►
Description
In this episode of At Your Service, hosts Susan Love and Ryan Voegtlin discuss cannabis and vaping with Karen Siska-Creel, R.N., M.S.N. and Isha Alston, R.N., M.S.N. from the Office of School Health and Support for Anne Arundel County.
A
B
Hi
I'm
Karen
siska,
creel
I'm,
the
director
of
school
health
services,
I,
have
I
oversee
all
the
health
care
in
the
schools,
over
86
000
students
and
the
delivery
of
school
health
services,
which
is
first
aid
and
care
coordination,
just
removing
all
Health
barriers
to
them
accessing
their
education.
I
see
350
staff
that
we
have
in
the
school,
so
yeah.
It's
a
lot.
D
B
To
be
honest,
it's
a
great
mom
job,
I
mean
you
know
it's
like
teachers.
You
know
you're
off
when
the
students
are
off,
you
get
to
be
home,
holidays,
weekends
and
as
a
nurse
there's
no
nights,
no
holidays
and
no
weekends.
You
don't
have
to
find
coverage
when
you
need
off
it's
very
friendly.
It
just
was
great
and
then
once
I
got
into
it
about
two
weeks
into
it.
I
just
knew
this
was
my
Niche.
It
was
the
best
kept
secret
in
nursing
and
I.
B
D
Absolutely
so
I
started
my
nursing
career
in
emergency
medicine,
emergency
nursing
and
emergency
departments
in
Baltimore
City
and
a
lot
of
times
you
see
and
while
I
love
that-
and
it's
always
going
to
be
part
of
me
and
close
to
my
heart.
You
see
people
on
the
worst
day
of
their
life
right
and
I.
Just
thought
there
has
to
be
a
way.
I
can
make
a
difference.
B
C
B
We're
hoping
it
doesn't
so
much
because
recreational
Cannabis
really
is
for
adults,
anyone
21
and
years
older.
So
now,
as
the
law
says
that
you
know,
there's
a
limited
amount
you
can
buy,
it
can't
be
used
in
public.
It
can't
be
used
in
schools,
on
federal
property
in
colleges
and,
as
I
said,
this
limited
amount.
It's
like
1.5
ounces
of
a
flour
or
12
ounces
of
consecrated
or
like
750
of
total.
So
we're
really
hoping
it
isn't,
because
it's
not
allowed
it's
still
prohibited
in
those
places.
So
we're
keeping
our
fingers
crossed.
A
So
do
you
think,
based
on
the
new
law,
that
it
will
be
easier
for
for
kids
to
get
cannabis
illegally?
You
know
laws
are
similar
now
I
guess
to
alcohol.
You
know
I
know,
there's
a
little
more
restrictive
nature
with
with
the
new
cannabis
laws,
but
do
you
think
kids
will
have
the
opportunity
to
get
cannabis
more
readily?
Well,.
B
We're
hoping
not
you
know,
you're
not
allowed
to
share
it.
We
are
encouraging
parents
to
just
like
other
Controlled
Substances.
Lock
it
up,
be
careful,
don't
use
it
in
front
of
your
children,
make
sure
that
you
have
conversations
with
them
on
the
dangers
of
it.
You
don't
want
it
to
be
something
that
they
have
access
to
now,
also
with
the
sales
they're
funny.
B
What
the
law
says
too,
is
you
they
can't
Market
it
or
sell
it
by
schools,
libraries,
Parks,
so
we're
really,
as
we
said,
we're
keeping
our
fingers
crossed
that
it's
something
that
they
don't
have
access
to,
and
we
ask
every
parent
any
user.
Please
make
sure
it's
locked
up
and
kept
away
from
children
because
it
can
be
very
harmful
and
dangerous.
Now
brains,
there
is
a
lot
of
research.
I
have
to
say
this
as
a
disclosure,
because
it's
still
federally
illegal
there's,
not
a
lot
of
research
on
the
effects
of
the
youth
brain.
B
You
almost
have
to
turn
to
other
countries,
which
is
something
we
started
doing
actually
before
the
show
to
get
ready.
I
was
like
well
what
studies
is
there?
There's
one
in
Australia
and
New
Zealand
that
talks
about
its
impact
in
decreasing
students,
graduation
rates
ability
to
get
degrees,
developing
developing
substance,
use
disorders
and
even
attempting
suicide.
So
there's
a
lot
of
outside
studies,
it's
just
not
in
the
United
States,
it's
just
because
it's
federally
prohibited,
which
I
have
to
say
you
know
it
can't
be
used
on
federal
property,
which
is
all
the
Mead
schools.
B
C
B
B
You
know
I,
hear
people
say
that
well,
I
used
it
when
I
was
in
high
school
and
what's
the
big
deal
it's
different,
it
is
not
the
same
drug
as
it
was,
so
we
really
the
effects,
there's
so
many
different
on
their
academics
and
on
work
performance,
their
behaviors
and
really
it's
just
such
a
gateway
drug
and,
as
we
said,
we
don't
know
the
effects
yet
of
the
brain.
There.
B
A
D
B
There's
also
a
piece
I
was
going
to
say
with
a
co-occurring
in
mental
health
disorders.
You
know
they
find
that
there's
a
definite
link
of
students
who
are
suffering
from
mental
health
disorders
and
then
also
have
substance
use
disorders
because
it's
like
60
to
75
percent,
it's
very,
very
high,
as
well
as
with
adult
population
right.
So
it
is
a
coping
as
Aisha
mentioned,
It's
A
coping
mechanism,
you
know
kind
of
helps
them
temporarily,
relieve
their
symptoms
versus
going
and
seeking
help.
So
yeah.
C
C
C
You
know
it
seems
to
be
extremely
prevalent
in
our
youth.
I
know
that
my
son,
when
he
was
in
high
school
and
Haley
graduated
two
years
ago,
he
would
find
Vapes
in
the
bathroom
they'd
be
in
the
toilet
paper.
Rolls
I've
have
conversations
with
my
daughter
who's
in
high
school.
So
what
is
vaping
and
what
you
know?
What
do
you
think
has
impacted
I
do
think
that
smoking
cigarettes
has
gone
down,
but
now
we
see
this
uptick
in
vaping.
So
just
your
thoughts,
yeah
I,
shot.
D
Anyone
cover
that
sure
absolutely
so.
Vaping
is
any
time
the
simplest
answers
anytime
you're,
using
a
handheld
electronic
device
to
inhale
a
vapor,
a
Mist,
an
aerosol
into
your
lungs,
that's
vaping,
okay,
so,
basically
how
the
devices
work
is
that
they
heat
up
the
liquid
turn
it
into
an
aerosol
and
then
you're
inhaling
that
through
a
mouthpiece
into
your
lungs
and
so
anytime,
you're
inhaling
things
into
your
lungs.
They
can
be
damaging
right.
So
what
are
the
devices?
They
have
many
names,
they
could
be
Jewels
right.
D
C
D
So
the
substances
that
are
most
likely
to
be
in
The
Vaping,
liquid
or
the
aerosol
one-
usually
it's
nicotine
right
in
varying
concentrations.
So
we
know
that
nicotine
is
the
harmful
substance,
that's
in
cigarettes
and
other
tobacco
products
and
the
addictive
substances
in
cigarettes
and
other
products
there's
sometimes
it
can
be
cannabis
or
THC.
So
you
can
Vape
cannabis
or
THC,
but
usually
it
is
nicotine
and
then
the
other
substances
that
are
in
it.
D
Yes,
it's
mixed
with
water,
but
it's
not
just
this
harmless
water
vapor
that
you're
inhaling
there
are
other
chemicals,
so
there's
flavoring.
That
has
to
happen
once
the
liquid
is
heated
up.
It
has
to
get
turned
into
an
aerosol.
So
there
are
other
chemicals
that
turn
it
into
an
aerosol
that
are
in
there
propylene
glycol
or
vegetable
glycerin.
D
Those
products
turn
it
into
an
aerosol,
and
then
there
are
there
can
be
heavy
metals
in
there
like
tin,
nickel
things
you
just
shouldn't
be
inhaling
and
that
aren't
safe
formaldehyde
is
even
in
there
yeah
formaldehyde,
which
we
know
that
research
says
that
causes
cancer
right
and
lung
disease
and
there's
also
acetate
in
there.
That's
linked
to
a
very
serious
lung
injury
illness
that
comes
from
vaping
wow.
A
C
A
C
D
D
C
Yeah,
so
it's
really
important
for
parents
and
families
and
caregivers
to
be
I,
think
mindful
of
what
they're
doing
around
their
kids
or
having
their
kids
having
access
too,
because
it's
really
access.
You
know
we
talk
about
access
in
homes
and
keeping
kids
safe
from
like
old
prescription
medicine,
that's
not
you
know
thrown
out
or
what
handled
or
dropped
off
at
the
health
department.
C
B
A
Welcome
back
to
At
Your
Service,
we
will
be
continuing
our
conversation
with
Karen
Cisco
Creo
and
Aisha
Austin
from
the
Department
of
Health
and
and
school
health,
and
we've
been
talking
about
cannabis
and
vaping.
So
thank
you
all
for
for
continuing
this,
this
very
informative
conversation
and
we're
going
to
start
our
first
question
with
something
we
visited
in
the
first
part
of
the
show,
but
time
back
to
the
connection
between
substance
use
and
and
mental
health.
Can
you
talk
to
us
more
about
that
and
how
how
those
two
can
be
connected?
Absolutely.
B
As
I
mentioned
earlier,
the
estimated
rates
of
co-occurring
mental
health
disorders
with
children
with
adolescents
and
substance
use
disorder
ranges
between
60
and
75
percent,
now
use
who
have
experienced
a
major
depression
event
they're
like
twice
as
likely
to
use
alcohol
or
substance
use
drugs
in
adults.
It's
surprising
one
out
of
four
adults
with
a
mental
health
illness
also
have
a
substance,
use
disorder
and
the
mental
health
disorders.
That
kind
of
more
highly
related
to
and
connected
to
substance
use
disorders
are
like
depression,
anxiety,
personality
disorders,
even
schizophrenia.
C
B
I
think
the
first
thing,
we'll
notice
as
parents
is
a
change
in
our
child's
Behavior.
You
know
maybe
change
in
friends.
Maybe
they
start
getting
trouble
their
grades,
stop
to
start
to
drop
all
of
a
sudden.
They
need
money,
their
behavior
is
a
little
off.
Their
appetite
could
change
their
sleeping
habits
could
change.
They
also
could
look
a
little
different.
You
know
raise
weight
their
eyes,
get
red
and
glassy
and
they
smell
a
little
different.
You
know
you
could
even
have
nosebleeds,
they
could
be
really
thirsty.
B
So
there
are
a
lot
of
different
signs
and
symptoms.
They
also
I
was
reading.
It
was
an
interesting
study
that
said,
if
you
really
want
to
know
as
a
parent
go
on
social,
meet,
look
on
your
child's
social
media
accounts
they
like
to
brag
about
it
and
post
it.
So,
even
though
you're
a
parent
you
want
to
protect
their
privacy
look
is
a
lot
of
times
they
brag
on
those
sites.
B
What
they're
doing
so
good
way
to
kind
of
check,
but
really
my
best
advice
is
anything
that
you
see
different
in
your
child's
Behavior
or
start
looking
into
it
and
see.
What's
going
on
in
their
life
because
something
could
be,
you
know,
they're
vaping,
as
you
said,
it
could
be
cannabis,
it
could
be
a
mental
health
disorder.
I
mean
you
just
don't
know
so.
I
think
being
involved
in
watching
is
is
the
best
thing
great.
B
D
Was
going
to
say,
I,
that's
a
great
question.
I
would
like
to
back
that
up
just
a
little
bit,
because
those
conversations
and
discussions
with
your
child
should
start
early,
have
age-appropriate
developmentally
appropriate
conversation,
starting
at
a
very
young
age
in
non-threatening
ways
and
in
a
safe
environment.
You
know
when
you're
driving
in
the
car
going
somewhere
or
when
you
guys
are
sitting
down
for
dinner,
start
a
conversation,
it's
important
to
have
those
conversations,
but
then
also
continue
to
talk
to
them
as
they
get
older.
D
You
know:
share
your
set
expectations
in
your
family
right
set.
Family
Rules
be
clear
about
what
your
views
are
on
substance
use
on
nicotine
or
tobacco
use,
and
then
so,
once
you
are
having
those
conversations,
if
you
hear,
if
you
notice
something,
then
you
want
to
encourage
discussion
right.
You
want
to
ask
open-ended
questions.
You
want
to
be
patient
with
them
and
be
ready
to
listen
and
hear
what
they
have
to
say.
A
Your
kids,
so
it's
something
you
brought
up
to
I,
think
that's
an
excellent
point
about
having
these
conversations
early
and
I
know
something
we
do
in
our
health
curriculum.
Is
we
don't
I?
Think
back,
you
know
when
I
was
in
school
was
more
about
these
are
drugs.
These
aren't
drugs
aren't
good.
You
know
it's
more.
The
factual
stuff.
A
D
Absolutely
you
want
to
role
play
scenarios
with
your
family
and,
with
your
with
your
children,
have
an
avoidance
plan.
So
if
you're
out
and
you're
hanging
with
your
friends
and
you're
offered
something,
what
are
you
gonna
say?
How
are
you
going
to
avoid
that
situation?
How
are
you
going
to
make
the
best
choice,
for
you
have
an
exit
plan,
so
a
lot
of
families
have
a
code
word.
If
your
child
texts
you
the
code
word,
that's
your
alert,
they
need
you.
They
want
an
out
from
that
situation.
So
it's
good
to
have
a
plan.
B
A
They're
out
with
kids
that
are
drinking
and
they
need
a
ride
like
all
kinds
of
piercedures
situations,
I
think
it's
good
to
have
those
role-playing
and
those
open
lines
of
communication
and
and
to
your
point
early,
because
sometimes
it's
too
late
when
they
get
older
and
you
haven't
developed
those
those
those
safe
conversation,
safe
spaces.
So
yeah.
D
C
D
C
B
I
think
what
is
marijuana
or
cannabis
from
now
from
years
ago
is
now.
It
is
so
synthetic
and
there's
so
many
chemicals
added
to
it
that
wasn't
prevalent
years
ago,
I
mean
now:
we've
even
had
cases
where
fentanyl
has
been
added
to
move
cannabis
and
they
bought
a
part,
the
guy
who
purchased
it.
They
had
no
idea
that
it
was
I
know.
Several
years
ago,
Anne
Arundel
County
had
our
first
fatality,
where
fentanyl
was
in
cannabis,
and
the
user
had
no
idea.
It
was
in
there
and
it
was
fatal
and
they
died.
B
C
A
A
So
what
let's
talk
about
some
programs?
So
parents-
you
know
they
've-
had
conversations
with
their
kids
and
and
their
kids
are,
are
struggling
with
substance
use
and
and
the
parents
want
to
get
them
some
help
or
they
want
to
get
some
help.
Hopefully,
what
are
some
programs
that
the
health
department
has
to
support
Children
and
adolescents?
Who
maybe
had
it
going
through
this
struggle?
Well,.
B
The
first
thing
I'll
brag
about
is
our
star
program,
which
is
screening
teens
to
access
recovery,
and
it's
great
it
any
child.
Any
student
in
middle
school
or
high
school
can
go
into
the
health
room
mentions
to
our
program
and
they
will
be
connected
virtually
with
a
licensed
therapist
now
in
high
school,
it's
through
the
health
department,
but
in
middle
school,
it's
actually
through
Thrive,
which
is
a
contract
that
you
guys
have
with
the
company
Thrive,
and
they
also
you
guys,
have
a
substance,
use
prevention
and
intervention
team.
B
So
any
student
you
know
or
parent
can
really
contact
students
can
contact
a
counselor
or
School
nursing,
get
connected
to
services
and
that's
the
advantage
of
stars.
They
come
in.
They
get
connected
right
away
and
screened
by
a
licensed
therapist
and
they
I
can
get
plugged
into
Services
if
they
need
it,
which
is
a
great
program
now.
The
health
department
also
has
some
additional
programs.
They
have
adolescent
Family
Services,
whichever
you
know
it's
easy.
You
can
just
call
look
at
for
the
number
online.
It's
just
a
222
number
I
think
it's
six,
seven,
seven.
B
What
is
it
A5
or
something
like
that
yeah
and
then
there's
a
Youth
and
Young
peer
support
group
program
that
the
health
department
has
too
is
again
it's
a
222
number,
it's
7076.,
so
there's
some
great
programs
available
that
students
and
parents
can
access
and
as
Aisha
mentioned,
even
online
number.
So
that's.
D
Great
online
resources
there's
also
smartphone
apps,
now
yeah,
you
know,
because
when
you're,
when
you
do
suspect
or
you
find
out
that
your
child
is
vaping
or
using
cannabis,
you
want
to
support
them
in
the
quitting.
So
there
are
also
resources
online
and
smartphone
apps.
That
will
walk
you
through
the
price
process,
but
you
should
also
reach
out
to
a
child
therapist,
like
mentioned
in
these
programs,
for
an
evaluation
and
resources,
and
also
don't
forget
about
the
your
primary
care
or
your
child's
pediatrician
and.
C
B
B
There
were,
like
six
kids
came,
came
in
I,
think
one
child
came
in
like
48
hours
after
we
launched
the
program,
so
it
was
great
and
since
then,
when,
since
we
launched
it
in
middle
school
last
year,
we
saw
two
students
and
then
we
also
saw
in
High
School
17
students,
so
I
think
in
total
we've
seen
about
32
students,
which
is
awesome.
These
are
32
students
who
are
screened
and
were
plugged
into
Services
if
they
needed
it,
which
is
wonderful
and
I.
B
Understand
too,
that
was
during
covid
I
know,
that's
what
so,
where
there
was
no
school,
so
you
know
yeah,
so
we're
very
proud
of
that,
and
and,
as
you
said,
you
have
several
different
Avenues
right.
There's
a
health
department,
pediatrician
crisis
right
where
the
students
himself
just
can
come
in
and
ask
for
help.
I.
C
Know
and
I
like
the
idea,
because
students
that
means
they
are
taking
ownership,
they
recognize
even
at
a
young
age.
Okay,
this
is
a
problem
right
and
so
they're
able
to
reach
out
and
I
always
find
that
to
be
the
stronger
way
for
kids,
because
you
know
some
kids
are
in
denial
or
the
rebel
and
I
also
think
for
parents.
C
If
they're
watching
this,
you
know
show
or
caregivers
that,
even
if
you
have
a
question
you
can
also
reach
out
for
information
like
I'm,
not
sure
if
this
is
what
I'm
seeing-
or
this
makes
sense,
but
I
know
that
there
are
people
like
the
school
health
nurse,
the
school
counselor
like
trying
to
put
the
big
picture
together,
because
sometimes
you
see
it
in
fragments
and
you're
like
wait
a
second.
So
this
is
a
great
opportunity
for
them.
C
Yeah,
so
I
just
think
that
we
of
some
great
things
happening
in
Anne,
Arundel,
County
and
that
we're
proud
of
them
and
then
we're
trying
to
really
support
our
students
and
families.
So,
thank
you
very
much
for
all
the
work
that
you
guys
do
and
I
appreciate
you
being
here
today
on
At
Your
Service
as
our
guests.
Okay,.