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PYB159 - Alcohol & Drugs > Week 6 - Prevention and determinants > Flashcards

Week 6 - Prevention and determinants Flashcards

1
Q

Risk Factors

A

predict initiation to drug use and risk of problems associated later in life

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2
Q

Protective Factors

A

mediate or moderate risk factors

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3
Q

Key Protective Factor

A

Resilience - Ability to be well adjusted and interpersonally effective in the face of an adverse environment

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4
Q

do risk and protective factors directly influence drug use?

A

no

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5
Q

Pharmocology

A

Pharmacokinetics and pharmacodynamics

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6
Q

Tobacco use patterns

A

never smoked - increasing
smoked previously - no change
smoke daily - decreasing

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7
Q

which drug was the leading cause of drug induced deaths in Australia?

A

pharmaceutical opiods

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8
Q

are males or females more likely to die due to drug-induced deaths?

A

males

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9
Q

Take-Home Naloxone

A
  • Opioid antagonist
  • Supplied through needle syringe programs
  • Over the counter and prescription
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10
Q

Two types of Naloxone

A

Prenoxad - intramuscular administration at 400ug doses in 0.4 ml (2mg/2ml syringe)
Nyxoid - intranasal administration at 1.8 mg in 0.1 ml

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11
Q

Determinants

A

The range of risk and protective factors that make someone more or less likely to develop a drug use disorder

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12
Q

different types of risk factors

A
  • Analogous to a snowball (earlier onset has a
    cumulative effect on subsequent, longer term risk trajectory)
  • snowstorm (multiple risks experienced concurrently that increase likelihood of harmful
    drug use)
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13
Q

Major risk & protective factors

Prior to birth

A

Risk:
- social disadvantage
- family breakdown
- genetic influences
- maternal smoking & alcohol use
Protective:
- born outside of Australia

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14
Q

Risk factors

SES

A
  • Social disadvantage / low SES
  • Highest drug use and problems exist in areas with low SES characteristic
  • economic discrepancies producing personal and interpersonal insecurities, tensions, and conflict, negatively influencing physical and mental health, well-being, coping, and competence
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15
Q

which drug is most used in low ses individuals

A

tobacco

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16
Q

Different SES and drug type

A

More advantaged: cocaine (6.1x), hallucinogens (3.9x), inhalents (2.8x) and pharmaceutical stimulants (2.7x)
less advantaged: pain-relievers and opiods (1.6x)

x = times more likely

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17
Q

14-17 year olds and 18-24 year olds

A
  • decline in the proportion of people aged 14–17 who consumed alcohol at risky levels, from 9.5% to just 5.5% in 2022–2023.
  • Illicit use of drugs higher among young females than young males for the first time
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18
Q

Risk factors

Trauma

A
  • Children affected by abuse or neglect have a
    higher risk of problems later in life
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19
Q

Risk factors

Genetics

A
  • Variations in the metabolism of substances
    ◦ Temperament
    ◦ Behavioural problems
    ◦ Personality factors
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20
Q

Protective factors

Ethnicity

A
  • family cohesion, rules and cultural norms, and parental supervision
  • Also can be a risk factor: Low SES communities, family trauma, social isolation.
  • Indigenous risk factors: Related to poverty, disadvantage, cultural dispossession & exclusion, & some other cultural factors (sharing culture, no traditional rules for alc)
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21
Q

Aboriginal people and harmful levels of drinking

A

generally drink less than non-indigenous but those that do are more likely to drink at harmful levels

22
Q

Major risk & protective factors

Infancy/Preschool

A

Risk:
- Parental neglect & abuse
Protective:
- Easy temperament

23
Q

Major risk & protective factors

Primary school (5-11yrs)

A

Risk:
- Early school failure
- Conduct disorder
- Aggression
Protective:
- Social & emotional competence
- Shy & cautious temperament

24
Q

Risk factors

family factors

A
  • Parent and family drug use: parental role modelling risks (Modelling less influential than quality of relationships & parental family management techniques)
25
Q

Risk factors

Education

A

Academic failure / Learning or behavioural difficulties at school
◦ May be both a contributor to and a result of drug use
◦ Can result in detachment from school community
◦ Impact on self-perception
Timing important
◦ Year 1 academic failure does not predict later delinquency
◦ Year 5 academic failure does predict later delinquency
Ongoing implications
◦ Poor academic performance can lead to a lack of training or employment opportunities

26
Q

Protective Factors

Education

A
  • Pro-social contact
  • Minimises boredom
  • Enhances intelligence
  • Development and identification of talents
  • Explore future aspirations
  • Environment supporting positive health behaviours
27
Q

Risk Factors

Secondary school (12-17yrs)

A
  • Low involvement in activities with adults
  • Perceived high level of community drug use
  • Community disadvantage and disorganisation
  • Availability of drugs
  • Positive media portrayal of drug use
  • Parent-adolescent conflict
  • Favourable parental attitudes to drug use
  • Parental AOD problems
  • Parental rules permitting drug use
  • Not completing secondary school
  • Peers who use drugs
  • Delinquency
  • Sensation seeking & adventurous personality
  • Favourable attitude toward drug use
28
Q

Protective Factors

secondary school (12-17yrs)

A
  • Attachment to family
  • Low parental conflict
  • Parental communication and monitoring
  • Religious involvement
29
Q

Risk Factors

Personality

A
  • Rebelliousness, non-conformity, low sense of
    responsibility, resistance to authority
    ◦ Sensation-seeking traits / adventurous personality
30
Q

Risk Factors

age of initiation

A
  • Earlier initiation increases risk of later abuse
  • Reasons for earlier onset:
    1. Peer associations
    2. Familial and societal norms
    3. Trauma/mental health issues
31
Q

Risk Factors

Peer factors

A
  • Strong predictor of later drug abuse
  • Peers have a strong immediate influence on choices
  • Peer modelling (social learning theory)
  • Shared sense of: Alienation/Rebelliousness/Sensation seeking
32
Q

Risk and protective factors

Adulthood (18-64yrs)

A

Risk:
* Frequent drug use in late adolescence
* Unemployment in early adulthood
* Mental health problems
Protective:
* Well-managed environment for alcohol use
* Marriage in early adulthood

33
Q

Risk and protective factors

retirement/old age (65+ yrs)

A

Risk:
* Losing a spouse
* Retirement
* Loneliness & reduced social support
* Poor health
Protective:
* Good health
* Social support

33
Q

General protective factors

A
  • Positive family relationships - clear, consistent boundaries
  • Healthy attachments / social bonding - stability and connectedness
  • Proactive problem solving - resilience
  • Development of a special talent - can lead to pro-drug using peer groups though
  • Personality and temperament
  • Career goals / aspirations
  • Above average intelligence
34
Q

Protective factors

Rat Park

A

When rats were given environments that were stimulating and gave them connection to other rats they preferred plain water. If they did imbibe from the drug-filled bottle, they did so intermittently, not obsessively, and never overdosed

35
Q

Prevention

A

measures that prevent or delay the onset of drug use as well as measures that protect against risk and reduce harm associated with drug supply and use

36
Q

What are we trying to prevent?

A

Drug use - delay initiation
Harm associated with drug use
◦ Route of administration risks
◦ Overdose/excessive use risks
◦ Avoidance of help seeking – e.g. due to legal concerns
◦ Risks of associated problems – e.g. accidents
◦ Harm to others – e.g. Laws prohibiting smoking in public
places
Rather than preventing something:
◦ Increasing resilience/other protective factors

37
Q

Primary prevention levels

A

Preventing uptake
- Preventing non-users starting or delaying first use
E.g. Supply reduction methods, education on harms to developing body, school-based and parent education programs

38
Q

Secondary prevention

A

Preventing harm
- Reducing risks to experimental/social users & avoiding transition to more regular use or possible harms
E.g. education on risks of addiction, advice on route of administration options

39
Q

Tertiary prevention

A

Reducing harm
- Reducing use or potential harms among regular users
E.g. NSPs, controlled drinking, drink driving campaigns

40
Q

Targets of prevention

universal

A

targeting whole population
e.g. national campaigns, advertising programs

41
Q

targets of prevention

selective

A

subgroups with above-average risk
e.g. School-based programs, Alcohol free communities

42
Q

targets of prevention

indicated

A

individuals with detectable symptoms
e.g. Counselling, advice lines, educational pamphlets

43
Q

When to target

A

early intervention - as early as possible in developmental pathway

44
Q

What goals or purposes?

A

◦ Attitudes
◦ Knowledge
◦ Expectancies
◦ Behaviour associated with drug use (risks)

45
Q

targeting specific risk factors

A
  • Peer factors, educational involvement etc…
  • Best approach is a combination of factors
46
Q

Adolescent interventions

A
  • Support for classroom based education programs - more effective if interactive, time-intensive and led by students
  • Life skills training programs and family based interventions
  • Support for regulation of price and availability of tobacco to young people
  • Lack of support for effectiveness of alcopop price increases
47
Q

Universal interventions for illicit drug use

A
  • Diversion programs
  • Prohibition:
    • May reduce drug use among non-users (Primary)
    • Not much evidence it affects current users
    • International changes to Cannabis laws have not been associated with significant increase in use
48
Q

Other universal interventions

A

◦ Good support for effectiveness of drink driving laws in Australia
◦ Support for public education campaigns Reductions in cigarette smoking and risky drinking
◦ Multi-faceted campaigns are the most effective (advertising, laws, taxes, etc…)

49
Q

where we need to do more

A
  • Binge drinking
  • Smoking/Vaping
  • Methamphetamine
  • Emerging Psychoactive Substances
  • Evaluation of prevention strategies
  • Community prevention/parenting/family support

PYB159 - Alcohol & Drugs (6 decks)

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