Transcript Substance Use

Melissa Corcoran, BSc
Megan Lowe, MA
Youth Outreach Service
Centre for Addiction and Mental Health
May 2, 2013
The materials set out are general principles and
approaches to assessment and treatment pertaining
to mental health and concurrent disorders, but do
not constitute clinical advice and do not replace the
need for individualized clinical assessment and
treatment plans by health care professionals.
© Melissa Corcoran & Megan Lowe, May 2, 2013
No unauthorized copying, distribution or amendment
without the written permission of Melissa Corcoran
& Megan Lowe
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Defining Mental Health
Youth and Substance Use
Concurrent Disorders
Parenting Strategies and Tips
Resources and Supports
Question and Answer Period
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A state marked by the absence of mental illness (DSM-IV-TR)
A state of well-being in which the individual realizes his or her
own abilities, can cope with the normal stresses of life, can work
productively and fruitfully, and is able to make a contribution to
his or her community (World Health Organization)
Mental health means striking a balance in all aspects of one’s life:
social, physical, spiritual, economic and mental. At times, the
balance may be tipped too much in one direction and one’s footing
has to be found again. Everyone’s personal balance is unique and
the challenge is to stay mentally healthy by keeping the right
balance (Canadian Mental Health Association)
Disorders
Issues
Generalized Anxiety Disorder
Anxiety
Major Depressive Disorder
Depression
Eating Disorders (Anorexia)
Disordered eating
Schizophrenia
Emotion regulation
Coping
Talking
Medications
Counselling
Breathing/Meditation
Substance Use
Alcohol
Marijuana
Opioids
Cocaine
Physical Changes
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Hormonal changes
Changes in brain
structure
Increase in appetite
Changes in sleep (fall
asleep later, wake
later)
Cognitive Changes
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Greater ability for
abstract thinking
Can take perspectives
of others
Capable of generating
hypotheses and
formulating opinions
Psychological
Changes
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Increased
independence from
parents
Develop meaningful
relationships outside
family
Improved ability to
regulate emotions
Begin plans for selfsufficiency
Adolescence is also often a time of experimentation, exploration and risk-taking
Risk Factors
• Maternal Pre-natal SU
• Parenting styles
• Exposure to violence at
home
• Parental SU/MH Problems
• Physical, psychological or
sexual abuse
• Poor academic achievement
• Poverty
• Neighbourhood /
Community Problems
• Peers
Protective Factors
• High-quality infantcaregiver relationship
• Appropriate discipline and
limit setting
• Strong affiliations with prosocial institutions
• Strong bond with
parent/significant adult
• Success in school
• Public policies that ensure
adequate income
• Involvement in appropriate
recreational/leisure activities
Substance Use
Your Estimate %:
CAMH 2011 OSDUHS Survey % :
• Alcohol
_______ %
• Alcohol
_______ %
• Tobacco
________%
• Tobacco
________%
• Opioid Pain
Relievers ________%
• Opioid Pain
Relievers ________%
• Cannabis ________%
• Cannabis ________%
• Cocaine
• Cocaine
________%
________%
Your Estimate %:
CAMH 2011 OSDUHS Survey % :
• Alcohol
_______ %
• Alcohol
54.9 %
• Tobacco
________%
• Tobacco
8.7 %
• Opioid Pain
Relievers ________%
• Opioid Pain
Relievers
14%
• Cannabis ________%
• Cannabis
22%
• Cocaine
• Cocaine
2.1 %
________%
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There is no definitive cause of substance use
problems among youth
Many risk and protective factors play a role in
determining which youth will go beyond
experimentation to developing substance abuse or
dependence problems
Involves complex relationships among
biological, psychological, and social factors in
the adolescent, their family, and the broader
environment (e.g. school, peers, community)
Non Use
/Experimentation
Use
Misuse
Abuse
Dependency
Addiction
Substance Abuse
Continuing substance use that results in
serious problems such as:
• Inability to function adequately at
work, school or home.
• Risk to self or others (e.g. drunk
driving).
• Repeated legal problems.
• Frequent interpersonal or family
conflicts.
Substance Dependence
Continuing substance use that results in major
physical, psychological, and behavioural
problems such as:
• Tolerance to the substance.
• Withdrawal from the substance.
• Use that is greater or longer than
intended.
• Desire to quit or unsuccessful efforts
to do so.
• Much time spent obtaining, using or
recovering from the substance.
• Giving up or reduced involvement in
usual activities.
• Continued use despite physical or
psychological problems resulting
from the substance.
What are Concurrent Disorders?
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Young people who develop substance use problems are
often dealing with many other issues, including mental
health problems
The combination of a substance use disorder and a mental
health disorder is referred to as “concurrent disorders”
Mental health problems may precede substance use and an
individual may be using substances to cope or “selfmedicate” mental health problems
Mental health symptoms may develop as a result of
substance use (e.g. alcohol and depression)
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Trigger: Substance use triggers mental health disorder in
youth with predisposition to that disorder
Create: Substance use produces psychological
symptoms
Exacerbate: Psychological symptoms get worse when
substances are used
Mimic: Substance use effects look like mental health
disorder
Mask: Psychological symptoms hidden by substance use
Independence: Substance use and mental health
disorder are not related to each other, but both may be
related to a common underlying factor
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Co-occurrence is high, unrecognized and always higher
than you think
Addressing single “problems” in isolation is not effective
Early intervention can decrease severity, duration and
onset of additional problems
Youth with CD are at higher risk for:
 Homelessness
 Suicide
 Victimization
 Poor health outcomes
 Incarceration/legal problems
 Re-hospitalization
Personal Narrative
Parenting Strategies and Tips
Change in sleep patterns
 Change in eating habits
 Change in mood
 Change in grades
 Change in finances
(asking for money, theft,
pawning possessions)
 Secrecy
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Loss of interest in
previous commitments
(hobbies, sports teams,
school clubs)
Significant avoidance
of family
Loss of friends
Surrounds self with
other drug users
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Education vs. Scare Tactics
Frightening or ‘worst case scenarios’ are often
ineffective
 Discussing issues together (e.g. researching online)
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Communication
I statements
 Identifying appropriate times to address issues
 Open-ended questions, paraphrase, reflect,
acknowledge
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Empathy
Be with them in the moment as they express themselves
 Remember what it was like to be an adolescent
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Parenting style and boundary setting
 Authoritarian
vs. Authoritative vs. Permissive
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Self-care and managing emotions
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Accessing support for yourself and child
We are all broken and wounded in this world.
Some choose to grow strong at the broken places.
(Harold J. Duarte-Bernhardt)
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Centre for Addiction and Mental Health (CAMH)
416-535-8501
www.camh.ca
oYouth Outreach Service
Ext 4548
oYouth Addiction & Concurrent Disorders Service (YACDS)
Ext 1730
oSubstance Abuse Program for Afro-Canadian & Caribbean Youth (SAPACCY)
Ext 6767
oOther Child, Youth, & Family Program Services
Ext 4366
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•Connex
Ontario Health Services Information
oDrug and Alcohol Helpline
oMental Health Helpline
oOntario Problem Gambling Helpline
www.connexontario.ca
1-800-565-8603
www.drugandalcoholhelpline.ca
1-800-531-2600
www.mentalhealthhelpline.ca
1-800-230-3505
www.opgh.on.ca
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Canadian Mental Health Association
1-800-668-6868
www.cmha.ca
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Kids Help Phone
1-800-668-6868
www.kidshelpphone.ca
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Family Services Toronto
416-595-9230
www.familyservicetoronto.org
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Gerstein Crisis Centre
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211 Toronto
416-929-5200 crisis line
www.gersteincentre.org
dial 211
www.211toronto.ca
Centre for Addiction and Mental Health Resources: www.camh.ca
The mental health and addiction 101 series (online tutorials)
Straight Talk and Do you know drug series…
Mental health information guides (depression, anxiety, schizophrenia, etc.)
Teens and Tweens Podcast Series
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Tips
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http://knowledgex.camh.net/podcasts/tnt/Pages/default.aspx
for talking to your kids about substance use
http://www.camh.ca/en/hospital/health_information/for_parents/Pages/Ten-tipsfor-talking-to-your-kids-about-substance-use.aspx
Paglia-Boak, A., Mann, R.E., Adlaf, E.M., & Rehm, J. (2009). Drug use among Ontario
students, 1977-2009: Detailed OSDUHS findings. (CAMH Research Document Series No.
27). Toronto, ON: Centre for Addiction and Mental Health.
Barankin, T. & Khanlou, N. (2007). Growing up resilient: Ways to build resilience in children
and youth.
Wolfe, D. A, et al. (Spring 2011, CAMH). What parents need to know about teens: Strategies
for reducing the risks of alcohol, tobacco, other drugs and gambling.
Wolfe, D. A. (Ed.) (2007, CAMH). Acting out: Understanding and reducing aggressive
behaviour in children and youth.
Question & Answer Period
Melissa Corcoran
[email protected]
416-535-8501
Ext 39127
Megan Lowe
[email protected]
416-535-8501
Ext 36770