Transcript Uppers, Downers & All Arounders

Uppers, Downers & All
Arounders
Chapter 8
Drug Use and Prevention
From Cradle to Grave
PREVENTION
• Prevention Goals
– Reduce the Supply
– Reduce the Demand
– Reduce the Harm
• History
– Prohibition enacted in 1917 by 18th amendment and
repealed in 1933
– Popular belief was that Prohibition was ineffective
– However, it did reduce health problems, domestic
violence, crime, and consumption
– There was increased legal costs and bootlegging
increased
PREVENTION
• Scare tactics and drug information often
included in drug information programs
• Skill building and resiliency programs addresses
the psychological roots of drug abuse by:
– General competency building
– Coping skills
– Reinforcement of protective factors & support
systems
• Community-based programs are effective in
getting entire neighborhoods to take
responsibility for preventing substance abuse
PREVENTION
• Public Health Model
– Three factors: User, environment, drug
– Prevention is designed to affect the user,
environment and drug
• Addiction is a disease in User
• User contributes to the environment or social
climate (neighborhood)
• The agent or drug introduces the disease
• Family Approach
– Prevention approach provides the family with
support, skills training and therapy along with
parenting skills
PREVENTION METHODS
• Supply Reduction
– Legislative & legal Procedures
• Prison
• Asset Forfeiture
• Prison population tripled between 1980 and 2002
to 2 million
• 55% of federal inmates were sentenced for drug
convictions
• Outcomes 10-15% reduction, yet is deemed
expensive
PREVENTION METHODS
• Demand Reduction
– Focuses on reducing demand for drugs
• Primary Prevention: anticipates and prevents
initial drug use
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Mainly for young people
Promote abstince
Help young people to refuse drugs
Delay drug use
Encourage healthy activities
• Secondary Prevention
– Seeks to halt drug use once its begun
– Drug diversion programs (Drug Courts)
– First-time Offenders
PREVENTION METHODS
• Tertiary prevention
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Stop Further Damage from Drugs and restore abusers to health
Uses group interventions
Extinction
Family Therapy
Psychopharmacological approaches
Treatment results in 40-50% decrease in use
Saves $4 - $5 for every $1 spent
• Harm Reduction
– Focuses on techniques to minimize personal and social
problems of drug use, rather than abstinence as a primary goal
– Needle Exchange
– Methadone Maintenance
– Designated Driver
– Controversial to zero tolerance
Cradle to Grave
• Small towns and rural areas use more drugs
than urban communities
• Most significant change in drug culture is use of
drugs occurring in earlier ages
• Drug use in pregnancy occurs in women of all
ages, ethnicities and economic backgrounds
– 18.6% of infants exposed to alcohol
• Fetal alcohol syndrome 3rd most common birth defect and
leading cause of mental retardation in U.S.
– 4.5% exposed to cocaine
– 17.4% exposed to marijuana
– 17.6% exposed to tobacco
Cradle to Grave
• Youth in School
– Most surveys under-represent the problem
– More than ½ of juveniles arrested tested
positive for alcohol and/or other drugs
– Drugs and alcohol disrupt the psychological
and emotional growth of children
– Adolescents with physical, emotional and
sexual abuse are high-risk for alcohol and
drug use, abuse and dependency
Cradle to Grave
• College Students
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80-90% on campus drink alcohol
44% binge drink
Men binge drinkers outnumber women
Second hand drinking effects include
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Assaults
Sexual assault
Unwanted sexual advances
Sleep and study time interrupted
Colleges have federal funds for prevention programs
Alcohol free dorms
Drug Policies
Love, Sex and Drugs
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Impacts sexual behavior
Triggers sexual aggression
Sexual harassment
Date rape
General Effects include
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Lower inhibitions
Enhancing performance
Increase fantasies
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Love, Sex and Drugs
• HIV/AIDs
– 42 million people worldwide
• STD’s
– 333 million worldwide
• Needle Transmitted Diseases
– Hepatitis A, B, & C
– Hepatitis C virus in 50-90% of IV drug users
DRUGS AT WORK
• Costs
– $140 billion in 1995
• $60 billion for drugs
• $80 billion for alcohol
– Loss of Productivity
• Late for work
• Absent
– Medical Costs
• Accidents at work
• Sick leave
– Legal Costs
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Embezzlement
Sale of corporate secrets
Property damage during commision of crime
Increased security
More Lawsuits
Lost of consumer good will
DRUGS AT WORK
• Employee assistance programs (EAP)
– Provides counseling services, treatment and
client monitoring
– For every $1 spent on EAP, employer saves
$5 - $16 dollars
• Drugs in military
– Drug testing began in 1980s
– Positive result is grounds for referral to
rehabilitation, or if that fails, discharge
– Heavy drinking in military high than general
population, 17% vs 12%
DRUG TESTING
• Thin layer chromatography
– Searches for variety of drugs
– Unable to distinguish illegal from legal over the counter drugs
• Enzyme-Multiplied Immunoassay Techniques (EMIT),
Radio Immunoassay (RIA) and Enzyme Immunoassay
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Seeks out specific drugs
Extremely sensitive
Rapidly performed
Easy to operated
EMIT test can confuse poppy seeds for heroin or other opioids
Can confuse one of the chemicals in Advil or motrin for
marijuana
– Vicks inhaler can be confused for methamphetamine
DRUG TESTING
• Gas Chromatography/Mass Spectometry
Combined (GC/MS) & Gas Liquid
Chromagraphy
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Most accurate
Detects trace amounts of drugs through urine
Very expensive
Requires trained operators
• Hair Analysis
– Chemical traces of most drugs are stored in hair
– Businesses and Casinos in Nevada uses it for drug
screening employees