Leanne Paisley, Addictions Counsellor at The Royal, spoke about youth and substance abuse, addictions and opioids.

1. Youth & Substance Use
Leanne Paisley
Regional Opioid Intervention Service
Addiction Counsellor
Date: Saturday October 5, 2013

2. Overview
Introduction
Housekeeping Notes (question and answer)
Substance Use/Abuse
– Opioids
– Marijuana
Mental Health

3. How does “Youth Substance
Abuse” Happen?
An excerpt from: “Young, Assured and Playing Pharmacist to
Friends”

4. Spectrum of Substance Use
The varying points of people’s use:

5. What is addiction?
• Chronic disease of brain reward circuitry
• Addiction is characterized by inability to consistently
abstain, impairment in behavioural control, craving,
diminished recognition of significant problems with
one’s behaviours and interpersonal relationships,
and a dysfunctional emotional response.
Excerpt from American Society of Addiction Medicine
(ASAM) definition

6. Who becomes addicted?
EVERYONE!
Risk factors that are commonly seen:
1. Stress
2. Family history
3. Self-esteem
4. Exposure
5. Trauma
6. Mental illness – concurrent disorders

7. The Statistics - Youth
• Between October 2010 and November 2011 CAMH
completed a survey with 9,288 Ontario students
• 54.9% of students used alcohol
• 22.3% of students binge drink
• 22% of students used cannabis
• 14% of students used opiates
• 1/8 students report symptoms of drug use problems

8. Opioids/Opiates/Painkillers

9. Prescription Opioid Abuse
• Opioid abuse is a growing problem
• Canada is the world’s third largest per capita
consumer of opioids. Ontario tops the list in Canada.
• Prescription opioids has become the predominant
form of illicit opioid use (rather than heroin)
• Increase in number of individuals seeking treatment
for opioid dependence in the last 10 years
• Opioids are a commonly abused substance by youth
and young adults

10. What is an Opioid?
• Opioids are depressants-- they slow down certain
brain functions
• Opioids are also referred to as narcotics
• Opioids can be effective painkillers
• Some opioids are prescription medications (like oxys,
fentanyl) and others are not (ie., heroin)

11. Why Prescription Opioids? Why now?
• Perceived safety because it is a pharmaceutical
• More socially acceptable than heroin
• Purity
• Potent opioid (euphoria effects)
• Easy access (inadequate monitoring of prescription
narcotics)
• High dose
• Possible to circumvent delivery system: chew, suck,
snort, smoke, inject

12. Opioid Dependence is characterized by
• Control – loss of control over use
• Consequences – continued use despite knowledge of
harmful consequences
• Compulsion to Use
• Cravings

13. Marijuana
• Also know as cannabis, pot, weed
• These plants have resin containing molecules known
as cannabinoids
• Cannabinoids bind to cannabinoid receptors in your
brain and other parts of your body, in particular the
nervous and immune systems
• It tends to suppress hormones produced by stress
reactions and stimulate an increase in dopamine in
the brain which activates pleasure pathways

14. Marijuana continued…
• Impacts: coordination, movement, decision making,
social skills, consciousness, short-term memory, and
the reward pathway (your ability to distinguish
between different things that feel good)
• Different effects depending on the person – can be
feelings of calm to feelings of paranoia
• Effects based on setting, environment, person’s
biochemistry, dosage, plant strain, person’s diet,
person’s mood or mindset

15. Potential Consequence of Substance Use
• Most concerning – overdose and death
• Addiction
• Accidents
• Infectious illnesses/diseases
• Loss of relationships or turmoil in relationships
• Decrease in functioning with school, job,
responsibilities
• Legal difficulties

16. Mental Health and Substance Use
• People with substance use problems have higher
rates of mental health problems than the general
population
• People with mental health problems have higher
rates of substance use problems than the general
population
• Young people age 15-24 are more likely to report
mental health and/or substance use problems than
other age groups
• Concurrent Disorders = condition in which a person
struggles with both a mental health and a substance
use problem

17. Rates of Concurrent Disorders
• 40-70% of people with substance use problems
have mental health issues
• Most common combinations:
– Substance use problems + Anxiety disorder
– Substance use problems + Mood disorder

18. Questions from Cue Cards?

19. Leanne.Paisley@theroyal.ca