1. Use and Behavioural Changes in Children and Youth. ~ Effective Interventions Presented by: Shirley Withers, BSW, RSW Addiction Services Horizon Health Network Marijuana ~

2. Agenda Introductions What is Marijuana? Factors Influencing Addiction NB Stats Difference Between Adolescents and Adults Impact on Behaviour Drug Use Continuum Stages of Change FARMERS/Effective Interventions Resources Q&A Thank You

3. What is Marijuana? Cannabis ~ Marijuana, Hashish, Hash, Hash oil, weed, pot… Symptoms of Use –Pupils normal to dilated –Red eyes, not bloodshot –Intoxicated look –Sluggish –Poor hygiene –Poor concentration –Relaxed inhibitions –Tremor in legs –Sore throat –Smell –Excessive talking –Change in appetite –Impaired coordination –Perception of time and distance impaired

4. What is Marijuana? Short term UseLong Term Use Impaired short term memory and concentration Calm Drowsiness Talkative Fearful Dry-mouth Relaxed Panic, paranoia, anxiety, depression Sensory perceptions seem enhanced Increased appetite Distorted sense of time and space Rapid heart beat Impaired motor skills Loss of motivation Difficulties with memory and concentration Lung damage Irregular menstrual cycles Infertility in males Lower immune system Chronic cough Depression Anxiety/panic disorder Aggression Low affect

5. Factors Influencing Addiction Interactive Factors Drug Drug Use Experience Experience Individual Environment

6. Drug Factors Rate of Onset –Rapid onset = more re-enforcement T ½ –Shorter T ½ = more re-enforcing Root of administration –Inhaled>IV>Transnasal>PO> Transdermal Amount Consumed/ Duration of Use

7. Individual Factors PSYCHOLOGICAL –PersonalityBeliefs –Mood/Feelings Skills –ExperienceKnowledge PHYSICAL GenderWeight Tolerance (Conditioning) General Health Food Genetics

8. Environmental Factors Where When With Whom Culture Employment Price Availability Laws Family

9. NB Students Drug Use Survey 2007 Cannabis Use by Year and Grade Grade 7 Grade 9 Grade10 Grade 12

10. Differences Between Adolescents and Adults Adolescents are at a much more crucial time developmentally than adults are; therefore, the impact upon them is much more developmentally devastating. The duration of a severe problem among adolescents at the time of diagnosis is usually less than 18 months. (5-15 rule) Adolescents do not generally have a loyalty to one particular drug, unlike adults. Many adolescents are poly-drug users and will use any drug that is available. Chemical use is rarely "social" among adolescents. "Partying" is going to a place where a group of people individually sedate themselves into oblivion! There is really nothing social about it. Consequences of drug use are somewhat different for adolescents. Also they do not have a long history of use, subsequently, there may not have been as many losses resulting in greater denial of both the adolescent and their family. Adolescents have many more enablers than adults, consequently, intervention is often delayed. The problem rarely presents as chemical dependency and is most often seen by parents, courts, and professionals as psychiatric, behavioral or family dysfunction. As a result, adolescents can be stuck with labels as anti-social personality, conduct disorder, ADD and clinical depression.

11. Impact on Behaviour Refer to Behavioural Check List ? Insert a picture here

12. I can Drive… AlcoholCannabis Decreases AlertnessAlters attention span and concentration Alters judgment Alters depth perception Reduces motor coordinationDecreases muscle strength and hand steadiness Vision may be blurred or doubled Decreases reaction time Or Can I?

13. Drug Use Continuum Stage 1 –Use Normal Feelings X PainEuphoria Stage 2 – Misuse Normal Feelings X PainEuphoria

14. Drug Use Continuum Stage 3 – Abuse X PainEuphoria Normal Feelings X PainEuphoria Stage 4- Addiction Normal Feelings

15. Stages of Change

16. FARMERS F eedback- of personal risk or impairment A dvice- clear advice to change R esponsibility- client’s personal responsibility for change M enu- alternative strategies for change E mpathy- therapist empathy is a potent catalyst for change R oll with Resistance S elf-efficacy- hope or optimism

17. Resources Horizon Health Addiction Services –(506) 452-5558 Horizon Health Mental Health –(506) 453-2132 Websites (handout) Portage Atlantic –(506) 839-1200

18. Thank You Other questions???