2. Understanding and Identifying Substance Abuse Trends Jennifer Keiser Unity Chemical Dependency Outreach Counselor

3. What are the trends? Cigarettes Smokeless tobacco Electronic cigarettes Marijuana Statistics obtained from the Monitoring the Future Survey 2013 Survey results.

4. Cigarettes *Cigarette smoking is the leading cause of preventable disease and mortality in the United States, and is usually initiated in adolescents.

5. Cigarettes Smoking peaked in 1996 for 8 th and 10 th graders Began a steady decline thereafter Smoking initiation by 8 th graders declined  1996- 49%  2013- 15%

6. Smokeless Tobacco Snuff – finely ground tobacco Usually sold in tins, loose or in packets Chew – leafy form of tobacco Usually sold in pouches Snus - New variation Dissolvable tobacco -

8. Smokeless Tobacco 30 day prevalence rates: 8 th graders  Peak in 1994 (7.7%), reached low 2013 (2.8%) 10 th graders  Peak in 1994 (10.5%)  2004 (4.9%)  2013 (6.4%) 12 th graders  Peak in 1995 (12.2%)  2006 (6.1%)  2013 (8.1%)

11. Introduced to the United States in 2007 Tobacco free product Are vaporizers –Instead of burning tobacco the mechanism heats up a liquid. It turns to a vapor which is inhaled or “vaped” Promoted as a way to quit regular cigarettes Promoted as the safer alternative to cigarettes Electronic Cigarettes

12. Are they safe? No Quality Control –Lack of disclosure of all the ingredients used, as well as the lack of/validity of health and safety claims of the manufacturers –2009- FDA found some cartridges of liquid nicotine contained traces of diethylene glycol (toxic chemical found in antifreeze) –FDA testing has found the actual amount of nicotine may not match what the label states and nicotine free cartridges still contain a low dose

13. –Some devices release metals during use, as well as other impurities known to be toxic and/or carcinogenic Liquid nicotine can be lethal –Call to poison control centers regarding e-cig nicotine- infused liquids rose sharply every month between September 2009 and February 2014, from 1 call to as many as 215 per month –0.3% to 41.7% of all emergency calls –51.1% of those calls involved accidental poisoning of kids under age 5 (source: CDC)

14. Health effects –E-cig users experience diminished lung function –Airway resistance –Cellular changes –Inflammation –Undetermined effects

15. Electronic Cigarettes Are they helping people quit? “Despite claims that e-cigarettes are helping people quit smoking, we found that e-cigarettes were associated with more, not less, cigarette smoking among adolescents” “E-cigarettes are likely to be gateway devices for nicotine addiction among youth” –Lauren Dutra, a postdoctoral fellow at UCSF Center for Tobacco Control and Research Study of 40,000 youth found that e-cig use among middle and high school students doubled between 2011 and 2012 ( 3.1%-6.5%)

16. Are they helping people quit?

17. Marijuana

18. Marijuana is the most common illicit drug in the United States. After a period of decline in last decade, its use has increased among young people since 2007 1960’s to today = 3x THC Genetically modified plant Perception of risk decreases=use increases

23. Ear Wax Hash

24. Ear wax Hash Name from appearance, not origin! Yellow-green waxy material Nicknames - Dabs, honey oil, butter Made with aerosol butane and resin of leaves & buds of female plant How to videos on youtube -recipe Can include up to 90% THC Highly hallucinogenic Reports lasting up to 3 days

25. Can you tell the difference ?

27. What Parents Can Do Create a safe, supportive environment to discuss the risks of tobacco, drug and alcohol use. Use everyday “teachable moments” as conversation starters. Connect with teens to find out what they know about drugs and alcohol and how they feel about the pressures they face. Communicate expectations clearly and what the consequences of use will be.

28. Get to know your teen’s friends. Monitor your teen’s whereabouts and online activity. Encourage community involvement and productive activities. Have family meals. Educate yourself on current trends of substance use. Ask for help and support.

29. Contact Information: Jennifer Keiser Unity Outreach Counselor 585-353-2517 jkeiser@unityhealth.org At McQuaid on Wednesdays and Thursdays

30. Thank you!