Preventing Suicide by Kelley Caravona, Suicide Prevention Coordinator with NAMI NH
NAMI New Hampshire welcomed Kelley (Gaspa) Caravona recently as their new Suicide Prevention Coordinator! We asked Kelley to tell us a bit about her background and why she loves prevention! Check out her blog below:
With a background in education and public health, I have dedicated a significant portion of my career to prevention. I truly believe in the importance and power of prevention and its relationship to an improved quality of life for all. Suicide prevention has become my passion. My suicide prevention expertise began several years ago with a Community Connect Gatekeeper training delivered by Ann Duckless from NAMI NH. I was so inspired by not only her knowledge and energy, but by the Connect philosophy, in that everyone plays a role in suicide prevention. I went on to become a 2nd generation Connect trainer and delivered various Connect and other suicide prevention trainings throughout the Winnipesaukee Public Health Region and New Hampshire. Obtaining my NH CPS and graduate degree in psychology has also enhanced my understanding of this complex public health issue. It has really come full circle for me, 7 years later joining the NAMI NH team as a Suicide Prevention Coordinator.
I believe that to do your work well, you must start by loving what you do. This work feeds my soul. It has impacted my thinking and the way I live on a level I never thought possible. Having educated and supported many community partners in various sectors and settings, one constant holds true…connection is critical for us all. Being a “connector” for folks never stops. It’s not a 9 to 5 job and that has by far been the biggest impact. However, as I mentioned, when you love what you do, it simply becomes who you are.
My knowledge and experience have provided opportunities for ongoing collaboration around suicide prevention. They add to the supportive network that exists here in our great state. This is not just the work of “experts.” It’s the work of us all. I am grateful to be a small part of an important infrastructure that educates and empowers communities to respond effectively to individuals at risk of suicide.
To learn more about NAMI NH visit https://www.naminh.org/
A Doctor’s Perspective on Marijuana: the Developing Brain and Addiction
Makin’ It Happen continued our weekly forum, ‘I’m ok, are you ok?’ Wednesday with presenter Dr. Molly Rosigno who is an Addiction Medicine Specialist from Catholic Medical Center and NH Healthy Families. Dr. Rossingnol discussed the effects of marijuana on the brain for National Prevention Week.
Dr. Rosignol began her presentation by discussing addiction. There are many factors that play into why an individual may become addicted to a substance including marijuana. Often it can be genetic, trauma can play a role, frequency of use, and many other risk factors play into whether an individual develops a substance use disorder.
Addiction works as a cycle in the brain. After use the user experiences relaxation and euphoria, followed by irritability and anxiousness that translates to cravings to use again. Initially these effects occur in different sections of the brain, however over time the cycle is streamlined leading to the process becoming more efficient, and faster. This is how addiction works.
Dr. Rosignol pointed out that there are some in our society that may say substance use is a choice. But the evidence is clear that craving that occurs in the frontal cortex is not a choice.
Dr. Rosignol went on to discuss neurological development. The brain is particularly vulnerable during adolescence to developing an addiction. Impulsivity and compulsivity are high because the frontal lobe is not fully developed. Substances such a marijuana increase the potential for addiction as a result. It becomes a sensation that is needed.
Dr. Rosignol pointed out that cannabis has over 400 biological compounds with 100-200 brain active cannabinoids that activate the brain’s Endocannabinoid System. The Endocannabinoid System is essentially brain receptors that react to cannabis. THC (Tetrahydrocannabinol) is the chemical responsible for most of marijuana’s psychological effects.
SAMHSA indicates that “marijuana is the most commonly used illegal substance in the U.S. and its use is growing”. Marijuana is the most used illegal drug in America 43.5 million people have used. Marijuana and THC are illegal at the federal level, however many states including Vermont, Maine and Massachusetts have legalized its use.
Dr. Rosignol pointed out that the perception of risk of marijuana has become lower over the years. She indicated there’s several reasons for this including commercialization and medicalization. Marijuana use is going up across the United States. The result is many young people do not consider marijuana use a risky behavior.
Dr. Rosignol went on to discuss addiction and diagnosis of Cannabis Use Disorder. Pointing out that not everyone that uses a substance is going to become addicted. However, she said it’s worth noting that they ‘are seeing an uptick in marijuana use disorder cases’.
Dr. Rosignol said that the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) is particularly important to her as a provider that works with patients including adolescents with Cannabis Use Disorder. The DSM 5 offers providers a tool to use in order diagnose substance use disorders. Dr. Rosignol often finds that youth with a Marijuana Use DIsorder commonly meet the following criteria from the DSM 5:
- Inability to manage commitments
- Continuing using even when it’s causing problems in relationships
- Giving up important activities because of use
Dr. Rosignol shared some statistics regarding Cannabis Use Disorder. Cannabis Use Disorder impacts 9% of those that use it as adults. If cannabis use is started in adolescence that number goes up to 18%. If an adolescent is a daily user of cannabis their propensity to have a marijuana use disorder goes up to 25-50%. Physical dependence/withdrawal for those with Cannabis Use DIsorder manifests as irritability, insomnia, vivid dreams, craving, anxiety increase, dysphoria.
Some of the effects of cannabis use include relaxation and euphoria. However, heart rate elevation, balance and coordination issues, amotivation syndrome, lower socio economic status in the future, lower IQ for those that started using before the age of 18, hunger, sleepiness, disorientation, and paranoia are all associated with cannabis use.
Dr. Rosignol pointed out that one of the best tools we have at our disposal to comat Cannabis Use Disorders is prevention and intervention. Protective factors for adolescents play an important role in their substance use. If a young person is involved in academics, sports or music and has a trusted adult in their life it can increase their propensity to be less impacted by Cannabis Use Disorder. “Protective factors” she said “improve the executive functioning of the frontal lobe”. Additionally, tools such as S2BI (Screen to Brief Intervention) are useful tool providers can use to diagnose severity of substance use disorders.
Dr. Rosignol pointed out that it is important to remember that if someone “has an addiction it’s the addiction that is the problem not the substance”. Cannabis Use Disorder is the most common diagnosis for youth. The good news is counseling and mutual help for adolescents works well for young people
Addiction is a chronic illness of brain recicurity. Marijuana exposure in youth and adolescents has known risks. Screening and intervention can be key in reducing risks of substance use. Referral for treatment works!
Join us next week for the I’m ok, are you ok forum entitled Rali NH: CODE 3/Rali Cares Virtual Trailer Tour – Hidden in plain sight. To register visit https://ralinh.eventbrite.com.
#NPW2020 Preventing Youth Tobacco Use (E-Cigarettes and Vaping) – by Breathe New Hampshire
For more than 100 years, Breathe New Hampshire, a statewide non-profit, has focused on critical issues related to lung health by providing educational programs, advocating for public health, and supporting scientific research to prevent, eliminate, and treat lung disease. While many of our programs are inclusive of COPD, asthma, air quality, and lung cancer, we have remained focused on the public health issue of tobacco use disorder, a leading cause of preventable death in the United States. With the emergence of electronic cigarettes this century, use of these products by youth and teens in recent years has become a substantial public health priority for our organization.
Our respiratory system is our body’s filter and critical to everyday life. Breathing is so important to life that it happens automatically. If you didn’t breathe, you couldn’t live. Like our brains, our lungs continue to develop into our early to mid-20’s. Both smoking and vaping can irritate and inflame the lungs, possibly resulting in permanent damage. Inhaling smoke or vaping aerosol can also weaken the body’s immune system. At any age, an individual who smokes or vapes is more susceptible to getting a respiratory virus like COVID-19.
E-cigarette use amongst youth and teens has dramatically increased in New Hampshire over recent years. The percentage of high school students who have used an electronic vapor product in the last 30 days increased by 10% from 23.8% in 2017 to 33.8% in 2019. (2019 NH YRBS). Likewise, the percentage of high school students who have ever used an electronic vapor product increased from 41.1% to 49.8% (2019 NH YRBS). Prior to COVID-19, the Centers for Disease Control and Prevention (CDC) had tracked cases of e-cigarette, or vaping, product use-associated lung injury (EVALI). As of February 2020, CDC reported 2,807 hospitalized EVALI cases and 68 deaths. All cases were linked to a history of using e-cigarette products, with many reporting the addition of Vitamin E acetate or THC. Tetrahydrocannabinol (THC) is a psychoactive, mind altering substance found in marijuana. As teen and young adult use continues to rise, the need for vaping and teen nicotine addiction prevention programs has never been greater.
Much like Big Tobacco did several decades ago with cigarettes, vape companies target and entice young customers to try their products. Colorful and sleek in design, many vape devices are marketed as being discreet “to be used where smoking is not permitted”. Marketing tactics include the use of flavored products and ads and social media campaigns which suggest vaping as a way to socialize with friends. Flavors mask the harshness of the tobacco and variety of chemicals and metals in these products. Most vape products contain nicotine. Many vapes actually have a much higher nicotine concentration than cigarettes. The adolescent brain is still developing into the early 20’s and is uniquely susceptible to nicotine addiction. 88% of adult smokers started before the age of 18. Exposure to nicotine at this age can become addictive for a young person, potentially creating a future customer for this industry. Promoted as safer than cigarettes, we do not yet know the long-term health effects of vaping.
It is important to note that since these products entered the United States in 2007, none of the vape companies in this country have applied or been approved to sell their devices as a cessation tool to help people quit smoking. New vape devices are constantly being introduced, challenging policy and regulation to keep pace. Over 450 devices and thousands of flavors are available. Around the country, some federal and local legal action has been taken. However, the industry continues to be not fully regulated and enforcement of existing regulations is lacking. All of this has contributed to the current youth vaping epidemic facing our nation today. The youth and teens are the guinea pig generation for these products.
At Breathe New Hampshire, we believe prevention starts early with awareness and education. In response to the youth vaping epidemic we developed an education program in early 2018 called Vaping Unveiled™: What Everyone Needs to Know. The program was created to educate youth, parents, schools and the community about the dangers of youth nicotine addiction through vaping e-cigarettes and provide resources to help teens quit. As schools continue to learn remotely throughout the remainder of the school year, Breathe New Hampshire now offers our Vaping Unveiled™ program virtually to accommodate the demand for education and prevention surrounding vaping and nicotine addiction. While this is a stressful and uncertain time for all of us, protecting youth and teens from the effects of nicotine addiction and potential lung disease remains our priority.
Resources to help teens quit vaping:
o My Life My Quit: www.mylifemyquit.com Text QUIT to 47848 or download the quitSTART
o Truth Initiative – This Is Quitting https://truthinitiative.org/thisisquitting
o SmokefreeTEEN: https://teen.smokefree.gov/
https://teen.smokefree.gov/become-smokefree/smokefreeteen-signup
For more information on e-cigarettes/vaping or to learn about our virtual Vaping Unveiled™ program please visit: https://breathenh.org/programs/vaping-unveiled
DCYF Family Well-Being Guide for COVID-19
Check out this new DCYF Family Well-Being Guide for COVID-19!
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A Doctor’s Perspective on Marijuana: the Developing Brain and Addiction
#NPW2020 Popcorn and Movie Night
Today’s theme for SAMHSA’s National Prevention Week is Preventing Underage Drinking and Alcohol Misuse. In order to recognize this theme we have a movie recommendation! So grab your popcorn and queue up Netflix.
Netflix just premiered the film Cracked Up: the Daryl Hammond Story. Daryl Hammond is the beloved Saturday Night Live star known for his impressions of Bill Clinton and Sean Connery. What you may not know about Hammond is that he is a survivor of childhood trauma.
According to the Cracked Up website “behind the scenes, Darrell suffered from debilitating flashbacks, self-injury, addiction and misdiagnosis, until the right doctor isolated the key to unlocking the memories his brain kept locked away for over 50 years”.
In the movie Darrell shows that great healing can come from ending the silence and shame around trauma. This is a must see for anyone that works in the field of substance misuse prevention, intervention, treatment, and recovery!
“When people are behaving in apparently self-destructive ways, it’s time to stop asking what’s wrong with them, and time to start asking what happened to them.” – Dr. Robert Anda and Dr. Vincent Felitti, Founders of the Adverse Childhood Experience Study
Caution: We do not recommend this film for young children. There are references to sensitive subjects such as child abuse, trauma, substance use disorder and more. We do recommend having an open conversation with your older children before and after screening. Please follow this link for some helpful resources regarding the film https://www.crackedupmovie.com/resource-center.
Preventing Prescription Drug and Opioid Misuse for National Prevention Week 2020
Preventing Prescription Drug and Opioid Misuse
By Jon DeLena, the Associate Special Agent in Charge, Drug Enforcement Administration’s New England division
I appreciate the opportunity to contribute to such an important topic, especially at a time when our ability to connect and communicate face-to-face has been so disrupted by COVID-19. I have been in law enforcement for 28 years, most of which has been spent with the United States Drug Enforcement Administration (DEA). I have held many positions and have been assigned to various DEA offices throughout the United States as well as international temporary assignments. Presently, I lead DEA’s operations in Massachusetts, Connecticut, Rhode Island, New Hampshire, Maine and Vermont. Over the last four years, since being stationed in New England, I have truly dedicated my efforts to the area of opioid abuse prevention and education for both law enforcement and the community at large. I have been fortunate enough to have made numerous public appearances on behalf of DEA, speaking on the topic of youth prevention, opioids, and the effect this crisis has had on law enforcement in particular. I had oversight of the DEA 360 New Hampshire Program which was a impactful effort to reduce the harmful effects of opioids in the greater Manchester, NH region. I was part of a team which organized the largest ever Youth Summit on Opioids which was attended by over 8,500 New Hampshire students and live-streamed and viewed by more than 35,000 people across the country. The then-Attorney General of the United States, Jeff, attended and called the event the “beginning of a National movement.” The sustainability of the DEA 360 Manchester program has proven itself through the numerous coalitions and youth groups developed and maintained from this effort.
As a leader in the world’s preeminent drug enforcement law enforcement agency, I can say with certainty that the drug trafficking organizations responsible for manufacturing and importing this deadly poison have only continued to increase their efforts. They have never been, nor will they ever be, moved by the death and destruction they cause; they are simply motivated by greed, and that will never change. DEA’s efforts in the New England region has grown exponentially as a result of this crisis. We have added resources, and continue to target the command and control elements of these violent drug trafficking organizations, who work closely to spread their illicit product through our neighborhoods. The opioid crisis has ripped apart our communities, and sadly, affected many people with whom I have developed relationships through my profession. From a very young age, I experienced the pain that families face as a result of addiction. This has helped guide and motivate me in my own personal journey, and helped me dedicate my efforts to stop this crisis.
Overcoming the opioid crisis and dismantling the drug traffickers responsible for distributing the illegal substances is not be something that one agency can do alone. It will truly take a team approach, and that is why DEA has worked so closely with our law enforcement and prevention partners to help educate our young and vulnerable to the dangers of opioid abuse. We must work together to connect with as many community members as we can with the education and information they need to make healthy decisions. We must also uplift and empower our young people to be upstanders in this fight and not just bystanders. I have heard first hand from so many of New Hampshire’s youth leaders that they want to be part of the solution. We must seize upon that opportunity to stand shoulder to shoulder with these motivated teens as we spread the critical message of prevention, and in turn the message of hope.
To learn more about the DEA visit www.dea.gov.
The Y’s, Pivoting During COVID-19
Makin’ It Happen continued our weekly forum, ‘I’m ok, are you ok?’ Wednesday with presentations from the Granite YMCA and the YWCA NH. Attendees heard from Jessica Goodine-Riendeau, Community Outreach Director at the YMCA and Katie Parent, YWCA REACH Program Manager, on how physical distancing and stay at home orders has changed their organization. They discussed what shifts they plan to make to provide safe, secure programming and facilities as they prepare for the stay at home order to be lifted.
The YMCA discussed their programming first. Goodine-Riedeau explained that Granite YMCA is the largest YMCA north of Boston. The Y is more than a gym, it’s a cause that helps bring about lasting personal and social change.
During this time the YMCA is offering Emergency Child Care through their child care programming. Child care which is vital allowing essential workers to continue going to their jobs. The YMCA has moved many of their services online through Facebook groups, online exercise classes and online support for children and their families. They are also providing to-go meals to families in need through their Nourishing Youth Program. Families can pick up meals every weekday from 4:30 – 5:30 pm until schools reopen. To learn more about all the YMCA has to offer visit https://www.graniteymca.org/.
Katie Parent of the YWCA organization presented a detailed overview of the services currently available. Although the offices for the YWCA are located in Manchester, the service area expands to a total of nine communities. The YMCA is dedicated to eliminating racism, empowering women, and promoting peace, justice, freedom and dignity for all.
The YWCA continues to serve the community 24/7 with their hotline which can be reached at 603.668.2299. The YWCA has launched a web chat and SMS text line Monday-Friday 9:00AM-4:30PM which can be accessed online at https://www.ywcanh.org/reach. Generally the YWCA provides accompaniments to individuals in need at hospitals, child advocacy centers, court houses, police stations and doctor’s offices. With COVID-19 they are responding in-person upon request. The YWCA continues to work hand in hand with DCYF. Usually, the YWCA offers emergency shelter through Emily’s House but in response to COVID-19 they have been finding alternative shelter in order to limit exposure to residents. Additionally, they support the Manchester ACERT Team by responding out to the community to children that have experienced trauma. The YMCA serves all individuals and services are free and confidential.
Initially at the beginning of NH the stay at home order, the YWCA was logging less calls to their crisis hotline than normal, which was a concern, however, calls are now reaching normal levels. To learn more about the YWCA please visit https://www.ywcanh.org/.
Both of these organizations are vital to the communities they serve. We are so lucky to have them! To view the entire forum please press play on the video below:
Please join us next week for a special National Prevention Week ‘I’m ok, are you ok’. Details will be available on our social media and website by Friday.
I’m Okay, Are You Okay? Online Forum: The Y’s, Pivoting During Covid-19 May 6th from 3:00-4
As part of our “Survive and Thrive Toolkit,” we encourage you to
tune in for Makin’ it Happens on-line forum: I’m okay, are you okay?
Makin’ It Happen would like to invite you to attend our online forum ‘I’m ok, are you ok’.
Both the YMCA and YWCA will be presenting:
The Y’s, Pivoting During Covid-19
Wednesday May 6th from 3:00 PM-4:00 PM.
Join us this Wednesday, May 06th, from 3PM – 4PM for our next “I’m okay are you Okay?” forum session focused on how the YMCA and YWCA have had to Pivot to continue to Provide, Protect and stay connected to the individuals they serve. We will hear from Jessica Goodine-Riendeau, Community Outreach Director at the YMCA and Katie Parent, YWCA REACH Program Manager, on how physical distancing and stay at home orders has changed their organization, and what shifts they plan to make to provide, safe secure programming and facilities as they prepare for the stay at home order to be lifted.
To register please go to Eventbrite click here You will receive a Zoom link once you register. If you have questions please reach out to me at brm@mih4u.org with questions.
Join us this Wednesday, April 29th from 3PM-4PM for the Sober Living Landscape part of our I’m ok, are you ok forum
This forum will be on the topic of Sober Living (Recovery Residences) facilities and homes in NH, and NHCORR’s efforts to accredit these facilities.
It’s hard enough to find safe, supportive sober living when straight out of treatment and early in recovery. Since mid-March many recovery residences have been facing unique challenges. Reoccurrence of residents condition, unemployment, delays in paying rent, and challenges to the culture and balance of recovery residence communities are emerging. Becoming accredited by NHCORR can help with some of these things (i.e. rental assistance), bus as we are finding, the Covid 19 response is still very challenging to our recovery community, and those providing safe places to live.
Register on Eventbrite at https://soberlivinglandscape.eventbrite.com/?ref=estw
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