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“Higher” EducationJackie Daniels, MSW, LCSW
Office of Alternative Screening and Intervention Services (OASIS)
Indiana UniversityFacebook: *Full Office Name
Twitter: IUDrugAlcPrev
General Information about use Health
Physical, Addiction, The Brain Consequences
Implications for Higher Ed Intervention/Prevention
Agenda
General Information
Chemistry/Physiology, Prevalence, Norms
Most commonly used “illicit” drug in US, Worldwide
Commonly used as medicine, food, hospitality, spiritual practices in many cultures
Social symbol- Revolution, freedom, political control, FREE LOVE
~4.0% of the world population use cannabis annually (162 million people)
THC – delta-9-tetrahydrocannabinol Main psychoactive ingredient; binds to nerve endings in several parts
of the brain The part of marijuana that affects senses, dulls pain, and produces a
“high”
Over 70 identified cannabinoids in marijuana Several others cannabinoids are of medical interest Includes cannabidiol, shown to relieve convulsion, anxiety,
inflammation, and nausea
General Information
Marijuana has its own drug classification
Most similar to hallucinogens/psychedelics Also shares properties with depressants and stimulants,
narcotic pain-killers
Smoking: Can reach the brain in 14 seconds Felt within minutes Peaks after 10 –15 minutes Lingers 2 –3 hours
Food and Beverage: Depending on dose, upwards of 3 hours
General Information
General Information
Prevalence
34% of IN College Students report smoking past year (IUB= 40.8, increase from 2011 ICSUS)
18.7% past month (IUB=23.5%, decrease from 2011 ICSUS)
Avg. age 1st use IN= 17.4 Most frequent consequences
Combining substances Guilt and Shame Driving
Acceptance 28.6 % feel peers
would strongly approve of “trying” once or twice
6.9% feel peers would strongly approve of using regularly
Survey results show an upward climb of peer approval over the last few years (significant)
Health
Physical Health
Rational scale to assess harm of drugs
Marijuana is in the least harmful category
Relative to other drugs in that category, marijuana use still carries some risk of harm
From Nutt et al, The Lancet 2007
Lungs
Smoke disables cilia which rid dirt and toxins from the lungs Immediate effects
Burning & stinging in mouth & throat. Heavy coughing.
Effects with regular, long-term use Increased phlegm production. Increased incidence of bronchial ailments
Physical Health
Heart
Dramatically increased heart-rate: Increase by 20-50 BPM (70-80 BPM baseline) Can contribute to feelings of panic/anxiety
Immune system Marijuana users can develop allergies to the
plant Symptoms include hives, rashes, wheezing, and
anaphylaxis (rarely) You can become allergic to marijuana even if
you have not previously experienced symptoms
Physical Health
Physiological Addiction:
the body becomes chemically tolerant causing increased craving and dependency.
Psychological Addiction: the mind becomes dependent upon the drug
causing one to obsessively think about the drug and to develop a love-trust relationship
Addiction
The of American Psychiatric Association (DSM-IV) and the
World Health Organization (ICD-10) criteria for AddictionAnswer yes or no to the following seven questions.
Tolerance Withdrawal Difficulty controlling your use Negative consequences Neglecting or postponing activities Spending significant time or emotional energy Desire to cut down
If you answered yes to at least 3 of these questions, then you meet the medical definition of addiction.
Addiction: Test Yourself
Some people aren't addicted to drugs or alcohol,
but abuse them.
The American Psychiatric Association (DSM-IV) definition of Substance Abuse is at least one of the following four criteria.
Continued use despite social or interpersonal problems. Repeated use resulting in failure to fulfill obligations at
work, school, or home. Repeated use resulting in physically hazardous situations. Use resulting in legal problems.
Addiction vs. Abuse
How do drugs affect the brain? All Drugs: affect dopamine receptors
The Brain
The Brain
Acute (present during intoxication)
Impairs short-term memory Impairs attention, judgment, and other cognitive functions Impairs reaction time
Persistent (longer than intoxication, not permanent) Impairs memory and learning skills (even after 24 hrs without
using) Long-term (potentially permanent effects of cumulative
use) Can lead to addiction (~9% of users become addicted) *Correlated with the development of mental disorders in
vulnerable individuals *May increase risk of anxiety and depression
The Brain
Marijuana has anti-emetic (anti-nausea) properties Downside: it hinders your ability to purge after ingesting
toxic substances, especially alcohol
Taking marijuana with prescription sedatives can lead to excessive drowsiness and significantly impair coordination and cognitive functioning
Smoking marijuana and tobacco together increases risks of lung cancer and other pulmonary diseases
Marijuana and Other Drugs
What is “medical marijuana”?
MARINOL Synthetic THC Pill form
Currently there are no FDA approved smoke-able medicines.
What about medical marijuana?
Consequences
Implications for Higher Education
Marijuana has been shown to impair executive
functions, attention, and memory
Heavier users experience more impairment
Impairments persist after 24 hours
Academics
Academics
Divergent Learning Finding creative
solutions to problems
Exploring ideas Low doses of THC
have been shown to improve this ability
Academics
Convergent Learning Recalling stored
information Applying conventional
and logical search, recognition and decision-making strategies
Even small amounts of THC impair one’s ability to do this
Marijuana can affect cognition for over 24
hours after use
In studies, people did not always realize they were experiencing cognitive deficits
Academics
Ranked 9th in the country for maximum
sentences for possession for any amount of marijuana
Ranked 3rd in the country for maximum sentences for possession of one ounce
29th in the country for percentage of total population who have used marijuana in the last year
Source: Jon Gettman, Ph.D. The Bulletin ofCannabis Reform 2007
Current Indiana Marijuana Rankings
Possession of Marijuana
Class A Misdemeanor – 30 grams or less Class D Felony – 30 grams or less and prior
conviction Class D Felony – more than 30 grams
Class A Misdemeanor is punishable by up to 1 year and up to a $5,000 fine
Class D Felony is punishable by six months to 3 years and up to a $10,000 fine
Legal Consequences in Indiana
Dealing of Marijuana
Class A Misdemeanor – 30 grams or less Class D Felony – 30 grams or less and prior conviction Class D Felony – 30 grams or less and recipient is under age 18 Class D Felony – more than 30 grams Class C Felony – 30 grams or less and in a park, public housing
complex, school bus, or within 1000 feet of a school Class C Felony – 10 lbs or more
Class C Felony is punishable by 4 to 8 years and up to a $10,000 fine
Driving under the influence (DUI) of marijuana=progressive sentencing (MS-FELONY)
Legal Consequences
In Indiana, a person in guilty of DUI if he or she operates
a vehicle while a controlled substance or its metabolite is present in the person's body. Ind. Code Ann. § 9-30-5-1(c)
Indiana has a zero tolerance per se drugged driving law enacted for cannabis, cannabis metabolites, and other controlled substances. (Indiana Code Annotated, Section 9-30-5-1 & Section 9-30-5-2)
A person who operates a vehicle impliedly consents to submit to chemical tests as a condition of operating a vehicle in Indiana. Id. § 9-30-6-1. A person must submit to each chemical test offered by an officer, or it will be considered a refusal. Id. § 9-30-6-2(d).
Indiana Drugged Driving Law
Under federal law (Section 3002 of 50 U.S.C. 435b), current or recent
drug use prohibits federal employees from obtaining security clearance
Many other occupations make employment decisions based on background checks
Companies that receive federal funds are required to prohibit marijuana use under the Drug-Free Workplace Act of 1988
Based on court rulings, companies are NOT required to make accommodations for medical marijuana users, even if medical marijuana is legal within the state
Institutions of Higher Education receiving government funding
Search yourself! In Indiana: mycase.in.gov
Career Consequences
Drug arrests/convictions are a matter of public record; they will be visible to potential employers for entire career
Search yourself! In Indiana: mycase.in.gov
Career Consequences
Higher Education Act of 1965 (amended) suspends federal financial
aid eligibility for students convicted of the sale or possession of drugs under federal or state law (with stipulations)
The U.S. Department of Education requires students receiving financial aid convicted of a drug crime to notify their school's financial aid office immediately
The suspension of eligibility for Federal financial aid begins on the date of the conviction and ends as follows:
- for Possession of a Controlled Substance 1st offense: 1 year- for Possession of a Controlled Substance 2nd offense: 2 years- for Possession of a Controlled Substance 3rd offense:
Indefinite- for Sale of a C.S. 1st Offense or 2nd Offense: 2 years- for Sale of a C.S. 3rd Offense: Indefinite
Financial Aid
Consistent Police Involvement
Campus Conduct and Community Courts are Concurrent (some PDP)
Progressive Sanctioning by Campus Conduct System Suspension, Expulsion Mandatory MIP & Marijuana Seminar Attendance
University Consequences
Prevention
I learned it by watching youPot-smoking surgeonSaw bladeTurtle trouble
“Just Say No”-Thank you Nancy Reagan
De-legitimizes authority Makes the authority figure seem ignorant and
out of touch Does not respect autonomy and personal
decisions Does not respect the POSITIVE effects that
drugs might have in someone’s life
“Just Say No”
Prevention
Be research based and theory driven
Integrate multiple parts of student life
The primary goals are to: Reduce, Delay, Decrease Transition from “use” to “abuse”, Harm Reduction
Primary, Secondary, Tertiary
Individual, Campus (Environmental), Community
IU CURRENT PREVENTION:Policy, Conduct, LegalCulture of Care- STEP UP IU!Strategic Planning Underway
Intervention
Basic Structure of OASIS and Referrals from
Office of Student Affairs, Admissions Office Continuum of Users Campus and Community Partners
Student Life and Learning, Student Advocates, IUHC CAPs, Student Legal Services
IUPD, Monroe County Prosecutor’s Office IU Code of Conduct and A-Z Guide
On and Off Campus Violations (Confusing for Students)
Marijuana Intervention Program
MIP
Survey
SCID-IV Non-Alcohol Use SUDs Questionnaire (DSM) MSI-X (Marijuana Screening Inventory) Marijuana Effect Expectancies Reasons for Quitting AUDIT (Alcohol) Stages of Change Assessment
Session I= 1 hour, relationship development, motivational interviewing and assessment
Psychoeducational, Individualized Feedback, Case Management and Referral (if necessary)
Components
Help students take ownership of behavior, choices
and consequences Develop critical and abstract thinking ability around
these choices, physical health and psychological well-being, examine academic and community standing
Develop awareness of values and ethical beliefs, how these shape decision-making
Advance self-efficacy and identity Assess for more serious problems and refer for
counseling/treatment/campus resources
Goals of M.I.P.
National Institute on Drug Abuse. http://www.whitehousedrugpolicy.gov/drugfact/marijuana/index.html http://www.addictionsandrecovery.org/definition-of-addiction.htm Indiana Collegiate Action Network (2012) Indiana College Substance Use
Survey - IUB American Psychiatric Association (1994) Diagnostic and Statistical Manual of
Mental Disorders Jessor, R. & Jessor, S. L (1977) Problem behavior and psychosocial
development: a longitudinal study of youth. Donovan, J.E. & Jessor, R. (1985) Structure of problem behavoir in adolescence
and young adulthood Substance Abuse and Mental Health Services Administration (SAMHSA) (2003) Clark County Prosecutor, Indiana ( 2010) Indiana Prevention Resource Center (2010) Alger, B. & Nicoll, R. ( 2004) Center for Addition and Mental Health (2010) Triggering Myocardial Infarction by Marijuana (2001)
Statistics and Sources
NREPP-SAMHSA National Registry of EBP and Practices Center for Study and Prevention of Violence- University of
Colorado National Institute on Drug Abuse (NIDA) Cannabis Youth Treatment Motivational Interviewing Resources Office of Alternative Screening and Intervention Services-
M.I.P. National Cannabis Prevention and Information Centre Indiana Prevention Resource Center Substance Abuse and Mental Health Administration
(SAMHSA)
Recources
