AOD and Specific Populations Flashcards
What is the age range of the definition of young people?
- 15–24 years (such as the Australian Burden of Disease data)
- 12–17 years (such as the Australian Secondary Students’ Alcohol and Drug survey),
- 10–29 years (such as the Alcohol and Other Drug Treatment Services National Minimum Data Set).
What is the most common time for the onset of substance use?
Adolescence
Describe the trend of inhalants for young people
- higher at a younger age and use decreases as age increases
- this is an unusual trend that we don’t tend to see with other drugs
- higher among females whereas other drugs are higher among males
Describe the trend of illicit drug use among young people
- 14-17: decreasing
- 18-24: increasing
- 14+ = increasing
At what year does the drinking pattern/status begin to change?
- In Year 10, risky drinkers sees a massive increase and shift
- risky drinking becomes the most prominent drinking status in Year 10
- continues to increase through the years
For alcohol, what group is far more likely to experience a complete absence of memory with no possibility of retrieval?
Young people
What is the difference between the drinking ability of young people and adults?
- Young people can drink for longer than adults as they are less susceptible to the sedation effect
- Final levels of GABA receptors are not reached until early adulthood -> adolescents have less GABA receptors on which alcohol can act
What are some treatment strategies for young people?
- engagement and development of therapeutic relationships
- protective factors, - risk factors
- education
- involving family and significant others
- strengthening relationship with at least one positive adult
- ensuring safety
What is the leading risk factor for older people (females: 65-84, males: 45-64)?
Tobacco
Describe the daily smoking trends in older people
- people in 60s who smoke daily are not decreasing at the same rate of younger people
- people in 50s who smoke daily has slightly increased
- people in their 50s were the most likely age cohort to smoke daily
- daily smoking among those aged 70 and over is lower than for people in their 50s and 60s, and this is decreasing
Describe the daily drinking trends in older people
- overall decline in population who drink daily
- people 70+ are the most likely to drink daily, followed by people in 60s and then 50s
- higher proportion of males than females were daily drinkers
Describe the illicit drug use trends in older people
- a greater amount of older people reported illicit drug use than in previous years
- Significant increase in 60+ who have used illicit drug in their lifetime
- recent use has nearly doubled among 50s
- most commonly used is cannabis and pharmaceutical drugs for non-medical purposes
- less likely to use cannabis compared to general population
- increase in cannabis use
Describe the pharmaceutical drug trends in older people
- increasing
non-medical use is lower for older people than the general population 14 and over - slight decrease in 50s
In what group is the rate of drug-induced deaths now much higher?
older people (45-64)
What are the best practice approaches to address the needs of older people?
- Early identification of issues in primary care settings
- Maintenance of social connections
- Promotion of community inclusion, positive environments and full and active lives
- Age-appropriate treatment components
- Longer treatments
- Physically accessible services (handrails, appropriate seating, transport etc)
- Outreach and home visits
- Workforce development to enable care for more complex co-morbidities.
What group is the most marginalised and disadvantaged drug users?
People who inject drugs
What are some negative health consequences of people who inject drugs?
- higher risk of fatal drug overdoses
- are disproportionately affected by blood-borne infectious diseases e.g. HIV
What are the most commonly injected drugs?
Heroin and methamphetamine
Most people who inject drugs had used what drug in the last 6 months?
- Cannabis
- also consume pharmaceutical drugs at higher rates e.g. morphine, oxycodone
What are some Injection-related health problems?
- experienced a dirty hit
- nerve damage
- artery injection
- risk of transmitting blood-borne viruses
What is the trend of HIV?
- low and stable nationally
Who is at a greater risk of HIV?
- males
- gay males
- those who have recently injected meth
- 45+ age
Who is at a greater risk of hepatitis C?
- those with longer injection histories.
- respondents reporting heroin or other opioids as the last drug injected
- respondents who reported imprisonment in the year
- among respondents who reported receptive syringe sharing in the last month
What is Injecting drug use behaviour strongly associated with?
○ Imprisonment ○ blood borne virus infections ○ homelessness ○ mental illness ○ depression ○ suicide attempts ○ non-consensual sex ○ unstable housing ○ low education
What are interventions for people who inject drugs?
- Engagement
- Psychoeducation
- Access to NSP
- Brief interventions
- Replacement programs
- Regular testing – prevention and early treatment
- General health / well being
- Peer interventions
What are patterns of drug use by women?
○ Higher rates of prescription medication use
○ Develop problematic use more quickly
○ More use of prescription medications
○ More “private” use/misuse
Describe the pattern of smoking by women
- long term downward trend
- peaking at middle age and then decreasing with age
- outer regional areas are more likely to smoke than women in major cities
- women in low socioeconomic areas are more likely to smoke
- aboriginal women more likely to smoke daily
Describe the pattern of alcohol use by women
- Long term downward trend in alcohol consumption at risky levels among Australian females.
- The proportion of females drinking alcohol daily has also decreased
Describe the pattern of illicit drug use by women
- increase in cannabis use among women in their 30s
- increase in cocaine use among women in their 20s
- increase in use of ecstasy among women in their 30s
- significant increase in recent meth/amphetamine use among women in their 40s
Describe some gender, biological and social differences of women
- Intoxication occurs with less alcohol intake
- Metabolize alcohol differently
- Develop cirrhosis of the liver more rapidly
- Increased stigma associated with use/misuse
- More often caring for children
- Cultural differences regarding status in society
- women more likely to self-medicate with AOD
- greater vulnerability to relapse than men
Describe the pattern of alcohol use by pregnant women
A declining rate of pregnant women consuming alcohol before they know they are pregnant
Describe the pattern of smoking by pregnant women
Proportion of women who smoked tobacco halved once they found out they were pregnant
Describe the pattern of illicit drug use by pregnant women
Few used cannabis and other illicit drugs before they knew they were pregnant.
What are treatment barriers for women seeking AOD treatment?
- Lack of awareness of the range of treatment options
- Stigma
- Childcare
- Perceived economic and time costs of residential treatment, including costs of family disruption
- Interpersonal issues / Lack of support
- Concerns about the type of treatment, especially confrontational approaches
- Hx of trauma
- Male orientated Tx
What are the patterns of AOD use among Culturally and Linguistically diverse people?
- less likely to consume AOD compared with people who primarily speak English
What are some higher risks of Culturally and Linguistically diverse
- Migrants moving from a culture of no alcohol use to a culture of high alcohol use
- Cultural specific substances brought to Australian context
- Stressors: PTSD/Trauma, family stressors, unemployment, language barriers and a lack of understanding of available services
What are the best practice approaches to addressing the needs of CALD communities?
- Using trained interpreters
- Displaying signage and images that reflect culturally diverse clients
- Resources and service information in major community languages or in formats that are easier for CALD clients to understand
- Providing care that is trauma-informed and client-centred: making efforts to understand each client’s cultural background, family, migration and settlement experiences
- Providing education and resources at CALD festivals/events
- Addressing social determinants such as a lack of connectedness to their community and strained family relationships
- Providing a culturally sensitive service that is familiar with the different needs, norms and experiences of different CALD groups
- Ensuring appropriate training for frontline staff; a diverse workforce
Describe the pattern of smoking by Indigenous
- smoking is decreasing
- higher rates of smoking than non-indigenous
Describe the pattern of alcohol use by Indigenous
- Indigenous people are more likely to abstain from drinking compared to non-indigenous.
- If/when they do drink they tend to drink at riskier levels compared to non-indigenous
- abstinence has increased
- increase in single occasion risk drinking
Describe the pattern of drinking 11 or more alcohol drinks at least once a month by Indigenous
Declining
Describe the pattern of illicit drug use by Indigenous
- a higher proportion of Indigenous Australians recently used illicit drugs, compared with non-Indigenous Australians
- no significant change in illicit drug use
Describe the pattern of drug-related deaths of Indigenous
- 3x higher than non-indigenous
- rate of unintentional drug-induced deaths among Indigenous Australians has increased
What are the best practice approaches to addressing the needs of Aboriginal and Torres Strait Islander people?
- Culturally responsive and appropriate mainstream programs
- Aboriginal and Torres Strait Islander community-controlled services leading the planning, implementation and delivery of programs
- Services delivered by specialist Aboriginal and Torres Strait Islander drug and alcohol services with an understanding of their physical, spiritual, cultural, emotional and social needs
- Screening and brief intervention in primary care, Aboriginal Medical Services and other relevant health services
- Services delivered in urban, regional and remote locations and in settings such as prisons, hospitals and mental health facilities
- Involvement of families and communities where appropriate
- Addressing the social determinants of alcohol, tobacco and other drugs use, including homelessness, education, unemployment, grief/loss/trauma and violence
- Interagency collaboration and data sharing.
Compared to heterosexual people, LGBTQ+ people were:
- 9 x likely to use inhalants
- 3.9 x likely to use methamphetamines
- 3.5 x likely to use hallucinogens
- 2.6 x likely to use ecstasy
Describe patterns of alcohol use by LGBTQ+ people
Heavy episodic drinking is higher than non-transgender people
Describe patterns of chemsex use by LGBTQ+ people
Higher rates of sexualised drug use
What is the connection between AOD and LGBTQ+ people?
- ‘Coming out’ increases the likelihood of prejudicial treatment
- Stigma LGBT identity
- Homophobia (internalised and externalised)
- Using to cope with negative feelings
- Loss of support systems
- Peer modelling of AOD
- Sexualised drug use and to build connections
- Many LGBTI people avoid mainstream services due to concerns about discrimination
What are the best practice approaches to addressing the needs of LGBTQ+ people?
- Not well defined
- Involve LGBTI community/ local LGBTI-friendly health clinics in health education and prevention programs
- Addressing minority stress, coming out and experiences of discrimination within Tx.
- Address homophobia and bullying in school education as well as provide comprehensive education around sexuality
- The importance of creating opportunities for supporting disclosure & improving inclusive practices.
- Decrease the ‘invisibility’ of LGBT clients accessing health services & provide a space that is safe & responsive.
- Workforce development and training about LGBTI people
- Provide support groups specifically for LGBTI people
- Provide relevant educational materials at LGBTI social
