20: Prevention & Treatment Flashcards
What are the three old approaches to prevention?
Primary prevention programs: target young, drug-naïve people.
Secondary prevention programs: target those who have tried the drug. Goal is to prevent using of other, more dangerous substances or switching into more harmful methods of drug abuse.
Tertiary prevention: relapse prevention, or follow-up programs.
What are the three current approaches to prevention?
Universal prevention programs: involve often all schoolchildren.
Selective prevention strategies: designed for those who are at high risk.
Indicated prevention strategies: targeted at individuals who show signs of developing problem.
What is the most effective approach for prevention?
Multidisciplinary approach, which involves family, school and community.
What are two methods for treating addiction?
Abstinence: “zero tolerance.” Endorsed by AA.
Harm reduction: reduce negative consequences of substance use. Goal is not abstinence, often reduces consumption.
What are three models of addiction?
Disease model: addiction = abnormal. Pioneered by AA.
Dependence model: opium, alcohol addiction (autotoxin). Substance abuse to combat withdrawal.
Positive reinforcement model: Stimulus presence increases behaviour. Explains “normal” drug use.
List three harms to the individual with regards to drug use.
Addiction: can cause other problems.
Health: overdose, communicable diseases, long term health problems.
Social: relationships, employment.
List three harms to family with regards to drug use.
Family functioning: relationship conflict, violence, financial issues.
Employment: job loss, unemployment.
Parenting: parental neglect, prenatal drug exposure.
List three harms to society with regards to drug use.
Crime: associated with addiction, illegal drug use, costs $$$.
Health care: to deal with individual/family, very expensive.
Productivity: economic issues.
Of the problems listed, what percentage are alcohol-related?
- On-the-job accidents
- Drowning
- Murders
- Suicide
- Highway fatalities
- Rape
- Child abuse
- Pedestrian fatalities
On-the-job accidents: 75% Drowning: 70% Murders: 60% Suicide: 55% Highway fatalities: 50% Rape: 50% Child abuse: 49% Pedestrian fatalities: 40%
When was Alcoholics Anonymous (AA) formed and what is its goal? How many members? Any similarly-structured programs?
Formed in 1935, goal is total abstinence.
2017 - over 2 million members in U.S.
Similarly-structured: Narcotics Anonymous.
List three methods of harm reduction to individuals.
Moderation counseling/therapy (EtOH).
Self-help groups: moderation management, guidelines for moderation, self-monitoring, info.
Cognitive-Behavioural Therapies: Behavioural Self-Control Training (BSCT), Moderation-Oriented Cue Exposure (MOCE).
Which is better: BSCT or MOCE? What did an 8-month follow up show?
Both methods produce similar results.
Follow up: 58% participants reported improvement in a low-alcohol dependence group, 35% in high-alcohol dependence group.
List four drugs used for pharmacotherapy and what substance is targeted. Also list whether they are used for abstinence or moderation.
Disulfiram (EtOH) - abstinence.
Naltrexone (EtOH, opiates, cocaine) - abstinence or moderation.
Acamprosate (EtOH) - abstinence or moderation.
Methadone/Buprenorphine (opiates) - abstinence or moderation.
Describe preventative healthcare measures for intravenous drug use and for smoking crack.
Intravenous drug use: needle exchange, safe injection sites, on-site detox services.
Smoking crack: associated with hep-C and HIV infections. Provide safe smoking kits.
Compare past statistics for InSite in Vancouver versus more recent statistics.
Increase in the number of individuals registered and number of daily average visits, decrease in heroin injections, increase in cocaine usage, less number of overdoses, greater number of referrals.
