1. prevention PATH 216 Mohamed M. B. Alnoor SUBSTANCE ABUSE

2. Definitions Contents Why do people use alcohol and other drugs Symptoms and Signs of substance abuse Initiation of substance use Consequences of substance abuse Risk factors & Protective factors of substance abuse Prevention of substance abuse

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

4. 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

5. 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. Definitions SUBSTANCE ABUSE “Substance”

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

7. Symptoms and Signs SUBSTANCE ABUSE Emotional effects: Aggression, burnout, anxiety, depression, paranoia and denial.

8. Symptoms and Signs SUBSTANCE ABUSE Behavioral effects: Slow reaction time, impaired coordination, slowed or slurred speech, irritability, excessive talking, inability to sit still, limited attention span and poor motivation or lack of energy.

9. Symptoms and Signs SUBSTANCE ABUSE Physical effects: Weight loss, sweating, chills and smell of alcohol

10. 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. When after repeated administration, increasingly larger doses of a drug must be administered to obtain the same effects with the original use. OR

11. Definitions SUBSTANCE ABUSE “ 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 Alcoholism means “alcohol dependence

12. Definitions SUBSTANCE ABUSE 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. additional problems: “ Substance dependence ”

13. Definitions SUBSTANCE ABUSE withdrawal when not using. (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 additional problems:

14. Definitions SUBSTANCE ABUSE Understanding Addiction Terminal/Permanent Chronic Addiction to alcohol and other drugs is: Progressive Primary Characterized by denial For 10% of people, abuse addiction.

15. Definitions SUBSTANCE ABUSE Basic components of disease model Chronic: Once you have developed an addiction problem to deal with it, recovery requires life long abstinence and active participation in recovery groups.

16. Definitions SUBSTANCE ABUSE Progressive : There are signs and symptoms of ddiction, no known cure, affecting every area of a the addict's life: physical, mental, emotional, and spiritual. Addiction gets worse over time - can be gradual or rapid, depending on the drug. Repeated use causes progressive damage.

17. Definitions SUBSTANCE ABUSE. Primary : It is the main problem that needs to be treated, 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, often leads to disease and possibly death.

18. Definitions SUBSTANCE ABUSE Denial: The user often seems to be the last to know that his life is out of control. There are effective strategies employed by professionals for helping to break through this denial, which must be overcome before treatment can take place.

19. Smoking is the ENTERANCE 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. “ Initiation of substance use” Internationally SUBSTANCE ABUSE

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

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

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

23. SUBSTANCE ABUSE At individual level: Aggressiveness, injuring himself or others, driving harming himself and others, infections at injection sites or blood borne (hepatitis B and C, and HIV), smoking leading to lung cancer and life revolves around substance use

24. SUBSTANCE ABUSE. At family level: Money on substance leads to family conflicts, family conflict becomes destructive emotionally and/or physically, money on substance replace other family needs and money on substance use treatment drains family resources.

25. SUBSTANCE ABUSE. At community level: To get money, substance abusers may steal, use violence or engage in crime, drug syndicates may commit violent crimes and/or recruit youth for illegal activities and violence and illegal activity that may harm individuals and/or create a climate of mistrust.

26. “RISK FACTORS ” SUBSTANCE ABUSE “PROTECTIVE FACTORS ” “Who uses substance ?” “FACTORS”

27. SUBSTANCE ABUSE Risk factors: Factors associated with greater potential to use substances: 1.Chaotic home environment. 2.Ineffective parenting. 3.Little mutual attachment and nurturing. 4.Parental/sibling substance abuse or mental illness. 5. 5. Academic failure

28. SUBSTANCE ABUSE. 6. Inappropriate/shy classroom behavior. 7. Poor social coping skills. 8. Perceived external approval of drug use(peer, family, community). 9. Affiliations with deviant persons

29. SUBSTANCE ABUSE Protective factors:Factors associated with reduced potential to use substances: 1.Strong family bonds. 2.Parental engagement in child's life. 3.Clear parental expectations & consequences. 4. Academic success. 5. Conventional norms about drugs and alcohol. 6. Strong bonds with pro-social institutions (School, Community, Mosque).

30. “PREVENTION” SUBSTANCE ABUSE  Primary prevention  Secondary prevention  Tertiary prevention

31. SUBSTANCE ABUSE “PREVENTION” TWO STRATEGIES  1- to reduce supply  2- to reduce demand Primary prevention To prevent initiation of substance use or delaying the age at which use begins.

32. SUBSTANCE ABUSE Primary prevention 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).

33. SUBSTANCE ABUSE “RISK FACTORS ” “PROTECTIVE FACTORS ” To reduce demand

34. SUBSTANCE ABUSE 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.

35. SUBSTANCE ABUSE 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.