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Eliana Morris:
Hello everybody. Welcome to our "Signs of Substance Use Disorders Among Youth" educational webinar. My name is Eliana Morris. I'm an admissions outreach advisor for the online Master of Social Work degree at Yeshiva University. So the Wuzweiler School of Social Work at Yeshiva University is a top 70 best graduate school for social work. It's also a top 55 best value school. It's rooted in the mission to be an educational, spiritual, and intellectual epicenter and it emphasizes knowledge enlightened by values. It's a really great blend of centuries old tradition alongside contemporary best practices to ensure students receive the highest quality academic experience possible. I would now like to introduce Dr. Kristy Aristy. Can you say hi, Kristy?

Dr. Kristy Aristy:
Hi, everybody.

Eliana Morris:
How are you?

Dr. Kristy Aristy:
Great.

Eliana Morris:
So, Kristy, do you wanna just quickly introduce yourself? Say a few things about yourself.

Dr. Kristy Aristy:
Absolutely. Hi, everybody. I hope you're all well. Thank you so much for joining us today on a very hot, hot summer day. I have been in the field of substance use disorders for about 25 years and I have worked with most populations. This includes populations who were formerly incarcerated, youth, families, as well as various types of individuals. So I'm happy to work with this presentation to you. I'm happy to talk about the wonderful new terms that are being associated with substance use disorders and getting you a little bit more familiar with kind of these new signs and symptoms with our newer generation. So, thank you.

Eliana Morris:
Thank you Dr. Aristy. I'm also extremely pleased to introduce Dr. Kimberly Moore. Dr. Moore, would you like to introduce yourself?

Dr. Kimberly Moore:
Sure. Hello and welcome, everyone. We are so excited to be with you this afternoon and with my colleague Dr. Aristy and with Eliana. We're just so pleased to be a part of this presentation. We're looking forward to giving a little bit of an over review for you around substance use disorders as it relates to you. I've been in the field as well for over 20 years working with a wide variety of different populations, community organizing, program designing, planning, and also a direct care practice. So again we all have a lot to learn. It's always a great time for a refresher and we're just happy to be here for the next hour with you. Thank you so much.

Eliana Morris:
Thank you, Dr. Moore. Okay, so I'm gonna, you know, kind of give it over to you guys and let you start presenting.

Dr. Kimberly Moore:
Excellent. Excellent. So thank you so much. So how about this? In 2022 there were nearly 49 million people in the United States who identified as having one substance use disorder. And according to the National Institute on drug abuse substance use disorders are chronic treatable conditions which people can recover from. Now to understand how the disorder occurs we have to think about this issue around maladaptive behavior or negative consequences that are associated with the use itself. So substance use disorders are defined in part by two things. One, the relapsing condition in which periods of abstinence not using substances can be followed by a return to use, but then also continued use despite known consequences. Now even with all of this there are many, many people who are looking forward to enrolling in treatment, who are looking to improve prevention methods, looking to reduce harm. And so it's important for us to think about, you know, the difficulties that come with that, the experience that comes with that, and the ways in which we as community members and practitioners can reduce the stigma around the help seeking process. That not only is just a substance abuse treatment program but in nontraditional settings. All of us should have the idea of being a provider. All of us have an opportunity to intervene and support a person and a family as they are on their journey toward the recovery experience. Eliana, next slide.

So let's consider the onset of substance use disorders through the lens of the stages of human development looking at risk factors and protective factors. We're gonna take it back a little bit to the basics. We have the preconception phase prenatal and infancy stages. Well we know that there are genetics. There's a predisposition to alcohol use and exposure during the infancy and early development stages. Well what's happening there? Children are developing their temperament. Parental engagement and modeling processes are happening during that time. Well what about, what happens in middle school? Well we know in middle school there's some impulse control, aggressiveness, hyperactivity, ADHD and behavior issues that may start to develop, right. Look at risk a little more closely. Well what happens during adolescence? Oh, we know that that's some experimentation might occur during this phase. That's the time where behaviors are starting to take shape, conduct disorders, maybe early substance use, challenges with being able to cope, maybe some disengagement, right. So the young people are beginning to experience their identity. They're kind of growing into themselves and maybe sometimes even antisocial behavior, right. So start to maybe isolate or take on other experiences. And then youth and young adults. Now moving on to independence, moving on to figuring out more responsibilities. Substance use, peer relationships, maybe disconnection, leaving home. Maybe a lack of commitment with adult roles and other behaviors that occur during these stages. So what we do know, right, are that there are risk factors for substance use among youth. Excuse me, risk factors for substance use among youth which include the following. Guardian/parental supervision or lack thereof. There might be some undiagnosed mental health disorders that occur. Issues around abuse and neglect. There might be some aggressiveness and other disorders that begin to develop very early on. Maybe some challenges in school and having some academic difficulties. What about substance use among peers? As in access and availability of substances as well is something that we have to look at. Now here's the flip side of that. Protective factors reduce risk factors for youth substance use. So what are some protective factors? Well there's developing processes where young people are learning skill development around how to regulate themselves, right. Self-management, communication, communication patterns. How do we resolve conflict? Learning how to respond versus how to react. How do we engage with people who are other than ourselves? Social support very early on is very important. The development of healthy peer groups and the healthy relationships and teaching young people how to select these. And then also boundaries and structure and limit setting are all factors that contribute to reducing risk. Next slide, Eliana. Now here's some information. According to the National Institute on Drug Abuse analysis of of census and CDC data there is an ongoing trend of teen overdose that occurs and this is significantly increased since the pandemic 2019 and beyond. We have some work that we have to do. We have got to take a look at what is happening with our young people and we're gonna get into some of the reasons why this might occur in a few moments. Let's move on, Eliana.

Common reasons for substance abuse. Ready? Accessibility. Ready for this one? How about accessibility very close to home? Sometimes in the home. Family and or friends, on the street, otherwise in places where people can just go and get it right there. Social factors. The bandwagon effect, everybody's doing it. Advertising and marketing all over the place. We're influenced by these. Mental health conditions. So we're talking about management of symptoms, right. What are we feeling? What can we do to reduce the symptoms or minimize them for us? Stress. We're all doing more with less. Our young people are challenged by school, work, other competing responsibilities at home and or outside. Curiosity. We just kinda wanna know what's going on. What is it like? Everybody's talking about it. It's being glorified. What's happening there? I wanna kinda know. I'll just do it once. Experimentation. We also have to think about isolation, right. So lack of social support. Many people are isolated. They're staying away from families within the homes but then also challenges with engaging outside. We see the text culture, the social media culture, text messaging, internet, email. Not necessarily engaged with one another, getting together, having these kind of relationships that we had many years ago. It's just the culture has changed a bit. Desire to experiment, as we talked about. There's so many choices. So many things to choose from. And then there's this idea around escape. Just escaping the reality of life on life terms. Social media we talked about as well. Images all over the place. This desire for performance, high performing perfection. What are some of common reasons for substance use among young people? Accessibility, social factors, mental health conditions, stress, curiosity, social media, peer pressure, lack of social support, desire to experiment, and escape. Now before we get to the next slide, I don't know if you're in the chat if you have an opportunity, but take a minute. They are the top five reasons for drug use among teens. If you have a second plop it in the chat and tell me what you think it is. What might be some of the top five reasons for drug use among teens? Let's take a second and plug it in?

Uh-huh. Oh, yes. Accessibility, self-medicating, friends. Yes, depression and pressure, loneliness. Yes. Absolutely. All of them. Social all social media, back to back. Yes, peer pressure, social factors, depression, yes, feelings of sadness, feelings of hurt and pain, disconnection. Lack of knowledge, 100%. We just don't have the information. Absolutely. Runs in the family. That's right Patrick. It sure does. Wanting to belong. This whole bandwagon. I wanna be with everybody else. I can't go to my friends and say I'm not using. I'm not interested in that. I'll be isolated. Dysfunctional home. Predisposition. Yes. Absolutely. Yes, Jana. Sylvia said accessibility. So, Eliana, let's go on to the next- Yes. Oh, someone said dopamine rush. Yes, Barbara, wanting to feel good right away. Eliana, let's go to the next slide. Everybody was on track. Top five reasons. Stress, peer pressure, escape, curiosity, and social media. PTSD from past experiences. That's right, Catherine. Absolutely. We're challenged by those feelings and that recall. What is it doing for us? We're having feelings about that. What do we do? Sometimes we turn to substances and it turns into a maladaptive pattern of living. So what we're gonna do now we're gonna turn it over to Dr. Aristy and she's gonna say a few words to us around signs and symptoms of substance use. We're gonna learn some information here. Dr. Aristy, you got it.

Dr. Kristy Aristy:
Thank you, Dr. Kim. Eliana, you can change to the next slide. Thank you so much. So the first thing we're gonna do is we're gonna talk about cannabis. But before we begin talking about cannabis what I really wanted to do was to make sure that we're honing in on the ages or groups that we're describing. So the first group that we're talking about is Generation Z, right. Those are our youth who were born between 1995 through 2009. And we're talking about Gen Alpha, right, or Generation Alpha, those who were born between 2010 and 2024. Now I have a question for the audience. We've all heard the term cannabis before, right. I'm making an assumption here. What do you think is a slang name for Gen Alpha for cannabis? What do you think is a slang? Thank you. Thank you, Marsha. Weeds. That's a absolutely, weed. Mhm. Pot, weed. Mhm. Phonic, loud, pot. This becomes so important. Smoker. Very good. Excellent. Excellent. I wanted to give you all some slang terms that I think are so important when we're discussing each of these substances. So for cannabis- That's what we're here to learn, Walter. So what we're hearing as well is that for cannabis when you hear a Gen Alpha discuss this specifically you will hear terms like "spliff." You're gonna hear things like "poochie." You're gonna hear them talk about, "Oh, we're using those hairy ones." Literally, "hairy ones." You're gonna hear terms such as "love leaf." They still use the term "hydro" and of course you're also gonna hear the term "zoom," right. And zoom is usually when they have mixed cannabis with something else, right. So when we're listening to Gen Alpha and they're using these slang words it becomes very important to hone in on what they're discussing and how they're talking about these newer terms to described substances. So what do we see in these groups? So some of the signs that we see of course are, one, this strong smell on the clothes, right. In some cases the cannabis is so strong you can smell it in the hair or you can smell it as soon as they pass by you, right. There's a strong smell. Another sign of course are the red eyes, right, which is the classic sign in terms of cannabis users who have a history of substance use, right. And I want to be really mindful here, right, because if you have allergies you're gonna get red eyes, right. So we shouldn't go around accusing our adolescents of using substances, right. So again with people with the history of using substances a classic sign is red eyes which you're also gonna notice for our adolescents who have the use of cannabis is their eating habits, right. Most of the time, at least 86% of the time, you're gonna find that their eating habits have increased, right. Especially the snacking, right. The other thing is is that they're touching everything, right. So if they're sitting in your class they're like playing with a pencil, they're jittering, they're moving around, or they're putting their head down with their hoodie, right. Especially the 12 year olds or the 13 year olds, right. But you can see this in youth as early as age 10. Right. So those 14 year olds, those 13 year olds, and those 12 year olds, right. The classic sign of that is putting their head down and they're touching everything on the table, right. They're using those hyper kinesthetic movements. We also see that they have an increased heart rate and they have intense coughing, right, and vomiting and they may be nauseous. Now some of the symptoms that our adolescents experience, and this is common amongst all groups, but I want to hone in on the adolescents is they see brighter colors, right. What I often have heard from my youth is that, "Wow, you know, Miss Kristy, it's so bright in your office. It's just so vivid. When did you change the curtains? Is there a new light in here?" Right. So we often hear that they describe these brighter colors.

Another thing is that they have an altered sense of time and space, right, where they begin to talk about things like philosophy, life philosophy. And they begin to say, "You know, I didn't realize that this is the reason why a bookshelf is called a bookshelf." Right. When they begin to have these philosophical life conversations and they get in depth about those conversations. Okay. So, again, altered space and time. Impaired moving and thinking and problem solving are absolutely classic. But I would have to say with prolonged use this becomes more noticeable especially when it comes to problem solving and thinking. You will see if there's an early user I would say about the age of 10 you really get to see these damages of impaired thinking and problem solving through the age of 18 where they begin to have issues with memory. They also have issues with understanding and making choices and sometimes their consequential thinking skills are stumped even after the age of 18. Okay. So I just want to let you know that over a long period of time this progresses to get even worse with progressive users of cannabis. The other thing that they experience in some cases is delusions and hallucinations because we know that cannabis sometimes is mixed with a lot of things. We also know that it has a high component of THC, right, which means that they're getting a lot of this hallucinogenic effect in their body which means that they may see things or they may hear things, right. And then in some cases some of the youth get what we call an interrupted psychosis where they may immediately become paranoid or they may immediately attack someone or they may immediately fight or flight, right, because they went directly into a psychosis. We definitely see this a lot with mixed types of cannabis. Eliana, next slide.

You got it. Alcohol. I'm gonna ask the audience the question again. Tell me, tell me what are some terms that you've been hearing from Gen Alpha? Alcohol. What are some slang terms? Just pop it in the chat. Yeah. So we haven't heard a lot of this. Believe it or not they're still using terms as "syrup." We're hearing things such as "liquid gold." We're hearing things such as "wa-ter." Not water, "wa-ter," right. And then we also hear enhancements of "we got that sip." S-i-p, right. So these are common phrases that we're seeing with alcohol. Another thing to be mindful of is that there has been an increased access to alcohol especially after and during the pandemic. Alcohol was allowed to continue as a business through the pandemic and people were allowed to have home deliveries of alcohol which gave families a greater access to a substance, right. And alcohol is one of those substances that actually became more accessible in the home. So again I just want you to all know, that right. Sometimes pandemics, you know, really increase the symptoms or really increased access which is what Dr. Kim was talking about. And this just happened to be one of the substances. What the audience should also know is that there has been an increase in first time diagnosis with alcohol use disorder with younger groups, right, than we've seen in the past 15 years, right. So we're definitely seeing the increases and younger ages of people who are actually being diagnosed with alcohol use disorder. So some of the signs, again, the smell or it's on the clothes, it's on the breath. Of course there's impaired walking, there's slurred speech, and of course we want to talk about the dehydration. Right. Again, these are for chronic users, right, or moderate users. For mild users, right, so people who don't drink that often or adolescents that don't drink often we're gonna see these low blood pressure and we're gonna see slow slower breathing because alcohol is a central nervous system depressant. Now some of the symptoms include judgment, right. They have difficulty with consequential thinking skills. Another thing is any type of cognitive or bodily impairment which means that they tend to not be able to walk straight or think straight or make continued decisions. They have slurred speech and of course after long use you can also start to have blackouts and tremors. And in some cases depending on the group they may have some issues with psychosis, right. Especially if they're binge drinking, right, they're drinking a lot at one period of time. And it's not over weeks or days at a time, right. What we often see with binge drinking for adolescents is that they may have a larger incidence of psychosis because they're drinking so much at one time.

Next. Vaping. Lots and lots of questions about vaping. Oh, yes. They definitely, Carnita, they definitely do talking about what it means to get wasted as well. Right. And, yes, absolutely. They definitely have access to it after the pandemic. Right. It has definitely changed the way that not only we have it in our homes but how we get it delivered to our homes as well. Right. Absolutely. So vaping. Lots and lots of people talk about vaping. Now what are some of the terms, the common terms, we're seeing with Gen Alpha for vaping? Thank you, Eden. "Spliff." "Hit." "Puff." "Hit." Yes, The most common terms are "hit" and "puff." Absolutely. "Spliff," Eden, I have to tell you is the common term that is used for vaping when it has cannabis or THC liquid inside of it. Mhm. Yes, absolutely, Rose. Mhm. Absolutely. So, again, for vaping what we see in the signs is that they have shaking hands, right. They have definitely red eyes and irritation, right. Dry eyes, dry throat, dry mouth, absolutely. Loss of appetite. And we also see that when they are withdrawing because vapes in some cases although they list their nicotine content it may be estimated, right, when it is not through a larger company or through a dispensing store. That content, whether it's the nicotine content or the THC content, may be completely off athough it's listed at 6% or 8%. And what happens is it causes the irritation. Absolutely. We definitely see vaping in elementary school. We definitely see vaping in middle schools as well. Absolutely. Absolutely. They definitely have different shapes. They definitely look like kids toys. Absolutely. Mhm. Some of the symptoms over a longer period of time is excessive coughing or when they're first use. Right. Because if they're not used to having things impacting their lungs they may have excessive coughing. Right. Because it's a foreign agent going into the lungs.

The next is they definitely experience chest pain, right, where they're experiencing because of the coughing, right. And in some cases when they're in withdrawal we're seeing that they're getting high fevers, right, 101, 100, right. And we're seeing large- Especially for those younger groups that tend to that 14 year old where they may have to be sent to an emergency room or they may have to be sent to in urgent care. We're also seeing high blood pressure very, very early on. Right. Because it's a constant smoke with vaping and it isn't like a, and for lack of a better term, traditional cigarette where it actually burns out. There is less of a control on how much you're smoking. Right. So that's what we're seeing there as well. And then with prolonged use what we're seeing over 30 days is that there are larger cases of pneumonia for those who are moderate to severe smokers in vaping. And I'm trying to be very mindful of the time. Eliana, can we scroll to the next one?

Eliana:
No, it's okay. You're passionate.

Dr. Kristy Aristy:
I am about drugs. Okay fentanyl. Fentanyl. And really when we think about fentanyl it's really just a higher concentration of synthetic opiates, right. And we're gonna talk about opiates as well, but what I wanted to say about fentanyl is that there are many severe names that are absolutely associated with fentanyl. What have you heard in terms of some of the common words that are used in describing fentanyl. What are the common terms for Gen Alpha? Common terms. Oh, are we a little stumped? It's okay. Right. So what we're hearing with Gen Alpha is that it's called the "joy plan," right. They're saying, "Got that joy-joy. We got the hops. We got the hocus." Like hocus pocus. "We got the hocus. We also got the toxi." And then, "We got the toys," right. That's what's often used to describe fentanyl and opiates. Absolutely. Right. So when- Is this link collected from around the US or is this state? That's a very good question. Actually we're seeing this link across Gen Alpha in the United States as a common language, right. And you're also gonna find that a lot of this common language is being outposted, Astrid, in various social media, right. Very, very interesting. They even talk about this with Gen Alpha, Gen X, Baby Boomers, right. That social media has a lot of this research but you can also find a lot of this information related to slang and substances or just slang for a particular generation in many journals. Okay. So I just wanted to give you that. So let's talk about fentanyl, right. It's enormously a problem in the United States. It is literally problematic because it causes overdoses and it causes deaths, right. We know that we're in a period where the pandemic kind of overshadowed the epidemic of opiates just in general. Right. But let's talk about the signs which is the muscle pain. Absolutely. We definitely see the blues of the blues. Sure is. And pink too, Sebastian. We see the runny nose, we see the itchy skin, we see the dozing off, and those tiny, tiny pupils. Actually, Eden, we're gonna talk about "skittles." "Skittles" is actually used for MDMA, right. That's actually used, that term "skittles" is actually used for ecstasy, right. And we're seeing that across the board in the United States for that group in particular. That's interesting. That's very interesting. Thanks, Annabelle.

So some of the symptoms that we see is the dizziness, this blurred speech, insomnia especially over a period of time with a mild to moderate use. It doesn't even have to be severe, right. If they have prolonged use what we see is that they begin to develop insomnia. They also have sweating and muscle aches. Eliana, because I'm trying to be mindful of the time. Because I can talk about this forever. Okay. It's very similar to that of opiates and, again, very similar terms that are being used. But when they start to say things like "F bomb" they're specifically referring it to discuss or talk about fentanyl, right. So we definitely see that and I think that's amazing, Barbara. Thank you so much, right. When you can get Narcan for your schools, you know, there's a possibility that you can save lives, right. So thank you for sharing that. Opiates, again, I'm not going to go over the signs and symptoms because it's relative it's really the same and it could be just as moderate or just severe as fentanyl. So we're going to go to the next slide.

Benzodiazepines. Can I- What I'd like for you all to do in the chat is to tell me what is the language associated with Benzodiazepines for Gen Alpha. Benzodiazepines. Tell me. Mhm. Benzo. Thank you. Benzos. Absolutely. But we're also hearing the term "football." We're also hearing "sticks." We're also hearing "xannies." We're also hearing "bliss." We're also hearing "blue silk." We're hearing "snow." We're hearing "dove." That's associated with Benzodiazepine depending on the type of benzodiazepine that they're using. Yes, "benzo" is the most common term associated with it, but then there are the other terms that are associated with because they know that adults are listening and we understand the term benzos, right So it's easier to mask. So, again, some of the signs very, very common are the headaches. You're going to see a loss of appetite but you're also going to see excessive weight loss at a very rapid rate, right. And, again, these are for people who are using, right. Please don't diagnose your students. Right. I wanted to be very, very sure that we all understand that there's a very thorough markup that happens when we're diagnosing and there's a very specific set of criteria that we do. It's always good to refer a student to a professional. So, again, we're talking about people who are currently using or adolescents that are currently using. And they have a decreased sex drive and of course they experience nightmares. And one of the most common symptoms with benzos is tinnitus, right. And we're also seeing cramps as well. In terms of symptoms, right, what do we need to look out for? There may be a reduction of the normal pattern of a person's anxiety, right. A reduction of the person's muscle spasm, but they have all of a sudden an increased hostility or an increased irritability that is not normal or a part of their normal pattern of behavior. They also have issues where their chest is depressing because Benzodiazepines can act as a central nervous system depressant, right. And there's also this level of of drowsiness, as well as confusion, right. So these are symptoms that we should be looking out for in the classroom and begin asking these questions, right, like, "How are you?" We can go to the next slide.

Hallucinogens. Hallucinogens are we're seeing this all, you know, where people are just talking about this in different ways, right. Some kids are saying that's such an old school substance, right. Nobody uses that, right. That's a Baby Boomer or that is a, you know, a Gen X kind of drug, you know, that's kind of old school. But what we're seeing is that there's a rise in hallucinogens and often our Gen alpha are using terms like "mad men." They're using "blue star," "poke," "fake," "eddie," and "magic," right. We're also seeing with the hallucinogens and we're seeing this more in suburban areas where they're kind of there's an increase in these hallucinogenic uses. So again some of the things that we really, really need to look out for as educators, as professionals in the field is, you know, is there a new pattern of behavior where that youth or adolescence is experiencing delusions or hallucinations, hostility, irritability or is just now starting to have episodes of psychosis? So these are things that we have to look out for. Eliana, next.

And of course MDMA which is known as Ecstasy or Molly. What a lot of the younger generation Gen Alpha is saying is that they're calling this "popsicle." They're calling this "purple." They're calling this "rims." "Rims" is fairly new. I would say maybe around two months new. They're calling it "tabs." They're calling it "ice." They're calling it "fire." They're calling it "chalk." And, you know, culturally they're calling it "cajitas," right. Right. Or they're calling it "boxes," right. They're calling it, they have a lot of names for Ecstasy and Molly and we're seeing this as an increase in the inner cities where more and more youth are having access to it. And I would say around the 13, 14 and 15 year olds we're seeing this as an increase with use with this substance. And, yeah, I know. It is sad, right. But it's, but, again, like Dr. Kim was talking about, there is more access to these substances, right, depending on where you are. Okay. So with ecstasy obviously some of the signs that the family is probably gonna notice, you know, pretty immediately is an onset of anxiety, an onset of paranoia, an onset of psychosis. And they're for the first time experiencing hallucinations, right. So they'll, you know, usually the family unit sees these things really, really early on unless their first time use is in an educational institution and that would be the teachers and or the students who would probably notice this first. And some of the symptoms that we need to be aware of is not only these signs but alertness that they're really, really energized in the beginning. I am talking about really, really energized. Right. They can run a mile. They can jump over a locker. They also have sensory intensity which means that if a person bumps into them it's gonna feel like their arm is broken, right Or if they're going to smell things really from far away, right. And there's an increase in body temperature which can mimic symptoms of a fever. Okay. So, Dr. Kim, I have to give you back the floor. Thank you so much.

Dr. Kimberly Morris:
Thank you, Dr. Aristy. Lesson planning time. We're gonna take some next steps. Eliana, move us forward. You got it. So there's nothing better than a good call to action. In September every year we have National Recovery Month and this is a great opportunity for us to get together, schools, community organizations, faith organizations, to really bring awareness to the recovery process, to substance use, prevention, et cetera. Everything from learning about the different treatment modalities to celebrating people's recovery experiences. This is a wonderful time to really have a laser focus on substance use and on the process of recovery. We know that there is a true connection around prevention and recovery. We wanna raise awareness and we wanna get our students and our families involved. So September is National Recovery Month. You can do something as simple as putting a banner up at your institution of choice that just says "Celebrating National Recovery Month." Maybe have a nice wall where students can sign their names in recognition. You can have speakers to come in, create maybe a small wrap group session, a support group to just talk about what it is. But it's a great opportunity for you to do it and I encourage you since we have people from all across different states to look at your state's, I would say, I don't know what it would be called, but your state's specific office that deals with substance abuse education or otherwise. And we're gonna get into some national, some federal entities to do that. Let's move on to the next slide, Eliana.

Okay. As I mentioned, March of 2025 is National Drug and Alcohol Facts Week. A wonderful opportunity for students to come up with some community action projects, maybe highlighting one issue at a time. In the chat a little earlier someone indicated that they lost someone at their school for fentanyl overdose and someone else in the chat talked about- Was it fentanyl or something being accessed by a young person as early as- Vaping. It was in the vaping. That there was somebody vaping as early as four years old, learning how to vape. So this is a great opportunity to bring families together, talk about treatment and recovery options, and highlighting one issue at a time as I indicated. National Drug and Alcohol Facts Week, March of 2025. Please make it something that you do. Eliana, let's move on. NIH, National Institute of Health has an excellent, excellent website. And when you have the PowerPoint slides you're gonna get all the links and everything that you can see all of this. It's created by scientists. They have these lesson plans that you can use from Grades 6 through 11. All of the activities are interactive. They do everything from science to life skills, risks and consequences, and it's really, really great. You will love it. You will love using it. Eliana, move on to the next one.

Eliana Morris:
We're powering through here.

Dr. Kimberly Morris:
Yeah. And just to piggyback just because it's-- They have a series called "The Mind Matters" and we talk about all the different substances of use that Dr. Aristy talked about. Opioids, cocaine, inhalers, marijuana, methamphetamine, nicotine, prescription stimulants, K2/Spice and bath salts. They're also available in English and in Spanish. There's the teacher's guide and there's the students handouts that you can use. But they're really, really wonderful. You can actually download them for free all of these resources available as well. Eliana. And then another one, "Get Smart About Drugs" as well is provided by Operation Prevention. Now this is a really great website, you know why? Because they actually have you to take a virtual field trip and that could be fun for the class, right. So everything is around substance use prevention, a resource guide that's available. They talk about careers in science, careers in education around substance use, education around social science. And everything is created by scientists and recommended opportunities for further research. This is a great point if you want to get your students involved in some specific projects as well. This is a great place to start. Let's move on to the next slide. And, again, as I mentioned, all of this information is here for you. You can do the Mind Matters for NIH. You can click on the research for parents, the information on how to kind of curate an activity around National Drug and Alcohol Facts Week, to Get Smart on Drugs, the DEA resources that are available. Next slide, Eliana. Same deal again, just breaking down some points that could help you. And again I'll definitely put myself out there if you wanna maybe talk through an activity or have some ideas or you wanna talk through an idea you wanna put together at your school. That's my wheelhouse Please feel free to email us and I'm happy to talk through maybe an idea with you that you can help to put together at your place of business. Next slide.

Eliana Morris:
All right. So now we're gonna kind of open it up for questions. Please use that question mark button on your screen if you have a question. We've already had a bunch come through. So I'll just start reading these out to you guys and you can kind of go from there.

Eden asks, "What would be good data to share to youth when they say that edibles are fine because it's not smoking?"

Dr. Kristy Aristy:
Oh, that's great. So if you go to the DEA website there are lots and lots of information and lots and lots of fun facts related to edibles.

Eliana Morris:
Great. Thank you. Thank you. And then Eden also asked, "Do the heat settings on a vape show more signs of damage in the lungs?"

Dr. Kristy Aristy:
Most of the damage that they see through the lungs are actually done through X ray, right. And it also depends on the individual and what the vape is, how much they're inhaling, the type of substance that they're inhaling. There are many factors to that. Okay. Thank you.

Eliana Morris:
Marshall asked, "Do people use straight fentanyl or is it always mixed into other substances?"

Dr. Kristy Aristy:
No, people use fentanyl, right. And people are prescribed fentanyl in some cases especially if they're going through pain management. So, yes, some people do have a prescription for fentanyl in its only use. Now as a street drug you're gonna see that, yes, it is sold on its own as well. Right. And people are using it on its own. But more commonly what we see is that it is mixed and that is what's causing the most harm in terms of overdoses and the problems, right, and complications related to opiate use.

Eliana Morris:
Thank you, Dr. Aristy. Another person asks, "Is it okay that for withdrawal of high risk addictions one can switch to low risk addictions, like for withdrawal of smoking one can use nicotine patch, et cetera?"

Dr. Kristy Aristy:
We call that harm reduction, right, and it is a commonly used framework and evidence-based practice in the field of addictions across the United States.

Eliana Morris:
Absolutely. And is there a price advantage to the users of the type of drug used? Like is there- I think this question is asking is there a reason like is there a financial reason as to why people are using specific drugs?

Dr. Kristy Aristy:
That's an interesting question. Some of this, and I would have to say that has not been widely studied on the Gen Alpha group. What we see is really it's an issue of access and that's what Dr. Kim wastalking about. What do I have access to? Whether it's in my community, whether it's in my home, whether it's being sold in front of my school, what do I have access to? Usually that's one of the largest common factors associated with the type of use but there's also cultural factors which I saw in here earlier. What is considered culturally appropriate? In some communities there may be large groups who may be using cannabis, right. So it looks like it's socially appropriate. There may be some who are using alcohol or they have family events where alcohol is always served, right. So it could be a cultural thing as well as access to the particular type of substance. And yes there are some substances that cost more than others. So prescribed drugs are always more expensive than illicit substances.

Eliana Morris:
Okay, great. Thank you. Okay, here's another one. If one is getting rid of stress, depression, and anxiety like dangerous life-threatening diseases by using such substances then what is wrong with it?

Dr. Kristy Aristy:
If you're looking at this from a theoretical framework such as harm reduction the idea is to incorporate education for safe use. If you're going to use let's talk about how to use safely. Let's educate you so that you're not harming yourself and that you're not harming other people. So again, if you're looking at use from that framework the idea here is you still need education because we want you to live even though you're choosing to continue to use until you're able to work through the root issue of the problem.

Eliana Morris:
Absolutely. Do the parents of a student caught with drugs or alcohol get help as well?

Dr. Kristy Aristy:
Yes. We call that in the United States collateral sessions. So normally they can enroll in family treatment. If they're mandated it's usually the entire family that receives treatment. However if it's just the adolescents who is using the substance it's voluntary for the family in some cases to participate in treatment.

Eliana Morris:
Wonderful. Katrina has a really interesting question that I've never really thought of before. She asks, "What is hookah classified under?"

Dr. Kristy Aristy:
Actually hookah is its own category but it can be between tobacco use depending on it or it could be cannabis use or depending on how it's shaped it could also be considered just under smoking, smoking and misuse because it's not considered a vape. And so if the hookah has THC and the person is actually using a cannabis block or a THC block it would fall under that category. If the person is using tobacco it would fall under that category.

Eliana Morris:
Gotcha. Gotcha. Thank you. Okay. Are you seeing an increase in heroin?

Dr. Kristy Aristy:
Correct.

Eliana Morris:
You are?

Dr. Kristy Aristy:
Across the United States, correct.

Eliana Morris:
Okay. How can we decrease youth access to substances? Why are the substances so widely available to youth?

Dr. Kristy Aristy:
That's a tricky question and here's the deal. There's a whole history as to the reason why there are so many drugs in the United States, right. And we can do an entire presentation on the history of substances in the United States. I think the easiest way to talk about the reduction of substance use in the community is to first identify that it's there. The second is to not have the attitude and not my backyard, right. And to actually have open conversations is also to increase prevention and prevention education that will really even though the substances that are there children who are more educated about substances over periods of time have been shown to be less likely to use substances.

Eliana Morris:
Okay I'm gonna ask a few more questions and then we're gonna move on just because we are getting close to that 4 p.m. Eastern mark and I wanna be, you know, the cognizant of everybody's time. Can you speak at all to edibles?

Dr. Kristy Aristy:
Dr. Kay, do you wanna take this or do you want me to take this?

Dr. Kimberly Moore:
Okay. Here's the thing, which edible are you talking about? Are you talking about lollipops? Are you talking about gummy bears? Are you talking about biscuits? Are you talking about brownies? Are you talking about cakes? What are we talking about when we're talking about edibles? When we're thinking about edibles what I have to say to you is that we have to be very careful if it's made with illicit substances. Illicit substances are literally in some cases made with rat poisoning, roach spray, pesticides, and when you bake it into a brownie, a muffin, a cake, or you- Oh, yes, Carrie. And or you take the oils and put it into gelatin pops to actually crystallize and make it a pop. I'm not gonna give you the formula here but I'm just saying when you do, when that occurs it gives you a higher prevalence of being poisoned. So again when it's made from illicit substances what happens is that you have a higher prevalence of being poisoned. Okay. When, you know, these are made through dispensaries, when these are made through distributed sellers that understand the chemical component of their plants they're safer. However there has been an increase in people going to the hospital because they're using edibles.

Eliana Morris:
There's a lot more questions but like I said I wanted to just get through the rest of these slides. I know that you all have a lot of questions and I'm sure both Dr. Aristy and Dr. Moore are available to answer those questions after the webinar as well. Am I correct about that?

Dr. Kimberly Moore:
Yes. Correct.

Dr. Kristy Aristy:
Yeah. I hear some of the audience are like, "Can you please do a part two?" And I'm like, "Yeah."

Eliana Morris:
We can definitely, you know, try to make that happen. Okay. So I did just want to go over a couple of things regarding the online Master of Social Work degree at Yeshiva University. We are as the moderator of this webinar I did want to take a moment to address what this program entails. You know, demand for social workers is gonna grow nine percent by 2031 which is a huge growth. It's much faster than average. Social work is also one of the broadest fields out there. I'm sure that Kristy and Kim would agree with me that there's many different ways to practice social work and it isn't just being a therapist, it isn't just working in addictions. It's you're kind of like a jack of all trades. Now the program here at Yeshiva University highlights things like cultural diversity, research methods, intervention and advocacy, professional ethics. Practical field work opportunities are available to apply your learnings and if you do have a bachelor's in social work specifically from the last five years advanced standing is available. So some of the really great things about this program, it's 100% online and 100% asynchronous. So that means there are no mandatory logon times, campus requirements, or Zoom classes. You do it on your own time pretty much at your own pace. There are always weekly deadlines and some group projects. But for the most part it's a very self-directed and self-paced program. Now I am going to ask if you're interested in learning more about the 100% online MSW please feel free. I'm starting a poll. You can go ahead and if you want more information we will reach out to you. So I'll just leave that open for a minute. Thank you both, Kristy and Kim, so much. This has been absolutely amazing. Thank you for joining us today. If you have questions for me about the MSW program or for Kristy and Kim I'm happy to forward those on. Feel free to reach out to onlinemsw@yu.edu. Wanted to share some citations and some references with you guys as well. Thank you all so much. I hope you have a wonderful afternoon and a great rest of your week.

Dr. Kimberly Morre:
Thank you, everyone.

Dr. Kristy Aristy:
Thank you everyone for participating.