Substance Abuse Prevention Specialist Training. Definition of Prevention A proactive process that empowers individuals and systems to foster a climate.

Substance Abuse Prevention Substance Abuse Prevention Specialist TrainingSpecialist Training

Substance Abuse Prevention Substance Abuse Prevention Specialist TrainingSpecialist Training

Definition of Prevention

A proactive process that empowers individuals and systems to foster a climate in which:

• Alcohol use is acceptable only for adults when risk of adverse consequences are minimal

• Prescriptions, over-the-counter drugs, and other abusable substances are used only for their intended purposes and as intended

• Illegal drugs and tobacco are not used at all

(CSAP’s Prevention Primer, 1994; SW CAPT online glossary)

Why introduction, history and overview?Why introduction, history and overview?

• To get to know each other a little betterTo get to know each other a little better

• To look at history in order to build on To look at history in order to build on our existing knowledge base and avoid duplicating our existing knowledge base and avoid duplicating ineffective and harmful practicesineffective and harmful practices

• To understand and practice using tools for capacity To understand and practice using tools for capacity buildingbuilding

IntroductionIntroduction

Attitudes About DrugsAttitudes About Drugs

• What attitudes about drugs did you grow up with?

• How do those attitudes affect and influence your role as a prevention professional?

Attitudes About DrugsAttitudes About Drugs

No matter how knowledgeable or competent we become as prevention professionals, our work is invariably influenced by the attitudes we grew up with. It is important that we become aware of those attitudes. It is also important that we explore and challenge those attitudes which may be counterproductive

Viewpoints of PreventionViewpoints of Prevention

• Read the “Viewpoint of Prevention” that was Read the “Viewpoint of Prevention” that was assigned to youassigned to you

• Hold a group discussion, representing your assigned Hold a group discussion, representing your assigned viewpoint, and express your viewpoint to the groupviewpoint, and express your viewpoint to the group

• Discuss the question: “What do you think is the best Discuss the question: “What do you think is the best way to address the problem of drugs?”way to address the problem of drugs?”

• You have 15 minutesYou have 15 minutes

Viewpoints of PreventionViewpoints of Prevention

• Did your group reach any consensus? Did your group reach any consensus?

• How difficult was it to represent a viewpoint different How difficult was it to represent a viewpoint different from your own?from your own?

• What insights did you get from listening to other people, What insights did you get from listening to other people, as well as to yourself?as well as to yourself?

• Why do you think it is important for prevention Why do you think it is important for prevention professionals to be familiar with points of professionals to be familiar with points of view that they may consider wrong?view that they may consider wrong?

It’s Better to Build a FenceThan Station an Ambulance

Do warnings and restrictions always work?

Perhaps we should add scary things…

Make it bigger?

Back in the day

Porches weren’t quite enough

• Scare em

Definition:The use of fear or disgust for the purpose of improved well-being

Goal:“Scare the health into them”(focus population)

Assumption:Awareness of negative consequences will result in positive behavior change

(Linkenbach, 1998)

Scare TacticsScare Tactics

Limitations:Good intentions but poor science. (Impact/outcome studies are often lacking, or some show a negative effect.)

Institutional Insanity:Are we doing what we’ve always done but expecting different results?

(Linkenbach, 1998)

Scare TacticsScare Tactics(continued)(continued)

Let’s show them what not to do…

Drugs of Abuse-Drugs of Abuse-ClassificationsClassifications

• Central Nervous System Depressants (Downers)Central Nervous System Depressants (Downers)

• Opioids (Downers)Opioids (Downers)

• Central Nervous System Stimulants (Uppers)Central Nervous System Stimulants (Uppers)

• Hallucinogens (All Arounders)Hallucinogens (All Arounders)

• Cannabinols (All Arounders)Cannabinols (All Arounders)

• Inhalants (Dissolvers)Inhalants (Dissolvers)

• Anabolic SteroidsAnabolic Steroids

VIAGRA

Central Nervous System DepressantsCentral Nervous System Depressants

• “Downers”: lead to decreased– reflexes - pulse rate– blood pressure - respiration

• Alleviate anxiety, reduce stress• Induce sleep• Have a synergistic effect• Examples: tranquilizers, alcohol

Beverage Alcohol12 oz. of beer

EQUALS5 oz. of wine

EQUALS1-1/2 oz. of liquor

EQUALS12 oz. of beer

EQUALS5 oz. of wine

EQUALS1-1/2 oz. of liquor

OpioidsOpioids

• Natural (from poppy) or synthetic (narcotics)

• Powerful painkillers• Frequently abused• Examples: heroin, morphine, codeine,

hydrocodone (Vicodin), methadone, fentanyl, Percodan, Percocet, Demerol

Central Nervous System Stimulants

• “Uppers”: lead to increased– reflexes - pulse rate– blood pressure - respiration

• Appetite suppressant• Paranoia, heart attack• Examples: cocaine, caffeine, nicotine,

amphetamines, Ritalin, meth, diet pills

CNS Stimulants

Hallucinogens

• “Altered state” of consciousness• Delusions, dissociation, confusion• lead to increased:

– blood pressure - pulse rate

• May cause paranoia, depression• Examples: LSD, psilocybin

(‘shrooms), Ecstasy, PCP, peyote

Hallucinogens

Cannabinols

• Euphoria, slowed reaction time• Lead to increased:

– blood pressure - pulse rate - appetite

• Amotivational syndrome, • Chronic use may decrease hormone levels• Examples: marijuana (“grass”, “weed”,

“joint”, “pot”) hashish, marinol

Cannabinols

Inhalants

• Breathable poisons

• Giddiness, headache, slurred speech

• Sudden Sniffing Death

• Examples: aerosols, gasoline, glue, nitrous oxide, paint thinner, “poppers”

Anabolic Steroids

• Reduce body fat / increase muscle mass

• Improve performance in some sports

• Side effects – males• Reduced sperm production * shrinkage of testicles

• Irreversible breast enlargement * acne * baldness

• Side effects – females• Increased facial and body hair * shrinkage of breasts

• Menstrual irregularities * deeper voice

• Other side effects • “’Roid Rage” * Increased risk of heart disease

Controlled Substances Act

• Schedule I – high potential for abuse– no accepted medical use– examples: heroin, LSD, marijuana

• Schedule II– high potential for abuse– accepted medical use with severe restrictions– may lead to severe psychological or physical dependence– examples: morphine, cocaine, methadone

Controlled Substances Act

• Schedule III – lower potential for abuse than I and II– accepted medical use– may lead to moderate or low physical dependence

or high psychological dependence– examples: anabolic steroids, codeine,

hydrocodone with aspirin or Tylenol,

oxycodone w/aspirin (Percodan)

or acetaminophen (Percocet)

Controlled Substances Act

• Schedule IV– lower potential for abuse than III – accepted medical use– may lead to limited physical or psychological

dependence – examples: Darvon, Talwin, Equanil, Valium, Xanax

• Schedule V– lower potential for abuse than III – accepted medical use– may lead to limited physical or psychological

dependence– examples: cough medicine with codeine

• Drugs of first use are the most common drugs of first use among youth – tobacco and alcohol (and in some communities inhalants and marijuana)

• Effective prevention professionals need to be familiar with which substances are being abused in their communities

• Drugs of first use claim more lives than all other drugs combined

(Data source: www.monitoringthefuture.org)

Drugs of First UseDrugs of First Use

Supply Reduction

Any method used to reduce the availability of drugs

(Examples: confiscation of drug shipments, destruction of crops, criminal penalties for possession and distribution, “sting” operations)

Demand Reduction

Any method used to reduce the demand for drugs

(Examples: assessment and treatment services, prevention curricula in schools, sobriety support services)

• Why do you think some drugs are seen as more acceptable, while others are considered unacceptable in our society?

• Why do you think our efforts at prevention have not eliminated drug use by adolescents?

Discussion QuestionsDiscussion Questions

• Scientific Theory Base

• Verified Methods

• Accountability for Service Effectiveness

• Academic Coursework or Degree

• Formal Training or Internship

• Code of Ethics

• Certification or Licensure

Evolution and Training of theEvolution and Training of thePrevention DisciplinePrevention Discipline

Building Blocks for SuccessfulBuilding Blocks for SuccessfulPrevention ProgramsPrevention Programs

• The program is The program is facilitated by knowledgeable and facilitated by knowledgeable and competent staffcompetent staff

• The program is The program is based on sound theorybased on sound theory and uses practices and uses practices grounded in researchgrounded in research

• The program is The program is systematically planned and assessedsystematically planned and assessed

• The program is The program is evaluatedevaluated

Building Blocks for SuccessfulBuilding Blocks for SuccessfulPrevention ProgramsPrevention Programs

• The program is The program is sensitive to participantssensitive to participants from a variety of from a variety of backgrounds and culturesbackgrounds and cultures

• The program is The program is developmentally appropriatedevelopmentally appropriate

• The program The program incorporates the mediaincorporates the media

• The program uses aThe program uses a code of ethics code of ethics

Elements of CognitionSensory input (cortex)

Memory(hippoc.)

AutonomicsAnd endocr.(hypothal.)

Emotions (amygdala)

Saliency priorities and values(OFC)

Saliency priorities and values(OFC)

Integrationand decision- making(PFC)

Behavior suppressed and activated

Behavior suppressed and activated

QUESTIONS and DISCUSSIONQUESTIONS and DISCUSSIONQUESTIONS and DISCUSSIONQUESTIONS and DISCUSSION