U.S. Surgeon General’s Message; Addiction Prevention Programs Work

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Among the most welcome for mental health professionals, policy makers and parents to hear as they battle the escalating social and personal tragedies of drug and alcohol abuse is this:

There is now a new national policy commitment to preventing abuse of alcohol and addictive substances, and with it, emerging new approaches to preventing youthful experimentation and dabbling in mind-altering substances from progressing into mental health crises.

Public Health Approach: Prevention

The new muscle behind the prevention/intervention message comes from the first-ever U.S. Surgeon General’s report on Alcohol, Drug and Health, Facing Addiction in America. It not only declares preventing use from escalating to abuse to be the mission—it emphasizes prevention works. “Evidence based programs have a 40% – 60%” success rate in terms of reducing the onset of addiction and associated behaviors,” says A. Thomas McLellan, Ph.D., the renowned addiction scientist who helped co-author the report, speaking at the landmark Facing Addiction in America conference in fall 2016. Dr. McLellan is chair of the board and co-founder of the Treatment Research Institute, Philadelphia, Pennsylvania.

Reason 1 Prevention Works: Tested Scientific Model

In the U.S., the public health prevention model has more than 100 years of study, data and positive outcomes of widespread improvements to the health of Americans. Diphtheria, tetanus, poliomyelitis, smallpox, measles, mumps, rubella are among the public health victories of the 20th Century.

“The public health-based approach called for in this Report aims to address the broad individual, environmental, and societal factors that influence substance misuse and its consequences, to improve the health, safety, and well-being of the entire population,” Dr. Vivek H. Murthy, M.D., M.B.A. Vice Admiral, U.S. Public Health Service Surgeon General explains in his November address and elaborates on The Surgeon General’s web site.

Reason 2 Prevention Works: Brain Science

In the past ten years, the medical and technological advances that yield insights into the brain on drugs – the emerging discipline of neurocognition and the biology of addiction—are yielding a level of proof never before available. And it’s persuasive.

Now, with the advent of technologies such as functional magnetic resonance imaging (fMRI) and other lower-radiation imaging studies safer to use on youth, researchers can observe brain tissue responding to drugs, map the molecular pathways that are activated or shut down by drugs and alcohol – and at last understand cause and effect.

The brain can be hacked by drugs; neurotransmission systems that normally regulate healthy behaviors such as judgment, motivation, decision-making and well-being can be negatively impacted by the disruptive input of chemical modulators that drugs and alcohol bring.  This is especially true for teens where their brains are not fully developed.  Brain science now shows that that use of addictive substances hacks and hijacks the brain’s functioning, while excessive and continual use can rewire the developing brains of teenagers in a damaging way.

Helping the Developing Brain

Making prevention a national mental health priority is exactly the right public health move. We believe that not every teenager who experiments with drugs or alcohol needs treatment—they need tools and a guide to navigate the new world of possibilities.

By promoting a conservative prevention/intervention mindset, which includes addressing substance use that has already started the goal is to help correct missteps that developmentally can be a natural part of adolescence—risk taking, including experimenting with mind-altering substances.

This is why we developed Gobi, a set of online tools, surveys, exercises, scripts, prescribed excises—such as parent or care-giver and youth going for a focused walk discussing prescribed questions—Gobi encourages reflection and connection to self and family. Available via a smartphone or other device, Gobi can help support, clarify, reconnect, redirect.

We are encouraged by the response to the early testing of the Gobi tool set. Our research shows there is ample evidence that young brains really are at risk—and no one sets out to make that happen when they crack their first beer. So yes, we’re out to save brains—and kids and families with them. That’s what Gobi’s about.

Contact Gobi: http://www.gobi.support/

Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.

©2017 Our Young Addicts   All Rights Reserved.

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Prevention, Perceptions, and…Puppies – Oh my!

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Prevention is an important public health initiative and I’m grateful for the opportunity to work with Minnesota’s Regional Prevention Coordinator Lindsey Smith this past year. She’s been key to our events with Anoka-Hennepin Schools and was a panelist for our conference, From Statistics to Solutions. As this week’s guest blogger, Lindsey offers distinctions between reality and perception when it comes to young people and substance use … along with effective actions we can take to curtail this.

“Isn’t it inevitable that youth will use alcohol and drugs in high school?” “If only we could do a better job of educating everyone about the dangers.” These are things I hear on a regular basis in my work as a substance use prevention specialist. My response to both is: not quite.

(Mis)Perception of Youth Use

Perception is our reality, as the familiar saying goes. What we believe to be true is influenced by a number of factors. The way information is reported to us through the media and by word of mouth are great examples. Both communication vehicles look for compelling stories to tell, which often emphasize extremes. Gossip isn’t interesting if it is about a mundane trip to the grocery store. It is interesting if a car went crashing through the front door though. I should expect to see a car in the produce section the next time I stop at Cub, right?

The more unusual, extreme, or concerning something is, the more likely we are to hear widespread conversation about it. This also happens with youth substance use. Students who used over the weekend tend to talk about it more than students who spent their time babysitting or watching movies. Media coverage of substance use related stories tend to focus on teen use, not on teens who choose to abstain. We are inundated with messages about teens using substances, so it is not surprising the common perception of youth substance use is it’s “typical” and, thus, a somewhat acceptable norm.

Here lies the difficulty: our perceptions are inaccurate. The majority of youth are making positive, healthy choices about substance use. For instance:

  • According to the 2014 National Survey on Drug Use and Health (NSDUH), 34.7 percent of 15-year-olds report they have had at least 1 drink in their lives. By default, this statistic also means 3 percent of 15 year olds surveyed report having never consumed alcohol.
  • The NSDUH also found 22.8 percent of 12-20 year olds reported drinking alcohol in the past month. This also means2 percent did not drink alcohol in the past month.

The use rates shared above are nothing to ignore. The concern over this information should not overshadow the hope we find in the other side of each statistic, however. We need to do a better job of highlighting the truly typical choices our youth are making. Let’s remind young people, parents, and community members that it is not abnormal to choose health and safety. Everyone looks for opportunities to feel connected and a part of a common experience. Let’s not allow misperception of what that experience is to fool us into a mindset which is both inaccurate and detrimental.

A Community View of Prevention

Breaking down misperceptions about substance use to fuel new community norms is one example of a prevention strategy. Educating youth, parents, and other caring adults about the harms of substance use is another, but is often mistaken as the only option. Prevention strategies can also include a change in business practice such as checking IDs or community policies which limit youth access and exposure to substances.

Whether you think of these as system changes, environmental strategies, or work that takes a really long time, you may wonder why public health professionals bother with them. I think the answer is best understood through analogy, a dog analogy to be specific.

In my household, the family member most often at the doctor is our dog, Brooks. This poor guy has had quite the battle with allergies, torn ACLs, etc. These issues do not stop him from being a young dog who wants to play and run though! After his first ACL surgery, the vet told us he should not run, jump, or fuss with the wound on his knee (which is like telling a fish not to swim). How did my husband and I try to prevent these things from happening? At first we focused our energy on scolding him each time he tried to jump on the couch or started licking his wound. I’m convinced Brooks started to think we changed his name to “No” because we used the word so often.

After a couple of days, we got smarter. Brooks loves to jump on our bed, so we shut the door to our room anytime we were away. We had Brooks wear a cone to make his wound inaccessible. We even went so far as to leash him every time we went outside so he wouldn’t chase after rabbits. Instead of continuing to tell Brooks to change his behavior, we created environments for him which prevented the risky behavior from happening at all.

This is what we do in public health. We work to create environments which inherently promote health and prevent risky behavior from happening. Rather than relying solely on education to stop youth from using alcohol and drugs, we use strategies that impact the entire community in which youth live.

Concepts into Action

What might you do to put these concepts into action? Here are a few ideas to get you started:

  • Think critically. Question information you receive that suggests it is normal for youth to use alcohol and drugs. Know that you have the majority on your side.
  • Talk to youth about misperceptions. What do they believe the norm is? Why? Remember that youth do care about what their parents think, even if they try to convince you otherwise. Find talking points and conversation starters at samhsa.gov/underage-drinking or www.drugfree.org.
  • Ask the same of adults. What do they believe is normal and why? Empower parents and caring adults to express their concerns about substance use for the young people in their lives.
  • Find confidence in your healthy choices. It can be uncomfortable for both youth and adults to be open about their belief youth substance use is unhealthy. Be an example of the majority who believes this too. Find inspiration from others who already have at myonereason.com and www.abovetheinfluence.com.
  • Find local data to learn what this looks like in your community. For those in Minnesota, sumn.org is a wonderful resource to locate this information.
  • Get involved! Join a neighborhood group, a community coalition, or another effort working to promote youth health. Community collaboration has shown to be one of the most successful ways to change the environment and reduce substance use. For more information, visit cadca.org or www.rpcmn.org.

Bio

Lindsey Smith Lindsey Smith is the Regional Alcohol, Tobacco, & Other Drug Prevention Coordinator, serving Minnesota’s seven county metro area. In this role, she supports local communities working to prevent substance abuse by providing resources, training, assistance, and consultation. By engaging multiple sectors of the community and using public health principles as a guide, she assists community collaboratives in reaching their goals.

http://www.rpcmn.org

Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.

 ©2016 Our Young Addicts   All Rights Reserved.

 

 

 

Addiction Science: The Teenage Brain and a New Online Drug and Alcohol Prevention Program

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Guest Blogger, Kim Bemis, founder of Gobi.

Every human culture has its intoxicating substances—and in each culture there is a subset of users who become addicted.

In the U.S., 21st century addiction problems are appearing earlier in life[1], according to the latest scientific data revealed in May by the nation’s foremost addiction experts at a New York conference I attended.

Addiction science reveals that abuse and addiction occurring in the biologically sensitive period of adolescence can harm a vulnerable brain—so much so that abusers’ and addicts’ brains may not reach their full potential or function normally. This is because repeated and chronic use of substances targets the paired system governing behavior: the brain’s reward center (nucleus accumbens) and the impulse-control center (prefrontal cortex). As the keynote speaker, National Institute on Drug Abuse (NIDA) Director Dr. Nora D. Volkow, put it: “Addiction and drugs attack the reward centers we need to survive. They hijack that system” by radically disrupting the neurochemical signals to produce constant reward-seeking behavior with no checks or balances from the impulse control center. “When executive function is decreased you are at risk of seeking rewards without sound judgment.”

Dr. Volkow also emphasized that the prefrontal cortex—that brain capacity so critical to making executive decisions in the person’s and society’s best interests—is not fully developed until age 25. Yet in our society, we have 15-year-olds—and younger—at risk of jeopardizing their developing brains with excessive use of drugs and alcohol. Not only do these chemicals have the power, over time, to change the circuitry of the developing adolescent brain, but extensive or continued use robs adolescents of normal and necessary growth experiences central to identity formation, positive affiliation, family/community connection and a sense of purpose.

This concerns me because I am an entrepreneur who has spent the last 11 years working in the drug and alcohol recovery field—and the scientific insights my background gives me suggest we are, as a society, at risk of creating a culture that promotes access to substances in a way that leads to easy use, frequent overuse and, too often, to abuse.

Of course, addiction doesn’t happen overnight; one drink won’t hurt. But the science suggests it is essential to educate the public to understand that teen substance use is a public health problem and that addiction is a complex brain disease that, in most cases, originates in adolescence. Our health systems must work to prevent or delay the onset of substance use through effective public health measures.[2] I want to do all I can to help prevent teens from abuse and addiction, to help them make better decisions. Here’s who I am and what I do:

  • A gratefully sober man for over 27 years, able to enjoy the blessings of family and friends because of my recovery from drug and alcohol addiction
  • A former executive of an internationally renowned treatment center helping people get sober, stay sober and reconnect with life
  • Now, the CEO of Gobi, a new, accessible and affordable approach to intervening to help teens who might be in trouble because of their substance use. Gobi (gobi.support) is a novel online tool for teens and their family members. It is science-based and developed by expert clinicians in addiction science, parents and teens, Gobi is intended to reach digital natives in their own space—online, with social media follow-up and support. At the same time, Gobi also supports parents, with research on adolescent substance use and tips on communicating effectively with teenagers. Figures 1, 2, and 3 convey sample findings from our recent user survey during the 60-day course of Gobi online programing.

Figure 1: Fig1_Gobi connects

Figure 2:Fig2_Gobi offers keys to change

Figure 3: Fig3_Gobi results

In May 2016 I had breakthrough experiences at two tremendous addiction conferences: “From Statistics to Solutions Prevention Summit: Addressing Underlying Issues of Youth Substance Abuse,” in the Twin Cities, with sponsors and partners including Know the Truth, Our Young Addicts, Minnesota Teen Challenge, and more, and “The Addicted Brain and New Treatment Frontiers: Sixth Annual Aspen Brain Forum,” sponsored by the New York Academy of Sciences and the Aspen Brain Forum in New York City.

Below, I share several key messages from the New York summit. In my next post, I’ll elaborate on my Minnesota conference aha moments, and the tremendously encouraging things happening.

  • Over time and frequent use, substance-induced changes to the brain impair a person’s self-control and ability to make sound decisions, while sending intense impulses to continue to use—just to feel “normal.”
  • Our brains develop from the bottom to the top and from the back to the front until approximately age 25. Brain circuitry during this developmental stage is particularly vulnerable to substances of abuse.
  • Data show that teenagers are more likely than adults to experiment with alcohol, cigarettes, and illegal/prescription drugs, and also have a higher rate of addiction: Among addicted Americans, 1 in 4 began using before age 18, which compares to 1 in 25 who started using at age 21 or later[3].
  • Underlying youth addiction is a complex network and interplay of neurobiology, psychology, social and family dynamics and genetics.
  • Brains do recover! Never lose sight of this.

Early detection and intervention in teen substance use, with the explicit goal of preventing the progression to abuse and addiction, is really where we need innovative approaches and programs to help youth and families.

My goal with Gobi is to foster better communication in families and to help teens make better decisions around using drugs and alcohol before the “brain hijacking” occurs. I look forward to sharing some preliminary user data that suggests despite worrisome trends in adolescent drug and alcohol use, there is also encouraging news, hope and help.

[1] In my next post, I will share demographics from our early research with teens participating in the program we designed to prevent early experimentation from leading to abuse and addiction.

[2] This is a stance I share with the National Center on Addiction and Substance Abuse. http://www.centeronaddiction.org/

[3] Data from a national survey of use patterns, Adolescent Substance Use: America’s #1 Public Health Problem.

http://www.centeronaddiction.org/newsroom/press-releases/national-study-reveals-teen-substance-use-americas-1-public-health-problem

Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.

©2016 Our Young Addicts   All Rights Reserved.

Why “Prevention” Doesn’t Sit Well With Me

When we become parents, we have a list of things we hope – and never anticipate – will never happen. Among these things, we hope our kids will never use drugs. If there is addiction in our family, we hope we will be effective in preventing them from experiencing addiction. If there’s no history of addiction, we hope they will never be “stupid enough” to use drugs … as if it’s “stupidity” that underlies it.

Chances are, though, we view underage drinking as a rite of passage; the same with marijuana. As for other “hard” drugs, we shake our heads in disbelief that our kids would even consider use.; after all, we are doing our best to be good parents.

Fast forward to the tween and teen years. Things change.

If your kid is using drugs and alcohol, it’s reason for concern. No bones about it. Whether it’s experimentation or out-right dependency, no use is good use for a developing brain. I think we can all agree, that youth substance use has the potential of leading nowhere good.

We must stop youth substance use. Better yet, we must prevent it in the first place. Heck yes.

Substance-use prevention, in theory, is fine and dandy. It’s predicated on good communication, good relationships, good boundaries. In fact, it’s our obligation as parents and as adults of influence (teachers, coaches, faith leaders, aunts, uncles, grandparents, neighbors, et al), to do everything in our power to prevent our youngsters from trying and using drugs and alcohol.

However, if your kid is using, prevention is a thing of the past. It’s too late, and many parents are kicking themselves wondering where they failed.

Reality check. If your kid is using, it is NOT your fault. You did not fail as a parent. You did not fail at prevention. This is not shirking responsibility – in fact, it is the ultimate in acceptance and the foundation for addressing and arresting addiction even as it spirals out of control.

Let’s face it. Addiction can happen. Not to all kids who use, but to some. Even to your kid.

It happened to mine. It might happen to yours. Sorry, it might.

But wait. What if you diligently employ the 35 ways to prevent addiction? What if you do “all the right things”? You’re immune, right? Your kid is safe, right?

Think again.

No kid wants to be addicted to drugs or alcohol. No kid believes they will be. Until they are. Until it’s too late. That’s addiction. It sneaks up and grips. It arrives with little warning, and it stays longer than ever imagined. It creates chaos, drama, trauma and more.

While I wholeheartedly embrace prevention in theory, I realistically acknowledge that it’s a bit of a crock. Yes, it is.

All the dogma about prevention provides a false sense of security. Prevention pundits, without meaning to, shame parents of young addicts because they flaunt all the things we could have, would have and should have done.

Oh, wait. These ARE the things we did … and it still did NOT prevent our kid from trying drugs and alcohol AND it did NOT prevent the kids with a predisposition (known or unknown) to addiction from developing a substance-use disorder.

If anything, these lists of “things to do” to prevent substance use set us up for unfortunate reality checks when experimentation escalates.

Certainly, there are mitigating circumstances – situations that contribute to substance use among young adults; that’s sad and unfortunate. There are underlying issues from self esteem, depression, anxiety, dysfunctional family dynamics, family history with addiction, and more that might lead to trying drugs – to “fit in” and to self medicate.

For the rest of us, the prevention message is somewhat insulting. By no means does this mean we are perfect parents who flawlessly parent in a prevention positive manner, but we are well intentioned and we’ve done our best. Beyond that, our kids sometimes do choose to try a substance and some of our kids are hooked from day one. There’s no way we can predict, and really, there is no way we can prevent.

One of my phrases, “been there, done that,” implies that I can offer you insights to prevent substance use; but really, it’s about connecting with you as a parent who has done your very best and in spite of this finds your kid using.

Instead, you find out your kid has tried drugs and alcohol so you’re now wondering what to do to halt your kid’s use, to reverse the situation. In my mind, this is of infinite value because we can’t control whether our kid will try substance, whether they will abuse them, and whether they will develop an addiction.

But we can intervene early and often. We can parent them through addiction. We can encourage treatment and support recovery. We can accept that we can’t MAKE them stop, but we can set boundaries and we can be there when they are READY. We can weather the treacherous, dangerous path that is addiction. We can face the ugly possibility of the worst, most horrifying potential outcome, More importantly, we can hope, pray and believe that sobriety is possible.

To recap, prevention is admirable and is our obligation as parents and adults of influence; but we must recognize that prevention isn’t always possible. Instead, if we find ourselves as parents of young addicts, we must be ready to meet this head on without guilting ourselves because prevention didn’t work. That is one of the reasons that the Our Young Addicts community exists – to surround and support each other, to embrace parents and professionals in addressing the number of kids trying and becoming addicted to drugs and alcohol.

I realize this may not be a popular perspective, but from my “been there, done that” experience, it offers liberation and empowerment to move from statistics to solutions.

Midwestern Mama

©2016 Our Young Addicts            All Rights Reserved

 

#TBT – Do “All The Right Things” But Kids Can Still Lose Their Way – Addiction Happens

In 2012, Midwestern Mama contemplated the dichotomy of doing “all the right things” but still having a kid who was struggling with addiction. It seemed to run counter to the recovery principles of “you didn’t cause it, you can’t change it, you can’t control it, you can’t cure it …” Which is it, she wondered? (And still does wonder.)

A Real Mom 5-7-12 – All the Right Things

To me, this is where parents and professionals need to come together for the sake of family consensus, treatment and recovery – for ourselves and our young addicts.

Absolutely, please share!

Last week I was talking with one of the professionals who has been with us from midway in our son’s journey.  As I was sharing updates, including pride in the progress Mid Atlantic Mom and I are creating with Our Young Addicts on WordPress, Twitter and Facebook, the professional asked if he could share these resources with another client.

Absolutely! (By the way – BTW – I never knew an online experience could prove so valuable until I gave it a try. So,we encourage others to see if it can help them.)

I was once just like this client – a parent looking for resources and trying to do the right things for my son and for myself not to mention for my husband and our other children.  Some days, I truly felt like my roles and responsibilities were colliding. I was acting part on gut and part on advice from others. In time, I was acting on a more spiritual, Higher Power  I desperately wanted someone to give me a simple three-step solution to stop my son from abusing drugs, to get him into treatment and recovery, and to get him back on track with a happy, healthy life.  It felt like there should be something like 1) have a direct, caring and honest conversation with him about our concerns, 2) take him to a doctor or counselor who will enroll him in treatment, and 3) go back to college … and BTW, tell your parents you are sorry for all the concern you caused and thank us for all the time, money and emotions they spent trying to help you.

That plan is far from simple and even farther from realistic. No matter what we said or did, these steps didn’t go as hoped or planned.  Every effort was met with resistance, hurdles, and more.

What I’ve learned is by acting on our gut as well as taking professional advice (conventional and alternative), we continue to do “all the right things” even if the outcomes haven’t always been “right.”  I’m grateful that none of those more experienced than I have said something like,  “OMG what were you thinking Midwestern Mama – that’s the worst thing you could do.” I’d have been mortified that I was not doing the best by our son and family.  Yet, sometimes, I wish someone would have spoken up and said otherwise.  Instead, we have a report card of As for effort but results TBD and I so much want an A (or at the very least a passing grade) for results – not for ours but for our son’s.

Neither Mid Atlantic Mom nor I have the answers, but we’ve each hit on a trifecta that works – one part gut (mom radar), one part advice (a mixture of professional, parental and alternative) and one part faithful spirit (Al-anon or similar).  Please share our resource so that it becomes richer with your contributions – be these experience, professional, alternative, parental, spiritual or whatever works.

We will keep sharing.  Please keep letting us know what’s working – or not working – for you.

Here for you,

Midwestern Mama