substance abuse prevention across the lifespan

Substance Abuse Prevention Across the Lifespan

Let’s Get Let’s Get AcquainteAcquainte

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Prevention

What is your definition of prevention?

PreventionThe role of prevention is to create healthy communities in which people have a quality

of life:

Healthy environments at work and in Healthy environments at work and in school school Supportive communities and Supportive communities and neighborhoods neighborhoods Connections with families and friends Connections with families and friends Drug and crime-freeDrug and crime-free Source: SAMHSA/CSAP

Prevention Definition

Prevention is a proactive process that empowers individuals and systems to meet the challenges of life events and transitions by

creating and reinforcing conditions that promote healthy

behaviors and lifestyles

Source: SAMHSA/CSAP

Prevention Definition (cont.)

The goal of substance abuse prevention is the fostering of a climate in which (a)

alcohol use is acceptable only for those of legal age and only when the risk of adverse consequences is minimal; (b) prescription and over-the-counter drugs are used only

for the purposes for which they were intended; (c) other abusable substances,

e.g. aerosols, are used only for their intended purposes; and (d) illegal drugs

and tobacco are not used at all

Source: SAMHSA/CSAP

SAMHSA’s SPFSAMHSA’s SPF

Source: SAMHSA/CSAP

The Strategic Prevention Framework (SPF) outlines a five-step planning process designed to draw resources from multiple sources to create a community-based approach to substance abuse prevention that cuts across existing programs and systems.

SAMHSA’s Strategic SAMHSA’s Strategic Prevention Framework Prevention Framework (SPF)(SPF)

Source: SAMHSA/CSAP

AssessmentProfile population needs, resources, and readiness to address needs and gaps

EvaluationMonitor, evaluate, sustain, and improve or replace those that fail

ImplementationImplement evidence-based prevention programs and activities

PlanningDevelop a Comprehensive Strategic Plan

CapacityMobilize and/or build capacity to address needs

SAMHSA’s Strategic SAMHSA’s Strategic Prevention Framework Prevention Framework (SPF)(SPF)

Source: SAMHSA/CSAP

Key Principles of the SPFKey Principles of the SPF

1. Adheres to a public health model 2. Utilizes data-driven decision

making3. Emphasizes outcomes-based

prevention

Source: SAMHSA/CSAP

Public Health: Public Health: Focus for Focus for Strategic Planning in PreventionStrategic Planning in Prevention

A public health approach focuses on change for entire populations and/or communities – the goal is sustainable community level change

Population-based public health focuses efforts across the lifespan

Why Be Concerned About Why Be Concerned About Health Across the Health Across the

Lifespan?Lifespan?

We need to understand the influence of social health determinants as predictors of population and individual health

Social determinants of health will influence health from early life

Contributed by Tania Garcia, CSAP’s Northeast CAPT March 06

It is commonly accepted that individuals are at highest riskhighest risk for

substance use & abuse at “transition” points in their life and at “key” stages across the across the

lifespan cyclelifespan cycle

The Lifespan CycleThe Lifespan Cycle

Early Childhood/ School Age

Prenatal

Adolescent

Young Adult

Adult

Elderly

Brain Developmentand the

Impact of ATODon the Brain

Olny srmat poelpe can raed this.

i cdnuolt blveiee taht I cluod aulaclty uesdnatnrd waht I was rdanieg.

The phaonmneal pweor of the hmuan mnid, aoccdrnig to a rscheearch at Cmabrigde

Uinervtisy, it dseno't mtaetr in waht oerdr the ltteres in a wrod are, the olny

iproamtnt tihng is taht the frsit and lsat ltteer be in the rghit pclae. The rset can be

a taotl mses and you can sitll raed it whotuit a pboerlm. Tihs is bcuseae the

huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe. Azanmig huh? yaeh and I awlyas tghuhot slpeling

was ipmorantt!

CortexLimbic System

Brain Stem

The Human BrainThe Human Brain

Introducing the Human Brain

The brain stem – controls basic functions critical to life

The limbic system – contains the brain’s reward system; in addition, it is responsible for our perception of other emotions, both positive and negative

The cerebral cortex – divided into areas that control specific functions

Source: Drugs, Brains and Behavior: The Science of Addiction, NIDA

Construction Ahead

motivation

emotion

judgment

Pruning occurs in stages, from back of the brain to the front

physical coordination; sensory processing;

Source: National CAPT Substance Abuse Prevention Specialist Training Manual, June 2006

Brain Development

Adolescence is a period of profound brain maturation

We thought brain development was complete by adolescence

We now know… maturation is not complete until about age 24-25!!!


motivation

emotionjudgment

Age 24-25

physical coordination; sensory processing;

Biology/GenesBiology/Genes EnvironmentEnvironment

DRUGDRUG

AddictionAddiction

Risk FactorsRisk Factors

Brain MechanismsBrain Mechanisms

•Genetics•Gender•Mental Disorders

•Chaotic home•Parent’s use & attitudes•Peer influence•Community Attitudes•Poor school achievement

•Early use•Availability•Cost•Route of administration•Effect of drug itself

Source: Drugs, Brains and Behavior: The Science of Addiction, NIDA

Alcohol and the Adolescent Brain

Stimulates release of dopamine and interferes with body’s own release of dopamine

Adolescents are LESS sensitive to the negative effects of acute alcohol intoxication

Adolescents can drink significantly more than adults before they experience the sedative effects of alcohol.

Impairs memory and learning at lower doses than adults who consume equal amounts


Tobacco and the Adolescent Brain

Nicotine increases production of dopamine, so smokers feel good

Adolescents more likely to get addicted than adults, and get addicted quicker

If someone reaches 18 without using, odds are 1 to 5 of never using

Tobacco Settlement acknowledged that companies targeted adolescents; “Hook them early or risk losing lifelong customer”

Need 3000 new smokers every day to replace the ones who die or quit

What Are We Preventing?

UseUse

MisuseMisuse

AbuseAbuse

AddictionAddiction


Institute of Medicine Institute of Medicine Continuum of CareContinuum of Care

Prevention Classification

The Institute of Medicine (IOM-1994) classified prevention interventions into three categories:

Universal preventive interventions Selective preventive interventions Indicated prevention interventions

Types of PreventionInterventions

Universal: Activities designed to reach the entire population, without regard to

individual risk factors and intended to reach a large

audience.


Selective: Strategies designed to target

subgroups of the general population that are

determined to be at risk for substance abuse.



Indicated: Designed to identify individuals who are experiencing early signs of substance abuse and other related problem behaviors and target them with special programs. The individuals have not reached the point where clinical diagnosis of substance abuse can be made.



Activity:

Universal, Selective or Indicated???

The Six CSAP Prevention Strategies

1. Information dissemination 2. Prevention education skills training3. Alternative activities4. Community-based process 5. Environmental/social policy6. Problem identification and referral


Providing info about nature & extent of drug use, abuse, addiction and the effects on individuals, families & communitiesProviding info on available prevention programs & servicesCharacterized by one-way communication

Information Information DisseminationDissemination

Source: Substance Abuse Prevention: The Intersection of Science and Practice, Julie Hogan, 2003

Involves two way communication and is based on interaction between the educator and the participantsActivities aim to affect critical life & social skills

Prevention EducationPrevention EducationSkills TrainingSkills Training


Goal is to have target populations participate in activities that are ATOD free;Assumption is that “constructive & healthy activities offset the attraction to drugs, or otherwise meet the needs usually filled by drugs” then the target population would avoid using drugs

Alternative ActivitiesAlternative Activities


Aims to enhance the ability of the community to provide more effective prevention through interagency collaboration, coalition building & networking

Community-Based ProcessCommunity-Based Process


Seeks to establish or change community standards, codes, & attitudes thereby influencing the incidence and prevalence of substance abuse in the general population;

Environmental Environmental ApproachesApproaches


Aims to identify those who have indulged in the illegal use of drugs in order to determine whether their behavior can be reversed through education or whether they need a referral for a chemical dependency assessment

Problem IdentificationProblem Identification& Referral& Referral


The Six CSAP The Six CSAP Prevention StrategiesPrevention Strategies

Research has shown that the most effective

prevention programs present a comprehensive approach that includes all

or many of the CSAP strategies


Prevention Across the Lifespan

Group ActivityGroup Activity1. Divide participants into four lifespan

workgroups: pre-natal, young adult, adult and elderly

2. Groups will brainstorm and record appropriate prevention strategies for their assigned age population.

3. Share with larger group.

Prevention Across the Lifespan: Prevention Across the Lifespan: Strategies at Various Stages of LifeStrategies at Various Stages of Life

Prenatal Young Adult Adult Elderly

NOTE: Early Childhood/School Age and Adolescent are the age populations traditionally served by prevention

programs, therefore our activity will focus on the traditionally under-served populations

Prevention Across the Lifespan

QUESTIONS

???

Rainbow Days, Inc.Training Services

www.rdikids.org1.214.887.0726

Janet Mitchell

[email protected]

substance abuse prevention across the lifespan

Documents

definition of prevention

samhsacsappublic health

public health model

strategic planning

public health focuses

substance use abuse

healthy communities

communitybased approach