[Noozhawk’s note: This article is part of Day 6 in Noozhawk’s 12-day, six-week special investigative series, Prescription for Abuse. Related links are below.]
It was once perceived as a rite of passage of sorts, but adolescence and substance use are now considered a toxic combination. More and more research is revealing that choices made at an early age — generally in the early teenage years — can have lasting effects, few of them positive.
“If you can delay or postpone someone’s use, you’re basically inoculating them against addiction,” said Shereen Khatapoush, director of Fighting Back’s Youth Services System, part of the Santa Barbara Council on Alcoholism & Drug Abuse.
“If someone uses alcohol, marijuana, anything, before the age of 15, they are four to five times more likely to have addiction or dependence at some point in their lifetime,” she said.
“So addiction, dependence, it’s fundamentally a developmental disorder. If you don’t start using as an adolescent, you’re probably never going to have a problem. You might experiment, you might have problem use at some point, but you probably won’t have real addiction or dependence issues.”
While there are exceptions, Khatapoush and others at CADA believe keeping children off drugs will greatly increase their potential for a healthy life.
“We’re not prohibitionists,” Khatapoush said. “We’re not saying no one should ever have a drink. We’re trying to prevent this harm, we’re trying to prevent — it sounds dramatic — the ravages of addiction and dependence.”
New research shows that the human brain does not fully develop until age 25, and drug use during teen years can disrupt parts of its development during that period. Especially at risk are pathways to the prefrontal cortex, the area of the brain that is thought to be involved in decision-making and planning complex cognitive behaviors, as well as in the expression of personality and appropriate social behavior. Some people may not develop emotional self-control and may instead turn to substance use as a coping mechanism, research shows.
“We see this fundamental arrested development in middle-aged people who used (substances) a lot as teenagers or young adults,” Khatapoush said.
Parents are the most important influence on whether a child starts using alcohol or drugs and they should have clear, consistent conversations about their expectations, she said.
Once a child starts using, his or her friends and peers often have the most influence, so parents are advised to be mindful of who their child spends time with and what they’re doing.
Lack of knowledge is the key issue, said Santa Barbara Unified School District Superintendent Dave Cash.
During his career, which includes top positions at districts throughout California, Cash said he has been in parent-student conferences after the student has been hospitalized, expelled or had another drug-related problem and the parent’s response has been, “I had no idea,” or, “He was taking what the doctor told him to take.”
Cash has a 19-year-old son whose close friend became addicted to OxyContin prescribed for an athletic injury. The friend ended up taking nearly a year off of school to recover and overcome drug-related physical issues.
“I’ve seen it one step removed and it was devastating,” Cash said.
As a principal seven years ago, Cash said he had no direct exposure to what he heard was happening — selling Ritalin to classmates, stealing codeine from a parent’s friend’s medicine cabinet, and “pharm parties” during which youths ingest anything and everything without regard to the effects of combining drugs with each other and alcohol.
He didn’t see prescription drug abuse as an emerging issue then, but he’s now certain the stories were true and the problem has not gone away.
Cash is working on an educational campaign for parents and students. He says the students who are educated and aware of the problem need to talk to their friends, while adults need to take a proactive leadership role.
Marlin Sumpter, who as the school district’s student services director is in charge of discipline, says it’s vitally important for parents to monitor medications — even going as far as counting the pills.
“Just because the bottle is still there doesn’t mean someone is not getting into it,” he said.
Fighting Back provides places for students to go with questions or someone to talk to at every secondary public school on the South Coast. The program’s Youth Services specialists have one-on-one counseling sessions with any student who needs to talk about anything, be it a relationship, problems at home or substance abuse.
Fighting Back also provides the bilingual SUPER (Substance Abuse Prevention Education Resource) program for students who have gotten in trouble for a drug or alcohol violation at school.
“When we bring (parents and students) together, it’s just so much more powerful and effective,” Khatapoush said.
Families new to the mandated program typically are ashamed and angry, she said.
“And the way they go out usually is crying and thanking us,” she said. “Because it helps, and it really reconnects the child and their parent and engages them in some really wonderful conversations — healing, helpful conversations — and gives them information that’s really useful.”
Meanwhile, Santa Barbara school district officials have encountered secondary students who have brought alcohol, marijuana or prescription drugs to school and are under the influence on campus.
The excuses of “I’m holding it for a friend” and “I found it in the gutter on the way to school” are still very popular, Sumpter said.
The 2010-2011 California Healthy Kids Survey asks about lifetime use of alcohol, inhalants, illicit and prescription drugs for nonmedical reasons, to get “high,” “loaded,” “wasted” or “stoned.”
Adolescents overwhelmingly use alcohol and marijuana as their drugs of choice, according to the findings. Forty-four percent of students in 11th grade report using alcohol and 35 percent report using marijuana to get high at least once. Ninth-graders report half those rates, at 18 percent for alcohol and 7 percent for marijuana.
Seven percent of 11-graders and 3 percent of ninth-graders have used prescription painkillers to get high at least once.
Nontraditional schools — La Cuesta Continuation High and Alta Vista Alternative High — have significantly higher rates than the other schools in terms of percentages, but have much smaller populations, at just 191 combined for the 2009-2010 school year.
Sumpter said he wasn’t aware of widespread drug or alcohol issues on the two campuses. The Healthy Kids Survey shows 68 percent of nontraditional students report using alcohol and 67 percent report using marijuana. Twenty-two percent of students have used prescription painkillers to get high.
In recent years, controlled substances-related issues contributed to half of the Santa Barbara school district’s expulsions. For 2009-2010, there were 40 expulsions for the secondary schools and 532 violence/drug-related suspensions — out of a junior high and high school total enrollment of 9,882.
Throughout Noozhawk’s research for its Prescription for Abuse series, authorities, officials and treatment professionals repeatedly asked reporters to stress how easy it is for young people to get access to these relatively inexpensive drugs.
Sumpter said he’s seen an increase in alcohol and drug issues for the past 15 years. First offenses get managed at the school level and more serious cases — like selling on the campuses — go straight to him.
“It’s just becoming easier to get it, so the struggle against it is greater,” he said.
Students are supposed to check in any prescription medications they have with the nurse’s office, but there are instances of sharing between students, often with painkillers like Vicodin. When one student has a headache, another will offer up a pharmaceutical solution, Sumpter said.
He suspects most use — or abuse — is done privately.
The highest risk hours for adolescents are between 3 and 6 p.m., since it’s typically a gap between adult supervision, Khatapoush said.
“Everyone’s at risk; every adolescent is because they’re developing,” she said.
A drug abuse trend specifically reported among the adolescent and young adult population is using cold and cough medicines.
“I’ve heard of kids overdosing and drinking an entire bottle of it and getting sick.”
Some of the motivation comes from young people on probation.
“If their usual drug choice is alcohol or marijuana and they know they’re going to be tested for it, they’re going to start changing to different types of drugs to get that high,” Nguyen said.
That can range from prescription painkillers to Xanax, an anti-anxiety drug. The most popular are cold and cough medicines such as Robitussin, known as “robo-tripping,” and Coricidin cold medicine pills, known as “red devils.”
“These kids know exactly how many of those pills they need to take to get high,” Nguyen said.
Cold and cough medicines have been used by 8 percent of ninth- and 11th-graders, according to the Healthy Kids Survey, and there are small percentages of students who have used barbiturates, tranquilizers, Ritalin or Adderall for a nonmedical purpose.
“There are kids who are taking it not just to get high, but so they can focus and do better in school,” Nguyen said. “I’ve heard kids ask their parents, ‘Can you please take me to the doctor so we can get Adderall so I can get better grades?’”
Without the conditions for which Ritalin or Adderall are prescribed, the drug’s effects differ between individuals. It’s a central nervous system stimulant used to treat attention-deficit disorder, attention-deficit hyperactivity disorder and narcolepsy, and overdose can cause fainting, fast heartbeat, vomiting or seizures.
“If you don’t have those conditions, a Ritalin pill will get you high almost as if you did coke or meth,” said Tom Miller, a District Attorney’s Office investigator.
“Not knowing what (dosage) is appropriate for you makes a big difference,” added Jackie Kurta, director of UCSB’s Alcohol & Drug Program. “Physicians say it’s one of those drugs that doesn’t necessarily relate to body weight with the dosage, it depends on your own brain.”