1. + High-Risk Alcohol use and the College Student Tom Szigethy, MA Associate Dean/Director of the Duke Student Wellness Center

2. + OUTLINE Defining the Terms Talking with Students Drugs of Abuse

3. + Defining the Terms

4. + DSM IV – Substance Abuse A. Maladaptive pattern of substance use (1 or more) within a 12 month period Failure to fulfill major role obligations Use when physically hazardous Substance related legal problems Continued use despite persistent or recurrent social or interpersonal problems

5. + DSM IV- Substance Dependence maladaptive pattern of SA within the same 12 month period, with 3 or more of: Tolerance-(increases) Withdrawal (withdrawal syndrome or take similar drug) Substance taken in larger amounts or longer duration than intended Persistent or unsuccessful effort to decrease or control use

6. + Much time spent to obtain, use, or recover from effects of substance Important activities given up or reduced because of use Use continues despite physical or psychological problems Substance dependence - continued…

7. + Talking with the student

8. + Determination Stages of Change Screening MaintenanceMaintenance ContemplationContemplationRelapseRelapse ActionAction Pre-contemplationPre-contemplation

9. + Determination Stages of Change Screening MaintenanceMaintenance ContemplationContemplationRelapseRelapse ActionAction Pre-contemplationPre-contemplation Alcohol.edu, Presidential Statement re position on alcohol Student Conduct, Policy, BASICS, Academic Affairs, ER Ed. Classes, CAPS, CDBH Internships, AA, Alanon, Brief Counseling, CDBH AOD Rehab, off- campus Admissions, Orientation, FAC, parents

10. + Motivational Interviewing Empathy Develop Discrepancy Avoid Argumentation Roll with Resistance Build Self-Efficacy

11. + Implications to the Medical World How do I do this in 2 minutes or less? The teachable moment

12. + Why screen in the Medical Office?

13. + Prescriptions Are the symptoms described through a medical malady…or maybe withdrawal from experimenting?

14. + Post Acute Withdrawal Symptoms These symptoms are a natural part of the recovery process. They are usually present from 6 to 18 months after addict stops drinking or drugging. Symptoms include: difficultly in thinking problems numbering things difficulty in focusing attention problems following logical sequences memory problems over or under-emotional, such as over-reacting or being numb over-reacts to stress sleep disturbances accident prone

15. + Why Students Use Anxiety Depression Social Acceptance Quell FEAR Cope with problems Aide a Sexual encounter

16. + What students do not understand about alcohol Measurement Blood Alcohol Content Tolerance Gender differences Pacing themselves Proof BiPhasic Curve

17. + What do students use?

18. + What are you aware of? Mephadrone (“Coke on speed”) Ritalin et al Cocaine GHB – soap, liquid E, G, GBH, Pot, weed, grass, buddha, scwag, 420, L, MaryJane, Chronic,Tree, reefer Bath Salts ALCOHOL