Substance Abuse: Prevention and Treatment

1. Education:Outcome measure is how much a person knows about the drug
2. Prevention of Use: Outcome measure is how many people experimented with the drugs

Public Health Model
-Primary: Aimed at young people who have not yet tried the substances in question
-goal is to try to keep people from trying drugs
-Secondary: Aimed at people who have tried the drug in question
-Goal is to try and keep them from using more dangerous substances and more dangerous forms of use
- Tertiary: Aimed at addicts
-Goal is relapse prevention

Medical Model
-Universal: designed for delivery to entire population
-Selective: designed for groups within the population who might be considered high risk
- Indicated: designed for individuals who show signs of developing problems

-The knowledge-attitudes-behavior model
- Affective education
- Social Influence model
- Dare
-Project ALERT/Life skills training program

-Providing information would increase knowledge of drugs and their effects
-Increased knowledge would lead to changes in attitudes about drug use
-Changed attitudes would be reflected in decreased drug using behavior

1971 study
-Students who had more knowledge about drugs tended to have a more positive attitude toward drug use

1973 report
-They are effective in producing increased knowledge about drugs
- They are ineffective in altering attitudes or behavior

Depends on what the goals were
-If it was for students to never experiment with drugs, then no
-If it was for student to be prepared to make rational decisions about drug use, then yes

Focus on the emotions and attitudes of students in addition to cognitive functions
-Components/Aspects
1.Values Clarification: Analyze and clarify their own values in life and make appropriate moral and ethical decisions.
2. Alternatives to drugs: Relaxation exercises, meditation, vigorous exercise, or exciting sports can help obtain a "natural high"
3. Personal and Social skills: Teach communication skills and enhance self concept through group activities, group meetings, and peer tutoring

1. Values Clarification
-Indirect anti-drug approach
-"Value Free"
- Children may learn values that are contrary to those of their parents

2.Alternatives to drugs
-Not always sensitive to the audience

1. Most substance abuse prevention programs have not contained adequate evaluation components
2. Increased knowledge has no impact on substance abuse or on intentions to smoke, drink, or use drugs
3. Affective education approaches appears to be experiential in their orientation and to place too little emphasis on the acquisition of skills necessary to increase personal use and social competence.
4.Few studies have demonstrated any degree of success in terms of actual substance abuse prevention

Refusal skills/pressure resistance
-Teach students to recognize peer pressure to use drugs and on teaching specific ways to respond without using drugs
-Termed psychological inoculation
Drug Free Schools (1986)
- Teach about drugs
- Teach about school policy

Components
- Training refusal skills--> 8 ways to say no
- Public Commitment--> Sign the pledge/promise not to do it
- Countering advertising--> Discuss hidden message in advertising and discuss the actual effects
- Normative education--> Present actual drug use statistics with the goal of changing the "everyone else is doing it" theory
- Use of teen leaders

Maybe all students don't need to be taught social skills or refusal skills.
-Cognitive Development Approach
- Individuals should make active, conscious decisions about trying drugs and then becoming occasional or regular users
- The prevention strategy maybe be different at each "stage of cognitive development"

17 week program delivered by police officers in 5th or 6h grade classrooms

Uses components of the Social Influence Model and the affective education programs
-SI model=refusal skills, teen leaders, and a public commitment
-AE program=self esteem building, alternatives to drug use, and decision making

Highly endorsed by everyone despite not being evaluated until over 10 years later
- 2 large scale studies
-Program had effects on self-esteem but no evidence for long term reductions in self reported drug use
- Program did increase drug and social skills knowledge but the effects on drug use was minimal

- A more recent review continues to support previous conclusions about the ineffectiveness of DARE