EXAM 2- Alcohol and Drug Abuse

What is an Individual Domain?

interventions that directly engage the child, such as teaching the child how to deal with anger effectively.

What is a family domain?

interventions work with parents and teach them how to provide better supervision and communication techniques with their child. The child is still the focus of this intervention program but aren’t directly involved with the structural changes of this domain.

What is a peer domain? 

works from the perspective of a peer (EX: teaching children how to be a good friend and set a good example). 

What is a school domain? 

about school level structural changes such as the implementation of policy (EX: high schools and colleges moving towards a smoke-free campus). 

What is a community domain? 

an intervention aimed at a group. (EX: community organizing efforts and policies that increase police patrols of drinking in the parks). 

Prevention Programs should ________ enhance protective factors and __________ or ________ risk factors. 

enhance ; reverse/reduce 

The risk of misusing drugs involves the ___________ among the number and type of risk factors (ex: deviant attitudes and behaviors) and protective factors (ex: parental support) 

relationship

the potential impact of specific risk and protective factors _____________. EX: risk factors within the family have greater impact on a younger child, while association with drug abusing peers may be a more significant risk factor for an adult. 

changes with age 

________ with risk factors (ex: aggressive behavior and poor self-control) often has a greater impact than later intervention by changing a child’s life path away from problems and toward positive behaviors. 

early intervention 

while risk and protective factors can affect people of all groups, these factors can have a _________ effect depending on a person’s age, gender, ethnicity, culture, and environment

different

What is an example of a risk and protective factor for the individual domain?

early aggressive behavior ; self-control

what is an example of a risk and protective factor for the family domain?

lack of parental supervision ; parental monitoring

what is an example of a risk and protective factor for the peer domain? 

substance abuse ; academic competence

what is an example of a risk and protective factor for the school domain? 

drug availability ; anti-drug use policies

what is an example of a risk and protective factor for the community domain? 

poverty ; strong neighborhood attachment 

What are some infancy and early childhood risk-factors?

• Difficult temperment 

• Insecure attachment

• Sexual abuse

• Early aggressive behavior

• Parental drug use

• Parental loss

• Traumatic experiences (various)

what are some infancy and early childhood protective factors?

• Self-regulation (ability to understand/manage your behavior and reactions 

• Secure attachment

• Mastery of communication and language skills

• Protection from harm and fear

• Support for early learning 

• Ability to make friends and get along with others

what are some adolescent risk factors?

• Peer norms in favor of drug use 

• Parental depression

• Family dysfunction

• Substance-using peers

• Early-onset depression and anxiety 

what are some adolescent protective factors?

• Mastery of academic skills 

• High-self esteem

• Emotional self-regulation

• Good coping skills and problem-solving skills

• Healthy peer groups 

what are some adulthood risk factors?

• Disappointment when life’s expectations are not met or realization of unattainable goals 

• Boredom with daily routines 

• Loss, grief, or isolation; loss of parents, divorce, death of a spouse or departure of children 

• retirement ; loss of meaningful role or occupational identity 

• Poor physical health 

what are some adulthood protective factors?

• Identity exploration in love, work, and world view 

• Future orientation

• Behavioral and emotional autonomy 

• Connectedness to adults outside of family 

• Subjective sense of self-sufficiency, making independent decisions, becoming financially independent 

what are some opioids?

• opium

• heroin

• morphine

• codeine 

• hydromorphine

• oxycodone (OxyContin)

• hydrocodone (Vicodin)

• fentanyl

• buprenorphine (Suboxone)

what do opioids do? 

cause:

• a dreamy, euphoric state

• lessened sensation of pain

• slowed breathing

• constipation

• pinpoint pupils

Opiate

drug that comes from the opium poppy (ex: opium, morphine, codeine, and heroin)

Opioid

more generic term that includes opiates and synthetic drugs that resemble opiates (fentanyl, oxycodone) 

for opioids → list the fastest to the slowest route of administration of a drug to get to the brain

• injecting into the bloodstream

• smoke the drug

• snorting/snuffing

• pill

fentanyl and getting into the body

achieves maximum brain concentration in seconds 

heroin and getting into the body

achieves maximum brain concentration in minutes 

• snorting causes slower absorption because the drug must travel through the mucous membranes of the nose then into the blood vessels beneath 

morphine and getting into the body

achieves maximum brain concentration in five minutes

List adverse birth outcomes associated with opioid use during pregnancy.

• poor fetal growth

• preterm birth (before 37 weeks)

• still birth

• birth defects 

• longer hospital stays after birth

• neonatal abstinence syndrome 

MN’s disparities in overdose mortality

• American Indians are 10x as likely to die from a drug overdose than white Minnesotans 

• Black people were more than 4x as likely to die from drug overdose than white Minnesotans 

what are the five less effective strategies for preventing drug use and abuse?

• scare approach

• pharmacology approach

• (oversimplified) decision making approach

• one time event approach

• personal testimony approach

What is the scare approach? 

emphasizing the worst dangers of drug use in order to create fear and anxiety, in hopes that the fear alone will prevent or stop risky behaviors. 

• graphic warnings/images

• scary stories told by someone in recovery 

• tragic consequences told by families or others impacted by someone else’s use 

• mock DUI crashes 

why is the scare approach ineffective? 

• people believed that these ads did not reflect their personal experiences 

• thought the ads represented dysfunctional users and not themselves 

what is the pharmacology approach?

provide immense levels of scientific knowledge about drugs → people will be less likely to use drugs

why is the pharmacology approach ineffective?

• providing too much information too early can negatively influence their healthy decisions and behavior

• this approach can lead users feeling they can safely handle the drugs because of their increased knowledge of how they work

what is the (oversimplified) decision making approach?

A method that simplifies the complexities of decision-making regarding drug use, often reducing the process to basic pros and cons without considering broader social and environmental factors.

why is the oversimplified decision making approach ineffective?

decision making models do not take the complexity of decision making into account 

why is the one time event approach ineffective? 

• may create temporary emotional arousal but do not impact behavior or intentions to use alcohol and other drugs 

• many students either don’t find the information relevant or forget the messages quickly after the assembly 

• fails to provide students with a clear message that is reinforce multiple times in their education 

why is the personal testimony approach ineffective?

• just because a person once used drugs, does not make them a good drug educator

Why is the personal testimony approach an ineffective primary prevention strategy but an effective tertiary prevention strategy?

• they can serve as role models and mentors for people who are going through treatment 

• they can both sympathize and emphasize with people who are in treatment, and those going through treatment feel less judgement and stigma by others who understand their experiences 

what are some examples of primary prevention strategies? 

• access policies 

• environmental controls and social determinants 

• price policies, taxes 

what are some examples of secondary prevention strategies? 

• substance use screening and treatment

• decreasing stigma associated with substance misuse/seeking help

• understanding addiction as a chronic brain condition 

what are some examples of tertiary prevention strategies? 

harm reduction

• naloxone access/training

• syringe/needle exchange program

what are some stimulants?

• cocaine

• caffeine

• amphetamine (Adderall)

• methamphetamine 

• cathinone (bath salts) 

what do stimulants do?

• cause a sense of energy, alertness, talkativeness, euphoria, and well-being 

• stimulate the sympathetic nervous system 

• increase movement 

• stimulate purposeful movement 

caffeine health effects 

• low to moderate dose → people reported increased alertness and ability to concentrate 

• higher doses → can lead to nervousness and agitation 

• increases excretion of calcium → lowering calcium levels in body 

• treatment for headache / migraine d/t constriction of blood vessels 

• causes dehydration 

caffeine protective health factors 

mild use (< 2-3 cups daily ~18 oz) may be protective for the following:

• type 2 diabetes

• parkinson’s disease 

• alzheimer’s 

• dementia 

• liver disease 

• certain cancers 

• coronary heart disease 

what are bath salts? 

synthetic stimulants; from synthetic cathinone class of drugs

effects of bath salts

• CNS stimulant

• euphoria and alertness

• confusion

• acute psychosis

• agitation

• combativeness

• aggressive

• violent

• self-destructive behavior

branding and direct to consumer marketing

• strategies used for pharmaceutical drug ads to create brand identities for the drugs. trying to create an emotional bond between a consumer and a product.

disease mongering

normalizing even the most obscure health conditions to expand the market for drugs and treatments. It involves promoting the belief that more people suffer from a condition than actually do, often leading to overdiagnosis and overtreatment.

• medicalizing something that is really just a part of everyday life

evergreening

when a company obtains new patents for incremental changes to an existing drug. typically you are not looking at any significant therapeutic advantage, you are looking at a company’s economic advantage. 

me-too drugs 

pharmacy drugs that are supposedly a new formula of an existing drug, but they are just old chemical compounds repackaged or modified to appear innovative. These drugs often offer little to no improvement in effectiveness or safety over their predecessors.

what are hallucinogens? 

drugs that change a persons thought processes, mood and perceptions 

• altered sense of reality 

what are some examples of hallucinogens?

• LSD 

• Mescaline/Peyote

• MDMA

• PCP

• Ketamine 

what are flashbacks?

the reemergence of some aspect of the hallucinogenic experience in the absence of the drug 

what are the 4 sensory and psychological effects of hallucinogens?

1. altered senses, including time 

2. loss of control

3. self-reflection

4. loss of identity and cosmic merging

what hallucinogens are the most physically dangerous?

• PCP

• ketamine

which hallucinogens tend to be associated with more psychological issues?

• LSD

• psilocybin (mushrooms)

• mescaline

• DMT

Effects of MDMA (ecstasy or Molly)

• causes feelings of empathy, openness, and caring 

• causes enhanced perception of sensory stimuli and distorted time perception 

• increases dopamine, norepinephrine, and serotonin levels 

what is universal prevention?

• strategies delivered to broad populations without consideration of individual differences in risk and for substance misuse

• Example populations: all HS students, everyone who lives in MN 

• strategies: community media campaigns, a range of policy and environmental strategies 

Selective/Selected Prevention 

• programs and practices delivered to a sub-group of individuals identified on basis of membership in a group that has elevated risk for developing substance misuse 

• example populations: homeless youth, foster youth, 11th grade students 

Indicated Prevention 

• further focuses on the ability to design interventions to address specific risk conditions 

• indicated populations are identified on the basis of individual risk factors or initiation behaviors that put them at high risk

• ex: students who have indicated binge drinking behavior or other types of substance use