Discuss Faith-based Initiatives

Discuss Faith-based Initiatives

Discussion: Faith-based Initiatives

Conceptualizations of Substance Abuse

Conceptualizations have changed over the years, often for political and social reasons rather than for scientific reasons.

“Dependence” or “abuse”

What substances can be abused?

APA focuses on alcohol, amphetamines, caffeine, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, and hypnotics or anxiolytics

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

21Defining Substance Abuse
Substance abuse: a maladaptive pattern of substance use that is manifested by recurrent and significant adverse consequences related to repeated use of a substance.

Failure to fulfill major role obligations

Repeated use in physically hazardous situations

Multiple legal problems

Recurrent social and interpersonal problems

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

22Defining Substance Abuse (Cont.)
Dependence: a cluster of cognitive, behavioral, and physiological symptoms that indicate continued use of the substance despite significant substance-related problems

Pattern of repeated, self-administered use

Tolerance, withdrawal, and compulsive drug-taking behaviors

A craving or strong desire for the substance

Preoccupation with supply, money to purchase, and getting through time between periods of use

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

23Sociocultural and Political Aspects of Substance Abuse
Determined largely by economic, cultural, and political conditions of potential users

Cultural conditions create ambiguity in clearly determining when a problem exists.

Competing value systems lead to cultural disintegration and a sense of powerlessness and hopelessness.

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

24Course of Substance-Related Problems

Path from initiation to dependency is multidimensional.

Person + substance + context/environment

Progression varies—from initiation to continuation, transition to abuse, and finally, addiction and dependency

Critical point is transition from use to abuse

Addiction/dependency marked by changes in both behavior and cognition

Once addiction is established, withdrawal symptoms are strong motivators to continue use

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

25Legal and Ethical Concerns
U.S. policy based on prohibition and criminal sanctions against use and sale of illicit drugs

Criminal activities (violence and drug trafficking)

Drinking and driving, working while intoxicated

Impact on fetus (FAS)

Modes of intervention

Limit access

Media campaigns

Educational programs

National organizations that promote community education, research, and support

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

26Prevention Strategies

Primary prevention

Needs assessment to identify high-risk situations and potential problems

Decriminalization and legalization of drugs(?)

Community-based programs

Training of health professionals

Faith-based initiatives

Volunteer consumer groups

Organized sports programs

Employer programs

Often overshadowed by “War on Drugs”

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

27Prevention Strategies (Cont.)

Secondary prevention

Screening and finding resources

CAGE: an alcoholism screening test

Clinical Institute Withdrawal Assessment (CIWA)

Use evidence-based programs

Efforts should be specific to aggregates, rather than directed at the “general public”

Incorporate culturally sensitive and appropriate interventions and strategies

Work toward improving individuals’ general competencies, communication skills, and self-esteem

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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