Youth & Substance Use

Leanne PaisleyRegional Opioid Intervention ServiceAddiction Counsellor

Date: Saturday October 5, 2013

Overview

IntroductionHousekeeping Notes (question and answer)Substance Use/Abuse

– Opioids– Marijuana

Mental Health

How does “Youth Substance Abuse” Happen?

An excerpt from: “Young, Assured and Playing Pharmacist to Friends”

Spectrum of Substance Use

The varying points of people’s use:

What is addiction? • Chronic disease of brain reward circuitry• Addiction is characterized by inability to consistently

abstain, impairment in behavioural control, craving, diminished recognition of significant problems with one’s behaviours and interpersonal relationships, and a dysfunctional emotional response.

Excerpt from American Society of Addiction Medicine (ASAM) definition

Who becomes addicted?EVERYONE!Risk factors that are commonly seen:1. Stress2. Family history3. Self-esteem4. Exposure5. Trauma6. Mental illness – concurrent disorders

The Statistics - Youth

• Between October 2010 and November 2011 CAMH completed a survey with 9,288 Ontario students

• 54.9% of students used alcohol• 22.3% of students binge drink• 22% of students used cannabis• 14% of students used opiates• 1/8 students report symptoms of drug use problems

Opioids/Opiates/Painkillers

Prescription Opioid AbuseOpioid abuse is a growing problem Canada is the world’s third largest per capita consumer of opioids. Ontario tops the list in Canada.Prescription opioids has become the predominant form of illicit opioid use (rather than heroin)Increase in number of individuals seeking treatment for opioid dependence in the last 10 yearsOpioids are a commonly abused substance by youth and young adults

What is an Opioid?

• Opioids are depressants-- they slow down certain brain functions

• Opioids are also referred to as narcotics • Opioids can be effective painkillers• Some opioids are prescription medications (like oxys,

fentanyl) and others are not (ie., heroin)

Why Prescription Opioids? Why now?Perceived safety because it is a pharmaceuticalMore socially acceptable than heroinPurityPotent opioid (euphoria effects)Easy access (inadequate monitoring of prescription narcotics)High dosePossible to circumvent delivery system: chew, suck, snort, smoke, inject

Opioid Dependence is characterized by

• Control – loss of control over use• Consequences – continued use despite knowledge of

harmful consequences• Compulsion to Use• Cravings

Marijuana• Also know as cannabis, pot, weed• These plants have resin containing molecules known

as cannabinoids• Cannabinoids bind to cannabinoid receptors in your

brain and other parts of your body, in particular the nervous and immune systems

• It tends to suppress hormones produced by stress reactions and stimulate an increase in dopamine in the brain which activates pleasure pathways

Marijuana continued…• Impacts: coordination, movement, decision making,

social skills, consciousness, short-term memory, and the reward pathway (your ability to distinguish between different things that feel good)

• Different effects depending on the person – can be feelings of calm to feelings of paranoia

• Effects based on setting, environment, person’s biochemistry, dosage, plant strain, person’s diet, person’s mood or mindset

Potential Consequence of Substance Use• Most concerning – overdose and death• Addiction• Accidents• Infectious illnesses/diseases• Loss of relationships or turmoil in relationships• Decrease in functioning with school, job,

responsibilities• Legal difficulties

Mental Health and Substance Use

• People with substance use problems have higher rates of mental health problems than the general population

• People with mental health problems have higher rates of substance use problems than the general population

• Young people age 15-24 are more likely to report mental health and/or substance use problems than other age groups

• Concurrent Disorders = condition in which a person struggles with both a mental health and a substance use problem

Rates of Concurrent Disorders

• 40-70% of people with substance use problems have mental health issues

• Most common combinations:– Substance use problems + Anxiety disorder– Substance use problems + Mood disorder

Questions from Cue Cards?

Leanne.Paisley@theroyal.ca

Thank You!