Dealing With Drug Use??
(See:
Drugs in American Society, 5th, 6th, 7th, 8th, and 9th editions, Erich Goode, McGraw-Hill, 1999/2005/2008/2012/2014. Chapter 15)

Education and Intervention

(or should that be "No thanks, I can make up my own mind?")

WWW Links:

Is this your child's future?

Prevention:

Primary

Secondary

Tertiary

Primary Prevention

Widespread today, practically universal

Early approaches: Cognitive

  1. Information on drugs and their effects
  2. Emphasized negative attitudes
  3. Scare tactics
  4. Knowledge=> Attitudes=> Behavior
  5. By early 1970's- re-evaluate. Increased knowledge==> Positive attitudes! Various programs worked fairly well at expanding knowledge of drugs and their effects, but impact on "attitudes" was problematic: Use increased.
  6. 1973: SAODAP ordered a stop to programs of the "cognitive sort. New emphasis: Decision making skills, rational choice. By 1976 use was still up, but increasing at a decreasing rate.

Late 1970's: Affective Education/Values Clarification. Focus:

  1. Emotions and attitudes
  2. "Getting in Touch" with oneself
  3. Values clarification
  4. Independence
  5. Elevating self-concept. Dealing with being included and/or excluded.
  6. Decision making skills
  7. Alternatives to drugs
  8. Basic philosophy: "If you feel good, why do drugs to feel good?"
  9. No real direct focus on drugs per se, but on moral choices/problem solving. Example at the high school level: Alien Invasion- All drugs destroyed, which should we bring back?
  10. Coping skills: explore and express feelings.
  11. Personal and social skills: increase competence; communication, success, etc. Role models and peer counseling/tutoring programs

1980's and on- Social Inoculation

  1. Focus shifts away from student and towards the "negative aspects" of the environment
  2. "Just say NO!"
  3. A 1984 review of existing programs (of various sorts) indicated that few, adequate evaluation studies existed and for the most part the indication was that there was little success
  4. Concern: Environment and Temptation. Drug use as endemic.
  5. Children must understand the pressures, learn to avoid situations, learn how to say NO, make a public commitment, and have experience/relationships with those who do not use.
  6. Zero Tolerance: 1987 William Bennett, "What Works; Schools Without Drugs"-- Ignores education, stresses: Searches, Suspension, Expulsion. By example: Official policy must indicate complete opposition, Smoking banned (Kirkwood High and video), Laws upheld, shift away from the "values stuff". Funding only for schools that demonstrate programs that teach drug use is wrong and harmful.

Types:

  1. Student assistance, group focus, peer counseling
  2. Smoking prevention: Refusal, normative education, role models, public commitment
  3. STAR, SMART, ALERT: curriculum based (7th grade)(summary from NIDA)
  4. DARE: (LA Police), First introduced in 1983. Designed for 5th-6th grade. Uniformed police, interactive- variety of components, stressing refusal and public commitment. DARE gained rapid popularity. By 1988: 500 programs, 1.5 million students. Today, practically universal. Drug Free School bill of 1991: 10% of funding to support DARE. Problems: No demonstration of effect. Recent criticism: Looks good, and sounds good, but having little impact on substance use.

DARE Focus

Good points:

Problems:

Studies

The New millennium: Harm Reduction?

 

Is Prevention Working? (SAMSHA and NIDA)

Secondary Prevention

Tertiary Prevention (Treatment)

Treatment Theories

Medical/Disease: Lost control, incapable of responsibility- medical intervention
  1. Detoxification (not a "real" treatment in and of itself).
  2. Antagonists: Alcohol (Antiabuse- Disulfiram), Narcotics: Nalorphine, Cyclazocine, Naloxone
  3. Maintenance programs and/or total abstinence.
  4. These approaches are designed to get drugs out of peoples system and, through negative reinforcement, keep them out. Seldom used individually.

Learning/Free will: Value issue, choices, decision making: Education (Cognitive-Behavioral Therapy)

Moral Model: Immoral choice- Punish. Prison.

Drug Courts

Treatment Types:

Studies on Treatment

General Considerations

Criteria for Evaluation

Methadone Maintenance

Criticism

Effectiveness

Heroin Maintenance (a re-emerging alternative)

Therapeutic Communities

Effectiveness

Out Patient Drug Free

Effectiveness

Self-Help Groups

AA Philosophy

Effectiveness

Back to Policy Issues

Overall Considerations on Treatment

YET:

Drug Testing: Jar Wars!

ACLU: Drug Policy/Drug Testing (Testing Drug Testing: A Bad Investment .pdf file 9/1/99)

Drug Testing becomes "common" in the early 1980's

The Law

URL: http://www.umsl.edu/~keelr/180/prevent.html
Owner: Robert O. Keel rok@umsl.edu
References and Credits for this Page of Notes
Last Updated: Thursday, April 26, 2018 11:56 AM