Webinar Presentation Video

A video recording of the Fairfax County Youth Substance Use Trends Webinar is available in the following languages: English, Amharic, and Spanish.

Objectives

Increase awareness and understanding of:

• substance use trends among youth 
• risk factors associated with substance use
• opioids and the dangers associated with them
• signs of substance use and overdose
• prevention and treatment resources available and how to access them 

Moderator

Stefan Mascoll, Fairfax County Public Schools (FCPS) Coordinator for Student Safety and Wellness

Panelists:

• Fairfax Health Department – Adam Allston/René Najera
• Fairfax County Police Department (FCPD) – Anne Rizza
• FCPS –Stephanie Beguin-Howard/Kelly Rankin
• Fairfax-Falls Church Community Services Board (CSB) – David Edelman/Birgit Snellenburg and Marla Zometsky
• Fairfax County Neighborhood and Community Services (NCS) – Jesse Ellis

Local Effects of the National Epidemic

• The decrease in fatal and non-fatal opioid overdoses in the Fairfax Health District (Fairfax County, Fairfax City, and Falls Church City) observed between 2017 and 2019 did not continue past 2020
• Similar to national and state data, local data on fatal and non-fatal opioid overdoses has been trending higher in 2021 compared to 2020
• Individuals of all ages are impacted by the opioid epidemic, with those in the 18 to 34 age group having the highest rates of fatal and non-fatal overdoses in the Fairfax Health District in recent years.

Overdoses in Adolescents

• Data on overdoses among adolescents, age 12-17, from Emergency Departments and Urgent Care Centers in Fairfax County, Fairfax City, and Falls Church
• After a decrease from 5 cases in 2016 to none in 2019, the number of opioid overdoses has increased to 11 in 2021
  • 6 as of March 21, 2022
• •Fentanyl is the opioid identified in most overdoses among all age groups

FCPD Overdose Investigation Unit (OIU) 

• 2021: 271 Non-Fatal Overdose Investigations
  • Nearly 50% had previously overdosed
  • 9 involved individuals under 18
• 2022 (as of 3/20/2022): 49 Non-Fatal Overdose Investigations
  • 7 involved individuals under 18
• 2021: 89 Fatal Overdose Investigations
  • One involved an individual under 18
• 2022 (as of 3/20/2022): 17 Fatal Overdose Investigations

OIU: Trends/Awareness

• Significant increase in the presence of fentanyl in counterfeit prescription pills (Percocet/Xanax)
  • DEA lab testing reveals 4 out of every 10 pills with fentanyl contain a lethal dose (dea.gov)
• Fentanyl is a common substitute or cutting agent in illicit narcotics such as Cocaine, MDMA, and Heroin

Why is fentanyl so dangerous?

Fentanyl is a powerful synthetic opioid analgesic, similar to morphine, BUT is 80 to 100 times more potent. There have been cases where other substances have been laced with fentanyl, increasing potency.
source:  DEA

What To Look For

Slide includes photos of authentic and counterfeit versions of Percocet and Xanax.

Safeguards & Law Enforcement Response

• Encourage guardians to monitor juvenile associations and whereabouts
• Urge guardians to regularly review correspondence through electronic devices and social media
• Following an overdose incident, the primary objective of law enforcement is to identify and apprehend the source of supply
  • Victim/Guardian cooperation is key in tracking down the source of supply but more importantly locating & confiscating any additional substances the victim may have access to

Self-Reported Substance Use

Percent of FCPS 8th, 10th, & 12th graders who report using substances in the past month, 2019 Fairfax County Youth Survey

Graph of Top Substances of Concern at Time of Referral to FCPS SAP Program
Source: FCPS SAP Data (2021-2022 School Year through Feb 2022)

Why Youth Use Substances

Photo of students

Why Do Young People Use Drugs

• To fit in: Peer pressure or perception of peer use
• To feel good: feelings of pleasure or euphoria
• To feel better: dealing with trauma, mental, emotional, physical pain or stress
• To do better: physical or cognitive performance enhancement
• To experiment: new experiences, coping with boredom
• Addiction and dependence: increased tolerance, chronic drug seeking adverse symptoms associated with withdrawal

Source: National Institute on Drug Abuse, bit.ly/36mBchn

Addiction

• Many Americans are impacted by addiction in some way.
• Addiction does not care about race, religion, ethnicity, or socioeconomic status. It can happen to ANYONE.
• Every person who suffers from addiction started with that first drink, pill, or puff.
• Educate yourself or ask a SAPS about the Stages of Addiction.

What is Addiction?

• A Brain Disease
• Addiction is characterized by:
• Inability to consistently Abstain;
• Impairment in Behavioral control;
• Craving, or increased “hunger” for drugs or rewarding experiences;
• Diminished recognition of significant problems with one’s behaviors and interpersonal relationships; and
• A dysfunctional Emotional response.

Source: 2016 American Society of Addiction Medicine

Drugs and the Adolescent Brain

• Dopamine levels are lower in teenagers, means they feel BORED and makes them more susceptible to false surges of dopamine delivered by drugs
• Reward system highly developed in teenagers, but prefrontal cortex not so much
• More likely to take risks and only pay attention to the positive part of their decisions/actions
• Dopamine creates feelings of calm and control.
• Major changes in the brain during this time. Pruning, forming new neural connections, and myelin.

Source: National Institute on Drug Abuse and Siegel, Dan, Brainstorm, 2014

What are Opioids?

Opioids is a term used for the entire family of opiate drugs, including natural, synthetic and semi-synthetic.

These drugs are chemically related and interact with opioid receptors on nerve cells in the body and brain.

OPIOID DRUGS INCLUDE:

• Heroin                        
• Buprenorphine
• Codeine
• Fentanyl
• Hydrocodone
• Percocet = Oxycodone + Acetaminophen
• Hydromorphone
• Meperidine
• Methadone
• Morphine
• Oxycodone

What are Opioids? (continued)

• Opioids are HIGHLY addictive.
• Opioids are necessary pain medications used everyday to help people manage pain.
• Opioids can also be illegal drugs sold on the street.
• Opioids are responsible for the majority of drug overdoses in the nation and Virginia.
• Opioids prescribed by doctors can be abused and may lead to addiction (i.e. sports injuries, etc.)
• ANYONE can become addicted to opioids.

Side Effects of Using Opioids

• Increased sensitivity to pain
• Anxiety & depression
• Slowed breathing
• Severe constipation
• Difficulty urinating
• Decrease in immunity
• Organ failure

What Does an Opioid Overdose Look Like?

• Not Responding - Doesn’t move and can’t be woken
• Slow or Not Breathing - A breath every 5 seconds is normal
• Making Sounds - Choking, gurgling sounds, or snoring
• Blue Lips & Nails
• Cold or Clammy Skin
• Tiny Pupils

Opiate Withdrawal Timeline

Image of the timeline for opiate withdrawal
After last dose, symptoms last 6-12 hours for short-acting opiates.
After last dose, symptoms last 30 hours for long-acting opiates.
After 72 hours, symptoms peak (nausea, vomiting, stomach cramps, diarrhea, goosebumps, depression, drug cravings)

What Can Parents Do?

Signs and Symptoms at Home

• Avoiding contact or conversations
• New friends you don’t know
• Increased mood swings, irritability, outbursts of anger
• Changes in eating and sleeping patterns
• Missing money or prescriptions
• Changes in physical appearance
• Loss of interest in hobbies or sports
• Lying (especially about who, what, and where)
• Secretive conversations with friends

Signs and Symptoms at School

• Skipping school (classes or full days)
• Suspension
• Failing grades
• Falling behind in class work
• Lack of motivation, apathy
• Excessive sleeping in class (especially after lunch)
• Defiance of rules, constant discipline issues
• Cheating
• Stealing
• Freely talking about drug use
• Erratic behavior changes on a day to-day basis

Communicating with your Teen about Drugs

• Approach them from a place of love.
• Talk about the why behind the use.
• Communicate clear family rules and expectations of your teens.
• Get them involved in positive activities.
• Help them access treatment or other forms of help.
• Be a good role model.

3 to Succeed

YouTube Video: 3 to Succeed - the Factors That Matter in a Child's Life

Prevention Strategies

• Parental/Caretaker Supervision
• Talk to your child about drugs and family rules/expectations around substance use
• Get teens involved with sports/activities/clubs/hobbies
• Be a positive role model
• Get child/family treatment for trauma, grief, family addiction, mental health concerns, etc.
• Take care of your physical, emotional and mental health.

Prevention Strategies

• Talk with your doctor about pain management and avoid unnecessary opioids; ask about alternatives.
• Never take opioids in greater amounts or more often than prescribed.
• Never sell or share prescription opioids.
• Monitor your child’s use of prescription medications
• Dispose of medication and lock up prescriptions, other commonly abused substances, & alcohol (contact your SAPS for medication lock boxes and disposal kits or visit a local CSB office: http://bit.ly/med-lock-box)
• Take a CSB REVIVE! training to learn how to recognize and reverse opioid overdoses
• Visit www.KnowRX.org for more information

REVIVE!

• REVIVE! trains individuals on:
• How to recognize the signs and symptoms of an opioid overdose
• How to administer naloxone to potentially reverse the effects of an opioid overdose
• What to do and not do when responding
• Each attendee receives a free REVIVE! kit, which includes all the supplies needed to administer naloxone. 
• Free Naloxone to Fairfax County residents
• Spanish Course Available
• More information and upcoming training dates: http://bit.ly/revive-csb

Early Intervention and Treatment Services

FCPS Substance Abuse Prevention (SAP)

Services:

• Tier 1: Education & Outreach for All Students, Families, Staff & Community
  • Prevention lessons/presentations
    • live, webinar, podcast, social media, classrooms, community
    • students, parents, teachers, community members
  • Community outreach
  • Prevention campaigns, initiatives, social media messaging
• Tier 2: Individual & Group Brief Intervention/Counseling:
  • Referrals
    • discipline & non-discipline
  • Brief screening, education, counseling
• Tier 3: Refer student/family to outside resources (higher level of care)
  • Partnerships with CSB & other community and private agencies and treatment centers

Fairfax-Falls Church Community Services Board (CSB)

• Outpatient
• Individual Therapy
• Family Therapy
• Group Therapy
• Day Treatment /Partial Hospitalization
• Residential/Inpatient/Detox
• Familiar Concept of Least Restrictive Environment

Supporting a Student in Treatment

• When a student is in school and in treatment
  • Finding safe places in school
  • Activities that do not have drugs involved
  • Staying in touch with parents
• Students returning from inpatient, residential or day treatment
  • To support a student’s return to school, a discharge plan should be done by the treatment provider
  • Reach out to SAP or school social work prior to discharge from a program to ensure there are no gaps in service

Healthy Activities for Kids

Finding Fun and Safe Programs

Benefits of Recreation Programs

• Safety
• Fun
• Healthy activities
• Academic support
• Social emotional development
• Positive relationships
• Good role models

Neighborhood and Community Services

The following programs are have after-school programs and summer programs:

• SACC
  • Grades: K-6
  • Locations: 100+
• Community Centers
  • Grades: K-12
  • Locations: 9 (3 more soon to open!)
• Teen Centers
  • Grades: 7-12
  • Locations: 12
• Tech Centers
  • Grades: K-12
  • Locations: 14
• Therapeutic Recreation
  • Grades: K-12
  • Locations: 10+

Other Programs

• Middle School After-School Program
• Park Authority “Parktakes” programs
• Community sports programs
• Community-based after-school programs

Connecting to Resources/Services

CSB

If the situation is immediately life-threatening, call 911.

• Fairfax-Falls Church CSB Emergency Services (24/7) - Available for people who have a mental illness, substance use disorder, and/or developmental disability in need of immediate help
  703-573-5679  https://bit.ly/CSB247
• CSB Entry and Referral - Assessment and referral services available for youth, adults, and pregnant women including office-based opioid treatment
  703-393-8500  https://bit.ly/CSBentry
• CSB Fairfax Detoxification Center (24/7) - A short-term residential program to help adults safely detoxify from the effects of drugs and/or alcohol
  703-502-7000 https://bit.ly/CSBdetox
• CR2 (24/7) - Provides rapid response to children, youth, and adults facing a mental health and/or substance use crisis. 
  572-364-7390   www.cr2crisis.com
• REACH (24/7) - Crisis stabilization for persons with developmental disabilities.
  855-897-8278   https://bit.ly/3Lc6YwX
• CSB REVIVE! - learn how to recognize and reverse opioid overdoses
  http://bit.ly/revive-csb
• Safe medication storage/disposal – request a free medication lock box/drug disposal kit
  http://bit.ly/med-lock-box

National Suicide Prevention Lifeline: 1-800-273-8255

• Veterans – Press 1
• En Espanol: 1-800-628-9454
• suicidepreventionlifeline.org

Crisis Text Line: Text HOME to 741741

• A live, trained Crisis Counselor receives the text and responds through a secure online platform.
• https://www.crisistextline.org/

PRS CrisisLink: 703-527-4077    Text line: CONNECT to 855-11

• offers crisis intervention, suicide prevention, and support to individuals in order to foster self-sufficiency by providing problem-solving skills and information on community resources so callers and texters can better cope with emotional trauma, personal and family crises.  
• https://prsinc.org/crisislink/

FCPS SAPS

• Parents/Guardians can call their child’s school front office staff or ask their counselor to connect to their school’s assigned SAP Specialist.
  OR
• Contact the Office of Student Safety and Wellness: https://bit.ly/3tG5Mw0
  571-423-4270  

Additional SAP Program info:

• FCPS resources
• Search Keywords: ATOD, SSAW, Vaping

Additional Resources

• NCS Prevention: prevention programs on topics such as substance use and effective parenting available upon request by schools/organizations; email: [email protected]
• Child Mind Institute: provides resources parents can use to teach kids mental health and coping skills
  https://childmind.org
• Youth Mental Health First Aid: certification course for adults working with youth
  https://bit.ly/3tEp1pF
• Chris Atwood Foundation: local non-profit providing a wide range of substance use services 
  https://www.thecaf.org/
• Northern Virginia Family Services (NVFS): offers many programs including mental health youth services and multicultural mental health services; can access NVFS services by connecting with your child’s FCPS school social worker, counselor, or parent liaison or via website/phone
  www.nvfs.org
• Healthy Minds Fairfax: provides information on identifying behavioral health needs and finding care
  https://bit.ly/36OAha0
• Fairfax County Opioid and Substance Use Task Force: County-wide effort to address the opioid epidemic
  https://bit.ly/3JJ18Th

Questions?