05. Substance Use Disorders and Childhood Exposures: What you need to know with Dr. Allek Scheele

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Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I had the honor of speaking with Dr. Allek Scheele. Dr. Scheele is currently doing her pediatric hospitalist fellowship at the Helen DeVos Children’s Hospital in Grand Rapids. Her research focuses on pediatric and adolescent substance abuse and exposure.

Let’s dive into Dr. Scheele’s expertise so we can learn the hard truths behind child substance abuse and what we can do to arm ourselves, the children, and parents with tools and strategies to prevent problems in their lives.

[00:01 - 04:24] Opening Segment

• Introducing today's guest, Dr. Scheele, and what we will be talking about
• Dr. Scheele talks about how she got into her field
• Opioid epidemic conference sparked her first interest
• Led a project on marijuana exposure
• Became addiction medicine certified
• Reflected on her passion and decided to do a Pediatric hospitalist medicine fellowship in her second year of residency

[04:25 - 17:53] The Shocking Truth Behind Substance Use and What To Do

• Dr. Scheele talks about the truths behind adolescent and adult addictions
• The average age of addiction starts around 12
• Preventative pediatrics can make a difference
• I talk about my experience with a 9 year old patient
• Monitoring the Future Study
• “You can’t tell who’s a good kid”
• Anyone can have a use disorder
• Dr. Scheele breaks down how to deal with prescriptions
• Talk with the family
• Don’t over-prescribe
• Not all pharmacies take back opioids
• Promote putting out notices for when there is an event
• Dr. Scheele talks a bit about vaping
• The last two to three years has shown the largest substance increase we’ve ever had
• These vaping products are obviously geared towards children
• All Juul products have nicotine and most teens are being tricked into getting hooked
• One pod equals a pack of cigarettes

[17:54 - 32:55] What We’re Seeing in the ER

• Dr. Scheele talks about the dangers of marijuana vaping
• Increase in accidental ingestion
• Decreasing stigma
• Marijuana ingestion is getting more creative causing kids to take in higher volumes
• Kids coming in with altered mental status
• What to screen for
• Dr. Scheele talks about preventative pediatrics
• Work asking about substances into your check with the adults
• The Vapors in the house can cause an infant to test positive for THC
• This can also be absorbed into their skin affecting long term brain development
• ADHD
• Schizophrenia
• Substance Abuse Issues
• I talk about promoting awareness
• How to work with adolescents
• Get to know who their friends are
• Make it nonchalant
• Be non-judgmental
• Ask what it is they like about what substance they’re taking
• Know stopping smoking weed will stop cyclical vomiting

[32:56 - 37:28] How to Deal With Alcohol Abuse

• Dr. Scheele talks about the current state of AA
• Know that it is part of the culture
• Fortunately there is a decline in binge drinking
• Gear...