drugs on the street - omed 2019 · 13,000 rx overdose deaths 20,000 heroin overdose deaths expected...

Drugs on the Street

Steven G. LigaMSW, LSW, LCADC, CPS, CCS

© 2017 Liga

� Differentiate between myths and facts regarding the trends of youth drug use over the past decade

� Identify the true "gateway" drugs and how those drugs have changed over time

� Understand emerging trends in drug use and implications for practice

© 2017 Liga

� Aunt Nora� Bernice� Binge� Blow� Bump� Candy

� Charlie� Dust� Flake� Mojo� Nose Candy� Paradise

� Rock� Sneeze� Sniff� Snow� Toot� White

© 2017 Liga

Cocaine

1996 2006 2016

� Past-monthalcoholuse 38.8% 31% 19.8%

� Past-monthcigaretteuse 28.3% 14.4% 5.9%

� Past-monthmarijuanause 17.7% 12.5% 13.7%

� Past-monthecstasyuse 1.5% 1% 0.5%

� Past-monthcocaineuse 1.7% 1.6% 0.5%

� Past-monthheroinuse 0.6% 0.4% 0.2%

Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future national survey results on drug use,1975-2015: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan.

© 2017 Liga

2002 2008 2015

� Past-monthalcoholuse 60.5% 61.1% 58.3%

� Past-monthsmokingrates 40.8% 35.7% 26.7%

� Past-monthmarijuanause 17.3% 16.6% 19.8%

� PastMonthcocaineuse 2.0% 0.7% 0.6%

� Past-monthecstasyuse 1.5% 1% 0.5%

� Past-monthheroinuse 0.1% 0.2% 0.3%

Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States:

Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). © 2017 Liga

� Brown sugar� Dope� Hell dust� Horse� Junk� Nose drops

� Skag� Skunk� Smack� Thunder� White horse� Cheese

© 2017 Liga

Heroin

0

1000

2000

3000

4000

5000

NumberinThousands

2015 National Survey on Drug Use and Health, SAMHSA

For their first illicit drug, twice as many youth tried prescription drugs as marijuana.© 2017 Liga

� 80% of heroin users start with prescription drugs

� 4.3 million Americans engaged in non-medical use of prescription painkillers in the last month.

� Rx medications are expensive – 30mg oxycodone $30

� Heroin as low as $5/hit

Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.

© 2017 Liga

� 13,000 Rx overdose deaths

� 20,000 heroin overdose deaths

� Expected to increase at LEAST by 25% in 2016 and again in 2017!

� For perspective:¡ Peakgundeaths=39,000in1993¡ PeakHIVdeaths=47,000in1995¡ Peakcarcrashdeaths=54,000in1972¡ Peakoverdosedeaths=65,000in2017

Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths —United States, 2010–2015. MMWR Morb Mortal Wkly Rep 2016;65:1445–1452.

© 2017 Liga

Josh Katz, New York Times. June 5, 2017

© 2017 Liga

A Fatal dose of fentanyl next to a penny (DEA)

© 2017 Liga

� Captain Cody

� Cody� Doors and

fours� Lean� Loads� Pancakes

and syrup� Purple drank� Schoolboy� Sizzurp

� D� Dillies� Footballs� Juice� Smack

� O.C.� Oxy 80� Oxycat� Oxycet� Oxycotton� Oxy� Hillbilly

heroin� Percs� Perks

� Biscuits� Blue heaven� Blues� Heavenly

blues� Mrs. O� O bombs� Octagons� Stop signs

Codeine Hydromorphone Oxycodone Oxymorphone

© 2017 Liga

� In medical terms, these are opioid analgesics, and in legal terms, narcotics.

� Confusion¡ Opiates:ANaturalPainRemedy¡ Opioids:SyntheticPainMedications¡ Opioidisnowusedfortheentirefamilyofopiatesincludingnatural,syntheticandsemi-synthetic.

© 2017 Liga

� Adam� Beans� Cadillac� California sunrise� Clarity� Essence� Elephants� Eve

� Hug� Love pill� Lover’s speed� Peace� Roll� Scooby snacks� Snowball

© 2017 Liga

�MorecommonlyknownasEcstasy,X,orMolly.� Past-monthuseofecstasyby12thgradersdropped70%fromitspeakin2000to2015.¡ Stillthesamelevelascocaineandnearly4xthelevelofheroin

Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future national survey results on drug use,1975-2015: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan.

© 2017 Liga

� Bennies� Black beauties� Crosses� Hearts� LA Turnaround� Speed� Truck drivers� Uppers

� Diet coke� JIF� Kiddie cocaine� Kiddie coke� MPH� Poor man’s cocaine� R-ball� Skippy� Skittles� Smarties� The Smart Drug� Vitamin R

© 2017 Liga

� Stimulant used to treat ADHD� Used by teens, young adults and

professionals to sharpen concentration and stay awake

© 2017 Liga

� Arctic blasts� Aura� Avalance or Avalanche� Bliss� Blizzard� Bloom� Blue silk� Bolivian bath� Cloud nine� Cotton cloud� Drone� Dynamite or Dynamite plus� Euphoria� Glow stick� Hurricane Charlie� Ivory snow� Ivory wave or Ivory wave

ultra

� Lunar wave� Mexxy� Mind change� Monkey dust� Mystic� Natural energy powder� Ocean snow� Plant food� Purple wave� Quicksilver� Recharge� Red dawn� Red dove� Rock on� Rocky Mountain High� Route 69� Sandman Party Powder� Scarface

� Shock wave� Snow day� Snow leopard� Speed freak miracle� Stardust� Super coke� Tranquility� UP energizing or UP

Supercharged� Vanilla Sky� White burn� White China� White dove� White lightning� White rush� White Sands� Wicked X or XX� Zoom

© 2017 Liga

� Powder sold as “bath salts”� Snorted, smoked or injected like cocaine� Can cause violent hallucinations

© 2017 Liga

�Syntheticformofmarijuana– advertisedassafe,legalalternativetomarijuana

�Driedherbalblendmarketedaspotpourriorincense

�Myth:BecauseSpiceproductsarenatural,theyareharmless.

© 2017 Liga

� Joe� No Doz

� Juice� Hard stuff� Sauce� Hooch� Moonshine� Vino� Draft

� Suds� Liquid bread� Oats soda� Tummy

buster� Liquid

courage� 12 oz. curl © 2017 Liga

Caffeine Alcohol

� FDAimposesa71mgcaffeinelimitinsoda– NOLIMITinenergydrinks

� 2nd mostpopulardietarysupplementforteensandyoungadults(NIH2017)

� Energydrinksareconsumedbyone-thirdofadolescents12-17(NIH2016).

© 2017 Liga

� Affects thinking, emotion, and coordination¡ Teen pregnancy, sexual behavior, assaults¡ Contributing factor in the top three causes of death

� Impacts brain development¡ Start at 15 =

¢ 15% develop alcoholism

¡ Wait until 21 = ¢ 2.5% develop alcoholism

© 2017 Liga

� Almost 88,000 people die from alcohol-related health problems every year.¡ This number does not include the 10265 alcohol-impaired

driving fatalities in 2015.

� Alcohol’s consequences often extend beyond the user and into society.

Department of Transportation (US), National Highway Traffic Safety Administration (NHTSA). Traffic Safety Facts 2014 data: alcohol-impaired driving. Washington, DC: NHTSA; 2015

© 2017 Liga

� What is the worst substance a pregnant woman can use?

¡ Alcohol - physical, mental, behavioral, and learning disabilities that can last a lifetime

¡ Tobacco – preterm birth, placenta abruption, small at birth, risk of SIDS

¡ Narcotics – withdrawal can cause miscarriage¡ Cocaine – placental abruption, miscarriage, low

birth weight, 25% increase risk of premature labor

American Congress of Obstetricians and Gynecologists. FAQ170, December 2013© 2017 Liga

� What if she is already using?

¡ Alcohol – stop, medical detox if addicted¡ Tobacco – stop, nicotine replacement only under

Dr’s care if necessary¡ Narcotics – don’t stop, switch to methadone

maintenance under a Dr’s care¡ Cocaine – stop

Forray, Ariadna. “Substance Use during Pregnancy.” F1000Research 5 (2016): F1000 Faculty Rev–887. PMC. Web. 3 Sept. 2017.

© 2017 Liga

� Most effective therapeutic intervention during pregnancy is Contingency Management

¡ Based on the principle of positive reinforcement as a means of operant conditioning to influence behavior change.

¡ The premise behind CM is to systematically use reinforcement techniques, usually monetary vouchers, to modify behavior in a positive and supportive manner.

Forray, Ariadna. “Substance Use during Pregnancy.” F1000Research 5 (2016): F1000 Faculty Rev–887. PMC. Web. 3 Sept. 2017.

© 2017 Liga

� Iowa, Minnesota, and North Dakota’s health care providers are required to test for and report prenatal drug exposure.

� Kentucky health care providers are only required to test.

American Pregnancy Association. Using Illegal Drugs During Pregnancy, July 2015. © 2017 Liga

� Some states consider prenatal substance abuse as part of their child welfare laws. Therefore, prenatal drug exposure can provide grounds for terminating parental rights because of child abuse or neglect.

� These states include: Arkansas, Colorado, Florida, Illinois, Indiana, Iowa, Louisiana, Minnesota, Nevada, Rhode Island, South Carolina, South Dakota, Texas, Virginia, and Wisconsin.


� Alaska, Arizona, Illinois, Louisiana, Massachusetts, Michigan, Montana, Oklahoma, Utah, Rhode Island, and Virginia’s health care providers are required to report prenatal drug exposure.

� Reporting and testing can be evidence used in child welfare proceedings.


� Some states have policies that enforce admission to an inpatient treatment program for pregnant women who use drugs.

� These states include: Minnesota, South Dakota, and Wisconsin.


� Currently, Tennessee is the only state in which a woman can be prosecuted for using illegal drugs while pregnant.

� Women are offered a choice between serving time in jail or joining a rehab program.


drugs on the street - omed 2019 · 13,000 rx overdose deaths 20,000 heroin overdose deaths expected...

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