Substance abuse prevention

Substance Abuse Prevention, also known as drug abuse prevention, is a process that attempts to prevent the onset of substance use or limit the development of problems associated with using psychoactive's substances. Prevention efforts may focus on the individual or their surroundings. A concept known as "environmental prevention" focuses on changing community conditions or policies so that the availability of substances is reduced as well as the demand.[1]

Rational scale to assess the harm of drugs

Substance abuse prevention efforts typically focus on minors – children and teens especially 15–35 years of age. Substances typically targeted by preventive efforts include alcohol (including binge drinking, drunkenness and driving under the influence), tobacco (including cigarettes and various forms of smokeless tobacco), marijuana, inhalants (volatile solvents including among other things glue, gasoline, aerosols, ether, fumes from correction fluid and marking pens), cocaine, methamphetamine, steroids, club drugs (such as MDMA), and opioids. Community advocacy against substance abuse is imperative due to the significant increase in opioid overdoses in the United States alone. It has been estimated that about one hundred and thirty individuals continue to lose their lives daily due to opioid overdoses alone.[2]

Protective and risk factors

Environmental and internal are two main factors that contribute to the likelihood of substance abuse. Environmental factors in the individual's adolescence include: child abuse, exposure to drugs, lack of supervision, media influence, and peer pressure. Drug activity in an individual's community may normalize the usage of drugs.[3] Similarly, if an individual is placed through treatment and then placed back into the same environment that they left, there is a great chance that person will relapse to their previous behavior. Internal factors that are within the child or personality-based are self-esteem, poor social skills, stress, attitudes about drugs, mental disorder and many others.[4] A few more factors that contribute to teen drug abuse are lack of or poor parent to child communication,[5] unsupervised accessibility of alcohol at home, having too much freedom and being left alone for long periods of time.[6] Additionally, there is evidence that gender moderates the effect of family, school and peer factors on adolescent substance use and abuse.[7] For example, some studies report that not living with both biological parents or having poor parent-adolescent communication is associated with substance use, especially in female adolescents.[8][9]

Main risk periods for drug abuse occur during major transitions in a child's life. Some of these transitional periods that could increase the possibility of youth using drugs are puberty, moving, divorce, leaving the security of the home and entering school. School transitions such as those from elementary to middle school or middle school to high school can be times that children and teenagers make new friends and are more susceptible to fall into environments where there are drugs available. One recent study examined that by the time are seniors in high school, "almost 70 percent will have tried alcohol, half will have taken an illegal drug, nearly 40 percent will have smoked a cigarette, and more than 20 percent will have used a prescription drug for a nonmedical purpose” (Johnston et al., 2013).[10] Binge drinking has also, been shown to increase once an individual leaves the home to attend college or live on their own.[11]

Most youth do not progress towards abusing other drugs after experimentation. Research has shown, when drug use begins at an early age, there is a greater possibility for addiction to occur.[12] Three exacerbating factors that can influence drug use to become drug abuse are social approval, lack of perceived risks, and availability of drugs in the community. Youths from certain demographics are also at higher risk for abuse and addiction. These groups include those suffering from a mental illness and come from a family history of addiction. Yet, some teens living with dual diagnosis prove that there is not always a causal relationship between mental illness and a substance abuse problem. Moreover, when addiction occurs, youth are more likely to require teen rehab as a form of treatment.[13] Most young adults have a false perception that they may be invincible. These individuals believe changes won't be made until an extreme event happens i.e. a friend overdoses, a car accident or even death. Even then it is not likely that they will see the correlation between use and trauma.

Plans on preventing substance abuse

Family based prevention programs

"Prevention programs can strengthen protective factors among young children by teaching parents better family communication skills, appropriate discipline styles, firm and consistent rule enforcement, and other family management approaches. Research confirms the benefits of parents providing consistent rules and discipline, talking to children about drugs, monitoring their activities, getting to know their friends, understanding their problems and concerns, and being involved in their learning. The importance of the parent-child relationship continues through adolescence and beyond" (National Institute of Drug Abuse, 2003).[14]

Smit, Verdurmen, Monshouwer, and Smil conducted research analysis to measure the effectiveness of family interventions about teen and adolescence drug and alcohol use. According to their data alcohol and drug use is very common in Western societies. For example, 18% of the young adults between the ages of 12-14 year old in US have indulged in binge drinking. According to quantities in 2006, 73% of 16-year-old US students were reported having used alcohol; In Northern Europe this is 90%. Since early use of alcohol and other substances may cause serious health, immediate solutions to these problem are required .[15]

School-based prevention programs
US Navy Master-at-Arms 1st Class Michael Turner of Mobile Security Squadron Two (MSS-2) collects information at the Substance Abuse Prevention Summit

There are a number of community-based prevention programs and classes that aim to educate children and families about the harms of substance abuse. Schools began introducing substance abuse oriented classes for their students in grades as low as preschool. The inclusion of prevention studies into classroom curriculums at a young age have been shown to help to break early behaviors that could be signs drug abuse in the future. Around 40% of children have tried alcohol by the time that they are ten.

There are organizations that educates, advocates, and collaborates to reduce drug and alcohol problems in the state. Some programs may begin by allowing students to be interactive and learn skills such as how to refuse drugs. This is proven to be a more effective method than strictly educational or non-interactive ones. When direct influences (e.g., peers) and indirect influences (e.g., media influence) are addressed, the program is better able to cover broad social influences that most programs do not consider. Programs that encourage a social commitment to abstaining from drugs show lower rates of drug use. Getting the community outside of the school to participate and also using peer leaders to facilitate the interactions tend to be an effective facet of these programs. Lastly, teaching youth and adolescents skills that increase resistance skills in social situations may increase protective factors in that population.[16][17]

Community prevention programs

Prevention programs work at the community level with civic, religious, law enforcement, and other government organizations to enhance anti-drug norms and pro-social behaviors. Many programs help with prevention efforts across settings to help send messages through school, work, religious institutions, and the media. Research has shown that programs that reach youth through multiple settings can remarkably influence community norms. Community-based programs also typically include development of policies or enforcement of regulations, mass media efforts, and community-wide awareness programs.[18] Increasing health education in the community also plays a role in helping to decrease the consequences of substance abuse.

On a community level, established safe injection sites that provide a hygienic space supervised by licensed healthcare professionals allow for safe monitoring of participants and provide health education and care to prevent overdose and abuse. Another way to help prevent overdose and abuse, especially regarding opioids, is the increased access and knowledge of naloxone. Naloxone is the standard opioid overdose reversal agent.[19] Studies show Overdose Education and Naloxone Distribution (OEND) programs decrease the rate of rate of deaths from opioid overdose.[20] Naloxone comes in different routes of administration such as, an injection that's administered intravenously, intramuscular, or subcutaneously and a nasal spray. Naloxone injection and the nasal spray are both commonly used in adults and children who are going through drug overdose because it is successful in reversing the overdose effects [21][22] As a safety precaution, patients taking opioids are recommended to always carry naloxone with them and should replace the naloxone regularly, via reference to the expiration date.[23]

National recognition of substance abuse prevention

In 2011 President Obama issued October as National Substance Abuse Prevention Month. It pays tribute to all people working hard to prevent abuse in communities and working hard to make a safer drug-free country. [24]

Millions of Americans currently participate in Red Ribbon Week activities, according to the National Family Partnership (NFP)—the Red Ribbon campaign’s national organizer. The Drug Enforcement Administration, a Federal partner in Red Ribbon Week, describes it as “the most far-reaching and well-known drug prevention event in America.” Through the efforts of the NFP, other national organizations, Federal and State agencies, and communities, Red Ribbon Week has become more than a call to action. It has grown to be a unifying symbol of family and community dedication to preventing the use of alcohol, tobacco, and illicit drugs among youth.[25]

In 2017, the FDA created the Opioid Policy Steering Committee (OPSC) to help guide FDA efforts in fighting this opioid epidemic specifically focusing on topics of new addiction, treatment support and development, assessment of risk over benefit and overall enforcement.[26]

In the United States, there is a Substance Abuse and Mental Health Services Administration that provides a free 365 days per year 24 hour phone service. Their purpose is providing information or therapy referrals to anyone experiencing substance use disorders or mental health issues. This national helpline number's is (1800-662-HELP (4357)).[27]

The NIH on drug abuse has made available research-based guides with the goal of preventing drug abuse and addiction in the youth.[28] One guide speaks on prevention for early childhood.[29] Another talks about prevention in children and adolescents.[30]

See also

References
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