SUBSTANCE ABUSE prevention MAN 215 Mohamed M. B. Alnoor

Definitions SUBSTANCE ABUSE Substance abuse: is the behavior of excessive use of a substance to modify or control mood or state of mind in a manner that is illegal or harmful to oneself or others.

Potential consequences of abuse include Definitions SUBSTANCE ABUSE Potential consequences of abuse include Accidents or injuries Blackouts Legal problems Poor job performance Family problems Sexual behavior that increases the risk of HIV infection

Definitions SUBSTANCE ABUSE “Substance” The word “substance” in substance abuse, is any chemical agent (natural or artificial) that affects the mind and is abusively used . Alcohol Illegal street drugs Addictive prescription and over the counter drugs. Other mind altering substances , and Tobacco. Substance: Alcohol, Tobacco, Marijuana, Inhalants, Cocaine, Stimulants/Depressants, Hallucinogens, Narcotics and Designer Drugs 

SUBSTANCE ABUSE Symptoms and Signs Emotionally Behaviorally Physically Abuse of alcohol and other drugs affects people: Emotionally Behaviorally Physically

Definitions SUBSTANCE ABUSE “tolerance” "Tolerance" describes changes in the way an addict reacts to a drug, where he needs more of the drug to get the same effect as before. OR When after repeated administration, increasing larger doses of a drug must be administered to obtain the same effects with the original use.

“substance abuse vs. substance dependence” Definitions SUBSTANCE ABUSE “substance abuse vs. substance dependence” The physiological state of neuro-adaptation produced by repeated administration of the drug, necessitating continued administration to prevent the appearance of the withdrawal syndrome Substance Dependence Substance dependence is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring any time in the same 12-month period: Tolerance, withdrawal, substance is often taken in larger amounts or over a longer period than intended, persistent desire or unsuccessful efforts to cut down or control substance use, a great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects, important social, occupational, or recreational activities are given up or reduced because of substance use, or substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance

“substance abuse vs. substance dependence” Definitions SUBSTANCE ABUSE “substance abuse vs. substance dependence” Substance Dependence is a more advanced problem, accompanied by certain changes in the way the person relates to the substance. Signs of dependence include all the signs of abuse plus some additional problems:

“substance abuse vs. substance dependence” Definitions SUBSTANCE ABUSE “substance abuse vs. substance dependence” additional problems: Experiences withdrawal when not using. Seems unable to stop. Preoccupied by “getting” and “using”. Tolerance(needs more to get the same effect). Gives up important things in order to use. Compulsions or cravings to keep using. Rebound. Withdrawal: The psychological and physiological reactions to abrupt cessation of a dependence-producing drug. Rebound: The exaggerated expression of the original condition sometimes experienced by patients immediately after cessation of an effective treatment

Definitions SUBSTANCE ABUSE “addiction” Addiction: The irresistible compulsion to use alcohol and other drugs despite adverse consequences. It is characterized by: repeated failures to control use increased tolerance increased disruption in the family.

Definitions SUBSTANCE ABUSE “addiction” Addiction is another way of saying “dependence.” When a person is addicted to a drug, say for example alcohol, we refer to the condition as “alcohol dependence.” Addiction (or dependence) is a syndrome including withdrawal symptoms, tolerance, inability to quit or cut back, and other problems. Effects of addiction: Abuse, tolerance, physical dependence – addiction, psychologic dependence –mind-body connection, alcoholism – chronic progressive potentially fatal and blackouts(anterograde amnesia experienced by alcoholics during episodes of drinking, even when not fully intoxicated; indicative of early, reversible brain damage).

Definitions SUBSTANCE ABUSE “addiction” “alcoholism” Alcoholism means “alcohol dependence.” An alcoholic is addicted to alcohol. Addiction leads to withdrawal symptoms. So an alcoholic would show withdrawal signs when not drinking, would show increased tolerance to alcohol, would be unable to control the amount of drinking, and so on.

Understanding Addiction Definitions SUBSTANCE ABUSE “addiction” Understanding Addiction For 10% of people, abuse addiction. Addiction to alcohol and other drugs is: Chronic Progressive Basic components of disease model: Chronic: Recovery requires life long abstinence and active participation in recovery groups. Progressive - there are signs and symptoms of addiction. Primary – it is the main problem, not secondary to something else. Terminal/Permanent – once addicted to a drug, always addicted and to all drugs, not just the drug of choice. If not stopped, the disease will be fatal. Disease is marked by denial, impaired (loss of) control, preoccupation, and adverse consequences. Primary Terminal Characterized by denial

SUBSTANCE ABUSE “use” Ways that people use alcohol and other drugs Experimentation Social/Recreational As a stress reliever

SUBSTANCE ABUSE “Initiation of substance use” Internationally Most children initiate tobacco, alcohol and illicit drug use between the ages of 13 and 16? There is about a 200% increase in the use of tobacco, alcohol and other drugs between grades 8 and 10.

SUBSTANCE ABUSE “Initiation of substance use” Internationally Risk to move on to marijuana is 65 times greater for persons who smoke or drink Risk to move on to cocaine is 104 times greater for persons who used marijuana The more risk factors someone has the greater likelihood to use substances.

SUBSTANCE ABUSE “Initiation of substance use” Internationally The lack of perceived power and control over their lives leads to boredom in and a search for freedom from that boredom. In under-developed countries the main reasons for drug use as stated by youth included lack of rights, food, health, education and a chance to earn a living.

SUBSTANCE ABUSE “use” Why do people use alcohol and other drugs? Substance use as outlet for emotional and physical stressors in life Financial and work problems Used to boost self image. Used to fit in/be accepted Insufficient knowledge about drugs and their effects

SUBSTANCE ABUSE “Consequences” individual level family level In addition to effects on the body, other consequences occur at individual level family level community level.

SUBSTANCE ABUSE “Who uses substance ?” “RISK FACTORS ” “PROTECTIVE FACTORS ” Factors associated with greater potential to use substances are called “risk factors.” Factors associated with reduced potential to use substances are called “protective factors.”

SUBSTANCE ABUSE “Who uses substance ?” “RISK FACTORS ” Chaotic home environment Ineffective parenting Little mutual attachment and nurturing Parental/sibling substance abuse or mental illness

SUBSTANCE ABUSE “Who uses substance ?” “RISK FACTORS ” Academic failure Low academic aspirations classroom behavior Inappropriate Shy aggressive

SUBSTANCE ABUSE “Who uses substance ?” “RISK FACTORS ” Poor social coping skills Affiliations with deviant patients Perceived external approval of drug use peer family community

SUBSTANCE ABUSE “Who uses substance ?” “PROTECTIVE FACTORS ” Strong family bonds Parental engagement in child's life Clear parental expectations consequences

SUBSTANCE ABUSE “Who uses substance ?” “PROTECTIVE FACTORS ” Academic success Conventional norms about drugs and alcohol Strong bonds with pro-social institutions School Community Mosque

SUBSTANCE ABUSE “PREVENTION” Primary prevention Secondary prevention Tertiary prevention

SUBSTANCE ABUSE “PREVENTION” Primary prevention To prevent initiation of substance use or delaying the age at which use begins. TWO STRATEGIES 1- to reduce supply Actions aimed to reduce supply: (based on the principle that the decreased availability of substances reduces the opportunities for abuse and dependence). Actions aimed to reduce demand: (including health promotion and disease prevention).   2- to reduce demand

SUBSTANCE ABUSE “PREVENTION” Primary prevention “RISK FACTORS ” To prevent initiation of substance use or delaying the age at which use begins. “RISK FACTORS ” “PROTECTIVE FACTORS ”

SUBSTANCE ABUSE “PREVENTION” Secondary prevention To target individuals in the early stages of psychoactive substance use, in order to prevent substance use becoming a problem and thereby limit the degree of damage to the individual.

SUBSTANCE ABUSE “PREVENTION” Tertiary prevention To end dependence and minimize problems resulting from use/abuse. This is to enable the individual to achieve and maintain an improved level of functioning and health. This is also called rehabilitation and relapse prevention.