Treatment is Effective Behavioral Health is Essential to Health - PowerPoint Presentation

Slide1

Treatment is Effective

Behavioral Health is Essential to Health

Prevention Works

People Recover

Improving the quality of life for

West

Virginians with behavioral health needs

West Virginia Department of Health and Human Resources

Bureau for Behavioral Health and Health FacilitiesSlide2

Synthetic DrugsSlide3

Cathy Coontz, MA, MS, PSII, NPN Prevention Lead for WV andNational Prevention Network for WVFunded by:This training is funded by a grant from the U.S. Department of Health

and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, and the West Virginia Department of Health and Human Resources, Bureau for Behavioral Health and Health Facilities. Slide4

Learning ObjectivesThis session will help the participant:Increase awareness about the impact of bath salts and synthetic marijuana use/abuse in WV

Recognize signs and symptoms and appeal of synthetic drug useIdentify the drug and packaging as well as the dangers of use/abuseSlide5

Bath SaltsBath Salts are synthetic stimulant drugsVERY DANGEROUS: addictive and potentially lethalMore potent than cocaineNot

organic-made with chemicalsThey do not contain fragrant soaps or oils, yet they are packaged to seem soSlide6

Bath SaltsCrystalized powder that can be white to brown, with shades in between and even speckled.Typically

an attractive package about the size of a tea bag.The label says “Not for Human Consumption”Manufactured mainly in China or India. There are labs in the US…Slide7

This is an example of

packaging. The size is slightly larger than a tea bag. Slide8

Bath SaltsAccording to the Drug Enforcement Administration, active ingredients in bath salts are:Methylenedioxypyrovalerone (

MDPV) and/or mephedroneMDPV and mephedrone are synthetic and addictive chemicalsSlide9

Bath Salts IngredientsMDPV (methylenedioxypyrovalerone)CFT (cocaine analog) mephedrone (amphetamine) cathinone (khat)naphyrone

(like amphetamine) 2-dPMP (2-diphenylmethylpiperidine or desoxypipradrol - like methylphenidate)Slide10

Slang Names for Bath SaltsInsect repellantPond scum remover Jewelry Cleaner Plant foodToy cleanerWater softener

Legal CocaineSlide11

Names on Bath Salt Packaging

Aura

BlissBloom

Blue SilkBolivian BathCharge +Charge PlusCloud 9Cloud NineEuphoria

Scarface

SextacySnow LeopardStardustTranquilityVanilla SkyWhite DoveWhite LightningZoom

Hurricane- Charlie

Ivory Coast

Ivory Wave

Lunar WaveOceanOcean Snow Pure IvoryPurple WaveRaving DragonRed DoveSlide12

Bath Salt CostsPrices range from $25 to $50 for 50 mg or ½ gram – depending where bought.Some use up to 200 mg. depending on their tolerance for drugsUsers say: “use 10th of what you would use for cocaine”Lots of stories about being careful about using too much can cause a really bad experience.Slide13

Common Home PackagingSize of a 50 cent pieceAverage price $30

Pictures

provided by Lt. Thomas J. Reagan

Bangor Police DepartmentSlide14

Where Bath Salts are PurchasedInternet as bath salts and/or “legal high”Some local shops hide it behind the counter (convenience stores)Head shops Slide15

Pictures

provided by Lt. Thomas J. Reagan

Bangor Police DepartmentSlide16
Slide17

What is the appeal?EuphoriaSociabilityStimulationSexual ArousalMusic AppreciationHallucinationsSlide18

Because “bath salts” are relatively new to the drug abuse scene, scientists are still unsure about what their long-term effects might be for those who try to use them recreationally. But one thing IS certain: it’s NOT worth the risk of finding out.Slide19

Demographic PrevalenceMales and femalesAges early 20s to 50sSeeing more and more young men in their 20s and increase in femalesTeenager use on the riseSlide20

Bath Salt Use in WVBath Salts abuse and problems associated with abuse are increasing at an alarming rate.2009-no

calls to Poison center for bath salts2010-304 calls (WV reported 4)2011-6,138 calls (WV reported 253)2012-

2,656 calls (WV reported 45)Slide21

Bath Salt UseCan be used in a variety of ways in a liquid form:SmokedSnortedInjectedOthersSlide22

SmokedBy soaking cigarettesWith a crack pipeOff of foilSlide23

SnortedSlide24

InjectedSlide25

Other MethodsOralCapsules, ‘bombing’-wrapping MDPV powder in cigarette papers and swallowing, dabbing, dissolved in liquidRectalEnema (user report:

1 mg mixed with 3 mL water)VaginalSoak tampons in solutionSlide26

Bath Salts Side Effects200 times MORE potent than RitalinSlide27

Bath Salts SymptomologyParanoia HallucinationsAnger Intense cravings to re-doseLoss of coordinationIntense thirst

Dry mouth Panic/anxiety VomitingDizzinessProfuse SweatingHyper alertnessViolenceElevated Blood pressureJaw clenching/tooth grinding (Bruxism)

DelusionsMood swingsDepressionSuicidal thoughts Slide28

Effects of MDPV“High” lasts 3-4 hours (or even days)Physical effects may last 6-8 hoursMay cause seizures, panic attacks, or psychosis with high doses or increased frequency of useAverage

dose approx. 5 to 20mgSlide29

VideoSlide30

Other Adverse Side EffectsSuicidal thoughts and actionsSelf mutilationRunning around, screamingThere is no crash – effects can last for days and wax and wane over the timeParanoia can be extreme – think someone or something is out to get them – weapons have been involved – guns, knives, hatchets, etc. Slide31

What to Look ForAgitation with or without violenceMay be catatonic (lights on – no one home)May get violent after catatonic state with little to no warningParanoia, yellingLarge pupils (not always)

“The Stare”Sweat and thirstSlide32

What to Look ForJerky body movementsGrinding of teethEuphoria and stimulation for hoursPsychotic for hours to days or longerSlide33

Labeling“Not for Human Consumption”Printed warning loophole to evade scrutiny from Food and Drug Administration (FDA) Slide34

LabelingThat’s why manufactures pretend that they are “bath salts, plant food, or water softeners”. But think about it: since when does plant food or bath powder cost $50 a milligram?In 2010, the DEA reported that MDPV and mephedrone were “related in chemical structure” to illegal drugs like Ecstasy,

cathinone and methamphetamine. In other words “bath salts” are essentially analogs, or chemical cousins, to illegal drugs.Slide35

WV House Bill 2505SUMMARY: Adding synthetic cannabinoids and hallucinogens and stimulants to the Schedule I list of controlled substancesWhat does this mean?

Now a misdemeanor to sell, buy, possess synthetic drugs in W.V.This bill was passed by both House and Senate and approved by the Governor in April 2011.Slide36

US Senate Bill 3187 (112th Congress-2

nd Session)SUMMARY: Added synthetic cannabinoids (K2, Spice), methylenedioxypyrovalerone (MDPV) and mephedrone (bath salts) to the Schedule I list of controlled substances. What does this mean?

Now a federal crime to sell, buy, or possess synthetic drugs in the U.S.This bill was passed by both House and Senate and signed by the President on July 9, 2012.Slide37

Is it in West Virginia?Some think “this is not happening in my county/city/town/neighborhood”THINK AGAIN

It IS in our back yardSlide38

BARBOUR 1

BERKELEY

BRAXTON

BROOKE

CABELL

CLAY

FAYETTE

GILMER

GRANT

GREENBRIER

HAMPSHIRE

HANCOCK

HARDY

HARRISON

JACKSON

KANAWHA

LEWIS

LINCOLN

MCDOWELL

MARION

MASON

MERCER

MINERAL

MONONGALIA

MONROE

MORGAN

NICHOLAS

OHIO

PENDLETON

POCAHONTAS

PRESTON

PUTNAM

RALEIGH

RANDOLPH

RITCHIE

ROANE

SUMMERS

TUCKER

TYLER

UPSHUR

WAYNE

WEBSTER

WETZEL

WIRT

WOOD

WYOMING

ANTS

PLEAS-

RIDGE

DODD-

HOUN

CAL-

MARSHALL

JEFFERSON

TAYLOR

MINGO

LOGAN

BOONE

Legend

1-5 Calls

6-10 Calls

11-15 Calls

16-20 Calls

20+ Calls

2011 Bath Salt Exposure Calls By County

Harrison County lead the state with 45 Bath Salt Exposure Calls

Kanawha County is second behind Harrison County with 39 Bath Salt Exposure Calls

Source: National Poison Data System; Human exposure calls by product code 1/1/2011 through 12/31/2011Slide39

BARBOUR 1

BERKELEY

BRAXTON

BROOKE

CABELL

CLAY

FAYETTE

GILMER

GRANT

GREENBRIER

HAMPSHIRE

HANCOCK

HARDY

HARRISON

JACKSON

KANAWHA

LEWIS

LINCOLN

MCDOWELL

MARION

MASON

MERCER

MINERAL

MONONGALIA

MONROE

MORGAN

NICHOLAS

OHIO

PENDLETON

POCAHONTAS

PRESTON

PUTNAM

RALEIGH

RANDOLPH

RITCHIE

ROANE

SUMMERS

TUCKER

TYLER

UPSHUR

WAYNE

WEBSTER

WETZEL

WIRT

WOOD

WYOMING

ANTS

PLEAS-

RIDGE

DODD-

HOUN

CAL-

MARSHALL

JEFFERSON

TAYLOR

MINGO

LOGAN

BOONE

2011 Bath Salt Exposure Calls By Region

Source: National Poison Data System; Human exposure calls by product code 1/1/2011 through 12/31/2011

Region 1: 34 Calls

Region 2: 10 Calls

Region 3: 20 Calls

Region 4: 67 Calls

Region 5: 96 Calls

Region 6: 26 CallsSlide40

K2/Spice (synthetic marijuana)Synthetic drugsSynthesized to mimic effects of marijuanaMore potent than THCNot

organic-made with chemicals (sprayed on plant material)When burned this substance usually has a pleasant odor…Slide41

K2 NationallyAmerica’s poison centers first received calls about “synthetic marijuana” in late 20092,960 calls in 2010--36 calls in WV6,955 calls in 2011--77 calls in WV

80% of these calls placed from ER, compared to 20% regularlySlide42

K2 in West VirginiaWest Virginia Poison Center36 human exposure calls received in 201077 human exposure calls received in 2011West Virginia Poison Center has reported an increase in K2 exposure calls in 2011 used in combination with other drugs since 2010House Bill 2505 banned the sale of synthetic cannabinoids in June 2011Slide43

K2 FactsChemicals were developed in lab for research for pain in cancer patients-much like medicinal marijuanaRecipe was destroyed because of adverse effects in lab animalsNot tested on humans, affects are not fully knownChemist in China and Korea started using these chemicals for

K2Slide44

K2 FactsMarketed as incenseK2 is typically sold in small, silvery plastic bags of dried leaves and marketed as incense that can be smokedResembles potpourri (usually sprayed on lemon grass or other herbs/plant material)

Marketed toward youthSlide45

What is the appeal?It produces a high similar to that of marijuana It doesn't contain tetrahydrocannabinol (THC), the psychoactive chemical in marijuanaK2 contains synthetic chemicals, known as JWH-018 and JWH-073, that mimic THC by acting on the cannabinoid receptors in the brain  

It binds with the CB1 receptor and produces a euphoric effect or high in humans. JWH-018 binds with CB1 receptors at a rate four times greater than THC (natural or synthetic)The common marijuana drug tests are calibrated to detect THC and THC metabolites, not the synthetics used in Spice or K2Slide46

How is it made?A mixture of herbs and spices (or just grass clippings)Typically sprayed with a synthetic chemical such as: e HU-210, HU-211, JWH-018, and JWH-073.The chemicals are known to stay in the human body for a long time.The

long term effects of the chemicals are unknown. Slide47

What does it look like?Slide48

How is it used?Smoked in jointsSmoked in pipesMixed in teaSlide49

Street NamesSpiceK2GenieYucatanFireSenseSmokeBlack MambaFake WeedDesigner

drugsSkunkBlissBombay BlueZohaiSlide50

Where is it sold?Mainly Online (Since 7-9-12)“Head Shops” Tobacco Outlets Various Retail OutletsGas Stations/Convenience StoresAccording

to the DEA, “Manufacturers of this product are not regulated and are often unknown since these products are purchased via the Internet whether wholesale or retail. Several websites that sell the product are based in China.”Slide51

Price$30 to $40 +/- per 3 gram packet.Price on Community:

DUIs with fatalitiesSuicidesDrug abused to evade drug screenings Slide52

EffectsDizzinessNauseaVomitingAnxiety ParanoiaRapid Heart BeatIncreased Blood Pressure

Loss of Consciousness Paranoid BehaviorIntense Hallucinations AgitationSeizuresSlide53

What can you do?Don’t feel helpless! Become educated about synthetics drugsTalk about it with neighbors, relatives, and co-workers The best prevention is setting clear expectations and guidelines for your kids and kids you know. They will listen…Slide54

Talk about it!Get the word out about “bath salts.” Contact your local Drug Free Coalition and ask them to have a forum or a community presentation.Get articles out in your local news papers.If someone you know experiments with “bath salts” don’t hesitate to get professional help.Slide55

ReferencesDrug Enforcement Administration, www.dea.gov American Association of Poison Control Centers, www.aapcc.orgk2spicediamond.com (this is an internet store)

stopthedrugwar.orgk3spice.blogspot.com (this is an internet store) CADCA Webinar – Designer Drugs: The New Frontierwww.fox59.com/news/wxin-lafayette-spice-ban-081810,0,5699301.storyNorthern New England Poison Center, www.nnepc.orgBangor Police Department, Bangor, Maine Web

MD www.webmd.comSlide56

ReferencesNational Institute on Drug Abuse, www.nida.nih.govOffice of National Drug Control Policy. www.whitehousedrugpolicy.govHouse Bill

2505, www.legis.state.wv.us/Bill_Status/Bills_history.cfm?input=2505&year=2011&sessiontype=RS&btype=billErowid, www.erowid.orgwww.mainelegislature.org/legis/bills/bills_125th/billtexts/HP119201.aspSlide57

Contact InformationCathy Coontz, MA, MS, PSII, NPN Prevention Lead for WV andNational Prevention Network for

WVDivision on Alcoholism and Drug AbuseBureau for Behavioral Health and Health Facilities350 Capitol Street, Room 350Charleston, WV 25301Cathy.E.Coontz@wv.gov