Do You Vape Bro?
What is the highest short term risk of E-cigarette use? Long term risks?
What is E-cigarette associated acute lung injury. Thought to be associated with vitamin E derivatives found in THC products.
Cancer
What is the highest predictive factor of adolescent smoking?
What is parental or older sibling smoking. Other risk factors for adolescent smoking include low self-esteem, being a “risk-taker,” increased stress and psychiatric disorders, exposure to media advertising, pressure from peers, low levels of parental monitoring, ease of access to cigarettes, and beliefs about the positive and negative effects of smoking
What % of adolescents have tried alcohol by 8th grade? High school graduation?
What is 20%, 80%.
8% of 8th graders and about 36% of 12th graders reported being intoxicated at least once.
Is marijuana use increasing or decreasing in adolescents? Opioids?
Increasing, decreasing
These balance out to where substance use disorders are the same in adolescents over time
This 1983 movie starring Al Pacino focuses on a drug lord in Cuba who deals primarily in the cocaine trade
What is Scarface
What % of high schoolers say that they have ever used E-cigarettes? (+/- 5%)
What is 47%
What % of adults who smoke began prior to age 18? (+/- 5%)
90%
What is the highest predictor of an adolescent developing alcohol use disorder?
What is parental substance use disorder. • ADHD/learning disabilities • Abuse, neglect, trauma, Untreated depression, anxiety, ADHD, learning disabilities, cutting behavior, Parental divorce, especially during adolescence, Friends and peers who use alcohol, tobacco, or other substances
What % of adolescents smoked marijuana in the past year?
10%
This 2012 movie stars Denzel Washington, an alcoholic pilot who steers a plan to a crash landing with minimal casualties
What is Flight
Has E-cigarette use been shown to help you stop smoking?
What is no, 2 large randomized trials have shown no increase in smoking cessation after a year
What are some risks of parental smoking prenatally and postnatally?
What is SIDS, cough, sputum production, and wheeze. There is a significant increase in the incidence of bronchiolitis and pneumonia in the first year of life, asthma, middle ear disease, dental caries, atherogenesis, and long-term risk of malignancies in adulthood, adults up to the age of 35 are more likely to be seen by a pediatrician than any other physician, this highlights the need for smoking cessation counseling to occur from us in the outpatient setting.
What are some protective factors against alcohol use in adolescents?
Adequate socioeconomic resources for family, Secure attachment, Reliable support and responsiveness from caregivers, Personal, academic, and social success, Stable, supportive home environment with clear parental expectation and rules, Friends not involved with substances, presence of mentors
What is the substance that most adolescents die from overdosing?
Opioids, Between July 2019 and December 2021, 2,231 adolescents aged 10-19 years died from a drug-related overdose; over 90% of these involved opioids. For every young adult overdose death, there are 119 emergency department visits and 22 treatment admissions
This 2018 movie starring Bradley Cooper and Lady Gaga addresses two stars struggling with substance abuse.
What is the typical nicotine concentration in an E-cigarette?
What is 0 to 59mg/mL (1 pod is the equivalent of 1 pack of cigarettes), 10 to 30 mg of nicotine in a conventional cigarette
What are the 5 A's of smoking cessation counseling?
ask, advise, assess, assist, and arrange
Is alcohol use increasing or decreasing in adolescents?
How many positive criteria on the DSM-5 do you need to meet to have substance use disorder? Mild, moderate, severe
mild, any 2 or 3 criteria; moderate, any 4 or 5 criteria; severe, any 6 or more criteria
This 1995 movie stars Nicolas Cage (Ben Sanderson), a Hollywood screenwriter who lost everything because of his alcoholism who moves to a new city and starts a relationship with a prostitute
Leaving Las Vegas
What is the highest predictive factor of adolescent smoking?
What is parental smoking
How much more likely are adolescents who smoke likely to drink? Smoke marijuana? Use cocaine?
Adolescents who smoke are 3 times more likely to drink alcohol, 8 times more likely to smoke marijuana, and 22 times more likely to use cocaine than nonsmoking adolescents.
What are some treatment options for alcohol use disorder?
Motivational interviewing (motivation of behavioral changes and working through ambivalence) – has been shown effective in decreasing substance use by adolescents • Cognitive Behavioral Therapy (functional behavioral analysis to determine precursors to drug use and identification and avoidance of circumstances leading to their use) • Behavior Modification Therapy/Contingency Management (rewards for adherence to treatment plans) • Family Counseling (treatment within a social and family network to increase level of monitoring, set behavior expectations with positive/negative consequences and enforcement for good/bad behavior) – most validated approach • Group Counseling (Alcoholics Anonymous, Narcotics Anonymous for adults) - data is not conclusive and no established pediatric options exist • Inpatient treatment/Higher levels of care o Medically managed withdrawal for patients with severe SUD o Acute Residential Treatment o Residential Treatment Center o Wilderness Programs o Partial Hospitalization (day programs)
Name 4 DSM-5 criteria for substance use disorder
Consuming the substance in larger amounts and for a longer amount of time than intended.
Persistent desire to cut down or regulate use. The individual may have unsuccessfully attempted to stop in the past.
Spending a great deal of time obtaining, using, or recovering from the effects of substance use.
Experiencing craving, a pressing desire to use the substance
Substance use impairs ability to fulfill major obligations at work, school, or home.
Continued use of the substance despite it causing significant social or interpersonal problems.
Reduction or discontinuation of recreational, social, or occupational activities because of substance use
Recurrent substance use in physically unsafe environments.
Persistent substance use despite knowledge that it may cause or exacerbate physical or psychological problems.
Tolerance: Individual requires increasingly higher doses of the substance to achieve the desired effect, or the usual dose has a reduced effect; individuals may build tolerance to specific symptoms at different rates.
Withdrawal: A collection of signs and symptoms that occurs when blood and tissue levels of the substance decrease. Individuals are likely to seek the substance to relieve symptoms. No documented withdrawal symptoms from hallucinogens, PCP, or inhalants.
This 2014 Sia song talks about the relationship between substance use disorder and suicide
"Chandelier"