Local Drug Use Trends 2011 & What We Can Do D. Scott Kelly MA,CAADC,CRPS Co-Founder & Executive Director Bay Area Substance Education Services, Inc. (BASES) 208 W Lincoln, Charlevoix, MI (231)

Local Trends in 2011 After all this time… Alcohol still most widely used locally Marijuana is on the rise Tobacco is still a concern Opiates & prescription pills are on the rise Heroin and needle use on the rise A New Development on Teen Alcohol Use New and unusual… Called “designer” or “club” drugs years ago, now called synthetics Synthetic cannabinoids – round two this year Synthetic stimulants Over the counters, herbals, strange and unusual concoctions

3 Alcohol - 30 Day Use Trends for Charlevoix County Students

4 Marijuana-30 Day Use Trends for Charlevoix County Students

A Major Reason People Take a Drug is they Like What It Does to Their Brains A Major Reason People Take a Drug is they Like What It Does to Their Brains

Stimulants CRACK METHAMPHETAMINE COCAINE

Types of Stimulant Drugs Cocaine Products Cocaine Products Cocaine Powder (Generally sniffed, injected, smoked on foil) “Crack” (smoked) Major areas of use: South America; USA (predominantly major urban centers, disproportionately impacts African American community); Increasing in Europe.

Types of Stimulant Drugs Amphetamine Type Stimulants (ATS) Amphetamine“Speed” Dexamphetamine“Ice” Methylphenidate “Crank” Methamphetamine“Yaba” “Shabu”

Methamphetamine vs. Cocaine Cocaine half-life: 1-2 hours Methamphetamine half-life: 8-12 hours Cocaine paranoia: 4 -8 hours following drug cessation Methamphetamine paranoia: 7-14 days Methamphetamine psychosis - May require medication/hospitalization and may not be reversible Neurotoxicity: Appears to be more profound with amphetamine-like substances

According to surveys and estimates by WHO and UNODC, methamphetamine is the most widely used illicit drug in the world except for cannabis. World wide it is estimated there are over 26 million regular users of amphetamine/methamphetamine, as compared to approximately 16 million heroin users and 14 million cocaine users Scope of the Methamphetamine Problem Worldwide

Time (min) % of Basal DA Output NAc shell Empty Box Feeding Source: Di Chiara et al. FOOD Natural Rewards Elevate Dopamine Levels

Time After Cocaine % of Basal Release DA DOPAC HVA Accumbens COCAINE hr Time After Nicotine % of Basal Release Accumbens Caudate NICOTINE Source: Shoblock and Sullivan; Di Chiara and Imperato Effects of Drugs on Dopamine Release Time After Methamphetamine % Basal Release METHAMPHETAMINE 0123hr Accumbens

Prolonged Drug Use Changes the Brain In Fundamental and Long-Lasting Ways

Source: McCann U.D.. et al.,Journal of Neuroscience, 18, pp , October 15, Decreased dopamine transporter binding in METH users resembles that in Parkinson ’ s Disease patients %ID/ cc. Control Methamphetamine PD

Their Brains have been Re-Wired by Drug Use Their Brains have been Re-Wired by Drug Use Because…

Partial Recovery of Brain Dopamine Transporters in Methamphetamine (METH) Abuser After Protracted Abstinence Normal Control METH Abuser (1 month detox) METH Abuser (24 months detox) 0 3 ml/gm Source: Volkow, ND et al., Journal of Neuroscience 21, , 2001.

–33 year old man, high on methamphetamine admitted to emergency room complaining of severe headache in Portland Oregon. –X-ray revealed 12, 2 inch nails (6 on each side) in his head, administered with aq nail gun. –The man at first claimed it was an accident, but he later admitted that it was a suicide attempt. The nails were removed, and the man survived without any serious permanent damage. –He was eventually transferred to psychiatric care; he stayed for almost one month under court order but then left against doctors’ orders MSNBC-TV

Long-term effects of stimulants  Strokes, seizures, and headaches  Irritability, restlessness  Depression, anxiety, irritability, anger  Memory loss, confusion, attention problems  Insomnia  Paranoia, auditory hallucinations, panic reactions  Suicidal ideation  Sinus infection  Loss of sense of smell, nosebleeds, chronic runny nose, hoarseness  Dry mouth, burned lips  Worn teeth (due to grinding during intoxication)  Problems swallowing  Chest pain, cough, respiratory failure  Disturbances in heart rhythm and heart attack  Gastrointestinal complications (abdominal pain and nausea)  Loss of libido  Malnourishment, weight loss, anorexia  Weakness, fatigue  Tremors  Sweating  Oily skin, complexion

Source: The New York Times, June 11, “ METH Mouth ” METH Use Leads to Severe Tooth Decay

Methamphetamine Psychiatric Consequences Paranoid reactions Long term memory loss Depressive reactions Hallucinations Psychotic reactions Panic disorders Rapid addiction

More on Synthetics… Spice & K2 Spice & K2

More on Synthetics… Bath Salts Bath Salts

More on Synthetics… Spice & K2 Spice & K2 Bath Salts Bath Salts

Based on local ER reports… More and more psychotic features coming into the emergency rooms locally Believed to be a result of synthetics – cannabinoids and stimulants Locals are involved in making their own concoctions of these and there is no way of knowing what is in them…

Michigan Economics… High levels of unemployment locally Unemployment benefits running out With the increases in drug use and more bizarre psychiatric responses from these chemicals, there is potential for increases in property crimes and violent crimes Need to TAKE ACTION NOW in a multitude of ways…