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Saturday, November 14, 2015

Opiates: Even With the Facts, Your Child Is At Risk

In the middle of an opiate health epidemic, young Americans are extremely vulnerable. Even though most youth know the dangers of risk-taking behaviors like using dangerous drugs, research confirms they are "hardwired to ignore what they have learned." To view this type of risk taking as inevitable and simply something children will "experiment with" as they develop independence is giving them permission to play Russian roulette with addiction and death. Parents, guardians, and caretakers such as schools must teach abstinence and zero tolerance for recreation use of prescription opiates and heroin.

The University of Michigan "Monitoring the Future" survey reports the abuse of opioid prescription painkillers is high in youth populations. 9.7 percent of high school seniors report using Vicodin in the past year, while 4.9 percent report using OxyContin. The study also put lifetime use of heroin at 1.00 percent for 12th graders.

Consider the "hard-wired" young brain, and also consider the facts of mortality. Indeed, teenagers have the double the risk of dying compared to their preteen selves. Opioid abuse must be stopped, no matter how much precious time, money, and effort are needed to effect significant change.

(Maia Szalavitz. "Why the Teen Brain Is Drawn to Risk." Time.

Dr. Laurence Steinberg, researcher and professor of psychology from Temple University, reports   adolescent brain development shows teenagers seek out risk-taking behaviors because the section of the brain most involved in emotion and social interaction becomes very active during puberty, while the section most critical for regulating behavior is still maturing into early adulthood.

According to Steinberg, heightened risk taking in adolescence is the result of competition between these two very different brain systems -- the socioemotional and cognitive-control networks -- that are undergoing maturation during adolescence, but along very different timetables. During the adolescence, the socioemotional system becomes more assertive during puberty, while the cognitive-control system gains strength only gradually and over a longer period of time.

(Laurence Steinberg. “Risk Taking in Adolescence: New Perspectives from Brain and Behavioral Science.” Current Directions in Psychological Science. April 2007.)

This explains, Steinberg says, why teens are so susceptible to peer pressure and why education and prevention efforts designed to keep teens from engaging in risk-taking behaviors don't work all that well. Steinberg claims teens take twice as many risks when friends are watching. "They didn't take more chances because they suddenly downgraded the risk," explains Steinberg. "They did so because they gave more weight to the payoff."

According to Steinberg's research, the presence of peers even increases risk taking by 50% in college undergraduates, but it does not influence the number of risks older adults took.

Steinberg explains that many simple prevention measures fail ...

"We have tried to prevent these behaviors by educating kids about the dangers of things like smoking, drinking, taking drugs, and unprotected sex. The thinking has been if they know about the dangers they won't do these things, but that is clearly not true."

(Salynn Boyles. "Teens Are Hardwired for Risky Behavior."
WebMD Health News. April 13, 2007.)

Steinberg says programs aimed at persuading teens not to engage in dangerous behaviors seem to have little impact. Just because we give them the facts, that doesn't mean we are changing their behaviors.

The Deadly Dilemma

So, youth typically get the facts about deadly opiates, yet largely due to their propensity to take risks and to give into peer pressure, they view themselves as "bulletproof" and defy the truth to engage in risky behaviors that support their desires for emotional and social interaction.

And, yet, a newer study suggests it may be that teens' notorious risk-taking behavior stems not from some immunity to known risks, but rather, from their greater tolerance to uncertainty and ambiguity. Teens love the unknown. "If the risks are known, adolescents engage (in risk-taking) less than adults do, but if they are unknown, this is reversed," Agnieszka Tymula, lead author of the study says.

Tymula explains: "This tolerance for unknown risks might stem from an underlying biological feature that makes learning about the unknown less unpleasant for adolescents than it is for adults."

She continues ...

"An early part of learning any type of new skill -- from typing to teaching -- is accepting instruction and consciously thinking about all of the tactics and techniques involved in performing the skill.

"While novices need to think step-by-step, however, experts will have incorporated the best routines into their brains to the point that they become automatic. This may be why the teen brain uses the higher-order cortex for risk decisions: it hasn't yet made enough of them to develop an intuitive reaction that it can 'offload' to other brain regions."

(Agnieszka Tymula, et al. "Adolescents’ risk-taking behavior is driven by tolerance to ambiguity." Proceedings of the National Academy of Sciences. May 01, 2012.)

Valerie Reyna, professor of human development and psychology at Cornell University, who has done her own research, agrees with Tymula, and says the study adds to her own findings. This research confirms how excessively teens tend to overestimate risk. Yet, it doesn't prevent them from engaging in risky behavior. They may get lost in the details about specific risks and overly focused on possible rewards, while ignoring the overall "gist" of the problem -- i.e., the ultimate consequences.

Reyna's work has shown that adolescents carefully think about risks most adults wouldn't even consider taking -- like, say, playing Russian roulette -- using their prefrontal cortex. Why are they wired this way? Their greater tolerance for uncertainty and the unknown -- and an increased desire for and focus on rewards -- probably helps them leave the nest.

(Maia Szalavitz. "Why the Teen Brain Is Drawn to Risk." Time. October 02, 2012.)

Fighting A Tough Battle

How can we best fight this flight into irreparable harm? Steinberg says we need to provide more structure to control young people's impulses and to regulate their behavior. That means focusing on ways to keep teens from getting into trouble. But he also says, "Parents have a bigger role to play than government, by monitoring the behavior of their teens and imposing their own rules to protect them from harm."

Tymula suggests that allowing teens opportunities to safely experiment -- for example, a simulator that shows sober teens what drunk driving is like -- could also help, by making an unknown risk seem more real and known. Allowing teens the opportunity to take risks in a safe context could also help them develop expertise that underlies gist-based thinking. Of course, this simulation seems very difficult -- impossible? -- to do when the enemy is opiate addiction.

Reyna has studied how teaching "gist"-based reasoning can help teens avoid dangerous sexual choices, finding that teens who are taught to focus on potential, catastrophic negative outcomes, rather than the odds, make fewer risky sexual decisions and have fewer partners.

Structure, regulation, parental involvement, simulators, focusing on catastrophic negative outcomes -- we must use the best available resources in a research-based commitment to curb opioid abuse in youth. Experts agree prevention is the best strategy.

The most commonly abused opiate drugs are prescription painkillers, but as many as 40 percent of teens don’t perceive any major risk with trying heroin once or twice (NSUDH). According to a study by the National Center on Addiction and Substance Abuse at Columbia University, the number of teens who abuse prescription drugs has nearly tripled since 1992.

The most commonly abused opiate drugs are heroin, Vicodin (hydrocodone), OxyContin (oxycodone), Darvon (propoxyphene), Diluadid (hydromorphone), morphine, fentanyl, codeine, and other related prescription painkillers.

We must educate ourselves and our loved ones with the best resources while limiting their access to deadly and addictive substances. The National Institute on Drug Abuse makes the entire publication of "Drugs, Brains, and Behavior: The Science of Addiction" available online. Please, click onto the following link to access their "Preventing Drug Abuse: The Best Strategy" material and begin the fight: http://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-abuse-best-strategy.

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