Talking to Teens about Drugs Found in Reverse Translation
as a parent
and a neuroscientist i often find myself
applying things that i learned from one
aspect of my life
into the other this has especially been
true
in the last few months of working from
home when i often found myself doing
both
at the same time as the dad
of a four going on 14 year old one word
that has lost
almost all meaning in our household is
no
it doesn’t matter who’s saying it how
many times it’s said
or the tone it’s set in the results are
often the same
complete indifference this four-year-old
who is loves scary dinosaurs
there isn’t really anything we can do in
terms of adding fear
to make him change his behaviors so what
does that have to do
with our topic today well for the last
30 to 40 years most of our campaigns
around
reducing substance use in adolescents
have taken the same approach
starting from nancy reagan’s just say no
campaign
to the reefer madness era and then even
more recently
trying to show graphic images of the
potential effects of substance use
even three days ago we have this
revision
of the justin nail campaign by the
current first lady
in the u.s and just like saying no to
the four-year-old
these approaches have largely not worked
in producing behavioral change so what
does work for that we turn to another
lesson
in my parenting adventures with two boys
under the age of eight
in our household the most commonly used
word
is why this can be heard
when we ask them to do something between
the two of them
in the form of why are you staring at me
why are you touching my things
and in the last few months between my
spouse and i in the form of why did we
do this to ourselves
the why question is important for the
adolescents
who are now becoming emerging adults and
are trying to make their decisions
about their substance use as well as for
researchers like myself to help
understand
why or why not adolescents should
or should not use drugs and it’s through
campaigns
that take the evidence from the research
and then translated to messaging for
these adolescents
combined with equipping them with better
social skills
that we have actually been able to bring
down the rates of substance use
in adolescents here is the data from
ontario
where we see consistent declines in the
use of tobacco
and alcohol in the adolescent or the
high school going population
the results for cannabis are similar but
we see
recent flutter possibly due to
localization and so we will see what
happens in the coming years
these data are largely consistent with
data from the us as well
where we see consistent declines in the
rates
of alcohol and tobacco use in high
school students
but not is all not all is heading in
this direction
the rates of e-cigarette use or vaping
as it’s called are actually increasing
and so here we see in the last year in
ontario
almost a doubling of the rates of
e-cigarette use
in adolescents in fact before the covid
epidemic or pandemic
what we were hearing on the media was
about the vaping
epidemic these rates can also be seen in
the u.s
with the single two largest increases
in recent history observed in the vaping
of nicotine
or thc which is the primary constituent
of the cannabis plant
or the psychoactive constituent of the
cannabis plant
why have there been increases in vaping
we don’t exactly know
but some reasons might be either related
to the perceived
lack of harm with these e-cigarettes and
while that is very
true for smokers who now quit their
combustible tobacco and move to these
electronic nicotine devices
it’s not necessarily true for
adolescents that were never smokers to
begin with
and as far for being safer than
cigarettes goes
that’s not exactly a high bar
so it’s important for us to figure out
why else
have these caught on so prevalently
in this population one reason might be
the use of
influencer social media influencer based
marketing
or some misinformation that might exist
about the contents
of these e-cigarettes i remember giving
a talk now three years ago
at a sorority at dartmouth college where
i did my postdoc
and while the talk was about alcohol and
cannabis use
all of the questions that i got after
the talk were about
jeweling at that time i didn’t even know
what dueling was
and so when i asked them what is dueling
they told me
these are these flavor pods that you can
use and vaporize just like e-cigarettes
that don’t have any nicotine in them
unfortunately
that couldn’t be further from the truth
in fact some of these pod devices
have more nicotine than the earlier
e-cigarette devices
and that’s when i realized that we had a
need
for greater information and
dissemination of that information
as well as more research related to why
do adolescents find these
the use of these e-cigarettes so
rewarding and appealing
since e-cigarettes and especially use
during adolescence
is relatively recent we don’t have a lot
of data
around the long term effects of this use
during adolescence what we do know so
far
is that adolescents who use e-cigarettes
are more likely to use other drugs
like alcohol or opiates in addition to
that they are more likely
to go on to develop cannabis use or
combustible tobacco use and lastly
these individuals are more likely to
have adhd
ptsd gambling disorder and
anxiety and those domains or these
effects are largely consistent
with what we know about the effects of
substance use
on the adolescent brain previous studies
have shown
that the risk of substance use during
adolescence
usually manifests itself in a change in
the risk trajectory
and results in three domains
cognitive deficits the risk for
substance use
which we know that the earlier you start
using substances
the more your risk of substance use
disorders later on in life
and then lastly the risk for mental
illness
the problem with these studies is that
they’re association studies
where we don’t know whether the
substance use actually
causally contributes to the development
of these three domains
it’s a chicken or egg question that
science struggles with
and we including our own lab are trying
to answer this question
one example of this might be the
relationship between adolescent cannabis
use
and schizophrenia while adolescent
cannabis use especially
early on and of higher potency cannabis
is considered a risk factor for the
development of schizophrenia
the high rates of cannabis use in
patients with schizophrenia
make it difficult to assess whether it
was the schizophrenia or the risk for it
that gave rise to the cannabis use or
whether it was the cannabis use
that gave rise to the schizophrenia the
same
might be true for e-cigarettes as well
maybe the individuals
that were going to go on to develop the
cannabis use disorder
or combustible tobacco use were the same
people that ended up using
e-cigarettes and it was a third factor
that was either related to their
genetics
or environment that gave rise to both
things
and that is where pre-clinical
animal-based
studies come in they help us answer
what the causal influence of adolescent
substance use
on the brain is and what the changes
that happen as a result of it
and at the same time control for those
confounding factors
that might come from genetic or
environmental influence
and i am not by any means the first
person to think of doing these studies
in animals to get at the causal basis
in fact we stand on the shoulders of
giants giants like linda spear
and others who have laid the groundwork
and set up
a solid foundation for us to stand on
they have established what age
in rodents is equivalent to that age
in humans they have established what
changes happen in the brain
in adolescents in animals and whether
those are in fact consistent with the
changes
observed in the humans because of these
changes were not consistent
these studies wouldn’t be of much value
and then lastly they have helped
establish what
is happening at the level of the
neurochemicals within the brain
these chemicals that are responsible for
all communication within the brain
is there something happening during
adolescence and have shown
that adolescence is a period of
considerable flux
this figure that you see behind me is
meant to be small for a reason
and difficult to see the point that
you’re supposed to take from here
is that across all the different
chemical messengers within the brain
during adolescence there is some flux
in those systems either they’re going up
or going down
or doing both at the same time and so
when substances are used during this
period
they interact with these fluctuations to
possibly produce
long-term changes and for those of us
that are dealing with either teenagers
at home
or are young enough to remember being a
teenager this figure probably also
explains a lot
and so today since the topic of the day
is intended to innovate i wanted to
highlight some ways
in which our group and others are
bringing innovation to this topic
while most of the previous studies that
test the effects of drugs
on the adolescent brain in animals have
used injected models of delivery
that’s not exactly how the humans use
the drugs
and so we have been working towards
establishing
routes of delivery that are more similar
to the used
those used in adolescence and so one way
we’ve done that is by creating
open source devices that allow us to
expose
animals to the vapor from those same
dual pods
that those students were asking me about
a few years ago
and we’ve made some important
discoveries with this along the way as
well
like a recent paper showing that
adolescents are in fact
more vulnerable because they find the
vapor
from those nicotine jewel devices more
rewarding
compared to adults we’re also
experimenting with other routes of
administration like edibles
not us but with the animals obviously
but in addition to that we
are now combining these with studies of
the brain circuitry to be able to get at
what are those causal changes in the
brain
that happen as a result of adolescent
substance use
and for that we use magnetic resonance
imaging based
studies of the brain which are akin to
those done in humans
and through this we can identify exactly
the changes that happen
in those humans that could be
contributed directly
to the substance use during adolescence
with the hope of identifying
those inflection points in those risk
trajectories that i was talking about
earlier
and someday through manipulating these
circuits
maybe reverse or prevent the effects
of adolescent exposure to substances
in the end i’ll come back to where i
started as i pic
as a parent i will continue to have
the frank discussions of the why of
substance use with my children
early and often and as a neuroscientist
i promise to continue giving talks like
this
to equip other parents with the why
so that they can have these important
conversations
with their kids
you