEEN USE OF 2-3X A WEEK SUFFERED FROM HYPOMANIA

• SIMILAR TO BIPOLAR IN LATER LIFE

SIGNS OF ADDICTION

• IT’S IN THE EYES!• IT’S IN THE SPEECH!• IT’S IN THE WALK, RIDE, DRIVE!• FRIENDS CHANGE• GRADES DROP• ATTITUDE/MOTIVATION CHANGES• APPETITE CHANGES

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YOUR ROLE AS A CASA• KNOW THE SIGNS• CONFRONT THE CHILD IN A NON-

THREATENING MANNER• BE READY WITH ALTERNATIVES• LOOK FOR NEGLECT IN FAMILIES

SUCH AS DISHES, LAUNDRY, UNCLEAN CHILDREN, MALNUTRITION

• OFFER ASSISTANCE FIRST

WHAT TO KNOW

• MARIJUANA IS STRONGER!

• 500 CHEMICALS• HYDROCANNAB

INOL IS MIND-ALTERING

• DABBING/VAPE DELIVERS HIGH LEVELS OF THC

HOW CASA CAN ASSIST• KEEP CHILDREN SAFE AT ALL COSTS• CALL YOUR SUPERVISOR IMMEDIATELY• KNOW THE DRUG TREATMENT

FACILITIES IN YOUR AREA AND HAVE THEIR PHONE NUMBERS HANDY

• WATCH FOR HOUSEHOLD DISRUPTIION• REFER OR REMOVE IF BEHAVIOR

CONTINUES!

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WHAT SHOULD WE DO?• EDUCATION IS KEY• RELIGIOUS EDUCATION• TEACHERS/COACHES• PHYSICIANS• SCHOOLS • PARENTS• YOUTH GROUPS• STEPPING UP TO WHAT IS GOING ON

WHERE DO WE GO FROM HERE?

• LENS = YOURS, MINE, OURS

• STOP, LOOK, LISTEN, REFER

• TAKE ACTION

SOCIETY IS BUILT ON FAMILIES THAT WORK

• SLOW DOWN• DE-STRESS YOUR OWN LIFE• TEACH PEACE - ALTERNATIVES• USE POSITIVE STATEMENTS• BE THE ONE FOR THE CHILD• BE OPEN AND TALK ABOUT DRUG

DANGER• BE THE BEST ROLE MODEL YOU CAN BE!

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CASA• REMEMBER, YOU CAN MAKE A

DIFFERENCE• CHANGE BEGINS WITH YOU• CASA WORK IS TOUGH BUT IN

MANY CASES YOU ARE THE ONLY STABLE PERSON IN A CHILD’S LIFE

• A STABLE PERSON CAN MODEL APPROPRIATE BEHAVIOUR AND INSPIRE SUCCESS!

THANK YOU!

ALICEN-J. MCGOWAN PhD

DrAlicen@gmail.com1920 Waukegan RdGlenview, IL 60035