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Substance Abuse — Tools to become Proactive

By Patti Shaffer

On Wednesday evening, May 30, a small crowd of Smithfield students, parents and concerned citizens gathered at the Smithfield High School auditorium to listen to a panel of experts speak about the effect of substance abuse among our youth and its effects on families and friends.

Program mediator, John J. Tassoni Jr., the Director of Operations, Community and Government Relations for The Substance Use and Mental Health Leadership Council of RI (SUMHLC) began by saying, “Each day 1.5 people in Rhode Island lose their lives due to substance abuse (that we know of) and last year it totaled 343!”

He adds, “Prescription drug misuse, which includes opioids used by adolescents ages 12 to 17 and young adults age 18 to 25 are the fastest growing drug problem in the US and also here in our communities. And it’s worse than you think. In fact, during one week in May, there were 44 cases of overdoses. It’s an ongoing problem and it happens in every community,” says Tassoni. “Not just in inner cities.”

Dr. Susan Storti, President, of SUMHLC said, “The drugs we are seeing most often are fentanyl, prescription opioids and heroin. Unfortunately, we are at a place and time that fentanyl is being smuggled in from overseas on a consistent basis, so it is difficult to be able to address all the overdoses. In fact, fentanyl is now also showing up in marijuana and cocaine.”

She goes on to say cocaine use among adolescents and adults has increased And, alcohol abuse continues to remain one of our top contenders. Historically, we are one of the ‘wettest’ states in the country. Unfortunately, that is our main distinction!”

“As far as prescription opioids, they are a gateway drug to heroin which is cheaper and easier to get. Heroin is also being combined with other drugs such as illicitly made fentanyl, which is more potent than morphine. This trend has led to a spike in opioid overdoses in every single state in the nation.

Storti adds, “there is also a sharp increase in benzodiazepine, zanax and sleeping pill use, and E cigarettes and vaping are also becoming more popular. Sadly, we are also seeing an increase in the number of attempted suicides in high schools along with adjustment disorders and anxiety problems, particularly toward the end of the school year, as seniors can be anxious about going on to college.

So, please make sure you store all prescriptions safely, or if no longer needed, dispose of them at a drug take-back program or return it to your pharmacy.

“On a more positive note,” Storti said, “Today, we are becoming aware at a much faster pace about drugs on the street and we are becoming more proactive versus reactive. For those who are in the midst of a crisis due to addiction, there is help available here in Rhode Island.”

Bob Houghtaling is the Director of the East Greenwich Drug Program for the last thirty-five years and before that he was a Drug Counselor for five years at a number of local treatment agencies. He said, “My job came about after a tragic accident in 1983 when a teenage boy named Todd Morsilli was struck and killed by a car driven by an intoxicated East Greenwich High School senior. He adds, “Over this last summer in our small town of East Greenwich, four high school students lost their lives due to either fentanyl or heroin. It just goes to show that substance abuse is a pandemic issue. It’s not relegated to any one particular community.”

Houghtaling says, “Young people can more successfully face adversity by being taught viable coping skills. We also need to recognize that mental health plays a key role when considering substance abuse.” He emphasizes, “Hopefully, when we promote resilience skills, the fundamental dynamics of young people maturing might be allowed to progress naturally. Kids need to know who they are, where they fit in and who is going to care about them.”

“Substance abuse does not occur in a vacuum. It takes prevention, treatment and aftercare efforts to ameliorate the concern. Parents and other adults play a key role in this dynamic.”

Kate Manning is a Treatment Consultant for American Addiction Centers (AAC), the leading substance abuse treatment facility that has locations nationwide. She also serves on the Rhode Island Critical Incident Stress Management Team as a Behavioral Health Member and continues to work closely with First Responders.

Manning says, “My job at AAC is to help people get into the right treatment plan, such as detox, IOP (intensive outpatient residential care) and recovery coping.

“After a detox program, a person should continue the continuum of care,” says Manning. “From detox they should go to residential. They need to have more care, and address the reasons they picked up the drug or alcohol in the first place, whether it be trauma or depression or anxiety. The resources are here, but sometimes they need help accessing them.”

She adds, “If a person doesn’t use all the resources available to them, they will most likely fall back into addiction. We are here to help.”

Kate Manning’s office is located at Clinical Services of Rhode Island, 600 Putnam Pike in Greenville.

Patricia Sweet, (Advanced Certified Prevention Specialist, ACPS) is a public health professional with over thirteen years experience working in substance abuse prevention. Sweet serves as the Director of Prevention for Tri-Town Community Action Agency. She also serves as the Regional Director of the Southern Providence County Region Task Force. Under the region she oversees five prevention coalitions in the communities of Smithfield, Johnston, Cranston, North Providence and Scituate.

“Sweet says, “As prevention specialists, our job is to develop and implement effective prevention strategies by raising awareness of substance abuse and promoting safety and well being. We accomplish this by providing information to educate parents and youth about the risk and harm of substances through psa’s, billboards, brochures, parent workshops, newsletters and speakers for students.

“We also try to reduce access, so we form partnerships with the police department so they can conduct compliance checks for youth sales. They also do party patrols, and check for responsible beverage server certificates for all those who serve alcohol.

Sweet adds. “We also assist and initiate in developing policies, laws, rules and ordinances that pertain to substance use. To provide the ease and the ability to access mental health services, the coordinators all have many resources and are able to make referrals to anyone in need.”

In addition says Sweet, “ Tri-Town Health Center has two behavorial health departments, one is in Smithfield and the other in North Providence. The health center provides services for all ages in the state of Rhode Island. We also have clinicians who work with youth who have mental health concerns and who have unhealthy use of substances. They also specialize in anxiety, depression, and substance use disorders. In addition, for those who have substance use disorders, if you are a patient of our health center, we offer medication-assisted treatment. Daytime and evening appointments are available.”

Sweet adds, “Our main job as prevention specialists is to try to prevent this from happening so that we can reduce substance abuse among our youth and maintain a healthy lifestyle.”

Michael C. Cerullo Jr., a psychotherapist in private practice who has evaluated and treated hundreds of adolescent and young adults spoke about the Addiction Syndrome, Marijuana and its mental health and brain developments impacts. “First,” he said, “research has shown over and over that one in six adolescents will become addicted to marijuana (pot). Second, this is not your Dad’s dope! Since 1980, pot’s potency has risen from 3 or 4 percent THC (the component that gets you high) to 18 to 25 percent for leaf and 85 percent or more for concentrates that are vaped in ‘pens’. Many adolescents prefer Vaping THC because, unlike alcohol, it is odorless and easy to conceal. Research indicates that one in five youths vaping to quit cigarettes, also use it with high potency concentrates.”

As to mental illness, Cerullo said “National studies show that in any given year, between 20 and 25 percent of adolescents are diagnosed with a marijuana sensitive condition. This means that, whether it is anxiety, schizophrenia, bi-polar, depression, anxiety or post-traumatic stress disorder, pot can cause it, trigger it, make it worse or sabotage its treatment. Pot literally plants itself in our brains. It settles into the fatty ‘insulation’ that protects neurons, softens it and strips it off thereby compromising various parts of the brain that regulate emotions, motivation, judgment, memory, coordination and more.” He also reported that marijuana is now twice as likely to be found in the toxicology of adolescents who succumb to suicide in Colorado.

Cerullo believes that instead of the gateway effect, the addiction syndrome is a more helpful way to understand the path to addiction. Initially, the presence of a biogenetic risk factor like mental illness, ADHD or addiction itself and/or, a stressor like trauma, parental divorce, or a relationship problem establishes the underlying vulnerability to addiction. At the same time, a substance like alcohol, pot, or pills becomes available. Then the youth tries it, likes it or gets relief from it. So together, the vulnerability and a few repeats of trying it develop a cycle in which the same or a different stressor is followed by repetitive substance use. This pattern eventually leads to full blown addiction.

A key aspect of this syndrome is object substitution or, ‘hop and swap’. “Young people tell me that on the weekends, when alcohol is easier to obtain, they get together, drink it and, along with pot may try whatever else, including pills, mushrooms, and even opiates might be available.” Cerullo said, “When alcohol and pot are used simultaneously, the already high impairment effect of each is amplified and the risks of a serious or fatal accident with either substance are significantly increased. One college sophomore I treat tells me that at his fraternity, he often sees students mixing high potency concentrates into their favorite drinks.”

How widely is pot used by adolescents and young adults in Rhode Island? Cerullo provided current statistics on self-reported “past month use”. According to the National Survey on Drug Use and Health, over the period 2015-16, RI ranks 1st nationally (10.4%) among adolescents and 2nd (32.3%) ages 18 to 25. And, according to the 2016 RI Student Survey conducted by the Department of Behavioral Health, Developmental Disabilities and Hospitals, pot and alcohol are tied at 21 percent.

Where do they get it? Cerullo said, “Diverted black or gray market medical marijuana, often from older friends and family with patient cards or sometimes on websites such as Craig’s list.” He said that the Internet is also a huge factor in spreading the messaging that the marijuana industry targets to young people. For example, “Weed is no longer just for getting high. It’s to help you through your stress, ease you into sleep and get you in the mood for love.”

“In a couple of words,” one parent asked Cerullo, “what would you advise us to prevent our kids from becoming addicted to marijuana?” His response: “There are no easy answers. As parents we need to learn about pot, listen to our kids and what they believe and like about it and engage in respectful discussions with them. We don’t have to agree with them or send them mixed messages, but we do need to learn what draws them to it. Most importantly, we need to become non-conformists, be vigilant and monitor them when we hear, “Everybody else does it” or, “It’s medicine so it can’t hurt” or ‘Johnny’s parents don’t think it’s such a big deal.”

The Substance Use and Mental Health Leadership Council of RI is the main advocacy organization in Rhode Island that represents agencies that provide mental health and addiction treatment, substance abuse prevention, primary health and wellness services to over 20,000 individuals annually. For more information call: 401 521 5759 or email: www.sumhlc.org

Two Recommended informational books to read: Street Drugs and How to raise a drug free kid.