Tuesday, December 24, 2013

Alcohol, holiday celebrations & teens

Over at the Seattle Mama Doc blog, Dr. Swanson writes about alcohol and the holidays.  She starts with:

Our children are growing up with mixed messages about alcohol and drugs, at least that’s how it feels to me here in Washington. It seems to me we’re grappling with using pot and what to do with alcohol as a community. As our state legalized marijuana use this past year, we sent a big flare into the sky. It’s possible we really do one thing and then say another in front of our children and teens, particularly at times of celebration. No question they are watching. Can you seriously imagine a pro football game without beer ads or a holiday party without booze? I can’t. The great luck is that we have profound influence over our children (tah dah!); we have a huge opportunity to help them survive.

Click here to read the entire post.

Thursday, December 19, 2013

Understanding the current marijuana market

The RAND Drug Policy Research Center released a report this week about our state's current marijuana market.  Most of the media attention about the report focuses on the finding that pot consumption among Washingtonians is higher than previously thought.  Other findings include:

Adult & Youth Access: 
The primary way that adults and youth who use marijuana get marijuana is through friends.  Friends provide marijuana to adults for free and for purchase -- about 80% of adults who purchase marijuana get it from friends.  Sixty-eight percent of Seattle high school students who use marijuana report getting it from a friend and 38% report consuming marijuana that came from a dispensary.  The report notes, "It is not surprising that such a large number of marijuana users in Seattle's public high schools report consuming marijuana that came from a dispensary; there are a lot of dispensaries in the Seattle Metro Area."  

Age: About 12% of current marijuana consumers are 12 to 17 years old and about one-third are between 18 and 25 years old.  One-third of "heavy" users (those who use 21-30 days per month) are 25 years old and younger.

Use Rates: 
Washington past month marijuana use rates rose by about 40% between 2008 and 2011 while use rates increased by about 10% nationally during that time.  People who grow marijuana consume "considerably greater" amounts of the drug than others.  King County residents account for 30% of all marijuana consumers in the state.

Low-potency marijuana that was the norm prior to 2000 accounts for a small share of the current marijuana market in Washington.  It is likely that the marijuana used in our state is more potent than marijuana used in other states. Forty percent of past month marijuana users and 52% of heavy users report consuming/"dabbing" concentrates (hash oils) with very high THC levels.

Interaction with Tobacco & Alcohol: 
Heavy marijuana users smoke tobacco at higher rates than non-heavy users.  Alcohol use among marijuana users is more prevalent than among the general population.  Alcohol use seems to increase with the amount of marijuana consumed.

Wednesday, December 18, 2013

Today's marijuana can have stronger effects on developing teen brain

Despite marijuana being the primary reason teenagers enter substance abuse treatment programs and the primary reason for visiting hospital emergency departments for drug misuse or abuse, most high school seniors think regular marijuana use is not harmful according to 2013 Monitoring the Future results.

The survey reports that 39.5 percent of 12th graders view regular marijuana use as harmful, down from last year’s rate of 44.1 percent, and considerably lower than rates from the last two decades.

The rates of marijuana use also show significant changes in the past two decades, with 6.5 percent of seniors smoking marijuana daily compared to 6 percent in 2003 and 2.4 percent in 1993.

“This is not just an issue of increased daily use,” said NIDA Director Nora D. Volkow, M.D. “It is important to remember that over the past two decades, levels of THC — the main psychoactive ingredient in marijuana — have gone up a great deal, from 3.75 percent in 1995 to an average of 15 percent in today’s marijuana cigarettes. Daily use today can have stronger effects on a developing teen brain than it did 10 or 20 years ago.”

Nearly 23 percent of seniors say they smoked marijuana in the month prior to the survey, and just over 36 percent say they smoked it during the past year.  For 10th graders, 4 percent say they use marijuana daily, with 18 percent reporting past month use and 29.8 percent reporting use in the previous year. More than 12 percent of eighth graders say they used marijuana in the past year.

“We should be extremely concerned that 12 percent of 13- to 14-year-olds are using marijuana,” Volkow added. “The children whose experimentation leads to regular use are setting themselves up for declines in IQ and diminished ability for success in life.”

Friday, December 13, 2013

Marijuana & adolescent health

Data from the Substance Abuse and Mental Health Services Administration show how teen marijuana use can be harmful.  Marijuana is the second most commonly used drug (after alcohol) by teenagers who use drugs.

Emergency Department Visits
The chart below shows that marijuana is the most frequently identified drug among adolescents visiting a hospital emergency department for a drug-related problem on a typical day.

Number of Emergency Department (ED) Visits for Drug Misuse or Abuse on a Typical Day for Patients Aged 12 to 17

Substance Abuse Treatment
Though alcohol is the drug of choice among adolescents, marijuana is, by far, the number one drug identified by adolescents entering substance abuse treatment.  This is different from adults -- alcohol is the primary drug identified by adults entering treatment.

Number of Adolescents Aged 12 to 17 Admitted to Publicly Funded Substance Abuse Treatment Facilities on a Typical Day

Thursday, December 12, 2013

Marijuana public consumption bills sent to City Council

Bills about pubic consumption of marijuana and public smoking were discussed during yesterday's City Council Housing, Human Services, Health, and Culture Committee meeting.

Discussion about Council Bill 117989 regarding public consumption begins at around 57:00 and Council Bill 117998 regarding public smoking begins at around 74:00.

To strengthen the public consumption bill so that it supports public health goals for helping youth access substance abuse-related services they may need, two items should be changed.

1. The bill should specify how the law will be enforced among minors.  While the first “Whereas” in the bill states that Initiative 502 legalized adult possession, the ordinance does not specifically distinguish between the enforcement of marijuana laws among adults (21 and older) from enforcement among minors (20 and younger).  

For example:

~ The bill states, “A person who violates this section is guilty of a class 3 civil infraction under RCW Chapter 7.80.”  The word “person” should be replaced with “adults 21 years old and older” since the law is different for minors.  Minors are to be referred to the King County Juvenile Diversion program and are not to be charged with a civil infraction.  The diversion program can help at-risk teenagers link with drug education or treatment services that may be needed.  

~ The bill  states that SPD intends to “provide a first warning for persons violating the provisions”.  Since the police play such an important public health role when it comes to linking teenagers to the substance abuse services they may need, warnings should be given to adults who are 21 years old and above but minors under the age of 21 should be referred to the King County Juvenile Diversion Program. 

Any City ordinance dealing with the enforcement of minors in possession of alcohol should be updated to include marijuana.  To reduce community risk factors for underage use and to link at-risk youth with services they may need, these laws should be enforced and the policy of referring youth to the diversion program should be followed.  

2. Define public use:  Council Bill 117989 states, “It is unlawful to open a package containing or consume marijuana, usable marijuana or a marijuana-infused product in view of the general public.”  Though the fiscal note attached to this ordinance says that the intent is to bring marijuana laws in line with alcohol laws, the language is different than alcohol-related language that states that public use of alcohol is illegal.  The ordinance should define what is meant by “in view of the general public” so that it is clear to citizens what will be enforced and what won’t be enforced when it comes to marijuana use outside of personal residences.  

Adult behavior impacts youth behavior.  All children, even teenagers, look to adults to determine how they should act.  One of the reasons tobacco smoking rates are down among youth is because they are not exposed to adults smoking tobacco as much as they were prior to the many smoke-free policies adopted throughout our communities.  The same holds true for alcohol and other drugs – the more teenagers see use as a normal part of adult life, including public life, the more likely they are to use the substances.  

Both bills were referred to the full Council.

Wednesday, December 11, 2013

Preventing initiation of drug use: What works

Community-based efforts to prevent substance use, like the work done by Prevention WINS, are an essential component of promoting health during adolescence and later life according to an article published in the most recent edition of JAMA – Pediatrics

The article discusses findings from a study conducted by the UW Social Development Research Group.  They looked at communities that used Communities That Care (CTC), a system similar to the Strategic Prevention Framework used by Prevention WINS.  During the study, coalitions of community stakeholders received training to use CTC.  They used data to identify elevated risk factors and depressed protective factors for adolescent problem behaviors in the community.  Like Prevention WINS, they implemented tested and effective programs for middle school youth, their families, and schools to address risks specific to their community.

The study showed that by spring of 12th grade, students in CTC communities were more likely than students in control communities to have abstained from any drug use, including alcohol and tobacco.  Using the CTC system continued to prevent the initiation of adolescent problem behaviors through 12th grade, 8 years after implementation of CTC and 3 years after study-provided resources ended.

The article goes on to note, The enduring effects of CTC through 12th grade were observed with little preventive programming targeting the high school years. Because CTC communities were asked to focus their prevention plans on programs for youths in grades 5 through 9, and continued to do so following study support, few students in the longitudinal panel were exposed to tested and effective programs beyond ninth grade. It is noteworthy that initiation of alcohol use, tobacco use, delinquency, and violence in the panel was prevented through 12th grade in CTC communities.

Targeting preventive interventions during middle school, a developmentally sensitive time for drug use and delinquency initiation, appears to have prevented the onset of alcohol and tobacco use . . . through high school. However, the present findings suggest that continued preventive interventions during high school may be needed to lower the current prevalence of substance use, delinquency, and violence among those who have initiated these behaviors. 

Friday, December 6, 2013

Underage drinking & driving awareness event held at Ballard High School

December is National Impaired Driving Prevention Month and Ballard High School hosted an assembly about the problem.  The My Ballard blog reported about it:

Today was a memorable day for the over 500 students who filled Ballard High School auditorium to hear UW Huskies’ tight end Austin Seferian-Jenkins and group of community members speak about the dangers of driving under the influence of drugs and alcohol. The assembly was a moving event that allowed all audience members to grasp the dire consequences that can result of making poor decisions before getting behind the wheel.

The assembly started with the emotional and intimate perspective of local mom Kelly Jones who tragically lost her son Kellen Jones in an alcohol related car accident outside Ballard Taco Time restaurant on April 4, 2010. Jones wanted students to hear the important message “from the heart of a mom” and impacted the attentive audience with images of the accident scene and the response of family and friends to the tragic deaths. “You have the obligation to yourself and to your family and friends to drive and ride responsibly,” said Jones to the students. Since the tragedy, Jones founded the Drive. Ride. Responsibly. campaign to spread awareness of the importance of both driving and riding responsibly.

Liberty Mutual has a great info-graphic about teenage drinking and driving on New Years Eve.  Here's the top part of it:

Wednesday, December 4, 2013

Prevent underage drinking and driving

December is National Impaired Driving Prevention Month.

What is the problem?
In Seattle, 18% of 10th grade students and 20% of 12th grade students report recently riding in a car with someone who has been drinking (2012 Healthy Youth Survey).  Last year, Prevention WINS released a video about how drinking and driving affected one NE Seattle teenager.

According to the Centers for Disease Control and Prevention (CDC):

  • 85% of teens in high school who report drinking and driving in the past month also say they binge drank. In the survey, binge drinking was defined as having 5 or more alcoholic drinks within a couple of hours.
  • 1 in 5 teen drivers involved in fatal crashes had some alcohol in their system in 2010. Most of these drivers (81%) had alcohol levels higher than the legal limit for adults.

Driving under the influence (DUI) is not only about alcohol  It's also about driving under the influence of prescription medications and marijuana.  According to the Washington State Toxicology Lab, marijuana impairment among drivers under the age of 21 is a serious problem.

  • One quarter of DUI cases that are marijuana related are aged under 21 years.
  • Marijuana is the most frequently detected drug in those under 21 years (including alcohol).

What can be done?
In proclaiming December National Impaired Driving Month,  President Obama states:

Everyone has a role to play in keeping our roads safe -- from parents, schools, and businesses to faith-based and community organizations. Together, we can teach young people, friends, and fellow citizens how to avoid a crash brought on by impaired driving. I encourage all Americans to designate a non-drinking driver, plan ahead for alternative transportation, or make arrangements to stay with family and friends before consuming alcohol. Americans should also know what precautions to take if using over-the-counter or prescription medication. 

Parents, in particular, have a significant role to play.  From the CDC:

Parental involvement, with a focus on monitoring and restricting what new drivers are allowed to do, helps keep new drivers safe as they learn to drive. Parents can consider creating and signing a parent-teen driving agreement with their teens. Research has shown that when parents establish and enforce the “rules of the road”, new drivers report lower rates of risky driving, traffic violations, and crashes.

Learn more at the CDC webpage about Teen Drinking and Driving.

Tuesday, December 3, 2013

Parent norms affect teen drug use

Norms and availability are two of the strongest predictors of youth marijuana use (see previous posts for details).  While the availability risk factor is relatively well known, the risk factor of "norms" is less well known.

"Norms" refers to what people think is normal and acceptable behavior.  If a certain behavior is considered normal or acceptable, it can shape human behavior.  Norms are present in different domains -- community, family, school, and peer groups.  The strongest predictors of youth marijuana use are peer norms followed by community and parent norms.  Following is more information about parent norms and how they affect teenage drug use.

Parental attitudes and behavior toward drugs . . . influence the attitudes and behavior of their children.  Parental approval of young people's moderate drinking, even under parental supervision, increases the risk of the young person using marijuana. . . . Further, in families where parents involve children in their own drug or alcohol behavior -- for example, asking the child to light the parent's cigarette or get the parent a beer from the refrigerator -- there is an increased likelihood that their children will become substance abusers in adolescence.  (From: Substance Abuse Prevention: The Intersection of Science and Practice, page 20)

In NE Seattle, Eckstein Middle School 8th graders report that parents think it is wrong from them to use marijuana or alcohol.  (WA Healthy Youth Survey)  Parents have been good at getting their attitude about kids not using drugs across to their young teenage children.

While the Prevention WINS coalition will continue to monitor NE Seattle student's perceptions about their parent's attitudes, we are also interested in how other adults in the community affect youth drug use.  While young teens still overwhelmingly perceive that adults think that their use of drugs is wrong, between 2010-12 there was a dip of 5 percentage points when 8th graders were asked about marijuana.  

Monday, December 2, 2013

Pot shop stings won't be enough to prevent marijuana availability among teenagers

Availability and norms are two of the strongest predictors of youth marijuana use.  An article in the Seattle Times discusses one form of availability (or, if you want to use the Department of Justice’s terminology: “distribution”): availability through buying marijuana in stores, expected to open in the middle of next year.  

Teenagers obtain marijuana from friends
What the article does not discuss is the primary way that youth who use marijuana actually get marijuana: through personal connections.  According to results from the 2012 Youth Risk Behavior Survey, the most common way that Seattle high school students who use marijuana get marijuana is from friends.  About as many of these high school students report getting marijuana from their home as they do from a medical marijuana retail access point. 

One ounce of marijuana
Photograph: Justin Sullivan/Getty Images 
Distributing an ounce of marijuana
Though substance abuse treatment providers have been witnessing an increase in youth using edible and vaporized marijuana products, I am going to use the “traditional” form of marijuana  as an example.

If a parent, older sibling, or older friend buys an ounce of marijuana (the legal limit for a sales transaction), it looks something like the photo on the left.  From a quick Google search about how many joints can be made from an ounce, it appears as if the number is anywhere from 30 to 100 joints with 50 to 60 being the most common answer.  This means that a consumer who buys an ounce likely will not use the entire stash at one time leaving quite a bit of marijuana left-over.  This is similar to liquor -- most people who drink alcohol do not drink an entire bottle of vodka all at once.  So, what happens to the left-overs?

If it belongs to a parent, will it end up in a cabinet, waiting to be used again?  We know with alcohol and with prescription medications, this can be a significant source for youth.

If it belongs to an older sibling or friend of a teenager, what stops them from sharing it with people under the age of 21?  Or selling it to them?  Lately, community members have been sharing stories of people taking liquor orders from teens and then stealing or buying it for them.  What prohibits people over the age of 21 from taking marijuana orders from minors and buying it for them? 

These are a few examples of availability that will not be addressed by the Liquor Control Board (LCB) conducting sting operations in pot shops.  These are examples of availability that are much more likely to be a problem than teenagers buying pot in stores.

So, while it’s essential that the LCB keeps an eye on pot shops to ensure they don’t sell to minors, policy makers and communities need to do more to curb availability.

Drug companies sue King County over secure medicine return program

As part of a comprehensive strategy for preventing teen prescription drug abuse, the King County Board of Health adopted a secure medicine return program earlier this year.  Last week, drug companies, who are held responsible for running the program, filed a lawsuit against King County in an effort to stop the program from being implemented.  


As part of the King County Take Back Your Meds Coalition, Prevention WINS advocated for the secure medicine return program.  Prescription drug abuse is a community problem that requires a multi-faceted prevention strategy.  As coalitions know, everyone has a role to play and the King County program is a perfect example of the role drug companies can play in preventing teen drug abuse.

Friday, November 29, 2013

More about the predictors of youth marijuana use

In the previous post, I provided an overview of a recent presentation about how marijuana availability and norms are strong predictors of youth use of the drug.  The information was based on a presentation given during a recent symposium at the University of Washington.

The presentation ended with a closer look at how new state marijuana laws may affect levels of risk for marijuana use among teenagers.  UW researchers predict that both availability and norms will change.  They point out that parenting behaviors, including parent use, may change.

When looking at increased marijuana availability among youth, researchers not only point to stores and the likely commercialization of marijuana similar to the commercialization of other legal drugs and consumable goods.  They also predict that more adults who are parents will use marijuana, making the drug available in the home.  With the proliferation of non-smoked forms of marijuana, public use of these hard-to-detect products may result in increased availability among youth.  

Since marijuana-infused foods have become more available through the medical marijuana system, it is expected that they will become more available in the I-502 system, as well.  If adults in a household keep marijuana-infused ice-cream in the freezer, how will it be differentiated from regular ice-cream and away from kids?   

The presentation concluded with discussion about implications of increased availability and norms favorable to marijuana use and what can be done.  Strategies to reduce home and social access were discussed.  Communities will need to monitor norms around use.  Availability and norms may be increasingly important risk factors that those of us who work to prevent youth drug use will need to address in our communities.  

Wednesday, November 27, 2013

Availability & norms are strong predictors of youth marijuana use

Lately, I've been engaging in discussions about what youth substance use prevention is and what it is not.  The field changed significantly over the past twenty years as research about healthy youth development increased.

To start with, a great deal of youth substance use prevention is based at the local level and starts with communities assessing their risk factors that contribute to teen drug use.  During a recent symposium at the University of Washington, researchers from the Social Development Research Group in the School of Social Work provided an overview of risk and protective factors specific to underage marijuana use.  

This first slide from the presentation explains that risk factors may be present in multiple domains: the community, the family, schools, and among individuals and their peers.  Within the community domain, "availability of drugs" and "community laws and norms favorable toward drug use" are identified as risk factors for youth marijuana use.

In this second slide, protective factors are identified.  Community factors that contribute to the prevention of underage marijuana use include "clear and healthy standards for behavior" and "pro-social opportunities".  

During the symposium, researchers focused on risk factors that are the strongest predictors of youth marijuana use.  They include availability of marijuana, perception of risk from using marijuana, and pro-marijuana norms among parents, youth, and in the community.

All of the slides may be viewed by clicking here.  A video of the presentation is available on the symposium website.

Tuesday, November 26, 2013

More about the risk factor "community laws & norms favorable toward drug use"

Yesterday, a pediatrician from Seattle Children's Hospital was interviewed about a marijuana party to take place on December 6 at Seattle Center during Winterfest, an event that attracts thousands of families with young children each year.

To learn more about the risk factor "community laws and norms favorable toward drug use", read a post from earlier this year. 

Friday, November 22, 2013

Risk & protective factors for underage marijuana use

Earlier this month, the University of Washington's Alcohol and Drug Abuse Institute hosted a Symposium on Legal Marijuana.  Videos and slides of the presentations are now available online.

Of particular interest to those of us working to prevent underage marijuana use, researchers from the UW Social Development Research Group provided information about risk and protective factors that are particularly relevant to youth marijuana use.  Watch the video below to learn more.

Wednesday, November 20, 2013

Prevent underage drinking, prevent driving under the influence

Last week, the Ravenna Blog reported about the sentencing of the drunk driver who killed two people and seriously injured two others in our community last spring.

This deadly incident could have been prevented, and not just by enforcing the ignition interlock law and other laws targeting adults.  It may have been prevented by preventing underage drinking.

Ninety percent of people who are addicted to alcohol or other drugs started using these substances as teens.  The earlier teenagers start using alcohol, the higher the likelihood they will be addicted as adults.  It is unknown if Mark Mullen, the man who was convicted for this tragedy, started using as a teen, but he had a long history of substance abuse, according to media reports.

Not all people who drive drunk are addicted to alcohol.  But over-consumption and addiction do increase health and safety risks.  By preventing youth alcohol use, a great deal of addiction and over-consumption, along with negative safety consequences such as DUIs, may be avoided.

And it's not just adults.  As a video the Prevention WINS coalition produced last year illustrates, teenagers in our community drive under the influence, too.  About one quarter of NE Seattle high school seniors report recently riding in a car with a driver who has been drinking.

Tuesday, November 19, 2013

Adolescent medicine nurse provides advice about binge drinking and sexual assault

Over at the Teenology 101 blog, Jen Brown, RN, writes about binge drinking:

Recently there was some media buzz about women and alcohol, and how our society should approach the topic.
It all started when Emily Yoffe, a writer for Slate, wrote this column on college women, drinking, and sexual assault. If you don’t feel like reading the whole article, a headline pops up on the website which sums it up: “The Best Rape Prevention: Tell College Women to Stop Getting So Wasted”. (To be fair, the article is more nuanced than that, and I’m not convinced Ms. Yoffe wrote that tagline.)
The response to the article was swift. Some responded with rebuttals while others stronglyagreed. The New York Times ran a “Room for Debate” piece that had a number of interesting viewpoints. Basically, opinions seem to fall down two lines: one party thinks women imbibing alcohol become vulnerable to sexual assault, and they should be told not to drink in order to protect themselves. The other sees this as a victim-blaming piece of advice that support a status quo in which rape culture runs rampant, and young women are expected to prevent their own rape.
So, even though I’m late to the game, I thought I’d give my take on this (although I’ve covered a lot of it in my Teens and Sexual Assault series).
I have no problem with advising women not to binge drink. I have no problem with advising men not to binge drink, either. Binge drinking is unhealthydangerous, and unless you’re over 21, illegal. And yet as we all know, teens and young adults both above and below 21 are binge drinking. We can educate young people, try to lower the risks, support policies that discourage alcohol abuse, and hope that the problem will diminish. But despite our best efforts, some teens and young adults will continue to use alcohol, and most in the U.S. will attend a few drunken parties.
So what is wrong with advising young women to protect themselves from becoming vulnerable? Nothing, in my opinion, as long as it’s a small piece of a much larger picture we are presenting.
Read more by clicking here.

Monday, November 18, 2013

General coalition meeting tomorrow

Prevention WINS General Meeting
Tuesday, November 19, 2013
8-9:30 a.m.
Seattle Children's Hospital Division of Adolescent Medicine
4540 Sand Point Way NE, Suite 200

All are welcome!  For more information please contact the Prevention WINS coordinator.

Monday, November 11, 2013

Alcohol ads reaching too many young people

From HealthDay:

Too many young Americans are watching television ads for beer, wine and other alcoholic drinks, a new study contends.

The number and frequency of such ads exceeds the industry's own voluntary standard, said researchers from Johns Hopkins Bloomberg School of Public Health in Baltimore.

Under that standard, which was adopted in 2003, alcohol companies agreed not to place any ads on TV programs when more than 30 percent of the audience was likely to be younger than 21.

If ads were curtailed to meet that standard, the "payoff in terms of reduced risk of underage drinking and harms related to it could be quite substantial," study author David Jernigan, director of the school's Center on Alcohol Marketing and Youth, said in a Hopkins news release.

Add marijuana to the advertising mix
In Washington, marijuana advertising will soon be added to the mix.  Advertising for marijuana dispensaries already exists.  (When riding the bus last week, my teenager saw ads in the local paper being read by the person sitting next to her.)  While the new marijuana market rules recently adopted by the Liquor Control Board state that ads must not target children, they will none-the-less be exposed to ads.  Plus, there is little, if any, monitoring of electronic marketing, especially social media.

What can parents do?
When parents and their children see ads for alcohol, marijuana, or tobacco, talk about them.  SAMHSA provides some tips for talking to teens about what they see in the media.  Parents and their teenage children can discuss:
  • What's the purpose of the ad?  Who created it and why?
  • What words, images, or sounds are used to create the message?
  • How does the message make you feel?
  • What are the message makers trying to accomplish -- sell a product, promote a belief, etc.

Friday, November 8, 2013

The Silk Road and teen access to drugs

Over at the Teenology 101 blog, Dr. Yolanda Evans writes:

The Silk Road sounds like a title of a romance novel, but in reality the story behind it is much more sinister. It is the name of an anonymous online market place for illicit drugs and has made headlines this week as the Federal Bureau of Investigations shut down the original version and arrested the person who started it. I first learned of the Silk Road last week at a symposium for pediatricians. A guest speaker at the conference, who is an expert on substance abuse, highlighted the fact that many teens are well aware of how to get drugs – illegal drugs – on the internet. I was dumbfounded (and so were nearly all of the other pediatricians in the room)! If something is illegal, shouldn’t it be a challenge to order and have delivered to your home? Apparently, it’s not that hard at all.

Read the whole post by clicking here.

Wednesday, October 30, 2013

What parents should know about marijuana products

Since releasing the underage marijuana prevention booklet for parents, a few youth substance abuse prevention advocates contacted me asking for information to share with parents about marijuana products other than the kind that is smoked.  They are concerned with what they witness in their communities – teenagers eating high-THC marijuana  food products and suffering mental health problems and ingesting highly concentrated hash oil and ending up in the hospital. 

With that in mind, here is what I know.  (Since I am learning something new about marijuana almost every day, please email me additional information if I am not up-to-date.)

Marijuana-infused cake pops
Each contains 111 mg THC
What are marijuana-infused foods?
Over the past year, I blogged about marijuana-infused foods several times.  Most recently on July 3 and September 10.

According to the newly-adopted I-502 rules, a serving size will contain up to10 milligrams of THC and a package can contain up to 10 servings.  This means that one package of a marijuana-infused food can contain up to 100 mg of THC.  If children, including teenagers, get their hands on these foods and do not read or abide by the serving size information, they may ingest a great deal of THC.  This is especially a concern because the effects of marijuana that is eaten may not be felt for 90 minutes or more.  If someone eats marijuana-infused foods and doesn’t feel high right away, they may eat more.

A recent article appearing in the Journal of the American Medical Association - Pediatrics describes an increase in marijuana food-related hospital emergency visits among young children in Colorado.  A Health Impact Assessment about marijuana ingestion among children was conducted by the Colorado School of Public Health and Children's Hospital Colorado.

What is hash oil?
Rolling Stone magazine recently published a short article about hash oil.  Here is an excerpt:

Unless you spend a lot of time in medical-state dispensaries, you probably haven't encountered the latest superstrong stoner craze: butane-extracted hash oil (BHO). How potent is it? A chunk of the stuff the size of a Tic Tac can be the equivalent of hoovering up an entire joint in one massive toke. Even for hardcore smokers, the experience – which fans call dabbing – can be like getting high for the very first time. Your head spins, your eyes get fluttery, a few beads of sweat surface on your forehead and, suddenly, you're cosmically baked.

Cannabis Cup
Second Place: "Best Concentrate"

Contains 58.5% THC
BHO . . . comes in a variety of consistencies: from hard, amber-like stuff ("shatter") to soft, golden goop ("budder" or "earwax").

The recent Cannabis Cup held in Seattle gave out awards for the best marijuana products, including “concentrates”.  Wax, oil, and shatter fall under the "concentrate" category.

A recent post to the Prevention Hub brings up concerns about youth using e-cigarettes as e-joints. 

Smoking marijuana in liquid and wax forms out of e-cigarettes is a new alarming trend gaining popularity amongst young people. Worryingly, marijuana smoked that way does not produce an odour or a flame, making it harder to detect. . . .While there is no data on how many teens are using e-cigarettes to smoke marijuana, a recent survey by the Centers for Disease Control and Prevention (CDC) showed that the use of e-cigarettes among middle and high schools students doubled from 2011 to 2012 (5% to 10%). . . . Experts say drugs and drug products made for people using marijuana legally are increasingly finding their way to those who are using them illegally.

In New York it is illegal to sell e-cigarettes to minors.  A news report describes how one person used an e-cigarette to consume marijuana undetected during a long train ride.

Hash oil & I-502
I-502 does not include hash oil and other concentrates as legal marijuana products that can be sold in stores.  Recognizing that concentrates have become increasingly popular among marijuana consumers, the Washington State Liquor Control Board recently submitted a request to the state legislature that they change I-502 to include "extract products" as products that are legal to sell in retail stores. 

Want more information about marijuana products?
Analytics 360 is a marijuana testing lab located in Fremont.  Their website includes a section about test results.  It lists and shows pictures of marijuana products including flowers, concentrates, edibles, liquids, and topicals.  Visit their website to get a better understanding of what marijuana products can be expected in I-502 licensed stores when they open next year.  

Tuesday, October 29, 2013

A parent's guide to preventing underage marijuana use

The booklet is written by Dr. Leslie Walker, Chief of the Division of Adolescent Medicine at Seattle Children’s Hospital, and Dr. Kevin Haggerty, Associate Director of the Social Development Research Group at the University of Washington.  Dr. Walker is a leader in adolescent medicine, especially adolescent substance abuse, and Dr. Haggerty is a leader in adolescent substance abuse prevention. 

The booklet includes information about:
~ Marijuana and teen health.
~ What parents can do to prevent teen marijuana use.
~ What the new law means for minors.

The goal of the booklet is to provide parents of children in grades 6-8 with tools they can use to prevent underage marijuana use.  Messages are prevention-oriented and are similar to what parents learn in Guiding Good Choices.  

The booklet is not a drug education resource.  It does not contain information about specific types of marijuana products.  A good source for drug education resources is the Alcohol & Drug Abuse Institute's marijuana website and clearinghouse

Page 8 of the guide includes a few resources that parents may access for more information.  It is by no means an exhaustive list and it focuses on NE Seattle.  It was intentionally kept short so that people could write in or affix stickers with their local resources.    

For more information about the booklet, please contact the Prevention WINS coordinator.

Thursday, October 24, 2013

King County Board of Health Subcommittee wins state prevention award

Lieutenant Governor Brad Owen and Miss
Washington Reina Almon present Mayor David Baker
with prevention award.

The King County Board of Health Subcommittee on Secure Medicine Return is the recipient of a Washington State Exemplary Substance Abuse Prevention Award in the Local Government category.  Board of Health member David Baker, mayor of Kenmore, received the award on behalf of the subcommittee at an awards event held October 21 during the Washington State Prevention Summit in Yakima.

Lieutenant Governor Brad Owen bestowed the award stating:

“The adoption of a secure medicine return program in King County is part of a multi-pronged strategy for preventing youth medicine abuse. It goes hand-in-hand with coalition and community-based educational activities; the statewide prescription monitoring program; law enforcement efforts to break up illegal sales of medications; and national campaigns teaching people to lock up their medications.  As with all substance abuse prevention, multiple partners are needed to be most effective.  The King County Board of Health's Subcommittee on Secure Medicine Return is a perfect example of government playing their part in prevention.”

The Subcommittee on Secure Medicine Return developed a rule and regulation to establish a secure medicine return program in King County that will reduce the amount of unused and unwanted medicines in homes and be part of a comprehensive, community-wide strategy for preventing youth substance abuse.  King County is only the second jurisdiction in the United States to adopt medicine return program using a product stewardship model that requires pharmaceutical companies doing business in the county to implement and pay for it. 

To learn more about the Secure Medicine Return program, visit http://www.kingcounty.gov/healthservices/health/BOH/MedicineTakeback.aspx

Thursday, October 17, 2013

Resources for parents for preventing teen drug use

Last night, a group of NE Seattle parents whose children attend Eckstein Middle School and Roosevelt High School got together to socialize, connect, and share information.  The group has been getting together for several years -- ever since a few of them took a Guiding Good Choices class at Eckstein.  Guiding Good Choices, and other evidence-based substance abuse prevention programs for parents, encourages parents to stay connected with one another and to support each other in keeping their children away from drugs.

The Prevention WINS coalition offers a variety of drug prevention "tools" for parents.  Videos featuring Dr. Leslie Walker are among them.  Here is one about networking with other parents.

Online Resources

·         PreventionWorksInSeattle.org includes a Parenting Tips & Tools page

 ·         Facebook: Facebook.com/Prevention.WINS helps parents stay connected

Classes & Guest Speakers

·         Parenting programs at Eckstein Middle School including Guiding Good Choices and the Strengthening Families Program.  

·         Start Talking Now –presentations for parents of 5th grade students in NE Seattle.  Prevention needs to start early and is especially important during transitions, such as the transition into middle school. 

·         Sex, Drugs & Facebook – information for parents of middle school, high school, and college students about social media and drugs and how to promote healthy Internet use.

Print ResourcesA Parent’s Guide to Preventing Underage Marijuana Use  (To be posted to PreventionWorksInSeattle.org by 11/15/13.) 

For more information about any of these resources, please contact the Prevention WINS coordinator.