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Emerging Drug Trends Electronic Smoking Devices 10/4/2018 Emerging Drug Trends Workforce ER Visits Cocaine School health Meth problems and Crime Local‐874 opioid dropouts Mental overdoses leading to Addiction health 27 deaths in 2016 Younger age of initiation‐11 Violence and Synthetic Drugs domestic abuse Heroin Regular use Marijuana “PINK” Kratom Alcohol Tobacco/nicotine Prescription Drugs Experimentation Access Perception of HARM Choice to medical issue Parents are the #1 influence on choice Electronic Smoking Devices 1 10/4/2018 Growing trend in “stealth use:” “With no odor or smell, you can get away with vaporizing pretty much anywhere without anyone ever thinking any wrongdoing.” Quote from Leaf Science article “Portable Marijuana Vaporizers Worth Investing In” Welcome Juul Use is referred to as “juuling” Juuling has shown a 270% jump among youth over the last year Use of the Juul 2 10/4/2018 “mission is preventing the illegal sale of our products to youth” Kit and Accessories $6‐$12 $12‐13 $48.95 Look alike? Pax Era • Micro USB • Similar pod • Temp adjust • THC concentrates 3 10/4/2018 Growing list of chemicals that can be “vaped”: • Nicotine- most common • Tobacco • Alcohol •Caffeine • Synthetic Drugs – Flakka – Opioids • Heroin •Meth • Cocaine • Marijuana • THC Oil • THC Concentrates- quickly rising “Dripping” Dripping involves multiple drops of “e-juice” going right to the atomizer (no filter) Increased heating to: • Produce more “vapor” • Stronger “throat hit” • Improve flavors • Higher concentration of chemicals More carcinogens??? Policies: • Location examples: school districts, community center, libraries, government buildings, restaurants, businesses, churches and other organizations – Smoke‐free – Tobacco‐free – Nicotine‐free – SF with ESD add on 4 10/4/2018 OTC & Rx Drugs of Abuse Dextromethorphan Triple C Lemon Drop Dextromethorphan (DXM) DXM is a common cough suppressant found in cold/cough medications • Medical doses: 10 to 29 milligrams • Abuse doses: 250 to 1,500 milligrams Narconon.org 5 10/4/2018 Stages of impairment 1. Inebriation similar to drunkenness 2. Inebriation plus slurred speech and possibly mild hallucinations 3. Altered state of consciousness, vision or other senses may be impaired 4. lose contact with their body, all senses shut off, similar to that of ketamine or PCP Impact of Abuse Damage from abuse: • Bone marrow and nerve cell damage • High blood pressure • Heart damage • Permanent brain damage • Liver failure • Tachycardia (rapid heart rate) •Seizures • Hyperthermia • Respiratory depression •Coma Side Effects • Euphoria • Double vision • Feelings of detachment • Drowsiness from the body • Impaired ability to walk. • Blotchy skin • Itching • Depression • Numbness of fingers • Difficulty speaking and toes • Dilated pupils • Symptoms of psychosis • Dizziness • Racing heart • Hallucinations • Vomiting • Involuntary movements (ataxia) 6 10/4/2018 Slang Terms Related to DXM • “Skittling,”- Triple C • “Robo,” • “Dexing” • “Tussin” Lemon Drop Lemon Drop • Made by mixing painter’s solvent or lighter fluid with over-the-counter cough syrup • Lemonade Powder is mixed in to cover the bitter taste • Active ingredient is Dextromethorphan (DXM) • DXM Gel Caps 7 10/4/2018 Lemon Drop Effects and Dangers • Psychedelic drug that produces strong hallucinations • Can cause anxiety or panic that can last for hours • High amounts of DXM can stop the heart, slow breathing and cause fatal liver injury • Nausea, vomiting and stomach pain • Extreme sedation or drowsiness, confusion and dizziness • Blurred vision, slurred speech and poor physical coordination • Numbness in extremities Lean/Purple Drank/Sizzurp/ Dirty Sprite What is it? • A combination of the following: – Prescription‐strength cough medicine. – Soft drinks. – Hard, fruit‐flavored candy • The prescription cough syrups used to make lean drink present the most danger because they often contain codeine, a powerful opioid drug • Another active ingredient in some prescription cough syrups is promethazine, an antihistamine that causes sedative effects and can impair motor functioning 8 10/4/2018 Short Term Side Effects • Dizziness • Blurred vision • Nausea • Memory problems Effects of Regular Users • Widespread health issues including – Dental decay. – Constipation. – Weight gain. – Urinary tract infections – May suffer from life‐threatening effects, which may be exacerbated when it is used in combination with other drugs • Some cases of coma and death have been reported • The risk of death is highest when combined with other sedative drugs or depressant substances such as alcohol Large in Teen Culture • The U.S. Drug Enforcement Administration’s figures show that one in ten American teens have sipped either over-the-counter or prescription syrup. • Huge in the Hip Hop Culture – Known has “Hip Hop’s Heroin” – Referenced in over 30 percent of rap songs that reached the top ten of Billboard’s Hot 100 in 2017 – 2014 Study found that codeine references more than tripled in rap songs between 2000 and 2007. 9 10/4/2018 Triple C What is Triple C • Slang term for the over-the-counter medication Coricidin HBP Cough & Cold – Contains Dextromethorphan, or DXM • The directions on a box of the medicine recommend one tablet every four hours to relieve cold symptoms – To achieve a high and to feel psychedelic effects, may take 10, 20, and even 30 pills at a time Other Forms of Triple C • Triple C (Coricidin Cough & Cold) = 30 milligrams of Dextromethorphan. • Coricidin Chest Congestion & Cough = soft gels containing 10 milligrams • Coricidin HBP Maximum Strength Flu = tablets containing 15 milligrams 10 10/4/2018 Street Names for Triple C • Orange Crush • C-C-C • Red Devils • Skittles Who Uses Triple C • Law enforcement sources indicate that teenagers and young adults are the principal abusers •Why: – Usually stocked on open shelves – Susceptible to shoplifting, which has caused some stores to place it behind the counter – Relatively low price Side Effects • Nausea •Seizure • Abdominal pain • Brain damage • Vomiting • Possibly death. • Irregular heartbeat • Confusion • High blood pressure • Agitation • Headache • Paranoia • Numbness of fingers • inappropriate laughter and toes • Loss of consciousness 11 10/4/2018 Side Effects • You can also experience sensory changes like unusual sounds, a weird sense of touch, or a feeling of floating in midair • About five to ten percent of Caucasian people do not metabolize DXM very quickly, and this demographic is especially at risk of overdosing • Taking it with antidepressants can be deadly Adderall Adderall • Used primarily to treat the symptoms of attention-deficit hyperactivity disorder (ADHD). • It has benefits with sleep disorders and reported, off-label utility in managing some forms of severe depression as well. • Central nervous system stimulant 12 10/4/2018 Short Term Signs of Abuse • Headache •Anxiety • Dry mouth • Restlessness • Hoarseness • Pounding or fast • Nausea heartbeat • Stomach upset • Shortness of breath • Digestive issues • Difficulty sleeping and • Reduced appetite staying to sleep • Diarrhea or • Excessive fatigue constipation • Changes in sex drive Long Term Signs of Abuse • Weakness or • Blistering or peeling numbness in the arms skin or legs • Changes in vision • Dizziness • Aggressive behavior • Slowed or difficult • Paranoia speech • Mania • Chest pain • Seizures • Hives or rash Long Term Abuse Health Issue • Large Cardiovascular Issues – Increasing your blood pressure. – Increasing your heart rate. – Increasing your body temperature to dangerous levels. Linked to higher risks of Heart Attack & Stroke 13 10/4/2018 Larger Issue-Mixing with Alcohol • Adderall has the ability to mask certain indicators of intoxication that people would otherwise use to slow or stop their consumption. If these signs go unnoticed, the user is at risk of continued drinking— potentially leading to alcohol poisoning, coma, or death. Teen Adderall Abuse • According to SAMHSA's National Survey on Drug Use and Health – 425,000 teens and adolescents between the ages of 12 and 17 reported misuse Adderall. – Approximately 2.5 million among young adults age 18 to 25 • Teens who misuse Adderall are also – 3 times as likely to have used marijuana. – 8 times as likely to have used cocaine or prescription tranquilizers like Xanax and Klonopin recreationally. – 5 times more likely to have misused prescription pain relievers. Xanax 14 10/4/2018 Xanax • Used to treat anxiety and panic disorders • Also called: – Xannies/Zannies – Handlebars/Bars – Blue footballs Drugabuse.com Xanax Dosing • Medical doses of .25mg, .5 mg, 1 mg, & 2 mg • Abuse dose of 2-12.5 mg Signs of abuse • Feelings of elation • Drowsiness • Sleeping for extended periods of time • Light-headedness • Difficulty concentrating • Problems with memory • Sluggishness • Nausea • Headache • Lack of coordination • Slurred speech • Confusion • Disorientation Drugabuse.com • Respiratory depression 15 10/4/2018 User Experience “Xanax makes you extremely sleepy and stupid. Kinda like being drunk. It also has a reputation of zapping your memory. You'll wake up the next day after 2mg of Xanax and wonder what the @#%& happened the night before” Bluelight.org Opioids 16 10/4/2018 What Happened With Opioids? • Misperceptions about their safety. – Because these medications are prescribed by doctors, many assume that they are safe to take under any circumstance • Increasing environmental availability – Prescribing rates are highest among pain medicine (49%), surgery (37%), and physical medicine/rehabilitation (36%). However, primary
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