Drug abuse prevention and treatment 授課教師：賴滄海教授 1-8-2010.

Drug abuse prevention and treatment

授課教師：賴滄海教授 1-8-2010

Learning Objectives

Major types of drug prevention program Levels of prevention program Alternatives to drug use Principles that characterized effective drug treatment Pharmacological strategies to treat addiction

Potential Factors that Influence

Potential Factors that Influence Drug Use

Individual influence Genetics, Personality traits, Attitudes and beliefs, peer resistance skills 。Interpersonal and societal influences Parents, Community, Peers, School policy, Local law enforce

ment, Personal situation

Potential Factors that Influence Drug Use

Environmental influences Federal laws, Minimum purchase age, Portrayal of alcohol, tobacco and drugs on

TV and movies, Marketing of alcohol, Cost of alcohol and drugs

Primary Prevention Program (Risk reduction before abuse)

Interpersonal factors Affective education (emotional literacy), Values clarification Resilience training Assertiveness training Refusal skill Drug information and education

Primary Prevention Program

Small group factors

Peer mentoring, counseling

Conflict resolution

Demonstrate misconception of peer norm

Alternatives to drug use

recreational, cultural, athletic

Strengthening families

Primary Prevention Program

Systems level

Strengthening school-family link

Strengthening school-community group links

Strengthening community support system

Media advocacy efforts

Reducing alcohol marketing

Secondary Prevention Program

Intervening in early abuse

Identification of abuse subgroups and

individual diagnosis

Early intervention coupled with sanction

Teacher-counselor-parent team approach

Developing healthy alternative youth culture

Recovering role model

Tertiary Prevention Program

Intervening in advanced abuse Assessment and diagnosis Referral into treatment Case management Reentry

Prevention program for drug abuse

Harm reduction model Community based School based Family based

Common school-based drug prevention approaches

Cognitive

Teach pharmacology of drugs

How they are used

Long-range consequences of use

(usually through scare tactics)


Affective

Raise self-esteem

Teach value and life skill

(typically do not include drug information)


Combined cognitive and affective

Teach problem solving, decision making, peer pressure resistance skill

Provide drug information to connect life skill and drug use and consequences


Social learning

Teach how to identify pressure from peers, media, advertising families

Teach resistance skills, counterargument

Student role play and practice resisting


Normative education

Correct misconceptions

Demonstrate actual norms through discussion, develop nonuse norms

Curriculum based drug education objectives- Elementary level

Drugs vs poison, effect of ATOD on the body Candy vs drug, drug overdose How to say NO Reason for taking drugs

Curriculum based drug education objectives- Junior high level

How peer pressure works, how to say NO How drugs affect the body Where to seek help Attitude toward drug use How to have fun without drug Harmful effect of ATOD

Curriculum based drug education objectives- Junior high level

Stress management, positive self-esteem How advertisers push drug Consequences of breaking drug laws Wine, beer and distilled spirits Family drug use violence and drug use in concerts Teenage drug use and associated problems

Curriculum based drug education objectives- Senior high level

Responsible use of medication How drug affect the body Legal vs illegal drugs Drinking, drug and driving Recreational drug use Stress management

Curriculum based drug education objectives- Senior high level

How to detect problem drug users Drug education, prevention and treatment Positive, negative role models How to build positive self-esteem Binge drinking, date rape Drug addiction and alcoholism Criminal sanction for drug use

Drug prevention in higher education

Awareness only model

Assumes that teaching about the harmful effects of drugs will change attitudes about use and abuse

Attitude change model

Assumes that people use drugs because of lack of self-esteem

Drug prevention in higher education

Social influence model

Assumes that drug users lack resistance skills

Person-in environment model

Stress that changes in the environment change people’s attitude about drugs

Family-based prevention program

Risks factors

Chaotic home environment

Ineffective parenting

Lack of mutual attachment and nurturing


Protective factors

Strong parent-child bonds

Clear rules of conduct

Communication of values

High level of supervision

Parental warmth, affection and support


Reach families of children at each stage Train parents in behavior skills to

reduce conduct problems in children

Improve parent-child relation

Consistent discipline and rule making

Monitor children’s activities


Drug information for parent and children Enhance protective factors Provide access to counseling services for

families at risk

Drug prevention programs in USA

The BACCHUS network 2005 BACCHUS and GAMMA peer education

network 1975

Boosting Alcohol Consciousness Concerning the Health of University Students

Greeks Advocating Mature Management of Alcohol


FIPSE 1987 Fund for the Improvement of Postsecondary

Education Drug Prevention Program Peer-based effort Curriculum infusion Improvisational theater group Strategies to change misconception of use Alternative events Change marketing of alcohol near campus


DARE 1983 Drug Abuse Resistance Education Presented in the classroom by uniformed police officers Drug Courts 1989 To divert substance abuser into supervised

community treatment centers to eliminate the destructive behaviors.

Alternatives for a drug abuser

Physical

Athletics, exercise, hiking

Dance, yoga

Carpentry, swimming

Outdoor work


Sensory

Sensory awareness training

Sky diving, scuba diving

Experiencing beauty of nature


Emotional

Individual counseling

Group therapy

Instruction in psychology of personal development


Interpersonal

Group therapy

Instruction in social custom

Confidence training

Volunteerism


Social

Activity in positive social change

Helping the disadvantaged

Tutoring handicapped individuals

Ecology action


Political

Political service

Lobbying for nonpartisan projects

Field work with politician and public officials


Intellectual

Reading, debate and discussion

Creative games and puzzle

Self-hypnotics

Training in concentration


Creative-aesthetics

Nongraded instruction in producing/or

appreciation art, music, drama

Creative hobbies


Philosophical

Discussions, seminar

Courses on ethics

The nature of reality

Relevant philosophical literature

Exploration of value systems


Spiritual-mystical

Nonchemical methods of spiritual development

Study of world religions Mysticism Meditation, yogic techniques

Principles of treatment

No single treatment is appropriate

for all individuals Treatment needs to be readily available Attends to multiple needs of the

individual


Must be assessed continually and modified

as necessary Remaining in treatment for an appropriate

period is critical Counseling and behavioral therapy are

critical component


Medications are an important element of treatment

Addicted individual with coexisting mental disorder should have both treated

Treatment does not need to be voluntary Medical detoxification is only the first step


Possible drug use during treatment must be monitored continuously

Should provide assessment for infectious disease

Recovery can be a long-term process

Detoxification-Sedative/hypnotics

*Substitution with longer-acting barbiturates for shorter acting CNS depressant – (abrupt withdrawal may cause life-threatening seizure)

*Gradually reduce the longer-acting barbiturates

*To treat Alcohol and barbiturate- need increased dose

*To treat barbiturate and heroin- barbiturate first

Detoxification-Alcohol

Delirium tremens Phenobarbital, Librium and Diazepam are commonly

prescribed to prevent withdrawal symptoms Treatment for malnutrition and Vit. Deficiency Diasulfiram – blocks ethanol metabolism, resulting in

headache, flushing and nausea Acamprosate – maintaining abstinence of alcohol

Detoxification- tobacco

Nicotine transdermal patches Nicotine gum Nasal spray inhalers

Detoxification-Heroin

Clonidine (Catapres) to relieve some withdrawal effects (vomiting, diarrhea)

Substitution with methadone, buprenorphine for heroin

Counseling to modify drug seeking behavior

Treatment- Amphetamines

Behavior intervention to modify thinking pattern, improve cognitive skill, change expectation, increase coping

with life’s stress

Detoxification- Cocaine

Outpatient versus Inpatient Benzodiazepines to relieve anxiety Bromocriptine, levodopa to relieve craving Desipramine and imipramine to relieve depre

ssion and craving Counseling, support from family, friends and

coworkers

Twelve steps by AA

1. We admitted we were powerless over alcohol-that our lives had become unmanageable

2. Came to believe that a Power greater than ourselves could restore us to sanity

3. Made a decision to turn our will and our lives to the care of God as we understood Him

Twelve steps by AA

4. Made a searching and fearless moral inventory of ourselves

5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs

6. Were entirely ready to have God remove all these defects of character

Twelve steps by AA

7. Humbly asked Him to remove our shortcomings 8. Made a list of all persons we had harmed, and became willing to make amend to them all

Twelve steps by AA

9. Made direct amends to such people wherever possible, except when to do so would injure them or others

10. Continued to take personal inventory and when we were wrong promptly admitted it

Twelve steps by AA

11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out

12. Having had a spiritual awakening as the result of these step, we tried to carry this message to alcoholics, and to practice these principles in all our affairs

Final report

Sent to [email protected]

Date: before 24.00 January 21, 2010

Drug abuse prevention and treatment 授課教師：賴滄海教授 1-8-2010.

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Transcript of Drug abuse prevention and treatment 授課教師：賴滄海教授 1-8-2010.