Substance Use: Trends, Harms, and Support for Students

2. Be in the Know:Substance Use

3. What are we talking about today? • What are students reporting? • Teen Brain • Harms of commonly used substances • Where can you get support and information?

5. Trends: Changes in Drug Use The Good News: • In 2017 44% of students in grades 7-12 (an estimated 332,000 in Ontario) report using no drug at all during the past year Downward trends 1999 to 2017: • -alcohol (from 66.0% to 42.5%) • -binge drinking (from 27.6% to 16.9%) • -tobacco cigarettes (from 28.4% to 7.0%) • -cannabis (from 28.0% to 19.0%)

6. Busting Stigma/Assumptions • What is the average age at which someone uses drugs for the first time? • What’s the most common drug used by youth?

7. Teen Brain The brain undergoes a considerable amount of development during the teen years, and does not fully mature until around the age of 25.

8. Unfortunately, developing brains are generally more prone to damage. This means that experimentation with drugs and alcohol can have lasting, harmful effects on teen brains.

9. Mental Health • Some mental illnesses have been seen to increase the incidence of substance use. • Substance use has been seen to increase the risk of experiencing mental health problems.

10. Why youth may use? “It helps me enjoy a party” “ It helps me forget about my problems” “ I use it out of boredom” “It helps me relax” “So I won’t feel left out” “Because I’m not supposed to” “I’m curious” “I can’t stop”

11. Alcohol • #1 drug used by youth • Youth drink differently than adults • Normalized in media/society • Perception of risk by youth and parents

12. Immediate Health Risks • Violence • Risky sexual behaviors   • Alcohol poisoning • Unintentional injuries • FASD

13. Long Term Health Risks • Cardiovascular Problems  • Mental Health • Social Problems • Neurological Problems • Liver Disease/Gastrointestinal Problems • Cancer

14. What is a Standard Drink? • Many people do not know how much alcohol they are actually consuming in a drink • Underestimating one’s consumption of alcohol can lead to binge drinking and related harms

16. Play Matters • Drinking games result in a large amount of alcohol being consumed in a short amount of time • Examples include: Century Club, Beer Pong, Kings, Chug-A-Lug, Flip Cup • Get caught up in the “game” and lose track of how much has been consumed

17. Alcohol Poisoning • Occurs when drinking large quantities of alcohol within a short period of time • Binge drinking (≥5 drinks/drinking occasion) • Depresses nerves that control involuntary actions such as breathing and the gag reflex • Funneling, Chugging, Drinking Games

18. Symptoms • Passing out, semi conscious • Cold, pale, bluish skin • Vomiting while sleeping • Slow breathing • Seizures • Incontinent of urine

19. Action • Recovery position • Call 911 • Stay with the person until help arrives • NEVER leave the person to sleep it off

20. Recovery Position

21. Tobacco • Tobacco is a plant - also known as Nicotianatabacum • Naturally contains over 2,500 chemicals - one of them being nicotine • When the tobacco plant is ripe, leaves are harvested, dried, fermented and aged • Processed leaves are now ready to be used in tobacco products

23. Tobacco Products • Smoked tobacco products • Cigarette • Cigar, Cigarillo and little cigars • Pipe • Waterpipe / Hookah • Smokeless tobacco products • Chew • Snus • Snuff • Heated tobacco products

24. Smokeless ≠ Harmless • Chewing tobacco may not produce smoke but it doesn’t mean it’s harmless: • Contains over 3000 chemicals, 28 are known to cause cancer • Higher levels of nicotine than cigarettes • Use can lead to: • Heart problems • Stomach problems • Tooth and gum problems • White patches or sores in the mouth • Addiction to nicotine

25. Second-Hand Smoke • Contains over 7000 chemicals, 69 are known to cause cancer • There is no safe level of second-hand smoke; everyone is at risk even if you don’t smoke Pets Infants and children Adults Unborn babies

26. Hookah ≠ Safer • Water does not filter out toxins • Has the same health effects as cigarettes • It can be addictive • Produces second-hand smoke with the same toxins as cigarettes: • BUT higher carbon monoxide levels • Inhale 100-200 X’s more smoke than 1 cigarette in a 1hour hookah session

27. Hookah’s can = disease Sharing a hookah with others (even friends / family) can spread the following disease(s): • Hepatitis • Flu • Meningitis • TB • All of the above

28. Nicotine and the Brain The brain is still “under construction” until ~ age 25 Nicotine during “construction” can: • risk for mood disorders later on • risks for addiction and further substance use • Harm the part of the brain that helps to focus and learn • Sensitive to the rewarding effects of nicotine

29. … Big Tobacco targets YOU Potential new users (AKA YOU) are targeted / “recruited” by: • Packaging • Flavours • Advertising and promotional activities

30. E-Cigarettes/Vape “Vaping” is the act of using an e-cigarette: • An individual sucks on the mouthpiece activating the heating element. • The liquid in the cartridge heats up, turning it into a vapour to be inhaled. • Vapour is only released when the e-cigarette is sucked on.

31. Fact or Myth Vapour products should be used because they have been around for awhile and are less harmful than regular cigarettes. Fact Myth

32. While e-cigarettes may be safer than regular cigarettes, less harmful doesn’t mean safe.

33. Fact or Myth Flavours used in vapour products are harmless and are only used to make it more enjoyable to vape. Myth Fact

34. Flavouring in vapour products Flavours added to vapour products may not be safe for breathing into your lungs. “Popcorn Lung” (Bronchiolitis obliterans): A serious irreversible disease that results in thickening and narrowing of smallest airways of the lungs. • Symptoms include a dry cough, shortness of breath, wheezing, and feeling tired • Caused by flavouring agent called diacetyl

35. Is vaping legal? NO Yes

36. Tobacco &Vaping Products Act • Health Canada’s “Tobacco and Vaping Products Act (TPVA)”, makes it legal for a vapour product to contain nicotine unless it makes a health claim. • In the future this act will protect youth from nicotine addiction and include: • Rules related to manufacturing standards and product and packaging labelling • Restrictions on the promotion of vaping products • Restrictions on the sale of vapour products that may appeal to youth • Banning the use of certain ingredients

37. Smoke-Free Ontario Act, 2017 • Cannot sell or supply vapour products to anyone under 19 years of age (includes e-liquid) • Cannot use an e-cigarette to vape any substance anywhere that you cannot smoke tobacco, such as: • On hospital and other health care facilities grounds • In child care facilities / daycares • Enclosed workplaces and workplace vehicles • Enclosed public places • Common areas in condos, apartment buildings or university / college residences • Reserved outdoor seating venues • In a vehicle with anyone > 16 years of age

38. Smoke-Free Ontario Act, 2017 • Cannot use an e-cigarette to vape any substance anywhere that you cannot smoke tobacco, such as: • On school property and public areas within 20m of the perimeter of the grounds • Public areas within 20m of the perimeter of the grounds of a Community recreational facilities • On restaurant and bar patios and public areas within 9m of the restaurant or bar patio • On and within 20 metres of children’s playgrounds, sports fields and spectator areas etc.

39. Fact or Myth • Vaping leads to increased chance of starting to smoke cigarettes Myth Fact

40. The Concerning Trend • Strong evidence that e-cigarettes are associated with initiation of cigarette smoking among youth.   • 31.5% of students who had smoked cigarettes also smoked e-cigarettes

41. Cannabis • Cannabis comes from the cannabis plant • Usually green/brown/grey coloured • THC is the main ingredient that causes the “high”

42. The Rise of THC 1969 until the late 1970’s cannabis contained roughly 1% THC 2017: cannabis contains 15-20% THC

43. Concerns with Cannabis • Cannabis smoke has cancer-causing toxins that can cause damage to the lungs • Cannabis use can cause decreased IQ, concentration, and poor memory • Users are 2x more likely to have a car crash while driving impaired

44. Teens who use cannabis are at an increased risk for depression, anxiety disorders and psychosis 1 in 6 people who use cannabis during their teens will develop a cannabis use disorder Youth are at the greatest risk of the negative health effects of cannabis because the brain continues to develop until age 25

45. Have you thought about… • Cannabis use can cause • Lower grades and exam scores • Relationship problems • Financial difficulties • Sperm abnormalities

46. Harm-Reduction • Policies, programs and interventions that reduce negative health and social consequences of substance misuse without quitting the substance completely.

47. Lower-Risk Cannabis Use Guidelines

48. Medicinal Cannabis Effective for: • For the treatment for chronic pain in adults (cannabis) • Antiemeticsin the treatment of chemotherapy-induced nausea and vomiting (oral cannabinoids) • For improving patient-reported multiple sclerosis spasticity symptoms (oral cannabinoids)

50. True or false: it is considered illegal to possess OPIOID pain medication unless you are a patient with a prescription from a licensed health care professional. • True • False