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Substance Use Awareness:

Nicotine, Cannabis, Fentanyl

Staff Presentation

Date: 10.31.23

This presentation contains a video that may be impactful to some staff. Please ensure that you have members of the multi-disciplinary school-site crisis team available to support as needed.

Facilitator Notes:

We are glad you’re here and we thank you for being present.
Substance Abuse can be a difficult and personal topic with which to engage. As such, we strongly encourage you to give the necessary attention to any feelings or stress you may experience during this training. That means, but not limited to, taking breaks with the content as needed, engaging in self-care practices during and after the presentation, and reaching out for help if you need it.
If you or someone you know is in crisis, call or text 988. A crisis counselor is available 24 hours a day to support you. Our school site crisis team is here to assist today as well.

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Learning Objectives

Learn about nicotine, cannabis, and fentanyl
Recognize the signs when someone is under the influence of a substance
Identify the signs of an opioid overdose
Become familiar with resources available for students to prevent or stop the use of substances

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Strategic Plan

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LAUSD 2022-2026 Strategic Plan

Joy and Wellness

Whole-Child Well-Being
Strong Social-Emotional Skills

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LAUSD Policy

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Nicotine

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Nicotine Facts

A highly addictive drug in tobacco plants
Can be smoked, sniffed, chewed, or inhaled
A stimulant
Contains harmful chemicals
Absorbed into the body and goes directly to the brain
Negatively impacts brain development
Link to mental health disorders

American Lung Association:

https://www.lung.org/quit-smoking/smoking-facts/health-effects/nicotine

National Institute on Drug Abuse: https://nida.nih.gov/research-topics/parents-educators/lesson-plans/mind-matters/nicotine-tobacco-vaping

Facilitator Notes:

Nicotine is a HIGHLY addictive chemical found in tobacco plants and all tobacco products like cigarettes, cigars, smokeless tobacco and e-cigarettes. It’s the reason why normal cigarette smokers have such a hard time quitting.
It can be smoked by way of cigarettes or cigars, inhaled through vape pens or e-cigarettes and hookahs, sniffed, and chewed.
Nicotine is a stimulant, which means it raises levels of physical or psychological activity in the body.
Nicotine contains harmful chemicals that negatively affect the brain and the body.
When nicotine is absorbed into the body, it goes directly to the brain.
Adolescents who consume nicotine are in danger of suffering long term effects because nicotine use during adolescence can change the brain chemistry.
Nicotine use during adolescence has been linked to lasting mental health disorders, which include negative impacts on memory, attention, and learning.

American Lung Association:

https://www.lung.org/quit-smoking/smoking-facts/health-effects/nicotine

National Institute on Drug Abuse:

https://nida.nih.gov/research-topics/parents-educators/lesson-plans/mind-matters/nicotine-tobacco-vaping

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The Harm in Nicotine

Traditional cigarettes contain over 7,000 chemicals
Some chemicals cause cancer
Other chemicals in cigarettes are toxins
Harmful ingredients in vape aerosol

CDC:

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html

Medical News Today:

https://www.medicalnewstoday.com/articles/vaping-vs-smoking#effects-of-smoking

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E-cigarette Facts

Electronic devices used for vaping that take in and heat liquid, producing an aerosol
Also known as e-cigs, vapes, vaporizers, hookahs, etc.
Users can get more nicotine from e-cigarettes compared to regular cigarettes
Kid-friendly flavors make it appealing
Also used to inhale cannabis and other drugs
Negative impact on the adolescent brain

Centers for Disease Control

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/pdfs/OSH-E-Cigarettes-and-Youth-What-Educators-and-Coaches-Need-to-Know-508.pdf

Facilitator Notes:

Let’s look at some facts about e-cigarettes.

E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or mix of small particles in the air. They look like regular cigarettes or pipes or other items commonly used by youth like USB flash drives, pens, or other items. They may use a battery or may be charged. Using an e-cigarette is sometimes called vaping.
Some vape product labels do not disclose that they contain nicotine and are marketed as containing 0% nicotine.
Users can consume even more nicotine through e-cigarettes. Users can buy extra-strength cartridges, which have a higher concentration of nicotine, or they can increase the e-cigarettes voltage to get a greater hit of the substance.
Companies have made flavored tobacco to appeal and attract youth. In November 2022, CA voters passed SB 793 prohibiting tobacco retailers from selling flavored tobacco products.
Some e-cigarettes are also used to vape cannabis and other drugs.

Centers for Disease Control

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/pdfs/OSH-E-Cigarettes-and-Youth-What-Educators-and-Coaches-Need-to-Know-508.pdf

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E-cigarette Use by Youth

2022 e-cigarette use remained a top concern for the Federal Drug Administration
About 1 in 10 (2.5 million) middle and high school students used e-cigarettes within the past 30 days
Currently, 14.1% (2.14 million) high school students and 3.3% (380,000) middle school students reported current e-cigarette use

U.S. Food & Drug Administration

https://www.fda.gov/tobacco-products/youth-and-tobacco/results-annual-national-youth-tobacco-survey#:~:text=2022%20Findings%20on%20Youth%20E%2DCigarette%20Use,-In%20October%202022&text=In%202022%2C%20about%201%20in,(past%2030%2Dday).&text=14.1%25%20(2.14%20million)%20of,reported%20current%20e%2Dcigarette%20use

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Common Side Effects

of Nicotine Use

Medical News Today

https://www.medicalnewstoday.com/articles/240820

Tobacco Free Life:

https://tobaccofreelife.org/why-quit-smoking/smoking-effects/nicotine-effects/

Dizziness/lightheadedness
Sleep problems
Blood-flow changes
Headaches
Shortness of breath
Racing heartbeat
Diarrhea
Nausea
Dry mouth

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Harmful Effects of Nicotine Use

Dangers and Risks Associated with Adolescent Nicotine Use

Anxiety
Irritability
Mood disorders
Poor impulse control
Learning difficulties
Vulnerable to using other drugs

Positive Choices:

https://positivechoices.org.au/teachers/tobacco-factsheet

Know the Risks E-cigarettes and Young People

https://e-cigarettes.surgeongeneral.gov/knowtherisks.html#:~:text=Youth%20and%20young%20adults%20are,permanent%20lowering%20of%20impulse%20control.

Truth Initiative:

https://truthinitiative.org/research-resources/harmful-effects-tobacco/nicotine-and-young-brain

Facilitator Notes:

Review the harmful effects of using nicotine, immediate and long term, on the infographic.

Then, press click and invite participants to read the list Dangers and Risks Associated with Adolescent Nicotine Use

Highlight the following:

Nicotine users often have anxiety, which can be a reason for why they use in the first place. However, research has shown that nicotine can cause anxiety disorders.
Recent research suggests that smoking causes an increased risk of depression, possibly because nicotine damages certain pathways in the brain that regulate mood.
As a result, nicotine may trigger mood swings.
Nicotine is also associated highly with mood disorders.
Many nicotine users have BD (bipolar disorder) and major depression.

Positive Choices:

https://positivechoices.org.au/teachers/tobacco-factsheet

Know the Risks E-cigarettes and Young People

https://e-cigarettes.surgeongeneral.gov/knowtherisks.html#:~:text=Youth%20and%20young%20adults%20are,permanent%20lowering%20of%20impulse%20control.

Truth Initiative:

https://truthinitiative.org/research-resources/harmful-effects-tobacco/nicotine-and-young-brain

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Cannabis/Marijuana

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Cannabis/Marijuana Facts

Produced from the cannabis sativa plant
Also called marijuana, weed, pot, grass, dope, bud, blunt, 420, etc.
Main active chemical is THC, Tetrahydrocannabinol
THC creates addiction
THC can impair and alter the mind
Cannabidiol (CBD) compound contains less than 0.3% THC
May cause marijuana use disorder
Can be smoked, vaped, eaten

National Drug Intelligence Center:

https://www.justice.gov/archive/ndic/pubs3/3593/index.htm#:~:text=High%20doses%20of%20marijuana%20may,%2C%20anxiety%2C%20and%20panic%20attacks

National Center for Complementary and Integrative Health

https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know

Centers for Disease Control

https://www.cdc.gov/marijuana/featured-topics/what-we-know-about-marijuana.html

Facilitator Notes:

Cannabis is produced from the cannabis sativa plant.
It’s also known as marijuana, weed, pot, grass, dope, among others.
THC is the main psychoactive compound in marijuana and it is addictive.
People who frequently use marijuana may develop marijuana use disorder which means they can’t stop using marijuana. When individuals start using in their adolescent years, they have a greater risk of developing marijuana use disorder, which is an addiction to marijuana.
Cannabis contains CBD.
CBD does not impair, which means it does not cause a high, because it has less than 0.3% of THC. Typically, CBD comes from the Hemp plant.
Marijuana can be smoked, vaped, or eaten as edibles.

National Drug Intelligence Center:

https://www.justice.gov/archive/ndic/pubs3/3593/index.htm#:~:text=High%20doses%20of%20marijuana%20may,%2C%20anxiety%2C%20and%20panic%20attacks

National Center for Complementary and Integrative Health

https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know

Centers for Disease Control

https://www.cdc.gov/marijuana/featured-topics/what-we-know-about-marijuana.html

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Cannabis/Marijuana Facts

FDA

https://www.fda.gov/consumers/consumer-updates/5-things-know-about-delta-8-tetrahydrocannabinol-delta-8-thc

Pittsburg City Paper

https://www.pghcitypaper.com/pittsburgh/delta-10-vs-delta-8-whats-the-difference-22709804

Delta 8 and Delta 10 are THC naturally extracted from Cannabis
Marketed for therapeutic and medical uses
Have not been evaluated or approved by FDA
Made more potent and dangerous
Mind altering and psychotic effects
Made into edibles and liquids

Facilitator Notes:

Ask the audience the following: How many of you have heard of Delta-8 or Delta-10?
Invite two - three participants to share what they know
Earlier I said that THC is the main psychoactive compound naturally produced in Cannabis sativa or Marijuana. It is also known as Delta 9.
Delta-8 and Delta-10 are less potent than Delta-9. The natural amount of THC is very low.
Excessive chemicals are sometimes used to extract the compound making the compound very harmful.
Main points being Delta-8 and Delta-10 can currently be sold at tobacco and vape shops without special licensing. Also, many of these products have psychoactive effects to the user similar to regular THC.

FDA

https://www.fda.gov/consumers/consumer-updates/5-things-know-about-delta-8-tetrahydrocannabinol-delta-8-thc

Pittsburg City Paper

https://www.pghcitypaper.com/pittsburgh/delta-10-vs-delta-8-whats-the-difference-22709804

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Facts About Edibles

Foods or drinks containing marijuana or THC
Can mimic regular foods that do not contain marijuana
Differing effects of eating and drinking edibles vs. smoking and vaping
Differing effects of THC in edibles based on potency and/or the individual
Food and Drug Administration (FDA) does not regulate edibles
Label shows products containing cannabis

CA Department of Public Health

http://publichealth.lacounty.gov/sapc/MDU/DE/MarijuanaEdiblesFactSheet040416.pdf

Facilitator notes:

Edibles are foods or drinks containing marijuana.
Cannabis edibles can be very potent and many users tend to have serious adverse reactions to using these products.
They are discreet and may appear to be cookies or candy which could go unnoticed by school administrators, teachers, or parents.
The effects of eating or drinking edibles can be very different from smoking marijuana or using a vaporizer.
When people smoke marijuana, they feel the effect almost instantly. When a person starts to feel the effects, they may stop smoking, which can control the dose. However, when people eat or drink marijuana, their bodies take longer to digest and metabolize it (break it down) before they feel the effects. By the time they feel “high,” it’s too late to control the dose.
How someone will react to edibles depends on the type and strength of the edibles, the person’s body mass, chemistry, metabolism, and the amount consumed.
These factors, combined with non-standard dosage labeling for marijuana edibles, make it common for a person to accidentally eat or drink a higher dose of THC than planned.
The labels shown are the symbols on products containing cannabis. Manufacturers must use these labels on edible packages or drinks.

CA Department of Public Health http://publichealth.lacounty.gov/sapc/MDU/DE/MarijuanaEdiblesFactSheet040416.pdf

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Regular Food or Edibles?

County of Los Angels PUblic Health:

http://publichealth.lacounty.gov/sapc/MDU/DE/MarijuanaEdiblesFactSheet040416.pdf

CDC

https://www.cdc.gov/marijuana/health-effects/poisoning.html

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Recognizing the Signs of Cannabis Use

National Drug Intelligence Center

https://www.justice.gov/archive/ndic/pubs3/3593/index.htm#:~:text=High%20doses%20of%20marijuana%20may,%2C%20anxiety%2C%20and%20panic%20attacks

National Institute on Drug Abuse

https://nida.nih.gov/publications/drugfacts/cannabis-marijuana

Euphoria
Dry mouth
Rapid heart rate
Red eyes
Slowed reaction times
Anxiety
Memory loss
Increased appetite

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Harmful Effects

of Cannabis Use for Teens

Dangers and Risks Associated with Teenager and Young Adult Cannabis Use

May cause marijuana use disorder
Affects the brain, specifically memory, learning, attention, decision-making, coordination, emotion, and reaction time
Increased risk of depression, anxiety, suicidal thoughts, psychosis, schizophenia
Issues at school or work
Greater chances of dropping out
Relationship problems

CDC

https://www.cdc.gov/marijuana/health-effects/teens.html

National Institute of Drug Abuse

https://nida.nih.gov/publications/drugfacts/cannabis-marijuana

Facilitator Notes:

There are several immediate effects of cannabis use is associated with lower attention span and it affects the way the mind processes information.
Earlier we mentioned Marijuana Use Disorder, which is addiction to marijuana. Over time, youth who begin cannabis use before the age of 18 are at greater risk of developing use disorder which may negatively impact academic performance and decrease motivation for daily activities.
More long-term effects of youth cannabis use include parts of the brain that control memory, learning, attention, decision-making, coordination, emotion, and reaction time
Several studies have found an association between long term cannabis use and psychosis schizophrenia* especially for those users who started using at a young age and use cannabis frequently.

CDC

https://www.cdc.gov/marijuana/health-effects/teens.html

National Institute of Drug Abuse

https://nida.nih.gov/publications/drugfacts/cannabis-marijuana

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Fentanyl

LAUSD Office of the Chief Medical Director

https://www.lausd.org/Page/18694

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Fentanyl Facts

National Institute of Drug Abuse

https://nida.nih.gov/research-topics/trends-statistics/infographics/what-fentanyl

DEA

https://www.dea.gov/press-releases/2022/08/30/dea-warns-brightly-colored-fentanyl-used-target-young-americans

Synthetic, man-made, opioid much more potent than heroin and morphine
Prescribed and/or illegal drug
Tasteless and odorless
Mixed with other drugs and laced in counterfeit pills
“Rainbow” fentanyl
Small quantity, 5-7 grains of salt, can have a deadly effect

Facilitator notes:

Let’s deepen our understanding of what fentanyl is and why it is so deadly.

Additional Facilitator notes:

Encourage participation by asking participants: Do you know how much fentanyl is enough to cause an overdose?
Invite responses.
Just 2 milligrams can kill a person. Do you know how much is 2mm?

Click return and when the picture of the pencil appears, highlight that the small amount on the tip of the pencil is enough to cause an overdose and/or death.

Click return again and highlight the following:

Fentanyl is a synthetic opioid, which means it was man-made, that is 50 times more potent than heroin and 100 times more potent than morphine.
It can be prescribed by a doctor to treat severe pain, but it can also be illegally sold and used.
Illegal fentanyl, known as “street fentanyl” is made into liquids, powder, and counterfit pills and is dangerous.
Many users are exposed to fentanyl without knowing, while others use it intentionally because of its potency.
Substances may be laced with fentanyl long before they reach the friends or friends of friends that teens trust.
The DEA has noted an increase in confiscating bright colored fentanyl being sold in cities across the country including California.
It is being seized in multiple forms, including pills, powder, and blocks that resembles sidewalk chalk.
It is assumed that the bright colored product (which resembles street chalk) is being marketed for youth due to it’s bright colors which resemble candy products.
While one pill may not be deadly, another one could be.

National Institute of Drug Abuse

https://nida.nih.gov/research-topics/trends-statistics/infographics/what-fentanyl

CA Dept of Public Health

www.cdph.ca.gov/Programs/OPA/Pages/Communications-Toolkits/Fentanyl-Overdose-Prevention.aspx

DEA

https://www.dea.gov/press-releases/2022/08/30/dea-warns-brightly-colored-fentanyl-used-target-young-americans

LAUSD Office of the Chief Medical Director

https://www.lausd.org/Page/18694

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Increase in Fentanyl Laced Pills

in the U.S. 2018-2021

https://www.sciencedirect.com/science/article/abs/pii/S0376871622001351

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Overdose Deaths

National Institute of Drug Abuse

https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates

Overall,

drug overdose deaths rose from 2019 to 2021 with more than 106,000 drug overdose deaths reported in 2021.

Deaths involving synthetic opioids, primarily fentanyl, continued to rise with 70,601 overdose deaths reported in 2021.

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Fentanyl in Los Angeles County

Fentanyl Overdose Deaths by Age, Los Angeles County, 2016 - 2021

Data Report: Fentanyl Overdoses in Los Angeles County. Health Outcomes and Data Analytics Branch, Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, November 2022.

Facilitator Notes:

The data above represents the number of LA County residents who have died to fentanyl poisoning since 2016.

Give the participants 2 minutes to examine the chart. After 2 minutes, ask, What do you notice and what do you wonder?

After participants have shared, share the bullets below if no one made reference to these points:

There has been a significant increase in deaths since 2016 as is evidenced by the this graphic image.
From 2016 - 2018 rates of youth overdose deaths were maybe 3-5 per year. In 2021 that number increased to 31 deaths.
Also, 18-25 year old residents represent a significant proportion of those who have passed due to fentanyl overdose.
Our goal is to work together to decrease these numbers of overdose hospitalizations and death due to fentanyl.

Data Report: Fentanyl Overdoses in Los Angeles County. Health Outcomes and Data Analytics Branch, Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, November 2022.

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Just One Pill Can Kill

This video was produced by the

United States Drug Enforcement Administration

https://lausd.wistia.com/medias/ker8foz4d6

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Signs of Opioid Overdose

California Department of Public Health https://www.cdph.ca.gov/Programs/OPA/Pages/Communications-Toolkits/Fentanyl-Overdose-Prevention.aspx

Recognizing the signs of opioid overdose

can save a life.

Here are some signs to look for:

Small, constricted "pinpoint pupils"
Falling asleep or losing consciousness
Slow, weak, or no breathing
Vomiting or gurgling sounds
Limp body
Cold and/or clammy skin
Purple or bluish lips and/or fingernails

Facilitator Notes:

Some of us have heard or seen on television news about people overdosing on fentanyl. Tragically, it has happened in schools, too.
Because of the increase in fentanyl use and overdose caused by fentanyl, it is importatnt that we are all aware of the signs of an opioid overdose. It can save a life!
However, besides fentanyl, a wide range of substances like alcohol, prescription medications and illegal medications, can also cause an overdose.
Sometimes it can be difficult to tell whether a person is very high or experiencing an overdose.
If you're having a hard time telling the difference, it is best to treat the situation like an overdose and call 911 - it could save someone's life.

Briefly review the common signs of overdose.

CA Dept of Public Health

https://www.cdph.ca.gov/Programs/OPA/Pages/Communications-Toolkits/Fentanyl-Overdose-Prevention.aspx

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Naloxone

Naloxone Training: https://lausd.csod.com/ui/lms-learning-details/app/curriculum/19788849-b116-4dc3-b737-ce25a479e6df

CDC: 5 Things to Know About Naloxone | Feature Topics | Drug Overdose (cdc.gov)

What is Naloxone

Naloxone is a medicine that can help people who are overdosing on an opioid. Opioids include prescription medications, heroin, and fentanyl. Narcan temporarily reverses the effects of an overdose from opioids.
Naloxone can be administered by a prefilled devices that sprays medication into the nose.
Naloxone is safe. Naloxone will not harm someone if you give it to them and they are not overdosing on an opioid.
Naloxone is one important step when helping someone who is overdosing.
If you have Naloxone, you can potentially save a life.

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What to do

if you think someone is overdosing:

Naloxone Trianing: https://lausd.csod.com/ui/lms-learning-details/app/curriculum/19788849-b116-4dc3-b737-ce25a479e6df

CDC: https://www.cdc.gov/niosh/docs/2019-127revised042019/

Call 911 immediately, from a landline when possible.

Administer naloxone, if available.*

Try to keep the person awake & breathing.

Lay the person on their side to prevent choking.

Stay with the person until emergency assistance arrives.

*Naloxone is a life-saving medication that can reverse the effects of opioid overdose and save lives.

The California Education Code (EC) Section 49414.3 and district policy BUL-133120, Administration of Naloxone Nasal Spray, authorize trained personnel to administer naloxone to a person exhibiting potentially life-threatening symptoms of an opioid overdose.

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Illegal Drug Activity

through Social Media

Social media apps used

by drug trafficking organizations

to sell illicit drugs:

Facebook
Instagram
Snapchat
TikTok
Twitter
YouTube

Communication about drugs:

Emojis
#Hashtags

DEA

https://www.dea.gov/sites/default/files/2022-03/20220208-DEA_Social%20Media%20Drug%20Trafficking%20Threat%20Overview.pdf

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Resources for Students

Maya Rosas

T.U.P.E. Coordinator

Beyond the Bell

mdr3802@lausd.net

(213) 241-3029

Francisca Gamez

High School Field Coordinator

Beyond the Bell

fxg9203@lausd.net

(213) 241-3111

Daniel Soto

Project Director

Institute for Health Promotion and

Disease Prevention Research

USC Keck School of Medicine

Resources at Schools:

Counselors, Psychiatric Social Workers, Psychologists, Restorative Justice Coordinators, administrators, etc.

LAUSD Resource Hotline:

askshhs.lausd.net

L.A. Unified Student and Family Wellness Hotline

(213) 241-3840

Monday-Friday, 8am-4:40pm

Press 2 for Mental Health

LAUSD Wellness Centers:

https://achieve.lausd.net/wellnesscenters

LAUSD Student Wellbeing Centers:

https://achieve.lausd.net/Page/18469

Community Resources:

SAMHSA National Helpline

1-800-662-HELP (4357)

Smoke Free Teen

https://TEEN.SMOKEFREE.gov

TEXT “QUIT” TO 47848

School Presenter Name

Dr. Kenneth M. Hill

School of Business and Tourism

kenneth.hill@lausd.net

(213) 241-3805

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Contacts

Maya Rosas

T.U.P.E. Coordinator

Beyond the Bell

mdr3802@lausd.net

(213) 241-3029

Francisca Gamez

High School Field Coordinator

Beyond the Bell

fxg9203@lausd.net

(213) 241-3111

Daniel Soto

Project Director

Institute for Health Promotion and

Disease Prevention Research

USC Keck School of Medicine

School Presenter Name

Dr. Kenneth M. Hill

School of Business and Tourism

kenneth.hill@lausd.net

(213) 241-3805