Presented by: Mark McDonald, MS, CRADC, CCGC

 The primary goal of prevention is to delay the first use of alcohol or other drugs.  Research indicates that adolescents who begin drinking before age 14 are significantly more likely to experience alcohol dependence at some point in their lives compared to individuals who begin drinking after 21 years of age.  That's why delaying the age of first use of alcohol and drugs is a critical goal of preventionalcohol and drugs  protective factors, especially proactive parenting and strong family bonds, can help delay adolescents' experimentation with drugs and alcohol and thus help reduce long-term problems.

Prevention needs a comprehensive, communitywide approach

Personal Self-talk, imaginings and visualizations, attitudes, beliefs and cognitions Interpersonal Modeling and reactions of others. Degree of anti-social vs. pro-social influence Community Reinforcement Physical environment and cultural “group” elements that maintain reward-cost contingencies

 Old information  Old attitudes and beliefs  Old motivators  Old skills and behaviors  Taking the Easy way out-impulsive, no plan  New Information  New Beliefs/values/and attitudes  New motivations  New skills and behaviors  Follow the plan

Arthur MendelsonArthur Mendelson: You're focusing on the problem. If you focus on the problem, you can't see the solution. Never focus on the problem! Arthur MendelsonArthur Mendelson: See what no one else sees. See what everyone chooses not to see... out of fear, conformity or laziness. See the whole world anew each day!

1. Target those with a higher probability of risk 2. Provide most intensive prevention/treatment to those at higher risk and fewer protective factors Pervasive, consistent messages to young people about drugs and alcohol can prevent substance abuse.

1. Attitudes, values, and beliefs 2. Friends 3. History of involvement in antisocial behavior 4. Personality 5. Employment/work ethic 6. Family 7. Early Substance Use/Abuse

1. Talking cures 2. Drug education 3. Biblio-therapy 4. Self-help programs 1. Medical model 2. Self esteem 3. Punishing smarter programs

 Scared Straight – deterrence theory; “make them fear prison.” o Nearly every study over the past 25 years has found dismal results, many even showing higher recidivism rates for Scared Straight participants. Has been characterized as criminal justice malpractice.  Drug Abuse Resistance Education (DARE) – didactic model; “kids don’t know drugs are bad for them.” o Most studies have found neutral effects for DARE. More recent versions of DARE, based upon cognitive-behavioral principles, have been more promising  Sheriff Joe Arpaio’s (Maricopa County Jail, Arizona) Tent Cities and Chain Gangs – more deterrence theory; “make them hate prison.” o By the jail’s own admission, its recidivism rate exceeds 60 percent

 Let’s develop the Network of Addiction and as we dismantle it.  Let us develop the Network of Support needed to reduce or intervene in the need and potential risk of those we serve.

 Curiosity  Conviviality  Competition  Opportunity  Environment  Social expectations  Social requirements  Family  Peers  Easy way out  Risk factors  Antecedents  Beliefs  Consequences  Models (many anti social models)  Education  Sense of self  Identity away from peers  Ability to intervene  Skills training  Self regulation and self decisions  Self efficacy  Communication connections  Monitoring/accountability  Appropriate individualized sanctions  PIC-R  Mentors and models (Pro social influences)

 Addiction  Addict  Drug of Choice  Supplier  Money  Work or Crime  Family  Friends  Relationships  Connections  Rituals  Enablers-including criminal justice system)  Paraphrenalia  Geography  Socialization  Criminogenic (anti-social) thinking/self defeating thoughts and behaviors  beliefs  Recovery  Addict  AA/NA-Self Help Meetings  Sponsorship  Literature  Church or spirituality Influence  Treatment-long term  Accountability/Supervision  Coping skills/living skills  Sanctions/Incentives/Motivators  Ongoing assessment of Risks/Needs  Case Management-Resources  Job Skills/Education opportunities  Family  Friends  Assist in removing barriers  Enlist ongoing support  Support for lifestyle changes  Develop internal supports for self efficacy  Medication Assisted Recovery

Move anti-social thinking and negative emotional states toward a pro-social direction. ƒ Reduce association with antisocial peers/others while enhancing association with pro-social models and mentors. ƒ Build self-regulation and problem-solving skills. ƒ Help others with a history/family history of substance abuse and antisocial behavior acquire and practice less- risky behavior in safe peer groups. ƒ Enhance rewards for non-using behavior through home, school/work, and leisure settings. ƒ Reduce substance abuse sufficient to shift the reward structure from anti-social to pro-social behaviors.

 We learn much of what we do through observing and speaking with others (“models”), rather than through personal experience  We form a cognitive image of how to perform certain behaviors through modeling, and use this image as a guide for later behaviors

Parents Pop Stars

Political Leaders

Historical Figures

Many anti-social role models Be a Canadian Hero Be Violent

Be a Jack-Ass or

You treat a disease, you win, you loose. You treat a person, I guarantee you, you'll win, no matter what the outcome.