Substance Abuse intervention and treatment, Final 3

Substance use patterns must be viewed within what context?

emotional adjustment in teen years

Adolescents with higher levels of cortisol

more vulnerable to SUDs

Why are older persons with an AUD overrepresented among those seeking health care?

Alcohol abuse exacerbates or causes many medical disorders for which older persons seek medical treatment

Easily resulted in misdiagnosis and mistreatment

...

how many medial students were excessive drinkers and how many met the criteria for alcohol abuse, Oddly, these students appeared to perform better than their non drinking peers

11% 18%

3 beers or mixed drinks consumed by a 60 year old may have the same effect on a drinker as how many consumed by a 21 year old?

12

Elderly make up approximately what percent of the US population?

12%

Adolescents make up how much of the US alcohol market?

12-20%

Heavy drinkers?

16.3%

Those under 21 are thought to consume how much?

17-20% of all alcohol in the US

What percentage of college students abuse illicit drugs (usually marijuana)?

20.2%, a rate similar to that in their non-college bound peers

How many admit that alcohol use had negatively affected their academic performance?

25%

What percent of HS students report having used a medication prescribed for somebody else?

25%

Alcohol use disorders have been identified in what percent of men and what percent of women hospitalized for medical treatment of conditions other than the AUDs

25% to 30% 5% to 12%

Percentage of elderly suicide victims have used alcohol prior to their suicide attempts

25-50%

Cigarette smokers in US under 18

3 million

In how many states can parents legally give alcohol to children under 21?

31

How many 8th graders have used alcohol at least once? 12 graders?

33% 70%

How many that smoke marijuana will become addicted?

33-40%

At what rate do parents underestimate teenaged alcohol consumption?

4 to 1

What is the risk of an adolescent developing an AUD when they drank before the age of 15 compared to 21?

4 to 6x higher

How many adolescents consume alcohol each year?

4.3 million

Number of teens that used marijuana in 2008

4.5 million

What percentage of college undergrads engage in heavy episodic drinking at least once every two weeks

40%

How many were binge drinkers

40.5%

How many children/adolescents smoke their first cigarette each day?

4400

What percentage of homeless people have a substance use disorder?

45-78%

what percentage of adolescents with diagnosis of CD will develop an SUD at some point?

50-80%

each day?

508000

How many college students were current alcohol users

61%

Up to what percent of individuals who are disabled have an alcohol use disorder?

62% Treatments for this group are limited

Tobacco is used by how many middle school students? HS students?

660,000 3 million

What percent of HS seniors reported having abused alcohol at least once?

77.4%

How many in Frats drink?

86%

2-4% of the elderly are thought to have what?

A SUD involving alcohol, drugs, or both

The role of the individual's substance use in the loss of one's home is complex, and there is not always what?

A causal relationship

Started heavy drinking later in life than european males

African Americans

What is the third most common psychiatric problem found in older persons?

AUDs

More likely to be a planned behavior than a response to external constraints

Abstinence from alcohol or drugs

Women are likely to abstain

Asian Americans

Why do older adults tend to experience negative consequences of their chemical abuse at levels that do not raise suspicion in family members or outsiders?

Because older individuals are more vulnerable to the negative effects of alcohol or drugs of abuse

College students were typically less likely to be what in HS than their non college peers?

Binge drinkers, but this pattern reverses itself after they enter college

In a college age population, what is the consequence of an SUD

Brains are still being molded so continued alcohol use can cause impairments adolescent brain is 4-5x more vulnerable to alcohol-induced brain damage as the adult brain binge drinking can contribute to neurological dysfunction, may have life long consequences for the abuser

Known relationship between what disorders and SUDs?

CD and ODD

30% of college students have used what when compared to 1% of the general population?

CNS stimulants

Assessment Instruments

CRAFFT TWEAK Drug Use Screening Inventory-Revised The Drug and Alcohol Problem Quick Screen Problem Oriented Screening Instrument for Teenagers Substance Abuse Subtle Screening Inventory 3

Also use

Cocaine, Hallucinogens, Inhalants, Marijuana, Meth

What lags behind the growth in the brain's reward system during adolescence?

Cognitive assessment/control systems of the brain

Which is more likely to drink with goal of intoxication?

College students

Why is it so difficult to detect SUDs in elderly people?

Concurrent medical problems AUD/SUD often mimics symptoms of other disorders commonly found in the elderly making differential diagnosis difficult Older drinkers attribute physical complications to the aging process rather than to their alcohol use

Children and adolescents abuse of chemicals in these groups are influenced by what?

Genetic heritage Environmental factors Life events

What problems in diagnosis and treatment of adolescent SUDs?

Diagnostic standards derived from adult SUD Lack tools needed to separate those adolescents that abuse from those who are addicted 1.1 million adolescents meet criteria for admission to treatment but only 1 in 10 ever admitted

What does college mean for many HS relationships?

Dissolution of them, building of new ones

What is the trend for adolescent cigarette smoking in the US during the past decade?

Downward trend

Who would make referrals?

Drug courts

Childhood

Early onset alcohol use (before 13) might reflect a genetic predisposition

Peer groups are always negative

False

Role in the college environment remains static

False

Student may find that they focus on what?

Finding a partner

Sexual minority groups tend to abuse chemicals more often than who?

General public

What are possible indicators that should be looked for?

Having a friend or close sibling who uses alcohol or drugs Social problems Poor impulse control Engaging in risk-taking behaviors Poor parental supervision and/or inconsistent discipline Trauma (including parental divorce) Victimization Poor academic performance Parental alcoholism

Late onset AUDs are usually from where?

Higher socioeconomic levels, enjoy higher income levels, and have stronger familial/social support systems on which to call They also tend to report more negative life events such as retirement, illness or death of a spouse, geographic relocation, loss of lifelong friends, deteriorating health, and depression

Drinking, especially heavy drinking tend to be a male activity

Hispanics

10% of elderly misuse prescriptions. What forms does it take?

Intentional overuse Underuse Erratic use Failure of doctor to obtain a complete drug history

What trend is expected to happen among AUD/SUD in older age groups?

It is expected to continue to increase

Early onset AUDs are usually from where?

Lower economic levels, have less education, smoke more,socialized with individuals that abused alcohol more often

What gender is more likely to abuse illicit drugs?

Males by a 2 to 1 margin

In 2011 what was the most commonly abused illicit compound?

Marijuana

Alcohol use is thought to be very widespread, and its death rate is 440% higher than the general public. What minority was just described?

Native Americans

Peer groups may influence initiation of substance use, but what about continued use?

Not as influential in supporting continued use

When of most college students drink?

On weekends and on holidays they are not required to be in school

What ratio of all prescription medications and over the counter medications are used by the elderly?

One third One half

Issue of child/adolescent abuse of this is of special concern since the abuse of these compounds is growing in popularity

Opioids

Who has a strong influence on fundamental issues in adolescence?

Parents

Who do adolescents gravitate towards?

Peer groups with similar views towards substance abuse

Stages of childhood/adolescents smoking

Preparatory Initiation Experimentation Transition

More cost effective than treating after the development

Prevention

College provides a transitional environment. To some degree protects from larger society

Provides sense of community Isolated environment with minimal parent supervision

Those with the strongest motives to attend college are more likely to what?

Reach out to others with similar values and least likely to abuse alcohol or drugs

Leading cause of mortality and/or having unprotected sex for older adolescents

SUDs

Danger of under diagnosis?

SUDs play significant role in teen suicide

Racial/ethnic group membership, as are siblings and vocational/occupational choices

Somehow involved in why children and adolescents abuse chemicals

Relationship between parental substance use during the childhood years and later used of the adolescent

Strong

Consequences of AUD/SUDs in the elderly

Subject to all of the dangers associated with the abuse of alcohol or drugs but compounded by age related bodily changes Accidental falls, bone fractures, depression, memory problems, liver disease, cardiovascular disorders, sleep problems

What plays a central role in the social lives of LGBT individuals?

Substances

What are more reasons that adolescents abuse chemicals?

Telecommunications Religious affiliation Music selection Personal values Rebellion Insomnia Abuse history or victimization (abuse in childhood may relate to later SUD development) Employment

5 basic reasons that they use

To feel grown up To take risks or rebel against authority To fit into a specific peer group To relax and feel good To satisfy curiosity about the drug's effects

Only 11% abstain from all chemicals throughout

adolescence

There is a need for what?

adolescent substance abuse rehab programs

What is normally seen as a rite of passage?

alcohol use

Adolescents that do this are 50% more likely to develop an AUD later in life

cigarette smokers

Students relationship with alcohol also related to

ethnic heritage

Adolescents substance treatment, is it a cause for optimism?

every year the delay of initiation drops risk for developing SUD by 5%

What about other undergrads?

find heavy alcohol use facilitates the establishment of social relationships with other heavy users

familial pressures to perform well in the college environment and advance socially following graduation may

inhibit the use of alcohol

What are students forced to do?

learn to function independently, develop social networks and deal with feelings of separation from home relationship with alcohol and illicit drugs also changes

Reports of high parental monitoring...

lower levels of substance abuse

Financial incentive for over-diagnosis?

many treatment facilities are for profit

Some individuals continue the substance use patterns that they established in their undergrad program while others begin to what?

mature out

How many suffer accidental injuries each year while intoxicated?

over 599000

how many college students are the victim of alcohol related sexual assault or date rape per year?

over 70 thousand

certain colleges have the reputation of being what?

party schools, where alcohol use seems to be higher

Use is lower in college students than in the general population

tobacco, 26.6% in college students, general population 34%