Part 5-- Approaches to substance abuse prevention. This last section will draw on information presented throughout the full course in order to make sense of the difficulties involved in developing effective prevention strategies. The application of available prevention research will be discussed with examples of approaches that have shown promise for reducing use and/or its negative impacts. We will cap-off this section with the groups’ presentations of specific drugs.
December 1 - December 8
16 (Drug abuse prevention and education), Pages 327-360.
quiz over Chapter 16 to be completed between Dec. 8 and 6:00pm Dec. 10
EXAM over PARTS 4 & 5 (120 pts.), Tuesday,
On Societal issues and
History of legal control of drugs, Prevention, and Marijuana,
including lecture information from 11/10 – 12/8, assigned readings.
GOALS of prevention:
The primary goals are to
1. reduce use, limiting the number of users and the types of substances used and
2. delay use in those that will use. Regarding the second goal, delaying the start of use reduces harm during a child’s development and reduces risk for developing addiction and abusive patterns of use. Recognizing that at least some proportion of the population will use psychoactive substances, further goals of prevention include
3. preventing the transition from “use” to “abuse,” and
4. diminishing harm resulting from use. This last would include not only ways to make use safer (e.g., needle exchanges, safer-drinking strategies), but also movement into treatment and prevention of relapse once treatment is completed.
Public Health refers both to different levels
of prevention and of intervention.
refer to where in the issue’s development the focus is: Before it
starts, as it develops, or after it has developed as a problem.
intervention,” on the other hand, refer to the focus for the strategy (e.g.,
community-focused, systems-focused (e.g., families, peers), or
are typically categorized as being primary, secondary, or tertiary.
refers to activities undertaken prior to an individual using.
Most educational programs fit under this, but so do programs
designed to reduce drug availability (e.g., law enforcement).
refers to activities applied during the early stages of drug use and would
encompass attempts to prevent the transition from use to abuse.
Early diagnosis, crisis intervention, and economic changes such as
increasing alcohol taxes can decrease use and interrupt problematic
patterns of use.
takes place at later (advanced) stages of drug abuse and refers to actions
to avoid relapse and maintain health status after therapy.
This is essentially the extended aspect of drug treatment.
are categorized as Universal, Selective, or Indicated.
Intervention refer to efforts focused on every eligible member
of a community.
These are programs aimed at an entire group (rather than
individuals) and include media campaigns, policies that affect all members
of a community equally, such as taxes and laws, and educational programs
provided to all students regardless their risk level.
Potential benefits are expected to outweigh costs for everyone.
Selective Intervention are more focused at a more
systems domain where higher-risk subgroups are targeted (e.g., children
from homes where family members have a history of drug use or college
students in general).
Indicated intervention is individual-focused
interventions and represents the most time and financially-intensive
programs. These include prevention efforts targeted at individuals, for
example those who show signs of developing problems, e.g., after receiving
a DUI or completing treatment.
Be sure to refer to Table 16-1 to see how these levels relate. Also, note again how risk factors and protective factors play a role in prevention.
Specifically, we dealt with factors in drug education that affect their effectiveness. Factors such as fear. Remember Rogers' Protection-Motivation theory regarding when and how fear messages can be effective.
In summarizing what makes an effective program, several things were listed:
Two overriding principles were:
In dealing with the information provided, the following were noted:
Techniques for providing the information included:
Be sure to note the uses and limits of fear described in the book and class.
For the different techniques summarized in the text, note the ways that they try to meet their goals (e.g., by focusing on one type of drug or specified group) and relate that back to the outlined principles.
The forms of prevention and intervention that will be focused on in the present section are secondary (activities applied during the early stages of drug use encompassing attempts to prevent the transition from use to abuse) and can happen at any of the levels of intervention: universal, selective, or indicated.
Several types of activity are relevant here:
As with universal, primary prevention approaches previously discussed, carefully determined and articulated goals are key for development and implementation of successful secondary prevention programs.
Compared to primary prevention, however, there is less agreement about the desired goals or on effective approaches to meet those.
It makes a difference if detection of use will bring about an opportunity for help quitting versus job loss, prosecution, or athletic ineligibility.
In class, the importance of understanding where someone is in relation to their drug use behavior and in relation to wanting to change was noted. The Stages of Change model is discussed as a way to gauge how to focus interventions:
There are many points of overlap between primary and secondary prevention (e.g., use of social norms), but also things that make secondary prevention more difficult. The difficulties come about precisely because the targets have had experience with the drug. Think about what that prior or ongoing experience might do to affect receptiveness or acceptance of messages.
Make sure you review the approaches to secondary prevention used on college campuses and in the workplace. Also, note the techniques and issues related to drug testing.
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