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Jackie Daniels, MSW, LCSW
Office of Alternative Screening and Intervention
                Services (OASIS)
               Indiana University
          Facebook: *Full Office Name
            Twitter: IUDrugAlcPrev
Agenda
                  
General Information about use
Health
  Physical, Addiction, The Brain
Consequences
  Implications for Higher Ed
Intervention/Prevention
General Information
         
  Chemistry/Physiology, Prevalence, Norms
General Information
                
 Most commonly used “illicit” drug in US, Worldwide
    Commonly used as medicine, food, hospitality, spiritual practices
     in many cultures
    Social symbol- Revolution, freedom, political control, FREE LOVE

 ~4.0% of the world population use cannabis annually (162 million
  people)
 THC – delta-9-tetrahydrocannabinol
    Main psychoactive ingredient; binds to nerve endings in several
     parts of the brain
    The part of marijuana that affects senses, dulls pain, and
     produces a “high”
 Over 70 identified cannabinoids in marijuana
    Several others cannabinoids are of medical interest
    Includes cannabidiol, shown to relieve convulsion, anxiety,
     inflammation, and nausea
General Information
               
 Marijuana has its own drug classification
   Most similar to hallucinogens/psychedelics
   Also shares properties with depressants and stimulants,
     narcotic pain-killers

 Smoking:
   Can reach the brain in 14 seconds
   Felt within minutes
   Peaks after 10 –15 minutes
   Lingers 2 –3 hours

 Food and Beverage:
   Depending on dose, upwards of 3 hours
General Information
                       Prevalence
                            
 34% of IN College Students    Acceptance
  report smoking past year
  (IUB= 40.8, increase from       28.6 % feel peers would
  2011 ICSUS)                      strongly approve of
 18.7% past month                 “trying” once or twice
  (IUB=23.5%, decrease from       6.9% feel peers would
  2011 ICSUS)                      strongly approve of
 Avg. age 1st use IN= 17.4        using regularly
 Most frequent consequences      Survey results show an
    Combining substances          upward climb of peer
    Guilt and Shame               approval over the last
    Driving                       few years (significant)
Health
 
Physical Health
Rational scale to assess
                         
harm of drugs
Marijuana is in the least
 harmful category

Relative to other drugs in
 that category, marijuana
 use still carries some risk
 of harm

From Nutt et al, The Lancet 2007
Physical Health
               
Lungs
  Smoke disables cilia which rid dirt and toxins from
   the lungs

  Immediate effects
    Burning & stinging in mouth & throat.
    Heavy coughing.

  Effects with regular, long-term use
    Increased phlegm production.
    Increased incidence of bronchial ailments
Physical Health
               
Heart
   Dramatically increased heart-rate:
     Increase by 20-50 BPM (70-80 BPM baseline)
     Can contribute to feelings of panic/anxiety

 Immune system
   Marijuana users can develop allergies to the plant
     Symptoms include hives, rashes, wheezing, and
      anaphylaxis (rarely)
     You can become allergic to marijuana even if you have
      not previously experienced symptoms
Addiction
                   
 Physiological Addiction:
   the body becomes chemically tolerant causing
    increased craving and dependency.


 Psychological Addiction:
   the mind becomes dependent upon the drug causing
    one to obsessively think about the drug and to
    develop a love-trust relationship
Addiction: Test Yourself
                             (DSM-IV) and the
 The of American Psychiatric Association
  World Health Organization (ICD-10) criteria for Addiction
Answer yes or no to the following seven questions.
      Tolerance
      Withdrawal
      Difficulty controlling your use
      Negative consequences
      Neglecting or postponing activities
      Spending significant time or emotional energy
      Desire to cut down
If you answered yes to at least 3 of these questions, then you
    meet the medical definition of addiction.
Addiction vs. Abuse
                               
Some people aren't addicted to drugs or alcohol, but
 abuse them.

The American Psychiatric Association (DSM-IV)
 definition of Substance Abuse is at least one of the
 following four criteria.
  Continued use despite social or interpersonal problems.
  Repeated use resulting in failure to fulfill obligations at work,
   school, or home.
  Repeated use resulting in physically hazardous situations.
  Use resulting in legal problems.
The Brain
 How do drugs affect the 
                          brain?
   All Drugs: affect dopamine receptors
The Brain
   
The Brain
                          
Acute (present during intoxication)
   Impairs short-term memory
   Impairs attention, judgment, and other cognitive functions
   Impairs reaction time
Persistent (longer than intoxication, not permanent)
   Impairs memory and learning skills (even after 24 hrs without using)
Long-term (potentially permanent effects of cumulative
  use)
   Can lead to addiction (~9% of users become addicted)
   *Correlated with the development of mental disorders in vulnerable
    individuals
   *May increase risk of anxiety and depression
Marijuana and Other
             Drugs
              
Marijuana has anti-emetic (anti-nausea) properties
  Downside: it hinders your ability to purge after ingesting
   toxic substances, especially alcohol

Taking marijuana with prescription sedatives can
 lead to excessive drowsiness and significantly impair
 coordination and cognitive functioning

Smoking marijuana and tobacco together increases
 risks of lung cancer and other pulmonary diseases
What about medical
        marijuana?
                      
What is “medical marijuana”?
   MARINOL
     Synthetic THC
     Pill form



Currently there are no FDA approved smoke-
 able medicines.
Consequences
     
Implications for Higher Education
Academics
                    
 Marijuana has been shown to impair executive
  functions, attention, and memory

 Heavier users experience more impairment

 Impairments persist after 24 hours
Academics
                 
 Divergent Learning
   Finding creative
    solutions to problems
   Exploring ideas
   Low doses of THC
    have been shown to
    improve this ability
Academics
                 
 Convergent Learning
   Recalling stored
    information
   Applying conventional
    and logical search,
    recognition and
    decision-making
    strategies
   Even small amounts of
    THC impair one’s
    ability to do this
Academics
                  
 Marijuana can affect cognition for over 24 hours
  after use

 In studies, people did not always realize they were
  experiencing cognitive deficits
Current Indiana Marijuana
              Rankings
                               
 Ranked 9th in the country for maximum sentences
  for possession for any amount of marijuana
 Ranked 3rd in the country for maximum sentences
  for possession of one ounce
 29th in the country for percentage of total
  population who have used marijuana in the last
  year



                 Source: Jon Gettman, Ph.D. The Bulletin
                        ofCannabis Reform 2007
Legal Consequences in
           Indiana
                          
 Possession of Marijuana
   Class A Misdemeanor – 30 grams or less
   Class D Felony – 30 grams or less and prior conviction
   Class D Felony – more than 30 grams

 Class A Misdemeanor is punishable by up to 1 year
  and up to a $5,000 fine
 Class D Felony is punishable by six months to 3
  years and up to a $10,000 fine
Legal Consequences
               
 Dealing of Marijuana
    Class A Misdemeanor – 30 grams or less
    Class D Felony – 30 grams or less and prior conviction
    Class D Felony – 30 grams or less and recipient is under age 18
    Class D Felony – more than 30 grams
    Class C Felony – 30 grams or less and in a park, public housing
     complex, school bus, or within 1000 feet of a school
    Class C Felony – 10 lbs or more
 Class C Felony is punishable by 4 to 8 years and up to a
  $10,000 fine
 Driving under the influence (DUI) of
  marijuana=progressive sentencing (MS-FELONY)
Indiana Drugged Driving
            Law
                             
 In Indiana, a person in guilty of DUI if he or she operates a
  vehicle while a controlled substance or its metabolite is
  present in the person's body. Ind. Code Ann. § 9-30-5-1(c)

 Indiana has a zero tolerance per se drugged driving law
  enacted for cannabis, cannabis metabolites, and other
  controlled substances. (Indiana Code Annotated, Section 9-
  30-5-1 & Section 9-30-5-2)

 A person who operates a vehicle impliedly consents to
  submit to chemical tests as a condition of operating a
  vehicle in Indiana. Id. § 9-30-6-1. A person must submit to
  each chemical test offered by an officer, or it will be
  considered a refusal. Id. § 9-30-6-2(d).
Career Consequences
                
 Under federal law (Section 3002 of 50 U.S.C. 435b), current or recent
  drug use prohibits federal employees from obtaining security
  clearance
    Many other occupations make employment decisions based on background
     checks

 Companies that receive federal funds are required to prohibit
  marijuana use under the Drug-Free Workplace Act of 1988
    Based on court rulings, companies are NOT required to make
     accommodations for medical marijuana users, even if medical marijuana is legal
     within the state
    Institutions of Higher Education receiving government funding


     Search yourself! In Indiana: mycase.in.gov
Career Consequences
           
Drug arrests/convictions are a matter of
public record; they will be visible to potential
employers for entire career

  Search yourself! In Indiana: mycase.in.gov
Financial Aid
                    
 Higher Education Act of 1965 (amended) suspends federal
  financial aid eligibility for students convicted of the sale or
  possession of drugs under federal or state law (with stipulations)
 The U.S. Department of Education requires students receiving
  financial aid convicted of a drug crime to notify their school's
  financial aid office immediately
 The suspension of eligibility for Federal financial aid begins on
  the date of the conviction and ends as follows:
       - for Possession of a Controlled Substance 1st offense: 1 year
       - for Possession of a Controlled Substance 2nd offense: 2
                years
       - for Possession of a Controlled Substance 3rd offense:
                Indefinite
       - for Sale of a C.S. 1st Offense or 2nd Offense: 2 years
       - for Sale of a C.S. 3rd Offense: Indefinite
University Consequences
                       
 Consistent Police Involvement

 Campus Conduct and Community Courts are
  Concurrent (some PDP)

 Progressive Sanctioning by Campus Conduct System
   Suspension, Expulsion
   Mandatory MIP & Marijuana Seminar Attendance
Prevention
    
“Just Say No”
            -Thank you Nancy Reagan
                      
I learned it by watching you
Pot-smoking surgeon
Saw blade
Turtle trouble
“Just Say No”
                 
 De-legitimizes authority
 Makes the authority figure seem ignorant and out of
  touch
 Does not respect autonomy and personal decisions
 Does not respect the POSITIVE effects that drugs
  might have in someone’s life
 Be research based and
  theory driven
 Integrate multiple parts of
  student life
 The primary goals are to:
  Reduce, Delay, Decrease
  Transition from “use” to
  “abuse”, Harm Reduction
                                Prevention
 Primary, Secondary,           IU CURRENT PREVENTION:
  Tertiary                      Policy, Conduct, Legal
                                Culture of Care- STEP UP IU!
 Individual, Campus
                                Strategic Planning Underway
  (Environmental),
  Community
Intervention
     
Marijuana Intervention Program
             MIP
                          
 Basic Structure of OASIS and Referrals from Office of
  Student Affairs, Admissions Office
 Continuum of Users
 Campus and Community Partners
   Student Life and Learning, Student Advocates, IUHC
    CAPs, Student Legal Services
   IUPD, Monroe County Prosecutor’s Office
   IU Code of Conduct and A-Z Guide
      On and Off Campus Violations (Confusing for Students)
Components
                  
 Survey
      SCID-IV Non-Alcohol Use SUDs Questionnaire (DSM)
      MSI-X (Marijuana Screening Inventory)
      Marijuana Effect Expectancies
      Reasons for Quitting
      AUDIT (Alcohol)
      Stages of Change Assessment

 Session I= 1 hour, relationship development, motivational
  interviewing and assessment
 Psychoeducational, Individualized Feedback, Case
  Management and Referral (if necessary)
Goals of M.I.P.
                  
 Help students take ownership of behavior, choices and
  consequences
 Develop critical and abstract thinking ability around these
  choices, physical health and psychological well-being,
  examine academic and community standing
 Develop awareness of values and ethical beliefs, how
  these shape decision-making
 Advance self-efficacy and identity
 Assess for more serious problems and refer for
  counseling/treatment/campus resources
Questions? Comments?
          
          Jackie Daniels
      danieljm@indiana.edu
         (812) 856-3898
        IU-Bloomington
Statistics and Sources

                    
    National Institute on Drug Abuse.
   http://www.whitehousedrugpolicy.gov/drugfact/marijuana/index.html
   http://www.addictionsandrecovery.org/definition-of-addiction.htm
   Indiana Collegiate Action Network (2012) Indiana College Substance Use Survey -
    IUB
   American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental
    Disorders
   Jessor, R. & Jessor, S. L (1977) Problem behavior and psychosocial development: a
    longitudinal study of youth.
   Donovan, J.E. & Jessor, R. (1985) Structure of problem behavoir in adolescence and
    young adulthood
   Substance Abuse and Mental Health Services Administration (SAMHSA) (2003)
   Clark County Prosecutor, Indiana ( 2010)
   Indiana Prevention Resource Center (2010)
   Alger, B. & Nicoll, R. ( 2004)
   Center for Addition and Mental Health (2010)
   Triggering Myocardial Infarction by Marijuana (2001)
Recources
                    
 NREPP-SAMHSA National Registry of EBP and Practices
 Center for Study and Prevention of Violence- University
  of Colorado
 National Institute on Drug Abuse (NIDA)
 Cannabis Youth Treatment
 Motivational Interviewing Resources
 Office of Alternative Screening and Intervention Services-
  M.I.P.
 National Cannabis Prevention and Information Centre
 Indiana Prevention Resource Center
 Substance Abuse and Mental Health Administration
  (SAMHSA)

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Higher Education 2

  • 1. Jackie Daniels, MSW, LCSW Office of Alternative Screening and Intervention Services (OASIS) Indiana University Facebook: *Full Office Name Twitter: IUDrugAlcPrev
  • 2. Agenda  General Information about use Health Physical, Addiction, The Brain Consequences Implications for Higher Ed Intervention/Prevention
  • 3. General Information  Chemistry/Physiology, Prevalence, Norms
  • 4. General Information   Most commonly used “illicit” drug in US, Worldwide  Commonly used as medicine, food, hospitality, spiritual practices in many cultures  Social symbol- Revolution, freedom, political control, FREE LOVE  ~4.0% of the world population use cannabis annually (162 million people)  THC – delta-9-tetrahydrocannabinol  Main psychoactive ingredient; binds to nerve endings in several parts of the brain  The part of marijuana that affects senses, dulls pain, and produces a “high”  Over 70 identified cannabinoids in marijuana  Several others cannabinoids are of medical interest  Includes cannabidiol, shown to relieve convulsion, anxiety, inflammation, and nausea
  • 5. General Information   Marijuana has its own drug classification  Most similar to hallucinogens/psychedelics  Also shares properties with depressants and stimulants, narcotic pain-killers  Smoking:  Can reach the brain in 14 seconds  Felt within minutes  Peaks after 10 –15 minutes  Lingers 2 –3 hours  Food and Beverage:  Depending on dose, upwards of 3 hours
  • 6. General Information Prevalence   34% of IN College Students  Acceptance report smoking past year (IUB= 40.8, increase from  28.6 % feel peers would 2011 ICSUS) strongly approve of  18.7% past month “trying” once or twice (IUB=23.5%, decrease from  6.9% feel peers would 2011 ICSUS) strongly approve of  Avg. age 1st use IN= 17.4 using regularly  Most frequent consequences  Survey results show an  Combining substances upward climb of peer  Guilt and Shame approval over the last  Driving few years (significant)
  • 8. Physical Health Rational scale to assess  harm of drugs Marijuana is in the least harmful category Relative to other drugs in that category, marijuana use still carries some risk of harm From Nutt et al, The Lancet 2007
  • 9. Physical Health  Lungs  Smoke disables cilia which rid dirt and toxins from the lungs  Immediate effects  Burning & stinging in mouth & throat.  Heavy coughing.  Effects with regular, long-term use  Increased phlegm production.  Increased incidence of bronchial ailments
  • 10. Physical Health  Heart  Dramatically increased heart-rate:  Increase by 20-50 BPM (70-80 BPM baseline)  Can contribute to feelings of panic/anxiety  Immune system  Marijuana users can develop allergies to the plant  Symptoms include hives, rashes, wheezing, and anaphylaxis (rarely)  You can become allergic to marijuana even if you have not previously experienced symptoms
  • 11. Addiction   Physiological Addiction:  the body becomes chemically tolerant causing increased craving and dependency.  Psychological Addiction:  the mind becomes dependent upon the drug causing one to obsessively think about the drug and to develop a love-trust relationship
  • 12. Addiction: Test Yourself  (DSM-IV) and the  The of American Psychiatric Association World Health Organization (ICD-10) criteria for Addiction Answer yes or no to the following seven questions.  Tolerance  Withdrawal  Difficulty controlling your use  Negative consequences  Neglecting or postponing activities  Spending significant time or emotional energy  Desire to cut down If you answered yes to at least 3 of these questions, then you meet the medical definition of addiction.
  • 13. Addiction vs. Abuse  Some people aren't addicted to drugs or alcohol, but abuse them. The American Psychiatric Association (DSM-IV) definition of Substance Abuse is at least one of the following four criteria.  Continued use despite social or interpersonal problems.  Repeated use resulting in failure to fulfill obligations at work, school, or home.  Repeated use resulting in physically hazardous situations.  Use resulting in legal problems.
  • 14. The Brain  How do drugs affect the  brain?  All Drugs: affect dopamine receptors
  • 15. The Brain
  • 16. The Brain  Acute (present during intoxication)  Impairs short-term memory  Impairs attention, judgment, and other cognitive functions  Impairs reaction time Persistent (longer than intoxication, not permanent)  Impairs memory and learning skills (even after 24 hrs without using) Long-term (potentially permanent effects of cumulative use)  Can lead to addiction (~9% of users become addicted)  *Correlated with the development of mental disorders in vulnerable individuals  *May increase risk of anxiety and depression
  • 17. Marijuana and Other Drugs  Marijuana has anti-emetic (anti-nausea) properties  Downside: it hinders your ability to purge after ingesting toxic substances, especially alcohol Taking marijuana with prescription sedatives can lead to excessive drowsiness and significantly impair coordination and cognitive functioning Smoking marijuana and tobacco together increases risks of lung cancer and other pulmonary diseases
  • 18. What about medical marijuana?  What is “medical marijuana”?  MARINOL  Synthetic THC  Pill form Currently there are no FDA approved smoke- able medicines.
  • 19. Consequences  Implications for Higher Education
  • 20. Academics   Marijuana has been shown to impair executive functions, attention, and memory  Heavier users experience more impairment  Impairments persist after 24 hours
  • 21. Academics   Divergent Learning  Finding creative solutions to problems  Exploring ideas  Low doses of THC have been shown to improve this ability
  • 22. Academics   Convergent Learning  Recalling stored information  Applying conventional and logical search, recognition and decision-making strategies  Even small amounts of THC impair one’s ability to do this
  • 23. Academics   Marijuana can affect cognition for over 24 hours after use  In studies, people did not always realize they were experiencing cognitive deficits
  • 24. Current Indiana Marijuana Rankings   Ranked 9th in the country for maximum sentences for possession for any amount of marijuana  Ranked 3rd in the country for maximum sentences for possession of one ounce  29th in the country for percentage of total population who have used marijuana in the last year Source: Jon Gettman, Ph.D. The Bulletin ofCannabis Reform 2007
  • 25. Legal Consequences in Indiana   Possession of Marijuana  Class A Misdemeanor – 30 grams or less  Class D Felony – 30 grams or less and prior conviction  Class D Felony – more than 30 grams  Class A Misdemeanor is punishable by up to 1 year and up to a $5,000 fine  Class D Felony is punishable by six months to 3 years and up to a $10,000 fine
  • 26. Legal Consequences   Dealing of Marijuana  Class A Misdemeanor – 30 grams or less  Class D Felony – 30 grams or less and prior conviction  Class D Felony – 30 grams or less and recipient is under age 18  Class D Felony – more than 30 grams  Class C Felony – 30 grams or less and in a park, public housing complex, school bus, or within 1000 feet of a school  Class C Felony – 10 lbs or more  Class C Felony is punishable by 4 to 8 years and up to a $10,000 fine  Driving under the influence (DUI) of marijuana=progressive sentencing (MS-FELONY)
  • 27. Indiana Drugged Driving Law   In Indiana, a person in guilty of DUI if he or she operates a vehicle while a controlled substance or its metabolite is present in the person's body. Ind. Code Ann. § 9-30-5-1(c)  Indiana has a zero tolerance per se drugged driving law enacted for cannabis, cannabis metabolites, and other controlled substances. (Indiana Code Annotated, Section 9- 30-5-1 & Section 9-30-5-2)  A person who operates a vehicle impliedly consents to submit to chemical tests as a condition of operating a vehicle in Indiana. Id. § 9-30-6-1. A person must submit to each chemical test offered by an officer, or it will be considered a refusal. Id. § 9-30-6-2(d).
  • 28. Career Consequences   Under federal law (Section 3002 of 50 U.S.C. 435b), current or recent drug use prohibits federal employees from obtaining security clearance  Many other occupations make employment decisions based on background checks  Companies that receive federal funds are required to prohibit marijuana use under the Drug-Free Workplace Act of 1988  Based on court rulings, companies are NOT required to make accommodations for medical marijuana users, even if medical marijuana is legal within the state  Institutions of Higher Education receiving government funding Search yourself! In Indiana: mycase.in.gov
  • 29. Career Consequences  Drug arrests/convictions are a matter of public record; they will be visible to potential employers for entire career Search yourself! In Indiana: mycase.in.gov
  • 30. Financial Aid   Higher Education Act of 1965 (amended) suspends federal financial aid eligibility for students convicted of the sale or possession of drugs under federal or state law (with stipulations)  The U.S. Department of Education requires students receiving financial aid convicted of a drug crime to notify their school's financial aid office immediately  The suspension of eligibility for Federal financial aid begins on the date of the conviction and ends as follows: - for Possession of a Controlled Substance 1st offense: 1 year - for Possession of a Controlled Substance 2nd offense: 2 years - for Possession of a Controlled Substance 3rd offense: Indefinite - for Sale of a C.S. 1st Offense or 2nd Offense: 2 years - for Sale of a C.S. 3rd Offense: Indefinite
  • 31. University Consequences   Consistent Police Involvement  Campus Conduct and Community Courts are Concurrent (some PDP)  Progressive Sanctioning by Campus Conduct System  Suspension, Expulsion  Mandatory MIP & Marijuana Seminar Attendance
  • 32. Prevention
  • 33. “Just Say No” -Thank you Nancy Reagan  I learned it by watching you Pot-smoking surgeon Saw blade Turtle trouble
  • 34. “Just Say No”   De-legitimizes authority  Makes the authority figure seem ignorant and out of touch  Does not respect autonomy and personal decisions  Does not respect the POSITIVE effects that drugs might have in someone’s life
  • 35.  Be research based and theory driven  Integrate multiple parts of student life  The primary goals are to: Reduce, Delay, Decrease Transition from “use” to “abuse”, Harm Reduction Prevention  Primary, Secondary, IU CURRENT PREVENTION: Tertiary Policy, Conduct, Legal Culture of Care- STEP UP IU!  Individual, Campus Strategic Planning Underway (Environmental), Community
  • 37. Marijuana Intervention Program MIP   Basic Structure of OASIS and Referrals from Office of Student Affairs, Admissions Office  Continuum of Users  Campus and Community Partners  Student Life and Learning, Student Advocates, IUHC CAPs, Student Legal Services  IUPD, Monroe County Prosecutor’s Office  IU Code of Conduct and A-Z Guide  On and Off Campus Violations (Confusing for Students)
  • 38. Components   Survey  SCID-IV Non-Alcohol Use SUDs Questionnaire (DSM)  MSI-X (Marijuana Screening Inventory)  Marijuana Effect Expectancies  Reasons for Quitting  AUDIT (Alcohol)  Stages of Change Assessment  Session I= 1 hour, relationship development, motivational interviewing and assessment  Psychoeducational, Individualized Feedback, Case Management and Referral (if necessary)
  • 39. Goals of M.I.P.   Help students take ownership of behavior, choices and consequences  Develop critical and abstract thinking ability around these choices, physical health and psychological well-being, examine academic and community standing  Develop awareness of values and ethical beliefs, how these shape decision-making  Advance self-efficacy and identity  Assess for more serious problems and refer for counseling/treatment/campus resources
  • 40. Questions? Comments?  Jackie Daniels danieljm@indiana.edu (812) 856-3898 IU-Bloomington
  • 41. Statistics and Sources   National Institute on Drug Abuse.  http://www.whitehousedrugpolicy.gov/drugfact/marijuana/index.html  http://www.addictionsandrecovery.org/definition-of-addiction.htm  Indiana Collegiate Action Network (2012) Indiana College Substance Use Survey - IUB  American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders  Jessor, R. & Jessor, S. L (1977) Problem behavior and psychosocial development: a longitudinal study of youth.  Donovan, J.E. & Jessor, R. (1985) Structure of problem behavoir in adolescence and young adulthood  Substance Abuse and Mental Health Services Administration (SAMHSA) (2003)  Clark County Prosecutor, Indiana ( 2010)  Indiana Prevention Resource Center (2010)  Alger, B. & Nicoll, R. ( 2004)  Center for Addition and Mental Health (2010)  Triggering Myocardial Infarction by Marijuana (2001)
  • 42. Recources   NREPP-SAMHSA National Registry of EBP and Practices  Center for Study and Prevention of Violence- University of Colorado  National Institute on Drug Abuse (NIDA)  Cannabis Youth Treatment  Motivational Interviewing Resources  Office of Alternative Screening and Intervention Services- M.I.P.  National Cannabis Prevention and Information Centre  Indiana Prevention Resource Center  Substance Abuse and Mental Health Administration (SAMHSA)

Notas do Editor

  1. Developed by Psychopharmacology Unit, University of Bristol, 2007. Reported in “The Lancet.”Legal/governmental definitions provide one viewpoint of “harm.” This diagram was created in UK:“We developed and explored the feasibility of the use of a nine-category matrix of harm, with an expert delphic procedure, to assess the harms of a range of illicit drugs in an evidence-based fashion.” i.e. Opinions of professionals across varying fields (medical, pharmaceutical, neuroscience, etc)
  2. MEDICAL MODEL
  3. The next 2 slides: 2 different types of learning (Divergent and Convergent). For divergent learning, MJ allows for creative processing of information and solutions to problems by relying on an external stimulus (i.e. drug)
  4. In convergent learning, this requires much more critical thinking, memory recallscience, math and technology
  5. Memory, information recall, “foggy”
  6. Justification: *Vision impairments-Peripheral vision (detecting other cars’ turn signals)DrowsinessCentral vision detection (stop lights)Time reaction (braking in time)Difficulty in maintaining speedsImpairment of night driving- recovering time from glare of on-coming trafficInterpretation and quick decision making
  7. *There are stipulations, check with DOE before sharing to make sure you know how it applies to your school and the state consequences/legal status
  8. Goals of prevention with cannabis:reduce use, limiting the number of users and the types of substances used and2. delay use in those that will use. Regarding the second goal, delaying the start of use reduces harm during a child’s development and reduces risk for developing addiction and abusive patterns of use. Recognition that at least some proportion of the population will use psychoactive substances3. preventing the transition from “use” to “abuse,” and4. diminishing harm resulting from use. This last would include not only ways to make use safer (e.g., needle exchanges, safer-drinking strategies), but also movement into treatment and prevention of relapse once treatment is completed. Prevention:· Primary prevention refers to activities undertaken prior to an individual using. Most educational programs fit under this, but so do programs designed to reduce drug availability (e.g., law enforcement). · Secondary prevention refers to activities applied during the early stages of drug use and would encompass attempts to prevent the transition from use to abuse. Early diagnosis, crisis intervention, and economic changes such as increasing alcohol taxes can decrease use and interrupt problematic patterns of use. · Tertiary prevention takes place at later (advanced) stages of drug abuse and refers to actions to avoid relapse and maintain health status after therapy. This is essentially the extended aspect of drug treatment. Intervention: · Universal Intervention refer to efforts focused on every eligible member of a community.These are programs aimed at an entire group (rather than individuals) and include media campaigns, policies that affect all members of a community equally, such as taxes and laws, and educational programs provided to all students regardless their risk level. Potential benefits are expected to outweigh costs for everyone. · Selective Intervention are more focused at a more systems domain where higher-risk subgroups are targeted (e.g., children from homes where family members have a history of drug use or college students in general). · Indicated intervention is individual-focused interventions and represents the most time and financially-intensive programs. These include prevention efforts targeted at individuals, for example those who show signs of developing problems, e.g., after receiving a DUI or completing treatment.
  9. Referrals:IUPD,Res Halls-Dean of Students (unique relationship) housed outside IUHC, still confidentialCommon Sanctions and Policy Violations from the CODE, Part II Student Responsibilities Section H. ACCOMPANY Marijuana ViolationsDisciplinary probation- leads to judicial recordUnauthorized possession, manufacture, sale, distribution, or use of illegal drugs, any controlled substance, or drug paraphernalia. Being under the influence of illegal drugs or unauthorized controlled substances.A violation of any Indiana or federal criminal law.Violation of smoking policy Legal consequences:Dean has zero tolerance for dealing500.00 in PDP fees$200.00 for our office 2012- death finals weekPossession under 30g, dealing over 30gJail over-crowding leads to release of non-violent offenders in communityCan be arrested for OWI if suspected of being high- breathalyzer not necessary. Up to courts to proveCannabis is a Schedule 1 drug in IN- meaning it has potential for abuse and has no recognized medical use in treatment in the USA, or lacks accepted safety for use in treatment under medical supervision. Same class as heroin, lsd, EcstasyArrests 2011/2012:201118 felony arrests168 paraphernalia161 possession3 Dealing Cannabis13 Narcotics Poss.7 Narcotics Dealing201222 felony arrests60 possession53 paraphernalia6 Dealing Cannabis8 Narcotics Poss.17 Narcotics Dealing
  10. Students complete initial survey for first appointment. $200.00 for serviceConversation/coaching/motivational approachDealing with legalization and decriminalization- partially education and information needed, otherwise belief systems. Students will sometimes want to transfer…SCID-IV Non Alcohol Use SUDS Questionnaire- DSM Criteria- used as indicator of abuse/depMSI-X- Helps identify “risky users”Alcohol use disorders identification test- refer on to SMART, talk about alcohol and assessMEE- Evaluate expectancies, develop discrepanciesIdentify change talk through reasons for quittingAUDIT- identify alcohol use problemsDetermine stage of change for appropriate MI approaches
  11. Follow-up appointments based on risk assessment (ambivalence, risk for future consequence, mental health and peer group, future endeavors dictated by background checks- with school and lawConversation, non-judgmental.Motivational Interviewing techniques:Motivation to change is elicited from the client, and is not imposed from outside forcesIt is the client's task, not the counselor's, to articulate and resolve his or her ambivalenceDirect persuasion is not an effective method for resolving ambivalenceThe counseling style is generally quiet and elicits information from the clientThe counselor is directive, in that they help the client to examine and resolve ambivalenceReadiness to change is not a trait of the client, but a fluctuating result of interpersonal interactionThe therapeutic relationship resembles a partnership or companionship COACHING