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PSY 320 - Ch 17 - Abuse Prevention

by: Elliana

PSY 320 - Ch 17 - Abuse Prevention PSY 320

Marketplace > University of Miami > Psychlogy > PSY 320 > PSY 320 Ch 17 Abuse Prevention
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Combined lecture & textbook notes
Drugs & Behavior
Dr. Marc Gellman
Class Notes
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This 6 page Class Notes was uploaded by Elliana on Thursday April 14, 2016. The Class Notes belongs to PSY 320 at University of Miami taught by Dr. Marc Gellman in Spring 2015. Since its upload, it has received 15 views. For similar materials see Drugs & Behavior in Psychlogy at University of Miami.

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Date Created: 04/14/16
PSY 320 Drugs & Behavior Chapter 17 Abuse Prevention Preven▯on vs. Treatment • Public health issue ◦ 50% Americans suffer from preventable/chronic diseases ◦ O▯en due to lifestyle choices • We spend 75% of our health care $$ on trea▯ng preventable condi▯ons ◦ Our country deals w/ trea▯ng problems rather than preven▯ng them • One of the biggest differences btwn health care in the US & other high-income countries is the emphasis we place on treatment vs. preven▯on • Substance abuse is a preventable condi▯on ◦ Each year drug abuse/addic▯on costs ~ $534 billion in preventable health care, law enforcement, crime, & other costs • Best approach to reduce substance abuse is preven▯on Substance Abuse Preven▯on • Process that a▯empts to prevent the onset of substance use or limit the development of problems associated w/ abusing psychoac▯ve substances • Preven▯on efforts may focus on individuals or their environment • "Environmental Preven▯on": ◦ Focuses on changing community condi▯ons/policies ◦ So that availability & demand of substances is reduced ◦ Typically focus on children & teens • Drugs have always been part of our society • The rela▯ve # of ppl who have problems w/ legal drugs is small ◦ Preven▯on efforts are focused on teaching ppl how to coexist w/ these drugs Society's A▯empts to Limit Drug Availability • As long as there is a market for drugs, there will be ppl to supply them ◦ Demand for drugs must be eliminated to a▯ack the source of the problem • Drugs will never disappear, so ppl need to learn to live in a world that includes them • Our society has accepted the con▯nued existence of tobacco/alcohol despite their harms • 1986 - Drug-Free schools ◦ Policies enforced against drug presence in schools • Locker checks, suspensions, expulsions ◦ Restric▯on of tobacco use for students & teachers • Tho goal of drug-free society may be unrealis▯c • 1989 - Drug-Free workplace program ◦ Employers to state drug use is unacceptable ◦ Ul▯mate goal to prevent drug users & subsequent firing Goals of Preven▯on • Tradi▯onal approach: ◦ Presen▯ng nega▯ve informa▯on about drugs to children in schools • Evalua▯ons of effec▯veness: ◦ Most preven▯on programs not evaluated un▯l 1970s PSY 320 Drugs & Behavior Public Health Model • Primary preven▯on ◦ Aimed @ young ppl who have no tried substances yet ◦ May encourage abs▯nence ◦ Must avoid giving info that produces arousal/curiosity in trying substances • Secondary preven▯on ◦ Aimed @ ppl who have experimented w/ substances but typically aren't suffering serious consequences • Many college students ◦ Goals: • Preven▯on of use of other/more dangerous substances • Preven▯on of more dangerous forms of use ◦ I.E. college programs promo▯ng responsible use of alcohol • Ter▯ary preven▯on ◦ Aimed @ ppl in substance abuse treatment or have stopped on their own • May be in court process, rehab, etc. ◦ Goal is relapse preven▯on • AA Con▯nuum of Care by the Ins▯tute of Medicine • Universal Preven▯on: no▯a l upop e r▯ne r◦ o F ◦ Community, school, etc. • Selec▯ve Preven▯on: ◦ For high-risk groups w/in a popula▯on ◦ I.E. children of addicts, or doing poorly in school • Indicated Preven▯on: ◦ For individuals who show signs of developing problems ◦ I.E. adult arrested for their first DUI Knowledge-A▯tudes-Behavior Model • Programs typically involve presenta▯ons by police & former users ◦ O▯en include tradi▯onal scare tac▯cs ◦ Pharmacological informa▯on • Approach assumes that increasing student knowledge about drugs will change their a▯tudes • Ques▯onable model ◦ Students w/ more knowledge about drugs tend to have more posi▯ve a▯tudes about use ◦ Effec▯ve in increasing knowledge ◦ Tho ineffec▯ve in altering a▯tudes/behavior • Concerns that programs were increasing drug use by teaching students about drugs they'd otherwise not have been exposed to • Possible goals: ◦ No experimenta▯on w/ drugs by students ◦ Ra▯onal decisions about drugs by students • Appropriate goal: Harm reduc▯on by teaching students to make ra▯onal decisions about drug use PSY 320 Drugs & Behavior Affec▯ve Educa▯on • Alterna▯ves to drugs ◦ Assumes that 1 reason young ppl take drugs is for the experience of altered states of consciousness ◦ Teaches students other ways of ge▯ng "high:" • Sports • Medita▯on ◦ Alterna▯ves need to be realis▯c & tailored to specific popula▯ons • Values clarifica▯on: teaches abili▯es to make appropriate decisions ◦ Discussing moral & ethical situa▯ons • Teaching social skills • Effec▯veness very small & don't last a▯er a year Social Influence Model • Preven▯on model adopted from successful an▯-smoking models • 5 key elements: 1. Training in refusal (ways to say no) 2. Public commitment, such as public pledges 3. Countering adver▯sing by teaching students to analyze ads 4. Norma▯ve educa▯on - teaching how many ppl don't do drugs 5. Use of teen leaders/educators Drug Abuse Resistance in Educa▯on (DARE) • Developed in 1983 in LA by LAPD • Spread to all states in the 1990s ◦ Ini▯ally widely accepted despite lack of studies suppor▯ng effec▯veness • Funded by millions of federal $$ • Contains many components of earlier preven▯on models ◦ Delivered by trained, uniform police officers ◦ Includes elements of Social Influence Model • Refusal skills, teen leaders, public commitment ◦ Includes elements of affec▯ve educa▯on • Self-esteem building, alterna▯ves to drug use, decision making • Studies on effec▯veness of DARE: ◦ 1994 - shown to increase self-esteem ◦ But no evidence for long-term reduc▯on in drug use ◦ Shown to increase knowledge about drugs & social skills ◦ Effects on drug use were marginal ◦ 2004 - review of earlier studies showed program effect is small & not sta▯s▯cally significant • Despite failure to demonstrate significant impact, gvt did not allow publica▯on of results due to financial investments Community Alterna▯ves • Peer influence ◦ Open discussions among child/adolescent groups • Peer par▯cipa▯on PSY 320 Drugs & Behavior ◦ Usually focus on groups of youth in high-risk areas ◦ Peers work & manage groups w/ adults ◦ Some▯mes paid for community service work ◦ Taught to be par▯cipa▯ng members of society Parent/Family Programs • Informa▯onal programs ◦ Provide parents w/ basic informa▯on about alcohol, drugs, & effects ◦ Signs of drug abuse in children ◦ Programs for addi▯onal informa▯on ◦ Teach awareness of parents' own use • Parent support groups • Family interac▯on approaches ◦ Families work as a unit to discuss/confront issues on drug abuse ◦ Improving family communica▯on ◦ General problem solving/response to emergencies • Strengthening Families program ◦ Targets children of parents who abuse substances ◦ 3 major goals: • Improve paren▯ng skills • Increase children's communica▯on/refusal/awareness skills • Improve family rela▯onships thru communica▯on & decreasing conflict ◦ Reduces alcohol & tobacco use in children as well as parents Programs demonstrated to be effec▯ve Life Skill Training (LST) • Developed in the 90s & refined thru-out the 2000s • Uses adolescents & college students to peer-teach skills/info needed to resist social influences on substance use ◦ Goal - increase personal/social competence, confidence, self-efficacy to reduce mo▯va▯ons to use • Structured for 15 class periods for 1st year, 10 booster sessions 2nd year, 5 booster classes 3rd year • Evalua▯ons, randomized controlled trials, booster sessions, etc. ◦ Significant reduc▯on in drug use found w/in white 7th grade popula▯on study ◦ Long-term effec▯veness even a▯er 3 years • LST modified to be beneficial for minority students as well What should we be doing • What needs to be done in par▯cular situa▯ons depends on the mo▯va▯ons for doing it • Example 1: ◦ State requirement for drug educa▯on as part of health curriculum ◦ In the absence of a par▯cular drug problem • Most appropriate approach might be balanced combina▯on of factual informa▯on/social skills training • Important to avoid teaching what you don't want students doing • Example 2: PSY 320 Drugs & Behavior ◦ Widespread concern/fervor about a local "epidemic" of drug/alcohol use ◦ Goal: using energy to organize community planning effort • Combining efforts on many levels • NIDA's current approach: ◦ Teaching substance dependence as a developmental disease & preventable problem thru understanding Preven▯on Research Findings • Addic▯on is a complex disease ◦ Usually begins in adolescence or childhood as brain changes ◦ Prefrontal cortex is the last part of the brain to develop - controls judgment & decision- making func▯ons ◦ May explain why teens are prone to risky drug use • No single factor can predict who will become addicted to drugs • Addic▯on is influenced by a tangle of factors involving: ◦ Genes, environment, age of first use • Recent advances in gene▯c research have enabled researchers to begin to uncover: ◦ Which genes make a person more vulnerable ◦ Which protect a person against addic▯on ◦ How genes and environment interact NIDA Findings • Describes biological variables & social circumstances that foster or protect against drug abuse/ addi▯on • Examines how neurobiology & social environment interact to effect likelihood of addic▯on • Social neuroscience ini▯a▯ve helps form be▯er understanding of neurobiological mechanisms & responses (gene▯c, hormonal, physiological) guide social behaviors related to abuse/addic▯on • Helps w/ understanding of social influences & sensi▯vity to nega▯ve consequences Preven▯on Works • Over 20 yrs of research demonstrates that preven▯on interven▯ons designed & tested to: k s i r ecud◦ R ◦ Enhance protec▯ve factors • To help children along each step of their developmental path • NIDA's ac▯vely suppor▯ng research that strives to help people across the lifespan develop and apply the skills and resources they need to stop problem behaviors before, and a▯er, they begin Understanding Neurobiology of Substance Abuse • Virtually all abused substances enhance dopamine ac▯vity ◦ Par▯cularly related to pleasure, motor, & cogni▯ve func▯on • Recent research has shown that: ◦ Prolonged drug use changes the brain in fundamental and long-las▯ng ways ◦ These changes can be both structural and func▯onal • Prolonged use of psychos▯mulants like methamphetamines may change the brain: gn i no▯cnu f ro t o m & ev▯ i ngoc de s imo rpm◦ C • Recovery: ◦ A▯er 2 yrs of being drug-free, some dopamine deficits recover • There's hope that recovery is possible PSY 320 Drugs & Behavior ◦ Some func▯onal deficits may persist


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