Week Six - Lecture Flashcards
Why focus on adolescents?
[] Adolescence is the most common time for onset of substance use
[] Risk taking feature during adolescence
[] Use in adolescence mediates use on adulthood
[] Adolescent Tx approaches rely on adult Tx - approaches but must take into account:
- adolescent drug misuse is different from adult drug misuse
- patterns of use
- assessment
- anticipated effects and consequences of substance use
- developmental differences and issues
- social and emotional contexts of use
- risk factors contributing to the onset
- trajectory
- level of skill, experience and realities
Young people:
Young people (between the ages of 10 and 24) face specific risks in relation to alcohol, tobacco and other drug problems. Rates of risky behaviours are generally higher among young people than the broader population. Some drug use has higher prevalence among young people and associated harm can be reduced by delaying intention.
Define Tobacco use in adolescent Australia:
Initiation 14.9 (20+ 15.9yrs)
Regular smoking begins 16 -19 yrs ~ rare 20+
Females:
More have ‘ever smoked’
Initiation at earlier age
more likely to continue smoking
Intention to smoke is a predictor of future smoking behaviour in secondary school students
Major determinants:
social factors (peer/parent smoking) and
emotional problems (anxiety, depression)
rather than an addiction to nicotine
Define alcohol use in adolescent Australia:
[] Risk of alcohol related harm increases rapidly with age
[] Lifetime use by the age of 19 is 60%
[] Trends in drinking has not changed
-Majority use alcohol infrequent; binge or risky for short term harms
-Young females drink at levels of greater risk than young males
-Males tend to drink more frequently on a weekly basis
-Most commonly drinking for social reasons
-Younger prefer spirits; Older males prefer beer (then wine); older females prefer wine
-Low awareness/understanding of the harms associated with excessive alcohol use
-Faster/heavier consumption patterns – “to get drunk”
-If experiencing harms, more likely short term harms – e.g., hangovers, amnesia
-Up to 20% report alcohol aggression or sexual risk taking
Define analgesics use in adolescent Australia
The reported use of substances such as Disprin, Panadol or Nurofen among students was extremely high - only 5% had never used these medications. Over two-thirds of all students had used analgesics in the past month
The main reason for analgesic use was to help ease the pain associated with a headache/migraine (52%). For the majority of students (90%) parents were the main source of analgesics
At all ages, females were significantly more likely to have used analgesics in their lifetime, in the past year and past month
Define Cannabis use in adolescent Australia:
- The most commonly used illicit substance, with 16% of students aged 12-17-years ever using the drug at some time in their lives.
- The proportion of use increased with age, with 4% of 12-year-olds and 31% of 17-year-olds reporting lifetime use
- There were no significant differences in the proportion of students using cannabis in the past week, past month or lifetime between 2008 and 2014. However, reported lifetime use continued to increase amongst the older age groups
- Age of initiation = 15yrs (20+ = 19 yrs)
- Heavy cannabis users - more likely to experience a range of difficulties
- Hazardous situations; Legal, social, interpersonal; LT cognitive impairment (Ashton 2002); Respiratory side effects (Hall 1998); Precipitation to psychosis (Hall and Degenhardt 2000); Depression
- Approx 10% of regular users develop dependence in early adulthood
What are risk factors that impact Seconadry (12-17 years)
Low involvement in activities with adults Perceived high level of community drug use Community disadvantage & disorganisation Availability of drugs Positive media portrayals of drug use Parental - Adolescent conflict - Favourable attitudes to drug use - Parental AOD problems - Parental rules permitting drug use Not competing school
Peers who use drugs
Delinquency Sensation seeking & adventurous personality Favourable attitude towards drug use
What are protective factors for Secondary (12-17) years
Attachment to family
Low parental conflict
Parental communication & monitoring
Religious involvement
What impacts does alcohol play on brain development:
[] Like other drugs, alcohol produces its effects by altering the actions of neurotransmitters
- modifies actions of two major neurotransmitters – GABA and glutamate
- these found throughout the brain – hence alcohol has widespread effects on behaviour – i.e., intoxication
- greater effect on developing areas of the brain, compared to those fully developed – evidence suggests that the damage could be permanent
Alcohol impacts on two areas of the brain that undergo major changes in adolescence
the hippocampus deals with memory and learning - suffers the worst damage. Those who drink more and for longer have significantly smaller hippocampi (up to 10% smaller)
the prefrontal area undergoes most change during adolescence - teen drinking could cause severe changes, affecting the formation of adult personality and behaviour
Define older people
harmful use of prescription medications, effects of illicit drug use and alcoholic increasing in older people (ages 60 or over) in Australia. Older people can be more susceptible to alcohol, tobacco and other drug problems as a result of difficulties with pain and medication management, isolation, poor health, significant life events and loss of independent living.
Define substance us relationship and the elderly:
() Drug use in early life is a strong predictor of later drug use
() Rate of drug use typically declines with age
() Morbidity and mortality associated with alcohol and tobacco use become common after age 50
() Management of substance abuse and dependence will emerge as an increasingly important public health problem in the coming decades - impact of baby boomers.
Define the prevalence of drug use with middle age and older people (40 or older):
Middle age and older people (40 or older)
<> only age group to show a statistically significant increase in illicit drug use between 2013 and 2016 (from 13.6% to 16.2%).
<> 50s generally have some of the lowest rates of illicit drugs use but this cohort has shown the largest rise in illicit use of drugs since 2001 (from 6.7% to 11.7% in 2016), although there was little change between 2013 and 2016 (11.1% to 11.7%).
<> 40s were the most likely age group to smoke daily in 2016 and their rate did not improve between 2013 and 2016 (16.2% and 16.9%)
<> consumption of 5 or more standard drinks at least once a month has been trending upwards since 2001.
<>significant increase in the proportion of 50–59 year olds consuming 11 or more standard drinks on a single occasion at least once in the past year (from 9.1% in 2013 to 11.9% in 2016).
What are the effects of ageing on substance misuse:
- Biological variables
- psychosocial variables
- psychiatric co-morbidty
- maturing out theory
Define ris factors associated with elderly (65+)
Loneliness & reduce social support
Continuation of high levels of non-problematic use
Retirement – SES, sense of role, unrealistic expectations
Negative life events
Health
