Health dimensions

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Health dimensions

  1. 1. Health Dimensions & Implications of Substance Abuse Maria Lourdes D. Hembra, MD, MMIP Center for Health Development Region VI Mandurriao, Iloilo City
  2. 2. Approximate Costs of Substance Abuse in the U.S.
  3. 3. Substance Abuse & Public Health <ul><li>Cancer </li></ul><ul><li>HIV/AIDS </li></ul><ul><li>Heart Disease </li></ul>
  4. 4. Social Problems Related to Substance Abuse <ul><li>Drugged driving </li></ul><ul><li>Stress </li></ul><ul><li>Violence </li></ul><ul><li>Child abuse </li></ul>
  5. 6. Why are Adolescents prone to Substance Use ? <ul><li>Greater motivational drives for novel experiences (experimentation) </li></ul><ul><li>Immature inhibitory control system (self-regulation) </li></ul>Chambers and Potenza, 2003
  6. 7. Impact of Substance Abuse <ul><li>Individual </li></ul><ul><ul><li>Adolescence </li></ul></ul><ul><ul><li>Mental illness </li></ul></ul><ul><ul><li>Consequences of substance use </li></ul></ul><ul><ul><li>Deaths </li></ul></ul><ul><li>Family </li></ul><ul><ul><li>Prenatal – smoking, cocaine </li></ul></ul><ul><ul><li>Child abuse </li></ul></ul>
  7. 8. Impact of Substance Abuse <ul><li>Community </li></ul><ul><ul><li>Homelessness </li></ul></ul><ul><ul><li>Crime </li></ul></ul><ul><ul><li>Education </li></ul></ul><ul><ul><li>Workplace </li></ul></ul>
  8. 9. Comparing Costs of Chronic Illness (US) <ul><li>Diabetes costs to society = $ 131.7 B annually </li></ul><ul><li>Cancer costs to society = $ 171.6 B annually </li></ul><ul><li>Substance abuse costs to society = $ 484 B annually </li></ul>
  9. 10. Contributors to the Economic Costs of Substance Abuse and Addiction <ul><li>Health care expenditures </li></ul><ul><ul><li>Alcohol and drug abuse services </li></ul></ul><ul><ul><li>Medical consequences </li></ul></ul><ul><li>Productivity (lost earnings) </li></ul><ul><ul><li>Premature death </li></ul></ul><ul><ul><li>Impaired job performance </li></ul></ul><ul><ul><li>Institutionalized population </li></ul></ul><ul><ul><li>Incarceration </li></ul></ul><ul><ul><li>Criminal victimization </li></ul></ul><ul><li>Other impacts on society </li></ul><ul><ul><li>Crime </li></ul></ul><ul><ul><li>Social welfare administration </li></ul></ul><ul><ul><li>Vehicular accidents </li></ul></ul>Adapted from Harwood et al., Addiction, 1999.
  10. 11. Why do people take Drugs <ul><li>To feel good </li></ul><ul><li>To feel better </li></ul><ul><li>To do better </li></ul><ul><li>Curiosity and “because others are doing it” </li></ul>
  11. 12. Conceptual Framework for Prevention <ul><li>Risk factors </li></ul><ul><ul><li>Biological </li></ul></ul><ul><ul><li>Psychological/behavioral </li></ul></ul><ul><ul><li>Societal/environmental </li></ul></ul><ul><li>“ More means more likely” </li></ul><ul><li>Reduction of risks leads to less vulnerability </li></ul>
  12. 13. Conceptual Framework for Prevention <ul><li>Protective factors </li></ul><ul><ul><li>Reduces likelihood that a substance abuse disorder will develop </li></ul></ul><ul><li>Positive characteristics and circumstances </li></ul><ul><li>Balance/buffer risk factors </li></ul>
  13. 14. Risk Factors <ul><li>ineffective parenting </li></ul><ul><li>chaotic home environment </li></ul><ul><li>lack of mutual attachments/nurturing </li></ul><ul><li>inappropriate behavior in the classroom </li></ul><ul><li>failure in school performance </li></ul><ul><li>poor social coping skills </li></ul><ul><li>affiliations with deviant peers </li></ul><ul><li>perceptions of approval of drug-using behaviors in the school, peer, and community environments </li></ul>
  14. 15. Protective Factors <ul><li>strong family bonds </li></ul><ul><li>parental monitoring </li></ul><ul><li>parental involvement </li></ul><ul><li>success in school performance </li></ul><ul><li>prosocial institutions (e.g. such as family, school, and religious organizations) </li></ul><ul><li>conventional norms about drug use </li></ul>
  15. 16. Profile of Filipino Drug Abusers <ul><li>Mean age 28 </li></ul><ul><li>11:1 male/female ratio </li></ul><ul><li>Single -51.65%, married – 34.44% </li></ul><ul><li>Occupation </li></ul><ul><ul><li>Unemployed 38.87% </li></ul></ul><ul><ul><li>Workers/employees 30.94% </li></ul></ul><ul><ul><li>Self-employed 12.47% </li></ul></ul><ul><ul><li>Students 5% </li></ul></ul><ul><ul><li>Out of school youth .90% </li></ul></ul><ul><li>Educational attainment </li></ul><ul><ul><li>High school level 29.41% </li></ul></ul><ul><ul><li>College level 28.23% </li></ul></ul><ul><ul><li>High school graduate 16.74% </li></ul></ul>Dangerous Drugs Board, 2003 (center based)
  16. 17. National Institute of Drug Abuse (NIDA)
  17. 18. HEALTH & SOCIAL CONSEQUENCES OF SUBSTANCE USE
  18. 19. Health Consequences of Substance Use <ul><li>HIV, Hepatitis and other infectious diseases </li></ul><ul><ul><li>Needle sharing </li></ul></ul><ul><ul><li>Risky sexual behavior </li></ul></ul><ul><li>Cardiovascular effects </li></ul><ul><ul><li>Increased heart rate (tachycardia) </li></ul></ul><ul><ul><li>Increased blood pressure (hypertension) </li></ul></ul><ul><ul><li>Irregular heartbeat (arrhythmias) </li></ul></ul><ul><ul><li>Cardiac enlargement (Cardiomegaly /cardiomyopathy) </li></ul></ul>
  19. 20. Health Consequences of Substance Use <ul><li>Respiratory effects </li></ul><ul><ul><li>Bronchitis </li></ul></ul><ul><ul><li>Emphysema </li></ul></ul><ul><ul><li>Lung cancer </li></ul></ul><ul><li>Gastrointestinal effects </li></ul><ul><ul><li>Heartburn </li></ul></ul><ul><ul><li>Ulcers </li></ul></ul><ul><ul><li>Bleeding </li></ul></ul><ul><ul><li>Pancreatitis </li></ul></ul><ul><ul><li>Hypoglycemia </li></ul></ul>
  20. 21. Health Consequences of Substance Use <ul><li>Musculoskeletal effects </li></ul><ul><ul><li>Cramps </li></ul></ul><ul><ul><li>Muscle weakness </li></ul></ul><ul><ul><li>Atrophy (malnutrition) </li></ul></ul><ul><li>Kidney damage </li></ul><ul><ul><li>Kidney failure </li></ul></ul><ul><li>Liver damage </li></ul><ul><ul><li>Hepatitis </li></ul></ul><ul><ul><li>Cirrhosis </li></ul></ul>
  21. 22. Health Consequences of Substance Use <ul><li>Neurological effects </li></ul><ul><ul><li>Seizures, stroke </li></ul></ul><ul><ul><li>Problems with memory, attention, decision making </li></ul></ul><ul><li>Mental health effects </li></ul><ul><ul><li>Paranoia, depression, hallucinations, aggression </li></ul></ul><ul><li>Hormonal effects </li></ul><ul><ul><li>Infertility, decreased libido, masculinization in women </li></ul></ul>
  22. 23. Health Consequences of Substance Use <ul><li>Cancer </li></ul><ul><ul><li>Lungs, neck, stomach, mouth </li></ul></ul><ul><ul><li>Throat, voice box, breast </li></ul></ul><ul><li>Prenatal effects </li></ul><ul><ul><li>Prematurity, miscarriage, low birth weight </li></ul></ul><ul><li>Mortality </li></ul><ul><ul><li>One in four deaths is attributable to alcohol, tobacco and other drugs </li></ul></ul>
  23. 24. Health Consequences of Substance Use <ul><li>Other health effects </li></ul><ul><ul><li>Appetite changes </li></ul></ul><ul><ul><li>Hyperthermia </li></ul></ul><ul><ul><li>Mood swings </li></ul></ul><ul><ul><li>Fatigue </li></ul></ul><ul><ul><li>Insomnia </li></ul></ul><ul><ul><li>Restlessness </li></ul></ul>
  24. 25. RANDOM DRUG TESTING ACTIVITIES Dangerous Drug Abuse Prevention and Treatment Program Department of Health
  25. 26. 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.
  26. 27. Who are required to undergo RANDOM drug testing? <ul><li>Students of Secondary and Tertiary schools </li></ul><ul><ul><li>Department of Education Order Number 63 series of 2003 “ General Guidelines on Random Drug Testing of High School Students ” </li></ul></ul><ul><ul><li>Requisites: </li></ul></ul><ul><ul><ul><ul><li>Pursuant to rules and regulations as contained in the schools student handbook </li></ul></ul></ul></ul><ul><ul><ul><ul><li>With notice to parents </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Government shall bear the cost of drug testing (private or public schools) </li></ul></ul></ul></ul>
  27. 28. <ul><li>Objectives </li></ul><ul><ul><li>Pursuant to Board Regulation No 6, 2003 </li></ul></ul><ul><ul><ul><li>To determine prevalence of drug users among students </li></ul></ul></ul><ul><ul><ul><li>To assess the effectivity of school-based and community-based prevention programs </li></ul></ul></ul><ul><ul><ul><li>To deter the use of illegal drugs </li></ul></ul></ul><ul><ul><ul><li>To facilitate rehabilitation of drug users and dependents </li></ul></ul></ul><ul><ul><ul><li>To strengthen collaboration efforts of identified agencies against the use of illegal drugs </li></ul></ul></ul>
  28. 29. And IF FOUND POSITIVE… <ul><ul><ul><li>Board Regulation No 6, 2003 </li></ul></ul></ul><ul><ul><ul><ul><li>Shall NOT be ground for expulsion or any criminal or disciplinary action </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Drug Testing is treated as a “Health” issue and not as a law enforcement issue </li></ul></ul></ul></ul>
  29. 30. <ul><li>8670 students tested, 287 schools selected at random nationwide </li></ul><ul><li>Nationwide Prevalence – 67 students out of 8,670 students is 0.8% </li></ul>
  30. 31. Student Random Drug Testing Confirmed 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
  31. 32. *2005 Random Drug testing of 8670 High School Students –yielded a 0.8% nationwide prevalence *2007 Random Drug testing of 7,499 College Students –yielded. 0.5% nationwide prevalence 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
  32. 33. The End !

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