Health Dimensions &Implications of Substance Abuse

Maria Lourdes D. Hembra, MD, MMIPCenter for Health Development Region VI

Mandurriao, Iloilo City

Approximate Costs of Substance Abuse inthe U.S.

Substance Abuse & Public Health

• Cancer

• HIV/AIDS

• Heart Disease

Social Problems Related to Substance Abuse

• Drugged driving

• Stress

• Violence

• Child abuse

Why are Adolescents prone to Substance Use ?

• Greater motivational drives for novel experiences (experimentation)

• Immature inhibitory control system (self-regulation)

Chambers and Potenza, 2003

Impact of Substance Abuse

• Individual– Adolescence– Mental illness– Consequences of substance use– Deaths

• Family– Prenatal – smoking, cocaine– Child abuse

Impact of Substance Abuse

• Community– Homelessness– Crime – Education – Workplace

Comparing Costs of Chronic Illness (US)

• Diabetes costs to society = $ 131.7 B annually

• Cancer costs to society = $ 171.6 B annually

• Substance abuse costs to society = $ 484 B annually

Contributors to the Economic Costs of Substance Abuse and Addiction

► Health care expenditures– Alcohol and drug abuse services– Medical consequences

► Productivity (lost earnings)– Premature death– Impaired job performance– Institutionalized population– Incarceration– Criminal victimization

► Other impacts on society– Crime– Social welfare administration– Vehicular accidents

Adapted from Harwood et al., Addiction, 1999.

Why do people take Drugs• To feel good• To feel better• To do better• Curiosity and “because

others are doing it”

Conceptual Framework for Prevention

• Risk factors– Biological– Psychological/behavioral– Societal/environmental

• “More means more likely”• Reduction of risks leads to less vulnerability

Conceptual Framework for Prevention

• Protective factors– Reduces likelihood that a substance abuse

disorder will develop

• Positive characteristics and circumstances• Balance/buffer risk factors

Risk Factors

• ineffective parenting• chaotic home environment• lack of mutual attachments/nurturing• inappropriate behavior in the classroom• failure in school performance• poor social coping skills• affiliations with deviant peers• perceptions of approval of drug-using

behaviors in the school, peer, and community environments

Protective Factors

strong family bondsparental monitoringparental involvementsuccess in school performanceprosocial institutions (e.g. such as

family, school, and religious organizations)

conventional norms about drug use

Profile of Filipino Drug Abusers• Mean age 28 • 11:1 male/female ratio• Single -51.65%, married – 34.44%• Occupation

– Unemployed 38.87%– Workers/employees 30.94%– Self-employed 12.47%– Students 5%– Out of school youth .90%

• Educational attainment– High school level 29.41%– College level 28.23%– High school graduate 16.74%

Dangerous Drugs Board, 2003 (center based)

National Institute of Drug Abuse (NIDA)

HEALTH & SOCIAL CONSEQUENCESOF SUBSTANCE USE

Health Consequences of Substance Use

• HIV, Hepatitis and other infectious diseases – Needle sharing– Risky sexual behavior

• Cardiovascular effects– Increased heart rate (tachycardia)– Increased blood pressure (hypertension)– Irregular heartbeat (arrhythmias)– Cardiac enlargement (Cardiomegaly

/cardiomyopathy)

Health Consequences of Substance Use

• Respiratory effects– Bronchitis– Emphysema – Lung cancer

• Gastrointestinal effects– Heartburn– Ulcers– Bleeding – Pancreatitis– Hypoglycemia

Health Consequences of Substance Use

• Musculoskeletal effects– Cramps– Muscle weakness– Atrophy (malnutrition)

• Kidney damage– Kidney failure

• Liver damage– Hepatitis– Cirrhosis

Health Consequences of Substance Use

• Neurological effects– Seizures, stroke– Problems with memory, attention, decision

making• Mental health effects

– Paranoia, depression, hallucinations, aggression• Hormonal effects

– Infertility, decreased libido, masculinization in women

Health Consequences of Substance Use

• Cancer– Lungs, neck, stomach, mouth– Throat, voice box, breast

• Prenatal effects– Prematurity, miscarriage, low birth weight

• Mortality – One in four deaths is attributable to alcohol,

tobacco and other drugs

Health Consequences of Substance Use

• Other health effects– Appetite changes– Hyperthermia– Mood swings– Fatigue– Insomnia – Restlessness

RANDOM DRUG TESTING ACTIVITIES

Dangerous Drug Abuse Prevention and Treatment Program

Department of Health

Random Drug Testing

is to subject students/employees for drug testing as selected following no specific pattern

and without prior notice and having an equal chance of being selected.

Who are required to undergo RANDOM drug testing?

• Students of Secondary and Tertiary schools– Department of Education Order Number 63

series of 2003 “General Guidelines on Random Drug Testing of High School Students”

– Requisites:– Pursuant to rules and regulations as contained in the

schools student handbook– With notice to parents– Government shall bear the cost of drug testing (private

or public schools)

• Objectives

– Pursuant to Board Regulation No 6, 2003

• To determine prevalence of drug users among students

• To assess the effectivity of school-based and community-based prevention programs

• To deter the use of illegal drugs• To facilitate rehabilitation of drug users and

dependents• To strengthen collaboration efforts of identified

agencies against the use of illegal drugs

• 8670 students tested, 287 schools selected at random nationwide

• Nationwide Prevalence – 67 students out of 8,670 students is 0.8%

Student Random Drug TestingConfirmed Positive Per Region

Region Positive Cases per Type

Total Number of Students Tested

Positive

Percentage

THC Met Both

1 0 0 0 0 0.0

2 0 0 0 0 0.0

3 1 1 0 2 3.0

4-A 4 2 0 6 9.0

5 1 0 0 1 1.5

6 2 0 0 2 3.0

7 3 3 4 10 14.9

8 2 0 0 2 3.0

9 1 0 0 1 1.5

10 13 0 0 13 19.4

11 10 0 0 10 14.9

12 7 0 0 7 10.4

CARAGA 9 0 0 9 13.4

ARMM 0 1 0 1 1.5

4-B 0 0 0 0 0.0

CAR 1 0 0 1 1.5

NCR 0 2 0 2 3.0

TOTAL 54 9 4 67 100.0

Region Total Number of Students Tested Positive

Total Number of Students Tested Positive

Dep Ed Ched

1 0 2

2 0 4

3 2 4

4-A 6 0

5 1 0

6 2 4

7 10 3

8 2 0

9 1 1

10 13 7

11 10 1

12 7 1

CARAGA 9 6

ARMM 1 4

4-B 0 0

CAR 1 0

NCR 2 2

TOTAL 67 39

*2005 Random Drug testing of 8670 High School Students –yielded a 0.8% nationwide prevalence

*2007 Random Drug testing of 7,499College Students –yielded. 0.5% nationwide prevalence

The End !