Webinar Moderator ADOLESCENT SUBSTANCE USE: CONTEMPORARY TRENDS IN PREVENTION & TREATMENT Tracy McPherson, PhD HOSTED BY: Senior Research Scientist ADOLESCENT SBIRT PROJECT, NORC at THE UNIVERSITY OF CHICAGO, Public Health Department and THE BIG SBIRT INITIATIVE NORC at the University of Chicago 4350 East West Highway 8th Floor, Bethesda, MD 20814 McPherson-Tracy@norc.org Produced in Partnership… 2018-2019 SBIRT Webinar Series Adolescent Substance Use Screening Tools: A Review of Brief ¨ Validated Tools Integrating Suicide Prevention into the SBIRT Model ¨ Are Healthcare Professionals Ready to Address Patients’ Substance ¨ Use and Mental Health Disorders? Adolescents, Young Adults and Opioid Use: When Is It a Problem? ¨ What to Do? Adolescent Substance Use: Contemporary Trends in Prevention and ¨ Treatment Integrating Adolescent SBIRT Education into Health Professional ¨ www.sbirt.webs.com sbirtteam@norc.org Training: Findings from A National Effort to Prepare the Next Workforce Download this flyer from our website! https://sbirt.webs.com/webinars Access Materials Ask Questions ¨ PowerPoint Slides ¨ Materials and Resources ¨ On Demand Access 24/7 ¨ Certificate of Attendance Ask questions and modify Audio Settings through the “Questions” pane of https://sbirt.webs.com/adolescent-use-trends your GoToWebinar Control Panel on your computer or mobile device. 1
Webinar Presenter Presenter Disclosures Ken C. Winters, Ph.D. ¨ I do have a personal and commercial interest with an edited Senior Scientist, Oregon book briefly noted as background material. Research Institute (MN branch) & Adjunct Faculty, Dept. of Psychology, U of Minnesota winte001@umn.edu Presenter Disclosures § Terms 1. Introduction § Resources § Levels of use ¨ I hope to avoid a reaction from you that was voiced by the 2. Developmental famous Italian-American physicist, Enrico Fermi, after he Issues 5. Summary attended a seminar: Early use § ¨ “Before I came here, I was confused about this subject. Having § Brain development 4. Treatment listened to your lecture, I am still confused -- but on a higher 3. Prevention level.” Source: US News & § Keys World Report, 2005 § Keys SBIRT § What is Meant by ‘Contemporary Trends’? Terms § 1. Introduction Resources § Levels of use § ¨ Highlighting current research on prevention and treatment 2. Developmental 5. Summary Issues ¨ Addressing these ‘emerging’ issues brain development science as a clinical tool ¤ SBIRT § Early use ¤ § Brain development cannabis is in the news! ¤ 4. Treatment 3. Prevention § Keys § Keys and SBIRT 2
Terms Free Resources 1.) Treatment Improvement Protocol (TIP) Series www.samhsa.gov/csat ¨ Adolescents = 12-18-year-old age group TIP #31: Screening and Assessing Adolescents for Substance Use Disorders (middle and high school) TIP #32: Treatment of Adolescents with Substance Use Disorders 2.) Principles of Adolescent Substance Use ¨ Substances = alcohol and other drugs (not Disorder Treatment: A Research-Based Guide tobacco) www.drugabuse.gov Free Resources Free Resources 3.) Paving the Way to Change 6.) SBIRT (National Council for Behavioral Health) www.tresearch.org https://www.thenationalcouncil.org/topics/screening-brief-intervention-referral-treatment- sbirt/ 4.) Substance Use Screening and Assessment Instruments Database 7.) SBIRT (Boston’s Children Hospital) http://lib.adai.washington.edu/instruments/ http://www.childrenshospital.org/ceasar/for-clinicians/resources 5.) Standardized tools for multiple phenotypes 8.) SBIRT (NORC) www.norc.org/Research/Projects/ https://www.phenxtoolkit.org/ 9.) SBIRT (IRETA) http://ireta.org/improve-practice/toolkitforsbirt/ Estimated Prevalence Rates of Drug Involvement in an $$ Resources Adolescent Population ~5% Substance Use Disorder-Severe 1.) Clinical Manual of Adolescent Substance Abuse Treatment (2011) Substance Use Disorder- www.psych.org (2nd edition in 2019) ~25% Moderate Substance Use Disorder- y 2.) Adolescent Substance Abuse: Research and Clinical Advances (2006) t Mild i r e www.cambridge.org v e Regular Substance Use S ~70% 3.) Motivational Interviewing with Adolescents and Young Adults (2011) Infrequent Substance Use www.guilford.com No Past Year Substance Use (source: adapted from Tammy Chung, Ph.D.) 3
Terms § 1. Introduction Resources § Levels of use § 2. Developmental 5. Summary Issues § Early use § Brain development 4. Treatment 3. Prevention § Keys § Keys and SBIRT “Careers" of Drug Use are Longer the Y ounger the Age of First Use 1.0 .9 Audience Polling Question #1 Age of .8 1 st Use Cumulative .7 Survival .6 Groups Which right or privilege in the US matches where experts place .5 under 15* ~50% longer the age at which the brain completes maturation? .4 a. Vote 15-20* .3 b. Gamble in casinos .2 .1 21+ c. Rent a car .0 d. Serve in the military 0 5 10 15 20 25 30 * p<.05 (different Y ears from first use to 1+ years abstinence from 21+) Source: Dennis et al., 2005 ¨ Based on research by neuroscientists, brain maturation continues through adolescence, until approx. age 25 4
A Developing Brain = More Acceleration on the “Go” (Limbic) System Compared to Less Imbalanced Neurodevelopment Breaking on “Stop” (Prefrontal) System Risk-Taking & Self Control Implications of Brain Development for Adolescent Behavior Preference for …. Based on science of brain development, a modern view 1. physical activity of risk taking in adolescence..… 2. high excitement and rewarding activities 3. activities with peers that trigger high intensity/arousal q evolutionarily adaptive 4. novelty q normative; important to development Less than optimal.. 5. control of emotions q significant individual differences 6. consideration of negative consequences q due primarily to emotional and contextual, not cognitive, Greater tendency to… factors 7. be attentive to social information 8. take risks and show poor self-control Source: US News & World Report, 2005 Brain Development: Implications for Prevention and Treatment Brain Development: Implications for Prevention and Treatment 2) Choose an evidenced-based treatment approach and make sure it has 1) Teach youth about brain “teen-brain friendly” features ¨ engaging development and the science of addiction ¨ relevant ¨ fun ¨ decision making skills https://www.drugabuse.gov/ publications/drugfacts/marijuana 5
Parent Resources Brain Development: Implications for Prevention and Treatment 3) Teach parents about brain development P = Promote activities that capitalize on the strengths of the developing brain. A = Assist children with challenges that require planning. R = Reinforce their seeking advice from adults; teach decision making. Prevent, Intervene, Get E = Encourage a lifestyle that promotes good brain development. Treatment, Recovery N = Never underestimate the impact of a parent being a good role model. www.drugfree.org T = Tolerate the “oops” behaviors due to an immature brain. § Terms 1. Introduction § Resources § Levels of use Audience Polling Question #2 2. Developmental 5. Summary For states in the U.S. that have legalized cannabis for Issues “recreational” use, what is the minimum legal age? a. 18 Brain development § § Early use b. 19 4. Treatment c. 21 3. Prevention d. 25 § Keys Keys § SBIRT § Risk and Protective Factors (Principles 1 – 4) Prevention programs should § Enhance protective factors and reverse or reduce risk factors q Address all forms of drug abuse, alone or in combination q Address the drug abuse problems of the local community by targeting q modifiable risk factors and strengthening protective factors Be tailored to address the risks specific to the target population q 6
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