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Video Transcript

Alyssa Mahramus, EVERFI: Thank you all so much for joining us today. My name is Alyssa and I’m the director of implementation for the educational technology company called EVERFI. We’re here today because of some really meaningful and thoughtful questions from students around the state of Pennsylvania about mental health, prescription drug safety and providing support to other. Based on the prescription drug safety program that you just went through, we asked students, when you’re thinking about how to support your health and others, what comes top of mind. And with those questions, we are joined today be a panel of experts coming from the Pittsburgh Penguins, the DEA and the FBI. We have partnered together to have a roundtable discussion, thinking about how we can best support students as they go forth in future endeavors so they can be successful. So let’s go ahead and meet our panelists.

Frank Lukez, FBI: My name is Frank Lukez, I’m a Supervisory Special Agent with the FBI. I currently supervise the Greater Pittsburgh Safe Streets Task Force and I have so for over five years now. I have 23 years in the FBI having previously served in Chicago and Cleveland field offices. I was a United States Marine Corps Infantry Officer for about 7 years prior to coming into the FBI. I’m originally from Canton, OH, so my story is one that, you know, any time I was given the opportunity to do any kind of career days, what I’d always tell the high school students is don’t ever get despondent if your grades aren’t what they need to be. I’m a classic example of someone who probably have never gone to college, because my grades were so terrible in high school, and somehow, I made it. Again, if anything, just small success stories every single day, get up in the morning, make your bed, and good things will happen. I think what’s most important from the panel discussion today, is just that this is such a serious topic that we talk about and certainly wasn’t really prevalent as when I was growing up and was your age. It just takes the ability to make sure that you’re always doing the right thing. If you’ve got friends or family members that aren’t, you need to try to talk to them and you need to try to get them help. If there’s one thing that I’d like to do, and I’m a father of 3 sons, I’ve got 2 in college right now. One is a first-year student at the US Military Academy at West Point. He’s a wrestler there, and I’ll send him book on individuals who have gone on to do great things, and I encourage him to read them, and my other two as well. But there’s a book that if you get an opportunity to go to a library, or if you go onto Amazon, the title is Fearless, and it’s about a navy seal by the name of Adam Brown. I say that because this is an individual who lost his life in Afghanistan on a deployment and was operating on one of the top military units in the world. The story of Adam Brown is one that should be taught to everybody, because this is an individual who grew up in Arkansas, he was a high school football star, and had a lot going for him. Then he got hooked on narcotics, and nearly lost his life, either through incarceration or through overdoses, and it was an opportunity that somebody gave him to go into the Navy and to a Navy Seal  buds training, and that’s where he found, what her referred to, as his “inner psycho” this ability just to compete and do great things. So it’s a great book, and I think that it’s one that can resonate with a lot of folks right now that feel like life’s pretty bad. But if you get an opportunity to read about this and read about what this individual went through, there’s a thousand stories like that, but it’s one, again, that I would encourage anybody to read. “Fearless, The Story of Adam Brown,” a Navy Seal. Thank you.

Jason Jerome, Penguins Foundation: My name is Jason Jerome and I’m the director of sports performance at the UPMC Limeaux sports complex. I got the blessed opportunity to work with the penguins and their penguins elite program. I do a lot of training with getting kids ready to play hockey, a lot of training on just getting physical preparedness. We work with a lot of athletes outside of the penguins as well. Different athletes from different backgrounds. I’ve done that my entire career. I was down in Miami, I’ve been up in Buffalo with the Sabres org as well. I’ve been able to travel around to different areas, but always with the same theme, getting people better, helping them succeed and preparing them to move on to the next level. One of the awesome opportunities I got though and the reason I was probably asked to be on this very cool panel was down in Florida it’s one of the hot beds for opioid abuse. Delray beach Florida which is where I was working is the one are in the country that indiv. Come to for substance abuse. There’s centers everywhere in that area. One of the things that I did outside of sport performance facility was invite indiv. Struggling with opioid addiction to come to our facility and we actually created an exercise program for them. We were able to write a grant to the state of Florida and show that exercise being introduced to their behavior modification program actually showed all different kinds of opportunities to change body and change how their thought processes were towards their behavior. We showed that exercise decreased the amount of relapse rates they had. I’ve taken that to heart with some of my background, having a parent that had a strong addiction and bring that into my professional life and help everybody out. So one thing I can say to everybody that’s on the panel. Very smart individuals that know a lot and have a lot of great experience. A lot of great information out there that can help.

Mike Dukovich, DEA: My name is Mike Dukovich and I’m a group supervisor with DEA. I’ve been a supervisor about a year and a half. I’ve been with DEA for 23 years and before that I was a local LE for 3 years. You’ll get a lot of stuff thrown at you today. I would encourage you to do your own research. Like frank said, I would read as much as you can about every subject you can and good luck.

Mahramus: This is all so great. Thank you so much for taking time out of your day and we’re very excited to hear from you. So this is how it’s going to work. Each of the panelists selected three questions based on the questions that were submitted. They’re going to have about 2 min each to answer the questions and we would love for all of the panelists to weigh in. we hope this give you a better understanding of prescription drug safety, also mental health and just really keeping yourself healthy and safe as you continue on to your future endeavors. Let’s go ahead and get started with the first question. We’re going to toss this over to Michael at the DEA. So Michael, why are their different names for opioids, stimulants and depressants and how do they effect different spots in the brain, just like we saw in the program.

Dukovich: The different names are, the stimulants and the depressants, are how they effect your body. Stimulants give you energy and pep you up, and depressants calm you down and make you tired. There are opiates that are for pain. Different drugs affect the brain in different ways. The simplest way it was explained to me, is that the grain is the messaging center, and tells you what your body needs. Different things affect the messages, or could block the messages, or could change the messages to your body. So that’s how it affects your brain.

Mahramus: Thank you. I’m going to go ahead to ask this one to the FBI. So Frank, if you do encounter an OD, how do you know what kind of OD it is.

Lukez: So traditionally, the first indicator of what the overdose is going to be, it’s going to be reported by the first responders. They are going to be the units that respond, whether it’s law enforcement, your paramedic units, your fire department officials, those are going to be the ones who respond to that crisis scene. Traditionally there’ll be drug paraphernalia there that will give an indicator as well as to what type of drug may have caused that overdose. If the overdose results in a fatality, then the medical examiner’s office will obviously do their toxicology reports to make a clear determination as to what type of drug actually caused the overdose. With respect to fatal overdoses, oftentimes among users, it might be a cocktail of different narcotics that are used, and also individuals may have preexisting conditions, underlying conditions, health reasons that may have resulted in that overdose. From where the federal agencies sit, we are going to get that information pushed up to us, from the first responders, those that are on the scene to deal with and triage those individuals. When we become aware od a cluster of overdoses, maybe one particular drug in a certain area that is causing a number of overdoses or a number of fatalities, then we look to work that problem from the origin of those individual overdoses, and try to track it back to where the creation point was, and the induvial who may have provided those narcotics and look at the bigger picture, and try to work and mitigate that problem.

Mahramus: Thank you so much Frank. This question is for you Jason. Given your background of working with Youth in a variety of ages, could you tell us based on your experience, how harmful are depressants on a youth’s health.

Jerome: Yeah I would start by trying to help everyone understand what an antidepressant does. So classified as a SSSR, serotonin, reuptake inhibitor. So we have to understand that serotonin that low levels give us those low levels gives us symptoms of depression. So that medicine we’re taking really tries to increase those serotonin levels. Everything acting on the brain gives us different outputs. And one of those bad output is not having serotonin are those depressant type symptoms. So when we take the medicine, there’s good things that come out of that but we do need to understand there’s always side effects of medicine we may take. Things that younger indiv. Will suffer from, things gastrointestinal stress, insomnia dry mouth, dizziness, weight gain is common and headaches. Everything has a positive and negative, where we see depression causing issues in our society. Where we have to weigh the balances of headaches, and some insomnia. We can manage those very easily so there’s some bad connotation around anti depressants, so to understand the science around it and understand the pos outcomes. If we are aware of what the side effects can be, I think we can communicate with mom and dad and teachers and coaches to understand what’s going on and communicate with our doctor’s as well should we need to change to a diff antidepressant.

Mahramus: That’s incredible feedback Jason and I really think you hit the nail on the head. It’s all about communications. Before the next questions, I would love everyone to weigh in. toss this question to frank: what is the best way when we know that someone is misusing or abusing drugs. How can we support them.

Lukez: That’s a great question, and again, unfortunately, I think it’s facing a lot of teenagers today, because its’ so prevalent in the school systems and its so prevalent in every community. I think it goes back to those individual personal relationships that you have. If this is somebody that you consider to be a fiend, I think that first step should be a conversation with that individual. If this individual has a significant addiction, make every effort to try to convince them that the only way out of it is to get help. Certainly, anybody who has an addiction has to recognize that they have it, and with that, accept help. It’s not often easy to do- to admit to something that is not good for you, and probably from your family members and friends, but to seek that help. If they really want to get better, and overcome this horrible problem that they’re facing they’ve got to realize they’ve got to do it with people that love them- friends, family members, the education staff. If they’re close to individuals in the community, whether it’s religious people, maybe they’ve got coaches that they can turn to, from an athletic standpoint. They’ve got to recognize 1- that they’ve got an issue, 2-they need individuals that love and care about them to help them out.

Dukovich: That’s a very hard conversation, because you know that they’re going to deny, or minimize their addiction. If possible, I would bring as many friend, or loved ones, as possible, to really hammer it home to them. 

Jerome: I think a lot of statistics show as well, that a lot of the addiction symptoms as well, are behavioral. If we don’t break the cycle of the environment that we’re in continually, by bringing in a lot of outside people, and a lot of outside opinions and whatnot, it’s hard for an individual to break that cycle. I’m just doing the same thing over, and over, and over, and over and over, it’s hard to break that habit. We develop good habits, we develop bad habits, so if we can’t change that environment, it’s hard to get into that system of help.

Dukovich: Sometimes a friend, also, may try to minimize their friends’ addiction, by just saying “They’re just having a bad day,” or by saying something completely different.

Jerome: The best thing a person could to is help out.

Lukez: Exactly, and the worst thing they could do, is not do anything. Maybe you hate to use the term “enable,” if they think they’re doing enough by just listening to their problems, and not doing anything about it, the worst thing they certainly any of us wouldn’t want to have is knowing that we could have potentially done something, even if it may have jeopardized that relationship to get them help, than to read about them in the newspaper the next day.

Mahramus: I think that’s something a lot of our students are thinking about. There’s a lesson within the program of how do we see the greatest growth, of how do we support one another, esp as we are all connected in a different way, we aren’t seeing each other every day in person. Jason I’m going to go back to you. This question relates to when someone does get over their addiction, what is the rate of relapse. Is that possible?

Jerome: Yeah, there’s a lot of good stats on that. A lot of people spent a lot of time researching. A lot of stats show that up to 60 percent of relapse rates are very likely. I think that speaks a lot to it’s a behavioral situation. I get a thought process that just happens and happens and then it’s hard for me to change the behaviors I have. so if I’m going out and have the same schedule everyday and going to school, practice doing homework, and includes home life, that’s going to continue to play out 5-6 days a week. The relapse rates, it’s kind of obvious that we are going to have those issues continuing. For me, something that’s very interesting as well to take note of, is the genetic, type of personality and I’m in that home with those types of behaviors, I’m likely to be stuck as a candidate for relapses because I’m in an environment that’s always calling for those types of situations to occur. I think it’s a real issue. And it’s something people will struggle with. We need to understand that being prescribed medicine for an addiction isn’t the end all be all cause we’re a lot smarter now with treatment centers and we are trying to use behavior modification as a way to get pas addiction. Fortunate being in the sports arena, with exercise, with serotonin levels being low causing depression, fatigue and sad feelings involved with depression, exercise changes that. It releases hormones that make us feel better about ourselves. It’s a way to turn things around. Behavior modifications are away to battle those relapses.

Mahramus: Thank you so much. Ok we’re going to go back over to Michael at the DEA and we’ve probably heard this in the news, if doctors are able to give prescription to patients who need them, why don’t they give them as needed as oppose to giving them in a huge group that may cause misuse. Why don’t think about how the patient can come back or mailed or delivered?

Dukovich: There’s a bunch of different reasons we’ve come across. Sometimes it’s just what the dr has always done. What they’ve done to make it easier on the patient. sometimes the patient is playing the doctor and trying to get more. Sometimes the doctor is just doing it for bad reason. They’re getting money from companies or selling scripts. Doctors are human too. Sometimes the dr has an addiction and may be splitting the pills with the patient. We’ve come across all kind of reasons why that happens. I think there’s a lot of reprogramming going on to only give out 12 pills here, or whatever amount to get you through and you just come back.

Mahramus: Yeah I think you made some really interesting points that I know i haven’t thought of and maybe others haven’t thought of. Each case is different. There’s a lot of different components that can go into why these prescription drugs have gotten to people and patients in the way they have. I think that’s why it’s really key to keep top of mind. Frank I’m going to toss it to you, but I think we all have a perspective because we’re all dealing with it together. Based on the last year or so, how many drug cases have you seen and have you seen an uptick due to the pandemic.

Lukez: I think the data on that is still outstanding. Obviously I think probably the second week or so of March is when things really hit home here in Western PA and for the most part, throughout the country when lockdowns started happening.  I think it’s going to be at least a year before we get a true indication on stats related to overdoses and drug investigations. I can tell you, from a federal standpoint, that the number of cases that we’ve worked this past year has remained pretty much on par with what we’ve done in the past 5 years, since I’ve been here. I think from a large scale, narcotics trafficking perspective, there are still a large volume of narcotics coming into the country. The level of narcotics inv has remained consistent. With respect to individuals being quarantined, I would assume, depending on their situation at home, it still comes down to the ability to get narcotics. It’s going to be a year or so before we get a true indication of how much the pandemic and the lockdowns had on narcotics trafficking and narcotic use.

Dukovich: There may have been a slowdown of certain things, like meth, for awhile, but they’ll just turn to something else, and we have been busy.

Mahramus: It’s going to take some time to see the effects, it’s all taking much longer than we thought. So there’s going to be different indicators to take into consideration, things that we’ve all gone through. Yeah. I’m really curious, once this all wraps up any findings you may have. This next question I’d love for us all to weigh in because we were all teens once. This question, I’ll toss to Michael. If you’ve smoked maybe two to four times in your life could this affect you really badly?

Dukovich: I think it is. I can’t stand cigarette smoke. Let alone anything else. My parents smoked and to this day I blame them for my bad sinuses. The problem is it leads to other things. Smoking cigarettes is one thing. It can affect your lungs. Vaping is horrible for you. It’s so many times worse because of the chemicals. You never know it’s chemicals and you never know what could be in there, what if the guy messed up. It could take one time and be an OD or death because you just don’t know what it is. 

Lukez: I agree with Mike. I think it’s easy for us now, sitting here, around this table, at the age we are, because at one point we were 13, 14, 15, and making decisions that probably weren’t wise, but at the end of the day, it’s just important to listen,. Anything that you do can have a harmful effect. Certainly, as Mike had indicated, you might think smoking a cigarette, or a vape pen, or any of these new ways of inhaling something, it’s not good for you. As Jason indicated earlier, I just think that if kids understood now of getting into good healthy habits, things that, if you start now, at the age of 13, 14 and 15, you’re going to maintain those throughout life. Things like staying away from alcohol, clearly, staying away from drugs, even, you know, kids use Copenhagen, or Skoal or any of those things, they’re just not good for you, and they can have long term effects. As Mike had indicated, many time you hear the word “gateway.” Those are things like, you start smoking cig, and then that leads to marijuana, then that leads to more challenging things. I just think it’s important to establish good behaviors early on. Exercise is critical. Jason indicated that earlier. Anyone sitting here knows that when we’ve kind of gotten out of shape, and we start to kind of get back in shape, how much better we feel. As long as they embrace more of a healthy lifestyle, both in diet and exercise, it just sets them up for success. That’s what it’s all about- small successes every day. Get up, make your bed, and move on from there.

Dukovich: That’s when I start getting back in shape.

Jerome: To your point, Mike, we have to be, as a public, we have to be understanding that the pharmaceutical companies that make the cigarettes use the drug nicotine to get people hooked on it.

Dukovich: Everyone’s trying to make money. Jason 100%. So if we go the gas station, we see all the different stinking types of cigarettes that you can buy. Somebody’s making money off of this stuff. There’s a lot of people, obviously consuming this, so it’s out there, right? There’s so many people, all walks of life, all ages- that are getting hooked on nicotine. Gateway- it’s an opportunity to say “my body likes this, and I’m going to keep on going. And if my body likes this, maybe I’m going to like vaping.” Ten times the amount of chemicals are in vaping, right? To marijuana, right? Who knows where it’s going to end- I flip that switch in my body- I like it- and I’m just going to keep on going. I’ll try this, and I’ll try that, I’ll try this.

Dukovich: It happens repeatedly when you talk to people. “I thought I would just try it one time, it led to this, and this, and it just snowballed from there, and I’m now addicted.” It only takes one time.

Lukez: I think Jason, you had indicated earlier, that every one of us is wired differently, genetically, An individual that lead a clean life, an exerciser fitness phenom, and they’ve never done anything, and they’ve had one alcoholic drink, and that leads to a life of dependency. I just think its critically important when you’re young to recognize that. Often, you hear it from your parents, or people you look up to that are telling you to do those right things, and sometimes you need to hear from others that “you are who you hang out with.” If you hang around people that live good, clean lives, do things the right way, then there’s a good strong possibility that you’re going to end up mimicking your friends that are doing things the right way.   

Mahramus: Something I heard again that you’re all talking about. It’s really that relationship. Creating strong relationships with teachers, peers, knowing the right thing to say and getting support and creating a healthy relationship for yourself. We created this new course around vaping and we’ve looked at the marketing that was once done with cigarettes with students and they’re just kind of re packing it now and doing it with vaping. Really interesting at how you’re looking at those big markets and those big agencies and how they may be taking advantage. Last question for today. Jason it’s for you. What do you think is going to happen when the pandemic is over and teens are still on antidepressant medication? Do you think those teens will still need medication?

Jerome: That’s a tough question. The dark side of the answer is I think there’s always going to be reasons for anxiety. That’s a major reason why someone would seek out help from a dr. and get prescribed anti depressants. I think the sad side of it there’s going to be bullying, stress of academics, time management. Again, god forbid there’s a situation in the household where maybe mom and dad are having a rough time handling everything, there’s still be behavior situations that’ll be tough to get over. Just because corona is over and we get back to somewhat normal doesn’t mean still won’t be a lot of stressors teens deal with and struggle with. A bleak outlook is we’re still going to have to find great ways to get over this together and find good programming for teens. The best thing I can preach is you may not be the best football player but go out there and play for the team. Be in a situation where you’re surrounded by good people. Be in a situation where you can do the best raise spirits a little big and use that as an advantage to get out of those thoughts. Difficulty sleeping. Everyone has it so much going on it’s hard to shut it down at the end of the night. All those things feed into bringing us down. I don’t see that going away. That’s life. We’re going to have to find a way to positively deal with those things. So if it’s getting a gym membership, equipment at the house, programs avail at school or community center, take advantage of them. It’s going around and finding the right people to be around. So when we do come out of this, we take advantage of things out there for us to put ourselves in a good spot.

Dukovich: I tell my kids that now- life’s not all gumdrops and lollipops. If this is hard, put a smile on your face and get through it. Let’s go for a walk. Let’s do something. Let’s play a game here. Put a smile on your face, and get through it.

Lukez: I agree 100% with what Jason and Mike have said. To Jason’s point earlier, we were discussing it this morning. I’m a huge believer that, kids today should be involved in a lot of different things, whether it’s sports- I’m a huge believer in sports because it teaches winning and losing. Band, orchestra, drama club, belong to something. Be around other individuals. Be around those who want to do well in whatever it is they’re doing. Again, as Jason indicated, you may not be the star quarterback or the lead in the play, or the drum major, but, by golly, get out there and be among your peers. Build those relationships. Know what it means to compete. I think that’s the best thing for anybody’s mental health. Again, if we talk about exercise, and not to diminish that, there’s no excuse for anybody not to get outside- even in today’s conditions. If you have a playground near you, you can go over there and do pull-ups off of the different apparatus over there, you can run. There are parks everywhere. Just get out and enjoy nature. It doesn’t matter what time of the year. I think that’s so good for mental health. But I think there’s no substitute for belonging to a team- whatever that team is. Just being around individuals and knowing what it means to compete. Win, lose and move on from there. Small successes.

Mahramus: This was all really insightful and I thank you all for taking the time, thinking of our students and community in all that you’re doing. Students, teachers, I thank you for your time as well. You have done an amazing job with these questions and I continue to invite you to ask those questions and create those connections and keep your health top of mind. If anything we’ve seen over the last couple months, is we’re all in this together, to support each other. This gives us some information to think about and I hope that you continue to put your heart and your should into everything you do. I appreciate you all joining us today. Thanks so much.