Why do people use drugs?  They want to

• change the way they feel
• to fit in with peers,
• to be less inhibited
• they’re bored
• life sucks (they’re angry, jealous, sad, abused)
• “for the fun of it.”

Judgment in drug-use is not helpful for a physician as it does not help the patient.

What drugs are kids using?  It depends on their age and their access to get drugs.  They can easily get marijuana, tobacco, and alcohol.  The easiest drugs for them to get are the deadliest: spray paint, cough medicine, or the parents prescription pills.  Coricidin Cough and cold (Triple C), Robitussin or delsym are cold medicines that are often taken in excess and used for a “high.”

I reviewed the YRBS for Nevada.  This is the Youth Risk Behavior Survey which gives statistics on regional risky behavior use.  Cocaine, Ecstasy, and meth use is decreasing in Nevada.

Of note, marijuana affects brain growth until age 25, even if it is legal.

Urine drug screens include two tests: an immunoassay which is for screening and then a gas chromatography-mass spectrometry is used as a confirmatory test if the screening test is positive.  The confirmatory test is to make sure there wasn’t a false positive test.  There are medications or foods that can make a urine drug screen look positive, when the patient has not taken that drug.  Physicians should know how long a urine drug screen will test positive after use.  Some drugs are detected in the system over 30 days, depending on length of use.

To screen for adolescent substance abuse.  CRAFFT Screening Interview.  http://www.caesar-boston.org/CRAFFT

How to reduce drug use? The only answer is multidimensional family therapy.  The kid is using for some reason, find the reason.  The whole family needs to have family sessions together.