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Be Prepared: �Substance Use and Home Safety

Jenny Sexton

APS Substance Use Counselor

Emily Siqveland

Dept. of Human Services, Opioid Response Coordinator

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Learning Objectives

  1. Understand commonly misused substances and signs of substance use.
  2. Learn how to increase your home safety and why it is important.
  3. Understand how to respond to an overdose emergency.
  4. Learn about free resources available to all Arlingtonians

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Commonly Misused Substances & Symptoms

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Electronic Cigarettes (Vapes)

Produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and other chemicals, such as diacetyl (flavoring chemical), organic compounds, and heavy metals (nickel, tin, and lead)

Users inhale this ultrafine aerosol deep into their lungs

Bystanders can also breathe in this aerosol when the user exhales into the air

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ANATOMY OF A VAPE

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How Do Vapes Work?

The inhaling of a vapor created by an electronic cigarette

E-cigarettes are battery-powered smoking devices. They have cartridges filled with a liquid that usually contains nicotine, flavorings (often fruit or candy flavorings), and chemicals

The liquid is heated into a vapor, which the person inhales

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NICOTINE POISONING

Nausea/Vomiting

Increased blood pressure

Abnormal heart rate (arrhythmia)

Dehydration

Loss of appetite

Fatigue

Dizziness

Headache

Anxiety

Hearing and vision changes

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COMMONLY USED VAPES AMONGST TEENS

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FLAVORING

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FLAVORING

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MARIJUANA

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WHAT IS MARIJUANA?

  • A greenish-gray mixture of the dried flowers of Cannabis sativa.
  • The main psychoactive (mind-altering) chemical in marijuana, responsible for most of the intoxicating effects that people seek, is delta-9-tetrahydrocannabinol (THC).
  • THC is found in resin produced by the leaves and buds primarily of the female cannabis plant.
  • The plant also contains more than 500 other chemicals, including more than 100 compounds that are chemically related to THC, called cannabinoids.

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THE DANGERS OF MARIJUANA

https://www.samhsa.gov/marijuana

    • Approximately 1 in 10 adults over the age of 18 will become addicted to marijuana.
    • Approximately 1 in 6 individuals under the age of 18 will become addicted to marijuana.

Addiction

    • Brain health- decrease of an individual’s IQ up to 8 points.
    • Mental health- increased risk of depression, anxiety, suicide planning, and psychotic episodes.

Long-term Effects

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VARIANTS OF THC

Leafy green

Oil (vaping)

Wax/Dab

Food (Edibles)

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Vaping THC

  • Vitamin E Acetate can harm the lungs when inhaled.
  • Increased risk of EVALI (e-cigarette or vaping product use associated lung injury).
  • Increased risk of developing lipoid pneumonia. When vaped oils get into the lungs, the lungs treat them as a foreign object and mount an immune response, resulting in inflammation and the buildup of liquids, which can cause lipoid pneumonia.

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ALCOHOL

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Alcohol

    • A drink that contains ethanol, a type of alcohol that acts as a drug and is produced by fermentation of grains, fruits, or other sources of sugar.

What is Alcohol?

    • Acting vivacious and overly happy.
    • Oddly passive.
    • Unusually argumentative and aggressive.
    • Violent, erratic behaviors.
    • Impaired coordination.
    • Increased risk-taking behaviors, such as having unprotected sexual intercourse or driving while intoxicated.

Symptoms of Alcohol Impairment:

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PRESCRIPTION MEDICATION

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Prescription Medication

Stimulants

  • A class of drugs that speed up messages travelling between the brain and body.
  • Make a person feel more awake, alert, confident or energetic.
  • Examples of Stimulants:
    • Cocaine
    • Nicotine
    • Amphetamines

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Depressants

  • Affect the central nervous system, slowing down the messages between the brain and body.
  • They can affect concentration and coordination and slow down a person’s ability to respond to unexpected situations.
  • Examples of Depressants:
    • Alcohol
    • Benzos
    • Opiates/Opioids

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COUNTERFEIT PILLS

https://www.dea.gov/factsheets/counterfeit-pills

Counterfeit prescription medications are manufactured and packaged to look like legitimate brand-name prescriptions.

These pills contain different ingredients than the actual medication.

May contain lethal amounts of fentanyl or methamphetamine.

They often appear identical to legitimate prescription pills, and the user is likely unaware of how lethal they can be.

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RAINBOW FENTANYL

  • Rainbow fentanyl—fentanyl pills and powder that come in a variety of bright colors, shapes, and sizes—is a deliberate effort by drug traffickers to drive addiction amongst kids and young adults.

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PERCOCET �30 MG

  • This combination medication is used to help relieve moderate to severe pain. It contains an opioid pain reliever (oxycodone) and a non-opioid pain reliever (acetaminophen).

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OVER-THE-COUNTER MEDICATION

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Over-the-Counter Medication

  • What is an Over-the-Counter medication? A nonprescription medication, which is used to treat symptoms without a prescription.
  • Commonly Abuse Over-the-Counter Medications
    • Nyquil
    • Robitussin Cough and Cold
    • Coricidin Cough and Cold
    • Benadryl
    • Sudafed

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SIGNS AND SYMPTOMS

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Signs and Symptoms

Losing

Losing interest in activities they once enjoyed

Dropping

Dropping old friends for a new group

Acting

Acting despondent, aggressive or angry

Sleeping

Sleeping more than usual

Breaking

Breaking rules

Exhibiting

Exhibiting physical changes like sudden weight loss, frequent nosebleeds, bloody or watery eyes, or shakes and tremors

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MENTAL HEALTH AND SUBSTANCE MISUSE

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What Does it Mean to Self-Medicate?

  • A behavior in which an individual uses a substance or any exogenous influence to self-administer treatment for physical or psychological ailments.

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PARAPHERNALIA

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COMMON HIDING SPOTS

Bras

Beltline

Pockets

Shoes

Lockers

Bookbag

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Stash Cans

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Why Lock Medications?

Every 10 minutes a child visits the ER for medication poisoning

Every 45 minutes poison control centers receives a call about children and teens exposed to opioid medications

90% of child poisonings occur in the home

Most cases (86%) are unintentional, like when a child finds pills that are within reach

58% of DC region poison control calls were for individuals under the age of 18.

42% were kids 6 years & younger.

7% age 6-12

Of the calls received by DC region poison control pain medications were the third most common poison exposure

20-25% teens report taking prescription medications from family without permission

Each year opioid medication poisoning causes more than 300 deaths in children and teens, with it being the single most frequent cause of pediatric fatalities reported to poison control

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How to Talk about Medications

  • Never call medication candy
  • Avoid taking medicine in front of young children as they often try to imitate adults
  • Teach younger children that they should never take medication on their own – medication is always administered by an adult
  • Teach children & teens that medication labels are rules not guidelines – taking more than recommended could cause harm
  • Teach teens how to read medication labels and drug facts
  • Talk to teens about only taking medications that are prescribed to them – misusing medication can cause harm

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Remember, it is never too early to talk about medication safety. Find tips for all ages at drugfree.org

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Safe Medication Storage

  • Use lock boxes
    • Need a free box? Contact: aari@arlingtonva.us
  • Keep out of reach
  • Keep in child proof bottles
  • Avoid keeping in purse and on counters

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Why Dispose of Medication?

Proper disposal of unused medications saves lives and protects the environment.

70% of opioids prescribed for surgery go unused, making them vulnerable to misuse

75% of individuals who misuse opioids started by taking prescribed medications

The majority of teenagers abusing prescription drugs get them from family and friends – and the home medicine cabinet.

90% of addictions start in teen years

Unused prescription drugs thrown in the trash can be retrieved and abused or illegally sold. 

Unused drugs that are flushed contaminate the water supply.

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How to Safely Dispose of Medications

Takeback boxes

Deactivation Bags

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In case of accidental medication poisoning…

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Recognizing and responding to an Opioid Overdose

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Virginia Overdoses

Arlington Overdoses

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Common Opioids

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Generic

Trade

Street

Hydrocodone

Lortab, Vicodin

Hydro, Norco, Vikes

Oxycodone

Oxycontin, Percocet

Ox, Oxys, Oxycotton, Kicker, Hillbilly Heroin

Morphine

Kadian, MSContin

M, Miss Emma, Monkey, White Stuff

Codeine

Tylenol #3

Schoolboy, T-3s

Fentanyl

Duragesic

Apache, China Girl, China White, Goodfella, TNT

Carfentanil

Wildnil

Drop Dead, Flatline, Lethal Injection,

Hydromorphone

Dilaudid

Dill, Dust, Footballs, D, Big-D, M-2, M-80s, Crazy 8s, Super 8s

Oxymorphone

Opana

Blue Heaven, Octagons, Oranges, Pink, Pink Heaven, Stop Signs

Meperidine

Demerol

Dillies, D, Juice

Methadone

Dolophine, Methadose

Meth, Junk, Fizzies, Dolls, Jungle Juice

Heroin

Diacetylmorphine

Dope, Smack, Big H, Black Tar, Dog Food

Buprenorphine

Bunavail, Suboxone, Subutex,

Sobos, Bupe, Stops, Oranges

Tramadol

Ultram, ConZip

Chill Pills, Trammies, Ultras

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A note on Fentanyl

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What is addiction?

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Prior Overdose

Memory Impairments

Children/adolescents with access to opioids in the home

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Relevant Laws

Safe Reporting of Overdoses

No individual shall be prosecuted for the unlawful purchase, possession, or consumption of alcohol, possession of a controlled substance, possession of marijuana, intoxication in public, or possession of controlled paraphernalia if:

  1. Such individual, (i) in good faith, seeks or obtains emergency medical attention (a) for himself, if he is experiencing an overdose, or (b) for another individual, if such other individual is experiencing an overdose, or
  2. Such individual remains at the scene of the overdose or at any alternative location to which he or the person requiring emergency medical attention has been transported until a law-enforcement officer responds to the report of an overdose. If no law-enforcement officer is present at the scene of the overdose or at the alternative location, then such individual shall cooperate with law enforcement as otherwise set forth herein;
  3. Such individual identifies himself to the law-enforcement officer who responds to the report of the overdose; and
  4. The evidence for the prosecution of an offense enumerated in this subsection was obtained as a result of the individual seeking or obtaining emergency medical attention.

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Good Samaritan Law

The law states that individuals who in good faith prescribes, dispenses, or administers naloxone or other opioid antagonist used for overdose reversal in an emergency to an individual who is believed to be experiencing or about to experience a life-threatening opiate overdose shall not be liable for any civil damages for ordinary negligence in acts or omissions resulting from the rendering of such treatment if acting in accordance with the provisions of subsection X or Y of § 54.1-3408 or in his role as a member of an emergency medical services agency.

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Steps to Respond to an Opioid Overdose�

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  1. Check for Responsiveness
  2. Call 911, if you must leave the individual alone, place them into recovery position.
  3. Give 2 Rescue Breaths (if the person is not breathing)
  4. Administer Naloxone
  5. Continue Rescue Breathing
  6. Assess and respond based on outcome of first naloxone administration

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**If you must leave an unresponsive person at anytime, put them in recovery position**

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NARCAN Nasal Spray

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2 doses in each kit

https://youtu.be/xa7X00_QKWk

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Other important notes

Safety

Serious side effects from naloxone use are very rare.

Using naloxone during an overdose far outweighs any risk of side effects. If the cause of the unconsciousness is uncertain, giving naloxone is not likely to cause further harm to the person. Reported side effects are often related to acute opioid withdrawal.

Naloxone will not reverse overdoses from other drugs, such as alcohol, benzodiazepines, cocaine, or amphetamines. 

Naloxone has no abuse potential.

Naloxone has the same dose for an adult and a child.

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Storage

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  • Naloxone has a shelf life of approximately 3 years (check the label on your product.) Store between 59°F to 77°F.
  • Naloxone may be stored for short periods up to 104°F.
  • Do not store naloxone in the car on hot summer days.
  • Do not freeze or leave naloxone in a car during the winter.
  • Naloxone may not be as effective if it is not stored properly. Only discard the naloxone once you have a replacement for it. If you don’t replace naloxone before it is needed, it is better to use it, even if it hasn’t been stored properly.
  • Naloxone does no harm when expired, so you may use an expired dose in an emergency if new doses are not available.

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Request Free Tools Through the Mail

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Stay in Touch

AARI@arlingtonva.us

@OneArlington

@AARI_Virginia

OneArlington.org

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Questions?

Emily Siqveland, LPC

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Arlington County Dept. of Human Services Opioid Programs Manager

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703-228-4216

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esiqveland@arlingtonva.us

Jenny Sexton, MA, CSAC, FAC, QMHP, CSAM

Substance Abuse Counselor

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All Elementary Schools Prevention Support

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Kenmore Middle School (Wednesday-Friday)

    • 703-228-2631

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Williamsburg Middle School (Monday-Tuesday)

    • 703-228-2441

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jennifer.sexton@apsva.us

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Contact Information

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Resources

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