Quiz: How Much Do You Know About Teen Alcohol and Drug Use?

Each year, the National Institutes of Health observes National Drug & Alcohol Facts Week in an effort to dispel myths about alcohol and drug abuse, and educate teens on dangers of use and addition. Take this quiz to test your knowledge of alcohol and drug use among teens, including what may be a warning sign.

    1. Teens may abuse alcohol and drugs for a variety of reasons. Choose all that apply.
      1. Negative peer pressure
      2. Family tensions
      3. Access to cash, alcohol and drugs
      4. Trauma
      5. Pressure to perform at school, in the home, or in extracurricular activities
    2. True or false: One-third of high school students have consumed alcohol in the last 30 days.
    3. Cigarette-like devices have gained popularity in recent years. Which are true about the danger of e-cigarettes? Choose all that apply.
      1. E-cigarettes may sometimes contain less nicotine than conventional cigarettes, but the addictive substance is still present.
      2. Non-users can be affected by emissions through second- and third-hand exposure.
      3. E-cigarette and conventional cigarette use have comparable levels of exposure to formaldehyde (a carcinogen).
      4. Because using e-cigarettes mirrors the dangers of cigarette use, the best way to quit cigarettes is to promote alternatives including gums and patches.
    4. True or false: Over-the-counter medications are harmless since they do not require a physician visit or a prescription.
    5. In 2014, the nonmedical use of prescription drugs was highest among young adults. What can parents due to properly store medication in the home, helping prevent prescription drug abuse?
        1. Throw expired or unused prescription medications in the trash as soon as possible.
        2. Store prescription medications in a purse or nightstand, out of sight of kids and teens.
        3. Include education on the dangers of prescription drug abuse as part of your safe storage practices.

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Putting a Stop to Opioid Related Hospitalization in Children

By Grace Lee, Sakina Hussain and Alice Kim, clinical pharmacists at CHOC Children’s

Opioids are a type of medication used to treat pain by blocking pain signals to the brain and decreasing the body’s perception of pain. When used appropriately under the supervision of a physician, prescription opioids are safe and effective medications. However, they are not without potentially serious side effects.

“The past two decades have seen a medical industry-wide emphasis on recognition and treatment of pain. This may have resulted in greater customer satisfaction, but it has led to more opioid products available in more homes than ever before,” says Dr. James Cappon, CHOC’s Chief Quality and Patient Safety Officer. “There are local and national increases in both accidental ingestions and poisonings in children and adolescents, and intentional overdoses in adolescents, too often with serious or even fatal results.”

Examining the Increase in Opioid-Related Hospitalization in Kids and Teens

A recent research study from the Yale School Medicine confirms this observation. Over a 16-year period from 1997 to 2012, a total of 13,052 hospitalizations for prescription opioid poisonings in children were identified. The number of young children aged 1-4 years admitted for opioid-related hospitalization (ORH) doubled, while a similar increase was seen among teens aged 15-19 years.

The reasons for these hospitalizations also varied by age group: children ages 1 to 4 were hospitalized primarily for accidental ingestion, while a majority of teenagers took the drugs with the intent to commit suicide or unintentionally overdosed when taking the drugs for recreational purposes, according to the study.

Side effects of opioid use and abuse

Commonly prescribed opioids for moderate pain include hydrocodone, oxycodone or morphine. Potent opioids such as fentanyl are used to treat severe pain related to cancers and other chronic illnesses.

Opioids can cause severe constipation, nausea, stomach upset, rash, drowsiness and confusion. If taken in excess, there is potential for dependence. Opioid overdose can result in dangerously slow breathing, low blood pressure and coma. In particular, opioids and alcohol are a notoriously deadly mixture.

Safeguarding our children

This study underscores the dangers of prescription opioids, which can often be more accessible than street drugs. “While greater awareness around reducing opioid dependence and prescribing is developing in the medical community, it is extremely important that our patients and families partner in keeping our children safe,” says Dr. Cappon.

Safeguarding our children starts with education and developing a healthy respect for these powerful pain killers. Precautions should be taken to store these medications away from children. Parents can also learn to identify signs and symptoms of opioid overdose to in order to seek help as soon as possible. Some practical tips include:

  • Safe storage – keep all medications away from your child’s reach and sight. Store in locked cabinets, if possible.
  • Safety cap – when filling prescription medications at pharmacies, request child resistant caps to be placed on the medication bottles to prevent easy access.
  • Safe administration – when giving medication to you child, double check the directions on the medication label. Liquid medications should be measured accurately when giving to your child. Keep track of how much medication is left over.
  • Safe disposal ­– expired medications or those that are no longer needed should be disposed of properly. The Food and Drug Administration recommends disposing some medicines, including opioids, by flushing them down the toilet or sink. If you are not sure whether your unused medication can be safely flushed, please check online for community drug take back days in your area.
  • Be aware of medication side effects – be familiar with common side effects of opioids such as nausea, vomiting, constipation, urinary retention, dizziness, drowsiness and confusion.
  • Recognize signs and symptoms of overdose – overdose is life-threatening. If you notice any of the following symptoms, call 911 immediately:
    • Pale face
    • Clammy skin
    • Limp body
    • Blue/purple lips and fingernails
    • Choking or gurgling noises while asleep
    • Cannot be awakened or are unable to speak
    • Slow/no breathing or heartbeat
  • Recognize signs and symptoms of inadequate pain control – it is important to control your child’s pain adequately with the right medications. Besides discomfort, inadequate pain control can lead to drug-seeking behaviors. Talk to your provider about the addition of non-opioid medications that can help with pain.
  • Be aware of your child’s physical and mental health ­– studies have shown that there is an increased risk of substance abuse (including opioids) in children with psychiatric disorders. Be involved with your child’s health and have an open discussion to prevent abuse.

For reference, a list of opioids and their brand names:

Opioid Brand Name
Fentanyl Actiq, Duragesic, Subsys, Lazanda, Fentora, Abstral
Hydrocodone Lortab, Vicodin, Norco  Hysingla ER, Zohydro ER
Hydromorphone  Dilaudid
Methadone Dolophine
Meperidine Demerol
Morphine MS contin, Kadian, Avinza, Embeda (with naltrexone)
Oxycodone Percocet, Oxycontin, Roxicodone, Oxecta, Xtampza ER, Oxaydo

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Exploring the Dangers of E-cigarettes

By Dr. Tomomi Hayashi, pediatric resident at CHOC Children’s

Cigarette-like devices have gained in popularity among teenagers in recent years. If you’re the parent of an adolescent, it’s important to separate fact versus fiction with these devices.

What are e-cigarettes?

E-cigarettes are battery-powered smoking devices that use cartridges filled with liquid containing nicotine. This liquid is then converted to a vapor which is inhaled. According to the Centers for Disease Control, 16 percent of high school students are currently using e-cigs, as of 2015. There are a variety of these delivery units: disposable cartridges that look just like a cigarette, all the way to complex rechargeable vaporizers.

E-cigarettes vs Cigarettes

E-cigarettes, unlike regular cigarettes, do not burn tobacco and therefore the individual does not inhale the same amount of tar and carbon monoxide. As a result, many people incorrectly assume they are safe to use. One common misconception is that e-cigarettes do not contain nicotine or other harmful substances. This is not true. In fact, e-cigarettes contain nicotine as well as other chemicals (toxicants, carcinogens and metal particles), that are harmful to the individual inhaling the substances and the people around them.

E-cigarettes contain anywhere from 0-36mg/ml of nicotine, while conventional cigarettes contain 10-30 mg of nicotine per cigarette. Nicotine is both toxic and addictive. It is absorbed into the lungs and body, affecting multiple systems including the brain and nervous system, as well as the heart by raising blood pressure, heart rate and possibly leading to abnormal heart rhythms. There is even the potential for heart failure and death. For children and adolescents, it can be very harmful to brain development. Because it is an addictive substance, once stopped individuals can feel depressed and tired. With prolonged use, nicotine can have serious effects on the body leading to heart disease, blood clots and stomach ulcers. Just like with smoking regular cigarettes, nonusers can be affected by emissions through second- and third-hand exposure.

While exposure to some chemical components has been shown to be lower in e-cigarettes, studies have shown comparable exposure to formaldehyde (a carcinogen), as well as increased exposure to compounds known to irritate the lungs and contribute to cardiovascular disease.

Alternatives for smokers

Because using e-cigarettes mimics cigarette use, the best way to quit cigarettes is to promote alternatives including gums and patches. Consult your primary care doctor with questions and information on a plan that is right for you.

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Alcohol & Drug Abuse in Teens

As adolescents become more independent, parents often worry about their teens making healthy decisions, including staying away from drugs and alcohol. In honor of National Drug and Alcohol Facts Week, we spoke to Dr. Harvey Triebwasser, director of adolescent medicine at CHOC Children’s about what parents can do to prevent alcohol and drug abuse in teens.

Warning Signs

The most common misconception among parents is the belief that “my kid would never do drugs.”

Parents play a crucial role in identifying possible warning signs of substance abuse in their child. But, outward appearance, school performance, or even extra-curricular activities are not necessarily indicators of drugs and alcohol abuse. Instead, parents should be aware of extreme changes in their teen’s mood, sleep patterns, and eating habits. Since these can also be signs of adolescent development, look for drastic changes, rather than minor shifts in habit.

Teens may abuse alcohol and drugs for a variety of reasons, says Triebwasser, including:

  • Negative peer pressure
  • Family tensions
  • Access to cash, alcohol and drugs
  • Trauma
  • Pressure to perform at school, in the home, or in extra-curricular activities

Parents who are mindful of these potential triggers can be proactive in preventing their teens from turning to drugs or alcohol as a coping mechanism.

Abuse Prevention

Parents must verbalize rules and expectations, including consequences for breaking rules. Quality communication is the key to building trust in the home, says Triebwasser.

They should also model the behavior they expect from their children. If a teen sees adults in their home abusing alcohol or drugs, they are more likely to experiment with substances themselves, he says.

Adults should also properly store and dispose of prescription medications. Behind alcohol and marijuana, prescription and over-the-counter drugs are the most commonly abused substances by Americans ages 14 and older, according to the National Institute of Drug Abuse.

Getting Help

A wide range of health services are available to teens at CHOC, provided my male and female physicians who specialize in adolescents.

Psychologists can also be part of the healthcare team, and address the needs of the whole family.

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Marijuana Edible Use Increasing Among Youth

A recent survey by the National Institute on Drug Abuse showed teens now see fewer risks in smoking marijuana. Marijuana use continues to exceed the use of cigarettes. Further, marijuana edibles are on the rise. These popular edibles are sold in fun, colorful packages and flavors that are appealing to kids.

We spoke to Orange County Sheriff Deputy Angela Andrade, who works with our community’s schools on drug prevention, and she shared the following tips for families:

Q: What are marijuana edibles?
A: Marijuana edibles are food items that are infused with marijuana. Edibles can be made at home with readily available recipes and are also sold pre-packaged. Along with any marijuana use, these edibles may cause negative effects on a youth’s brain, including loss in IQ and poor learning outcomes. Kids usually make them at home or get them from friends. Some marijuana dispensaries are known to carry the pre-packaged edibles.

Today, marijuana has THC (tetrahydrocannabinol – the chemical responsible for most of marijuana’s psychological effects) levels that are 15-25 percent higher than what was found in marijuana in previous years.  Reprocessed substances, known as “concentrates,” are also on the rise and can reach THC levels as high as 99 percent. Marijuana concentrates are usually found in four categories, which look like gooey or wax-like substances: hash oil, honeycomb wax, budder, as well as kief (crystals). Concentrates are made by separating the active cannabinoids from the plant by friction or using a solvent such as butane. With these THC increases, users are more susceptible to overdosing. There are also higher incidences of accidental ingestion by children since many of these edibles are in the form of sweets, cookies, cakes and candies.

Q: What are kids’ attitudes today about the risks of marijuana?
A: Kids falsely believe that edibles are fun and exciting. They seem less harmful to kids because they taste like a special treat or dessert. With the legalization movement in some states, many kids misconstrue the risks involved with recreational marijuana. Our federal law, however, considers marijuana a dangerous illegal drug, and you can be charged with a misdemeanor and pay a fine up to $1,000 and/or one year in jail if found possessing marijuana.

Courtesy of blogs.denverpost.com/eletters
Courtesy of blogs.denverpost.com/eletters

Q: What consequences can kids face if caught with these edibles?

A: Most school districts have a zero tolerance policy when it comes to the possession of drugs on campus. Students can be suspended or expelled for possessing any controlled substance. See federal law consequences above.

Q: What tips do you have for parents who suspect their kids are using edibles, or other drugs?
A: One in six teens who experiment with marijuana become addicted. It also increases their probability of becoming addicted to other illicit drugs.  It is important for parents to create and maintain a clear zero tolerance rule for any drug use. Boundaries help teenagers make better decisions and reinforce acceptable behaviors. Above all, communication is key. Be involved with your teen and his activities and get to know his friends. Help to provide a safe and fun environment.

Learn more about drug prevention education, including upcoming community presentations.

Or, call the Drug Use Is Life Abuse program at 714-647-4133.

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