substance abuse prevention across the lifespan. let’s get acquainted
TRANSCRIPT
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Substance Abuse Prevention Across the Lifespan
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Let’s Get Let’s Get AcquainteAcquainte
dd
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Prevention
What is your definition of prevention?
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PreventionThe role of prevention is to create healthy communities in which people have a quality
of life:
Healthy environments at work and in Healthy environments at work and in school school Supportive communities and Supportive communities and neighborhoods neighborhoods Connections with families and friends Connections with families and friends Drug and crime-freeDrug and crime-free Source: SAMHSA/CSAP
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Prevention Definition
Prevention is a proactive process that empowers individuals and systems to meet the challenges of life events and transitions by
creating and reinforcing conditions that promote healthy
behaviors and lifestyles
Source: SAMHSA/CSAP
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Prevention Definition (cont.)
The goal of substance abuse prevention is the fostering of a climate in which (a)
alcohol use is acceptable only for those of legal age and only when the risk of adverse consequences is minimal; (b) prescription and over-the-counter drugs are used only
for the purposes for which they were intended; (c) other abusable substances,
e.g. aerosols, are used only for their intended purposes; and (d) illegal drugs
and tobacco are not used at all
Source: SAMHSA/CSAP
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SAMHSA’s SPFSAMHSA’s SPF
Source: SAMHSA/CSAP
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The Strategic Prevention Framework (SPF) outlines a five-step planning process designed to draw resources from multiple sources to create a community-based approach to substance abuse prevention that cuts across existing programs and systems.
SAMHSA’s Strategic SAMHSA’s Strategic Prevention Framework Prevention Framework (SPF)(SPF)
Source: SAMHSA/CSAP
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AssessmentProfile population needs, resources, and readiness to address needs and gaps
EvaluationMonitor, evaluate, sustain, and improve or replace those that fail
ImplementationImplement evidence-based prevention programs and activities
PlanningDevelop a Comprehensive Strategic Plan
CapacityMobilize and/or build capacity to address needs
SAMHSA’s Strategic SAMHSA’s Strategic Prevention Framework Prevention Framework (SPF)(SPF)
Source: SAMHSA/CSAP
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Key Principles of the SPFKey Principles of the SPF
1. Adheres to a public health model 2. Utilizes data-driven decision
making3. Emphasizes outcomes-based
prevention
Source: SAMHSA/CSAP
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Public Health: Public Health: Focus for Focus for Strategic Planning in PreventionStrategic Planning in Prevention
A public health approach focuses on change for entire populations and/or communities – the goal is sustainable community level change
Population-based public health focuses efforts across the lifespan
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Why Be Concerned About Why Be Concerned About Health Across the Health Across the
Lifespan?Lifespan?
We need to understand the influence of social health determinants as predictors of population and individual health
Social determinants of health will influence health from early life
Contributed by Tania Garcia, CSAP’s Northeast CAPT March 06
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It is commonly accepted that individuals are at highest riskhighest risk for
substance use & abuse at “transition” points in their life and at “key” stages across the across the
lifespan cyclelifespan cycle
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The Lifespan CycleThe Lifespan Cycle
Early Childhood/ School Age
Prenatal
Adolescent
Young Adult
Adult
Elderly
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Brain Developmentand the
Impact of ATODon the Brain
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Olny srmat poelpe can raed this.
i cdnuolt blveiee taht I cluod aulaclty uesdnatnrd waht I was rdanieg.
The phaonmneal pweor of the hmuan mnid, aoccdrnig to a rscheearch at Cmabrigde
Uinervtisy, it dseno't mtaetr in waht oerdr the ltteres in a wrod are, the olny
iproamtnt tihng is taht the frsit and lsat ltteer be in the rghit pclae. The rset can be
a taotl mses and you can sitll raed it whotuit a pboerlm. Tihs is bcuseae the
huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe. Azanmig huh? yaeh and I awlyas tghuhot slpeling
was ipmorantt!
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CortexLimbic System
Brain Stem
The Human BrainThe Human Brain
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Introducing the Human Brain
The brain stem – controls basic functions critical to life
The limbic system – contains the brain’s reward system; in addition, it is responsible for our perception of other emotions, both positive and negative
The cerebral cortex – divided into areas that control specific functions
Source: Drugs, Brains and Behavior: The Science of Addiction, NIDA
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Construction Ahead
motivation
emotion
judgment
Pruning occurs in stages, from back of the brain to the front
physical coordination; sensory processing;
Source: National CAPT Substance Abuse Prevention Specialist Training Manual, June 2006
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Brain Development
Adolescence is a period of profound brain maturation
We thought brain development was complete by adolescence
We now know… maturation is not complete until about age 24-25!!!
Source: National CAPT Substance Abuse Prevention Specialist Training Manual, June 2006
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motivation
emotionjudgment
Age 24-25
physical coordination; sensory processing;
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Biology/GenesBiology/Genes EnvironmentEnvironment
DRUGDRUG
AddictionAddiction
Risk FactorsRisk Factors
Brain MechanismsBrain Mechanisms
•Genetics•Gender•Mental Disorders
•Chaotic home•Parent’s use & attitudes•Peer influence•Community Attitudes•Poor school achievement
•Early use•Availability•Cost•Route of administration•Effect of drug itself
Source: Drugs, Brains and Behavior: The Science of Addiction, NIDA
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Alcohol and the Adolescent Brain
Stimulates release of dopamine and interferes with body’s own release of dopamine
Adolescents are LESS sensitive to the negative effects of acute alcohol intoxication
Adolescents can drink significantly more than adults before they experience the sedative effects of alcohol.
Impairs memory and learning at lower doses than adults who consume equal amounts
Source: National CAPT Substance Abuse Prevention Specialist Training Manual, June 2006
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Tobacco and the Adolescent Brain
Nicotine increases production of dopamine, so smokers feel good
Adolescents more likely to get addicted than adults, and get addicted quicker
If someone reaches 18 without using, odds are 1 to 5 of never using
Tobacco Settlement acknowledged that companies targeted adolescents; “Hook them early or risk losing lifelong customer”
Need 3000 new smokers every day to replace the ones who die or quit
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What Are We Preventing?
UseUse
MisuseMisuse
AbuseAbuse
AddictionAddiction
Source: National CAPT Substance Abuse Prevention Specialist Training Manual, June 2006
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Institute of Medicine Institute of Medicine Continuum of CareContinuum of Care
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Prevention Classification
The Institute of Medicine (IOM-1994) classified prevention interventions into three categories:
Universal preventive interventions Selective preventive interventions Indicated prevention interventions
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Types of PreventionInterventions
Universal: Activities designed to reach the entire population, without regard to
individual risk factors and intended to reach a large
audience.
Source: National CAPT Substance Abuse Prevention Specialist Training Manual, June 2006
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Selective: Strategies designed to target
subgroups of the general population that are
determined to be at risk for substance abuse.
Types of PreventionInterventions
Source: National CAPT Substance Abuse Prevention Specialist Training Manual, June 2006
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Indicated: Designed to identify individuals who are experiencing early signs of substance abuse and other related problem behaviors and target them with special programs. The individuals have not reached the point where clinical diagnosis of substance abuse can be made.
Types of PreventionInterventions
Source: National CAPT Substance Abuse Prevention Specialist Training Manual, June 2006
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Activity:
Universal, Selective or Indicated???
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The Six CSAP Prevention Strategies
1. Information dissemination 2. Prevention education skills training3. Alternative activities4. Community-based process 5. Environmental/social policy6. Problem identification and referral
Source: National CAPT Substance Abuse Prevention Specialist Training Manual, June 2006
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Providing info about nature & extent of drug use, abuse, addiction and the effects on individuals, families & communitiesProviding info on available prevention programs & servicesCharacterized by one-way communication
Information Information DisseminationDissemination
Source: Substance Abuse Prevention: The Intersection of Science and Practice, Julie Hogan, 2003
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Involves two way communication and is based on interaction between the educator and the participantsActivities aim to affect critical life & social skills
Prevention EducationPrevention EducationSkills TrainingSkills Training
Source: Substance Abuse Prevention: The Intersection of Science and Practice, Julie Hogan, 2003
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Goal is to have target populations participate in activities that are ATOD free;Assumption is that “constructive & healthy activities offset the attraction to drugs, or otherwise meet the needs usually filled by drugs” then the target population would avoid using drugs
Alternative ActivitiesAlternative Activities
Source: Substance Abuse Prevention: The Intersection of Science and Practice, Julie Hogan, 2003
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Aims to enhance the ability of the community to provide more effective prevention through interagency collaboration, coalition building & networking
Community-Based ProcessCommunity-Based Process
Source: Substance Abuse Prevention: The Intersection of Science and Practice, Julie Hogan, 2003
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Seeks to establish or change community standards, codes, & attitudes thereby influencing the incidence and prevalence of substance abuse in the general population;
Environmental Environmental ApproachesApproaches
Source: Substance Abuse Prevention: The Intersection of Science and Practice, Julie Hogan, 2003
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Aims to identify those who have indulged in the illegal use of drugs in order to determine whether their behavior can be reversed through education or whether they need a referral for a chemical dependency assessment
Problem IdentificationProblem Identification& Referral& Referral
Source: Substance Abuse Prevention: The Intersection of Science and Practice, Julie Hogan, 2003
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The Six CSAP The Six CSAP Prevention StrategiesPrevention Strategies
Research has shown that the most effective
prevention programs present a comprehensive approach that includes all
or many of the CSAP strategies
Source: Substance Abuse Prevention: The Intersection of Science and Practice, Julie Hogan, 2003
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Prevention Across the Lifespan
Group ActivityGroup Activity1. Divide participants into four lifespan
workgroups: pre-natal, young adult, adult and elderly
2. Groups will brainstorm and record appropriate prevention strategies for their assigned age population.
3. Share with larger group.
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Prevention Across the Lifespan: Prevention Across the Lifespan: Strategies at Various Stages of LifeStrategies at Various Stages of Life
Prenatal Young Adult Adult Elderly
NOTE: Early Childhood/School Age and Adolescent are the age populations traditionally served by prevention
programs, therefore our activity will focus on the traditionally under-served populations
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Prevention Across the Lifespan
QUESTIONS
???