When Drug Use Becomes Addiction: Helping Students Become Sober

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When Drug Use Becomes Addiction Helping
Students Become Sober

• Peter A. DeMaria, Jr., M.D., FASAM
• Tuttleman Counseling Services
• Temple University
• Clinical Associate Professor of Psychiatry
• Temple University School of Medicine

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What is Addiction?

• Addiction is a primary, chronic disease with
  genetic, psychosocial, and environmental factors
  influencing its development and manifestations.
  The disease is often progressive and fatal. It
  is characterized by continuous or episodic
  impaired control over drinking or drug use,
  preoccupation with alcohol or drugs, use of
  alcohol or drugs despite adverse consequences,
  and distortion in thinking, most notably denial.

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College Student Developmental Stage
ADOLESCENCE

• Invincible
• Subject to peer pressure
• Risk-taking
• Want to be independent

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The Life History of A Substance User
Abstinence
Abstinence
Experimentation
Abuse
Dependence
Relapse to Use
Sobriety
Recovery
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Some Factors Affecting Drug Experimentation/Contin
ued Use/Addiction
Peer Pressure
Genetics
Psychiatric problems
Stress
Availability
Boredom
Curiosity
Trauma/abuse
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Core Alcohol Drug Survey-2005
(A sample of 33,379 undergraduate students from
about 53 colleges in the United States)
30 Day Prevalence Rate by Drug Type
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College Student Opiate UseCORE Study
If Temple has 33,000 students, then 462 used in
the last year 231 used in last 30 days
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Monitoring the Future Annual Prevalence for
12th Graders
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Papaver somniferum (Opium poppy)
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Patterns of Use

• Heroin 10 bags
• Snorted, injected, smoked
• Average habit 80-100/day
• Prescription Narcotics
• Percocet (oxycodone, 5/pill)
• OxyContin (oxycodone, 0.50/mg.)
• Dilaudid (hydromorphone, 15-20/4 mg pill)
• Tylenol w/Codeine 3,4 (1-5/pill)
• Lortab/Vicodin (hydrocodone)

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Prescription Opiate Drugs
Vicodin
Percocet
OxyContin
Dilaudid
Tylenol 4 w/codeine
Lortab
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Cycle of Addiction
Drug Use
Obtain drugs
Physical dependence
Withdrawal symptoms
Obtain money for drugs
Need for drugs
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Consequences of Addiction

• Inability to attend classes/do schoolwork
• Breakdown of relationships
• Decrease in self-care
• Inability to work
• Financial problems (cash flow)
• Illegal behavior
• Medical risks
• Psychiatric illness

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DEA Domestic Monitoring Program Heroin Purity
Comparison by City, 1998
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Progression of Opiate Use
Prescription Opiate Medication
Snort Heroin
Inject Heroin
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Opiate Addiction Personal Perspective
http//www.youtube.com/watch?vRuXPZ9Ryc_U
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How People Change
Precontemplation
Contemplation
Preparation
Prochaska J, DiClemente C, Norcross J. In search
of how people change applications to addictive
behaviors. Amer Psychol 471102-1114, 1992.
Action
Maintenance
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General Principles of Treatment

• Comprehensive evaluation
• Engagement in treatment
• Treatment setting
• Detoxification vs. maintenance
• Counseling
• Self-Help (12 step)

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The Temple Experience

• Time period 1/04 through 5/08
• 33 Students have been treated
• 2 Continuation treatment (excluded)
• 1 Treated by colleague (excluded)
• Average age 22.3 years old (19-31)
• 67 Male
• 90 Caucasian
• 47 Not involved in a relationship

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Year in School at Presentation
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Population Characteristics

• 67 Smoke tobacco
• 57 Dink alcohol
• 53 Use drugs IV
• No HIV or HCV infections
• Family History
• Psychiatric 50
• Drug alcohol 73
• 60 Report a history of past addiction treatment
• 27 Report a legal history

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Psychiatric Diagnosis16/30 (53.3) had a history
of a psychiatric diagnosis
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Opiate Use at Admission
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Initial Urine Drug Screen
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Length of Treatment
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Opiate Use with Time in Treatment
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Cocaine Use with Time in Treatment
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Benzodiazepine Use with Time in Treatment
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Marijuana Use with Time in Treatment
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Number of Illicit Drugs in the UDS with Time
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Disposition of Admitted Patients
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Challenges

• Accept the disease of addiction
• Commit to sobriety
• Acknowledge that marijuana is a drug
• Engage in treatment
• Finances
• Managing free time/boredom

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How Can You Help

• Remember that addiction is a disease.
• Addiction is treatable.
• Refer a student to TCS for help.
• Support a students recovery.
• Relapse is part of the disease process.
• Dont give up hope.
• Keep trying.

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