Pubh 3003 1st Edition Lecture 8Outline of Last Lecture I. Controlled Prescription DrugsII. Different types of abused drugs III. Cost of illegal DrugsIV. Drug Schedules V. How should we respond?VI. Drugs around the worldOutline of Current Lecture I. Developmental and Age Baseda. Preschool and Elementary Ageb. Middle and High School c. Collegei. First Year CollegeII. High risk consequences of drinking III. Women and Alcohola. Binge DrinkingIV. Middle AdulthoodV. Old Agea. Prescription Drug AbuseVI. Immigration and Refuge Current Lecture:Population- Specific StrategiesDevelopmental and Age Based - Birth to 11 years – behaviors performed to : a. obtain reward from adult (affect, attention) and b. avoid punishment from adult. Very dualistic: Right from wrong- 12 to 20 Years: Look to peers for social messages; adult figures less important. Begin todevelop greater abstract thinking skills; encourage them to carefully evaluate all sides of an issue and be able to justify conclusions- 20 to 25 years: seeking to define role in society. Focus on role modeling and lessening burden to society Preschool and Elementary ageThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.- Behaviors are “adult- oriented” - Dualistic thinking; “right” or “wrong”- Legality and morality have strong meaning - Focused on bodies (respond well in info and advice that targets their health)- Program should target improving academic and social-emotional learning to address risk factors (early aggression, academic failure, school dropout)o Self controlo Emotional awarenesso Communicationo Social problem-solvingo Academic support especially in readingMiddle and High School- Looks to peers for social skills messages; adult figures less important- Peer education and peer advocates have greater impact- Prevention should target socially undesirable or unsexy activities- Environmental strategies:o Teaching retailers about importance of not selling to minors, how to properly verify proof of ageo Increase taxes on legal substances - Prevention programs should increase academic and social competence with following skills:o Study habits and academic supporto Communicationo Peer relationshipso Self-efficiency and assertivenesso Drug resistance skillso Reinforcement of anti-drug attitudeso Strengthening personal commitments against drug useCollege - Defining role in society- see themselves as community citizens and can play a role in influencing others (positively or negatively )- Peer educators continue to be important- Equipping young adults with bystander intervention skills - Environmental strategies should be applied- Address social normso Undergrads report thinking ~95% of people between 14 and 114 have had an alcohol beverage in the last 12 monthso Reality: approx. 1/3 of the US population has been abstinent from alcohol in the past year First year College Students - Behavior interventions reduce alcohol consumption and alcohol- related problemso Personalized feedbacko Moderation strategieso Expectancy challenge o Identification of risky situationso Goal- settingA Snapshot of Annual High Risk College Drinking Consequences - Alcohol use is best predictor of teen sexual activity and risky sexual behavioro Sexual Abuse- 97,000 students between the ages of 18 ad 24 are victims of alcohol related sexual assault or date rapeo Approximately Half of sexual assault cases involved alcohol o Unsafe Sex: 400,000 students between the ages of 18 and 24 had unprotected sex and more than 100,000 students between the ages of 18and 24 report having been too intoxicated to know if they consented to having sexo Approx. 1 of 5 college students have reported abandoning safer sex practices when they are drunk (even when they do protect when they are sober)- Among young attendees at STD clinics, substance abusers report more risky sexual behavioro Patients aged 15 to 24 of a public sexually transmitted disease clinic who had a substance use disorder (SUD) were two or three times as likely as those without an SUD to report multiple sexual partners and inconsistent condom use during the past year. Overall, 43 percent of the 448 patient who participated in the Pittsburgh clinic study had an alcohol or marijuana use disorder, and these young people also were 70 percent more likely to be diagnosed with a sexually transmitted disease during their visit Women and Alcohol - Binge drinking (4 or more drinks per occasion) is common among women in US (1 in 8)- Excessive drinking for women usually begins in college as they match their behavior to men, and continues as they get older- Are you concerned about your drinking?o 1980’s 1 in 10 women said yeso 2002 1 in 5 women said yesMiddle Adulthood- Highly complex and individualized phenomenon - Rarely a captive group (except work-based prevention program)- Shift to secondary and tertiary prevention (preventing moving further down line of substance use or adding new substances)- Teaching harm reduction- Addressing stress; what is the root cause? How can stress be managed?- Self-care Old Age (Considered to be 65 and older)- Specifically prone to prescription drug abuseo Uses ¼ of all prescription drugs sold in the USo Prevalence of abuse may be as high as 11% o May be able to obtain prescription med relatively easilyo Lower tolerance (Liver has harder time metabolizing drug)o Increased likelihood of taking multiple drugs  increased chance of forgetting to take pill or taking too many  possibly dangerous drug interactions- Prevention approaches should honor life experiences, respect individual needs, empower personal autonomy- Harm reduction- Education on medication safety and importance of coordinating medical and mental health care providers to monitor for potential drug interactions- One on one sessions to identify reasons for use, identify coping skills, etc. Fears Rise of Medication Misuse by the Elderly - “Prescription drug abuse and misuse by seniors doesn’t get much attention. But with the senior population steadily growing, its getting harder to ignore. Many seniors develop addictions to prescription drugs. Others are taking medication that has little effect or unintentional effects, either because they are taking it for too long, they wereprescribed too big a dose, or its reacting badly with other medications. The misuse of medications is a rising problem in seniors