Trends in Substance Use

Host: Dr. Jennifer Hunter, Assistant Director for Family and Consumer Sciences Extension, University of Kentucky 

Guest:  Alex Elswick, Extension Specialist for Substance Use Prevention and Recovery

Episode 16, Volume 2

0:00 Welcome to Talking FACS; what you need to know about family, food, finance and fitness. Hosted by the University of Kentucky Family and Consumer Sciences Extension Program, our educators share research knowledge with individuals, families and communities to improve quality of life.

0:21 Dr. Hunter: Hello and welcome to Talking FACS. This is your host, Dr. Jennifer Hunter, Assistant Director for Family Consumer Sciences Extension at the University of Kentucky.

Today, I'm pleased to have joining me, Alex Elswick, our Extension Specialist for Substance Use, Prevention and Recovery. Welcome, Alex.

0:36 Alex Elswick: That's a mouthful every time; isn’t it?

0:37 Dr. Jennifer Hunter: It is a mouthful. It is a mouthful. Today's topic is really and truly, we're just going to have a conversation about those trends in substance use that we kind of see every day.

I think that… and we were just chatting before we started taping about that so much of the news right now is really focused on e-cigarettes. And we've done an entire podcast on jeweling and e-cigarettes and understanding what they are.

But my husband and I we're talking about it last night that if you're just scrolling through the news on your phone or through social media or just turning on the TV, that it is just really kind of predominating the press right now. But then there's also other trends in terms of other substances and what might be upticks or reductions.

So, we're just going to talk some about those stories that folks are seeing in the news centering around substance use and just helping us understand more about them.

1:34 Alex Elswick: Yeah, absolutely. So, the first and one that's most prominent people's minds, probably, I just read a story, the front page of The Wall Street Journal this morning about the E-cigarette ban proposed by the Trump administration to ban flavored e-cigarette products.

So, this is something we did with cigarettes; flavored cigarettes and flavored tobacco a few years ago, with the exception of menthol cigarettes. And it's really effective, because in many ways, these products are marketed to young kids. Even if some big tobacco company might say they're not, there certainly are and that's what the research would say.

So, it's a big step in trying to address teen vaping. Because as we talked about in our other podcast on vaping and e-cigarettes, it actually is a safer alternative to smoking cigarettes. And so, when it's used as harm reduction or when it's used as a quit-aid to quit smoking, it's effective.

The problem is that an equal number of people to those who are using it to quit smoking are new users. So, they're nicotine naïve; they've never had nicotine before and their first experience with nicotine is with an e-cigarette, which is, of course, a problem.

2:44 Dr. Jennifer Hunter: You know, I've shared this with you the other day, because as most of our listeners know, that I have a teen and he's in high school. And so, all those things that we experience as parents navigating kids through high school, I have the benefit of coming to work and having a group of specialists that can help coach me as a parent.

But I was sharing with you the other day about that. And we'd been to a football game and that there was a group of what appeared to be high school-age students behind me; I was not with my son at the time. I was actually with my daughter, our younger one, but that they were vaping predominantly throughout the football game.

And I mentioned it to my son later. And his immediate response was, “Yeah, it's everywhere. It's on the school bus. It's in the bathrooms. It's just literally everywhere you go.” And I can remember being in high school, you know, there'd be probably somebody smoking in the bathroom in between classes.

But the difference between that and what he kind of describes is just a huge leap. And it's a lot for a parent to kind of take in as well and really kind of wrap their mind around and understand.

3:52 Alex Elswick: Yeah. And it sounds like what Riley's describing is really pretty accurate, because Secretary of Health and Human Services (his name is Alex Azar) said this morning that the research is showing 25 percent of high school youth are using vape and e-cigarettes, which is alarming.

So, when you look at rates of teen smoking or drinking alcohol or anything, it hasn't even been near comparable to 25 percent in years and years and years.

4:20 Dr. Jennifer Hunter: Really.

4:21 Alex Elswick: Not even close. Yeah. And so, really, we've made great strides in terms of reducing smoking in general and in particular, teen smoking. We're actually at an all-time low now; which is fantastic. But it's quickly been replaced by vaping. 25 percent is a lot of people.

4:36 Dr. Jennifer Hunter: That's a lot of people. It's a lot of people and concerning as a parent, for sure. You use the term a minute ago, “nicotine naive.” Can we talk just a little bit about what nicotine does to an individual or does to their brain?

4:50 Alex Elswick: Yeah. So, what's interesting is that nicotine itself, in terms of physical harm, is not terribly harmful. So, like in terms of cigarettes, nicotine is the addictive chemical, but it's all the additives and chemicals that produce a lot of harm for cigarettes.

So, theoretically, the idea was for vapes and e-cigarettes that an aerosol inhaled, including nicotine, wouldn't be as harmful. Well, first of all, inhaling aerosols, a bad idea.

5:17 Dr. Jennifer Hunter: Right.

5:18 Alex Elswick: You don't want to do that. Number two, while nicotine doesn't seem to produce physical harm in terms of to your heart, to your lungs, to the same extent that all these other chemicals do, it does do an immense amount of damage to your brain.

So, we know that your brain is always changing. It is especially true for an adolescent brain. The term is neuroplasticity. So, people describe the adolescent brain like play dough; like it's just constantly being molded and changed. And so, the behaviors and the patterns of behaving for an adolescent are really important to their long term development.

And nicotine use predisposes people for other kinds of addiction later in life; all sorts of increased risk for other problems. It's an issue.

5:57 Dr. Jennifer Hunter: It's an issue. Let's talk about maybe some other issues out there. What are other current trends in terms of substance use that folks may be seeing in their news feed and how can we help them understand them more?

6:08 Alex Elswick: So, a big one that was in the news about a month ago is we're sort of celebrating, in a sense, the first reduction in overdose deaths in almost 10 years. From June of 2017 to June of 2018, which is the latest data we have, there was a 15 percent reduction in overdose deaths.

So, that's a big deal because 15 percent reduction represents about 230 lives saved. So, that is something we should celebrate.

However, that's a 15 percent reduction from the worst year on record. So, it actually puts us on par with 2016 numbers, which at the time, 2016 was the worst year on record. So, guarded optimism.

So, 230 lives saved is a wonderful thing. Every one of those 230 lives is a person; a human being who have family, who love them. But I would also say we lost 1,333 people during that 12-month span. It's a lot of people.

7:05 Dr. Jennifer Hunter: And is the reduction in deaths, do you think that's associated with greater access to things such as naloxone or NARCAN or is that actually reduce substance use?

7:18 Alex Elswick: Yeah. Also, a great question. Most of the experts are saying it's kind of three or four fold. So, first, it would be greater access to naloxone (NARCAN).

Second, would be greater access to medication for opioid use disorders. So, we talked and one of our podcasts about medication like Suboxone, Methadone, Vivitrol; things like that.

But third, and this is a scary emerging trend is a lot of people are transitioning to using methamphetamine instead.

7:45 Dr. Jennifer Hunter: And that was going to be the third trend that we talked about. So, let's just segue into that and tell us something about the methamphetamine trend.

7:53 Alex Elswick: Yes.

7:54 Dr. Jennifer Hunter: That's a mouthful.

7:55 Alex Elswick: Yeah, it is a mouthful. Yeah. So, we're seeing more people using methamphetamine. It's kind of making a resurgence. We're certainly seeing it in data. But I'm really hearing it on an anecdotal basis from a lot of people who work in treatment because methamphetamine is such a devastating drug. And so, I'm just hearing a lot of talk about it.

So, people are less likely to experience an overdose death as a result of methamphetamine than they are with opioids. So, in some ways you could see that as less harmful, but meth is certainly a destructive drug.

So, I think particularly for rural parts of Kentucky, where we see meth labs and shake and bake meth and things like that. It's a huge concern.

8:37 Dr. Jennifer Hunter: Do they know why we're seeing a resurgence of meth?

8:41 Alex Elswick: We don't know why. There's been some debate. I know some people are suggesting it's because people who use drugs or have become more fearful of opioids. I would be a little hesitant to endorse that view until we actually see what data says about that.

8:56 Dr. Jennifer Hunter: Right. Alex, I'll tell you, it's always informative when you have the time to come in and sit down and talk to us that you leave us with so much to think about.

But I always feel more well-informed as a consumer and I think that that is part of when we think about the subject matter or when we think about substance use, prevention and recovery, that you were charged with just helping consumers feel more educated and understand more is a step in the right direction.

9:24 Alex Elswick: It's always a pleasure to do it. Thanks.

9:26 Dr. Jennifer Hunter: Thank you.

9:27 Thank you for listening to Talking FACS. We deliver programs focusing on nutrition, health, resource management, family development and civic engagement.

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