Psychoactive substances and new technologies abuse in children and adolescents

Lenka ChudomelovaDepartment of Child and Youth Health

3rd Faculty of Medicine

Definition Psychoactive drugs are chemical substances

that affect the brain functioning, causing changes in behavior, mood and consciousness.

Commonly abused drugs

Cannabinoids: hashish, marijuana Depressants: barbiturates, BZD Dissociative anesthetics: ketamine, phencyclidine Hallucinogens: LSD, mescaline, psilocybin Opioids: codeine, fentanyl, heroin, morphine, opium Stimulants: amphetamine, methamphetamine,

cocaine, nicotine Other compounds: anabolic steroids

Why do people take drugs? To feel good

drugs produce intense feelings of pleasure euphoria is followed by other effects, which differ with the type of drug used stimulants (cocaine): the “high” is followed by

feelings of power, self-confidence, and increased energy opiates (heroin): feelings of relaxation and

satisfaction

Why do people take drugs? To feel better

social anxiety stress-related disorders depression

To do better improve their athletic or cognitive performance

Curiosity and „because others are doing it“ strong influence of peer pressure

Early signs of risk in the family lack of mutual attachment and nurturing

by parents or caregivers ineffective parenting a chaotic home environment lack of a significant relationship with a

caring adult a caregiver who abuses substances,

suffers from mental illness, or engages in criminal behavior

Risk factors outside the family inappropriate classroom behavior, such as

aggression and impulsivity academic failure poor social coping skills association with peers with problem behaviors,

including drug abuse misperceptions of the extent and acceptability of

drug-abusing behaviors in school, peer, and community environments

Drug abuse/substance abuse

compulsive, excessive, and self-damaging use of habit forming drugs or substances, leading to: addiction or dependence serious health damage (kidneys, liver, heart) psychological harm (such as dysfunctional

behavior patterns, hallucinations, memory loss)

death

Drug addiction/drug dependence

compulsive craving for a drug which offers

short-term intense relief/pleasure rapid induction of emotional state individuals

normally are not able to experience

Development of addiction

1st stage = FIRST CONTACT mostly in a group as a unique episode experience of belonging to a particular

group or culture

2nd stage = EXPERIMENTATION a positive experience from the first contact

often motivates uncertain and anxious children to continue

Development of addiction

3rd stage = USAGE, restful phase trigger point (conflict, trauma) because of the positive effect the child often regularly

returns drug becomes part of their social life - perceived as

“the best period of his/her life ever” evolves into compulsive patterns of substance-seeking

and substance-taking behavior that take place at the expense of most other activities

somatic complaints begin to appear, breaking promises, increasing need for money, occasional absence following weekend trips, late arrivals home, deterioration of relations in the family and at school, loss of friends

Development of addiction

3rd stage = USAGE, problematic/advanced usage

develops after a few months rather years of usage cumulating problems

loss of control over drug use, desire to confide loss of hobbies, lack of interest in school, work, family conflicts and theft serious health problems

young person perceives problems and tries to prove he's got a control

5 – 10 days sober establish him falsely in his view within next years the head currently runs two programs –

program of a drug and program of abstinence

Development of addiction

4th stage = ADDICTION unconditional loss of control over life

drug brings nothing positive loss of dignity destruction of the closest relations delusion and inability to perceive reality loss of lust for life

difference between problematic usage and addiction? doses of the drug ability to admit the addiction

Development of addiction

5th stage = QUITTING never ending stage life will never be as friendly as with the drug experiencing pain high motivation great social support

ESPAD 2011 - Alcohol

ESPAD = The Europian School Survey Project on Alcohol and Other Drugs

1,6 % strict nondrinkers 60,0 % regular consumers

! Risk alcohol consumption rising !

Example: drunkennes during last month admitted 37% of 16 year old:

1/5 three times during the past month 5% ten times

ESPAD 2011 - Illegal drugs

experience with: cannabis .......................... 42% ecstasy ............................ 8,3% hallucinogens .................. 5,6%

first experience in younger age girls prefer to experiment with amphetamines

and sedatives

Consumption of tobacco, alcohol and drugs in CR one of the leading positions in Europe reasons

high tolerance to consumption physical and financial accessibility even for children and

youth influence of media („celebrities“) commercial interests role models in the family lack of control mechanisms and sanctions

Gambling

slot machines terminals electro roulette common cause

lack of money (allowance) lack of hobbies peer influence

Virtual reality

internet addiction computer games completely identical problems as in drug

addiction

Prevention principles prevention programes should enhance protective

factors and reduce risk factors (Hawkins et al. 2002)

prevention programes should address all forms of drug abuse (legal, illegal drugs, inappropriate use of legally obtained substances (Johnston et al. 2002)

prevention programes should address the type of drug abuse problem in the local community (Hawkins et al. 2002)

prevention programes should be tailored to address risks specific to population characteristics like age, gender, ethnicity (Oetting et al. 1997)

Risk factors x protective factors

Risk factors Domain Protective

factors

Early Aggressive Behavior

Individual Impulse Control

Lack of Parental Supervision

Family Parental

Monitoring

Substance Abuse Peer Academic

Competence

Drug Availability School Antidrug Use

Policies

Poverty Community Strong

Neighborhood Attachment

Examples of preventive interventions Prior to birth

preventing/delaying pregnancy in young and vulnerable mothers

antenatal health service antenatal educational courses/home visitation

Examples of preventive interventions Early childhood

school preparation programes school-based drug education parent education family therapy

Examples of preventive interventions Adolescents

school-based drug education peer intervention, peer eduaction youth sport and recreation programs mentorship employment and training

Examples of preventive interventions Community based prevention

education campaignes homelessness strategies crime prevention regulation and law enforcement judicial procedures harm-reduction strategies (I.e. low threshold centers)

How to say “NO”

assertiveness an important communication skill learn to reject things that are not right for him based on his

conviction, ability to say no can save the child from the very first contact

with the drug

self-confidence/self-esteem child should perceive that he is a unique human being child with an adequate self-esteem would not use drugs to

confirm his confidence in relation to peers

Literature http://www.who.int/substance_abuse/publications/global_

alcohol_report/en/ http://www.espad.org/ http://www.unodc.org/unodc/en/data-and-analysis

/WDR-2012.html http://www.who.int/substance_abuse/links/othersites/en/ NIDA: Preventing drug use among children and adolescents.

(A research-based guide for parents, educators and community leaders. Second edition.)