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 the conversation towards keeping them safe
- Don’t antagonize them
- You are on their side
- Arm parents with strategies for their children
[37:29 – 44:29] Closing Segment
- Pediatric advocacy and what we can do
- Have an idea of what is going on in the local government
- Get involved with your local AAP chapter
- Dr. Scheele talks about how she was able to change some legislation
- I talk about belonging to your state chapters
- Final takeaways from me
- ‘Good kids’ may have substance issues too
- Opioid disorders may often begin with prescribed medications
- Vaping is prevalent and there is no such thing as nicotine free vape juice
- Consider edible ingestions when you see altered mental status
- Be persuasive not judgemental with motivational interviewing
- Arm parents
- Advocate at state and local government – join your local chapters
Tweetable Quotes:
“There, very well, could be one patient who smokes marijuana every day because they pick up what their parents didn’t finish smoking, and they don’t know that’s bad…the sooner we can intervene, the better it is for their life.” – Dr. Scheele
“I feel like the trick with adolescents is, I don’t think there’s a one size fits all approach to counseling them about almost anything.” – Dr. Scheele
Resources Mentioned:
- Motivational Interviewing
- Monitoring the Future Study
- AAP
- Youth Risk Behavior Surveillance
- 2018 National Survey of Drug Use
If you’d like to know more about Dr. Scheele and keep the conversation going you can find her on Instagram, LinkedIn.
If you’d like to connect with me, you can find me at LinkedIn, Facebook, and Twitter or email me at [email protected] . To learn more about me visit https://www.medicalbhs.com/
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