Drug abuse is becoming a growing social and a public health problem. There are many substances blamed to be of use and abuse. Substances are either licit or lawful (bought legally as tobacco and alcohol) and illicit or illegal as heroin, cocaine, amphetamines, or cannabis. This has influenced public and individual view to the whole problem. Public view on a drug being a licit one, there is no enough cause to face its consumption. Second, being licit, it is available for everyone’s’ wide use; yet, the harm is still cropping up (Fagg, pp.1-15). This essay aims to discuss briefly prevention of substance abuse.
On reviewing the literature, substance use, abuse, and dependence are used interchangeably (Fagg, pp. 1-15). Based on the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR (2002), both substance abuse and dependence are maladaptive patterns of substance use. The difference is mainly in the decisive factors needed to consider a case an abuse or dependence. Drug abuse is an individual showing one or more of the following signs within 12 months of drug use. Repeated drug use results in failure to fulfill a principal commitment (work, school, social, or family). The individual does not avoid using the drug in possibly risky circumstances as driving or working on a machine. Other signs include repeated use of the drug despite exposure to legal problems, social or family problems caused by, or aggravated by using the drug. In drug dependence, the individual fulfills at least three (or more) of the following signs on condition, signs take place within 12 months of drug intake. First is tolerance, it takes one of two forms , either there is a need to take increasing doses to get the wanted effect or continued intake of the same dose results in reduced effect. Second, drug withdrawal results in symptoms relieved by drug intake. Third, is despite continuous urge to stop the drugs but repeated trials persistently failed. Fourth, longtime, persistent, repeated, and failing efforts spent trying to control the drug intake are signs of drug dependence. Other signs are declining significant commitments whether social, work-related, or leisure-related because the individual keeps on taking the drug (DSM-IV, pp.185-198).
A successful substance abuse prevention program should fulfill the following stipulations (National Institute on Drug Abuse, pp. 2-25).
- About risk and protective factors: a prevention program should focus on strengthening protective factors, and minimizing risk factors. It should also address all possibilities of substance abuse (single or in combinations) and should be planned for the targeted community.
- Prevention programs usually give better results if combined (school and family targeted), and delivered at times of transition (as the transition from middle school to high school)
- It should be research-based in structure, content, and delivery.
- It should be long-term with interventions or booster sessions, and delivered in multiple settings (school, clubs, family, or religious organizations)
- Several Meta-analysis studies confirmed that interactive approaches produce better results than non-interactive ones.
- A successful prevention program should include training of the executive personnel.
Based on data from the Institute of Medicine (IOM), there are three different approaches to choose the one most suitable to the target group. The universal approach, the selective approach, targets a subgroup considered at high risk. Third, is the indicated approach that aims at the subgroup showing early signs of substance dependence (Nebraska Behavioral Heath Program, pp.9-10).
Prevention of substance abuse needs inclusive and intricate approaches that interconnect school, family, and community. Whatever the approach is, it has to rely on an understanding of the psychological, social, and cultural factors behind the problem (Center for Mental Health in Schools at UCLA, p. 85). Psychological comorbidity is common with substance abuse, Rosack (p.32) stated that smoking in the targetUS population is nearly 23%, in schizophrenia and mood disorders patients tobacco abuse rises nearly to 90%. A figure that points to how important prevention-associated, intervention programs are.
Works Cited
- American Psychiatric Association (2002). Diagnostic and Statistical Manual of Mental
- Disorders DSM IV-TR (4th ed). Washington, D.C.: American Psychiatric Press.
- Center for Mental Health in Schools at UCLA. UCLA Dept. of Psychology. A resource aid packet on Substance Abuse. 2003.
- Fagg, D. “Adolescent Drug Use.” Revolve vol 13 2006. p. 1-15.
- Nebraska Health and Human Service System. Office of Mental Health, Substance Abuse and Addiction Services. SICA Guidance Document For Selecting Science-Based and Promising Substance Abuse Prevention Strategies. By Nebraska Behavioral Health Prevention Program. 2004.
- Rosack, J. “NIDA, APA Collaborate On Substance Abuse Series.” Psychiatric News vol 39 (4) 2004. p. 32.